With changing times , continuing to work from home seems very appealing. But is it really safe for your body? Excessive sitting behaviour has increased more than ever since Covid times in the comfort of your home. This increases the risk of Low back and upper back pain, wrist pain, neck pain, shoulder pain, headaches and other overuse injuries.
How many breaks do you take from your chair? Are you using a chair while you work from home?
At Physio Now it’s our mission to help you get more active and also guide you with ergonomics for Work from home.
5 simple things you could do to stay more active and maintain a good posture during your work hours:
1- Opt for Sit to Stand desk– this helps you switch positions and doesn’t load your joints for too long. In addition, it also improves alertness and productivity. You can consider asking your supervisor for investing in an ergonomic chair or adjustable table. We could help the process by writing a letter for the same after assessing your injuries.
2- Put timers to stretch every hour- this will help you stay on track even if you get very busy with work, again making sure to redistribute the load on your joints thus preventing injuries.
3- Learn some basic Postural exercises from your Physiotherapist at Physio Now. This will keep you in a good posture enabling reduced tightness in your muscles
4- Keep the documents/files required for your day’s meeting around the house so as and when you need it will keep you moving.
5- Opt for a separate keyboard if you use a laptop and an ergonomic mouse- these will help prevent neck, wrist and elbow injuries.
Sitting posture
Work from home is so much more common now because of the pandemic. We at Physio Now are focused on Postural Assessment and Treatment. This includes stretching and strengthening exercises, endurance training for postural muscles, Manual therapy for sore muscles and stiff joints, electrotherapy for pain relief, tapping, cupping and acupuncture.
Knee Replacement Physio is necessary after having surgery. People get knee replacement surgeries because they have a lot of pain and limitations with their knee. These surgeries are usually for people who have advanced arthritis. Its important to do proper Knee replacement physio after the surgery to get your knee to a good functional level.
You will receive in-patient Physiotherapy at the hospital. You will work on regaining your knee movement. In addition, you will also start with some gentle strengthening exercises. Physiotherapists at the hospital will teach you how to walk with a walker and go up and down stairs before you are sent home.
What Happens after you go home?
Once at home, you should have homecare Knee replacement physio services that are provided. Usually, a Physiotherapist will visit your home once a week. They will help you to work on progressing your exercises. However, once all this is completed, there will still be some remaining pain, limitations of movement and strength deficits.
Therefore, it is important to seek out private Knee replacement physio in the community. This will allow you to continue working on the remaining issues. As a result, this extra Physiotherapy treatment will allow you to achieve full recovery. Our goal is to get you back to all of the things you like to do!
Frequently Asked Questions about Knee replacement physio
There are usually a lot of questions regarding seeking out additional Physiotherapy services. It can seem quite challenging to find the right clinic to work with you. However, having all the necessary information will certainly make things a little bit easier! Here are some of our Frequently Asked Questions:
Do I need a doctor’s referral to see a Physiotherapist in the community?
Registered Physiotherapists are considered to be primary care providers and therefore you do not need a doctor’s referral to receive care. However, if you have any extended health care (EHC) insurance that covers Physiotherapy treatments, your insurer may need a doctor’s referral to approve the coverage. If you do have any EHC, then it may be worthwhile to call the company and find out the details of the coverage prior to coming in for your initial appointment.
Will the treatments be covered by OHIP?
Will the treatments
be covered by OHIP?
PhysioNow is a private practice and therefore our services are not covered by OHIP. We do however accept extended health care insurance. We can bill electronically on your behalf if your plan allows us to do so. If you do not have any EHC, we can offer a reduced fee to reduce some of the financial stress of receiving treatment. Please give us a call to discuss this if this applies to you:)
Am I eligible for OHIP Physiotherapy?
To receive physiotherapy services covered by OHIP, you have
to attend an OHIP-licensed clinic and you have to meet certain eligibility
criteria.
65 years of age and older;
19 years of age and younger; or
Recently discharged as an inpatient from a hospital and in need of physiotherapy services. These must be directly connected to the condition, illness or injury for which you were admitted to the hospital.
Our administrative staff can certainly help you with any further questions that you might have.
How fast can I book an appointment at PhysioNow?
Since we have 3 locations in Mississauga, and 1 location in Etobicoke, we can get you in for treatment same day if needed. We try our hardest to work with your availability.
What should I wear for the appointment?
