Signs you may have Upper Cervical instability.

Cervical instability is an orthopaedic condition wherein a patient has an upper neck or head disorder. A patient experiences this disorder either through a genetic disorder or it may be acquired later in life due to some causes.

Understanding Upper Cervical Instability:
With modern times and dependency on technology and gadgets, the lifestyle of everyone in the world is taking a hit. From kids to senior citizens everyone is hooked to smartphones and applications. Some do it for their job and others just for fun. With the constant use of smartphones and being constantly glued to them, the spine health of a human being is getting negatively impacted causing neck pain. While some of these pains are perfectly harmless the others might have a disorder. This disorder may or may not be Cerival instability.

In Cervical instability, the cervical vertebrae can move beyond the normal range of motion. This is possible due to loose or stretched out ligaments. This disorder causes the cervical spine to not be of appropriate support to the head and hence ceases the perfect motion of the movement of the head.

How do you know you have Upper Cervical Instability?
Like any other disorder, there is no prominent factor or sign that can say you might have cervical instability but here are few signs that can help you understand and go for a proper diagnosis.

  • You might have difficulty holding your head up.
  • Experience pain in the shoulders.
  • Consistent headaches.
  • Pain near the skull.
  • Unstable feeling in the neck region.
  • Heaviness in the head.
  • Imbalance of the body.
  • Tenderness.
  • Tingling sensation shooting down your spine.
  • A loss of awareness of the limbs.
  • Less to No Neck Muscle Strength.

  • The above-mentioned signs or symptoms might point the finger to Cervical Instability and to be perfectly sure and get a proper diagnosis you must refer to an experienced and qualified expert.

    What are the reasons you might get Cervical Instability?
    Defining the reason to get a disorder is impractical. Knowing the cause of the disease is like understanding the existence of the universe. But still, there are a few causes and reasons which can point to the specific disorder. Here are a few:

    • Genetic Disorder: Cervical Instability in a human can be defined by the abnormality in the DNA sequence of the patient passed down from their parents.
    • Syndromes: Syndromes like Down- Syndrome and Ehlers-Danlos come with a pre-associated condition called cervical instability.
    • Past-Disturbance: Cervical Instability is a disorder associated with the cervical spine in a human, and any trauma to the cervical spine can cause the disorder within a human. From car crashes to any other injury which can overstretch the ligament.

    • Treatments for Cervical instability?
      Of course, clinical and medical treatments are important to go ahead with the process of healing. But what we forget many times is that Physical or Physio treatment is also of the same importance. With Physio treatment, you can enhance the movement of the spine and can help with the speedy recovery along with clinical treatments.

      Physio treatments for Cervical Instability?

      • 1. Posture Education and Spinal Manipulation
      • 2. Strengthening Exercises
      • 3. Proprioception Exercises
      • 4. Post-Operative Rehabilitation

      • All the above-mentioned treatments are non-surgical and majorly help in decreasing the stress in passive subsegments of the spinal functionality.

        Without any resistance, the step while starting the non-surgical treatment is to go see an expert physiotherapist like Dr GK Balaji, who will not just diagnose the perfect physical treatment for your disorder but also under his supervision and guidance you can rest assured to wake up pain-free.


6 secrets of people who avoid workout injuries

In this sedentary lifestyle where most of our days are spent sitting on a desk, working out has become a necessity and no longer remains a luxury. The gyms are always filled and that is great, but did you know you could injure yourself while working out? No, we don’t mean by dropping a heavyweight on yourself. We mean you could be prone to many internal injuries like sprains, muscle strains and even torn ligaments. And No this information is not an excuse for you to stop going to the gym or to stop working out. But just a disclaimer for you to start safe exercising.

What is Safe exercising?

Safe exercising makes you less likely to hurt yourself or suffer from any injuries. With Safe exercising, you can follow these tips to avoid any injuries while taking care of your health.

  • Hydration: This is no secret that being hydrated always helps you, but being hydrated while exercising is 100 times more important. Do you know why ? Well, while working out an average human sweat a lot which leads to dehydration in the body. In-taking fluids like water can balance out your hydration level. Having water also reduces the soreness of muscles experienced post-workout. Don’t forget to sip the water every 15 minutes while working out and save yourself from injuries and pains.
  • Equipment Knowledge: Have a proper demo before using any equipment or machine. Let your trainer show you, how to use the machine before stepping on it. Having a tailored routine for yourself is very important as it considers everything from your weight to any health conditions you have.
  • When it comes to weight lifting, don’t just lift the weights in any way you like. Ask a professional or a trainer to guide you.

