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What is a fracture?

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If you have a fracture, it means you have broken a bone.  Fractures are common injuries and they can happen to people of all ages, from the very young to the very old.  Common areas where fractures happen include shoulder, spinal vertebrae, elbow, wrist, knees and ankle.  Majority of fractures occur with trauma to the bone – either from a fall or a blunt force.

Fracture

How do you know that you have a fracture?

Most people can usually feel that they have broken a bone because the signs and symptoms can be very obvious.  These include:

  • Swelling or bruising over a bone
  • Deformity around the injury area, such as arm or leg
  • Pain that gets worse with any movement or added pressure
  • Inability to put any weight through the joint
  • Protruding bone through the skin (in the case of open fractures)

Is it always obvious that you have a fracture?

In some cases, fractures are less obvious.  For example, some ankle fractures may look a lot like ankle sprains. The patient may not even know that it was a fracture until it shows up on an X-ray.  Similarly, fractures through the spine may feel a lot like back pain initially.  This is due to the structural make-up of the spine.  However, one of the most key features of a spinal fracture is that it occurs after some sort of trauma, most commonly a fall.  Therefore, if there is a traumatic event reported, it is important for the physiotherapist to to rule out any potential spinal fracture by doing a thorough assessment.

Are some people more prone to fractures compared to others?

Yes!  For most people, fractures happen after a traumatic event and it takes quite a bit of force to break a bone.  However, for people who have osteoporosis, fractures can happen with very minor stumbles or movements.

What is osteoporosis?  It’s a medical condition where the bones become fragile or brittle from loss of bone tissue.   Fractures associated with osteoporosis are called fragility fractures and they occur due to the weakness of the bone itself.  For a person with this medical condition, their bones can be injured with traumas that would not normally affect the average person.  If someone presents with back pain and they have had trauma, even a minor one, the therapist has to ask whether they have osteoporosis to rule out potential fragility fractures.

How are fractures diagnosed?

Whenever there is a suspicion of a fracture, X-rays are necessary to confirm the presence of the fracture.  The x-ray will also show the exact location and severity of the fracture.  However, in some cases, an X-ray may not be sensitive enough to show the fracture.   In these situations, more sensitive tests like a CT, MRI or bone scan will be better options.

Are all fractures the same?

No, fractures are not all the same.  In fact, there are 4 main classifications:

  • Displaced – the bone snaps into 2 or more parts and moves so that the two ends are not lined up straight.
  • Non-displaced – the bone breaks partly or all the way through, but the ends remain lined up
  • Closed – bone breaks but there is no puncture wound in the skin
  • Open – bone breaks through the skin

There are also 7 different types of fractures to describe the specific nature of the break:

  • Greenstick – incomplete fracture, where the broken bone is not completely separated
  • Transverse – the break is in a straight line across the bone
  • Spiral – the break spirals around the bone, common in a twisting injury
  • Oblique – the break is in a diagonal line across the bone
  • Compression – the bone is crushed, causing the broken bone to be wider or flatter in appearance
  • Comminuted – the break is in three or more pieces
  • Segmental – the same bone is fractured in two places, so there is a ‘floating’ segment of bone

Moreover, if you wish to know more about fractures and their types visit the here, https://www.webmd.comFra/a-to-z-guides/understanding-fractures-symptoms

What is the treatment for fractures?

The medical treatment for fractures depends on the type of fracture.  The fractured ends of the bone must be set in their proper place and held there for the bone to heal properly.  This process is called reduction.  Most fractures are repositioned without the need for surgery.  This is called closed reduction.  Once the bones are in proper position, the joint will be in a cast so that the bones can heal.  The length of casting is usually 6 weeks because that is how long it typically takes the fractured bones to heal.  However, there are circumstances where the period of immobilization may be either shorter or longer depending on the nature of the fracture.

In contrast, open reduction is done for fractures that are more complicated.  In these cases, the repositioning of the bones is done during surgery.  The surgeon will use screws and or plates to keep the bone fragments in proper position to allow for healing.  Just like with closed reductions, there will be a period of immobilization after open reduction surgery.  Furthermore, depending on the fracture and the needs of the patient, the hardware may either be left in permanently or taken out with another surgery once the fractured bone has completely healed.

There are however some fractures that cannot be effectively immobilized such as spinal and rib fractures.  For these types of fractures, the affected area is protected with avoiding certain activities or postures.

How long does it take for a fracture to heal?

Most uncomplicated fractures take approximately 6 weeks for the bones to heal.  Although medically, the injury would have healed, functionally there may still be a lot of limitations. For fractures that are more complicated and required surgery, the healing times may be a little longer due the surgery.  There are also some people who will heal at a slower rate because of various health conditions or medication use.

