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Foot Pain Management Mississauga, Foot Pain Treatment Mississauga, General Category, Shockwave Therapy

What You Should Know About Your Achilles Tendinitis

March 6,2024 Erin Mills Physiotherapy Leave a comment

What is the Achilles tendon?

The Achilles tendon is one of the strongest tendons in the human body. Anatomically, it connects our calf muscles to the back of the heel bone. Its main action is to point the toes and ankle downwards when our foot is off the ground or raise the heel off the ground when our foot is on the ground.

Functionally, it is used whenever we are engaged in walking, running, or hopping-like activities and helps us with force production and shock absorption. The tendon is extremely strong and can withstand high amounts of stress Unfortunately, this can also predispose it to injury and cause ankle pain.

Stages of Achilles tendon injuries

Diagram showing the different stages of Achilles tendon problems

1) Achilles tendinitis: Inflammation has developed or is developing in the tendon.

2) Achilles tendinosis: There is now degeneration along with or as a byproduct of the inflammation. This is usually an issue that takes a long time to occur. For example, if an Achilles tendinitis is left untreated for months, it can eventually transition into the tendinosis.

3) Achilles tendon tear or rupture: As the tendon fibers are weakened from the tendinosis, it increases the chance that they can tear entirely.

What is Achilles tendinitis?

Achilles tendinitis means inflammation has developed in the tendon. Potentially, due to overuse of the tendon or a trauma like a fall or sport injury. Inflammation is the human body’s natural and healthy reaction to any kind of injury or disease. However, when it lasts for too long it can start to have negative effects. The inflammation can be rated as minimally painful to severely painful. At this last stage is where a patient’s walking ability can be compromised.

Causes of Achilles tendinitis:

1) Trauma: Direct trauma on ankle during car accident, fall etc

2) Running, dancing, jumping: Constant high impact movements increase the risk of injuring the Achilles tendon

3) Flat feet: Having flat feet may change the weight distribution in the foot and put extra pressure on the tendon

4) Playing Sports: Playing less frequent sports does not allow their body to take pressure regularly and increases the chances of injury

5) Heavy standing job: Constant being on feet increase the chances of injury

6) Bony spur in heel / Plantar Fasciitis/ Ankle fracture:
Extra fluid from swelling or bony protrusions in the ankle can rub against the tendon causing an injury.

7) Calf, knee, or hip muscles weakness:
Muscle strength imbalances can cause compensations in the tendon and increase the stress it is exposed to.

Sign and symptoms of Achilles tendinitis:

1) Pain and inflammation in back of heel bone
2) Stiffness and tenderness in ankle
3) More pain after any strenuous activity
4) Leg weakness
5) Worse in the morning, might improve as day goes by

Diagnosis

Book your assessment with a registered physiotherapist. They will assess your posture, leg alignment, range of motion of joints, muscular strength and determine the source of your pain.

Additionally, diagnosis may be achieved through imaging like Diagnostic Ultrasounds and MRIs.

How do I treat it?

In the beginning, non-invasive therapy will help to treat the condition.

1) RICE protocol

Rest: Stop doing activities that stress your tendon. Switch to low-impact activities, such as swimming, that put less stress on the Achilles tendon.

Icing: Put ice on your tendon for up to 20 minutes, as needed throughout the day.

Compression: Compress, or put pressure on, the tendon using an athletic wrap or medical tape.

Elevation: To reduce swelling, lie down and raise your foot on pillows so it’s above the level of your heart.

2) Shockwave therapy:

Shockwave therapy can be an effective treatment for this condition.

Shockwave therapy may help improve the condition, especially for stubborn conditions that have lasted over 6 weeks.

3) Physiotherapy:

Muscle release, stretching and strengthening exercises will help improve the tendinitis.

4) Orthotics:

Proper footwear and the use of custom orthotics will help support the foot and ankle, putting less stress on the tendon.

Achilles pain? Look for PhysioNow!

If you are looking for treatment for your Achilles pain, or any other type of foot, ankle, or sport injury, look no further. PhysioNow has many expert Registered Physiotherapists prepared to help you with diagnosis, treatment, orthotics, bracing, shockwave therapy and more. With locations across Burlington, Oakville, Mississauga , and Etobicoke we have you covered. Book PhysioNow today for your first assessment and treatment.

General Category

Plantar Fasciitis: Physio 101

December 7,2023 Erin Mills Physiotherapy Leave a comment

What is plantar fasciitis?

As the name suggests, plantar fasciitis is inflammation of the plantar fascia — a tough, fibrous band of tissue that runs along the sole of the foot. Plantar fasciitis is one of the most common causes of heel pain. It commonly causes stabbing pain, especially with your first few steps in the morning or after being off your feet for a while. As you get up and move, the pain normally decreases. Eventually, it might return after long periods of standing or when you stand up after sitting. It is more common in runners and in people who are overweight.

What are the symptoms?

