Tag Archives: physiotherapy

ACL REHAB, ACL Rehabilitation, ACL Tear, Knee Pain, Physiotherapy, Sports Injuries, Sports Physiotherapy

Lindsey Vonn: Resilience and Rehabilitation

Leave a comment

The Winter and Summer Olympics are awaited eagerly by both viewers and athletes across the world. We get to witness amazing feats of athleticism and elite performance across all kinds of sports! For a competing athlete, the Olympics can be everything to them. It’s the ultimate goal, allowing them to push through pain, injuries and intense stress, all for the chance to prove themselves on the world stage. For one incredible Team USA athlete, their leadup into the Olympics was one of resilience and determination. This is the story of Lindsey Vonn.

What is Lindsey Vonn’s story?

Lindsey Vonn is one of the most decorated alpine skiiers in history, winning over 84 World Cup titles across different disciplines of alpine skiing. She has consistently been competing (and competing successfully!) at the highest level despite numerous and severe injuries including fractures and ligament tears. She made a decision to retire in 2018, citing her history of injuries. However, she decided to return to competitive skiing in 2024 after receiving a knee replacement surgery. She became the oldest downhill skiing World Cup winner in 2024, at the age of 41. This brings us close to the present day, the 2026 Winter Olympics.

At the World Cup in Jan 2026, she crashed and had to be airlifted off the mountain. Later, it was revealed that she had ruptured her left knee’s ACL. Despite this, she communicated her intent to still compete in the Olympics 1 week later. Unfortunately, at the Olympics, she had another crash where she had to be airlifted off the mountain. Afterwards, she stated that she had suffered a complex tibia fracture requiring several rounds of surgery.

How did Lindsey Vonn manage to compete with her injuries?

A case like Lindsey Vonn’s is instrumental to showing the importance of sports rehabilitation. Throughout her career, she sustained multiple serious knee injuries, including anterior cruciate ligament (ACL) tears, medial collateral ligament (MCL) injuries, tibial plateau fractures, and meniscal damage. She underwent several reconstructive surgeries, particularly on her right knee.

High-level alpine skiing places extreme forces on the knee joint. For example, cutting, rapid deceleration, torsional loads, and high-speed turns require not only strength, but joint stability and proprioception. Returning to competition after ligament reconstruction demands months of structured rehabilitation, often 9-12 months or longer. Her career illustrates that prior injury does not automatically end athletic performance, but it does require lots of dedication to a rehabilitative program.

How did Lindsey Vonn’s pre-existing injuries affect her?

Previous injuries pre-dispose athletes to further injuries, due to changes that happen through out the body. For Lyndsey Vonn, the rupture in her ACL tendon definitely affected the strength and stability around her knee. Some of these changes include:

1. Strength asymmetries

Muscles around the injury tend to get weaker. For example, quadriceps inhibition and hamstring weakness are common long-term consequences of knee injury. Even subtle asymmetries can affect force generation during high intensity sports and movements.

2. Proprioception and neuromuscular control

Tissue injury disrupts mechanoreceptors responsible for the sense of proprioception, or joint position awareness. This awareness gives your joints stability which is especially important during movements like pivoting and cutting.

3. Load tolerance

Cartilage and meniscus damage can reduce shock absorption capacity. Sufficient strength and coordination of muscles must be retrained to compensate

4. Psychological readiness

Fear of reinjury (kinesiophobia) is a well known barrier to return to sport, whether you’re a competitive or recreational athlete. Confidence in your body and its ability to resist injury is necessary to achieve your full potential.

In Vonn’s case, repeated returns to elite skiing required not just healing, but continuous adaptation. Competing with a history of knee reconstruction often means meticulous strength programming, external bracing support, and careful monitoring of training volume.

What does this mean for a recreational athlete?

Even if you’re not at an elite level for sports, you should still rehabilitate each of your sports injuries. Not only will it reduce your risk for future injury, but it can help you achieve new levels of performance. Many recreational players experience similar injury patterns. For example, ACL tears, meniscal injuries, ankle sprains, rotator cuff tears, and stress fractures are common across many sports including soccer, basketball, skiing, running, and CrossFit.

A common misconception is that once pain decreases, the injury has resolved. In reality, pain reduction often precedes full tissue healing and neuromuscular recovery. Returning to sport too early without restoring the necessary strength and control, can create a cycle of recurrent injury.

If you have a pre-existing sports injury, consider:

  • Are both sides equally strong?
  • Can you perform single-leg movements with control?
  • Can you perform all the necessary movements of your sport?
  • Do you have the endurance to play a full game/session of your sport?
  • Do you have the same jumping/hitting power as before the injury?
  • Are you following a structured strengthening program?

Sports physiotherapy addresses these gaps systematically.

Need help with a sports injury?

Then look for PhysioNow! Lindsey Vonn’s career is proof that sports injuries do not have to be the end. If you have suffered a recent or even a long time injury that’s affecting or stopping you from playing or participating, there is help. Our expert physiotherapists are avialable at 10 locations across the west GTA from Burlington, Oakville, Mississauga, Etobicoke, and offer Physiotherapy, Massage Therapy, Manual Osteopathy and more! Book with PhysioNow today for your first assessment and treatment!

Back Pain, neck pain, Neck pain Treatment Mississauga, Neurological, Physiotherapy

Physio 101: Centralization vs Peripheralization

Leave a comment

Medical terminology can be a patient’s biggest nightmare. During a session, a lot of unfamiliar terms describing symptoms, conditions, muscles, and more can be used. Today, we will be discussing a process called centralization and peripheralization that is encountered a lot during physiotherapy. To elaborate, spinal and musculoskeletal pain and other symptoms can sometimes move, change location, or feel different with certain movements or exercises. The two important terms physiotherapists use to describe these changes are centralization and peripheralization.

Understanding these concepts helps you understand your treatment, reduce fear, and improve your rehabilitation outcomes.

What is centralization?

Centralization occurs when pain that was felt farther away from the spine (for example, in the leg or arm) moves closer to the spine or reduces in intensity with specific movements or positions.

