Tag Archives: physiotherapy

Fracture, Fracture Rehabilitation, Fracture Treatment, Physiotherapy

Fibular Fracture: I Broke my Leg!

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What is a fibular fracture?

The fibula is one of two bones in the lower leg, the other being the tibia. Fractures of the tibia and fibula are common in those who have low bone density, specific diseases or anatomical features resulting in changes in bone structure. Also,the likelihood may also depend on the activity level, sports and types of training individuals do. 

Fibular fractures can happen anywhere along the shaft of the bone. Fortunately, due to the smaller size and degree of weight bearing of the fibula relative to the tibia, a fibular fracture is considered less severe. 

How do these fractures happen?

Usually, these fractures are caused by traumatic force to the bone.

  • High impact trauma: For example, these can be from a car crash, pedestrians being hit by a vehicle, falls from heights and more
  • Sports injuries: Especially, in contact sports like football or hockey. Alternatively, a sudden twist or rotational force can fracture the fibula even without a direct blow

What does a fibular fracture look like?

A fracture will result in a sharp, severe pain on the leg which worsens when you put weight on it

Symptoms of a fibular fracture may include:

  1. Pain and tenderness along the outside of the leg
  2. Swelling on the outside or sometimes the entire lower leg
  3. Visible deformity
  4. Inability or difficulty to bear weight on affected leg
  5. Numbness and coldness in feet 

When do I start Physiotherapy Treatment?

After being in a cast for several weeks and being cleared by the fracture clinic, you should see a Physiotherapist for Fracture Rehabilitation. Oftentimes, the knee and ankle become stiff, and the muscles weaken from disuse. Consequently, it is important to begin Physiotherapy Treatment as soon as you can. First, you will focus on regaining the range of motion, strength, and coordination in the lower leg. Simultaneously, you will work on restoring your normal walking pattern and functional abilities like weightbearing, balancing, squatting and stairs. Below is an example of a general rehabilitation program with Physiotherapy after a fibular fracture.

Phase 1: Protection (0-6 weeks)

  1. Patient will be in a cast for about 6 weeks and may be restricted in putting weight on the leg
  2. Encourage leg elevation
  3. Focus on ankle pumps, upper extremity and core strengthening

Phase 2: Early mobility and strengthening (6-8 weeks)

Exercises help increase the range of motion by pushing the ankle into dorsiflexion
  1. Focus on restoring range of motion in all the lower extremity joints
  2. Strong emphasis on ankle dorsiflexion range (bringing your ankle up)
  3. Focus on foot intrinsic muscle strengthening
  4. Start strengthening exercises for the musculature around the ankle, knee, and hip
  5. Gradual progression of weight bearing back to normal
  6. Gait retraining

Phase 3: Continue strengthening (8-12+ weeks)

Box jumps are a high impact exercise that challenges the entire lower body. Consequently, they require a strong foundation of strength before beginning.
  1. Advanced strengthening exercises including resistance training ex. weighted squats, lunges
  2. Start incorporating higher impact activities such as jogging
  3. Progress to plyometric (jumping) and exercises in multiple planes

It is important to note that not everybody will move through the phases of rehabilitation at the same pace. Thus, it is important to have supervision from a trained professional like a Physiotherapist. Ultimately, this will ensure that you are progressing appropriately and minimize your risk of reinjury.

Get started with PhysioNow!

If you are dealing with a fracture or any other types of leg pain, look for PhysioNow! We have many experienced clinicians including Physiotherapists, Massage Therapists, Manual Osteopaths, and Athletic Therapists to assist you in your recovery. We have 10 locations with free and accessible parking located across the GTA. Book with PhysioNow today for your first assessment and treatment!

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Hip Pain, Physiotherapy, Total Hip Replacement Surgery

Total Hip Arthroplasty: What you Need to Know!

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What is a total hip arthroplasty?

Total Hip Arthroplasty (THA), or a hip replacement surgery is a procedure that replaces damaged bone and cartilage in the hip joint. Instead, it replaces it with prosthetic components mainly using two techniques. The type of technique used will be discussed between you and your surgeon and is influenced by demographic and lifestyle factors.

1: Cemented: Used more in geriatric (older) populations or patients who have a more sedentary lifestyle 

2: Non-cemented: Indicated for younger populations, or patients having active lifestyles

Why do people get hip replacements?

On the left shows a healthy hip with an intact joint surface, the middle shows degeneration of the surfaces in the hip, the final image shows the outcome of the surgery where the hip surfaces are replaced.

