What is a concussion?

Concussion management is important for the recovery of a concussion, which is a form of a traumatic brain injury.  A concussion results from getting either a direct or indirect trauma to the head.  The trauma to the brain produces changes in the brain chemistry that can result in a wide variety of symptoms.  These symptoms can clear up within a couple of weeks.  However, for some people the symptoms can last for several weeks and months.

How do you know that you have a concussion?

A concussion injury results in a unique set of symptoms and limitations.  The signs and symptoms of a concussion include:

• Headache
• Dizziness
• Nausea and/or vomiting
• Sensitivity to light
• Sensitivity to sound
• Sleep disturbance
• Excessive fatigue
• Poor concentration
• Feeling frustrated or impatient
• Visual disturbances
• Poor balance
• Taking longer to think
• Restlessness
• Fogginess

These symptoms require some form of concussion management to improve and allow patients to completely recover.

What can I do to help with my concussion management?

A concussion has a significant impact on your day to day life.  This is especially true considering all the symptoms that are listed above.  The most important thing to remember about a concussion is that the injury creates a situation of energy imbalance in your body.  This happens as a result of the brain systems that are affected and how your body tries to manage working through those changes.

There are definitely things that can be done to help with your concussion management at home.  The main focus of self care of concussion is managing the energy imbalance and trying to reset your system.

Concussion Management Tip #1: Have a fixed sleep and wake time every day.

Sleep is often disturbed with a concussion injury.  It is important to allow your body to get into a routine with sleep because this will give you to get into a routine and ensures the same amount of sleep on a daily basis.  Having this fixed bed time and wake time gives your body the ability to manage its energy needs.

Concussion Management Tip #2: Avoid napping during the day.

Napping during the day interrupts the sleep cycle routine that your body needs to recover from a concussion.  You want to make sure that you save your sleep for the night so that you can restore your sleep cycle and prevent insomnia or restlessness at night.  However, if it is not possible to make it through the day without napping, it is recommended that you limit the nap to only 30 mins so that it doesn’t take away too much sleep from your normal bedtime.

Concussion Management Tip #3: Focus on proper nutrition.

Because a concussion impacts your body’s ability to manage energy, it is important to fuel your body with proper nutrition.  Try to eat your meals on a regular schedule every day and stay properly hydrated.  It is also important to stay away from foods that may disrupt your ability to get a good quality night of sleep.  For example, avoiding caffeine, alcohol, sugary foods and heavy meals in the late evening is recommended.

Concussion Management Tip #4: Include exercise in your day routine.

You may think that with the nature of the concussion symptoms that exercise is the last thing you should think about.  However, research shows the benefits of including exercise in your daily routine.  The right type of exercise actually helps reset your body and assists in your overall recovery.  A good place to start is with doing a daily walk of 20-30 mins at a comfortable pace.  Choosing a quiet path and listening to some classical music or wearing sunglasses can help manage some of the concussion symptoms.

Concussion Management Tip #5: See a Registered Physiotherapist.

Although your symptoms can reduce with the above mentioned self care tips, it is important to see a health professional who knows how to assess and treat a concussion injury.  A Registered Physiotherapist can do a thorough investigation into your symptoms and can provide treatment to help address those concerns.

Will a concussion get better on its own?

For a lot of people, a concussion can improve in about 2 weeks’ time with the recommendations described above.  However, for some others, a concussion can last for several more weeks or even months.  In a few cases, the symptoms can last for more than a year. Therefore, it is important to seek out concussion rehabilitation if the symptoms don’t seem to be subsiding after a week or two.  In fact, getting treatment sooner than later helps with achieving a faster recovery.

At PhysioNow, we have Registered Physiotherapists who are trained in the assessment and treatment of concussion injuries.  The physiotherapist can do a thorough examination into the symptoms of the concussion and provide the most appropriate education and treatment to help you recover.  Every concussion is different and our physiotherapists make sure that the treatment provided is specific to your injury, symptoms and goals.

What does physiotherapy treatment for a concussion look like?

Physiotherapy treatment for concussion has several different components.  At PhysioNow, the main features of treatment include:

• Education – activity modifications and general do’s and don’ts to help with the recovery of the injury
• Manual therapy for the cervical spine – the neck is often involved in a concussion injury and contributes to the overall symptom presentation.  The neck therefore benefits from manual therapy such as soft tissue work, mobilizations and stretches.
• Exercises for the head, eyes and neck to desensitize the concussion symptoms and allow for a safe return to work, school and activity.

Do not let your concussion injury stop you from living your life.   Call PhysioNow today to book your assessment!

Tendonitis is a common diagnosis for many people.  Tendonitis means that the tendon structure has been altered in some way resulting in weakness in the structure.  There are different degrees of severity of tendonitis.