    • Workout Gear: Yes, this is as important as choosing your type of equipment. What you wear in terms of shoes and comfort makes you more or less likely to injuries. Having tight grip shoes on a treadmill is as important as knowing how to work out on a treadmill.
    • Stretching: Warming up and cooling down before and after the workout are so underrated. Stretch your muscles before you start exercising, such as jogging or doing yoga, to prepare them for activity and prevent injury. Afterward is the time when your muscle needs to be stretched again because it will stiffen up from use during exercise.
    • No repetition: Repetition of the same form of exercise is not advised every day. Change your exercise routine every week for your muscles to contract and tone in different positions. Following the same workout, every day can make your body rigid and prone to injuries.
    • Listen to your body: Your body needs rest on some days and it whispers through constant soreness and pains. One of the best ways to avoid fitness injuries is to know your body’s limitations. Don’t push yourself to the point of pain. If you feel pain, you may be injured. Stop your workout, and rest for a day.

    Keeping these few tips in mind while starting your workout journey is beneficial for you in the long run.

    But, what if you somehow you still injure yourself after taking all the precautions? Does it get severe? Is there any non-medicated way to cure yourself from the pain? Yes, there is. Physiotherapy can help to make you pain free.


How physiotherapy helps COVID-19 patients to recover faster

During the COVID-19 pandemic, a lot of people affected by the virus face a lot of challenges while recovering from the virus attack. Physiotherapy has been contributing a lot to ensure speedy recovery as well as rehabilitation for the Covid-19 patients.

Enhances pulmonary rehabilitation

When it comes to pulmonary rehabilitation, it varies with each patient. Physiotherapy helps to enhance the function of the lungs and reduces the requirement for external oxygen support.
In Covid-19 patients, the virus causes difficulty in breathing that worsens the function of the lungs which affects the normal circulation of blood to the entire body and vital organs.
With the help of different breathing techniques, physiotherapist helps to improve the capacity of the lungs when the patients come out of ventilator support. The primary goal of physiotherapy is to restore the lungs capacity to normal.

Enhanced Mobility

In many cases, patients remain bedridden in the intensive care unit (ICU) for extended periods. Patients often remain in a prone position for many hours, which can cause post-ICU dysphagia, muscle weakness, myopathy, and neuropathy owing to critical illness, as well as reduced joint mobility, pain in the neck and shoulders, difficulty standing, and impaired balance and gait, with consequent limitations in activities of daily living. In these patients, physiotherapy focuses on helping people gain mobility as early as possible.
It starts by helping patients move their arms, legs, and body in the bed. Physiotherapists monitor the vitals like blood pressure, oxygen levels and respiratory rate to make sure the movements are carried out safely. Also, patients are offered help to learn to dress and lift objects around them easily in initial stages.

Helps in better recovery in older people with Cormorbidities

Most patients admitted to the hospital with COVID-19 are older people with chronic conditions like diabetes, heart diseases, kidney problems, obesity, etc. Physiotherapists forms a part of multidisciplinary approach based on personalised evaluation and treatment intervention and not limited to exercise training.

A lot of people encounter a lot of problems with mental health and physical function while recovering from COVID-19. Physiotherapists help them recover physically and mentally and live healthy life.
Physiotherapy interventions are tailored towards holistic rehabilitation to address all system impairments and play a crucial role in facilitating functional recovery and resumption to work. As a key strategy, Physiotherapy can help minimize the negative impact of COVID-19 on health and functionality.


How post Covid-19 physiotherapy rehabilitation is beneficial for Covid patients?

A lot of patients recover successfully from deadly COVID-19 disease, but a lot of them also have to face the short/long term effects caused due to the disease. To treat the after-effects of the disease one needs to put in a lot of effort and this is where physiotherapy rehabilitation after COVID-19 is required. These rehabilitation services are offered by certified physiotherapists.

The role of the physiotherapist becomes an integral part of the rehabilitation process for patients with COVID-19 who face challenges with physical movement.

After being discharged from the hospital the patients are asked to increase their physical activities. The doctors ask their patients to perform certain physiotherapy exercises for Covid-19 patients

Most hospital patients are referred to a physiotherapist at the time of discharge. Non-hospital patients are also asked to engage in certain post-COVID physiotherapy exercises to recover faster.

Post-COVID Rehabilitation- What does it mean?

To help the patients get back to normal functioning and reduce disability, some interventions are introduced to help them recover faster. This is known as rehabilitation.

A lot of patients recover from COVID-19 infection and face some residual symptoms. In such cases, rehabilitation can be helpful to reduce the impact of deadly COVID-19 on the overall function of the body and the health of an individual.

The residual effects of Covid -19 include effects on the cardiovascular system, respiratory system, nervous system, and mental health, etc.,

People with residual effects of respiratory system experience shortness of breath and chest physiotherapy for covid 19 patients helps them maintain saturation at almost 97-98%.