What happens after the cast is taken off?

Once the fracture itself is healed, there may still be some remaining limitations from the injury.  Because the fracture would have been immobilized for several weeks, there will a significant loss of range of motion and strength in the affected joint.  Physiotherapy is an important part of your recovery.  A Registered Physiotherapist can help you recover all your function after your fracture.  It is important to follow up with physiotherapy to make sure that you can safely return to all your previous activities.  A registered physiotherapist will assess the limitations and prescribe the necessary range of motion and  strengthening exercises and get patients back to their expected quality of life.  The physiotherapist may also use manual stretches and mobilizations to help improve your mobility.

Do not let your fracture hold you back from living your life.  Call PhysioNow today to book your appointment to see a Registered Physiotherapist!

Applewood Physionow, Erin Mills Physiotherapy Ltd., Etobicoke Physiotherapy, Frozen Shoulder, General Category, Hurontario-Eglinton PhysioNow, Long Branch PhysioNow Ltd., Lorne Park PhysioNow, PhysioNow, Physiotherapy

FROZEN SHOULDER

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WHY DO I HAVE SHOULDER PAIN

You haven’t done anything to hurt your shoulder. However, you may find yourself unable to move your shoulder and it may cause serious pain if you try. This is a condition known as Frozen Shoulder, and it can greatly affect your daily life.

Frozen shoulder, also known as Adhesive Capsulitis is a condition that leads to a painful loss of range of motion in the shoulder joint.

frozen shoulder

frozen shoulder

SYMPTOMS 

It causes persistent shoulder pain, inflammation and stiffness in the connective tissue of the shoulder. Therefore, the condition is known to gradually worsen over time.

These persistent symptoms can make daily tasks extremely painful and challenging.
Frozen shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue, which causes a painful restriction in range of motion. However,  without proper treatment, this shoulder condition can last for years.

Things you should do to Heal Your Frozen Shoulder

Frozen Shoulder can be caused by many different factors but it always results in pain and reduced motion.

HOW LONG SHOULD IT TAKE FOR A FROZEN SHOULDER TO HEAL?

Frozen Shoulder, on average, can take between 6 months to 2 years, to heal. If you don’t want to suffer for the next 2 years and take painkillers that really don’t help much, follow these tips:

TIPS TO HEAL 

• Pay Attention to Your Posture and Sleeping Position
If you have frozen shoulder, you are vulnerable to reduced sleep quality.
This is especially true during the first stage or the freezing stage, which is the phase when you will feel the most pain.
However, getting adequate sleep promotes healing and reduces inflammation.
To help you stay comfortable as you sleep, you can put a pillow under your affected arm, with your hand resting on your stomach.
If you tend to sleep on your side, make sure you don’t sleep on your affected shoulder. In addition, place your affected arm on a pillow across your chest as if hugging it.
When you are standing or sitting, make sure you have good posture. Keep your shoulders back and avoid slouching or slumping to help ease your pain.
• Regularly Use Your Affected Arm

WILL IT HELP TO KEEP YOUR SHOULDER IMMOBILE?

Keeping your arm and shoulder idle will not help with the healing process.  Moreover, resting these parts all the time will only worsen your condition.
One of the most common causes of a frozen shoulder is reduced or total immobility, which may be due to factors like a broken arm, stroke, recovery from surgery, or a shoulder injury. As a result, if you keep your arm and shoulder immobile, the capsule that encases the joint thickens and tightens.

EXERCISE AS THERAPY

On the other hand, if you perform gentle exercises as prescribed by your therapist, you can improve your shoulder’s strength and range of motion.

• Stretches
Keep your shoulder moving throughout the day
Stretches may help to increase flexibility, improve range of motion, and prevent injury. Some examples of stretches includes the following:
Firstly, standing arm lifts
1. Make fists with your hands and bring them in front of your hips.
2. Inhale as you lift your arms overhead so your hands come together above your head.
3. Lower your arms down to the original position.
4. Repeat 10 times.

Secondly, cross arm stretch
1. Bring your left arm across the front of your body at about chest height.
2. Support your left arm with the elbow crease of your right arm or use your right hand to hold your left arm.
3. Stretch out your shoulder and continue to face forward.
4. Hold this stretch for 30 seconds.
5. Repeat on the opposite side.

Lastly, shoulder rolls
1. Maintain good posture while standing or sitting.
2. Roll your shoulders up, back, and down.
3. Do this movement 10 times.
4. Then, roll your shoulders up, forward, and down 10 times.

