Neck related or cervicogenic dizziness is one of the common causes of dizziness and affects 45-80% population. However, while treating the symptoms of being dizzy/light-headed, this diagnosis is commonly missed.
How can it come from the neck?
Nerves from the upper part of the neck connect with the vestibular system(area of the brain responsible for balance). As a result, any injury or impairment in the upper neck like car accident (whiplash), abnormal posture or any inflammatory condition could eventually lead to disturbance in the vestibular system. This, in turn, leads to dizziness.
How to know if your dizziness is related to your neck?
If you are experiencing lightheadedness, unsteadiness, feeling imbalanced and above all, feeling like your external environment is spinning
Moreover, if your symptoms comes with moving the head quickly in any direction, during sitting or standing up
Further, if you are experiencing headache and neck pain
In addition, you have a history of neck injury due to a car accident or neck pain due to abnormal posture
Diagnosis:
There is no specific test with good evidence for cervicogenic dizziness. However, there are tests that will help you rule out other causes of dizziness. This, in turn will help in concluding that cervical spine is the cause for your symptoms.
How could physiotherapy help you with dizziness?
First of all, there will be a comprehensive assessment of your symptoms. Then, the physiotherapist designs a treatment plan incorporating manual therapy , exercises, education and other modalities like acupuncture. Consequently, it will help treat the neck as well as the vestibular system.
Neck related dizziness
Prognosis:
Cervicogenic dizziness usually has good prognosis. It usually resolves with the treatment of neck and the vestibular system. About 75% of patients have reported significant improvement in their symptoms.
Are you experiencing any of these symptoms? Our Vestibular physiotherapists specialize in treating this. Book an appointment today at one of our clinics! We will do an assessment and help you get better.
Why choose PhysioNow for Physiotherapy Mississauga?
• Over 16 years of providing top rated Physiotherapy Mississauga
There are 4 convenient locations- Erin Mills, Applewood, Lorne Park and Long Branch
• Awards/nominations? PhysioNow: nominated for a Top Choice Award in 2020.
• A team of highly qualified physiotherapists and massage therapists
All of our physiotherapists and massage therapists have several years of experience in their field and are registered in good standing with the College of Physiotherapy and Massage Therapy.
• Services we offer
Services are provided for all ages and for a variety of conditions. For instance, our therapists are specialized in several areas including manual therapy, acupuncture, vestibular rehabilitation, concussion , sports injuries, pelvic health and soft tissue techniques.
Lower Back Pain Treatments
Donjoy Defiance ACL Repair Brace
Return To Sport After ACL Ligament Repair
In addition, we do custom orthotics and braces. For your convenience, we are currently also offering our physiotherapy services virtually .
• Direct billing available
In addition, Direct billing is available to most of the insurance companies so it is convenient for you. For instance, we also deal with third party insurers like MVA and WSIB.
• Flexible hours and free parking available
Above all, we are open for extended hours ( ) to help you at a time that is best for you.
What to expect at Physiotherapy Mississauga?
First, you have an assessment with our physiotherapist. They will do a full check up of the problem area .
Next, the physiotherapist will then prescribe a treatment plan especially for you.
Further, they can also help you understand more about your condition.
We will answer your questions .
Lastly, changes may be made in your daily routine.
As a result, this will help you to get better faster.
COVID considerations: We take excellent precautions!
• Providing a face mask and use of 70% alcohol hand sanitizer for each patient upon arrival into the clinic
• Installation of sneeze guards at the front desk
• In addition, Sanitization of treatment beds after before each patient use
• Disinfecting commonly touched surfaces between every patient
• Switching out pillowcases with each patient use
• All staff will wear a gown and mask and wash hands between each patient contact
Kevin Durant originally injured his calf in early May during the second round of playoff games. The injury had been labeled a ‘calf injury’ and Durant has not been able to play for over 30 days. After doing a shoot around with the team, the Warriors made the decision to allow Durant to play for Game 5. Durant came out strong, scoring 11 points in 12 minutes of play. But things changed as he tried to do a crossover move and had to fall to the floor on the sidelines. He was grabbing onto his lower right calf, more towards his Achilles tendon. In conclusion, from the replays, it looked like he may have torn his Achilles tendon.
What is the difference between a calf strain and an Achilles tendon tear?
Kevin Durant’s injury
Calf Strain : Did Kevin Durant have this injury?
It is possible that Kevin Durant had a calf strain to start.