Usually, the reason people get hip replacement is due to severe osteoarthritis (OA) that is causing high pain, loss of function, and disability. For example, when someone is having trouble walking and being independent with their daily activities due to issues with hip OA. Other reasons may include rheumatoid arthritis induced cartilage or bone damage, after a slip and fall on the hip (especially in older populations), and femoral neck fractures. However, some people may be ineligible for this surgery if they have peripheral vascular disease, history of blood clots, an ongoing infection, or septic arthritis.

Generally, hip replacements/THAs are safe procedures with great outcomes. Post-surgery, the most common complications to watch for include deep vein thrombosis which is a blood clot in the leg, or a post-surgical infection in the joint.

Physiotherapy Rehabilitation After Total Hip Arthroplasty

Total Hip Replacement Surgery

Total hip arthroplasties are highly effective surgical procedures designed to alleviate pain and restore function in patients with severe hip arthritis or hip joint damage. Initially, post-operative rehabilitation is crucial to ensure the continued success of the surgery and to optimize the patient’s recovery. Physiotherapy plays a vital role in this rehabilitation process, helping patients regain strength, mobility, and overall function. Read on to learn more about the phases of rehabilitation with Physiotherapy!

1. Immediate Post-Operative Phase

First, the immediate post-operative phase begins as soon as the patient wakes up from anesthesia. Then, physiotherapists start with gentle exercises to promote blood circulation and prevent complications such as deep vein thrombosis (DVT). Simple movements like ankle pumps, quadriceps sets (squeezing the big thigh muscle), and gluteal sets (squeezing the buttocks muscles) are encouraged. These exercises are designed to improve blood flow, reduce swelling, and initiate muscle activation without putting undue stress on the new hip joint.

Early mobilization is a critical component during this phase. Within 24 to 48 hours after surgery, patients are usually assisted to sit up and begin walking with the help of a walker or crutches. The goal is to start weight-bearing activities as tolerated, promoting healing and preventing stiffness.

2. Early Rehabilitation Phase

The early rehabilitation phase spans the first few weeks after surgery. During this period, physiotherapists focus on gradually increasing the intensity and range of exercises. Patients are taught specific hip-strengthening exercises such as leg raises, hip abductions, and gentle stretching. Additionally, simple balance and coordination exercises are also introduced to enhance stability and prevent falls.

Not only this, but pain management is a significant focus during this phase. Physiotherapists work closely with the medical team to ensure that pain is adequately controlled, allowing patients to participate actively in their rehabilitation. For example, ice therapy, electrical stimulation, and manual techniques may be used to manage pain and reduce inflammation.

3. Intermediate Rehabilitation Phase

The intermediate phase, typically from 4 to 12 weeks post-surgery, aims to build on the progress made in the early phase. Now, physiotherapy sessions become more intensive, incorporating resistance training and functional exercises. Furthermore, activities such as stationary biking, swimming, and gentle aerobics are introduced to improve cardiovascular fitness and endurance.

During this phase, the focus shifts towards improving gait and mobility. For example, patients practice walking without assistive devices, concentrating on proper walking mechanics and posture. Also, stair climbing and descending exercises are introduced to further enhance functional independence.

Strengthening exercises for the hip and surrounding muscles are progressively intensified. At the same time, core strengthening exercises are also incorporated to improve overall stability and support the hip joint.

4. Late Rehabilitation Phase

The late rehabilitation phase, typically beyond 12 weeks post-surgery, focuses on preparing the patient for a return to normal activities and, if possible, sports. Now, physiotherapy sessions aim to restore full strength, flexibility, and function. Advanced balance and proprioception exercises are introduced to ensure the patient can handle more complex movements and environments.

At this stage, patients may engage in low-impact sports such as golfing, cycling, and swimming. High-impact activities, such as running or jumping, are generally discouraged to protect the new hip joint from excessive wear and tear. However, each hip rehabilitation is different and should be discussed with your surgeon to understand your specific limitations.

Education on lifelong joint protection and healthy lifestyle choices is an essential part of this phase. Patients are taught strategies to prevent injury and maintain joint health, such as maintaining a healthy weight, avoiding high-impact activities, and incorporating regular exercise into their daily routine.

Getting a hip replacement soon?

If you are getting a total hip replacement soon and are looking for some advice and help, look for PhysioNow! Physiotherapy can help you maximize your strength and function prior to surgery to ensure that recovery is as smooth as possible. Then, after the surgery, we will work with you to return your hip back to its normal function with an individualized care plan. Our Physiotherapists are ready to get you started. Book with PhysioNow for your first assessment and treatment today!

