With changing times , continuing to work from home seems very appealing. But is it really safe for your body? Excessive sitting behaviour has increased more than ever since Covid times in the comfort of your home. This increases the risk of Low back and upper back pain, wrist pain, neck pain, shoulder pain, headaches and other overuse injuries.
How many breaks do you take from your chair? Are you using a chair while you work from home?
At Physio Now it’s our mission to help you get more active and also guide you with ergonomics for Work from home.
5 simple things you could do to stay more active and maintain a good posture during your work hours:
1- Opt for Sit to Stand desk– this helps you switch positions and doesn’t load your joints for too long. In addition, it also improves alertness and productivity. You can consider asking your supervisor for investing in an ergonomic chair or adjustable table. We could help the process by writing a letter for the same after assessing your injuries.
2- Put timers to stretch every hour- this will help you stay on track even if you get very busy with work, again making sure to redistribute the load on your joints thus preventing injuries.
3- Learn some basic Postural exercises from your Physiotherapist at Physio Now. This will keep you in a good posture enabling reduced tightness in your muscles
4- Keep the documents/files required for your day’s meeting around the house so as and when you need it will keep you moving.
5- Opt for a separate keyboard if you use a laptop and an ergonomic mouse- these will help prevent neck, wrist and elbow injuries.
Sitting posture
Work from home is so much more common now because of the pandemic. We at Physio Now are focused on Postural Assessment and Treatment. This includes stretching and strengthening exercises, endurance training for postural muscles, Manual therapy for sore muscles and stiff joints, electrotherapy for pain relief, tapping, cupping and acupuncture.
Migraine is type of headache which radiates to jaw, eyes, one of face and neck and shoulder sometimes. It can cause throbbing and severe sensations on your one side of face including jaw and eyes and forehead. Sometimes, it is accompanied by other symptoms like pressure in back of head, pulsating sensation on face, sensitive to noise, light, nausea and vomiting. Migraine management is of utmost important from the time you start experiencing it.
Symptoms:
Migraine attacks are long lasting depending on the patient. It can vary from hours to days. Sometimes, it is severe enough to interfere in your daily life and work life.
Sign and symptoms:
Pressure/tension in different area of head, usually in back of the head
Difficulty in Concentration
Nausea and sometimes accompanied by fever
Vomiting
Sensitive to noise
Sensitive to lights
Flashes on face
Visual disturbance like blind spot or flashes of lights
Usually chewing disturbance when jaw is involved
Tingling and numbness o face
Mood changes
Diarrhea
What is Aura?
Migraine starts from some basic symptoms slowly about 15-20 minutes and then lasts for days. However. it usually involves the nervous symptoms first and one after another involves other systems like vision, jaw and teeth, shoulder and neck. Also, starts having visual disturbance like sensitive to screen, wet eye, etc.
– Lock jaw means difficulty in opening jaw
– Sleep disturbance
– Reduce range of motion in neck
– Pressure on back of head
– Ringing in ears
– Feels heavy arms and shoulder
How it starts?
Migraine usually starts with aura and then gets symptoms more severe. It usually begins with dull pain and radiates to face or head and become severe. It gets worse with physical activities. Majority of people usually has nausea, vomiting, fever and mild headache. Migraine can last from 3-5 hours to 3-4 days. It is very common to get migraine stacks once every week or 2-3 times every month.
Causes:
There is not any specific cause for migraine. Migraine headache is one of the symptoms. However, there are some risk factors which could impact migraine like,
– Posture
– Stressful environment
– Sleep disorder
– Desk worker
– Sex: women tend to have more episodes of migraine than men
– Family history: person who has family history of migraine, they are more prone to have migraine attacks.
– Medical conditions such as anxiety, depression, sleep disorder
– Skipping meals
– Caffeine
– Hormonal changes like menopause, menstrual cycle
– after heavy and strenuous physical activities
– change in weather
– Cervical spine derangement
Types:
Following are some common types of migraine. Most of them starts with its Aura.
Tension migraine: Person who has stiff neck and cervical spine derangement could have tension migraine. Sometimes it radiates to neck or mid back.
Menstrual Migraine: It triggers when female is having her menstrual cycle.
Vestibular migraine: Patient has ringing in ear, loss of balance, dizziness while change in positions. Also, patient feels nausea, vomiting, lethargy.
Ophthalmic migraine: In this type of migraine, mostly, accompanied with temporary loss or disturbed vision, wet eyes, concentration disturbance and sensitive to screen.
There are some researches on migraine management as its cause varies patient to patient. However, based on patient’s symptoms, Physiotherapist will recommend line of treatment. Also, Physiotherapist help you to assess your posture thoroughly and provide relevant treatment. Following are some basic advice or line of treatment for migraine:
Exercises for migraine management:
Firstly, posture correction: Try to sit upright and avoid forward head posture. As a result, your brain gets enough blood supply for its functions and gets less fatigue. Also, Work on your neck and thoracic spine muscles to keep your posture upright. However, strengthening and stretching exercises for back paraspinals will help maintain proper posture. Try to avoid forward head posture and keep your neck and neutral and straight position. Try to use back support and ergonomic chair to keep your posture straight.
Secondly, eye exercise: Working on desktop most of the time of the day makes our eye muscles weak. Contact your physiotherapist for better assessment and figure it out which exercise will make your eyes healthier.
Lastly, sleeping position: Most of the episode of migraine starts since patient wakes up in the morning. One of the causes would be neck position while sleeping.
Therefore, contact your physiotherapist for better advice on your sleeping posture and sleeping pillow.