Examples of centralization include:

  • Leg pain moving from the calf to the thigh
  • Arm pain reducing and becoming more localized to the neck
  • Radiating pain decreasing while central discomfort remains

Centralization is generally considered a positive sign in physiotherapy.

What is peripheralization?

Peripheralization is the opposite phenomenon. It occurs when pain:

  • Moves farther away from the spine
  • Becomes more widespread
  • Increases in intensity in the limb

For example:

  • Low back pain spreading further down the leg
  • Neck pain traveling into the arm or hand
  • Symptoms becoming sharper or more intense at areas farther from the spine

Peripheralization often indicates that a movement or load is not currently well tolerated.

Why do centralization and peripheralization occur?

Model of the spine
Model of the spine showing how the nerves (yellow) exit through spaces around the spine. These nerves give us sensation in our limbs so problems centrally can produce pain and symptoms peripherally

The spine, discs, joints, and nervous system are highly interconnected. Changes in symptoms reflect how these systems respond to movement and load.

Possible contributors include:

  • Mechanical loading of spinal structures
  • Sensitivity of neural tissues
  • Protective responses from the nervous system
  • Individual movement patterns and postures

Ultimately, these symptom changes provide valuable information for guiding treatment. Your physiotherapist can interpret these changes to determine whether the treatment is working well, or whether a different technique needs to be used.

Why is centralization important for physiotherapy?

A condition that displays centralization is commonly associated with:

  • Improved outcomes
  • Reduced nerve irritation
  • Better tolerance to movement

When symptoms centralize, physiotherapists often continue or build upon the movements that produce this response. So what happens to the patients that don’t show a centralization response? Unfortunately, while centralization is desireable to have, not all patients experience it. Thankfully, many people still recover fully without clear centralization patterns, it just may take more time.

Physiotherapy always considers the whole clinical picture, including function, pain levels, strength, and confidence with movement.

What does peripheralization mean for treatment?

Peripheralization does not mean lasting harm or damage is being done to the tissue. Instead, it signals that:

  • A movement may need modification
  • Load may need to be reduced
  • A different strategy may be more appropriate

Physiotherapists use this information to adjust treatment safely and effectively. A movement that causes peripheralization may become a part of treatment later on, but is currently not appropriate.

A summary of centralization vs peripheralization

An example of a repeated movement is back extension in a lying position. Over the course of the repeated movements, symptoms in the leg and back are being watched for change.

Physiotherapists assess symptom responses during:

  • Repeated movements
  • Postural changes
  • Functional tasks

This helps identify patterns of centralization vs peripherilization:

  • Movements that reduce symptoms
  • Movements that aggravate symptoms
  • Optimal starting points for rehabilitation

Treatment is then tailored to encourage positive responses while avoiding unnecessary symptom flare-ups.It’s important to understand that symptom location does not always reflect tissue damage where the pain is felt. Even though your pain might be in the ankle, your physiotherapist will be checking your back for the possibility of referred pain.

Looking for physiotherapy treatment?

Look for PhysioNow! We have 10 locations across the west GTA including Burlington, Oakville, Mississauga and Etobicoke. Our expert clinicians can help you recover from an injury, neck pain, back pain, and more. Don’t wait any longer, we can help you get back to your normal life. Book with PhysioNow today for your first assessment and treatment. We can be reached at P: 289-724-0448 Email: applewood@physionow.ca

Health and Wellness, Medical Imaging, Physiotherapy

Medical Imaging: Things Your Physiotherapist Wants You to Know

Leave a comment

Medical imaging is something many of us are familiar with in Canada. Whether you’ve had an x-ray, ultrasound, MRI, or CT, you may have had to undergo one or the other at some point in time. For many people, they think of it as the gold standard for understanding their pain or injury. In fact, i’s completely natural to want answers, but here’s something us physiotherapists wish more people knew:

Medical image findings are poorly connected to pain, and you don’t need imaging to start recovering with physiotherapy treatment!

What is the connection between medical imaging and pain?

One of the most important things we can teach our patients to relieve lots of fear and anxiety is the fact that medical imaging results have a very poor correlation with people’s symptoms. Now what does this mean? Research studies have consistently shown that individuals that have no pain and have imaging done still have “abnormalities” such as:

  • Disc bulges/herniations
  • Degenerative disc disease
  • Varying levels of arthritis
  • Tendon tears
  • Mensical tears

On the other side of this, people with pain and other symptoms may have imaging that comes back normal or inconclusive! Importantly, this does not mean that what you are feeling isn’t real, but that pain has many different sources that all interact to form the big picture. Overall, the main takeaway is to not overly rely on medical imaging, what’s more important is to listen to what your body is telling you.

When is medical imaging useful or not useful?

The American Academy of Family Physicians (AAFP) has published a recommendation of “Don’t do imaging for lower back pain in the first 6 weeks (unless red flags are present)”. They found no connection of imaging with better recovery, only an increase in health care costs.

Now there is definitely a time and a place for medical imaging. It is a useful diagnostic tool and when used appropriately, provides a lot of information and guide our prognosis. For example, x-rays to confirm fractures after a fall. What we are trying to avoid is sending every patient with lower back pain for an x-ray or MRI that will likely have low diagnostic value, and has a much higher chance of getting better by starting physiotherapy treatment. Additionally, these excessive referrals can strain the health care system’s limited resources, resulting in those who actually would benefit from imaging having to wait for longer periods of time.

Another time where we recommend medical imaging is during a course of physiotherapy treatment where we start to detect red flags (indicators of more severe medical conditions), or when the condition is not responding as expected. Here, the physiotherapist and members of the medical team can work collaboratively to determine the likely issue, and can expedite imaging or referrals to a specialist when warranted.

How does physiotherapy treat without imaging?

Remember that imaging is just one piece of the puzzle. There are many other clues that your physiotherapist can use to piece it together including:

  • Range of motion
  • Muscular strength
  • Quality of your movements
  • Coordination and balance
  • Special tests designed to assess specific conditions
  • Which movements or positions are hard to you

With most conditions, there are a pattern of subjective and objective symptoms that your physiotherapist will be able to identify and match to the most likely conditions.

