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Motor Vehicle Accident: Injuries and Insurance

July 26,2023 Erin Mills Physiotherapy Leave a comment

Motor Vehicle Accidents / MVA and physiotherapy.

Motor Vehicle Accident

Injuries sustained from a motor vehicle accident affect your normal function in life differently. It depends on the extent of the impact. Thus, it is very important to address any pertaining issues from the accident to your doctor. Additionally, to start rehabilitation at the earliest to decrease the impact of injury and its effects.

MVA injuries can be as minor as sprains or strains or it can be extensive that might include concussion, fractures, neurological involvement, other musculoskeletal involvements, etc.

Once you are involved in an accident and you are discharged from your preliminary care, you would contact your auto insurance company for guidance on starting physiotherapy sessions.

Physiotherapy sessions for a motor vehicle accident:

Once you decide to attend a physiotherapy clinic, these are the few things to do and to expect on your first visit.

Book an appointment in a clinic which you decide to proceed with.
Once you arrive expect to fill a few Auto insurance forms and clinic specific forms to start your assessment at the clinic.
You would be seeing a physiotherapist who could be your primary care provider.
The therapist would do a detailed assessment on your situation and would also go over your treatment plan pertaining to your injury.
Your treatment session would be patient specific and progressive to get back to your normal functionality.

Facts about your treatment plan and coverage:

Once you are in a motor vehicle accident, you are mostly covered by the auto insurance company for treatment sessions.

Your treatment coverage depends on the category that you fall into.

Minor injury guideline/ MIG, where your injury falls into the category of sprains and strains and would need a shorter duration of recovery and treatment sessions. Your treatment sessions could extent up to 4 months or as needed. Reassessments are done as needed to see your progress and to plan further with your sessions.
Out of Minor injury guideline, where your injury is more extensive or catastrophic. Where the duration of recovery is longer and so the treatment allotment is longer when compared to MIG.
Any multidisciplinary approach needed would be advised and would be recommended to your insurance company for further proceedings.

Commonly seen injuries after a motor vehicle accident:

Motor Vehicle Accident Whiplash

Whiplash injury to the neck: which can include one or more of the symptoms ; pain, stiffness, swelling, muscle spasm, headaches, tingling /numbness into the hands, weakness, difficulty sleeping.
Low back Sprain/ strain or disc related symptoms which includes, pain, stiffness, tingling and numbness into the leg, disturbed sleep.
Shoulder, elbow, wrist, hip, knee, ankle sprain/ strain.
Seatbelt or airbag related pains in the chest area and abdominal area.
Fractures.
Concussion symptoms which might include dizziness, headaches, light and noise sensitivity, blurred vision, nausea, issues with concentration, imbalance, weakness, slurred speech, anxiety, depression, etc.
Vestibular symptoms with symptoms such as dizziness, nausea, vomiting, difficulty with positional changes, sense of imbalance, etc.

Treatment sessions:

These are patient specific.

Electrical modalities such as IFC, TENS, Ultrasound, LASER, heat or cold packs for pain relief and decreasing muscle spasm, and to improve circulation to the area.
Manual therapy which includes soft tissue techniques, joint mobilization, joint traction. Muscle energy techniques to reduce pain, improve function in the joint.
Exercises for improving mobility, strength, and also function.
Braces and splints for immobilization as needed.
Post concussion therapy focusing on your symptoms and additionally presentation, which is provided by a physiotherapist trained in concussion therapy.
Vestibular rehabilitation services provided by a physiotherapist specifically trained in vestibular rehab.

Need some help?

Your assessment session would ideally be an hour and treatment sessions would be 45 min to an hour in our clinic. Here at PhysioNow, we have many highly knowledgeable physiotherapists that can assist you with your injuries. If you think physiotherapy may help with an injury from an MVA, book with PhysioNow today for your first assessment and treatment!

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Scoliosis: Types, Symptoms and Treatments

July 24,2023 Erin Mills Physiotherapy Leave a comment

Scoliosis

A side deviation or curvature in your spine is scoliosis. It could be in your neck, mid back and lower back. It can present in more than one area.

The most common area where it develops is mid-back. Cervical and lumber spine are very common when it comes to two curvatures.