Home-education for migraine management:
Most importantly, manage your screening time. IT profession and one who work on desk mostly, they have to manage their screen time and break time. Try to take few minutes break every 3-4 hours to give relaxation to your eyes and brain. Also, Keep your work station ergonomically correct which will enhance your productivity for your work.
Moreover, try to take 7-8 hours deep sleep. It will provide relaxation to your brain and makes it ready next day to work again with best capacity.
Lastly, also avoid skipping your meal. Try to have your all meals on time. Because our body needs carbohydrates on regular time for better work. Our body has set up its biological cycle to have source of energy. If you skip meals, brain starts to get tired easily and begins sign and symptoms of migraine.
In conclusion, if you have a long history of migraines, seek help of highly skilled physiotherapist at PhysioNow. Book your appointment today.
There are a number of conditions which cause pain and pelvic floor dysfunction. We have discussed a few of those conditions here today. Fortunately most of the conditions are treated with physiotherapy interventions.
Pelvic pain and dysfunction
Common conditions related with internal pelvic structures:
Provoked vestibulodynia: In this your pelvic area is very sensitive to touch or pressure. You will feel pain with
light touch,
pressure,
inserting tampons,
wearing tight pants or
intercourse.
urinary urgency
Vaginismus: You feel difficulty and/or pain with vaginal penetration. This will lead to avoidance of sexual activity or internal pelvic examination.
Bladder pain syndrome: You feel pain and pressure with urge to urinate at any time. You will get an increased urge to urinate. Symptoms usually starts with bladder infection.
Dysmenorrhea: You will feel painful cramps with mensuration. It affects about 90% of the women. This could include pelvic adhesions, pelvic inflammatory disease and cervical stenosis.
Pelvic pain
Conditions related to activities and damage to structures:
Dyspareunia: It is pain with sexual intercourse. Damage to the structures like:
episiotomy,
tears,
reduced mobility of cervix or soft tissues,
bladder pain,
overactive muscles and
inflammation
Coccyx pain: It is the pain in tail bone are with sitting, sit to stand, sexual activity, or with bowel movements. Usually caused by any trauma, inflammation or muscle imbalance.
Conditions involving neurological structures:
Pudendal Neuralgia: There is pain and numbness in the area supplied by nerve from anus to penis or clitoris. You will feel pain with sitting, fecal and urinary incontinence. There are other underlying conditions that can restrict your pelvic mobility. This leads to compression of your pudendal nerve.
Male pelvic pain issues:
Certain conditions such as dysfunction of pelvic muscles, non-bacterial inflammation of prostate, Pudendal neuralgia, anal fissures, Coccydynia, bladder pain causes pelvic pain in male patients.
Pelvic floor therapist helps you with thorough assessment and treatment based on the diagnosis. Educating you about the cause of the pain. Managing with home exercise program.
Treatment techniques done by pelvic floor physiotherapists:
For vestibulodynia:
Physiotherapy is considered as the first line of treatment for you. Your physio will treat with tissue care, manual techniques for painful points, muscle imbalance, relaxation techniques. You will learn to avoid wearing tight clothes and diet modification.
For Dyspareunia:
Relaxation techniques along with dilator insertion helps to relieve tension in the vaginal area. Pelvic therapist will releases scar tissue in the vaginal area which reduces pain. Soft tissue techniques improves the mobility of the cervix and scar tissue.
Bladder pain syndrome: Releasing the tension in pelvic floor muscles and posture correction helps to reduce your symptoms. Incontinence can be treated with pelvic floor muscle training, positioning and certain stretches of the muscles in the pelvic floor area.
Vaginismus: Treatment involves stretching of pelvic floor tissues with external and internal techniques, scar mobilization, muscle overactivity with dilators and relaxation techniques.
Dysmenorrhea: Techniques involve breaking the adhesions in the pelvic floor area and release the narrowing in the cervix.
Techniques to help to reduce your pain:
Relaxation techniques,
stretches,
soft tissue release
Injury with any activity:
Pudendal neuralgia: Your Physio will treat you with nerve release, stretches, and posture correction. Sensory re-education to reduce the numbness in the pudendal nerve supply.
Coccyx pain: Treatment involves pelvic floor relaxation techniques, mobilization of coccyx. We will mobilize it internally and externally. Proper positioning with cushion, exercises to improve the mobility helps to reduce the pain the coccyx.
Male pelvic pain: Treatment includes release of pelvic floor muscles to ease up the pain. We will treat you with stretches, positioning, mobilization, relaxation.
DON’T WAIT TO START PHYSIOTHERAPY TREATMENT
If you notice any of the above symptoms, it’s important to consult your pelvic floor physiotherapist. You can reduce the risk of complications by taking early treatment.. Book a consultation at PhysioNOW with a Registered Physiotherapist today.
Neck related or cervicogenic dizziness is one of the common causes of dizziness and affects 45-80% population. However, while treating the symptoms of being dizzy/light-headed, this diagnosis is commonly missed.
How can it come from the neck?
Nerves from the upper part of the neck connect with the vestibular system(area of the brain responsible for balance). As a result, any injury or impairment in the upper neck like car accident (whiplash), abnormal posture or any inflammatory condition could eventually lead to disturbance in the vestibular system. This, in turn, leads to dizziness.
How to know if your dizziness is related to your neck?
If you are experiencing lightheadedness, unsteadiness, feeling imbalanced and above all, feeling like your external environment is spinning
Moreover, if your symptoms comes with moving the head quickly in any direction, during sitting or standing up
Further, if you are experiencing headache and neck pain
In addition, you have a history of neck injury due to a car accident or neck pain due to abnormal posture
Diagnosis:
There is no specific test with good evidence for cervicogenic dizziness. However, there are tests that will help you rule out other causes of dizziness. This, in turn will help in concluding that cervical spine is the cause for your symptoms.