What are tendons?

Tendons are found at the end of the muscle and act like a flexible cord.  Tendons connect muscles to other body parts, usually bones.  The function of the tendon is to pull on the structure that they are attached to when the muscle is working.  For example:

• When you do a biceps curl, the biceps tendon pulls the forearm bones up, bending your elbow.
• As you are walking, the Achilles tendon pulls the heel bone up which moves the foot downwards.
• When you raise your arm, the rotator cuff muscles pull on the shoulder bone and move your arm up

Therefore, the main function of tendons is to carry load and produce movement.  As a result, if tendons become injured, then the impact to movement and overall function can be significant.

How do tendons get injured?

Firstly, injury to the tendon can occur when there is a direct trauma to the structure, such as with a fall, a direct blow to the area or an overstretching of the area.  In some more serious circumstances, traumatic injuries can lead to a complete rupture of the tendon.  This usually occurs when the force applied to the tendon is more than what it can tolerate causing it to tear.  A complete rupture of the tendon can be a more serious injury and may require surgery for the patient to regain their function.

Secondly, and more commonly, tendons get injured over time with repetitive activity or movements.  Tendons are made to carry a certain load.  The structure of the tendon can get changed over time with the repetitive or prolonged stressors of home, work or activity.  These loads will impact the tendons ability to work properly and alter their structural make up.

How do injured tendons become painful?

Different tendons can carry different amounts of load.  When the tendon is overloaded, injury can occur.  For example, if a person at the gym has been lifting 50 lbs for several weeks and then one day they decide to lift 80 lbs, the rotator cuff tendons may not be ready to tolerate the sudden increase in weight.  Similarly, if someone is usually at the office typing for about 4 hours and then they had to do 10 hours of typing one day, the wrist tendons may get overloaded with the increased activity.  In both these scenarios, the tendons may become irritated and painful as a result of the overload.

For some people, the structural changes of the tendon may have happened several years in the past.  The body learns to compensate for such changes keeping the involved area pain free despite the changes in the tendon.  If the person then overdoes an activity or gets an injury, it may make that once pain-free tendon now painful.  Although it may seem related to the most recent activity or injury itself, the actual symptoms may be coming from the pre-existing structural changes to the tendon.

Where does tendonitis usually occur?

Tendonitis can occur anywhere in the body where there are tendons.  However, some tendons tend to be more susceptible to injury compared to others due to increased work or stress to those joints.  Some of the most commonly occurring types of tendonitis are:

• Rotator Cuff Tendonitis (Shoulder)
• Lateral epicondylitis or Tennis Elbow
• Medial epicondylitis or Golfer’s Elbow
• Tendonitis of the wrist
• Patellar Tendonitis (Knee)
• Achilles Tendonitis (Heel)

What are the signs and symptoms of tendonitis?

• Pain
  • Usually described as a dull ache
  • Usually occurs when moving the affected joint
• Swelling
• Tenderness
• Decreased strength of muscles of the affected joint
• Pain when the affected muscles have to carry load

What are the stages of tendonitis?

Treating tendonitis effectively involves identifying the correct stage of the injury process of the affected tendon.  Tendonitis injuries can present in the acute, sub-acute and chronic stages.

• Acute Stage
  • Very early stages of the injury (ie. First few days after a fall or overstretching incident)
  • Pain can be very sharp and there may be a lot of movement loss through the joint
  • There may also be signs of inflammation
• Subacute/Chronic Stage
  • A few weeks/months/years after the start of pain
  • Pain may be duller and is dependent on specific activities
  • The patient may have made many different compensations to deal with the symptoms

What is the treatment for tendonitis?

Acute Stage

The treatment options will be different for the different stages of the injury.  The specific stage of the injury will be identified during the assessment by the Registered Physiotherapist.  If the physiotherapist suspects that there is something more serious going on like a fracture or complete tear, then they may make a referral to the doctor for further investigation.

In the acute stage, the goals of management is to reduce pain and regain mobility of the affected area.  Pain can be significant and sharp at this stage.  The physiotherapist may therefore use some pain-relieving modalities like IFC or Ultrasound to help reduce the acute discomfort.  They may also provide some gentle soft tissue work as well some gentle exercises to keep the area mobile.  The physiotherapist may also make recommendations for activity modifications at home and work to help with the recovery process.

Subacute and Chronic Stage

The management will change in the subacute and chronic stage of the injury as the area settles down and healing of the tendon occurs.  Treatment at this stage is geared toward strengthening the tendon structure so that it can carry load appropriately.  The exercises must remodel the tissues of the tendon so that they can learn to do the work correctly.  The strengthening should be progressive in nature so that the affected tendon can tolerate increasing mechanical loads.