Since we are assessing your knee, you should bring a pair of shorts so that the knee is easily visible and accessible.
How long will the
first visit take?
The first visit usually takes about 1 hour to complete. During this visit, your Physiotherapist will meet with you and go through an assessment. As a result, they can fully understand the limitations and restrictions that require treatment. In addition, your Physiotherapist will also provide treatment that same day. This will include some modalities, hands on therapy, exercise prescription and education.
How long do follow-up visits take?
How long do follow-up
visits take?
Your follow-up visits usually range between 45 mins to 1 hour. This depends on how far along you are with your treatment. Your Physiotherapist will re-assess you after every couple of visits to track any changes. This will allow them to progress your treatment.
How many visits will
it take before I am fully recovered?
The number of visits needed to fully recover is different for every patient. Everyone heals at a different rate. As a result, it is difficult to set out a firm timeline. In general, the majority of people complete about 8-12 weeks of treatment. As they improve, more and more of the treatment can be completed independently at home.
I know there are 4 different locations of PhysioNow. Can I book an assessment at one office and then a follow-up at a different office if necessary? ?
Yes, you can definitely have your assessment at one office and your follow up at another office if necessary. Firstly, we will try our best to book appointments that work best for you. Secondly, if one location works better than another, there is no issue with changing locations. Lastly, we can send over your treatment file to the other office. As a result, the Physiotherapist seeing you has all the information. In conclusion, we can provide ongoing treatment at any location.
We hope that these FAQs provide you with the information that you are looking for. We hope that you will feel comfortable to choose PhysioNow for your physiotherapy care!
PhysioNow
Lastly, if you or someone you know is planning to have a Knee replacement, we at PhysioNow are happy to help! We have many highly trained Physiotherapists at all of our clinics. Call today to get started! https://www.physionow.ca/
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!
Pain and injury can happen to anyone. Most people have at least one injury or episode of pain in their lifetime. As a result, this leads them to seek professional help. The most common types of injuries are related to muscle, bone and joints. However, underlying diseases can also result in pain that leads people to seek Physiotherapy & Exercise.
What are the different types of Physiotherapy & Exercise available?
Physiotherapy
Physiotherapists use their knowledge of the body to provide Physiotherapy & Exercise treatment. In addition, they assess, diagnose and treat symptoms from injuries.
Massage Therapy
Massage therapy is the manipulation of soft tissues. For example: muscles, connective tissues, tendons, ligaments and joints.
Massage therapy reduces pain associated with everyday stressors. For example, muscular over-use and chronic pain conditions.
Osteopathy
Osteopathy views the body as a unit. Above all, they believe that healthy tissues require proper circulation of our body’s fluids
Osteopaths use hands on treatments to assess and restore balance through our body’s systems. For example: musculoskeletal, cardiovascular and neurological,
Different Types of Physiotherapy & Exercise
There are many Physiotherapy & Exercise options to help with recovery from an injury. For example:
Electrical Modalities
Manual therapy
Soft tissue releases
Joint mobilizations
Joint manipulations
Passive stretching
Electrical modalities
Ultrasound
Laser
Interferential Current
TENS
Shockwave
Decompression therapies
Mechanical lumbar traction
Mechanical cervical traction
Inversion tables
Alternative treatments
Acupuncture
Cupping
Supportive products
Braces
Taping
Custom Knee Unloader Brace for Meniscal Injuries
How do I know what treatment is right for me?
It is hard to choose what kind of treatment to try. In other words, deciding what would be most effective for treating your pain. This is especially true if this is your first time experiencing an injury and/or pain.
A lot of people end up trying what they are familiar with. For example, if you have had previous injuries and had Physiotherapy & Exercise for those injuries, you would know what worked. There is a personal preference regarding which Physiotherapy & Exercise treatments work best for us.
What Physiotherapy & Exercise provides the best overall results?
Physiotherapy & Exercise
The one type of treatment that is the most beneficial is Physiotherapy & Exercise. This is mainly because our bodies are built to move. There is truth in the saying, “If you don’t use it, you’ll lose it.”
Exercise has positive results for almost all injuries . The type of Physiotherapy & Exercise that is best will depend on the injury. There is no universal approach to exercise that works for everyone. This is because we are all built differently. However, what works for one person doesn’t mean it will work for another.
What type of exercises are most beneficial?