Medical imaging wait times: The reality

MRI waiting times are usually several months.

Unfortunately, the reality of wait times for tests, for referrals, for surgeries, can be anywhere from days, to weeks, to months, to a year plus. At the higher end, this can leave people stranded in the system awaiting help, having to manage their pain and disability for months at a time. During this time, the condition may worsen, people become scared of moving, and this may delay recover times. This is why we recommend that people start physiotherapy as soon as possible, even while awaiting imaging. Many times, people will start to improve, and some completely, before the day of their test.

As trained professionals, physiotherapists will be able to personalize the plan to your unique circumstances to ensure safety, comfort, and effectiveness of the treatment. Of course, there are some cases where medical imaging may still be required, but before that point you can still improve your strength, mobility, pain and function.

Awareness is the key

Our goal is to raise awareness about the trap of medical imaging. Words like degeneration, tear, and bulge, are very scary to read on a report and leave patients feeling disempowered and discouraged. The great news is that for most people, those words can be disregarded and improvement can still be found, you might just need a little help getting there!

If you are waiting for medical imaging, confused by previous results, or looking for treatment for your pain, then look for PhysioNow! With a team of expert health professionals including Physiotherapists, Registered Massage Therapists, and Manual Osteopaths, you are in good hands. We have 10 locations across the west GTA including Burlington, Oakville, Mississauga, and Etobicoke. Please feel free to reach us by Phone: 289-724-0448 Email: applewood@physionow.ca. Book with PhysioNow today for your first assesssment and treatment!

Back Pain, Headaches: Neck Pain, Low back Pain, Motor Vehicle Accidents, neck pain, Physiotherapy

Physiotherapy After a Motor Vehicle Accident (MVA)

Leave a comment

A motor vehicle accident (MVA) can cause high degrees of neck and back pain, even if the impact seemed minor. Oftentimes, people will feel pain, stiffness, headaches, and/or reduced movement. Additionally, these symptoms may occur immediately, hours after, or even days or weeks after the accident. Thankfully, physiotherapy plays an important role in helping your body heal properly and prevent long-term complications.

In Ontario, most people fall into the Minor Injury Guidelines (MIG) after a car accident that entitles them to $3500 of medical treatment, including physiotherapy. This is usually sufficient to treat less severe injuries such as strains, sprains and whiplash disorders. After a car accident, the last thing you want to deal with is wordy forms and legal speak. Luckily, PhysioNow and our clinics are one of the preferred providers of MVA treatment from Intact, and our staff is ready to streamline the process for you. Find out more about our MVA treatments here!

Why is neck and back pain so common after an MVA?

Sudden forces during a collision can strain muscles, joints, and ligaments in the spine. Common injuries include:

  • Whiplash (neck injury)
  • Muscle strain and tightness
  • Joint stiffness
  • Nerve irritation
  • Poor posture due to pain and guarding

Without proper care, these issues can turn into ongoing or chronic pain.

How does physiotherapy treat MVAs?

At our clinic, we focus on pain relief, restoring movement, and helping you return to daily activities safely. Your physiotherapy treatment may include:

  • Pain and inflammation management
  • Hands-on manual therapy
  • Personalized exercise plans
  • Strengthening exercises for neck, back, and core muscles
  • Posture and movement correction
  • Education on safe activities, work, and daily movements

All treatment plans will be adapted to each patient, based on the symptoms, goals, and stage of recovery.

How does PhysioNow help with auto insurance claims?

On your first day, there will be many forms to read over and fill out. Don’t worry, our staff will be able to guide you through and answer any questions that you have!

We understand that dealing with auto insurance after an accident can be stressful. Our clinic helps by:

  • Accepting auto insurance (MVA) claims (not all private clinics will)
  • Direct billing when applicable
  • Communicating with your insurance company and other healthcare providers
  • Creating treatment plans that follow insurance guidelines
  • Guiding you through forms and what to expect

This allows you to focus on your recovery while we handle the paperwork.

Why is early physiotherapy so important?

Some people choose not to pursue physiotherapy right away. However, the longer you let a problem persist, usually the more disruptive it becomes. In some cases, waiting may prolong recovery times. Since you will have the coverage, we encourage people to get started with their rehabilitation as quickly as possible. The benefits of early physiotherapy includes:

  • Reduces pain and stiffness early
  • Prevents long-term complications
  • Improves movement and confidence
  • Speeds up return to work and daily life
  • Reduces reliance on pain medications

Start your MVA recovery with PhysioNow

If you’ve been in a motor vehicle accident and are experiencing neck or back pain, early physiotherapy can make a big difference. Our experienced physiotherapists are here to guide you through every step of recovery. PhysioNow has 10 locations across the west GTA including Burlington, Oakville, Mississauga, and Etobicoke. Please feel free to contact us by Phone: 289-724-0448, Email: applewood@physionow.ca, or through our online portal. Book with PhysioNow today to get started with your MVA assessment and treatment.

Acute Ankle Sprains, Ankle pain, Physiotherapy, Sports Injuries, Sports Physiotherapy

Ankle Mobility Matters: A Hidden Reason Behind Back, Hip and Knee Pain

Leave a comment

Ankle mobility, or rather the lack of it, is often overlooked. Many people assume ankle problems only matter if they’ve had a sprain or fracture. In reality, limited ankle mobility can affect your entire body, from your knees and hips to your lower back. At physiotherapy clinics, it is very common to see patients with knee pain, hip pain, or back pain where the root cause is actually poor ankle movement. Understanding ankle mobility and how it ties into the whole body can help you proactively prevent pain and reduce your injury risk.

What is ankle mobility?