How could physiotherapy help you with dizziness?
First of all, there will be a comprehensive assessment of your symptoms. Then, the physiotherapist designs a treatment plan incorporating manual therapy , exercises, education and other modalities like acupuncture. Consequently, it will help treat the neck as well as the vestibular system.
Neck related dizziness
Prognosis:
Cervicogenic dizziness usually has good prognosis. It usually resolves with the treatment of neck and the vestibular system. About 75% of patients have reported significant improvement in their symptoms.
Are you experiencing any of these symptoms? Our Vestibular physiotherapists specialize in treating this. Book an appointment today at one of our clinics! We will do an assessment and help you get better.
Why choose PhysioNow for Physiotherapy Mississauga?
• Over 16 years of providing top rated Physiotherapy Mississauga
There are 4 convenient locations- Erin Mills, Applewood, Lorne Park and Long Branch
• Awards/nominations? PhysioNow: nominated for a Top Choice Award in 2020.
• A team of highly qualified physiotherapists and massage therapists
All of our physiotherapists and massage therapists have several years of experience in their field and are registered in good standing with the College of Physiotherapy and Massage Therapy.
• Services we offer
Services are provided for all ages and for a variety of conditions. For instance, our therapists are specialized in several areas including manual therapy, acupuncture, vestibular rehabilitation, concussion , sports injuries, pelvic health and soft tissue techniques.
Lower Back Pain Treatments
Donjoy Defiance ACL Repair Brace
Return To Sport After ACL Ligament Repair
In addition, we do custom orthotics and braces. For your convenience, we are currently also offering our physiotherapy services virtually .
• Direct billing available
In addition, Direct billing is available to most of the insurance companies so it is convenient for you. For instance, we also deal with third party insurers like MVA and WSIB.
• Flexible hours and free parking available
Above all, we are open for extended hours ( ) to help you at a time that is best for you.
What to expect at Physiotherapy Mississauga?
First, you have an assessment with our physiotherapist. They will do a full check up of the problem area .
Next, the physiotherapist will then prescribe a treatment plan especially for you.
Further, they can also help you understand more about your condition.
We will answer your questions .
Lastly, changes may be made in your daily routine.
As a result, this will help you to get better faster.
COVID considerations: We take excellent precautions!
• Providing a face mask and use of 70% alcohol hand sanitizer for each patient upon arrival into the clinic
• Installation of sneeze guards at the front desk
• In addition, Sanitization of treatment beds after before each patient use
• Disinfecting commonly touched surfaces between every patient
• Switching out pillowcases with each patient use
• All staff will wear a gown and mask and wash hands between each patient contact
Kevin Durant originally injured his calf in early May during the second round of playoff games. The injury had been labeled a ‘calf injury’ and Durant has not been able to play for over 30 days. After doing a shoot around with the team, the Warriors made the decision to allow Durant to play for Game 5. Durant came out strong, scoring 11 points in 12 minutes of play. But things changed as he tried to do a crossover move and had to fall to the floor on the sidelines. He was grabbing onto his lower right calf, more towards his Achilles tendon. In conclusion, from the replays, it looked like he may have torn his Achilles tendon.
What is the difference between a calf strain and an Achilles tendon tear?
Kevin Durant’s injury
Calf Strain : Did Kevin Durant have this injury?
It is possible that Kevin Durant had a calf strain to start.
The bulk of the calf is made up of 9 different muscles. Three muscles work together to produce a downward movement of the foot. These 3 muscles attach themselves into the heel bone:
Gastrocnemius
Soleus
Plantaris
Other Muscles of the calf/ foot
The other 6 muscles cause knee, toe and foot movements in different directions. These muscles are located deeper in the calf area. However, these muscles travel around the sides of the ankle and attach to different parts of the foot and toes. These muscles are:
Popliteus
Flexor digitorum longus
Flexor hallucis longus
Tibialis posterior
Peroneal longus
Peroneal brevis
Sometimes injuries are labelled incorrectly. Pain in the calf region is attributed to the first three muscles. However, a calf strain could involve any one of the 9 muscles mentioned above. As a result, it is up to the health professional to correctly identify which of the muscles are involved in the strain.
Severity of Calf Strain: What Grade did Kevin Durant have?
In general, a calf strain is caused by overstretching or tearing of the calf muscles. This type of injury can occur suddenly or over time. The severity of the strain is graded by the amount of muscle damage that has occurred:
Grade 1
Mild or partial stretch or tearing of a few muscle fibres
The muscle may be tender and painful
Strength and function are maintained
Grade 2
Moderate stretching or tearing of a greater percentage of muscle fibres
A snapping or pulling sensation may be felt at the time of the injury
More tenderness and pain
There may be some visible bruising
Loss of strength and function
Lastly, Grade 3
Severe tear of the muscle fibres, commonly a complete rupture
A ‘popping’ sound may be heard of felt at the time of the injury
There is definite bruising and sometimes there is a visible ‘dent’ in the muscle
Severe loss of strength and function
Signs and Symptoms of a Calf Strain
A snap, pull or “pop” felt or heard at the time of injury
Pain and weakness in the calf area
Swelling in the calf area
Tightness
Bruising
Weakness in the calf when doing any weight bearing activities
Limping when walking
What is the usual Physiotherapy treatment for a calf strain?
Treatment for a calf strain is like that of any other muscle in the body. The goals of the treatment include:
Reducing pain
Improving range of motion of the knee and ankle
Improving the strength
Speeding up recovery time
Returning to activities
Preventing re-injury
How long does it take to recover from a calf strain?
