Wednesday, 12 June 2013

What are the Lumbar Multifidi and Transversus Abdominus?

Hello everyone..welcome to our simple blog..have you read the previous entry on Low Back Pain and Lumbar Stabilization Exercises?, i introduce you to the smallest yet most powerful muscle that gives support to the spine..The lumbar multifidi are the deepest layer ofmuscles of the back. They attach from the vertebral arches to the spinous process. Each multifidi connects 1 -3 vertebrae, (the vertebrae are the bones of the spine) controlling movement between the vertebrae.

Now, let's move to the Transversus Abdominus. The Transversus Abdominus is the deepest of the abdominal muscles and is also a stabilizer of the spine. Support by this muscle is considered to be the most important of the abdominal muscle and has also been found to be in a weakened state in those who have chronic back pain or problem.It's normal action along with the action of the lumbar multifidus muscles function together to form a deep internal corset that acts to stabilize the spine during movement. This pattern of protection is disrupted in patients with low back pain. It is uncertain why these muscles become dysfunctional after a low back injury, but specific exercises focusing on the contraction of these two muscle together will improve the protective stabilizing ability of the spinal muscles, reduce pain intensity, and improve activities of daily living as well as body awareness and long of to how about your back?do you have a good back or bad back?..don't forget to contact us for consultation and treatment if your back give you a problem..Have a good day everyone..

 Transversus Abdominus From the front

Transversus Abdominus from the side

Low Back Pain and Lumbar Stabilization Exercises

It has been estimated that approximately 80% of people in Western countries have experienced low back pain (LBP) at some point in their lives. Most cases resolve within 2-4 weeks without any medical intervention. However, within 1 year following the first episode of LBP, 60 -80% of patient will have recurring pain. Current research has reported that in most cases of LBP, certain muscles of the back that stabilize the spine are reflexively inhibited (shutdown) after injury. These muscles do not spontaneously recover even if patients are pain free with a return to normal activity levels. These specific muscles work together to support and stabilized the spine to help prevent LBP. These muscles include the lumbar multifidi and the transversus abdominus. We will talk and discuss more on these muscle on the next entry. Take care of your back everyone :) Have a good day!

source: Low Back Care Protocol Supplement

Tuesday, 14 May 2013

Back Rehabilitation

Approximately 8 out of 10 people will experience the symptoms of back pain at least one time in their life. Bed rest used to be recommended immediately after a back injury, however this is no longer recommended. Now it is suggested that you resume your daily activities as soon as possible after an injury. A few weeks later, gentle stretching and strengthening of the back muscles is recommended.
A comprehensive back rehabilitation program should consist of both stretching as well as strengthening. The abdominal muscles should also be included as they play an important role in back rehabilitation by assisting in stabilization of the spine. The following exercises should be included to comprise a well rounded back rehabilitation program.

Back Extension:
1) Lie on your stomach
2) Prop yourself up on your elbows extending your back
3) Start straightening your elbows, further extending your back
4) Continue straightening your elbows until a gentle stretch is felt
5) Hold for 15 seconds
6) Return to the starting position
7) Repeat 10 more times
Cat Stretch:
1) Get down on the floor on your hands and knees
2) Push your back up towards the ceiling (like a cat arching it's back)
3) Continue arching until you feel a gentle stretch in your back
4) Hold for 15 seconds
5) Return to the starting position
6) Repeat 10 more times
Hip Rolls:
1) Lie on your back with your knees bent and feet flat on the floor
2) Turn your head to the left as you relax and let your knees fall down to the floor on the right side by rotating your trunk
3) Hold for a count of five
4) Return to starting position
5) Turn your head to the right as you relax and let your knees fall down to the floor on the left side by rotating your trunk
6) Hold for a count of five
7) Repeat 10 more times
Core Exercise:
1)Position yourself on all fours, with your hands and legs supporting you on the floor
2)Slowly extend your left leg straight behind you
3)Make sure that your back remains straight and parallel to the floor
4)Hold this position for 5 to 10 seconds
5)Repeat using the opposite leg
Leg Raises:
1)Lie on your back
2)Bend your knees to 15 degrees
3)Contract your abdominal muscles to lift your feet off the floor in an arc like motion above your head
4)Slowly (in the same arc like motion) return your legs/feet to the floor
5)Repeat 10 more times
Sit Ups:
1)Lie on your back
2)Bend your knees to a comfortable position
3)Lock your fingers behind your head
4)Curl your head, shoulders, upper and lower back off the floor - no more than six inches
5)Hold this position for 5 seconds
6)Slowly return to starting position
7)Repeat 10 more times
As always, discuss starting any rehabilitation program with your physician. If any activity causes more pain, stop the exercise immediately. The exercises should be performed three times per day.

