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Ankle Sprain

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An ankle sprain is a common Sports injury which happens when the ankle stretches more than normal. This over stretch weakens the ligaments that hold the bones together. Ligaments are the fibrous bands that hold the ankle joint together.

The ankle consists of 3 joints. The joints are between the lower end of two long bones in your leg. They are called the Tibia and Fibula. They attach to the two bones in your feet called the Talus and calcanium.

Together with the muscles and ligaments, the bony ends on the sides of your long bones called malleoli provide stability to the joint. The ankle is least stable when the foot is down. Most stability is provided by the ligaments. As a result, the majority of ankle sprain injuries happen when your foot is in this position.

There are two types of sprains. An inversion injury happens when the foot rolls inwards. This causes injury to the ligaments on the outside of the ankle called lateral ligaments. Most of the time a ligament called anterior talofibular ligament (ATFL) is injured. The ATFL is the weakest of the lateral ligaments.   

An eversion injury happens when the foot is rolled outwards. This causes injury to the ligaments on the inside called the Deltoid ligament. As the medial ligament requires a greater force to be injured, these sprains always take longer to rehabilitate.

Risk Factors

Based on the severity of symptoms, an ankle sprain is classified into 3 grades.

If you have a previous history of ankle sprain, you will have more chances of re injury. This happens because the strength and integrity of the muscles and ligaments around the ankle joint will be affected.

The other risk factors are poor balance, sudden change in direction , age, poor condition of playing surface and inadequate warm up. Lastly, inappropriate footwear and a lack of external ankle support in case of recent injuries can cause increased risk.

Grade 1 – Mild swelling and tenderness with little impact on function.

Grade 2- Moderate swelling, pain and impact on function. You will have reduced range of movement and instability of the joint.

Grade 3 -Large swelling, loss of function and marked instability at the joint.

Symptoms

Symptoms of Ankle Sprain

Pain, bruising, swelling and difficulty to weight bear are the initial symptoms. As a result, pain is usually worst in the first two or three days. The location of pain indicates which ligament is injured.

In severe injuries where there is complete rupture of a ligament, you will feel instability in the ankle joint. If you have suffered from a severe ankle sprain, there is a chance of associated fractures. As a result, you may require an x ray to determine the possibility of broken bones.

Physiotherapy Treatment

Physiotherapy Treatment for Ankle Sprain

Your physiotherapist will be able to assess the possibility of some of the common fractures using a special palpation method.  The other aims of ankle examination are to check for any instability. Lastly, we look for loss of range of motion, reduced strength, reduced proprioception and associated injuries.

Exercises for Ankle Sprain

Initial treatment is focussed on Protection and optimal loading. That means the right amount of activity to stimulate healing. In addition, Ice, compression and elevation(POLICE) are also recommended in the first 48 hours after injury.


Protection of the joint?

 Taping, bracing, or crutches if needed. In addition, we also recommend the use of an aircast boot. As a result, this will restrict movement and allow for more rapid healing. PhysioNow stocks aircast boots in all sizes at the Applewood Office.


Optimal Loading ?

Optimal Loading

Avoid activities which cause pain. Minimize the amount of walking you do. Use of crutches, air cast boots, braces or taping  may be advised by your Physiotherapist on assessment.


Ice

 It is recommended that you Do Apply ice cubes or ice packs in a damp towel up to 15 minutes every 3 hours for the first 48 hours when you are awake. Do not apply ice directly to your skin. Please, Do not apply ice if you have cold intolerance due to any medical condition.

We do not recommend the use heat in the early phase of injury.


Compression

Compression involves using a bandage from toes to just above the ankle joint. Make sure that the compression does not cause more pain or restrict the circulation. If you are in doubt, your Physiotherapist can teach you how to apply the bandage in the early phase of injury.

Compression


Elevation

Elevate your injured leg above your heart level using pillows while resting.

Ultrasound therapy, Laser acupuncture, taping, bracing, and exercises are used to reduce pain and inflammation. In addition, manual therapy and exercises are used for improving the range of motion, strength and joint position sense (proprioception).

Once all the movements are pain free and there is adequate muscle strength and proprioception, functional exercises can be started. These exercises will be directed to your normal Sports Activities and Activities of Daily Living.

Bracing for Ankle Sprain

Healing Time for Ankle Sprain


  The healing of ligaments takes about 6 weeks, but also depends on the severity of the injury and other medical problems which you might have. Consequently, everyone recovers from the injury at different rates. As the ligament is healing it is important to do specific exercises advised by your Physiotherapist to improve flexibility and strength.