Stabbing pain in the bottom of your foot near the heel
The pain is usually the worst with the first few steps after a long sleep, long periods of standing or getting up from sitting

What are the causes?

Inflammation and pain in the fascia can be caused by:

An increase in activity level (like starting a walking or running program)
Structure or shape of the foot
Surfaces on which you stand, walk or run
Type of footwear
The weight you carry

What are the risk factors?

Even though plantar fasciitis can develop without an obvious cause, some factors can increase your risk of developing this condition. These include:

Age – Plantar fasciitis is most common in people between the ages of 40 and 60
Certain types of exercise – Activities that place a lot of stress on your heel and attached tissues. For example, long-distance running, ballet dancing and aerobic dance can contribute to the onset of this condition
Foot mechanics – Flat feet, a high arch or even an atypical pattern of walking can affect the way weight is distributed when you are in standing. Subsequently, this can put added stress on the plantar fascia
Obesity – Excess weight can put extra stress on your plantar fascia
Occupations that keep you on your feet – Commonly, factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces are at increased risk.

Plantar Fascitis and Physiotherapy:

1. Stretching and Physical Therapy

Stretching is one of the best treatments for plantar fasciitis. A physical therapist can show you stretching exercises that you can repeat at home several times a day. Along with stretching, the exercises can also strengthen your lower leg muscles, helping to stabilize your ankle.

2. Icing and Medication

Icing the sore spot on your foot several times a day may help with pain and inflammation. Additionally, your doctor may also recommend nonsteroidal anti-inflammatory medication.

3. Rest, Activity Modification and Orthotics

It helps to keep the weight and stress off your foot, at least partially, while your plantar fascia is healing. Your doctor may recommend a combination of treatments.

4. Shock Wave Therapy

Shockwave therapy applied to a patient's heel

Image by pvproductions on Freepik

This therapy is based on delivering low-energy or high-energy shock waves to a specific area. Then, the shock waves create microscopic trauma, which triggers a healing response from the body. This process is thought to help promote healing in the plantar fascia.

Our team of expert physiotherapists at PhysioNow are prepared to help you with your foot pain. They will help diagnose and guide you through a treatment to reduce pain and improve your quality of life. Book your first appointment with PhysioNow today!

Custom orthotics, Foot Pain Treatment Mississauga, Health and Wellness

Orthotics, 4 Reasons To Get Them!

July 31,2023 Erin Mills Physiotherapy Leave a comment

Orthotics

Orthotics are specially designed equipment that provide support to the feet and ankles to improve your lower body’s alignment. Since the body is all interconnected, misalignment at the feet can lead to compensation at the knees, hips, and lower back and contribute to pain and dysfunction in those areas. Thus, orthotics are a great tool to help correct this and alleviate pain and discomfort in the body. In this blog, we will go over how they work and how they can improve your quality of life.

1. Relieving Pain with Orthotics

Pain points in the feet

The biggest reason that people seek physiotherapy is to address either pain or discomfort somewhere in their body. Orthotics are invaluable help here as they offer targeted support to areas to relieve strain and pressure on joints, muscles, or ligaments. thus, they can redistribute weight more evenly across the foot and are most commonly used in conditions like plantar fasciitis or heel pain. Some individuals also choose to wear them for comfort.

2. Correcting biomechanical imbalances

Healthy foot vs flat foot

Flat foot and custom insole

Biomechanics is the study of how the body moves. Orthotics can play a big role in correcting these biomechanical imbalances such as overpronation as shown above, (flat feet, fallen arch or feet rolling in) or oversupination (high arches or the foot rolling outwards), which may cause a chain of effects through the rest of the body. Your physiotherapist may suggest orthotics to promote proper alignment, support the arch of the foot, and optimize foot positioning to reduce the risk of injuries and pain due to poor biomechanics.

3. Improve performance

For athletes and active individuals, orthotics can help improve your game. Additionally, the right pair can create small biomechanical advantages to create significant performance improvements by providing stability, decreasing energy expenditure, and preventing injuries. Moreover, they can be tailored to each athlete to suit their individual needs and maximize your potential.

4. Reduce postural strain with orthotics

Custom measuring

Poor posture can lead to significant problems from knee to back to neck pain. Additionally, postural correction exercises, orthotics can be a huge help with achieving optimal postures that minimize the amount of strain on the muscles and joints in an upright position. Thus, by ensuring the body has a proper base of support, orthotics help correct the optimal alignment of our body. In doing this you are minimizing the energy expenditure needed to maintain the position.

Orthotics offer a wide variety of benefits from reducing pain to correcting posture and imbalances. They are a great complement to physiotherapy treatment and are very popular due to their customizability. As shown below, orthotics are custom made for each individual using a foam imprint. This ensures that they will address your specific needs and fit perfectly.

Foam imprints for custom fit

If you are interested in getting a pair or are wondering whether if they may be the solution to your pain, contact PhysioNow today. We have many experienced physiotherapists that can conduct a postural and gait assessment on you to determine whether orthotics are right for you and which modifications to get. Book with PhysioNow today for your first assessment and treatment!

