NCMT Procedure In Frozen Shoulder.

Frozen shoulder technically referred as Adhesive capsulitis presents as a painful and movement restricting disorder of the capsule of shoulder joint; the connective tissue surrounding the glenohumeral joint of the shoulder causing inflammation and stiffness. The cause of it is unclear and yet to be established as per the conventional science. The pain usually aggravates when at rest and lying but shows some degree of amelioration when the affected joint is subjected to movements.frozen shoulder_poadmanilyam blog_drawing by Dr.Bhat

In frozen shoulder at certain cases, the synovial fluid would be lacking causing stress during active and passive movements restricting the range of movement (R.O.M). At other times, in certain subjects the shoulder capsule get  thickened causing swelling due to a band of scar tissue aka adhesions getting  formed with in the shoulder capsule. There by, providing less space within the joint for the humerus, restricting the movement of the shoulder making it get stiff and painful.

Our Vaidya Rangaprasad Bhat, after examination of the alignment of the amsa sandhi marma and the structures forming the joint adopts the thadaval, amarthal and adangal as the case necessitates in relieving the pain.

Furthermore, to maintain the relief provided and improve the Q.O.L (Quality Of Life) of the subject under treatment he follows the NCMT procedure over the specific marmas to provide support and stability to the amsa marma and its associated marmas.
Continue reading “NCMT Procedure In Frozen Shoulder.”


Dr.Bhat’s Non Conventional Marma Taping in Musculoskeletal pain of lower limbs

From over a decade’s clinical experience and exposure in health sector  through conventional and non-conventional modalities of marma  chikitsa  provided in Padmanilayam, our Vaidya Dr.A.Rangaprasad Bhat, the pioneer  started adapting and  practicing , a non-conventional procedure  of taping over the marmas in pain management. wp-1481137262987He  coined the term Non Conventional Marma Taping Procedure (NCMT) for that procedure, as it was applied over the marmas. Up on a series of cases undertook for marma taping in the management of acute & chronic musculo skeletal  pain, Vd.Rangaprasad Bhat have been helping the health seekers from getting relieved from pain of the following conditions, when approached in  person. He has postulated the exclusion criteria for his pioneer method, with the experience attained by keen observation, over close quarters of health seekers treated by him.

Inclusion criteria for NCMT Procedure:-

Osteoarthritis / sandhi vata, get often produced by the repetitive loading injury over the joints.

Gouty arthritis / vAtarakta is a clinical condition, commonly affecting the 1st MTP joints with typical mono-articular involvement. The deposits of sodium urate crystal upon the joints, tendons, bones, peri articular tissues and the bursae causes this painful condition.

Rheumatoid arthritis / Amavata affects the feet in common, where in the earliest changes occur at the MTP joints.

Ganglia, one of the most common soft-tissue masses of the foot and ankle, gets typically located at the back of the MTP joints and tendons.

Calluses / kadara, usually forms under the head of metatarsal  bone within the subcutaneous fat adjacent to skin.

Achilles tendinitis is an overuse injury of the Achilles tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone.

Plantar fasciitis/ vatakhuddaka – presents with stabbing pain occurring usually with the  first steps in the morning. Up on getting up and moving, the pain decreases, but returns again when one stands for a longer period and while rising from sitting posture.

Heel spurs / vatakanaTaka – occur in at least half the people who have plantar fasciitis.It is a bony growth that usually begins on the front of the heel bone and points toward the arch of the foot.

Restless legs syndrome / pAdakSHepa – features, uncontrollable urge to move the legs, due to leg discomfort.  At most of the times it  happens in the evenings or nights while one is sitting or lying down.

Pinched nerve / ekamante ante avapIDiditam – occurs, when too much pressure gets exerted  to a nerve by surrounding tissues, such as bones, cartilage, muscles or tendons.

Bunion / pAdAnguSHTa vakrata – occurs next to the base of the big toe which is  is a bony bulge along the edge of the foot usualy in majority of cases is associated with misalignment of the first toe joint. Wearing ill-fitting or uncomfortable shoes is a predisposing cause for it.

Proximal tibiofibular subluxation /  upajANu vishleSHaNa – causing pain along the lateral aspect of the knee is the due to hypermobility of the proximal tibiofibular joint. Common complaints of “popping” and lateral knee pain occurs due to ncreased fibular external rotation resulting in injury to the protective capsule and ligaments of the joint. Relief from marma taping is usually  followed with an advice for  life style and postural modifications up on due consideration of the biokinetics of the work of the health seeker.