It is very important to complete the whole rehabilitation process. If you do this, it will reduce the chances of re injury. In conclusion, we want to get you back to your pre-accident Sports Activities as soon as possible!

How to reduce the risk of Ankle Sprain

To reduce the risk of ankle sprain, make sure that you:

Warm up before exercise or activity.

Cool down with slow stretches after the exercise or activity

Wear supportive shoes

Take extra care when you walk or exercise on slippery or uneven surfaces.

 Adequate stretching and strengthening of your muscles if you have a history of previous injury.

Give enough time to recover between training sessions.

 Use the right sports gear.

 Taping or use of brace in competitive games if you had a recent ankle sprain.


How to book an appointment with a Physiotherapist at PhysioNow?

Locations for PhysioNow clinics

We have four Physiotherapy clinics of which three are located in Mississauga and one is in Etobicoke. https://www.physionow.ca/locations/

You can call 289-724-0448 to book for a same day appointment with one of our highly trained Physiotherapists. Most of the time we can arrange your initial visit on the same day in a location which is nearest to you. Your initial appointment will be a one to one 40 minutes session. This appointment will be with a Physiotherapist and includes initial assessment, education and treatment.

You will have 40 minutes of follow up, which will be usually 2 to 3 sessions a week depending on the factors identified on initial assessment, treatment plan and your goals.

Call today to get started on your Physiotherapy for Ankle Sprain!

General Category, Pelvic Health, Pregnancy Mississauga

Pregnancy related Pelvic pain

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Pregnancy Related Pelvic Pain
Pregnancy Related Pelvic Pain

                        Pregnancy and Pelvic girdle pain


Pregnancy Related Pelvic Pain: Words Can Hurt

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.

Exercise during pregancy
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 2018 P

  1. 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!

General Category, Pelvic Health, prostate surgery

The Mysterious Pelvic Floor

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Pelvic Floor Muscles


The Mysterious Pelvic Floor


What is The Mysterious Pelvic Floor??

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, Ankle pain, Applewood Physionow, Applewood Sports & Physiotherapy Ltd, Erin Mills Physionow, Erin Mills PhysioNow, Erin Mills Physiotherapy Ltd., Etobicoke Physiotherapy, Falls Prevention, Foot Pain Management Mississauga, Foot Pain Treatment Mississauga, General Category, Long Branch PhysioNow Ltd., Long Branch Physiotherapy, Lorne Park PhysioNow, Lorne Park Sports & Physiotherapy Ltd., Manual Therapy, PhysioNow, Physiotherapy, Physiotherapy Etobicoke, Registered Physiotherapist Mississauga, Registered Physiotherapy Mississauga, Sports Injuries, Sports Physiotherapy

Acute Ankle Sprains

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Acute Ankle Sprains

Acute Ankle Sprains

Acute Ankle Sprains

How do Acute Ankle Sprains happen?

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

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

Acute Ankle Sprains

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

Registered Physiotherapy for Acute Ankle Injuries

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!

Acute Ankle Injuries

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.

To get started on your Acute Ankle Sprain Treatment, Give PhysioNow a call Today!

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Shoulder Injuries

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Shoulder Injuries

Shoulder Injuries

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

What Causes Shoulder Pain?

There are several reasons why people suffer from shoulder pain.

  • Trauma

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

    • Motor vehicle accidents
    • Falls
    • Sports injuries
    • Violent incidents

  • Poor workplace ergonomics

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

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

Proper desk ergonomics

Proper desk ergonomics

  • Poor posture

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

  • Good-Posture-vs-Poor-Posture

    Good-Posture-vs-Poor-Posture

  • Repetitive activities

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

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

 

  • Congenital or Developmental changes –

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

Some Basic Shoulder Anatomy

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

Shoulder Injury

Shoulder Anatomy

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

The Soft Tissues around the Shoulder Joint

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

Bursae of the shoulder joint

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

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

Signs and Symptoms of Shoulder Injuries

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

 

Healing Times for Shoulder Injuries

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

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

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

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

Physiotherapy/Massage Treatment for Shoulder Injuries

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

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

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

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

Registered Physiotherapy for Shoulder Injuries

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

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

 

 

 

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

Registered Massage Therapy for Shoulder Injuries

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

  • shoulder injuries

    Registered Massage therapy for shoulder injuries

 

 

 

 

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

Call PhysioNow today to get treatment for your shoulder injury!