The length of time for recovery from a calf strain injury depends on the severity of the injury. On average:
Grade 1: 10-12 days
Grade 2: 4-6 weeks
Lastly, Grade 3: 6 months after surgery
Achilles Tendon Rupture : Kevin Durant’s final injury
The gastrocnemius, soleus and plantaris muscles unite to form the Achilles tendon. The tendon is a tough band of tissue that connects these three calf muscles to the heel bone. When the calf muscles contract, the Achilles tendon is tightened and pulls the heel. As a result, the action allows the foot to be pointed down. A complete tear of this tendon is called an Achilles tendon rupture.
Signs and symptoms of Achilles Tendon Rupture
Sudden and severe pain at the back of the ankle or calf
Sound of a loud pop or snap
Immediate swelling and weakness
Visible bruising and possible denting in the tendon
Treatment options for Kevin Durant’s Achilles Tendon Rupture
Non-surgical treatment
Rest
Crutches
Ice
Pain medication
Immobilisation for the first few weeks with a walking boot and heel wedges
Recovery may take longer but risks of surgery are avoided
Surgical Treatment
Involves making an incision in the calf and stitching together the torn tendon
Minimally invasive surgical techniques are available
Risks of surgery include possible infection and nerve damage
The choice between surgical or non-surgical treatment depends on different factors. A patient’s age, activity level and severity of the injury all play a factor. In general, younger and more active people, especially athletes, choose surgical repair. In contrast, older and more sedentary individuals usually choose the non-surgical pathway. In either option, rehabilitation is a lengthy and difficult process to make sure full function is returned.
So, what happened to Kevin Durant?
The Kevin Durant was out for over a month with an initial calf strain. Due to the amount of time that he was out of the game, it’s likely that he had a grade II strain of his calf. As a result, his return to the game resulted in a complete Achilles tendon rupture. In review, it makes you wonder whether he was physically able to return to play. Did he have enough time for recovery from his initial injury to withstand the demands of the game?
Basketball is a sport that has a lot of pivoting, stop and go movements and bursts of high intensity activity. In conclusion, it is possible to say that judging from how soon into the game the injury happened, that Kevin Durant was likely not fully recovered.
Professional Sports: Decisions for return to play. Should Kevin Durant have returned to play in Game 5?
However, in professional sports, there is a lot of pressure from all fronts to get a star player back in the game. The team was down 3-1 and having Durant back in the game boosted their confidence and morale. As a result, the fans wanted the Warriors to win. The organization wanted the team to hold on to their title again. In addition, Kevin Durant himself probably felt terrible that he wasn’t able to play and support his team. As a result, all of these pressures likely led to the decision for him to play.
Unfortunately, our bodies are not always able to function like we want them to. In Durant’s case, his return to the game led to an even more serious injury, which required surgery. In conclusion, after surgery he will have to endure a lengthy process of physical therapy and will likely be out for the entire next season.
Return to Play Decisions
This is an excellent example of the importance of return to play decisions. Regardless of the sport and regardless of the injury, it is vital that the health and well being of the athlete is the top priority. In conclusion, returning to play too soon isn’t worth risking a more serious injury. Lastly, a more serious injury can affect the athlete’s future participation in the sport.
Physiotherapy Treatment options for Achilles Rupture
If you or someone you know has experienced calf pain or an achilles rupture, our Physiotherapists at PhysioNow are here to help! We have treated many patients with exactly these injuries. Call today to get started on your treatment and get back in the game!
Neck pain is a common problem for a lot of people. Physiotherapy for Neck Pain is one of the top 5 reasons why people go for physiotherapy treatment. People can get neck pain after many different types of activities. Some of the most reported examples are:
Getting a kink in the neck after a bad night’s sleep
Feeling pain in the neck and shoulder area after doing some heavy lifting at home or at the gym
Feeling pain in the neck when using the computer for long periods of time
Feeling pain in the neck after an accident, such as a fall or motor vehicle accident
Assessment for Neck Pain
Signs and Symptoms
There are many obvious signs and symptoms of a neck injury. Some of these include:
Pain in the neck
Restricted movement of the neck
Sensations of tightness or stiffness in the neck
There are also some not so obvious signs and symptoms of a neck injury:
Pain in the arm
Headache
Pins & needles in the arm
Numbness in the arm
Weakness in the arm and/or hand
Patients who experience these symptoms may think that they have an injury to their arm. They may get worried because of the unusual pins and needles or numbness they are feeling. However, most of the time these symptoms are coming from the neck. An experienced physiotherapist will be able to make the connection between a patient’s arm symptoms and their neck pain.
Treatment for Neck Pain
The treatment for neck pain will vary depending on the nature of the injury. Your Physiotherapist will first start with an assessment to figure out what the problem is. During the assessment, they will ask some questions about how the pain started. They will also get details on how the symptoms behave. Some examples of these questions include:
How long have you been feeling your pain?
How intense is your pain on a scale from 0 to 10?
Was there an incident that started the pain?
Where exactly do you feel your symptoms?
What kind of symptoms do you feel?
What kind of activities make your pain feel worse or better?
In conclusion, answers to these questions will allow your Physiotherapist to understand the nature of your injury. They will then perform a physical assessment. Finally, certain physiotherapy tests that will help them further understand your injury.
Physiotherapy Tests for Neck Pain
Movement of the neck and arm
Tenderness of the muscles around the neck
Sensation of the arm
Strength of different muscles in the arm
Reflexes of the arm
In conclusion, once your Physiotherapist is done gathering all the information, they can come up with a diagnosis for your neck pain.