PHYSIOTHERAPY AS TREATMENT

• Do Not Skip Your Physical Therapy Sessions

One of the most important aspects of your treatment plan is physical therapy.
Physiotherapist will teach you exercises that focus on stretching the joint capsule. As a result, when your condition improves, you can move on to strengthening exercises.
In conclusion, if you have a frozen shoulder, make sure you attend all physical therapy sessions to keep your progress on track.

If you would like to learn a bit more about your shoulder , this will show you  a bit more  :  https://teachmeanatomy.info/upper-limb/joints/shoulder/

DON’T WAIT TO START PHYSIOTHERAPY  TREATMENT

However, If you notice tension or tightness in your shoulders, it’s important to take steps to relieve the tension as soon as possible. As a result, early treatment can reduce the risk for complications.
In conclusion, it’s a good idea to exercise, to loosen up your shoulders even if you don’t have severe tightness. Try to bring your awareness to this area of your body throughout the day, and work on relaxing and releasing tension.
If you’re experiencing long-lasting or intense pain, Book a consultation at PhysioNOW with a Registered Physiotherapist today.

Applewood Physionow, Erin Mills PhysioNow, Hurontario-Eglinton PhysioNow, Long Branch PhysioNow Ltd., Lorne Park PhysioNow, Pelvic Health, PhysioNow

What is Pelvic Health in Men?

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Pelvic health in men is a topic lacking attention, recognition, and research.  More specifically, issues with the pelvic floor affect many men and can be very disruptive to their lives.  Consequently, pelvic floor physiotherapy helps us accept, understand and treat the pelvic related issues for men.

Pelvic health

Causes of pelvic health issues for men

There are several pelvic health issues for men.  For example, some of the common problems faced by men are:

Incontinence

  • 1 in 9 men are incontinent
  • Incontinence means loss of urine in small volume or dribbling by coughing, sneezing, laughing, lifting, exercise or transitional movements.
  • Risk Factors for incontinence include Obesity, Chronic illness, Medication, Smoking, Chronic straining, Radical Prostatectomy, and Prostate enlargement
  • Consequently, there are a lot of social issues related to incontinence, including:
    • Decreased self esteem
    • Depression
    • Isolation
    • Reduced social activity
    • Reduced/Disrupted physical activity

Erectile dysfunction 

  • There may be physical or psychological factors that could cause erectile dysfunction.
  • Risk factors can include Diabetes, heart conditions, tobacco use, being overweight, drug or alcohol use or any psychological conditions.

Pelvic pain syndrome 

  • Pelvic pain syndrome can include a number of different conditions.
  • More specifically, pelvic pain includes  or pressure/ throbbing in pelvis, rectum, or genitals.
  • Additionally, there may also be bowel and bladder problems.

Nocturia 

  • Waking at night multiple times for voiding.

Tight Pelvic Floor

  • The pelvic muscles around your sacrum and pelvis are like a hammock supporting your internal organs.
  • They contract for preventing dribbling and relax for urination.
  • Therefore, tightness through these muscles may interfere with their normal function.

Hypertonic Vs Hypotonic Muscles 

  • A hypertonic muscle is a muscle in too much tension, which causes pain or urgency of the bowel and bladder.
  • In contrast, hypotonic or low muscle tone may not be able to hold the pelvic structures in place and cause prolapse.
  • Additionally, there could also be a mixed presentation involving both situations.

Chronic Constipation

  • Constipation is a common cause of damage to muscles and ligaments around pelvic area.
  • Consequently, it can result in over-stretching of nerves due to prolonged and repetitive strain
  • Therefore, chronic constipation can lead to weak muscles around the pelvis.

Additionally, falls, traumas and sports can injure the pelvic floor muscles

Precautions for pelvic health issues in men 

Modifications of risk factors helps prevent and keep up the pelvic health of men.  Some of these modifications include:

  • Reduction of the strain on the pelvic floor muscles
  • Weight loss with an appropriate diet
  • Working with your doctor to manage diabetes and heart disease.
  • Limiting alcohol
  • Stopping the use of tobacco and drugs
  • Regular exercise
  • Mental health care

What is Pelvic Health Physiotherapy? 

Firstly, the Registered Physiotherapist will take a history of the symptoms and any relevant medical information.  Secondly, the therapist will examine the external and internal muscles and soft tissues related to the pelvic area.  Specifically, this helps in identifying any dysfunctions or limitations.  Finally, the Physiotherapist will then develop an individually tailored treatment plan based on the findings and diagnosis.