Ankle mobility refers to how well your ankle joint moves. Normally, the ankle joint moves into dorsiflexion (bringing the foot closer to the ankle), plantarflexion (pointing the foot away from the ankle), inversion (sole of the foot towards the middle), eversion (sole of the foot away from the middle), and a combination of these movements. There are relative “normals” for each movement recorded in degrees, but ultimately, there are lots of individual variations of normal. Usually, we talk about restricted ankle mobility in something being different for that specific person, such as between their left and right sides. Healthy ankle mobility is essential for:

  • Walking
  • Running
  • Squatting
  • Going up and down stairs
  • Maintaining balance
  • Absorbing shock during movement

Why is ankle mobility so important?

In our daily movements, ankle mobility is key. As seen above, a deep squat requires a lot of dorsiflexion mobility.

To sum it up, when ankle motion is restricted, your body is forced to compensate elsewhere. For example, the ankle is one of the first joints that contacts the ground while moving around. If it does not have the mobility to perform its job as a shock absorber properly, them the joints above it must work harder. As a result, they will experience a greater proportion of stress. For another example, somebody without sufficient dorsiflexion in their ankle has a very hard time going down stairs. Instead, a lot of pressure goes into the knee as it has to bend much more to compensate for the ankle. Try it yourself at home! Can you go down the stairs without bending your ankle? Instead, you might find this happening when ankle mobility is limited:

  • The knee collapses inward or twists
  • The hip rotates excessively
  • The lower back moves more than it should
  • Balance becomes less stable
  • Muscles fatigue faster

Over time, these compensations increase stress on other joints and tissues, leading to pain and injury.

Common causes of ankle restrictions

Following the use it or lose it principle, immobilization is one of the biggest causes of ankle restrictions. After getting it off, it is essential to start moving immediately to regain range of motion.

Ankle stiffness can develop for many reasons, even without recent injury. For example, many people don’t realize their ankle never fully recovered after an old sprain. It might have recovered 90% of the way so that they don’t notice it day to day, but over the course of years the effects from that can build. Common causes include:

  • Previous ankle sprains (even years ago)
  • Immobilization in a boot or cast
  • Tight calf muscles
  • Muscle contractures
  • Scar tissue
  • Prolonged sitting
  • Wearing unsupportive footwear
  • Reduced activity levels
  • Arthritis
  • Poor movement habits

Signs that you may have limited ankle mobility

You may have ankle mobility issues if you notice:

  • Heels lifting off the ground during squats
  • Knee pain doing stairs or lunges
  • Feeling stiff in the ankles, especially in the morning
  • Poor balance on one leg
  • Recurrent ankle sprains
  • Feel like you have “tight calves” despite stretching a lot
  • Pain during walking or running
  • Feeling unstable on uneven surfaces
  • Back or hip pain with no clear cause or changes in range of motion

How do I improve my ankle mobility?

Physiotherapist helping their patient regain dorsiflexion range of motion

Physiotherapy is a great way to learn your areas of weakness or vulnerabilities and get help addressing them. Specifically for the ankle, you can focus on restoring ankle mobility and correcting compensation throughout the body. At PhysioNow, treatment typically includes:

  1. Comprehensive assessment: Your physiotherapist assesses range of motion, muscle length and tension, biomechanics, gait patterns, balance and coordination, muscular strength and more. This helps identify the extent of your ankle stiffness and how its affecting the rest of your body.
  2. Manual therapy: Hands on techniques can reduce stiffness, improve flexibility, break down scar tissue, reduce pain, and more. The specific techniques used will be decided based on the results of the assessment
  3. Home exercise plan: Targeted exercises focusing on your areas of need and goals will be given. These may includes stretching, mobility, functional, strength, balance, speed, coordination, power exercises and more! Your physiotherapist will work with you personally to decide.
  4. Movement retraining: If you have been compensating for a long time, you will have to unlearn your old compensatory habits. For example, you may have to readjust to proper mechanics for squatting, walking, running, sports movements and more.

Looking for help with an ankle?

Look for PhysioNow! We can help with sports injuries, ankle, back, knee, hip pain, and so much more. We have 10 beautiful locations across the west GTA including Burlington, Oakville, Mississauga, and Etobicoke. Our experienced clinicians can answer any questions you have and get you back to feeling and doing great. Find us at P: 289-724-0448 or E-mail: applewood@physionow.ca. Book with PhysioNow today for your first assessment and treatment!

Back Pain, Headaches: Neck Pain, Health and Wellness, Low back Pain, mindfulness, neck pain, Physiotherapy, Sleep

Physiotherapy for Better Sleep: Treatment to Help You Rest

Leave a comment

Better sleep, a goal that many of strive for day after day. Unfortunately, the struggle to get a good night’s sleep may be known to many of us. Tossing and turning, waking up with a stiff neck or sore back, or feeling exhausted even after a full night in bed, sound familiar? At PhysioNow, we often see patients who come for back pain or neck pain, but once we treat the underlying physical tension, they start sleeping better too. Ultimately, that’s because your body and sleep quality are closely linked. Physiotherapy helps your body relax, realign, and recover, so you can fall asleep easily and wake up feeling truly rested. 

Why does sleep matter?

We all know sleep is important, but are you aware of what actually goes on in your body when you’re catching z’s? Good sleep is when your body performs its most powerful repair work. To name a few, your muscles rebuild and recover from daily stress or exercise, tissues and joints heal from inflammation or injury, the nervous system calms down and resets and even more!

When your sleep is disturbed, this natural recovery process is interrupted. Over time, you may notice:

  • Morning stiffness
  • Fatigue
  • Slower healing
  • Reduced focus
  • Reduced mental function

If your pain or posture issues are keeping you awake, it’s a sign your body isn’t getting the deep rest it needs. This can lead to a chain effect of other negative symptoms in the body. Overall, we all know how it feels to be sleep deprived and not feel great, so lets see how we can fix it!

How does physiotherapy give you better sleep?