Arthritis, Hand Pain Treatment, Health and Wellness, Hip Pain, Physiotherapy, Shoulder pain, Wrist pain

Rheumatoid Arthritis and What You Should Know

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Rheumatoid arthritis (RA) is an inflammatory disorder that can affect multiple joints, usually on both sides simultaneously. In other words, if it affects your wrists, it would likely be both, not just one. RA is an autoimmune disorder. Essentially, a flare up is when your immune system starts to attack your own body’s tissues. Ultimately, it has systemic (body-wide) effects and can damage your skin, lungs, heart and blood vessels in some cases.  RA mainly damages the lining of your joints causing large amounts of pain and swelling that can eventually result in joint line erosion and deformities. In most cases, the damage is permanent and leads to a decreased quality of life and increased disability.

What increases the risk of developing Rheumatoid Arthritis?

The ultimate cause of rheumatoid arthritis is unknown, but what we do know is certain things increase the risk of development. This includes:

  • Family history
  • Smoking
  • Obesity
  • Environmental or external factors (exposure to pollutants, stress, infection etc)
  • Sex: Women develop RA more often than men

What are the signs and symptoms of Rheumatoid Arthritis?

The symptoms depend on the current stage the condition is in, and it cycles between two stages:

  1. Relapsing: Also known as a flare up, symptoms appear and are more intense
  2. Remitting: Symptoms including pain will decrease or are absent, but structural deformities will persist  

During a relapse/flare up, symptoms include:

  • Pain in the joints, usually 4 or more joints at a time
  • Warmth and redness around the affected joints
  • Swelling 
  • Tender to the touch 
  • Morning stiffness
  • Fever
  • Fatigue

In the early stage of RA, the small joints of the body like the fingers or toes are more affected. As the disease progresses, the larger joints become involved like the wrists, knees, ankles, elbows and hips.

How is rheumatoid arthritis diagnosed?

Primarily, RA is identified through a combination of a physical exam, analysis of your health history, x-rays and other imaging tests, and blood work looking for markers that may indicate the presence of the disease.

Physiotherapy Management of Rheumatoid Arthritis

  1. Education about the condition and the key role of interprofessional and collaborative care in the management of RA:
    Managing your Rheumatoid Arthritis requires coordination of care from a variety of health care professionals.

    Your Physiotherapist can help you understand the condition, identify early signs and advise you on how to proceed or where to seek help. For example, they may help connect you to a medical doctor and a rheumatologist (professional that specializes in the care of inflammatory conditions) for specific management of RA. Additionally, these specialty clinics may provide additional resources for the management of the condition. 

    2. Activity modification

    During a flare up, strenuous activity should be avoided and rest becomes the priority. This may include things like lifting, climbing stairs, and even walking can put excessive pressure on the joints. To help, your Physiotherapist may give you strategies to help you manage fatigue, conserve your energy, and prescribe you with a gait aid or other adaptive devices. For example, using a walker or cane to offload the lower body, or installing railings or raised toilet seats.

    3. Therapeutic exercise

    During periods of remission, therapeutic exercises will be used to maintain normal muscle strength and prevent deterioration. The duration, severity, and types of exercise will be determined after a thorough assessment. Your Physiotherapist will uniquely adapt the exercises to an appropriate level for your condition. Overall, these exercises could include range of motion and stretching, aerobic conditioning, and strengthening.

    4. Manual therapy

    Manual therapies like soft tissue release, gentle joint mobilizations, and other massage techniques are useful for relieving pain and swelling and improving flexibility. It is also beneficial for promoting a general feeling of well being and increasing mood, which is often affected in this condition. Thus, it is an important part of the management of RA.

    Where can I find help?

    If you are experiencing difficulties with RA or any kind of joint pain, look for PhysioNow! We have many expert Registered Massage Therapists and Physiotherapists that can help you with your recovery today. With 10 clinics across the GTA from Burlington, Oakville, Mississauga, and Etobicoke, our highly accessible locations are ready to serve you! Book with PhysioNow today for your first assessment and treatment!

    General Category, Hip Pain, Total Hip replacement, Total Hip Replacement Surgery

    Hip Replacement Surgery Techniques: Which One is Better?

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    Anterior vs. Traditional Technique in Hip Replacement Surgery

    Images from left to right showing the degeneration of a hip joint and what it looks like after the total hip replacement surgery

    Hip replacement surgery is a common procedure to relieve pain and improve function for patients with hip arthritis or other degenerative conditions. Fortunately, there has been significant advancements in this field in recent years. For hip replacement surgery techniques, there are two primary techniques used. First, there is the anterior approach. Alternatively, there is the traditional/lateral approach. Overall, each method has its own set of benefits and challenges, influencing recovery time, pain levels, and long-term outcomes. In this blog, we will explore both techniques to help patients understand their options and their upcoming surgery.

