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Shoulder Injuries

Shoulder Injuries

Shoulder Injuries

Shoulder injuries are a common problem for many people. It can happen to people of all ages from children to the elderly. The pain from shoulder injuries can be very severe and cause a lot of limitations with work and activity. Shoulder pain is one of the top 5 reasons why people seek out Physiotherapy and Registered Massage Therapy treatments.

What Causes Shoulder Pain?

There are several reasons why people suffer from shoulder pain.

  • Trauma

    – any type of direct or indirect trauma can produce shoulder pain if the arm and/or shoulder is involved

    • Motor vehicle accidents
    • Falls
    • Sports injuries
    • Violent incidents
  • Poor workplace ergonomics

    – For people who work in offices, they may spend the majority of their time sitting in front of a computer. If the desk set up is not properly, then this may start to produce stress and pain into the shoulder. For example,  poor ergonomics can include:

  • poor desk and screen height
  • improper positioning of the keyboard and mouse
  • inadequate chair height and support
Proper desk ergonomics

Proper desk ergonomics

  • Poor posture

    – Many people have developed poor body postures over time. For some it starts young with spending a lot of time studying. It can also happen after carrying a heavy backpack or playing a lot of video/computer games. For others it starts later in life with workplace demands and poor office set up.

  • Good-Posture-vs-Poor-Posture

    Good-Posture-vs-Poor-Posture

  • Repetitive activities

    – Some people perform tasks that are repetitive at work and/or home. If the shoulder is not strong enough to support the work that it’s having to do, then injury may occur. For example,this can  include:

  • Overhead lifting
  • Sorting things on a belt
  • Operating heavy machinery
  • Typing

 

  • Congenital or Developmental changes

  • Some people are born with a unique bone structure that may place them at increased risk of injury. For example, the acromion of the shoulder blade can have 4 different shapes. For instance, if you have a hooked shape, there is more potential for rotator cuff injury.

Some Basic Shoulder Anatomy

Having some knowledge of basic shoulder anatomy will help with understanding why shoulder pain develops. The shoulder joint is quite complex. There are a lot of structures that attach to or around the shoulder. The shoulder allows for a lot of movement .  As a result, there is less stability through the area. It’s a joint that is held together by soft tissues.  Therefore, there is not a lot of bony protection. The shoulder is made of 4 separate joints that work together to allow function:

Shoulder Injury

Shoulder Anatomy

  • Glenohumeral (GH) joint – this is a ball and socket joint and is where majority of our arm movement happens. The socket is made up by part of the shoulder blade and the ball is made up of the humerus, which is the long bone of the upper arm.
  • Acromioclavicular (AC) joint – joint between the acromion of the shoulder blade and the collar bone.
  • Sternoclavicular (SC) joint – joint between chest bone and the collar bone.
  • Scapulothoracic joint – the joint between the shoulder blade and the ribs at the back of the chest.

The Soft Tissues around the Shoulder Joint

We know that the shoulder is held together by many soft tissues including ligaments, muscles and tendons.   Other important structures include the joint capsule surrounding the ball and socket joint.  Lastly, your shoulder has  subacromial and subdeltoid bursae. The function of the joint capsule is to protect the joint and produce a lubricating fluid. Shoulder bursae are small fluid-filled sacs that act as a cushion between the bone and other moving parts.

Bursae of the shoulder joint

What are some of the types of injuries that can happen to the shoulder?

  • Sprains/Strains of any of the muscles, tendons and ligaments
  • Tears/Ruptures of any of the muscles, tendons and ligaments
  • Rotator Cuff Tear
  • Rotator Cuff Tendonitis
  • Tendonitis/Tendinosis
  • Fractures
  • Bursitis
  • Dislocations
  • Adhesive Capsulitis or Frozen Shoulder
  • Osteoarthritis
  • Nerve entrapments/injuries

Signs and Symptoms of Shoulder Injuries

  • Pain
  • Swelling
  • Restricted movement
  • Weakness
  • Instability
  • Bony deformities

 

Healing Times for Shoulder Injuries

The healing time for shoulder injuries will vary depending on the injury. Most simple sprains/strains will likely take anywhere from 6-8 weeks to get better.

Fractures of the Shoulder can take 6-8 weeks to heal the fracture.  After the fracture is healed, the soft tissues may require up to 4-5 months to heal fully with proper Physiotherapy.