Improving sleep quality can be the main focus or even a side effect of physiotherapy treatment. Many of the treatment techniques used will either directly or indirectly affect your sleep. We may not think about it often, but there is certainly a science behind sleep! Here are different ways that physiotherapy can affect give you better sleep:

1. Easing pain and tension that disrupt sleep

For example, many people struggle with a difficult time falling asleep or waking up due to discomfort in the night and being able to go back to sleep. Physiotherapists use techniques such as manual therapy, gentle joint mobilizations, soft tissue release, and modalities to reduce discomfort. Once your pain decreases, your body automatically relaxes, making it easier to fall asleep and stay asleep through the night. 

2. Correcting postures and sleep positions

Your posture during the day affects your comfort at night. As a result, your physiotherapists will assess your spinal alignment, pillow height, and mattress type. We can guide you on ideal sleeping postures to fit your individual circumstances. Some of these tips may include tips like side sleeping with a pillow between your knees or back sleeping with one under your knees to reduce strain. 

3. Managing stress and nervous system overload

Physiotherapy helps regulate your nervous system through mindfulness breathing exercises, gentle stretches, and relaxation. Deep breathing activates your body’s “rest and digest” mode, lowering heart rate and easing muscle tension. There is also evidence for the healing power of touch, and the benefits of massage on easing stress.

4. Improving mobility and reducing restless nights

When joints or muscles are stiff, your body keeps adjusting during the night. A personalized mobility and strengthening program can help you move freely and rest comfortably. 

5. Supporting recovery from injury or surgery

After injury or surgery, pain and immobility often lead to poor sleep. Physiotherapy assists recovery, restores function, and reduces the need for pain medication that can disrupt deep sleep.

Easy physiotherapy tips for a better night’s sleep

  • Stretch before bed: Get your body into a relaxing routine by stretching gently for 5–10 minutes.
  • Breathe deeply: Try slow belly breathing before bed. You may combine this with the stretches or when lying down to calm the mind
  • Adjust your pillow: Make sure your pillow is supportive. It should keep your spine in a neutral position when lying on it
  • Stay active during the day: Movement improves circulation and exercise is know to improve sleep quality
  • Watch screen time: Blue light delays sleep hormones
  • Address discomfort early: Don’t wait until pain becomes chronic

Looking for help with better sleep?

Look for PhysioNow! At PhysioNow, our experienced physiotherapists focus on your complete well-being, not just symptom relief. We take time to understand how your posture, work habits, and daily activities affect your body and sleep. With this information, we can make you a personalized plan to address your concerns.

We offer personalized one-on-one care, education on posture, sleep ergonomics, and relaxation,e exercise plans for flexibility and strength, breathing and mindfulness guidance and more. Come find us at 1 of our 10 locations across the west GTA, including Burlington, Oakville, Mississauga and Etobicoke. Book with PhysioNow today for your first assessment and treatment!

P: 289-724-0448 E-mail: applewood@physionow.ca

acupuncture, Neurological, Physiotherapy

Bell’s Palsy: Causes, Symptoms, and How Physiotherapy Helps

Leave a comment

What Is Bell’s Palsy?

Bell’s palsy is the most common form of facial paralysis worldwide. While the sudden onset of facial weakness can be alarming, the condition is usually temporary and, with appropriate care, highly treatable. Bell’s palsy is an acute, often temporary paralysis of the facial nerve, also known as the 7th cranial nerve. This nerve controls the muscles responsible for facial expression, including smiling, blinking, and closing the eyes.

When the facial nerve becomes inflamed or compressed, it can result in:

  • Pain or discomfort on one side of the face
  • Sudden facial weakness or paralysis
  • Difficulty performing everyday facial movements

Bell’s palsy can affect people of all ages, although it is uncommon in children under 15 and adults over 60. While Bell’s palsy is not considered permanent, a small number of people may experience lingering symptoms. For most individuals, recovery begins within 2 weeks to 6 months.

What causes Bell’s Palsy?

The exact cause of Bell’s palsy is not fully understood. However, strong evidence suggests it is related to viral reactivation, leading to inflammation within the narrow bony canal through which the facial nerve travels.

Possible viral triggers

  • Herpes simplex virus (HSV-1)
  • Varicella-zoster virus (shingles)
  • Epstein–Barr virus
  • Influenza viruses

This viral reactivation causes swelling that disrupts the nerve’s ability to function normally.

Possible other risk factors

You may be at higher risk of developing Bell’s palsy if you have:

  • Diabetes
  • Pregnancy (particularly in the third trimester or postpartum period)
  • A recent viral illness
  • Autoimmune conditions
  • High stress levels
  • Hypertension
  • A family history of Bell’s palsy
  • Guillain-Barré syndrome

What are the signs and symptoms?

Symptoms typically appear suddenly, often overnight, and on one side of the face.

Facial muscle symptoms

  • Drooping on one side of the face
  • Inability to fully close the eye
  • Difficulty smiling or raising the eyebrow
  • Drooling
  • Impaired blinking

Sensory symptoms

  • A feeling of numbness or altered facial sensation
  • Pain behind the ear or along the jaw

Other symptoms

  • Increased sensitivity to sound
  • Reduced tear or saliva production
  • Excessive tearing or dry eye
  • Altered taste on the front portion of the tongue

How is Bell’s Palsy diagnosed?

Bell’s palsy is usually diagnosed through a clinical examination and medical history. Since some of the other causes of facial paralysis are quite serious, it is important that you see a doctor immediately. Your healthcare provider will first rule out other causes of facial paralysis, such as:

  • Stroke
  • Lyme disease
  • Ramsay Hunt syndrome
  • Tumours

Additional testing may be required if symptoms are atypical or slow to improve, including:

  • MRI or CT scans
  • Blood tests if infection is suspected

What can you expect?

Most people experience significant improvement within three weeks, with approximately 70–85% making a full recovery within 3–6 months.

Factors that may indicate a slower recovery include:

  • Complete paralysis with no early movement
  • Diabetes
  • Older age
  • Painful onset
  • Delayed initial improvement

What is the role of physiotherapy in Bell’s Palsy treatment?

Physiotherapy plays an important role in recovery, particularly if facial weakness persists beyond the initial weeks.