Muscle and bone injuries will require some form of mobility. Most importantly, progressive strengthening exercises.
Nervous system diseases such as strokes or Parkinson’s Disease will require more balance and functional exercises.
Respiratory illnesses like COPD or emphysema will need exercises that improve and strengthen the muscles of breathing and posture
Concussion rehabilitation will need visual and vestibular re-training exercises.
Conditions such as diabetes, cancer, cardiovascular disease, autoimmune conditions need a combination Physiotherapy & Exercise. Therefore, cardiovascular and strengthening exercises have been shown to be most effective in managing their condition.
Which healthcare professional can prescribe Physiotherapy & Exercise?
It is up to the health care professional to assess your condition and prescribe the correct exercises for you. Registered Physiotherapists are experts in the assessment of all types of injuries. They will be able to give the most appropriate treatment for you. As a result, there is always a strong emphasis on exercise and promoting activity.
A Physiotherapist will be able to develop a specific exercise program for you. They will factor in your age, fitness level and ability to do the exercises at home. The physiotherapist will be able to guide you with adding exercises into your routine so that it becomes a habit.
Why is exercise
therapy an important part of treatment?
A lot of times, people who are inactive think that exercise therapy refers to working out in a gym. Exercise therapy can refer to any exercise that you enjoy doing. For example: stretching, riding a bike, swimming, yoga and lifting weights.
Pain or Fear of Injury
If pain or fear of injury is preventing you from exercise, seeing a Physiotherapist can help get the process started. Firstly, a Physiotherapist can assess where the source of the pain or weakness is coming from. Secondly, they start giving the most appropriate exercises to overcome those restrictions.
Subsequently, with effort, consistency and time, you can see the difference that exercise therapy can provide. As a result, this will lead you to include activity into your everyday life. Feeling confident with your progress will help lead you to seek out similar active programs in your community.
In Conclusion
Exercise should always be a part of the treatment plan. With an aging population, there needs to more emphasis placed on Physiotherapy & Exercise. As a result, this will prevent weakness related to ageing and frailty. Strength and ongoing exercise will allow you to maintain your function and independence as you age.
If you or someone you know would benefit from Physiotherapy & Exercise, please call today. At PhysioNow Mississauga and PhysioNow Etobicoke, we are ready to help!
Pregnancy related Pelvic pain can create great challenges. Imagine you are 32 weeks pregnant with your first child and you start to have pain in the low back and pubic area when you change position. Pregnancy related pelvic pain can happen when you sit, stand for longer periods or when you walk. The pain makes it very difficult for you to function. As a result, you may worry about whether you can continue to work and manage your household.
Pregnancy Related Pelvic Girdle Pain:
Words Can Hurt
Now imagine you have seen your health care provider and have been told that your pelvis is separating. They tell you this is because of the hormone Relaxin. Then you are told that you may need to put up with this until after you have your baby .
In addition, you are told, “it will probably get better afterwards”. “Be careful” “If it hurts, don’t do it”, “Your pubic bone is splitting”, “Your pelvis is unstable”. These are common words of advice or explanations pregnant women with pelvic girdle pain (PGP) receive from their healthcare providers. (From the Canadian Physiotherapy Association – Pain Science Division)
What is Pregnancy related pelvic girdle pain?
Pregnancy related Pelvic pain is characterized by pain around the pubic and sacroiliac joints. It can present as pain in the inner groin and adductor area, the buttocks or the sides of the hips. As a result, it is aggravated most commonly by maintaining sustained postures or changing position.
This Pelvic pain affects approximately 16-25% (Kanakaris 2011) of pregnant women, although it is very likely under reported and dismissed as a normal consequence of pregnancy.
Prognosis for Pregnancy related pelvic pain
The prognosis for pregnancy related pelvic girdle pain is very good. The majority of women improve within a few months after delivery. Only approximately 5-8.5% (Kanakaris 2011) go on to have persistent symptoms. Understanding this issue is the role of your Physiotherapist. Physiotherapists can help!
How does Breast feeding affect pregnancy related pelvic girdle pain?
Urban myths regarding breastfeeding being associated with laxity-related musculoskeletal pain should be put to rest. Suggestions to “be careful” (suggesting fragility), restrict function (reinforcing disability), to rest more and avoid activity (usually makes symptoms worse) should be set aside.
