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The Mysterious Pelvic Floor

Pelvic Floor Muscles


The Mysterious Pelvic Floor


What is The Mysterious Pelvic Floor?

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

Acute Ankle Sprains

Acute Ankle Sprains

Acute Ankle Sprains

How do Acute Ankle Sprains happen?

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

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

Acute Ankle Sprains

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

Registered Physiotherapy for Acute Ankle Injuries

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!

Acute Ankle Injuries

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.

To get started on your Acute Ankle Sprain Treatment, Give PhysioNow a call Today!

Shoulder Injuries

Shoulder Injuries

Shoulder Injuries

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

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

    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 Injury

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.
    • Shoulder Exercise

 

 

 

  • 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
  • shoulder injuries

    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.

Call PhysioNow today to get treatment for your shoulder injury!

 

Accident Rehabilitation

Accident Rehabilitation

Accident Rehabilitation

What is Accident Rehabilitation?

Motor vehicle accidents happen everyday in Ontario.  As a result, they produce a lot of pain, disability and stress for those involved. The impact can be quite debilitating. Accident rehabilitation is treatment that is given after being involved in a motor vehicle accident. It is important to seek out Registered Physiotherapists who are experienced in Accident Rehabilitation to ensure proper recovery. At PhysioNow we offer high quality Registered Physiotherapy and Registered Massage therapy treatments to help you recover from your injuries.

Accident Rehabilitation

Registered Massage Therapy

Who is entitled to receive Accident Rehabilitation?

Any person who has been involved in a motor vehicle accident in Ontario is entitled to receive Accident Rehabilitation benefits . This would include if you were a pedestrian hit by a vehicle.  It would also include coverage for treatment if you were involved in an accident outside of Ontario, but reside in Ontario.  However, if you are  injured and do not have your own insurance, you can still apply for accident benefits. The circumstances of the accident will determine which insurance company will pay for the benefits. For instance, you may be covered by the person that hit you or the Motor Vehicle Accident Fund.

How much accident benefit coverage is available?

The amount of the benefits that you are entitled to depends on the severity of your injuries. There are two categories of benefits available:

  • Minor Injury Guideline (MIG)

    • This plan is for people who have minor injuries including whiplash and sprains and strains.
    • The majority of motor vehicle accident injuries fall within this category
    • The MIG plan is standardized across all of Ontario in terms of its entitlement to Treatment benefits no matter where you receive treatment.
    • If you are under a MIG, the maximum benefit under the MIG is $3500

 

  • Major Injury Guideline (non-MIG)

    • This plan is  for people who have suffered serious injuries from an accident
    • Examples include fractures, surgeries, major neurological trauma and concussions
    • The maximum entitlement under this plan will vary depending on your injuries, but could be up to $65,000.

What is the process of receiving accident benefits?

Once the accident is reported to the insurance company, the  adjuster will ask if there are any injuries from the accident.  The adjuster will send you a package of forms that you have to complete and send back. The adjuster will also likely put you in touch with an approved physiotherapy clinic in the area closest to you. The clinic will then contact you to schedule an initial assessment.

1st visits with a Physiotherapist can take place within 1 day of the accident.  You are also able to go directly to your Approved Physiotherapy Clinic to initiate a claim and get started on your treatment.  The Approved Clinic can get the paperwork started for you.

PhysioNow is an approved company for the purposes of Motor vehicle accidents in Ontario.  PhysioNow is allowed to directly bill your treatment to your Auto Insurance company. They can provide all of the forms that you need to get started.

 

Accident Rehabilitation

Whiplash Pain

What are the most common injuries from a Motor Vehicle Accident?

Most car accidents tend to be minor in nature. The most common types of injuries are:

  • Whiplash

    • Happens when the force of the impact pushes your neck back and forth really fast
    • This causes a sprain/strain of the your muscles and ligaments of the neck
    • Symptoms range from pain, stiffness, numbness/tingling into the arms and hands, headache and loss of motion
  • Thoracic & Lumbar strains

    • The impact causes the joints and muscles of the spine to be over-stretched
    • The mechanism is similar to whiplash
    • Symptoms include pain, limited movement, numbness/tingling into the arms and/or legs, weakness
  • Shoulder strains

    • It is common for the shoulder to get injured in a car accident, especially for the driver – this is because their arms are usually holding on to the steering wheel
  • Concussion

    • Concussions are a form of a traumatic brain injury and can vary from mild to severe
    • It is possible for Concussions to occur as a result of either direct or indirect trauma to the brain
    • The most common symptoms of a concussion are dizziness, nausea, sensitivity to light and sound, headache, fatigue, difficulty concentrating and fogginess
    • Accident Rehabilitation

      Concussion

What can I expect from my first visit at the physiotherapy appointment?