Physiotherapy can help to:

  • Improve facial symmetry
  • Restore coordinated facial movement
  • Reduce compensatory habits
  • Prevent long-term complications such as synkinesis (involuntary movements, e.g., the eye closing when smiling)
  • Improve confidence and overall facial function

When should physiotherapy start?

Physiotherapy may be recommended:

  • Immediately: For education, eye protection, and gentle guidance
  • Within 2–3 weeks: If facial weakness continues or recovery is delayed

Early education is essential to avoid habits that may interfere with optimal recovery.

What physiotherapy treatment techniques are used for Bell’s Palsy recovery?

Facial neuromuscular retraining (NMR)

This is the most evidence-supported physiotherapy approach for Bell’s palsy.

It focuses on:

  • Correct activation of facial muscles
  • Small, precise, and controlled movements
  • Avoiding overuse or forceful exercises
  • Re-learning coordinated facial patterns (e.g., smiling without eye involvement)

Guided facial exercises

Exercises are tailored to your stage of recovery and may include:

  • Eyebrow raises
  • Forehead wrinkling
  • Gentle closed-lip smiles
  • Nose scrunching
  • Controlled blinking

These exercises are typically performed slowly using mirror feedback to ensure correct movement. The Facial Palsy Org UK has a great resource with pictures and videos demonstrating some of these techniques.

Massage, soft tissue therapy, and needling

Picture demonstrating type of needle that may be used in acupuncture on the face
Very fine needles are used in acupuncture around the face

Manual techniques and acupuncture may be used to:

  • Reduce muscle tightness or overactivity
  • Improve circulation
  • Prepare muscles for retraining
  • Reduce facial discomfort

Mirror therapy

Using a mirror helps improve awareness, movement control, and reduces unwanted compensatory patterns.

Eye protection strategies

If the eye cannot close fully, physiotherapists may recommend:

  • Blink-training exercises
  • Lubricating eye drops
  • Taping the eye closed at night
  • Techniques to prevent dryness and irritation

Looking for more help?

Look for PhysioNow! We have expertly trained clinicians across the west GTA ready to help! Look for us at 1 of our 10 locations including Burlington, Oakville, Mississauga and Etobicoke for Bell’s Palsy Treatment. Feel free to contact us by Phone at 289-724-0448 or by Email at applewood@physionow.ca for any inquiries or booking requests. Book with PhysioNow today to receive your first assessment and treatment!

Carpal Tunnel Syndrome, Ergonomics, Hand Pain, Hand Pain Treatment, Physiotherapy, Wrist pain

Hand Tingling and Numb? Get Physio for Carpal Tunnel Syndrome!

Leave a comment

Carpal Tunnel Syndrome (CTS) is a common condition that affects millions of people worldwide, particularly those who perform repetitive hand movements. It occurs when the median nerve, which runs from the forearm into the palm of the hand, becomes compressed at the wrist. This can result in numbness, tingling, weakness, and pain. Ultimately, these can affect your ability to perform daily tasks including grasping, eating, typing and more.

Where is the carpal tunnel?

Diagram of the carpal tunnel, depicting where the median nerve is affected under the tendon sheath and the resultant area of pain and numbness, thumb, 2nd, 3rd, and half of the 4th finger.

The carpal tunnel is a narrow passageway located on the palm side of your wrist, surrounded by bones and ligaments. Within this tunnel, several tendons and the median nerve run through, controlling sensation in the thumb, index, and middle fingers. When the tunnel becomes constricted or inflamed, pressure on the median nerve increases, leading to the symptoms associated with CTS.

How do I know if I have carpal tunnel syndrome?

The symptoms of CTS typically develop gradually and can range from mild to severe. Common signs include:

  • Numbness or tingling: This often affects the thumb, index, middle, and sometimes the ring fingers, particularly when holding objects or during activities that involve repetitive hand movements, such as typing or writing
  • Pain: A dull ache or sharp pain may occur in the wrist or hand, often extending up the arm
  • Weakness: People with CTS may experience difficulty gripping objects, as their hand muscles may weaken over time
  • Worsening symptoms at night: CTS symptoms tend to be more pronounced at night, often disrupting sleep

What makes someone vulnerable to it?

Office workers are increasingly at risk due to repetition and long hours. Remember to take breaks, adjust your setup, and try different ergonomic options!

There are several factors that can contribute to the development of CTS. While certain individuals may have a genetic predisposition to a smaller carpal tunnel, other common causes include:

  • Repetitive hand movements: Jobs that involve prolonged typing, using a mouse, assembly line work, or playing musical instruments are the most at risk
  • Injury or trauma: Wrist fractures or dislocations can cause swelling in the carpal tunnel, increasing pressure on the median nerve
  • Inflammatory conditions: Conditions like rheumatoid arthritis, diabetes, and thyroid dysfunction can contribute to CTS by affecting nerve function or causing inflammation around the wrist
  • Pregnancy: Hormonal changes during pregnancy can cause fluid retention, which increases pressure on the carpal tunnel. Additionally, mothers are also at risk post-partum due to holding and nursing their baby
  • Obesity: Excess weight can also put additional pressure on the wrists, increasing the risk of developing CTS

How is it diagnosed?

Diagnosis typically involves:

  • Medical history: The pattern of symptoms is usually very distinctive in CTS, a simple history will tell your practitioner a lot
  • Physical exam: The practitioner will ask about your symptoms and may perform tests to evaluate the strength and sensation in your fingers and wrist. Often, holding certain positions and tapping the median nerve is enough to reproduce symptoms in CTS
  • Ultrasound: An ultrasound will create an image of the wrist to show whether the nerves and tendons are inflamed and being compressed
  • Nerve conduction studies: These tests measure the electrical activity of the median nerve and assess how well the signals are traveling through the carpal tunnel
  • Electromyography (EMG): This test measures the electrical activity of muscles and can help pinpoint nerve damage.

How do we treat carpal tunnel syndrome with physiotherapy?

The treatment for CTS depends on the severity of the condition. In mild cases, conservative approaches like physiotherapy are often effective, while more severe cases may require consultation with a surgeon.