Do you have backpain problem?please do contact us for inquiries and book your appoitnment with us. Thanks!
0198099042 (mohd. Ihtisyam)


Monday, 13 May 2013

What is 'Myofascial Release (MFR)' ?

What is Myofascial Release?

Myofascial Release is a highly specialized stretching technique used by physical therapists to treat patients with a variety of soft tissue problems.
To understand what Myofascial Release is and why it works, you have to understand a little about fascia. Fascia is a thin tissue that covers all the organs of the body. This tissue covers every muscle and every fiber within each muscle. All muscle stretching, then, is actually stretching of the fascia and the muscle, the myofascial unit. When muscle fibers are injured, the fibers and the fascia which surrounds it become short and tight. This uneven stress can be transmitted through the fascia to other parts of the body, causing pain and a variety of other symptoms in areas you often wouldn't expect. Myofascial Release treats these symptoms by releasing the uneven tightness in injured fascia.
In other words, Myofascial Release is stretching of the fascia. The stretch is guided by feedback the therapist feels from the patient's body. This feedback tells the therapist how much force to use, the direction of the stretch and how long to stretch. Small areas of muscle are stretched at a time. Sometimes the therapist uses only two fingers to stretch a small part of a muscle. The feedback the therapist feels determines which muscles are stretched and in what order.
Each Myofascial Release technique contains the same components. The physical therapist finds the area of tightness. A light stretch is applied to the tight area. The physical therapist waits for the tissue to relax and then increases the stretch. The process is repeated until the area is fully relaxed. Then, the next area is stretched.
The therapist will be able to find sore spots just by feel. Often, patients are unable to pinpoint some sore spots or have grown used to them until the physical therapist finds them. The size and sensitivity of these sore spots, called Myofascial Trigger Points, will decrease with treatment.
Most patients are surprised by how gentle Myofascial Release is. Some patients fall asleep during treatment. Others later go home and take a nap. Most patients find Myofascial Release to be a very relaxing form of treatment.
Myofascial Release is not massage. Myofascial Release is used to equalize muscle tension throughout the body. Unequal muscle tension can compress nerves and muscles causing pain. Progress is measured by a decrease in the patient's pain and by an improvement in overall posture.

Who can benefit from Myofascial Release?
Myofascial Release should be considered when a patient has not responded to more traditional forms of medical and physical therapy treatment. I have successfully treated patients with the following diagnoses using Myofascial Release as part of my physical therapy treatment plan.

BACK STRAIN, chronic back pain, low back pain, thoracic back pain
Persistent, recurrent back pain can cause or be the result of asymmetrical soft tissue tension that does not respond to active stretching by the patient. Active myofascial trigger points can be the stimuli for continued muscle spasm. The pain–spasm cycle further distorts the patient’s posture and causes additional soft tissue injury. Using Focused Myofascial Stretching, the physical therapist can neutralize the trigger points and equalize the soft tissue tension, decreasing the postural asymmetries.

CHRONIC CERVICAL STRAIN, chronic cervical pain
Persistent cervical pain can cause or be the result of asymmetrical soft tissue tension that does not respond to active stretching by the patient. Active myofascial trigger points can cause radiating pain into the face, jaw, skull, shoulders, upper back and down the arms. Chronic cervical strain and forward head posture can cause vertigo and balance dysfunction. All of these problems must be addressed in a comprehensive physical therapy treatment program.

When a patient does not completely recover from an initial injury, inefficient accommodation to the residual restriction of movement causes additional asymmetrical soft tissue stresses. Chronically irritated and inflamed tissues develop adhesions that further limit efficient movement. As this feedback loop continues, the patient’s pain complaint becomes diffuse and global. Pain causes fatigue, depression and impaired sleep.

Myofascial Release can address all of these problems as part of a comprehensive physical therapy treatment program. As a direct, "hands-on" treatment, Myofascial Release reverses the physical withdrawal behavior of many patients who are in chronic pain. As the asymmetrical soft tissue stresses decrease, the feedback loop is interrupted. Sleep patterns improve and overall pain decreases. Gradually, the layers of injury are peeled away like an onion until only the sequelae from the original injury are present and can be treated.