Type of scoliosis:

C-shape: This is most common type, there is only one-sided curve. The most common area for C shape to develop is in the thoracic spine and also lumber spine. In this type, scoliosis side leg could be short compared to non-scoliotic side. Sometimes, there are changes in the scapular level. Scoliotic side scapula will be lower than non-scoliotic side.
S- shape: In this type, two curvatures are present in the spine. One curvature is the primary scoliosis and the other curvature develops in compensation of the primary curvature. In this type, the scoliotic sided leg is short and the scapular level is higher than the non-scoliotic side. S-shape will bring other complications such as respiratory issues, cardiovascular issues, etc.

‘S’ Shaped curve and ‘C’ Shaped Curve

Causes of scoliosis:

Usually, the cause of scoliosis is unknown. However, following are a few possible causes mentioned:

Poor Posture habits: People who have habits of not following ergonomics pattern of posture are at risk. One who has the habit of leaning and sitting mostly on their right or left, are also at risk.
Carrying heavy stuff on back: People who have to deal with the delivery of heavy packets and lifting heavy objects are at risk.
Family history: Sometimes, scoliosis runs in family. There are higher chances in these cases.
Congenital limb length discrepancy: Congenital limb length discrepancy needs immediate correction otherwise; it will lead to scoliosis.
Neurological disorder: Neurological disorders like cerebral palsy, multiple sclerosis, Down Syndrome which are progressive diseases have muscular imbalance.

Signs and symptoms:

Limb length discrepancy
Visible deviation of spine to one direction
Uneven shoulder and pelvis height
In anterior view, one sided rib is popping out.
Chronic neck and also lower back pain
Breathing difficulties in severe cases
Recurrent lung conditions like pneumonia, atelectasis, etc.
Pain and numbness
Fatigue due to muscle imbalance

Assessment of scoliosis:

Imaging: X-ray is the gold standard or MRI.

Physiotherapy Assessment: assess in posterior view which means back view with open back.

Therapist will look for visible prominent border of scapula.
with bending forward the scapular border will be seen as well as deviation .
When leaning backward , a visible S shape or C shape will be seen.

Risk factors of scoliosis:

Scoliosis is bony disorientation which is irreversible. The best management is prevention. However, if it not managed well enough , it can lead to many complications.

Lung disorders: Specially, thoracic spine scoliosis has a chance to affect the respiratory system as it disturbs the alignment of the rib cage. Deep breathing becomes limited or difficult and that is why the lower portion of the lungs get less air. As a result of this, atelectasis develops in some areas of the lung.
Limb length discrepancy: Lumber scoliosis has a major effect on pelvis alignment. As scoliosis is irreversible, it leads to permanent muscular imbalance. Thus, there is limb length discrepancy.
Scapular winging: Thoracic scoliosis has drastic effect on scapular orientation. The scapula takes part in shoulder movement. Indirectly, mid back, scapula and the shoulder joint are all affected because of spinal curvature.
Herniated disc in spine: Lumber spine scoliosis has a higher chance to develop a herniated disc. Therefore, you may develop pain in the lower back and down the leg into the thigh, knee or ankle. Please seek immediate attention in this case.

Management of scoliosis:

Scoliosis is a irreversible bony deformity.

Posture: Contact your physiotherapist for a better understanding for well maintained posture at work and home. Correction in pelvis alignment will help in preventing it from getting worse.
Deep breathing exercise: Deep breathing exercise will help in maintaining lung function. Additionally, with breathing exercises, chest mobility exercises will help in maintaining flexibility in the spine and avoid lung conditions like pneumonia, atelectasis, etc.
Spinal mobility exercises: Contact your physiotherapist for proper exercises. Your Physiotherapist can better assess scoliosis and based on that provide spinal mobility exercises to stop it from getting worse.
Orthotics: orthotics adjust leg length discrepancy from scoliosis.
Education: Finally, a physician or physiotherapist can help you to better assess and understand this condition.

Need some help?

Your concerns are best managed by a health care professional. Here at PhysioNow, we have many highly knowledgeable physiotherapists that can assist you with your issue. If you think you may have scoliosis or are diagnosed with it, book with PhysioNow today for your first assessment and treatment!