Treatment for Neck Pain
Treatment for Neck Pain
Using the information from the assessment your Physiotherapist will develop a treatment plan for you. The treatment plan will include different methods to reduce your pain and improve your function. For example, some common Physiotherapy treatment tools at PhysioNow include:
Interferential Current (IFC)
This is electrical stimulation that helps with pain management
There are 4 pads that are placed around the painful areas of the neck
Moreover, the strength of the current is dependent on your comfort level – stronger does not mean better
We ask you to indicate when you feel a strong, but comfortable amount of sensation
In summary, IFC distracts the body’s pain signals to give relief of pain
Lastly, this electrical modality is usually applied for 15 minutes
If you are interested in knowing more about Interferential Current Treatment, please check out this article .
Heat therapy
Heat is used as another pain management tool
As a result, it is usually combined with the IFC so that you can have both at the same time
At PhysioNow, our therapists use moist heat packs for heat therapy
As a result, moist heat is the most effective form of heat because it allows the heat to get deeper into the tissues
In summary, Heat therapy increases circulation, relaxes soft tissues and reduces pain and stiffness
In conclusion, heat is usually applied for 15 minutes
Manual Therapy
Manual therapy involves “hands-on” treatment by the Physiotherapist
As an Example, the most common forms of manual therapy involve soft tissue work, mobilizations and passive stretching
Moreover, soft tissue work helps reduce tissue tension and improves circulation in the area
There are a lot of muscles around the neck and when there is injury or pain these muscles become tight and stiff
This Soft tissue work around the neck is gentle to generally loosen these tissues
In addition, soft tissue work can also be very deep to work out specific tissue knots
In conclusion, your Physiotherapist will always consider your comfort for these types of treatment
Mobilizations
Mobilizations help decrease the stiffness in the joint
In short, there are 7 vertebrae in the neck and stiffness can develop at any level
Your Physiotherapist can apply different levels of gentle pressure to get the joints of the neck moving
For example, some muscles that most often get tight in the neck include the scalenes, upper trapezius, sternocleidomastoid and levator scapula
Your Physiotherapist will be able to determine which muscles are tight
The stretches are usually held for about 20-30 seconds and repeated 2-3 times
Exercise prescription
Exercise prescription
In addition, Exercises are an important part of any Physiotherapy treatment
Special Exercises that will be given to you depending on your specific neck injury
The exercises can help get your joints moving, stretch the soft tissues and strengthen the muscles around the neck
Moreover, these exercises will allow you to keep treating yourself on a outside of your Physiotherapy appointments. This speeds up your recovery
As a result, we know that patients who perform their exercises on a regular and consistent basis will have the fastest results with their Physiotherapy treatment
Education
Education
In addition, Education is another important part of Physiotherapy treatment for neck pain
If you have a good understanding of your condition and treatment, you will have the best results with your recovery
Lastly, an experienced Physiotherapist should be a great teacher
For example, your Physiotherapist may suggest that you use a specific pillow for improved sleep, or suggest ways to maintain good posture during work hours
Massage Therapy for Neck Pain
We know that Registered Massage Therapy can also be a very effective treatment for Neck Pain. At PhysioNow, we have many excellent Registered Massage Therapists at all of our clinics.
In conclusion, using these Physiotherapy treatment options produces great results for neck pain. Your Physiotherapist will work with you to help you achieve the best recovery possible and get back to doing the things you love.
If you or anyone you know is experiencing neck pain, please call today! At PhysioNow, we are ready to help!
The Pelvic Floor. Perhaps you have heard this referenced
before but did not have a definitive idea of what it was. Is it just a region
in the body? A single muscle? Let us explore this very important topic.
The Pelvic floor
is a group of extremely important muscles located on the inside of the pelvis
with a hammock like orientation. They attach to the tailbone (coccyx) at the
back, the pubic bone in the front and span side to side.
Functions:
These muscles are involved in several complex functions but
are often overlooked in their contribution due to their “out of sight, out of
mind” presence. These functions include:
1. Bowel and Bladder Function and Support
Assists in control of the bladder and bowel (helping to prevent incontinence) in males and females. In females, the pelvic floor supports the uterus and other organs located in the pelvic cavity. This helps to prevent prolapse. Prolapse is the lowering down of a pelvic organ from its normal position.
Contribution to our Core Muscles?
The pelvic floor acts as the base of our core together with the deep back muscles and diaphragm. Core muscles help to provide strength and stability of the spine.
Involvement in Sexual Function
The pelvic floor plays a role in sensation during sexual intercourse. As a result, dysfunction of these muscles may lead to painful intercourse. In addition, it can lead to decreased sensation, and reduced erectile function amongst other symptoms.
Involvement in pregnancy and delivery
The strength of the pelvic floor muscles is very important during pregnancy. They help to support the extra weight of pregnancy. This can reduce certain symptoms of discomfort. They can also help to decrease the incidence of incontinence (bladder leakage), and prolapse. Additionally, they play a large role during delivery in guiding the baby’s head down the birth canal.
Symptoms of Dysfunction?
When the pelvic floor is working in harmony, it plays a big role in a variety of our functions. What happens when something is not quite balanced in the pelvic floor? Symptoms may arise. For example, they can be as a result of one of two scenarios: weakness in the pelvic floor or increased tension in the pelvic floor.
What about Kegels?
It is common to assume that any pelvic floor concerns are automatically as a result of weakness. Many people think that kegels should immediately be practiced. However, kegels are NOT always the answer! If the primary problem in the pelvic floor is tension, kegels can in fact do more harm than good. The Mysterious Pelvic Floor issues can be solved with a little Pelvic Physiotherapy!