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Patellofemoral pain syndrome

November 16,2018 Sharon Tierney Leave a comment

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

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.

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!

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Fracture Rehabilitation

November 5,2018 Sharon Tierney Leave a comment

Fracture Treatments Mississauga, Etobicoke & Oakville _ PhysioNow

Fracture types

Fracture Rehabilitation

Fractures are common injuries . They can happen to people of all ages, from the very young to the very old. The majority of fractures occur with trauma to the bone. It could be either from a fall or a blunt force. Most people can readily feel that they have a broken bone. This is because the signs and symptoms can be very obvious.

Some of these indicators of Fracture are:

Swelling or bruising over a bone
Deformity of an arm or leg
Pain that gets worse with any movement or added pressure
Inability to put any weight through the injured area
Protruding bone through the skin (in the case of open fractures)

In some cases, however, fractures can be less obvious. Some ankle fractures may look a lot like ankle sprains. You may not even know that it was a fracture until it shows up on an X-ray.

Spine Fractures

Fractures through the spine may feel a lot like back pain initially. This is due to the make-up of the spine. Bony injuries to the back do not produce any of the obvious signs and symptoms . However, one of the key components of a spinal fracture is that it occurs after some sort of trauma. This is most commonly a fall. Therefore, if there is a traumatic event reported, the physiotherapist will rule out any potential spinal fracture. They will do a thorough assessment. If the Physiotherapist suspects a potential fracture, we will refer you back to your doctor to get X-rays done.

Fragility Fractures

In people with osteoporosis, fractures can happen with very minor stumbles or movements. Osteoporosis is a condition where the bones become fragile or brittle from loss of bone. Fractures associated with osteoporosis are called fragility fractures. They occur due to the weakness of the bone itself.

If you have Osteoporosis, your bones can be injured with small traumas that would not normally affect the average person. If you have back pain and you have had trauma, the Physiotherapist will ask whether you have osteoporosis. This is to rule out potential fragility fractures.

Diagnostic tests for a Fracture

In any incident where there is a suspicion of a fracture, X-rays are necessary. This will confirm the presence of the fracture, its exact location and severity. However, in some cases, an X-ray may not be sensitive enough to show the fracture. In these situations, if a fracture is still suspected, more sensitive tests like a CT, MRI or bone scan may need to be completed.

Fracture Classifications

There are 4 main classifications of fractures:

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 – the bone breaks but there is no puncture wound in the skin
Open –the bone breaks through the skin

Types of Fractures

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

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

Fracture Treatment

In terms of management of fractures, the treatment 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.

Fracture Repositioning

Most fractures are repositioned without the need for surgery. This is called closed reduction. Once the bones are positioned properly, the joint is casted . The length of casting is usually 6 weeks. This is how long it typically takes the fractured bones to heal. There are circumstances where the period of casting may be either shorter or longer. This depends on the nature of the fracture. If it is an ankle or foot fracture, the doctor may also recommend that you wear an aircast boot to stop your foot from moving.

PhysioNow carries a full supply of these aircast boots if you need one.

Open Reduction (Surgery) after Fracture

Open reduction (surgery) is done for fractures that are more complicated. The repositioning of the bones wil be done with surgery in this case. The surgeon will use screws and or plates to keep the bone fragments in proper position. This allows for proper healing. Following open reduction, you will have a period of immobilization . The length of time for a fracture thathas required surgery will depend on the bone that was fractured. It also depends on the severity of the fracture. Also, depending on the fracture and the needs of the patient, the hardware may either be left in permanently or taken out with another surgery. If removal of the hardware is necessary, it will happen once the fractured bone has completely healed.

Spinal and Rib Fractures

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.

Healing times for Fractures

In terms of healing times, most uncomplicated fractures take approximately 6 weeks for the bones to fuse. Although medically, the fracture would have healed, 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.

Delayed Healing of Fractures

There are also some people who will heal at a slower rate because of various health conditions or medication use. So, if you have diabetes, osteoporosis or are a long time user of prednisone, you may fall into this category. Scaphoid Fractures also may have delayed healing because there is a poor blood supply to the bone.

Registered Physiotherapy after Fractures

Once the fracture itself is healed, there may still be some remaining problems from the injury. Since the fracture would have been immobilized for several weeks, there will be a significant loss of movement and strength around the broken bone.

It is important to follow up with Physiotherapy for Fracture Rehabilitaton. This helps to ensure that there can be a safe return to all previous activities. A Registered Physiotherapist will be able to assess the limitations. They will prescribe the necessary range of motion and strengthening exercises and then you can get back to all of your normal activities quickly!

PhysioNow Etobicoke and Mississauga

PhysioNow has highly trained Registered Physiotherapists on staff to help you after a Fracture. We are open evenings and weekends to help meet your needs. We also do direct billing to your insurance plan if you have one and if they allow us to do so on your behalf.

Call today to get started on your Fracture Rehabilitation!