The bulk of the calf is made up of 9 different muscles. Three muscles work together to produce a downward movement of the foot. These 3 muscles attach themselves into the heel bone:
Gastrocnemius
Soleus
Plantaris
Other Muscles of the calf/ foot
The other 6 muscles cause knee, toe and foot movements in different directions. These muscles are located deeper in the calf area. However, these muscles travel around the sides of the ankle and attach to different parts of the foot and toes. These muscles are:
Popliteus
Flexor digitorum longus
Flexor hallucis longus
Tibialis posterior
Peroneal longus
Peroneal brevis
Sometimes injuries are labelled incorrectly. Pain in the calf region is attributed to the first three muscles. However, a calf strain could involve any one of the 9 muscles mentioned above. As a result, it is up to the health professional to correctly identify which of the muscles are involved in the strain.
Severity of Calf Strain: What Grade did Kevin Durant have?
In general, a calf strain is caused by overstretching or tearing of the calf muscles. This type of injury can occur suddenly or over time. The severity of the strain is graded by the amount of muscle damage that has occurred:
Grade 1
Mild or partial stretch or tearing of a few muscle fibres
The muscle may be tender and painful
Strength and function are maintained
Grade 2
Moderate stretching or tearing of a greater percentage of muscle fibres
A snapping or pulling sensation may be felt at the time of the injury
More tenderness and pain
There may be some visible bruising
Loss of strength and function
Lastly, Grade 3
Severe tear of the muscle fibres, commonly a complete rupture
A ‘popping’ sound may be heard of felt at the time of the injury
There is definite bruising and sometimes there is a visible ‘dent’ in the muscle
Severe loss of strength and function
Signs and Symptoms of a Calf Strain
A snap, pull or “pop” felt or heard at the time of injury
Pain and weakness in the calf area
Swelling in the calf area
Tightness
Bruising
Weakness in the calf when doing any weight bearing activities
Limping when walking
What is the usual Physiotherapy treatment for a calf strain?
Treatment for a calf strain is like that of any other muscle in the body. The goals of the treatment include:
Reducing pain
Improving range of motion of the knee and ankle
Improving the strength
Speeding up recovery time
Returning to activities
Preventing re-injury
How long does it take to recover from a calf strain?
The length of time for recovery from a calf strain injury depends on the severity of the injury. On average:
Grade 1: 10-12 days
Grade 2: 4-6 weeks
Lastly, Grade 3: 6 months after surgery
Achilles Tendon Rupture : Kevin Durant’s final injury
The gastrocnemius, soleus and plantaris muscles unite to form the Achilles tendon. The tendon is a tough band of tissue that connects these three calf muscles to the heel bone. When the calf muscles contract, the Achilles tendon is tightened and pulls the heel. As a result, the action allows the foot to be pointed down. A complete tear of this tendon is called an Achilles tendon rupture.
Signs and symptoms of Achilles Tendon Rupture
Sudden and severe pain at the back of the ankle or calf
Sound of a loud pop or snap
Immediate swelling and weakness
Visible bruising and possible denting in the tendon
Treatment options for Kevin Durant’s Achilles Tendon Rupture
Non-surgical treatment
Rest
Crutches
Ice
Pain medication
Immobilisation for the first few weeks with a walking boot and heel wedges
Recovery may take longer but risks of surgery are avoided
Surgical Treatment
Involves making an incision in the calf and stitching together the torn tendon
Minimally invasive surgical techniques are available
Risks of surgery include possible infection and nerve damage
The choice between surgical or non-surgical treatment depends on different factors. A patient’s age, activity level and severity of the injury all play a factor. In general, younger and more active people, especially athletes, choose surgical repair. In contrast, older and more sedentary individuals usually choose the non-surgical pathway. In either option, rehabilitation is a lengthy and difficult process to make sure full function is returned.
So, what happened to Kevin Durant?
The Kevin Durant was out for over a month with an initial calf strain. Due to the amount of time that he was out of the game, it’s likely that he had a grade II strain of his calf. As a result, his return to the game resulted in a complete Achilles tendon rupture. In review, it makes you wonder whether he was physically able to return to play. Did he have enough time for recovery from his initial injury to withstand the demands of the game?
Basketball is a sport that has a lot of pivoting, stop and go movements and bursts of high intensity activity. In conclusion, it is possible to say that judging from how soon into the game the injury happened, that Kevin Durant was likely not fully recovered.