Physiotherapy treatment for pelvic health can include:

  • Manual Therapy like mobilization, myofascial and trigger point release
  • Exercises like stretching, strengthening, and specific posture correction and breathing exercises
  • EMS – electric muscle stimulation helping contract the weak muscles
  • Biofeedback – Helps you understand how and when to effectively activate the muscles
  • TENS to relive pain
  • Bowel and bladder tracking
  • Education
  • Self care – Avoid pushing or straining when urinating. Relaxing methods such as warm baths, stretching with yoga, and maintaining good posture helps the pelvic floor muscles.

All in all, don’t let pelvic health issues to affect your life.  Remember prevention is better than cure.  Call PhysioNow today to book your assessment!

 

Applewood Physionow, Erin Mills PhysioNow, Hurontario-Eglinton PhysioNow, Long Branch PhysioNow Ltd., Lorne Park PhysioNow, PhysioNow

Physiotherapy – 5 things to expect from your appointment

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There are more and more people who are using physiotherapy services to help them recover from their injuries and pain conditions.  However, there are also a lot of people who do not understand what physiotherapy can offer.  Physiotherapy plays an important role in keeping people healthy and active.

Physiotherapy

What is physiotherapy?

Physiotherapy is a health care profession that helps people regain their strength and function.  A Registered Physiotherapist will do an assessment that helps them understand the nature of the patient’s problem.  They will then develop a treatment plan.  More specifically, the treatment plan will address the limitations that is not allowing them to live out their best quality of life.  The main goals of physiotherapy is to restore, maintain and improve strength, function and movement.

What kind of symptoms can physiotherapy help treat?

  • Pain
  • Decreased range of motion
  • Weakness
  • Limited flexibility
  • Loss of function
  • Poor balance
  • Dizziness/Vertigo

What kind of injuries can physiotherapy treat?

How do you go about seeing a Registered Physiotherapist?

Most people have at least one friend or family member who has received physiotherapy for an injury.  For example, people will usually ask their friends or family for clinic recommendations.  If none are available, then most people will do a quick google search to see their options.  Once they find a clinic that appears reputable and is easily accessible, then the next step is to call the clinic and book an assessment.  A lot of first-time patients feel some anxiety about starting physiotherapy because they do not know what to expect from the appointment.

What is a physiotherapy assessment?

The assessment is an important first step in starting your physiotherapy program.  During the assessment, the patient will meet with a registered physiotherapist who will assess the patient’s condition.  What are some of the typical things to expect during a physiotherapy assessment?

1. Conversation with the physiotherapist.

The physiotherapist will ask some details about the patient’s pain or injury.  This helps the physiotherapist gain an understanding of their specific condition.  More specifically, the answers will help the physiotherapist form some potential diagnoses.  For example, some questions the physiotherapist may ask include:

  • When did the pain start?
  • Was there a specific incident that started the pain?
  • Has the pain changed since it first started?
  • Is your pain better in morning, afternoon or evening?
  • What activities or positions make the pain feel worse?
  • What activities or positions make the pain feel better?
  • Have you had this type of pain in the past?
  • Have you had any other injuries in the past?
  • What kind of work do you?
  • How is your general health?

2.  The physical assessment.

During this part of the assessment, the physiotherapist will ask the patient to do certain movements and tests.  The physiotherapist will observe what happens to their pain in response to these tests.  The type and amount of testing that is done will depend on the specific injury.  The physiotherapist may also check a patient’s strength levels, neurological signs, balance and any other tests that will help them arrive at a potential diagnosis.

3.  The patient should expect to do a fair amount of movement during the appointment and should be dressed in comfortable clothes.

Comfortable clothing, such as gym or yoga wear, is recommended for physiotherapy sessions.  For patients who have knee injuries it is suggested that they wear a pair of shorts.  Patients who are coming in for shoulder injuries, should wear a sleeveless top.  This will help give the physiotherapist better access to the injured areas so that they can see and feel what’s happening.

Physiotherapy is an active treatment program and patients should be dressed the part!

4.  The physiotherapy treatment.

Once the physiotherapist understands the patient’s condition, they can develop a treatment plan to address their limitations.  In most cases, treatment is started immediately after the assessment.  Furthermore, the exact type of treatment that the physiotherapist will provide will depend on the patient’s condition.  For example, a physiotherapy session may consist of a number of different treatments, including:

  • Education

    • The physiotherapist will help explain their assessment findings and their impression of the condition
    • Additionally, the physiotherapist will explain some of the DOs and DON’Ts to help the patient achieve their best recovery
    • They will also educate on best postures and the use of ice or heat for pain management

  • Manual therapy

    • The physiotherapist may find it beneficial to do some hands-on work for the injury
    • More specifically, manual treatment may include soft tissue releases, joint mobilizations and passive stretches