Trapped lateral plantar nerve causes pain, numbness or tingling in the heel area due to a sprain, fracture or varicose vein near the heel. Except the  fracture, in  rest of the two causes marma taping is useful.

Pump bump / pAdamUla kanda is a painful swelling  at the back of the heel, which occurs due to the worn shoe pressing the back of the heel.

Patellofemoral pain syndrome / jAnUpari graha – presents with mild to severe knee pain when the  posterior surface of the patella contacts with the thigh bone.

Ilio tibial Band syndrome presents with a stinging sensation of pain just above the knee joint over the outerside of the knee or sometimes along the entire stretch of the band.

Patellar tendinitis / Kapoli snAyu davathu – commonly known as Jumper’s knee, occurs in athletes of sports involving jumping activity like basketball and volleyball. Anterior knee pain is the usual complaint, whose onset is insidious involving either entire infrapatellar or the infrapatellar pole. Clinical stages 1 to 3 of Patellar tendinitis gets relief from pain through marma taping. Stage 4 falls under surgical purview, since either partial or complete rupture is the presentation.

Osgood–Schlatter disease seen in young adolescents presenting with  inflammation of the patellar ligament at the tibial tuberosity causing a  painful swelling just below the knee. Type I of OSD, where in small are displaced proximally not requiring surgery, is entrusted for Marma taping. Stage II & II of OSD is counseled, and referred to an Ortho Surgeon.

Superficial peroneal nerve entrapment – presents with numbness or altered sensation around the outer aspect of leg at times and vague pain over the dorsum of the foot, very commonly.

Ligament Sprain of knee and ankle in stage I & II can be managed with marma taping.

Deep peroneal nerve entrapment’s clinical presentation varies in the form of vague pain or  a burning sensation, or a cramp over the dorsum of the foot.

Inter digital neuritis – we have treated just 2 cases of this category where in the response to the pain was not satisfactory in a case and the other case could not be observed due to discontinuation from treatment.

Medial Tibial Stress Syndrome commonly known as Shin splints occurs due to the event of  inflammation of the muscles, tendons, and bone tissue around the tibia, caused in persons who indulge in gym activities or rigourous body shape work outs in its initial days. The Pain presents along the inner border of the tibia bone, where in the muscles are attached to it.

Calf muscle cramps / pinDikodveSHTaNa – caused due to laxed valves of varicose veins resulting in invisible to visible tortuosity of the saphenous veins have been effectively helped with pain relief to the helth seekers through marma taping along with ayurveda medicines.

Pirififormis syndrome / nitamba arti  causing sciatic referred pain to the lower leg gets relief from pain through marma chikitsa.

Hamstring strain / Khalli – is a sort of overuse injury like ITBS, often associated with running presenting acute pain at the back of thigh muscle.


Exclusion criteria for NCMT Procedure:

Tendinosis involves angiofibroblasic  hyperplasia, degeneration, and necrosis of the involved tendon with few or no inflammatory cells.

Tenosynovitis involves  inflammation of the tendon sheath with  synovial inflammation, infection or mechanical irritation resulting in fluid accumulation in the sheath.

Tendon ruptures occur in tendons weakened by degeneration or due to repetitive micro trauma, infection, or systemic disease such as diabetes.

Foreign body granulomas manifests,  in response to foreign objects such as thorns or sharp pieces of wood, broken  glass, or plastic  penetrating  the soft tissues of the foot

Plantar fibromatosis consists of localized fibrous proliferation that arises from the superficial and medial aspect of the plantar fascia.

In  Neuropathic osteoarthropathy,  the inter tarsal and tarso metatarsal joints are most commonly involved, followed by the MTP joints. Impaired pain sensation and proprioception leads to repetitive trauma and joint destabilization.

Osteomyelitis of the foot most often results from transcutaneous spread of infection and most commonly occurs in diabetic patients.  Cutaneous ulcers may develop at pressure points, especially under the first and fifth metatarsal heads.

Deep Vein thrombosis – is avoided addressing with Marma Taping, in fear of dislodging  the thrombosed blood causing occlusion of blood vessels in remote area.

Pain in Ecchymosed and bruised area avoided to prevent infection occuring over the affected area.

Disclaimer: The inclusive criteria of the diseases and the fact about the QOL improvement is solely related to the PAIN MANAGEMENT.