So, what are some of the symptoms associated with pelvic floor dysfunction?
Urinary issues, such as the urge to urinate, incontinence (bladder leakage), urinary frequency and painful urination.
Bowel concerns such as constipation and incontinence
Lower back pain
Pain in the pelvic region, genitals, or rectum.
Discomfort during sexual intercourse for women.
Pressure in the pelvic region or rectum.
Muscle spasms in the pelvis.
What are some of the Risk Factors for issues with The Mysterious Pelvic Floor ?
A history of back pain
Previous trauma to the pelvic region such as a fall or pelvic radiotherapy
Ongoing constipation (i.e. for example, regularly straining to empty your bowels)
A chronic cough or sneeze (e.g. due to asthma, smoking or hayfever)
Being overweight, or having a body mass index above 25, and
Heavy lifting on a regular basis – either at work or at the gym most commonly
During pregnancy and post-partum, some factors may arise
Women who are going through, or have been through, menopause
Women who have had gynaecological surgery (e.g. hysterectomy)
Men who have had prostate surgery
Elite athletes such as gymnasts, runners or trampolinists.
What is a Pelvic Physiotherapist and How Can We Help?
What is a Pelvic Physiotherapist and How Can We Help?
A Pelvic Physiotherapist has advanced training . They assess and treat the pelvic floor through a combination of external and internal examinations. This treatment is for both males and females. Internal examination allows the Physiotherapist, to evaluate the pelvic floor directly. As a result, this will help to identify contributing factors to your concern.
Typically, tension or weakness are underlying imbalances in the pelvic floor. The Mysterious Pelvic Floor issues are usually treatable!
Although this is an area less known for its muscle contribution, the parallel of a shoulder injury should be drawn here, for example. In order to help treat a shoulder problem, a Physiotherapist would still have to evaluate all the muscles around it. We would check to see where the problem lies. Once found, these same muscles would be treated directly.
This is the same principle to keep in mind when trying to understand pelvic floor problems and treatment.
Treatment of The Mysterious Pelvic Floor?
Once a full examination has been completed, the Pelvic Physiotherapist discusses the results with you. Together, they will develop a treatment plan with you. Pelvic Physiotherapy treatments vary, however, some of the methods often used can include:
Postural training
Release and mobilizations , (often the low back, hips, etc. are involved).
Connective tissue release. Connective tissue is the thin layer found above our muscles. Sometimes, it can cause tension pulls and compression in areas. As a result, this causes pain and poor function.
Dilator work
Internal techniques to release areas of tension. We teach contraction exercises AND relaxation techniques. These are often overlooked
Exercises: These are positional to alleviate pain and pressure. They strengthen, stretch, and activate muscles. As a result, they help to build endurance, and improve coordination.
Breathing techniques
In cases where internal assessment or treatment may be painful, external treatment can be started first. This can often reduce the tension causing the internal discomfort. Improvements can be made to achieve your ultimate goals.
It is also important to note that Physiotherapists are primary health care providers. Therefore, you can see a Physiotherapist without a doctor’s referral. However, if your Physiotherapist feels that you may benefit from further testing, we will reach out to your doctor of choice.
Summary of The Mysterious Pelvic Floor
The Mysterious Pelvic Floor doesn’t need to be so mysterious!
Two of the most common phrases that I hear patient’s mention during or after a pelvic physiotherapy assessment are:
“I didn’t even know that this type of Physiotherapy existed” and
“I wish I knew about this sooner”
These phrases are often derived from patients who have a pelvic concern. In most cases, it has significantly affected their function. It has resulted from the belief that nothing could be done, besides “living with it.”
My hope is that Pelvic Physiotherapy becomes well known! My hope is that you seek treatment as often as our rotator cuff friends. Afterall, they both involve muscles that can be easily treated. Take care of your pelvic floor, it is literally of foundational importance!
If you or someone you know suffers from Pelvic Floor issues, PhysioNow can help! We have specially trained Pelvic Floor Physiotherapists available at all of our clinics to help. Call today to get started on your treatment!
Acute Ankle sprains are common injuries in people of all ages. They can happen in many different circumstances. However, they always involve some type of fall or twisting movement to the ankle. For example:
Going downstairs and missing the last step resulting in twisting the ankle
Landing on the ankle in a twisted position after coming down from a lay-up in basketball or in a Sports Injury
Slipping on an icy street while walking
In all of these situations, the ankle gets a sudden movement and/or trauma that causes it to twist more than its normal range of movement allows.
Acute Ankle Sprains
What structure gets injured with an acute ankle sprain?
The structures that are injured with acute ankle sprains are the ligaments around the ankle joint. Ligaments are soft tissue structures that connect two bones together. Their function is to prevent the bones from moving too far away from each other. Ligaments help maintain normal movement between the bones.
With ankle sprains, the ligaments get over-stretched beyond what they can tolerate which causes tears in their fibres. The ligaments that are involved in acute ankle sprains are present on the outside (lateral), inside (medial), and top of the ankle.
Are there different types of acute ankle sprains?
There are three main types of ankle sprains:
Inversion
Eversion
High Ankle Sprain
The terms relate to the direction of ankle movement that caused the injury to occur.
INVERSION ANKLE SPRAIN
An inversion sprain occurs when the ankle is forcefully turned inwards.
This type of acute ankle sprain is the most commonly occurring of the three because the ligaments on the outside of the ankle are generally weaker than the rest.
Another name for an inversion ankle sprain is lateral ankle sprain
A lateral ankle sprain injures the ligaments on the outside of the ankle.