During the initial visit, you will have to complete some forms.  These forms are essential to submitting a successful claim. The experienced administrators at PhysioNow can help you to fill them out to make the process easier for you. The good thing about the  paperwork is that you only need to complete it once! After the initial paperwork, you can focus just on your recovery.

What can I expect from my Initial Assessment with the Registered Physiotherapist at PhysioNow?

Your Registered Physiotherapist will meet with you.  We will start by asking some questions to get an understanding of your injuries. For example, some sample questions can include:

  • How did the accident happen?
  •  Questions that will screen you for more serious injuries that could require further medical attention
  • Locating all the painful areas and injuries that have occurred
  • Details about past medical and injury history

Once this information has been collected, your Registered Physiotherapist will do a full assessment. We will check all of your  affected areas for movement and strength. This will start to give us an idea of the severity of your symptoms. We will then use this information to decide whether you will be classified as either MIG or non-MIG.

After this, we will then  fill out the required treatment plan for you.  In conclusion, we will go over what the plan will look like with you. Lastly, they will discuss treatment timelines and treatment goals. At PhysioNow, there will also be  time allocated  to start some light treatment to give you pain relief.

What kind of treatment will be provided for Accident Rehabilitation?

The types of treatment provided after vehicle accidents  will depend on the nature of your injuries.  It will also depend on  what your Physiotherapist feels is most appropriate for  you, taking into account all of your injuries. As a result, your treatment plan may include a variety of different treatments such as:

  • Treatment will start slowly at first and focus first on pain control,
  • Modalities – Ultrasound, Laser, Interferential Current
  • TherapyManual therapy – gentle soft tissue work, mobilizations, assisted stretching
  • Exercises – range of motion, postural and strengthening exercises
  • Concussion Treatment if needed
  • Education – explanations of the injuries and do’s and don’ts to help the recovery process
  • After that, this will be followed by recovery of movement, and then strength.
  • Lastly, we will work on helping you get back to all of your normal activities both at home and work
  • Neck Pain Treatment

    Accident Rehabilitation

How long will the treatment  take to complete for Accident Rehabiliation?

The length of the treatment plan depends on whether you are on a MIG or non-MIG pathway.

  • MIG (Minor Injury Guidleline)
    • 2 phases
      • 1st phase: 12 weeks in length
      • 2nd phase (if required): additional 4-8 weeks
    • Non-MIG ( Non- Minor Injury Guideline)
      • Timeline is at the discretion of your physiotherapist and will vary depending on your injuries
      • For post-surgical cases or individuals with multiple serious injuries, the timeline can be well over 1 year

As a result, it is very important to seek out Accident Rehabilitation as soon as possible when you have been involved in a car accident. The pain and limitations that you experience after an accident can really affect your quality of life. Therefore, scar tissue from injuries starts to form quickly after an injury.

At PhysioNow we want to help you get back on your feet and back to doing things that are important to you!  Give us a call at 289-724-0448 to get started today!

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome

            Patellofemoral pain syndrome

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome happens when your knee cap does not track properly.  The knee joint consist of two joints.  The tibiofemoral joint which is between the two long bones in your leg and the second one is the patellofemoral joint.  This  is between the femoral condyle (end of thigh bone) and the knee cap. The cartilage on the back of the knee cap glides on the cartilage on the front of the condyles of the femur. The knee cap usually sits in a snug groove at the end of the thigh bone.

Knee movements are controlled by a number of muscles connected to the knee cap. Your  thigh muscle helps to stabilize the knee cap and enables it to move smoothly in the groove.  When this is pulled out of the groove, you can develop Patellofemoral pain syndrome.

Causes of Patellofemoral pain syndrome or Anterior knee pain

Patellofemoral pain syndrome, is one of the most  common causes of pain in the knee. Pain is usually felt under the knee cap.  This is where it glides on the femur/thigh bone. If you have patellofemoral pain syndrome, it hurts when you bend and straighten your knee . There are a number of factors which can cause the pain.