Physiotherapy treatments include:

  • Manual therapy techniques: Soft tissue techniques, mobilizations, and more are used to decrease pain and symptoms, and increase mobility
  • Nerve gliding exercises: These exercises gently slide the nerve back and forth in the body, restoring normal mobility and decreasing pain, swelling, and inflammation
  • Ergonomic adjustments: If your job or daily activities contribute to CTS, your physiotherapist will show you how to adjust your working conditions. For example, a desk job can use a more ergonomic keyboard and mouse to can reduce strain on the wrists.
  • Wrist splinting: Your physiotherapist can recommend a splint for you to wear. Wearing a splint at night or during activities can help keep your wrist in a neutral position, reducing pressure on the median nerve.

Other treatments may include:

Your physiotherapist will collaborate with the other members of your health care team to determine other treatment options. These may be used alongside physiotherapy or if physiotherapy alone is not effective.

  • Steroid injections: Corticosteroid injections can reduce inflammation and relieve pain and swelling in the carpal tunnel
  • Anti-inflammatory medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can reduce pain and inflammation.
  • Referral to a surgeon: If conservative measures do not improve symptoms, surgery may be required. The most common procedure for CTS is called carpal tunnel release surgery. This involves cutting the ligament that forms the roof of the carpal tunnel, which helps relieve pressure on the median nerve

Looking for help with wrist pain and hand pain?

Look for PhysioNow! Our expert clinicians offer Physiotherapy, Massage Therapy, Manual Osteopathy and more. Get your hand pain and wrist pain treated today! PhysioNow has 10 locations across the west GTA including Burlington, Oakville, Mississauga, and Etobicoke. Book with PhysioNow today for your first assessment and treatment. Feel free to reach out at P: 289-724-0528 or Email: applewood@physionow.ca

Images by FreePik

Back Pain, Ergonomics, Headaches: Neck Pain, neck pain, Physiotherapy, Posture

Tech Neck: Why Modern Screen Habits Are Causing Neck & Shoulder Pain

Leave a comment

Unfortunately, Tech Neck, or neck and shoulder pain due to devices, have quietly become one of the most common complaints we see in our PhysioNow clinics today. With the rise of remote work, longer hours on laptops, back-to-back virtual meetings, and constant phone use, many people are experiencing a new kind of discomfort known as Tech Neck. This condition is more than just stiffness, it affects posture, sleep, concentration, and overall well-being.

What is tech neck?

Tech Neck describes pain and tightness caused by prolonged screen time in everyday life. The human body is not designed to spend hours leaning forward, rounding the shoulders, or keeping the neck bent. However, many people unknowingly hold these positions for long periods every day. Over time, this posture overloads the neck, upper back, and shoulder muscles, causing tension, fatigue, and reduced mobility.

One of the biggest challenges with modern screen habits is that they often become part of your routine without realizing it. You might start your day on a laptop, switch to your phone, move to online meetings, scroll during breaks, then end the day watching TV, all involving the same forward-head position. Even if you try to sit up straight, long hours eventually take a toll. The good news is that physiotherapy can help relieve these symptoms and teach you how to protect your body from ongoing strain. With a combination of hands-on therapy, strengthening exercises, posture improvement, and ergonomic advice, most people experience noticeable relief within a few sessions.

What are the common signs and symptoms?

  • Comes on gradually, usually worsening over time
  • Constant stiffness, tightness, and/or pain in the neck, shoulders, and upper back
  • Headaches that start from the base of the skull
  • Sharp pain when turning your head
  • Fatigue or heaviness in the neck
  • Pain between the shoulder blades
  • Tingling or numbness down the arm in some cases
  • Reduced ability to turn your head
  • Difficulty holding postures for longer periods of time

Why does tech neck happen?

Looking down at your laptop or while writing on the desk can put your neck into an awkward posture. Talk to your physiotherapist to learn different strategies and aids that can prevent this.

Screen use has changed dramatically in the last few years. The pandemic increased work-from-home setups, often in non-ergonomic environments like sofas, dining tables, or beds. Many people still use these setups today, leading to more frequent neck pain. Other contributing factors include poor ergonomic habits such as:

  • Long hours without movement or changing posture
  • Improper office set up ex. screen off to the side chair height
  • Use of handheld devices or laptops in laps

How does physiotherapy treat it?

Physiotherapy offers a well-rounded approach to reducing pain, improving posture, and preventing symptoms from returning. A physiotherapist identifies which muscles are tight, which are weak, and how your daily habits contribute to the problem. Here’s what treatment usually includes:

1. Hands-on manual therapy

Manual therapy improves mobility, reduces stiffness and can alleviate pain. With continued treatments, benefits will become longer lasting and more effective

Gentle hands-on techniques help reduce tension and pain in the affected areas.
This may include:

  • Soft tissue release
  • Cervical (neck) and thoracic (upper-back) joint mobilizations
  • Assisted movements and muscle stretching
  • Trigger point release

2. Postural training

Many people are unaware of how much daily posture contributes to pain. Physiotherapy helps you understand simple posture corrections you can use while working, texting, or relaxing. These small habits make a big difference over time.
You will learn:

  • Neutral head and neck position
  • Proper alignment for sitting, standing
  • How to reduce forward-head posture
  • How to sit actively rather than slouch
  • How to self-manage your posture

3. Strengthening exercises

Weak muscles around the neck and upper back make it difficult to maintain good posture. Strengthening these areas helps the body support long hours of daily tasks. You will be provided with a personalized home exercise program to support your success.
Your physiotherapist may include exercises for:

  • Deep neck flexor muscles
  • Shoulder blade stabilizers
  • Upper-back strength
  • Core support to reduce slouching

4. Mobility program

Stretching helps reduce tightness caused by long hours of sitting. Additionally, if you have lost some range of motion these will help you restore them. Conveniently, these can be done at home or during work breaks. Common stretches include:

  • Chest opener/pec stretch
  • Upper trapezius stretch
  • Levator scapula stretch
  • Thoracic spine mobility exercises
  • Shoulder blade mobility

5. Ergonomic advice

Your physiotherapist can help you adjust your workstation to reduce strain. Sometimes, just a few small adjustments can significantly reduce neck pain. Your physiotherapist can evaluate your specific setup and give persaonlized recommendations. For example, they may recommend:

  • Raising your laptop or monitor
  • Adjusting your chair height
  • Using a lumbar cushion
  • Maintaining screen at eye level
  • Supporting your arms while typing
  • Avoiding working from the couch

Need help with neck pain?