Most tendon injuries improve in approximately 8-12 weeks but there are some more complex cases that could take longer to resolve.  With tendons that have structural changes that started several years ago, the remodelling of the fibres may take longer to accomplish.  As with many other injuries, early treatment for these types of injures produces overall better results and helps improve a patient’s quality of life sooner than later.

At PhysioNow, our physiotherapists work with the patient to identify their specific limitations and help them recover.  Call PhysioNow today to book your appointment for tendonitis!

Why do I have back pain?

If you have had low back pain, you are not alone.  Back pain is one of the most common reasons people see a doctor or miss days at work.  Even school-age children can have back pain.  Having some tips for back pain will help people manage their symptoms on a regular basis.

Back pain can range in intensity from a dull, constant ache to a sudden, sharp or shooting pain.  It can begin suddenly as a result of an accident or by lifting something heavy, or it can develop over time as we age.

Low back pain is caused by common causes like:

• Poor posture
• Sitting for long hours
• Awkward movements
• Excessive use of lower back muscles causing overuse injuries
• Inappropriate ways of lifting weights
• Trauma
• Frequent Bending Forward
• Degenerative conditions

What are the types of back pain?

There are two types of back pain:

• Acute (short-term back pain) lasts a few days to a few weeks.

Most low back pain is acute. It tends to resolve within few days to weeks with self-care and physiotherapy and there is no residual loss of function.  However, in some cases a few months may be required for the symptoms to disappear.

• Chronic back pain (long term back pain) is defined as pain that continues for 12 weeks or longer, even after an initial injury or underlying cause of acute low back pain has been treated.

About 20 percent of people affected by acute low back pain develop chronic low back pain with persistent symptoms at one year.

Even if pain persists, it does not always mean there is a medically serious underlying cause or one that can be easily identified and treated.

In some cases, physiotherapy treatment successfully relieves chronic low back pain, but in other cases pain continues despite medical and surgical treatment.

What are some simple tips for back pain?

Tips for back pain #1 – Maintain Good Sitting Posture

If you spend most of the day sitting in front of the computer, in an inappropriate posture and slouching, then there is an increased risk of developing back pain.  There is an ergonomically correct way to sit:

• Eyes should be at the top of the computer screen.
• Shoulders should be relaxed.
• Desk should roughly be at the same height of the armrests.
• Your hips and knees should be at 90 degree angles.
• Feet should be flat and well supported.
• A lumbar roll should be used to support the back.

Good sitting posture while sitting, and using a lumbar support roll can help you to relieve undue pressure on the spine and hence reduces the back pain.

Tips for back pain #2 – Sleep Better

When you have back pain, sleeping can be hard.

It can be a vicious cycle because when you don’t get enough sleep, your back pain may feel worse.  A poor sleep position can also aggravate back pain.

Try lying on your side.  Place a pillow between your knees to keep your spine in a neutral position and relieve strain on your back.  If you need to sleep on your back, slide a pillow under your knees.

Be sure to sleep on a comfortably firm mattress.

Tips for back pain #3 – Maintain a Healthy Weight

 Shedding extra pounds lightens the load on your low back.

Weight loss really helps with pain, because it reduces the amount of mechanical force onto the spine.

If you need help, ask your doctor for advice on a diet and exercise plan that may work best for you.

Tips for back pain #4 – Stretch and Strengthen

Strong muscles, especially in your abdominal core, help support your back. Strength and flexibility may help both relieve your pain and prevent future episodes.

Doing it first thing in the morning is usually encouraged.  However, if you’re older or worried about overdoing it, you can do your stretching and strengthening exercises later in the day when your body is warmed up.

Yoga, Pilates, Physical therapy, are just a few of the ways to strengthen your core and the muscles around your hips and back. An example of a good exercise that targets your upper and lower back is to lie on your tummy and push on your hands and come up into a sloppy push up.

Tips for back pain #5 – Physical Therapy

Physical therapists can teach you how to sit, stand, and move in a way that keeps your spine in proper alignment and alleviates strain on your back.

We can teach you specialized exercises that strengthen the core muscles that support your back.  A strong core is one of the best ways to prevent recurrence of back pain in the future.

Studies show that when you increase your strength, flexibility, and endurance, back pain decreases The best treatment for managing low back pain is staying strong and active.

At PhysioNow, we have Registered Physiotherapists who can provide the necessary back pain treatment.

Do not let back pain stop you from living your life. We have 5 locations across the communities of Mississuaga and Etobicoke to help you manage your pain.

Call PhysioNow to book your assessment with a Registered Physiotherapist and get started today!