FIBROMYALGIA, Myofascial Pain Dysfunction, Fibrositis
Myofascial Release is one of the most effective treatments for patients with moderate to severe symptoms of fibromyalgia. Soft tissue adhesions and active Myofascial Trigger Points must be reduced before the patient can participate in an active exercise program successfully. Postural asymmetry is energy expensive and contributes to the extreme fatigue reported by patients who have fibromyalgia. The patient may initially feel worse when beginning treatment with Myofascial Release. As postural symmetry improves, the patient will feel less fatigued and have less morning stiffness.

TRIGGER POINTS, tender points
Myofascial Trigger Points can produce symptoms that mimic many other medical diagnoses. For example, hypersensitive Myofascial Trigger Points in the neck and shoulder muscles can cause headaches, tooth pain, jaw pain, difficulty swallowing, pain behind the eyes, pain in the eyes, vertigo, intrascapular pain, arm pain and hand pain. Myofascial Trigger Points can cause atypical angina, diarrhea, groin pain, sciatic distribution pain, chest and abdominal pain. For a complete description of the effects of Myofascial Trigger Points, please consult Myofascial Pain and Dysfunction: The Trigger Point Manual, volume I and II by J.G. Travell and D.G. Simons, William & Wilkins Publishe


Adakah anda mengalami masalah seperti diatas? dan ingin mencuba rawatan Myofascial Release? Hubungi kami (mohd. Ihtisyam) 0198099042 untuk pertanyaan dan temujanji.

Saturday, 11 May 2013

What is 'Stroke' ?

Stroke or cerebrovascular accident (CVA) refer to neurological sign/symptoms that’s result from diseases involving blood vessels in disorder of cerebral circulation include any diseases of the vascular system that causes ischamia or infarction of the brain or subarachnoid space.

Primary goal in early rehab
- To prevent secondary emotional, intellectual and physical deteriorations.
- To prepare the patient and relative for challenge ahead.

Functional motor training
Active participant from patient in rehab process to optimize performance of functional action.
Emphasize function on daily activity, such as stand up, sitting down, reaching and manipulation.
Training methods are take account of movement biomechanics, muscle characteristics, environment context and pathology of impairment.

General Principles of Training

- Anticipate and prevent soft tissues contracture, preferably by active means or passive means if necessary.
- Elicit muscles activity utilizing kinesiological principles such as elimination of gravity, eccentric/ isometric contraction using functional electrical stimulation.
- Train motor control using concrete goals by : 
encourage the patient to activate muscle synergistically.
to activate muscles at a particularly length.
to sustain a muscle contraction under certain load condition.
to generate and utilize momentum.
to increase of movement.

- Increase muscles strength by increasing repetition and load relevant to specific actions (actions: standing, sitting down, stair climbing)
- Modified activity/environment to achieve of particular outcome.
- Training on balance – functional postural adjustment/balance are analyzed in sitting, standing, and performing activities (reaching forward, side way, to touch or lift up an object).

Therefore, those patient with difficulty in balance must:
training activity related to daily activities (standing up, sitting down, stair walking)
Activity can be modified gradual from simple procedure and minimum postural adjustment that need to be performed to harder task. 
increase distance of objects 
Increase object weight
Changing object location

Home - based Therapy

What is Home-based Therapy? 

Home-based therapy simply means
    …………rendering medically-related services
     to patients in a home setting rather than in
     a medical facility. 

Why THERAPY at home?
1). Sense of empowerment
2). Facilitate practice of skills / tasks in own living environment ( Senaman boleh dilakukan di rumah sendiri)
3). Greater flexibility – Patient can choose his/her own time/schedule to do physiotherapy treatment (Pesakit boleh memilih sendiri masa dan tarikh untuk melakukan rawatan fisioterapi)
4). Faster recovery due to greater support from family (Pemulihan akan berlaku dengan lebih pantas kerana mempunyai sokongan dari keluarga)
5). More convenient ; in terms of transportation to healthcare centre ( memberi keselesaan kepada pesakit dan penjaga dimana pesakit yang susah untuk bergerak, tidak perlu lagi diangkat ke kenderaan untuk pergi ke pusat kesihatan/hospital )

Bagi sesiapa yang memerlukan rawatan pemulihan Stroke, boleh lah hubungi kami untuk pertanyaan dan temujanji. Terima kasih.