Look for PhysioNow! We have many expert Physiotherapists, Massage Therapists, and Manual Osteopaths that can help you with your neck pain, shoulder pain, or back pain. We have 10 locations across the GTA including Burlington, Oakville, Mississauga, and Etobicoke. Book with PhysioNow today for your first assessment and treatment!

Fees and Financing, Health and Wellness, Manual Osteopathy, Massage Therapy, Physiotherapy

5 Ways to Use Your Benefits to Benefit Your Health

Leave a comment

As another year comes to a close, it’s time to get the most of your benefits! At PhysioNow, this is a busy time for our clinic and we encourage all of our patients to take advantage and get the care they need. If you’re like most Canadians, your extended health care benefits reset at the end of the year. Maybe you’ve told yourself you’ll book that physiotherapy session “next week,” or you’ve been meaning to replace those worn-out orthotics but keep putting it off. The truth is, those benefits are there for a reason, to help you stay healthy, pain-free, and active.

How can I use my benefits?

Examples of insurance benefits providers in Canada accepted by PhysioNow including Canada Life, Manulife, Claim Secure, GreenShield, Johnson, and Desjardins

At PhysioNow, we handle all the difficult parts for you. Most insurers will give you an online portal or card with the details of your plan. First, locate that information then all you have to do is bring it with you to your first appointment. Our staff will take care of the rest, and the good news is most insurers allow us to bill them directly, making things simple for you. Please check our fees and financing page for a more complete list of accepted insurances and the benefits of direct billing. Each individual’s plan is different including how much coverage and which services are covered. We encourage you to check with your provider if you are not sure!

Here are five simple ways you can use your remaining benefits at PhysioNow before the year wraps up.

1. Physiotherapy: Get ahead of aches and pains

Physiotherapy isn’t just for injuries, it’s also about prevention. If you’ve been noticing stiffness, recurring aches, or minor discomfort, now’s the perfect time to get it checked. A physiotherapist can assess your movement, posture, and strength to uncover what’s really causing the issue before it becomes a bigger problem.

In conclusion, using your benefits for physiotherapy sessions can help you:

  • Recover from pain or injury faster
  • Improve mobility and strength
  • Prevent future problems with targeted exercises
  • Improve balance or decrease chance of falls
  • Learn strategies to improve your posture

Physiotherapy can make sure you go into the holidays and new year feeling good about your health!

2. Massage therapy: Ease tension and reset your body

Man receiving registered massage therapy services

With busy schedules, long hours at desks, and colder weather setting in, muscle tension builds up fast. Massage therapy is a great way to relieve stress, reduce muscle tightness, and improve circulation.

Many insurance plans cover registered massage therapy (RMT), making it an easy way to use your benefits. Whether you’re dealing with chronic tension, postural strain, or just need a mental reset, this is your chance to end the year feeling refreshed. Many of our patients use massage therapy regularly throughout the year as a preventative and maintenance strategy. If we can stop the pain from happening in the first place, that’s the best way to do it!

3. Manual osteopathy: Restore balance and mobility

Manual osteopathy focuses on how the body’s structure, muscles, joints, and fascia, all work together and influence each other. As such, this is a very holistic style of treatment that incorporates many different manual therapies. Gentle hands-on techniques can help you improve your body’s alignment, mobility, and circulation.

If you’ve been dealing with headaches, back stiffness, or general fatigue, manual osteopathy can act alone or even complement your physiotherapy or massage care. By working on multiple systems at once, it restores overall body balance. While a relatively newer service, it it being covered under many extended health care plans now, so it’s worth checking if it’s included in yours.

4. Orthotics: Skip the foot pain

Custom orthotics

Worn-out or poorly fitted orthotics can cause more harm than good. If your feet, knees, or lower back have been sore lately, it might be time for an update. If you work a job or have al lifestyle that requires you to be on your feet a lot, orthotics can make a huge difference in fatigue and comfort.

Custom orthotics are designed to support your unique foot structure and help align your body from the ground up. At PhysioNow, our physiotherapists can assess your gait and provide a prescription for orthotics. These are often partially or fully covered under many benefit plans and can be shipped directly to our clinic, making life convenient for you. Additionally, your physiotherapist can then ensure the fit and make any adjustments necessary before you take them home.

Your feet do so much for you everyday. Investing your remaining benefits here means investing in long-term comfort and stability.

5. Braces and Supports: Protect and prevent

Brace for ACL Injury
An example of an ACL brace by DonJoy, they are often made to custom fit each knee

From ankle braces to wrist supports, these tools can help stabilize joints, reduce pain, and prevent further injury, especially if you’re active or recovering from a strain. At PhysioNow, we offer a range of off the shelf braces or even custom knee braces. Keep in mind that some insurances may require a doctor’s note for reimbursement.

Using your extended health care coverage at PhysioNow to get properly fitted braces ensures you’re getting professional-grade support with advice from health care professionals.

Ready to use your benefits?

Your extended health care benefits are designed to help you feel your best, not just when something goes wrong. Use them efficiently to keep you moving, balanced, and healthy. Don’t let them go to waste!

If you’re not sure which services are covered or what would help you most, our team can guide you through your options and tailor a plan that fits your goals and your benefits. If you have more questions, please contact our PhysioNow team at Phone: 289-724-0448 or Email: applewood@physionow.ca or feel free to walk in to one of our clincis! We have 10 locations across the west GTA from Burlington, Oakville, Mississauga to Etobicoke. Don’t let your benefits go unused, book with PhysioNow today!