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Accident Rehabilitation

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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
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Patellofemoral pain syndrome

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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!

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Sciatica

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Sciatica Treatment Mississauga

Sciatica

Sciatica

Sciatica is a term that gets used quite frequently in the physiotherapy world. This refers to pain, tingling and/or numbness that goes down the back, hip or entire leg.

Who can get Sciatica?

  • It can happen to both younger and older adults for a variety of reasons.
  • For some, it starts after a traumatic event like a slip and fall or after a motor vehicle accident.
  • It can seem like pain develops out of nowhere for others.
  • Pain can start gradually then suddenly increase in severity.
  • The majority of the time, sciatica is a condition that starts with some mechanical changes in the low back that build up gradually over a period of time.

What is Sciatica?

  • The term sciatica itself refers to irritation of the sciatic nerve
  • It is the largest nerve in our body
  • This nerve has its roots at the lower levels of the lumbar spine
  • It  runs through the buttock area, and down the back of the thigh
  • Around the level of the knee, the sciatic nerve splits up into several smaller nerves that run down to supply the muscles of the lower leg, ankle and foot

What are the symptoms of Sciatica?

The symptoms produced by sciatica follow the pathway of the nerve and can reach all the way down to the toes. The symptoms can range from:

  • pain
  •  pins and needles
  • numbness
  • weakness in the leg or all of the above

ACUTE Sciatica

  • Sciatica can be very debilitating when it is in the acute stage.
  • Pain can be quite sharp and severe.
  • As a result, sciatica can limit your movement and function completely.
  • A lot of patients at this stage will rate their pain intensity at a 9 or 10 out of 10.
  • Any position or movement may be pain producing.
  • Anything you try, including over the counter medication, may not help with the intensity of pain.
  • You may feel very helpless and scared at this stage.
  • The sudden onset of intense pain may make you wonder if there is something seriously wrong.
  • You may even feel that you need to go to the emergency room because the pain is so severe.

Should you go to the Hospital for Sciatica?

  • It is not necessary to go to the Hospital for Sciatica.
  • Typically, most people with Sciatica can recover quickly with the help of a trained Registered Physiotherapist!
  •   PhysioNow has trained professionals standing ready to help you Now!
  • We do not need a doctors referral to see you at PhysioNow.
  • However, you may  require a doctor’s note for your insurance plan to cover your treatment.
  • Our Physiotherapists will screen for any serious issues and send you to a doctor if they find any ‘red flags’ with your Sciatica.
  • We will direct bill to your Extended Health Plan if your plan allows us to do so.

However, if you feel more comfortable seeing a doctor first, head to the Hospital or your family doctor.

At the hospital, the standard procedure will be to rule out anything potentially serious. Some of the more serious causes of severe low back pain can include:

• Fracture
o History of significant trauma
o If there is osteoporosis present, then minor traumas are risk factors
o Loss of function with all movements making pain worse

• Cancer
o 55 years of age or older
o Previous history of cancer
o unexplained weight loss
o Increasing levels of pain that are not relieved by rest

• Infection
o Fever
o Malaise
o Constant pain
o All movements make the pain worse

• Cauda Equina Syndrome
o Severe low back pain
o Pain, numbness or weakness in one or both legs
o Saddle anesthesia – loss of or altered sensations in your legs, buttocks, inner thighs, backs of your legs, or feet
o  Sexual dysfunction
o Sudden changes in bowel or bladder functions – difficulty with relieving yourself or difficulty with holding it in

The role for Physiotherapy in Sciatica

  • Any of the above-mentioned conditions would require emergency treatment, which the hospital would provide.
  • Thankfully, for most patients, their sciatica is not from anything  serious.
  • Most incidences of sciatica are mechanical in nature and can be treated with Physiotherapy.
  • Once the hospital has ruled out anything serious, they will likely prescribe some medication for pain management and provide a referral for physiotherapy.
  • For most people, sciatica can be treated with conservative treatment such as physiotherapy.
  • The important thing about treating sciatica effectively is to determine the correct source of the pain and address those specific areas.

What is causing the Pain from Sciatica?