Too many women have weaned their babies early. They have done this in hopes this would alleviate their Pelvic girdle pain. This decision is based upon “helpful” advice, often from their Health Care Provider, despite the fact that there is no evidence to support this. As a result, many women are sadly advised not to lift their babies for several weeks after delivery. They are told to avoid doing this in order to avoid aggravating their Pregnancy related Pelvic girdle pain.
The good News!
The good news is that Pregnancy related Pelvic girdle pain can be managed very successfully! You can be shown effective self management programs which allow you to take control of your own care. This will allow you to become more confident, comfortable and active during your pregnancies.
Good strategies can be integrated into daily activities. As a result, it is possible to manage work, daily activities and child/baby care independently during pregnancy and postpartum.
Studies have also shown that vaginal deliveries are not only safe for women with Pregnancy related Pelvic Girdle pain, they are even preferable. Bjelland (2012) found a 2-3 fold increased risk of severe Pregnancy related Pelvic girdle pain (PGP) postpartum in women with PGP after a planned Cesarean Section.
Pregnancy related Pelvic Girdle pain Leads to a significant decrease in Quality of Life
Pregnancy related Pelvic Girdle pain Leads to a Significant Decrease in Quality of Life:
Five main categories emerged:
1. Pelvic girdle pain affects the ability to cope with every day life a) Postpartum depression- 3x more prevalent in this group of women (Gutke 2007)
2. Coping with motherhood and changing roles a) 20% avoid future pregnancies because of fear of Low Back pain and Pregnancy related pelvic girdle pain (Brynhildsen 1998)
3. Relationship between partners often reached the breaking point
4. Questioning one’s identity as defined by profession and work
5. Lack of acknowledgement of pain and disability Elden H. et al: Life’s pregnant pause of pain: Pregnant women’s experiences of pelvic girdle pain related to daily life: A Swedish Interview Study. Sexual & Reproductive Healthcare. (2013) Engeset J. et al. Pelvic girdle pain affects the whole life—a qualitative interview study in Norway on women’s experiences with pelvic girdle pain after delivery. BMC Res Notes. (2014) 7: 686.
How Can Physiotherapy help with Pregnancy related pelvic girdle Pain?
We at PhysioNow believe that Physiotherapists have a privileged role in helping to shape the experience of pregnant women with Pelvic girdle pain. Physiotherapists are in the ideal position to calm anxiety and correct misconceptions. We are happy to educate you about your condition. We explain it in a way that decreases the threat of your pain and gives you permission to move.
Pregancy related pelvic pain
Physical activity is now seen as a critical part of a healthy pregnancy. Pregnant women should accumulate at least 150 minutes of moderate-intensity physical activity each week over a minimum of three days per week. However, being active every day is encouraged. Following the 2019 Guideline for Physical Activity throughout Pregnancy can reduce their risk of pregnancy-related illnesses such as gestational diabetes, high blood pressure and preeclampsia by 25 percent. (https://csepguidelines.ca/guidelines-for-pregnancy/)
Pain Management in Pregnancy: Joint SOGC/CSEP Clinical Practice Guidelines Nov 2018P
Muscle training for the pelvic floor (e.g., Kegel exercises) may be performed on a daily basis to reduce the risk of urinary incontinence. Physiotherapist Instruction in proper technique is recommended to obtain optimal benefits.
2. Pelvic floor muscle training with a Physiotherapist is recommended to prevent urinary incontinence during pregnancy and after delivery
3. Core stability training with a Physiotherapist is recommended to prevent and treat back and pelvic pain during and following pregnancy.
4. Pregnant women who experience lightheadedness, nausea, or feel unwell when they exercise flat on their back should modify their exercise position to avoid this position.
Supervised antenatal and postnatal pelvic floor muscle training has been shown to be protective against Urinary Incontinence(UI), particularly in high risk groups Boyle et al 2012, Stafne et al 2012, Reilly et al 2002.
If you or someone you know suffers from Pregnancy related pelvic girdle pain, we can help! We have highly trained Physiotherapists ready to help you with this very unpleasant condition. Please call PhysioNow today to get started!
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!
Acute Ankle sprains are common injuries in people of all ages. They can happen in many different circumstances. However, they always involve some type of fall or twisting movement to the ankle. For example:
Going downstairs and missing the last step resulting in twisting the ankle
Landing on the ankle in a twisted position after coming down from a lay-up in basketball or in a Sports Injury
Slipping on an icy street while walking
In all of these situations, the ankle gets a sudden movement and/or trauma that causes it to twist more than its normal range of movement allows.