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Chronic Ankle Instability Could Cause Your Ankle Not To Heal

July 20,2023 Erin Mills Physiotherapy Leave a comment

Chronic Ankle Instability

Ankle sprains are one of the most common injuries. Rest, ice, compression and elevation, or the RICE rule, are the go-tos for ankle sprains. In most cases, the ankle will heal between 4-12 weeks. Many people will allow the ankle to heal on its own but a failure to seek treatment and physical rehabilitation for the ankle after just one injury is enough to leave it weaker and more vulnerable to future sprains. Which in turn could result in chronic ankle instability.

What causes ankle instability?

After an ankle injury, there is damage to the ligaments, tendons, and potentially even the ankle joint itself. Ligaments function to limit the normal movement in the ankle, and once they are injured, they may get lax (stretched out). Resulting in the ankle being more unstable. Additionally, the injury results in a loss of strength in the muscles that control the ankle movement, further increasing the instability of the ankle. Finally, it also results in a loss of sensory receptors in the ankle that communicate to our brain where our ankle is in space. This decreased sensation makes it harder to balance and control the ankle which contributes to the ankle instability.

How do I know if I have chronic ankle instability?

Questions to ask yourself include:

Does my ankle ever give out?
Do I avoid walking on uneven surfaces out of fear of falling?
Do I feel like I can’t “trust” the ankle?
Do I try to avoid putting all my weight onto one ankle?

If you said yes to these questions and you have had a severe ankle injury or a history of multiple ankle sprains, you may have chronic ankle instability.

Is it permanent?

Chronic ankle instability is not permanent it can improve with the help of a physical therapist and individualize exercise plan. An untreated ankle injury may be chronic when it is not given sufficient time to heal and is constantly being reaggravated. Thus, the first step to treatment will be a proper rehabilitation program with a health professional.

Who treats ankle instability?

Physical therapists are the first step in conservative management of chronic ankle instability. Your physical therapist will perform an assessment on your ankle range of motion, strength, and balance and will assess for any laxity, or more movement than is normal, within the ankle and ankle ligaments.

After an ankle injury, there is a loss in strength and proprioception (awareness of the position of the body in space). So exercises are given to re-strengthen the muscles, increase ankle stability, balance, and retrain the body awareness of the ankle. Furthermore, a brace and/or taping is recommended to support the stabilization of the ankle, especially for individuals who engage in high-risk activities like sports.

Chronic Ankle Instability Brace and Tapping

Chronic Ankle Instability Exercises

However, not all injuries are capable of recovering with conservative management. Thus, in very severe cases, surgery may be an option to repair the injured ligaments and give the ankle stability.

What happens if its goes untreated?

Without treatment, an individual will continue to have difficulties balancing, walking on uneven terrain, and putting weight onto the ankle. Subsequently, the instability may worsen over time and will have a much greater risk of reoccurring injuries to the ankle. Thus making it more challenging to recover from these injuries. Additionally, it can result in damage to the bones and cartilage within the ankle joint as the muscles weaken and fail to support the joint. Therefore, to avoid severe injury it is highly recommended that individuals seek expert treatment.

If you are having stability problems with your ankle, book with PhysioNow today for an initial assessment and treatment. We have many capable physical therapists that will be able to help your ankle recover!

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Trigger Finger? What can you do about it?

July 20,2023 Erin Mills Physiotherapy Leave a comment

Trigger finger? What to do

Trigger Finger

Lately you’ve noticed that your finger seems to be clicking, and maybe it also catches or locks into a bent position. Sometimes you may need to use your other hand to help you “unlock” your finger. What is this? We call this condition trigger finger.

Your finger locks in a flexed position. The position it locks in resembles the position of a finger when it is pulling a trigger.

If you have trigger finger, you may also have:

Stiffness and swelling, especially in the mornings.
Painful or painless clicking, catching, locking into the bent position then popping straight.
Loss of full range of motion of the fingers into flexion and extension (bent and straight).
Nodule is felt with other hand.
Pain that radiates to the tip of the finger and/or into the palm.

Why does Trigger Finger happen?

An exact cause is unknown, it develops spontaneously or consequently to another disease, repetitive hand movements during a job, or recent trauma to the hand.