EVERSION ANKLE SPRAIN
An eversion sprain occurs when the ankle is forcefully turned outwards.
This type of force injures the ligaments on the inside of the ankle.
The ligaments on the inside of the ankle are called the deltoid ligament
An eversion ankle sprain is also called a medial ankle sprain
HIGH ANKLE SPRAIN
A high ankle sprain is the rarest of the three types and it occurs when there is excessive twisting of the shin.
The ligaments that are injured with this type of injury are located above the ankle.
The location of the ligaments is why this injury is called a ‘high’ ankle sprain.
Are some people more at risk for Acute Ankle Sprains than others?
There are certain risk factors that may make ankle sprains more likely to happen. However, the research is a little inconclusive on why this is so. Some of these possible factors include:
Poor muscle strength/fitness
Increased weight
Decreased muscle-reaction time
Previous history of ankle sprains resulting in poor balance
Can there be different severities of Acute Ankle Sprains?
The severity of the ankle sprain depends on how much the ligament was overstretched in the process of the injury. Sprains are classified by different grades to explain the severity:
Grade I: mild stretching or tear of the ligament, with little or no instability at the joint
Grade II: incomplete tear of the ligament, with some instability in the joint
A Grade III: ligament is completely torn or ruptured and there is no stability in the ankle
Ligaments affected in Ankle Sprains
What should you do if you think you have sprained your ankle?
In all three types of Acute Ankle Sprains, it is important that you see a health care provider. The health care provider, whether it is a doctor or a Registered Physiotherapist, will first rule out the possibility of fracture. There is always the possibility of a fracture with Acute Ankle Sprains. The ligaments attach onto a bony area and if the twist is severe enough, it can pull off a chunk of the bone. When this happens, it can cause a fracture. Signs and symptoms of a potential fracture include:
Lots of swelling
Increased bruising
Increased tenderness over specific areas of the ankle
Difficulty or inability to put weight through the injured ankle
When the signs and symptoms are suspicious of a fracture, then an X-ray must be completed. If there is no evidence of fracture, then your doctor may send you for an ultrasound. In the end, they should refer you for Physiotherapy treatment. So ask your doctor to send you to Physiotherapy if they don’t think to recommend it themselves.
What will happen during my first Physiotherapy appointment?
During the Physiotherapy assessment, your Registered Physiotherapist will assess everything to do with your Acute Ankle injury, including:
Pain intensity and location
Swelling
Sensation
Range of motion
Ankle stability
Strength
Balance
This will provide some baseline information for your Physiotherapist.
How can Registered Physiotherapy help treat Acute Ankle Sprains?
The treatment for acute ankle sprains depends on the type of sprain as well as the severity of the injury.
Immobilization
Because of their affect on ankle stability, a Grade II or III injury will require some immobilization. This is usually done through a removable walking cast.
The purpose of the immobilization is to protect your injured ligaments from movement and external stressors, so that they can heal.
The period of immobilization will depend on the injury and your health care provider will provide specific instructions.
A grade I sprain will not require any immobilization because the stability of the ankle is still intact. However, your Physiotherapist will recommend activity modification to help with the healing process.
Physiotherapy Treatment in the acute phase?
In the initial phase of the treatment, the Physiotherapist may focus on pain relieving modalities
Electrical modalities like IFC and Ultrasound can help relieve pain and swelling
The Physiotherapist will also prescribe gentle mobility exercises to help improve or maintain movement through the ankle
The length of the acute phase depends on the severity of the sprain
Ankle Rotations for movement Recovery
Treatment in the later stages of Acute Ankle Sprains
Once the ligament healing is underway and the patient feels a little better with their pain, the treatment will get more progressive
It will focus on regaining mobility, strength and function through the ankle
Your Physiotherapist will prescribe exercises that are going to help regain the lost range of motion and strength.
Over several weeks, the exercises will be progressed as you improve.
Another important aspect of treating an ankle sprain is including balance re-training in the program.
Balance is very much affected after an ankle sprain and it is something that must be improved with specific exercises. This is very important no matter whether you are returning to Sports or just everyday living! Balance Retraining is key to Falls Prevention!
We use our balance ability on a regular basis with walking on uneven surfaces or when trying to recover from a stumble. Therefore, it is important to improve balance ability to prevent any possible re-injury of the ankle.
If you have had an acute ankle sprain before, and DID NOT attend Physiotherapy, it is likely that you are at increased risk of reinjuring your ankle or falling again!
Physiotherapy Mobilizations
Do I need to get Physiotherapy treatment after Acute Ankle Sprains?
There are some people who have sprained their ankle multiple times and never sought out treatment for the injury. They usually give themselves some time for the pain to get better and then go about their usual activities.
This type of management is not usually recommended because multiple ankle sprains can affect the stability of your ankle. As a result, this may create problems in the future. Also, the reduced stability in your ankle may cause compensations in your knees and hips. This can complicate the picture and make your injury more complex.
It is therefore recommended that you seek out proper Registered Physiotherapy care to address an ankle sprain soon after it occurs. This ensures that your acute ankle sprain heals in a timely manner without added complications. The most important part of treatment is regaining your balance. If you do not do this, another injury in quite likely.
Shoulder injuries are a common problem for many people. It can happen to people of all ages from children to the elderly. The pain from shoulder injuries can be very severe and cause a lot of limitations with work and activity. Shoulder pain is one of the top 5 reasons why people seek out Physiotherapy and Registered Massage Therapy treatments.
What Causes Shoulder Pain?
There are several reasons why people suffer from shoulder pain.