Friday, 10 May 2013

Ahli Fisioterapi (2)

Personal Particular

Full Name                     : Mohd. Ihtisyam Bin Abd Zateh
Address                        : Klinik Kesihatan Pekan Sipitang, 89857 Sipitang, Sabah.           
Hand phone                   : 0198099042 / 0128619157
Email                            :

Educational Background

Diploma in Physiotherapy
(Masterskill Global College, Kota Kinabalu)
January 2010 – Disember 2012 

Subjects Taken Before Practical:

 - Electrotherapy

- Musculoskeletal/Orthopedic

- Cardiorespiratory

- Neurology (Stroke Rehabilitation)

- Special Topic (Women’s Health, Sports Injury, Geriatric, Pediatric)

Clinical Exposure

·         Berkat Physiotherapy Centre, Sandakan (2 months )

·         Hospital Duchess Of Kent (HDOK), Sandakan (2 months )

·         Kudat Distric Hospital (2 months)

·         Sipitang District Hospital (2 months)

·         Taman Didikan Kanak-kanak Kelainan Upaya, Kudat (TDKKU) (2 months )

·         Rumah Warga Tua Sandakan (2 Months )

·         3 Months Attachment Course at Physiotherapy Unit, Kudat District Hospital : ( 4 February 2013 - 3 Mei 2013 ) 

Commitment :

Available during weekdays and Weekends



- Noraziah Abd Latif
- Physiotherapist U32
- Klinik Kesihatan Jinjang, KL

Diploma in Physiotherapy
College of Allied Health, Sungai Buloh, Selangor (Jan 2002 - Dis 2004 )

p.s :
Since i already transferred to KL since last month, i won't be able to do home physiotherapy in Sabah.. I wish my partner, Syam all the best n good luck! If you have any question or anything regarding physio treatment, please do call/contact us..we will do our best to assist you..thank you!

Freelance Physiotherapy

Assalamualaikum dan salam sejahtera..Untuk pengetahuan rakan-rakan dan pembaca disekitar Kota Kinabalu, Sabah, kami ada menyediakan perkhidmatan rawatan fisioterapi di rumah anda..bermakna anda hanya menjalani rawatan fisioterapi dirumah sendiri. Antara perkhidmatan fisioterapi yang kami sediakan ialah:
1).  Rawatan Fisioterapi bagi pesakit Stroke ( Stroke Rehabilitation)

2). Rawatan Fisioterapi bagi Sakit Belakang (Backpain) / Sakit Leher/ Sakit Bahu dan Sakit Lutut

3). Relaxation and Sport Massage ( Urutan Relaksasi dan Urutan Sukan ) / Myofascial Release, Accupressure and Trigger Point Therapy

4) Therapeutic Exercises

Jika ada pertanyaan, sila hubungi saya, Mohd. Ihtisyam Bin Abd. Zateh ( 0198099042 )
e-mail :

Terima Kasih!

Thursday, 9 May 2013

Ahli Fisioterapi

Assalamualaikum dan selamat datang ke blog Home Physiotherapy Services. Nama saya Mohd. Ihtisyam Bin Hj. Abd. Zateh dan merupakan graduan Diploma Fisioterapi dari  Masterskill Global College Kota Kinabalu, Sabah. Sebelum itu, bagi yang belum berapa mengenali bidang Fisioterapi, saya akan terangkan secara ringkas dan pada tentang Fisioterapi dan perkhidmatan rawatan yang diberilan oleh Ahli Fisioterapi.

Ahli Fisioterapi ertinya seseorang yang dilatih dan berdaftar sebagai Ahli Fisioterapi untuk mempromosi kesihatan fizikal, dan menganalisa, membentuk diagnosa Fisioterapi dan memperakui, serta menjalankan rawatan Fisioterapi untuk memulih atau memulih semula sebarang kondisi fizikal dan ketidakupayaan bagi mengembalikan atau memudahkan pergerakan dan keupayaan fungsi optimum. 
(AHP Bill)

 Physiotherapist means an individual who is trained and registered as a physiotherapist to promote physical health, and to analyze, make physiotherapy diagnosis for and certify, carry out physiotherapy treatment to habilitate or rehabilitate any form of physical condition and disabilities in order to restore or facilitate optimum movement and functional abilities.                                         
                                                                                                                                (AHP Bill) 

Antara peranan dan tanggungjawab Ahli Fisioterapi ialah :
1). Melakukan Penilaian Fisioterapi ( Physiotherapy Assessment)
2). Merangka Program Pelan Rawatan ( Plan Treatment Programme )
3). Melakukan Rawatan ( Perform Treatment )
4). Menyediakan pendidikan pesakit dan penjaga (Provide patient and caregiver's education)

Sekian...jumpa lagi...