Common Causes of Patellofemoral pain syndrome

  • Weakness in the hip and thigh muscles-Weakness in the thigh muscles can cause increased load which may lead to pain. Pain in your knees will further limit the activity of your muscles and over time can cause further weakness. Weakness of the inner thigh muscle  will affect the movement of the knee cap as you do your normal activities. Weakness in your hip muscles also can affect activities like climbing stairs and walking.
  • Excessive loading or rapid increase in the load for muscles around the knee-Depending on your usual activities, your knee will have a level of activity that is tolerated by your joint. Rapid increases in loading of activity may lead to a highly irritable or sensitive joint. This can cause Patellofemoral pain syndrome.
  •  Posture or position of hip, knee and feet-Flat feet or excessive turning in of feet can change movement mechanics further up the leg and cause excessive strain in your knee cap.
  • Tight muscles around the knee-Tightness in the muscles can reduce the movement of your knee and affect  how your joint works . This will lead to excessive loading during activities. The common muscles that become tight are your hamstrings, Quadriceps, Iliotibial band and calf.
  • Previous injury or dislocation of knee cap
  • Desk top work, where a lot of sitting can cause pressure on the kneecap.
  • Irritation of fat pad around the knee
  • Tendinitis of quadriceps tendon
  • Bursitis around the knee
  • Osteoarthritis

When poor biomechanics are repeated with each step of your walking and running it may lead to a highly sensitive joint and Patellofemoral pain syndrome.

Symptoms

  • The onset of  knee cap pain is normally gradual rather than traumatic.
  • Pain at the front, back and sides of the knee with or without swelling.
  •  Bending and straightening of knee can cause pain.
  • Pain after prolonged sitting or when you keep the knee bent for longer periods of time.
  • Clicking or grinding when you bend or straighten your knee.
  • Pain when you go up and down the stairs, up hill /down hill, squatting, running or jumping.
  • Poor knee control or stiffness

Physiotherapy Treatment

Patellofemoral Pain Syndrome treatment

  • Physiotherapy is the most effective treatment for short- and long-term management of Patellofemoral pain syndrome. Your Physiotherapist will fully assess you on your first visit to identify your functional limitation. They will also help to set goals and identify contributing factors for the pain.   They will  provide a customized rehabilitation program.
  • In the initial phase of rehabilitation, treatment is directed towards reducing the pain, swelling and muscle inhibition. To do this PhysioNow will  use electrotherapy modalities, acupuncture, rest, taping, gentle motion or joint mobilization and muscle setting exercises.
  • Once the pain and swelling reduces, treatment is focused towards modifying the  factors that have been identified as a cause for the problem.
  • Rehabilitation typically emphasizes increasing strength and pain free movements.  It also will address postural correction, improving the  stability of the pelvis, balance and functional abilities.
  • Stretching exercises to address the tight muscles and strengthening the weak muscles will improve your load tolerance.
  • Successful rehabilitation requires adherence to your exercise program .
  • You will also need to reduce the aggravating movements and slowly build the endurance and strength for those activities over time.
  • Prior to discharge you will be given a safe progression of exercises and functional activities.
  • For long term management, your foot and knee control will be assessed by your Physiotherapist.
  • As a result, you may require  custom foot orthotics to correct your foot position.
  • This will  help to improve foot and knee control.
  • Others might need a hip stabilization program and your Physiotherapist will be happy to discuss with you the long term rehabilitation plans if this is needed.Custom orthotics for Patellofemoral Pain syndrome

How long it will take to get better?

We expect to see improvements with Physiotherapy over a 3 to 6-month period.   Further improvements continue beyond this period. Adherence to your specific exercise program is important in maintaining the improvement. Most people will get back to their normal function with rehabilitation in the short term. Many patients can continue in their chosen activity during rehabilitation.  Some modification of activity may be all that is needed.

If you play sports, you will need to do sports specific exercises to ensure a safe return to sports. It is good to wear proper supporting footwear to help keep your feet in a good position.  This will  improve alignment of your knees.

How to book an appointment with a Physiotherapist at PhysioNow?

We have four Physiotherapy clinics of which three are located in Mississauga and one is in Etobicoke. You can call 289-724-0448 to book into any of these clinics  for an appointment with a Physiotherapist.

Most of the time we can arrange your initial visit on the same day in a location which is nearest to you. Your initial appointment will be a one to one 40-60 minute session with a Physiotherapist which includes treatment as well on the first day.

Your follow up appointments  will typically take  40 minutes.  Normally, we would recommend 2 to 3 sessions per  week depending on the factors identified on initial assessment, treatment plan and your goals.  If you have limited funding available, we will be happy to work with you to develop a home exercise program.

Please call today to get started on your treatment for Patellofemoral Pain Syndrome at PhysioNow!