  • With most sciatica patients, the pain is coming from pressure on one or more of the roots of the sciatic nerve.
  • The pressure on the nerve affects the proper function of the nerve and causes the symptoms to go down the leg.

What about if I have Tingling and Numbness? Is that more serious?

  • The tingling, numbness and weakness that a patient may experience is not something that will be permanent in most cases.
  • A good analogy for this process is like when someone is stepping on a water hose.
  • The pressure from the foot stops the water from passing through the hose.
  • However, once that foot comes off the hose, the water will flow through without any issues.
  • Similarly, the symptoms along the leg will get better once the pressure is removed off the nerve. Physiotherapy will help with this!
  • This pressure on the nerve may be caused by an injury to the disc or bony changes in the area.
  • An experienced physiotherapist will be able to perform a thorough assessment that will determine the potential cause of the sciatica.

Physiotherapy Treatment

  • Once the cause of your sciatica is established, the Physiotherapist will be able to provide the most appropriate treatment to take the pressure off the nerve.
  • Lots of research out there has shown that passive treatments such as heat, ice, and electrical modalities, like IFC and ultrasound, do not provide long term solutions.
  • These types of modalities may be useful in the acute phase to help with the management of pain.
  • They can be combined with other treatments as part of the overall treatment plan for sciatica.
  • However, on their own, they are unlikely to make any significant and long-lasting changes.
  • Specific movements are usually the most effective at shutting off your Sciatica Pain!
  • Your Trained Physiotherapist will determine the best movement for you to shut off your Pain!

Sciatica Treatment

Positions and Movements that can Help with Sciatica Pain

  • More importantly, there has to be an evaluation of what positions and/or movements are pain producing and which are pain relieving.
  • A physiotherapist who has lots of experience working with low back issues will be able to help make this discovery.
  • Therefore, the results of the movement assessment will allow for the prescription of the appropriate exercise to help take the pressure off the nerve roots.
  • For example, if you feel less leg symptoms when you arch your back backwards, then that means your nerve is less irritated with that movement.
  • As a result, your treatment plan will then include exercises that involve various forms of backwards movements that continue to improve your leg symptoms.

  • Possible Sciatica Treatment

What Does Centralization of the Pain mean?

  • As the pressure on the sciatic nerve improves, the pain will move upward towards the low back in a process called centralization.
  • In general, these changes may happen quickly for most patients.
  • However, with more complex cases, it can take longer to ease the pain and regain function.
  • As a result, any movements that  produce centralizing symptoms are going to be beneficial in reducing pain.
  • In the majority of cases, pain can be resolved completely, and you can return to your normal level of activities quickly.

What do I need to know to keep the pain away?

  • It is important that the physiotherapist provides proper education.
  • They should give you  a good home exercise program for the continued maintenance of your sciatica condition.
  • As a result of the pain, some patients will continue to avoid certain activities or movements because of their experience with sciatic pain.
  • Therefore, it is important that your physiotherapist  work with you to regain full function and confidence with your mobility.

PhysioNow has highly trained Registered Phyiotherapists ready to help you with Sciatica.  We have same day emergency appointments available.  Call today to help with the Sciatica Pain! 289-724-0448.

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PELVIC FLOOR: POSTURE

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PELVIC FLOOR: POSTURE

Pelvic Floor: Posture

PELVIC FLOOR: POSTURE is a very important area if you have issues with urinary incontinence, pelvic pain, etc.  The muscles of the pelvic floor support the abdominal and pelvic viscera.  These muscles are active in standing and sitting. Furthermore, because the abdomen is a fluid-filled cavity, intra-abdominal pressure  is distributed in all directions.  The Pelvic Floor muscles, which form the floor of the abdominal cavity, contribute to its muscle control.

As a result of this contribution to control of intra-abdominal pressure, the muscles of the pelvic floor are likely to contribute to control of the spine and pelvis. The slouched posture places a lot of pressure on our internal organs and pelvic floor. This can cause a worsening of:

  • urinary incontinence,
  • pelvic pain,
  •  symptoms related to prolapse,
  • and rectus diastasis.