  • Exercise therapy

    • A key component of physiotherapy is helping to regain mobility and strength
    • The physiotherapist will provide exercises that will help regain any lost range of motion and strength
    • The physiotherapist will also continue to progress the exercises as the patient shows improvement with their exercise program
    • The goals of the exercise program are to improve the functional abilities of the patient and help them get back to their regular activities

  • Electrical modalities

    • A physiotherapist may use some electrical modalities to help manage pain or promote healing depending on the injury
    • Some examples of electrical modalities include Interferential Current, Ultrasound and Laser

5.  The patient should expect to be present at the clinic for at least 1 hour for their assessment.

The amount of time that it takes to complete the first visit can range anywhere between 45 mins to 1 hour.  More specifically, if the condition is very complex or the patient has a lot of movement limitations, the assessment may take longer.  The physiotherapist needs a good amount of time to do a thorough and accurate job of understanding the patient’s injury.

Once the assessment and first treatment are complete, the physiotherapist will make recommendations for future appointments.  For most patients, it is recommended that they book at least two appointments a week for 3-4 weeks and then depending on their recovery, they can start to wean off.  Some patients will have a quick recovery and may not need a lot of treatments.  Others may have more chronic or severe injuries that may need several weeks or months to improve.  The physiotherapist will make sure that the patient is receiving the amount of treatment that they need to get the fastest possibly recovery.

Physiotherapy has an important role to play in the recovery and management of a lot of conditions.  Its focus on active participation and exercise makes sure that patients maintain their function and experience a better quality of life.  Call PhysioNow today to book your physiotherapy appointment!

 

Applewood Physionow, Erin Mills PhysioNow, General Category, Hurontario-Eglinton PhysioNow, Long Branch PhysioNow Ltd., Lorne Park PhysioNow, PhysioNow

Benefits of Custom Knee Braces

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The custom knee braces are useful for many reasons.  The most common reasons are to correct alignment or stability of the knee.  Therefore, the brace allows people to continue to be mobile and active despite their knee injury or pain.  At PhysioNow, we have custom knee braces available from DonJoy, Breg and Ossur.  A Registered Physiotherapist with training in knee braces  will recommend and measure the brace that’s the most appropriate for the needs of the patient.

Custom Knee Brace

Types of Custom Knee Braces

There are different types of braces for different types of knee conditions.  The custom knee brace needs to be specific to the condition for it to be effective.  Some examples of the types of custom knee braces include:

Brace for ligament instabilities

The main ligaments of the knee that give the knee stability are the ACL, PCL, MCL and LCL.  These injuries occur during sports or recreational activities where there is trauma or physical contact and overstretching of the structures occurs.  These ligament braces help provide stability to the knee.  These are commonly prescribed either before or after surgery for limiting the damage to an already injured area.  These braces also help to avoid further complications from surrounding structures.

Rebound Knee brace

This brace is also known as a custom cartilage or unloader brace.  It is specially made for offloading a structure or part of the knee that is damaged.  These include the cartilage or menisci.  The purpose of these braces is to allow improved weight bearing ability and increased activity tolerance.

Osteoarthritic custom knee brace

These braces follow the same principle as mentioned above, to unload the knee, especially when walking or during weight bearing activities.  With arthritic joints, we often notice an unbalanced joint loading as the condition worsens.  The brace helps in distributing equal weight and preventing excessive loading to the opposite leg. The counterforce provided by the brace helps remove tension on the structures underneath.

What are the benefits of a custom knee brace?

  • Custom knee braces can help individuals with existing knee injuries and be beneficial in rehabilitation
  • They can help improve quality of life so you can do what you love everyday by increasing stability and reducing the pain or stress on joints and other structures
  • These braces can enhance the efficiency when bending, crouching, or lifting heavy weights by reducing joint compression and shock absorption during the movements
  • Custom knee braces can assist the athletes and improve performance with increased stability and support through the knee

Fitting & Prescription of custom knee braces

It is advisable that patients wear the knee braces directly on their skin.  However, occasionally it can cause irritation on more sensitive skin.  But wearing it directly on your skin prevents the brace from sliding, which may interfere with its effectiveness.

Fortunately, there is usually health insurance coverage for custom knee braces. However, the exact coverage varies with individual plans.  Therefore, at PhysioNow, we start with a consultation to go over your specific needs and recommend the best bracing option.  We then do the measurements for the brace and send this information to the insurance company to determine how much coverage is available.  A doctor’s prescription is usually required as well.

Don’t let your knee pain stop you from living your life.  Call PhysioNow today to set up a consultation for a knee brace!