Trauma
– any type of direct or indirect trauma can produce shoulder pain if the arm and/or shoulder is involved
Motor vehicle accidents
Falls
Sports injuries
Violent incidents
Poor workplace ergonomics
– For people who work in offices, they may spend the majority of their time sitting in front of a computer. If the desk set up is not properly, then this may start to produce stress and pain into the shoulder. For example, poor ergonomics can include:
poor desk and screen height
improper positioning of the keyboard and mouse
inadequate chair height and support
Proper desk ergonomics
Poor posture
– Many people have developed poor body postures over time. For some it starts young with spending a lot of time studying. It can also happen after carrying a heavy backpack or playing a lot of video/computer games. For others it starts later in life with workplace demands and poor office set up.
Good-Posture-vs-Poor-Posture
Repetitive activities
– Some people perform tasks that are repetitive at work and/or home. If the shoulder is not strong enough to support the work that it’s having to do, then injury may occur. For example,this can include:
Overhead lifting
Sorting things on a belt
Operating heavy machinery
Typing
Congenital or Developmental changes –
Some people are born with a unique bone structure that may place them at increased risk of injury. For example, the acromion of the shoulder blade can have 4 different shapes. For instance, if you have a hooked shape, there is more potential for rotator cuff injury.
Some Basic Shoulder Anatomy
Having some knowledge of basic shoulder anatomy will help with understanding why shoulder pain develops. The shoulder joint is quite complex. There are a lot of structures that attach to or around the shoulder. The shoulder allows for a lot of movement . As a result, there is less stability through the area. It’s a joint that is held together by soft tissues. Therefore, there is not a lot of bony protection. The shoulder is made of 4 separate joints that work together to allow function:
Shoulder Anatomy
Glenohumeral (GH) joint – this is a ball and socket joint and is where majority of our arm movement happens. The socket is made up by part of the shoulder blade and the ball is made up of the humerus, which is the long bone of the upper arm.
Acromioclavicular (AC) joint – joint between the acromion of the shoulder blade and the collar bone.
Sternoclavicular (SC) joint – joint between chest bone and the collar bone.
Scapulothoracic joint – the joint between the shoulder blade and the ribs at the back of the chest.
The Soft Tissues around the Shoulder Joint
We know that the shoulder is held together by many soft tissues including ligaments, muscles and tendons. Other important structures include the joint capsule surrounding the ball and socket joint. Lastly, your shoulder has subacromial and subdeltoid bursae. The function of the joint capsule is to protect the joint and produce a lubricating fluid. Shoulder bursae are small fluid-filled sacs that act as a cushion between the bone and other moving parts.
Bursae of the shoulder joint
What are some of the types of injuries that can happen to the shoulder?
Sprains/Strains of any of the muscles, tendons and ligaments
Tears/Ruptures of any of the muscles, tendons and ligaments
Rotator Cuff Tear
Rotator Cuff Tendonitis
Tendonitis/Tendinosis
Fractures
Bursitis
Dislocations
Adhesive Capsulitis or Frozen Shoulder
Osteoarthritis
Nerve entrapments/injuries
Signs and Symptoms of Shoulder Injuries
Pain
Swelling
Restricted movement
Weakness
Instability
Bony deformities
Healing Times for Shoulder Injuries
The healing time for shoulder injuries will vary depending on the injury. Most simple sprains/strains will likely take anywhere from 6-8 weeks to get better.
Fractures of the Shoulder can take 6-8 weeks to heal the fracture. After the fracture is healed, the soft tissues may require up to 4-5 months to heal fully with proper Physiotherapy.
However, frozen shoulders can take over 1 year to improve. There are also a lot of individual differences in healing time amongst different people, even for similar injuries. For example, some of these factors can include:
Age
Severity of Injury
Was surgery required ?
Level of fitness and/or mobility
Commitment to treatment
Ability to modify workplace or home environment to allow for best treatment response
Presence of other injuries
Amount of time that the injury/pain has been present
Physiotherapy/Massage Treatment for Shoulder Injuries
Treatment for shoulder pain will depend on the type of injury. It will also depend on the area that has been injured.
However, since the shoulder is made up of 4 joints, treatments should target the whole shoulder and not just the individual area injured. This will allow the shoulder to return to its full function. It will also reduce the risk of re-injury.
In sum, the main goals of any shoulder pain treatment will be to:
Decrease pain
Regain full movement
Recover strength and stability
Return to pre-injury activities
Registered Physiotherapy for Shoulder Injuries
A Registered Physiotherapist will start with a full assessment so that we can identify the source of the shoulder pain. This will allow us to provide the best treatment for you. Treatment can typically include:
Manual therapy
soft tissue work
mobilizations
assisted stretching of the shoulder and nearby areas
Modalities – these are usually used in the early phase for pain relief
Ultrasound
Laser
IFC or TENS
Heat/Ice
Exercise prescription
Movement and strengthening exercises that are specific to the injury
So, it is important that you complete the prescribed exercises on a regular basis at home.
In short, this will ensure that you are continually providing treatment to the shoulder even when you are not physically present in the clinic.
Education
Explanation of the condition
Rationale for the treatment choices
In essence, Do’s and don’ts to help the injury along
Registered Massage Therapy for Shoulder Injuries
Registered Massage Therapy can be very helpful to release tight muscles around the upper back, neck and shoulder blades
Registered Massage therapy for shoulder injuries
Shoulder injuries can be quite debilitating, and it is important to seek out a Registered Physiotherapist for assessment and treatment sooner rather than later. Like most other injuries, the longer an injury is left untreated, the more chronic it becomes. As a result, it makes it more difficult to resolve in a timely manner.