Pelvic Floor: Posture, sitting slumped

  • Research has shown that when we sit in a slumped posture, our pelvic floor muscle activity is much less than when we are sitting tall.
  • Pelvic Floor: Posture IS VERY IMPORTANT!
  • slouched sitting postures decrease the activity of your transverse abdominal muscles.
  • A Proper breathing pattern encourages the pelvic floor to move more dynamically.
  • Dysfunctional breathing patterns inhibit this dynamic movement of the pelvic floor.

Pelvic Floor: Posture,  

  • An assessment by a Pelvic Health Physiotherapist includes a thorough postural examination.
  • Your Pelvic Health Physiotherapist will be able to identify your unique postural compensations
  • They can help guide you on the road to improved body posture awareness.

CHECK OUT THIS LINK FOR FURTHER INFORMATION.

At PhysioNow, we have fully trained Pelvic Health Physiotherapists that can help to assess and treat pelvic issues like the following conditions:

  • Constipation
  • Dyspareunia
  • Endometriosis
  • leakage of urine
  • pain with intercourse
  • pelvic organ prolapse
  • pelvic pain
  • urinary incontinence
  • vaginismus
  • erectile dysfunction

If you or someone you know suffers from one of these conditions, give us a call today.  We would be happy to help!

  1. Sapsford, RR. et al (2006) Sitting posture affects pelvic floor muscle activity in parous women: an observation study. Aust L Physiother. 52(3):219-22
  2. Reeve, A., Dilley, A., (2009) Effects of posture on the thickness of Transverse Abdominal Muscle and Pelvic Floor Muscle Exercises for Stress Urinary Incontinence: A Randomized controlled Trial. J Phys Ther Sci. 26(8): 1161-1163.
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Vaginismus

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Vaginismus

Vaginismus and Physiotherapy

Vaginismus is a painful feeling of discomfort or inability when inserting a tampon, finger, penis or during a doctor’s internal pelvic exam. It occurs when there are involuntary contractions of the muscles in the outer third of the vagina.

Primary Vaginismus: when a woman has never been able to have pain free intercourse due to pelvic floor muscle spasm.

Secondary Vaginismus: pain that develops sometimes later in life after a traumatic event such as childbirth, surgery, or a medical condition.

With Vaginismus, there is usually significant Connective Tissue Dysfunction that needs to be addressed first before any internal work. It is suggested that you follow up the self-help treatment for connective tissue dysfunction before embarking on the stretching exercises with the dilators.

Pelvic floor exercises and Desensitisation techniques

A physiotherapist may be able to teach you pelvic floor exercises, such as squeezing and releasing your pelvic floor muscles, that can help you gain control over the muscles causing the vagina to close involuntarily. Occasionally, a technique called biofeedback may be useful. A small probe is inserted into your vagina. This monitors how well you are doing the exercises by giving you feedback as you do them.
Biofeedback can help with the following:

• Teach you strategies that may help to relax the muscles that are contracting involuntarily
• Teach you appropriate timing of the contraction and relaxation of the pelvic floor muscles.
• Educate you about your condition and why it might be occurring.
• Teach you various strategies for getting the muscles to relax
• help you to Use manual therapy to release the muscles either externally and/or internally that are causing the contractions.

More information about Vaginismus can be found here.

Some general tips about pelvic floor muscle exercises:

• Choose a convenient time and place where you can exercise regularly.
• Put a reminder about pelvic muscle exercises somewhere obvious to you (or set an alarm on your watch or mobile phone).
• Avoid quick pelvic floor muscle exercises where you don’t hold the contraction. This tends to cause an increase in pelvic floor muscle resting tone.
• Be aware that it will take 6 to 8 weeks of regular exercise before you can expect to see improvement. It will take approximately 3 months for the pelvic muscles to strengthen.
• You could try inserting one finger into the vagina to check the strength of your squeeze as you pull in the pelvic muscles. Alternatively, you may be able to feel a pelvic floor contraction if you place the tip of your index finger on the perineal body (on the outside, between the vagina and back passage).