Professional Sports: Decisions for return to play. Should Kevin Durant have returned to play in Game 5?
However, in professional sports, there is a lot of pressure from all fronts to get a star player back in the game. The team was down 3-1 and having Durant back in the game boosted their confidence and morale. As a result, the fans wanted the Warriors to win. The organization wanted the team to hold on to their title again. In addition, Kevin Durant himself probably felt terrible that he wasn’t able to play and support his team. As a result, all of these pressures likely led to the decision for him to play.
Unfortunately, our bodies are not always able to function like we want them to. In Durant’s case, his return to the game led to an even more serious injury, which required surgery. In conclusion, after surgery he will have to endure a lengthy process of physical therapy and will likely be out for the entire next season.
Return to Play Decisions
This is an excellent example of the importance of return to play decisions. Regardless of the sport and regardless of the injury, it is vital that the health and well being of the athlete is the top priority. In conclusion, returning to play too soon isn’t worth risking a more serious injury. Lastly, a more serious injury can affect the athlete’s future participation in the sport.
Physiotherapy Treatment options for Achilles Rupture
If you or someone you know has experienced calf pain or an achilles rupture, our Physiotherapists at PhysioNow are here to help! We have treated many patients with exactly these injuries. Call today to get started on your treatment and get back in the game!
Neck pain is a common problem for a lot of people. Physiotherapy for Neck Pain is one of the top 5 reasons why people go for physiotherapy treatment. People can get neck pain after many different types of activities. Some of the most reported examples are:
Getting a kink in the neck after a bad night’s sleep
Feeling pain in the neck and shoulder area after doing some heavy lifting at home or at the gym
Feeling pain in the neck when using the computer for long periods of time
Feeling pain in the neck after an accident, such as a fall or motor vehicle accident
Assessment for Neck Pain
Signs and Symptoms
There are many obvious signs and symptoms of a neck injury. Some of these include:
Pain in the neck
Restricted movement of the neck
Sensations of tightness or stiffness in the neck
There are also some not so obvious signs and symptoms of a neck injury:
Pain in the arm
Headache
Pins & needles in the arm
Numbness in the arm
Weakness in the arm and/or hand
Patients who experience these symptoms may think that they have an injury to their arm. They may get worried because of the unusual pins and needles or numbness they are feeling. However, most of the time these symptoms are coming from the neck. An experienced physiotherapist will be able to make the connection between a patient’s arm symptoms and their neck pain.
Treatment for Neck Pain
The treatment for neck pain will vary depending on the nature of the injury. Your Physiotherapist will first start with an assessment to figure out what the problem is. During the assessment, they will ask some questions about how the pain started. They will also get details on how the symptoms behave. Some examples of these questions include:
How long have you been feeling your pain?
How intense is your pain on a scale from 0 to 10?
Was there an incident that started the pain?
Where exactly do you feel your symptoms?
What kind of symptoms do you feel?
What kind of activities make your pain feel worse or better?
In conclusion, answers to these questions will allow your Physiotherapist to understand the nature of your injury. They will then perform a physical assessment. Finally, certain physiotherapy tests that will help them further understand your injury.
Physiotherapy Tests for Neck Pain
Movement of the neck and arm
Tenderness of the muscles around the neck
Sensation of the arm
Strength of different muscles in the arm
Reflexes of the arm
In conclusion, once your Physiotherapist is done gathering all the information, they can come up with a diagnosis for your neck pain.
Treatment for Neck Pain
Treatment for Neck Pain
Using the information from the assessment your Physiotherapist will develop a treatment plan for you. The treatment plan will include different methods to reduce your pain and improve your function. For example, some common Physiotherapy treatment tools at PhysioNow include:
Interferential Current (IFC)
This is electrical stimulation that helps with pain management
There are 4 pads that are placed around the painful areas of the neck
Moreover, the strength of the current is dependent on your comfort level – stronger does not mean better
We ask you to indicate when you feel a strong, but comfortable amount of sensation
In summary, IFC distracts the body’s pain signals to give relief of pain
Lastly, this electrical modality is usually applied for 15 minutes
If you are interested in knowing more about Interferential Current Treatment, please check out this article .