Acute Ankle Sprains
What structure gets injured with an acute ankle sprain?
The structures that are injured with acute ankle sprains are the ligaments around the ankle joint. Ligaments are soft tissue structures that connect two bones together. Their function is to prevent the bones from moving too far away from each other. Ligaments help maintain normal movement between the bones.
With ankle sprains, the ligaments get over-stretched beyond what they can tolerate which causes tears in their fibres. The ligaments that are involved in acute ankle sprains are present on the outside (lateral), inside (medial), and top of the ankle.
Are there different types of acute ankle sprains?
There are three main types of ankle sprains:
Inversion
Eversion
High Ankle Sprain
The terms relate to the direction of ankle movement that caused the injury to occur.
INVERSION ANKLE SPRAIN
An inversion sprain occurs when the ankle is forcefully turned inwards.
This type of acute ankle sprain is the most commonly occurring of the three because the ligaments on the outside of the ankle are generally weaker than the rest.
Another name for an inversion ankle sprain is lateral ankle sprain
A lateral ankle sprain injures the ligaments on the outside of the ankle.
EVERSION ANKLE SPRAIN
An eversion sprain occurs when the ankle is forcefully turned outwards.
This type of force injures the ligaments on the inside of the ankle.
The ligaments on the inside of the ankle are called the deltoid ligament
An eversion ankle sprain is also called a medial ankle sprain
HIGH ANKLE SPRAIN
A high ankle sprain is the rarest of the three types and it occurs when there is excessive twisting of the shin.
The ligaments that are injured with this type of injury are located above the ankle.
The location of the ligaments is why this injury is called a ‘high’ ankle sprain.
Are some people more at risk for Acute Ankle Sprains than others?
There are certain risk factors that may make ankle sprains more likely to happen. However, the research is a little inconclusive on why this is so. Some of these possible factors include:
Poor muscle strength/fitness
Increased weight
Decreased muscle-reaction time
Previous history of ankle sprains resulting in poor balance
Can there be different severities of Acute Ankle Sprains?
The severity of the ankle sprain depends on how much the ligament was overstretched in the process of the injury. Sprains are classified by different grades to explain the severity:
Grade I: mild stretching or tear of the ligament, with little or no instability at the joint
Grade II: incomplete tear of the ligament, with some instability in the joint
A Grade III: ligament is completely torn or ruptured and there is no stability in the ankle
Ligaments affected in Ankle Sprains
What should you do if you think you have sprained your ankle?
In all three types of Acute Ankle Sprains, it is important that you see a health care provider. The health care provider, whether it is a doctor or a Registered Physiotherapist, will first rule out the possibility of fracture. There is always the possibility of a fracture with Acute Ankle Sprains. The ligaments attach onto a bony area and if the twist is severe enough, it can pull off a chunk of the bone. When this happens, it can cause a fracture. Signs and symptoms of a potential fracture include:
Lots of swelling
Increased bruising
Increased tenderness over specific areas of the ankle
Difficulty or inability to put weight through the injured ankle
When the signs and symptoms are suspicious of a fracture, then an X-ray must be completed. If there is no evidence of fracture, then your doctor may send you for an ultrasound. In the end, they should refer you for Physiotherapy treatment. So ask your doctor to send you to Physiotherapy if they don’t think to recommend it themselves.
What will happen during my first Physiotherapy appointment?
During the Physiotherapy assessment, your Registered Physiotherapist will assess everything to do with your Acute Ankle injury, including:
Pain intensity and location
Swelling
Sensation
Range of motion
Ankle stability
Strength
Balance
This will provide some baseline information for your Physiotherapist.
How can Registered Physiotherapy help treat Acute Ankle Sprains?
The treatment for acute ankle sprains depends on the type of sprain as well as the severity of the injury.
Immobilization
Because of their affect on ankle stability, a Grade II or III injury will require some immobilization. This is usually done through a removable walking cast.
The purpose of the immobilization is to protect your injured ligaments from movement and external stressors, so that they can heal.
The period of immobilization will depend on the injury and your health care provider will provide specific instructions.
A grade I sprain will not require any immobilization because the stability of the ankle is still intact. However, your Physiotherapist will recommend activity modification to help with the healing process.