However, frozen shoulders  can take over 1 year to improve. There are also a lot of individual differences in healing time amongst different people, even for similar injuries. For example, some of these factors  can include:

  • Age
  • Severity of Injury
  • Was surgery required ?
  • Level of fitness and/or mobility
  • Commitment to treatment
  • Ability to modify workplace or home environment to allow for best treatment response
  • Presence of other injuries
  • Amount of time that the injury/pain has been present

Physiotherapy/Massage Treatment for Shoulder Injuries

Treatment for shoulder pain will depend on the type of injury. It will also depend on the area that has been injured.

However, since the shoulder is made up of 4 joints, treatments should target the whole shoulder and not just the individual area injured. This will allow the shoulder to return to its full function. It will also reduce the risk of re-injury.

In sum, the main goals of any shoulder pain treatment will be to:

  • Decrease pain
  • Regain full movement
  • Recover strength and stability
  • Return to pre-injury activities

Registered Physiotherapy for Shoulder Injuries

A Registered Physiotherapist will start with a full assessment so that we can identify the source of the shoulder pain. This will allow us to provide the best treatment for you. Treatment can typically include:

  • Manual therapy
    • soft tissue work
    • mobilizations
    • assisted stretching of the shoulder and nearby areas
  • Modalities – these are usually used in the early phase for pain relief
    • Ultrasound
    • Laser
    • IFC or TENS
    • Heat/Ice
  • Exercise prescription
    • Movement and strengthening exercises that are specific to the injury
    • So, it is important that you complete the prescribed exercises on a regular basis at home.
    • In short, this will ensure that you are continually providing treatment to the shoulder even when you are not physically present in the clinic.
    • Shoulder Exercise

 

 

 

  • Education
    • Explanation of the condition
    • Rationale for the treatment choices
    • In essence, Do’s and don’ts to help the injury along

Registered Massage Therapy for Shoulder Injuries

  • Registered Massage Therapy can be very helpful to release tight muscles around the upper back, neck and shoulder blades
  • shoulder injuries

    Registered Massage therapy for shoulder injuries

 

 

 

 

Shoulder injuries can be quite debilitating, and it is important to seek out a Registered Physiotherapist for assessment and treatment sooner rather than later. Like most other injuries, the longer an injury is left untreated, the more chronic it becomes. As a result, it makes it more difficult to resolve in a timely manner.

Call PhysioNow today to get treatment for your shoulder injury!

 

Accident Rehabilitation

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!

TMJ syndrome

TMJ syndrome

TMJ syndrome is broadly classified into 2 syndromes.
The temporo- mandibular joint (TMJ) is the synovial joint that connects the jaw to the skull. These joints are located just in front of each ear.

TMJ syndrome

Classification of TMJ syndrome

TMD is broadly classified into 2 syndromes:
• Muscle-related TMD (myogenous TMD), sometimes called TMD secondary to myofascial pain and dysfunction
• Joint-related TMD, or TMD secondary to true articular disease

Causes of TMJ syndrome

• trauma
• disease,
• wear and tear due to aging
• oral habits, such as chewing gum, tobacco, candy or ice

  • grinding your teeth or clenching your jaw

 

Signs and Symptoms of TMJ syndrome

• Pain in the jaw
• Clicking and popping sound in the ear
• Pain while chewing the food
• Stiff and sore jaw muscles
• headaches

Treatment for TMJ syndrome

general

  • • including heat to the joint,
    • nonsteroidal anti-inflammatory drugs (NSAIDs)
    • avoiding chewing gum, candy, ice, or tobacco
    • stress reduction.

    • wear a mouth guard at night
    • avoid activities that require you to keep your mouth open such as fellatio
    • avoid eating food that is hard to chew such as steak

If you are interested in knowing a bit more about this syndrome, check out this link .

 

Physical therapy techniques for TMJ syndrome may include:

• Jaw exercises to strengthen muscles and improve flexibility and range of motion.
• Heat therapy to improve blood circulation in the jaw.
• Ice therapy to reduce swelling and relieve pain.
• Massage to relieve overall muscle tension.
• Transcutaneous electrical nerve stimulation (TENS),
• Movement of the temporomandibular (TM) joint to release scar tissue that restricts muscle movement and to improve range of motion.
• Ultrasound therapy- to reduce pain and swelling and improve circulation.