Heat therapy
Heat is used as another pain management tool
As a result, it is usually combined with the IFC so that you can have both at the same time
At PhysioNow, our therapists use moist heat packs for heat therapy
As a result, moist heat is the most effective form of heat because it allows the heat to get deeper into the tissues
In summary, Heat therapy increases circulation, relaxes soft tissues and reduces pain and stiffness
In conclusion, heat is usually applied for 15 minutes
Manual Therapy
Manual therapy involves “hands-on” treatment by the Physiotherapist
As an Example, the most common forms of manual therapy involve soft tissue work, mobilizations and passive stretching
Moreover, soft tissue work helps reduce tissue tension and improves circulation in the area
There are a lot of muscles around the neck and when there is injury or pain these muscles become tight and stiff
This Soft tissue work around the neck is gentle to generally loosen these tissues
In addition, soft tissue work can also be very deep to work out specific tissue knots
In conclusion, your Physiotherapist will always consider your comfort for these types of treatment
Mobilizations
Mobilizations help decrease the stiffness in the joint
In short, there are 7 vertebrae in the neck and stiffness can develop at any level
Your Physiotherapist can apply different levels of gentle pressure to get the joints of the neck moving
For example, some muscles that most often get tight in the neck include the scalenes, upper trapezius, sternocleidomastoid and levator scapula
Your Physiotherapist will be able to determine which muscles are tight
The stretches are usually held for about 20-30 seconds and repeated 2-3 times
Exercise prescription
Exercise prescription
In addition, Exercises are an important part of any Physiotherapy treatment
Special Exercises that will be given to you depending on your specific neck injury
The exercises can help get your joints moving, stretch the soft tissues and strengthen the muscles around the neck
Moreover, these exercises will allow you to keep treating yourself on a outside of your Physiotherapy appointments. This speeds up your recovery
As a result, we know that patients who perform their exercises on a regular and consistent basis will have the fastest results with their Physiotherapy treatment
Education
Education
In addition, Education is another important part of Physiotherapy treatment for neck pain
If you have a good understanding of your condition and treatment, you will have the best results with your recovery
Lastly, an experienced Physiotherapist should be a great teacher
For example, your Physiotherapist may suggest that you use a specific pillow for improved sleep, or suggest ways to maintain good posture during work hours
Massage Therapy for Neck Pain
We know that Registered Massage Therapy can also be a very effective treatment for Neck Pain. At PhysioNow, we have many excellent Registered Massage Therapists at all of our clinics.
In conclusion, using these Physiotherapy treatment options produces great results for neck pain. Your Physiotherapist will work with you to help you achieve the best recovery possible and get back to doing the things you love.
If you or anyone you know is experiencing neck pain, please call today! At PhysioNow, we are ready to help!
The Pelvic Floor. Perhaps you have heard this referenced
before but did not have a definitive idea of what it was. Is it just a region
in the body? A single muscle? Let us explore this very important topic.
The Pelvic floor
is a group of extremely important muscles located on the inside of the pelvis
with a hammock like orientation. They attach to the tailbone (coccyx) at the
back, the pubic bone in the front and span side to side.
Functions:
These muscles are involved in several complex functions but
are often overlooked in their contribution due to their “out of sight, out of
mind” presence. These functions include:
1. Bowel and Bladder Function and Support
Assists in control of the bladder and bowel (helping to prevent incontinence) in males and females. In females, the pelvic floor supports the uterus and other organs located in the pelvic cavity. This helps to prevent prolapse. Prolapse is the lowering down of a pelvic organ from its normal position.
Contribution to our Core Muscles?
The pelvic floor acts as the base of our core together with the deep back muscles and diaphragm. Core muscles help to provide strength and stability of the spine.
Involvement in Sexual Function
The pelvic floor plays a role in sensation during sexual intercourse. As a result, dysfunction of these muscles may lead to painful intercourse. In addition, it can lead to decreased sensation, and reduced erectile function amongst other symptoms.
Involvement in pregnancy and delivery
The strength of the pelvic floor muscles is very important during pregnancy. They help to support the extra weight of pregnancy. This can reduce certain symptoms of discomfort. They can also help to decrease the incidence of incontinence (bladder leakage), and prolapse. Additionally, they play a large role during delivery in guiding the baby’s head down the birth canal.
Symptoms of Dysfunction?
When the pelvic floor is working in harmony, it plays a big role in a variety of our functions. What happens when something is not quite balanced in the pelvic floor? Symptoms may arise. For example, they can be as a result of one of two scenarios: weakness in the pelvic floor or increased tension in the pelvic floor.