Other tips to reduce Vaginismus:

• If you are overweight, try reducing your weight.
• Try not to become constipated, as a full bowel will put pressure on the bladder. Straining to empty your bowel will weaken the pelvic muscles.
• If your job involves lifting, think of your pelvic muscles as well as your back. Pull up your pelvic muscles when lifting a heavy weight.
• If you smoke, consider quitting. Frequent coughing puts a strain on the pelvic muscles.

If you or someone you know suffers from Vaginismus, please call PhysioNow today! Our specially trained Physiotherapist can start your treatment Now!

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Dyspareunia

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Dyspareunia and Physiotherapy
Dyspareunia
Dyspareunia is genital pain experienced by women just before, during or after sexual intercourse. Some women have always experienced pain with intercourse from their very first attempt. Other women begin to feel pain with intercourse or cyclically with menstruation. They can also have pain after an injury or infection . Sometimes the pain increases over time. When pain occurs, the woman may be distracted from feeling pleasure and excitement.

Causes

• vaginal dryness from menopause, childbirth, breastfeeding, medications
• skin disorders that cause ulcers, cracks, itching, or burning
• infections, such as yeast or urinary tract infections
• spontaneous tightening of the muscles of the vaginal wall
• endometriosis
• pelvic inflammatory disease
• uterine fibroids
• irritable bowel syndrome
• radiation and chemotherapy

Other factors that affect a woman’s ability to become aroused can also cause dyspareunia.
These factors include:
• stress, which can result in tightened muscles of the pelvic floor
• fear, guilt, or shame related to sex
• self-image or body issues
• medications such as birth control pills
• relationship problems
• cancer, arthritis, diabetes, and thyroid disease
• history of sexual abuse

Symptoms of Dyspareunia

• Pain while inserting a tampon or during penis penetration
• Pain with certain sexual partners
• Deep pain during thrusting
• Burning pain or aching pain
• Throbbing pain, lasting hours after intercourse

Check out this link for more information.

Physiotherapy Treatment for Dyspareunia

Education:

To help describe how the pelvic floor muscles can cause pain. Education can also provide techniques that can be used at home.

Manual Physiotherapy: to mobilise muscle and soft tissue, normalize overactive muscles, improve circulation and desensitize painful areas.

Desensitization therapy: learning vaginal relaxation techniques, such as Kegel exercises, that can decrease pain.

Sex therapy: learning how to re-establish intimacy and improve communication with your partner.

Water-based lubricants rather than petroleum jelly or other oil-based lubricants are preferable. Oil-based lubricants tend to dry the vagina.

Psychologic therapies: Cognitive-behavioral therapy and mindfulness-based cognitive therapy can be helpful.

Pelvic muscle relaxation exercises: used with biofeedback, this can help women with tight pelvic muscles learn to consciously relax tight muscles.

If you or someone you know suffers from dyspareunia, please call today to get started on Physiotherapy treatment! We can help at PhysioNow. Often only a few visits with our specially trained Phyiotherapist can help to get you on the road to recovery.

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Prostatitis

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Prostatitis

Prostatitis

Prostatitis or Prostatodynia Physiotherapy

Prostatodynia or Chronic Pelvic Pain Syndrome (CPPS) is a pelvic pain condition in men. This means ‘inflammation of the prostate’. There are two basic types of prostatitis, acute and chronic.

Acute Bacterial Prostatitis

Acute Bacterial Prostatitis is an infection of the prostate. This type of Prostatitis causes chills and fever. In this case, you need your Doctor’s attention promptly!

Nonbacterial or Chronic Prostatitis

The other is Nonbacterial or Chronic Prostatitis. This can be treated with alternative treatments such as Pelvic physiotherapy, exercises, lifestyle modifications etc. Investigations in this case show that bacteria and yeast are negative. The physical examination does not usually show anything unusual. However, the prostate may be swollen. What can make the problem even more confusing is that often young, otherwise healthy men develop this condition. Antibiotics, pain-killers, and medications prescribed are often not effective. Many men have been told that they must learn to live with the symptoms because a cure is not available.