You need to consider that physiotherapy after Covid-19 is an integral part of rehabilitation in different phases like

  • Early discharge
  • Enhance his psychological and physical abilities
  • Support the patient
  • Reduce the chances of readmission

strong>Why Physiotherapy is important in post-COVID rehabilitation?


physiotherapy after covid-19

is important as it helps

  • Enhance exercise tolerance in post-acute virus infection
  • Cut down the hospital re-admissions
  • Improve overall health and promote quality life.
  • Get back to the routine and perform daily activities while managing muscle pain and fatigue
  • Enhanced function of respiratory muscles and reduce breathlessness
  • Improve muscle function in lower and upper limbs.Educate on useful techniques to manage stress and fatigue while carrying out basic activities.

Physical therapy for covid patient can help him/her recover faster and resume daily activities effectively.


What is orthopedic physiotherapy?

Orthopedic physiotherapy works on the musculoskeletal system. The system comprises bones, muscles, and joints all through the body.
These components are prone to strains, sprains after surgery, injuries, or fracture.
Orthopedic areas include the back, limbs, and neck that can be affected on any part of the body.
Thankfully physiotherapy contributes a lot to treat orthopedic conditions. Some common types of orthopedic physiotherapy are

  • Shoulder therapy
  • Hand therapy
  • Knee therapy
  • Sports therapy
  • Physical rehabilitation

Orthopedic physical therapy involves the care for the musculoskeletal system, which comprises of

  • muscles
  • bones
  • joints
  • connective tissue
  • ligaments and tendons

Orthopedic physical therapy is given in hospitals, outpatient clinics, sports facilities, trained nursing facilities, and also at your home.

Conditions treated by Orthopedic physiotherapy

Orthopedic physiotherapy help treats almost all conditions that affect your mobility or movement in daily life.
If you have undergone surgery, orthopedic physiotherapy helps eliminate pain, improve your mobility, walking and prevent the building up of added scar tissue. Also, it can help you get back to normal mobility, balance, and strength.
People who undergo the following surgeries also seek help from orthopedic physiotherapist like

  • Knee replacement
  • Rotator cuff repair
  • Knee arthroscopy
  • Hip replacement
  • Cancer surgery
  • Heart surgery

Some of the treatments also used with orthopedic physiotherapy are

Exercise therapy

The physiotherapist would build an exercise regime that would include mobility, strengthening, and balance-building exercises.
Make sure you practice the exercises under the supervision of your physiotherapist to ensure you are doing the exercises correctly. After you get to learn the right way to do the exercises you can continue doing them at home individually to enhance your mobility and strength.


Traction helps reduce the pressure off the affected or compressed joints. The technique is performed by the physiotherapist manually with hands or with the help of equipment. This technique is helpful for patients suffering with

  • Lower back pain
  • Degenerative disc spine issues
  • Neck pain

Hot & Cold Therapy

Orthopedic physiotherapist utilizes both hot and cold therapy to treat swelling and musculoskeletal pain. Heat & ice prevents muscle damage.

Soft tissue manipulation

This therapy is a manual physical therapy wherein the physiotherapist utilizes hands-on techniques on the ligaments, muscles, and fascia. The technique helps maximize muscle function.


Here the physiotherapist would add water therapy to the existing treatment plan. The exercises are performed in a pool.
This therapy is beneficial if you have injuries or joint problems as water offers resistance.


Physiotherapy- An effective therapy to restore the function and mobility

Injuries are quite common in day-to-day lives, but no need to make it an obstacle. You can always face challenges and get back to normal life with appropriate treatment. The doctors often recommend medications for the pain, but if you want to get long-term pain relief then physiotherapy can help you.  The best physiotherapist in Chandigarh or your town can help you understand how physiotherapy effectively works on muscles and bones to help restore normal function.
Physiotherapy helps manage

  • Sports injuries
  • Accidental injury
  • Weight issues
  • Chronic pain
  • Before/after surgery issues
  • Sleep Apnea
  • Pelvic floor disorders
  • Bone ailments
  • Rehabilitation

The experienced physiotherapists help treat different issues like back pain, neck pain, spinal mobility issues, etc and you will find some related therapies below

Spinal Manual Therapy

Spinal manual therapy involves short and sharp movement that enhances the normal movement of the joints. With the help of trained physiotherapists, spinal manipulation can be performed to help you get relief from lower back pain.

Visceral Manipulation

It is an organ-centric fascial mobilization technique that treats the symptoms of poor posture, dysfunction, and pain. Visceral Manipulation therapy helps treat conditions like chronic low back pain, neck and shoulder pain, pelvic floor dysfunction, and viscera postural dysfunctions.

Craniosacral Therapy

Craniosacral therapy is a non-invasive therapy that restores cranial mobility and unusual restriction in the head. It can help treat dyslexia, fascial pain, autism, learning disabilities, and many more health problems.