What about Kegels?
It is common to assume that any pelvic floor concerns are automatically as a result of weakness. Many people think that kegels should immediately be practiced. However, kegels are NOT always the answer! If the primary problem in the pelvic floor is tension, kegels can in fact do more harm than good. The Mysterious Pelvic Floor issues can be solved with a little Pelvic Physiotherapy!
So, what are some of the symptoms associated with pelvic floor dysfunction?
Urinary issues, such as the urge to urinate, incontinence (bladder leakage), urinary frequency and painful urination.
Bowel concerns such as constipation and incontinence
Lower back pain
Pain in the pelvic region, genitals, or rectum.
Discomfort during sexual intercourse for women.
Pressure in the pelvic region or rectum.
Muscle spasms in the pelvis.
What are some of the Risk Factors for issues with The Mysterious Pelvic Floor ?
A history of back pain
Previous trauma to the pelvic region such as a fall or pelvic radiotherapy
Ongoing constipation (i.e. for example, regularly straining to empty your bowels)
A chronic cough or sneeze (e.g. due to asthma, smoking or hayfever)
Being overweight, or having a body mass index above 25, and
Heavy lifting on a regular basis – either at work or at the gym most commonly
During pregnancy and post-partum, some factors may arise
Women who are going through, or have been through, menopause
Women who have had gynaecological surgery (e.g. hysterectomy)
Men who have had prostate surgery
Elite athletes such as gymnasts, runners or trampolinists.
What is a Pelvic Physiotherapist and How Can We Help?
What is a Pelvic Physiotherapist and How Can We Help?
A Pelvic Physiotherapist has advanced training . They assess and treat the pelvic floor through a combination of external and internal examinations. This treatment is for both males and females. Internal examination allows the Physiotherapist, to evaluate the pelvic floor directly. As a result, this will help to identify contributing factors to your concern.
Typically, tension or weakness are underlying imbalances in the pelvic floor. The Mysterious Pelvic Floor issues are usually treatable!
Although this is an area less known for its muscle contribution, the parallel of a shoulder injury should be drawn here, for example. In order to help treat a shoulder problem, a Physiotherapist would still have to evaluate all the muscles around it. We would check to see where the problem lies. Once found, these same muscles would be treated directly.
This is the same principle to keep in mind when trying to understand pelvic floor problems and treatment.
Treatment of The Mysterious Pelvic Floor?
Once a full examination has been completed, the Pelvic Physiotherapist discusses the results with you. Together, they will develop a treatment plan with you. Pelvic Physiotherapy treatments vary, however, some of the methods often used can include:
Postural training
Release and mobilizations , (often the low back, hips, etc. are involved).
Connective tissue release. Connective tissue is the thin layer found above our muscles. Sometimes, it can cause tension pulls and compression in areas. As a result, this causes pain and poor function.
Dilator work
Internal techniques to release areas of tension. We teach contraction exercises AND relaxation techniques. These are often overlooked
Exercises: These are positional to alleviate pain and pressure. They strengthen, stretch, and activate muscles. As a result, they help to build endurance, and improve coordination.
Breathing techniques
In cases where internal assessment or treatment may be painful, external treatment can be started first. This can often reduce the tension causing the internal discomfort. Improvements can be made to achieve your ultimate goals.
It is also important to note that Physiotherapists are primary health care providers. Therefore, you can see a Physiotherapist without a doctor’s referral. However, if your Physiotherapist feels that you may benefit from further testing, we will reach out to your doctor of choice.
Summary of The Mysterious Pelvic Floor
The Mysterious Pelvic Floor doesn’t need to be so mysterious!
Two of the most common phrases that I hear patient’s mention during or after a pelvic physiotherapy assessment are:
“I didn’t even know that this type of Physiotherapy existed” and
“I wish I knew about this sooner”
These phrases are often derived from patients who have a pelvic concern. In most cases, it has significantly affected their function. It has resulted from the belief that nothing could be done, besides “living with it.”
My hope is that Pelvic Physiotherapy becomes well known! My hope is that you seek treatment as often as our rotator cuff friends. Afterall, they both involve muscles that can be easily treated. Take care of your pelvic floor, it is literally of foundational importance!
If you or someone you know suffers from Pelvic Floor issues, PhysioNow can help! We have specially trained Pelvic Floor Physiotherapists available at all of our clinics to help. Call today to get started on your treatment!