Symptoms may include a few or all of the following:

• Pain in the testicles, or tip, shaft or base of the penis
• Pain at the perineum (the area between the testicles and penis)
• Urination Causes Pain
• Increased pain in sitting
• Pain or discomfort with sexual arousal, or during or after ejaculation
• You May notice Pain or discomfort above the pubic bone
• Urinary frequency
• Urinary urgency
• Pain before, during or after a bowel movement
• Decreased interest in sex

Treatment

The Pelvic Health Physiotherapist creates an individualized treatment program. Treatment is based on pelvic floor dysfunction, symptoms, and response to the treatments.

The following treatment programs and techniques may be involved in Pelvic Physiotherapy for Prostatitis:

Trigger point release therapy

Trigger point release therapy is also known as myofascial trigger point release. Trigger point release therapy is an alternative treatment for chronic prostatitis. It is often helpful for treating CP/CPPS symptoms that are associated with stress and tension of the pelvic floor muscles.

Trigger point release therapy is often combined with paradoxical relaxation therapy. This exercise method involves autonomic self-regulation. This decreases pelvic floor muscle tension. It teaches you how to release this tension. Paradoxical relaxation involves a specific breathing technique to help relieve anxiety.

Total body

Total body (exercise, chronic stress management, lifestyle) changes help relieve pain. It is important to know which foods make the symptoms worse. Try to avoid those foods. The most common foods that have been found to trigger symptoms include:

• Spicy foods
• Hot peppers
• Alcoholic beverages
• Acidic foods
• Wheat
• Gluten
• Caffeine

Check out this patient’s experience.

Please call PhysioNow today to get started on your recovery from Prostatitis.

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Pelvic Health Physiotherapy

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Pelvic Health Physiotherapy
Pelvic Health Physiotherapy

What is pelvic health physiotherapy?

Pelvic floor muscles form the ‘bowl’ or ‘hammock’ that supports our lower back and pelvic organs (bladder, uterus/prostate and rectum).
Pelvic health physiotherapists have taken courses allowing them to perform an internal evaluation in order to assess the tension and strength of these muscles. Often there is too much tone of the pelvic floor leading to weakness.

What are common symptoms of pelvic health dysfunction?

• Leakage of urine with coughing, sneezing, laughing and exercise
• Urgent need to urinate or leaking before you get to the washroom
• Constipation/straining with bowel movements
• Heavy feeling or bulge in the vagina
• Pain in the pelvic or low back or genital area
• Pain with intercourse
Check out this link for more information.

Some benefits of Pelvic Floor Physiotherapy

• Leave your house without worrying about your bladder
• Exercise without worrying
• Sleep through the night
• Learn to control urgency

What can I expect on my first Visit for Pelvic Health physiotherapy?

A medical history will be taken with a discussion of your concerns. Questions will be asked to further understand your symptoms. Your posture, muscles of your hip, low back and abdominal will be assessed for contributing factors such as weakness or tightness. In addition to the external exam, an internal exam of your pelvic floor (vaginally and rectally) may be included to assess imbalances and dysfunction of the muscles and soft tissues.
Based on the assessment findings and your goals, the physiotherapist will put together a treatment plan.

What can I expect for treatment with Pelvic health physiotherapy?

Pelvic Health Physiotherapy Treatments Typically include,

• Correcting postural dysfunction
• Manual therapy
• Connective tissue release
• Pelvic floor muscle facilitation with breathing techniques
• Exercises for other core muscles
• Training for healthy bladder and bowel habits
• Education such as behavioural therapy/stress management

We have fully trained Pelvic Health Physiotherapists at each of our clinics ready to help you. If you have any questions, or would like to book an appointment, please contact the clinic .

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Post Prostatectomy Incontinence

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post-prostatectomy-incontinence

Post-prostatectomy-incontinence is a common problem after radical prostatectomy. Patients report that this is the symptom which most disrupts their quality of life. Up to 75 percent of men experience a short period of mild incontinence. This is particularly after removal of the catheter that was placed during surgery. Most patients regain total urinary control after radical prostatectomy. However, this can take up to a year to achieve. Apparently, a small percentage (2% to 4%) experience permanent incontinence. Following radical prostatectomy, men who experience post-prostatectomy-incontinence may express concerns about visible wetness, urine odor, and the type of clothing that can be comfortably worn.
post-prostatectomy-incontinence
Types of Urinary Incontinence

The two types of post-protatectomy incontinence following prostate surgery are:
• Stress incontinence – Stress incontinence is the involuntary loss of urine that can occur during physical activity, like lifting a heavy object, or when you laugh or sneeze. These . activities put increased “stress” or pressure on the bladder.
• Urge incontinence – Urge incontinence is the sudden need to urinate due to bladder spasms or contractions.