Neuro-developmental Therapy

Neuro-Developmental Therapy is an effective hands-on technique that helps treat movement dysfunctions – CNS disorders in children.  The therapy is quite effective in improving your child’s function, postural control, etc

Sensory Integration Therapy

Sensory Integration Therapy helps adults & children build physical development and balance.  It also improves attention and confidence.

Dry Needling Therapy

Dry Needling Therapy helps restore the natural efficiency of the muscles to expand & contract thereby enhancing function and reduce muscular pain.


A manual technique that works well with all types of pains

Spinal manipulation is also known as called spinal manipulative therapy. In this technique, the practitioners make use of a device or hands to apply controlled thrust to a specific joint of the spine.

The force applied differs but the thrust applied moves the joint considerably that it could do itself.

The spinal manual therapy is performed mostly by chiropractors but can be carried out by licensed osteopathic physicians or physical therapists etc

An amazing approach

Spinal manipulation is used by children and adults and the pain conditions that can be treated using spinal manipulation are

Spinal manipulation – Is it safe?

Spinal manipulation is quite safe when carried out by a licensed and trained practitioner. The side effects observed are temporary which includes temporary muscle stiffness, soreness, and muscle pain.

Spinal manipulative therapy is a technique that involves the combination of moving & thrusting joints, exercise, massage, and physical therapy.

The therapy is created to ease off the pressure on your joints, enhance nerve function, and reduce inflammation. This therapy is highly effective in treating pain in the head, neck, back, and shoulder. Chiropractors use this therapy to treat disorders like sinus issues or menstrual pain.

Treating lower back pain with Spinal Manual therapy (SMT)

Spinal Manual Therapy is quite helpful in treating lower back pain which is a common problem faced by a lot of people these days. Lower back pain affects your daily life and can cost you a lot as a medical expense.

The low back pain is caused by tumor, fracture or infection etc though there are other causes too.

Sometimes lower back pain also spreads into your legs and buttocks and in such cases, SMT is quite effective.

SMT a simple manual technique includes both mobilization and manipulation. When it comes to manual mobilizations, your physiotherapist would move your spine within a specified radius of motion. The physiotherapist would use passive and slow movements which start with a small area and slowly increased to a wider area of motion.

Manipulation technique helps treat a lot of health ailments and since it is a non-invasive treatment, many people find it easy and helpful to get rid of the pain. You can also use it along with other treatments for faster recovery. If you are not interested in surgical treatments, you can opt for SMT as an alternative to eliminate many health disorders.

For Consultation, please contact

Dr. G.K Balaji
Consultant – Spinal Manual, Cranio Sacral Therapy, Neuro Developmental Therapy
Fortis Hospital, Sector 62, Mohali, (Punjab)
Mob: 9501778779,7508281645, 9780068097



NDT in Physical therapy

Neurodevelopmental treatment (NDT) is a sensory –motor problem solving approach used by physical therapists / occupational therapists. The approach is designed to improve the function in children and adults having difficulty managing movement due to neurological disorders like head injury, stroke or cerebral palsy etc. Preference is given to attain Mobility over a strong Trunk stability, movement is enhanced through a sensory motor experience.

Benefits of Neurodevelopmental Treatment

  • Allow functional movements on optimal posturesto be incorporated into daily activitiesto avoid further impairments & abnormal patterns of movement.
  • Utilize Key Points of control to enhance movements.
  • Assist children with the cerebral palsy who having difficulties with postural control and movement on attempting to rise against gravity.
  • Enhance functional cortical reorganisation for improving the child’s function, social participation and quality of life.

Our physical and occupational therapists work towards providing these children a new environment where they can improve on their development. Along with their families, we try to give them a new life where the developmental issues would never be a concern or barrier for the child to explore the environment.


Craniosacral Therapy

The Cerebrospinal fluid is one of the highest known elements that are contained in the body and unless the brain furnishes this fluid in abundance, a disable condition of the body will remain. In craniosacral therapy, thebones in the cranium and spine used as “handles” to release the restriction in the membranous system to allow the fluid to flow properly. The Dural system is continuous down the spine to thecoccyx, the Dural sleeve extends of what is known as Dural tube. And this Dural tube is attached with the connectivetissue which runs all over the body. The commonsigns of release in craniosacral therapy are visualised and felt through softening, lengthening, increased fluid and energy flow, heat, and client takes a deep breath. Craniosacral therapyhas its wide application from paediatric to geriatric population. It has been proved effective treatment for chronic neck pain, symptoms of fibromyalgia, for general movements in preterm infants, for controlling behaviour in children with sensory processing disorder and many more conditions.

Craniosacral therapy is considered as an alternative and non-invasive technique that helps you get control over your physical, mental and emotional health by focusing on regulating the craniosacral system. This technique minimises the exaggerated sympathetic system and improvise the parasympathetic system by creating a balance between both systems thereby reducing stress, anxiety and induce deep relaxation for normal behaviour.