The condition occurs due to inflammation and narrowing in the “pulley” system in the hand. As seen in the image below, the tendons of our muscles must pass through a band of tissue in order to control the fingers. The tendon normally glides through this tunnel without issue but the tissue of the tunnel can thicken and narrow, combined with enlargement of or nodules developing in the tendon itself, resulting in impaired movement and the tissues blocking each other.

Trigger Finger Nodule and Tendon

How to treat trigger finger?

The first line of recommended treatment for any condition is conservative care. A physiotherapist can help you recover your hand function and quality of movement. These treatments
may include:

Soft tissue techniques, joint mobilizations, and stretches to try and increase the mobility in the
area.
Modalities like ice, paraffin wax, and electrical stimulation to help with pain, inflammation, and swelling.
A home exercise program that focuses on increasing range of motion, strength, and gliding of the tendons
Education on wearing a splint (as shown below) which blocks the finger from moving excessively, allowing you to go about your daily life without aggravating the condition. Wear this between 6-10 weeks and your physiotherapist may ask you to wear them at night, during work, or as much as possible during the day.

What options do you have for treatment?

In some cases, this condition may be persistent and medical management with your primary provider. For example, options
may include corticosteroid injections to reduce inflammation and the frequency of the finger locking. Unfortunately, patients may require further intervention when conservative treatment fails, in which case a surgical release of the finger may be indicated. When combined with physical therapy after the surgery, there is usually a rapid and significant improvement in function at relatively low risk. However, there are always increased risks to surgical procedures compared to conservative treatment and where possible, trigger finger should always be treated with non-surgical strategies first and surgery as last resort.

Need some help?

Let us manage your trigger finger. Here at PhysioNow, we have many highly knowledgeable physiotherapists that can assist you with your issue. If you think you have trigger finger or have been diagnosed with it, book with PhysioNow today for your first assessment and treatment!

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Headaches? See how Physiotherapy can help you!

June 15,2023 Erin Mills Physiotherapy Leave a comment

How do Headaches occur?

There are many different types of headaches with many different causes. Many people may blame it on the weather, stress, or work, and feel like it is out of their control and that nothing can help their headaches. If this sounds like you, there is treatment available and you do not have to live with your pain. Headaches that stem from your neck or jaw are treatable through physiotherapy and can result in a decreased intensity and frequency or even stop them completely. However, migraines can also be manageable with rehab.

What are headaches from the neck?

Cervicogenic Headache

Headaches that stem from the neck are known as cervicogenic headaches and are a type of referred pain. Referred pain means that the pain actually originates from another part of the body, and not the place where you actually feel the pain. Moreover, the head pain is actually coming from problems in the tissues and/or joints in the neck.

Common symptoms of cervicogenic headaches include:

Firstly, one-sided headaches
Second, neck stiffness
Decreased motion in the neck
Radiating pain to the eyes, shoulder, or arms
Lastly, they are triggered by certain neck positions or movements

What are headaches from the jaw?

Headaches stemming from the jaw result from dysfunction in the jaw joint, anatomically known as the temporomandibular joint (TMJ). This joint connects your lower jaw to the skull and is used in actions such as talking and chewing as it allows the opening and closing of the mouth. Therefore, headaches are one of the common symptoms of jaw dysfunction. Though they are lesser known, it is commonly missed as a source.

Common symptoms of TMJ dysfunction include:

Clicking on the jaw
Pain or tenderness with jaw movements (biting, talking, chewing, etc)
Headaches, especially in the morning (due to grinding and clenching of the jaw during the night)
Also, neck stiffness

How can physiotherapy help?

Your physiotherapist will provide a comprehensive assessment of your neck and jaw to determine a specific treatment plan for you. The evaluation may include observing your resting posture, and the way your jaw and neck move. Also, how much movement is available in your jaw and neck, and more.

Your treatment plan may include strengthening weak muscles, correcting posture and faulty movement patterns, stretching and mobility exercises, manual therapy techniques like soft tissue massage and joint mobilizations to reduce pain and increase range of motion. They may use modalities like heat, electrotherapy and acupuncture as well depending on your condition and goals of treatment. Your physiotherapist will work closely with you to develop an individualized plan of treatment including a home exercise program, and education on self-management of your condition at home. They can also inform you and help you get in contact with other healthcare practitioners that may need to be involved in your care.

If you are experiencing persistent headaches, book with PhysioNow today for your first assessment and treatment!