If you have any further queries please call PhysioNow. Our experienced Registered Physiotherapists would be happy to help you recover from TMJ syndrome.  There are Registered Physiotherapists at each of our locations that are trained specifically to assess and treat this injury.  Assessment takes about 40-50 minutes and each treatment typically takes about 30-40 mins.  Resolution of TMJ syndrome can be quite rapid with some patients only requiring a few visits for the pain the stop.

Call today!

Benefits of massage therapy 

Benefits of Massage Therapy

There are many Benefits of massage therapy.  Below you will find some of the injuries that benefit most from massage therapy.

  1. Whiplash Injury

    A common injury from a motor vehicle accident, whiplash is a neck sprain resulting from the sudden forces typical of a car crash.

    Symptoms

    • Neck stiffness
    • Headache
    • Dizziness
    • Paresthesia
    • Shoulder, back or arm pain

    Benefits of massage therapy

    Massage therapy can be used for the treatment of both acute and chronic conditions. RMTs can work with a wide variety of patients, of all ages, in the treatment of illness, injury rehabilitation and disability.

  2. Fibromyalgia

    Fibromyalgia is associated with widespread chronic pain, fatigue, memory problems and mood changes. It occurs more often in women than in men. It is not a disease, but rather a syndrome that can be managed.

    • Benefits of massage therapy
    • The first will be relaxation to improve sleep.
    • The second benefit is improved muscle tonicity
    • A fifth benefit is diminishing the effects of any anxiety or depression
  3. Low Back Pain.

    The low back is susceptible to strain because of its weight-bearing function. Connection in movements, such as twisting and bending can cause Low back pain. Muscle strain is caused when muscle fibers are over-stretched or torn. Inflammation is common at the site of injury.  This is usually accompanied by pain with movement.

    Causes

    • Facet joint disease
    • Osteoarthritis
    • Muscle strain
    • Mechanical pain
    • Degenerative disc disease

    Benefits of massage therapy

    Some benefits of Massage therapy for Low Back Pain include the following:

    • Reduced pain.
    • Improved joint mobility.
    • Improving circulation.
    • Improving lymphatic drainage.
    • Reducing muscular tension.
  4.  

  5. Pregnancy

    Massage Therapy performed during pregnancy can:

    • Reduce anxiety
    • decrease symptoms of depression,
    • relieve muscle aches and joint pains,
    • improve labor outcomes and newborn health.

If you or someone you know could benefit from Massage Therapy,  please call PhysioNow. Our highly experienced Massage Therapists would be happy to help you!

Neck Pain Treatment

Neck Pain Treatment

Neck Pain Treatment

Pain in your neck can happen for several different reason  . Neck Pain Treatment can help get you back on your feet quickly.  It can happen suddenly from an accident or fall.  Even sleeping in an awkward position can cause neck pain. Other times it can build up over several months or even years and gradually get worse. And sometimes, it may seem like there is no reason and you just wake up one day with neck pain.

Neck Pain Treatment:  Possible symptoms you may feel

  • The way you feel the pain can also vary depending on how the  injury happened.
  • Some neck injuries will have just pain as the symptom.
  • Other neck injuries will include pain but also have weakness and pins and needles as well.
  • Sometimes you will have pain that is just in the neck itself. In other cases, pain is felt more in the arms or hands.  When this happens,  you might not think that there is anything wrong with your neck at all.
  • Neck pain Treatment can be difficult mostly because it can be difficult to properly diagnose. It is important to find an experienced Registered physiotherapist to make sure that appropriate treatment is received.

See this link for possible causes of Neck Pain.

Neck pain Treatment options:

There can be a variety of treatment options that can be successful at managing neck pain.

  • Modalities such as heat and IFC/TENS can help with reducing pain temporarily.
  • Manual treatment techniques like soft tissue work and mobilizations help with improving mobility and reducing stiffness and tissue tension.
  • Doing the appropriate exercises will also help stretch and strengthen the affected areas.
  • Acupuncture is another modality that can help with reducing pain and improving stiffness.
  • Massage therapy is another treatment approach that can greatly alleviate pain and stiffness and help further the patient’s recovery.
  • Ultimately, there are a variety of treatment options available to treat neck pain. It is up the treating therapist and their expertise to determine the best treatment approach to correct the pain and achieve the patient’s goals.

Neck pain can be very painful  and really affect a your quality of life. It is important to seek help as soon as possible so that the pain and limitations can be addressed and recovery can be achieved quickly!

Call PhysioNow today to get started!