Physiotherapy Treatment in the acute phase?
In the initial phase of the treatment, the Physiotherapist may focus on pain relieving modalities
Electrical modalities like IFC and Ultrasound can help relieve pain and swelling
The Physiotherapist will also prescribe gentle mobility exercises to help improve or maintain movement through the ankle
The length of the acute phase depends on the severity of the sprain
Ankle Rotations for movement Recovery
Treatment in the later stages of Acute Ankle Sprains
Once the ligament healing is underway and the patient feels a little better with their pain, the treatment will get more progressive
It will focus on regaining mobility, strength and function through the ankle
Your Physiotherapist will prescribe exercises that are going to help regain the lost range of motion and strength.
Over several weeks, the exercises will be progressed as you improve.
Another important aspect of treating an ankle sprain is including balance re-training in the program.
Balance is very much affected after an ankle sprain and it is something that must be improved with specific exercises. This is very important no matter whether you are returning to Sports or just everyday living! Balance Retraining is key to Falls Prevention!
We use our balance ability on a regular basis with walking on uneven surfaces or when trying to recover from a stumble. Therefore, it is important to improve balance ability to prevent any possible re-injury of the ankle.
If you have had an acute ankle sprain before, and DID NOT attend Physiotherapy, it is likely that you are at increased risk of reinjuring your ankle or falling again!
Physiotherapy Mobilizations
Do I need to get Physiotherapy treatment after Acute Ankle Sprains?
There are some people who have sprained their ankle multiple times and never sought out treatment for the injury. They usually give themselves some time for the pain to get better and then go about their usual activities.
This type of management is not usually recommended because multiple ankle sprains can affect the stability of your ankle. As a result, this may create problems in the future. Also, the reduced stability in your ankle may cause compensations in your knees and hips. This can complicate the picture and make your injury more complex.
It is therefore recommended that you seek out proper Registered Physiotherapy care to address an ankle sprain soon after it occurs. This ensures that your acute ankle sprain heals in a timely manner without added complications. The most important part of treatment is regaining your balance. If you do not do this, another injury in quite likely.
Prostatodynia or Chronic Pelvic Pain Syndrome (CPPS) is a pelvic pain condition in men. This means ‘inflammation of the prostate’. There are two basic types of prostatitis, acute and chronic.
Acute Bacterial Prostatitis
Acute Bacterial Prostatitis is an infection of the prostate. This type of Prostatitis causes chills and fever. In this case, you need your Doctor’s attention promptly!
Nonbacterial or Chronic Prostatitis
The other is Nonbacterial or Chronic Prostatitis. This can be treated with alternative treatments such as Pelvic physiotherapy, exercises, lifestyle modifications etc. Investigations in this case show that bacteria and yeast are negative. The physical examination does not usually show anything unusual. However, the prostate may be swollen. What can make the problem even more confusing is that often young, otherwise healthy men develop this condition. Antibiotics, pain-killers, and medications prescribed are often not effective. Many men have been told that they must learn to live with the symptoms because a cure is not available.
Symptoms may include a few or all of the following:
• Pain in the testicles, or tip, shaft or base of the penis
• Pain at the perineum (the area between the testicles and penis)
• Urination Causes Pain
• Increased pain in sitting
• Pain or discomfort with sexual arousal, or during or after ejaculation
• You May notice Pain or discomfort above the pubic bone
• Urinary frequency
• Urinary urgency
• Pain before, during or after a bowel movement
• Decreased interest in sex
Treatment
The Pelvic Health Physiotherapist creates an individualized treatment program. Treatment is based on pelvic floor dysfunction, symptoms, and response to the treatments.
The following treatment programs and techniques may be involved in Pelvic Physiotherapy for Prostatitis:
Trigger point release therapy
Trigger point release therapy is also known as myofascial trigger point release. Trigger point release therapy is an alternative treatment for chronic prostatitis. It is often helpful for treating CP/CPPS symptoms that are associated with stress and tension of the pelvic floor muscles.
Trigger point release therapy is often combined with paradoxical relaxation therapy. This exercise method involves autonomic self-regulation. This decreases pelvic floor muscle tension. It teaches you how to release this tension. Paradoxical relaxation involves a specific breathing technique to help relieve anxiety.