What Can Be Done to Treat post-prostatectomy-incontinence after Prostate Cancer Treatment

• Pelvic floor exercises: Kegel exercises strengthen the muscles when you squeeze them
• Stop urinating mid-stream. These exercises can be combined with biofeedback programs that help you train these muscles even better.
• Supportive care. This treatment includes behavioral modification. This includes drinking fewer fluids, avoiding caffeine, alcohol, or spicy foods, and not drinking before bedtime.

People are encouraged to urinate regularly and not wait until the last moment possible before doing so. In some people, losing weight may result in improved urinary control. Supportive care also involves changing any medications that interfere with incontinence.

• Neuromuscular electrical stimulation.

This treatment is used to retrain and strengthen weak urinary muscles and improve bladder control. With this treatment, a probe is inserted into the anus and a gentle current is passed through the probe at a level below the pain threshold.This causes a contraction. The patient squeezes the muscles when the current is on. After the contraction, the current is switched off.

As you can see, there are many things that can be done to treat post-prostatectomy-incontinence. PhysioNow has trained pelvic Health Physiotherapists in Etobicoke ready to help you get started on regaining your life. It is hard to talk about these symptoms, and harder yet to find somebody who can help. Our therapists are sensitive and discreet. You will be treated in a quiet private room and your privacy will be fully respected. Get started today! Call today and ask for a pelvic health physiotherapy consultation at PhysioNow.

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Female & Male Pelvic Pain

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Female & Male Pelvic Pain Female & Male pelvic pain

There are various conditions which are treatable under male and female pelvic pain.

Vulvodynia

Pain that affects the entire vulva
Symptoms
• Burning
• Stabbing
• Stinging
• Itching
• Sensitive to touch and pressure
• Functional limitation (Sex/ tampon/clothes)

Vestibulodynia

The vestibule is where the vulva (area of the skin on the outside) meets with the vagina. It is an extremely sensitive part of your body.
Symptoms:
Hypersensitivity on light touch, such as during intercourse and on insertion of tampons.Some women have pain but are able to tolerate penetrative sex. They may have soreness and tenderness. This may include soreness with tight clothes and even light touch to the area.

Dyspareunia, Vaginismus, Dysmenorrhea, Irritable Bowel Syndrome (IBS) and Endometriosis

Endometriosis

Vaginismus: Inability to penetrate due to spasm of the muscles
Dyspareunia: Painful vaginal penetration in the absence of disease
Dysmenorrhea:
Irritable Bowel Syndrome (IBS): Abdominal Pain or discomfort, At least 3 days per month in the last 3 months.

Irritable Bowel Syndromes

Pain is associated with 2 or more symptoms:
– Improvement with defecation
– Onset associated with a change in stool frequency
– Onset associated with a change in stool form

Anal Disorders

Men have pelvic pain!

• Chronic Pelvic Pain Syndrome
• Interstitial Cysts
• Bladder Pain Syndrome
• Levator Ani Syndrome
• Urethral Syndrome
• Coccydynia
• Pudendal Neuralgia
• Anal fissures

Physiotherapy Treatments for Female & Male Pelvic Pain

Kegel Exercise

Connective tissue massage

Dermoneuromodulation or non?nociceptive input
Improve mobility of affected areas
Down regulate the sympathetic nervous system (nervous system restore and relax)
Nutrition
Behavioural techniques (manage stress)
Movement Therapies
Kegel exercises depending on the type of muscle tone and condition.
Contract relax and Reciprocal inhibition techniques
Add mobilizations–? massage with movement

As you can see, there are many things that can be done to help with Female & Male Pelvic Pain. PhysioNow can Help! We have fully trained Pelvic Health Physiotherapists to help with all of these conditions. Call today to book an appointment!