Total body
Total body (exercise, chronic stress management, lifestyle) changes help relieve pain. It is important to know which foods make the symptoms worse. Try to avoid those foods. The most common foods that have been found to trigger symptoms include:
Pelvic floor muscles form the ‘bowl’ or ‘hammock’ that supports our lower back and pelvic organs (bladder, uterus/prostate and rectum).
Pelvic health physiotherapists have taken courses allowing them to perform an internal evaluation in order to assess the tension and strength of these muscles. Often there is too much tone of the pelvic floor leading to weakness.
What are common symptoms of pelvic health dysfunction?
• Leakage of urine with coughing, sneezing, laughing and exercise
• Urgent need to urinate or leaking before you get to the washroom
• Constipation/straining with bowel movements
• Heavy feeling or bulge in the vagina
• Pain in the pelvic or low back or genital area
• Pain with intercourse
Check out this link for more information.
Some benefits of Pelvic Floor Physiotherapy
• Leave your house without worrying about your bladder
• Exercise without worrying
• Sleep through the night
• Learn to control urgency
What can I expect on my first Visit for Pelvic Health physiotherapy?
A medical history will be taken with a discussion of your concerns. Questions will be asked to further understand your symptoms. Your posture, muscles of your hip, low back and abdominal will be assessed for contributing factors such as weakness or tightness. In addition to the external exam, an internal exam of your pelvic floor (vaginally and rectally) may be included to assess imbalances and dysfunction of the muscles and soft tissues.
Based on the assessment findings and your goals, the physiotherapist will put together a treatment plan.
What can I expect for treatment with Pelvic health physiotherapy?
Pelvic Health Physiotherapy Treatments Typically include,
• Correcting postural dysfunction
• Manual therapy
• Connective tissue release
• Pelvic floor muscle facilitation with breathing techniques
• Exercises for other core muscles
• Training for healthy bladder and bowel habits
• Education such as behavioural therapy/stress management
We have fully trained Pelvic Health Physiotherapists at each of our clinics ready to help you. If you have any questions, or would like to book an appointment, please contact the clinic .
Post-prostatectomy-incontinence is a common problem after radical prostatectomy. Patients report that this is the symptom which most disrupts their quality of life. Up to 75 percent of men experience a short period of mild incontinence. This is particularly after removal of the catheter that was placed during surgery. Most patients regain total urinary control after radical prostatectomy. However, this can take up to a year to achieve. Apparently, a small percentage (2% to 4%) experience permanent incontinence. Following radical prostatectomy, men who experience post-prostatectomy-incontinence may express concerns about visible wetness, urine odor, and the type of clothing that can be comfortably worn.
Types of Urinary Incontinence
The two types of post-protatectomy incontinence following prostate surgery are:
• Stress incontinence – Stress incontinence is the involuntary loss of urine that can occur during physical activity, like lifting a heavy object, or when you laugh or sneeze. These . activities put increased “stress” or pressure on the bladder.
• Urge incontinence – Urge incontinence is the sudden need to urinate due to bladder spasms or contractions.
What Can Be Done to Treat post-prostatectomy-incontinence after Prostate Cancer Treatment
• Pelvic floor exercises: Kegel exercises strengthen the muscles when you squeeze them
• Stop urinating mid-stream. These exercises can be combined with biofeedback programs that help you train these muscles even better.
• Supportive care. This treatment includes behavioral modification. This includes drinking fewer fluids, avoiding caffeine, alcohol, or spicy foods, and not drinking before bedtime.
People are encouraged to urinate regularly and not wait until the last moment possible before doing so. In some people, losing weight may result in improved urinary control. Supportive care also involves changing any medications that interfere with incontinence.
• Neuromuscular electrical stimulation.
This treatment is used to retrain and strengthen weak urinary muscles and improve bladder control. With this treatment, a probe is inserted into the anus and a gentle current is passed through the probe at a level below the pain threshold.This causes a contraction. The patient squeezes the muscles when the current is on. After the contraction, the current is switched off.
As you can see, there are many things that can be done to treat post-prostatectomy-incontinence. PhysioNow has trained pelvic Health Physiotherapists in Etobicoke ready to help you get started on regaining your life. It is hard to talk about these symptoms, and harder yet to find somebody who can help. Our therapists are sensitive and discreet. You will be treated in a quiet private room and your privacy will be fully respected. Get started today! Call today and ask for a pelvic health physiotherapy consultation at PhysioNow.