    The Anterior Approach

    The anterior approach for hip replacements, also known as the “frontal approach,” is a relatively newer method in which the surgeon accesses the hip joint through an incision made at the front of the hip. Notably, this technique does not require cutting through muscles or tendons that attach to the hip joint, which can lead to a faster recovery and potentially less pain post-surgery. Additionally, the anterior approach allows for the use of minimally invasive techniques, which means smaller incisions and less soft tissue disruption. This article from Yale Medicine offers more information about the anterior approach.

    Advantages:

    1. Faster recovery: Because fewer muscles and tissues are disturbed during surgery, patients often experience less postoperative pain and a quicker return to normal activities like walking
    2. Lower risk of dislocation: The anterior approach reduces the risk of hip dislocation since the joint is not manipulated as much during surgery
    3. No muscle cutting: The procedure involves no cutting of major muscles or tendons, leading to a less traumatic recovery and less muscle loss.

    Disadvantages:

    1. Limited surgeon experience: The anterior approach requires specialized training and experience. Surgeons need to be adept in using this technique, which is still relatively new compared to the traditional approach
    2. Difficult for certain patients: The anterior approach may not be ideal for patients with certain body types, such as those that are obese or have very muscular builds. The position of the hip joint may be more challenging to access in this population
    3. Numbness at the thigh: In this approach the nerve that gives us sensation at the front of our thigh gets stretched, and some numbness may be present. Usually, this resolves in a couple months

    The Traditional (Posterior/Lateral) Approach

    The traditional technique involves making an incision either at the back (posterior) or the side (lateral) of
    the hip. In these approaches, the surgeon must cut through muscles and tendons that attach to the
    hip joint. While this technique has been used for decades, it is associated with a longer recovery time
    and a higher risk of complications such as dislocation in the early months after surgery.

    Advantages:

    1. Widespread use: The posterior and lateral approaches are well established and widely used,
      meaning most surgeons are highly skilled in these techniques
    2. Better for complex cases: This technique may be better suited for patients with more complex
      hip deformities or for those who have had previous hip surgeries
    3. Lower risk of nerve injury: The traditional method has a lower risk of damaging nerves, as the
      surgical site is farther from nerve pathways

    Disadvantages:

    1. Longer recovery: The muscles and tendons that are cut during the surgery take time to heal. Accordingly, this may delay recovery, increases the risk of pain, and requires more rehabilitation.
    2. More post-op restrictions: While the posterior approach offers excellent access to the hip joint, it is associated with a higher risk of hip dislocation early on. To minimize risk, your surgeon may give you a list of restricted movements known as hip precautions for 6-8 weeks

    Which hip replacement surgery technique is right for you?

    Choosing between the anterior and traditional techniques for the hip replacement depends on a variety of factors. For example, your surgeon’s analysis of the situation, your body type, and any underlying health conditions. You and your surgeon will have a consultation to discuss the best option for you. The anterior approach may be chosen for patients who are in relatively good health and can handle a faster recovery. However, for those with more complex cases or other health concerns, the traditional posterior approach remains a reliable choice.

    In conclusion, both the anterior and traditional techniques for hip replacement surgery offer distinct advantages and limitations. First, patients should have a detailed discussion with their surgeon to determine the most appropriate surgical approach for their situation. With advances in surgical techniques, hip replacement remains a highly effective treatment. Ultimately, it can improve your quality of life and restore your mobility. Importantly, the success of both types of surgery are dependent on receiving the proper physiotherapy treatment post-operatively. PhysioNow is a leading provider of post-operative care for Total Hip and Knee Replacement Surgeries. Pre-book with PhysioNow today for your first session after your operation!

    Physiotherapy, Total Hip replacement, Total Hip Replacement Surgery

    Total Hip Replacement Treatment: Get Better with Physiotherapy!

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    HIP REPLACEMENT TREATMENT will help speed up your recovery process. While healing and recovery time will vary between patients, proper management can minimize complications and optimize your function. Supervised Hip Replacement Treatment by a Registered Physiotherapist will help to restore your strength and range of motion.

    This guide can help you better understand your exercise and activity program after a hip surgery. At PhysioNow, our Registered Physiotherapists will help you return to your daily activities. To ensure your safe recovery, be sure to check with your Physiotherapist at PhysioNow or surgeon before performing any of the exercises shown.

    Safety Precautions after a Total Hip Replacement

    After hip replacement surgery, precautions must be taken to allow proper healing. It is important that you follow the safety precautions your surgeon gave you for the given time period, usually 6-12 weeks. Depending on the surgical procedure and approach used for your hip replacement, the precautions may be different or even not at all! Your surgeon and Physiotherapist in hospital will help teach you these initial precautions, and your outpatient Physiotherapist will remind you of them. Below are some of the most common hip precautions and some tips on how to adhere to them. Again, these precautions may not apply to you so make sure you check with your surgeon and Physiotherapist specifically!

    • Avoid more than 90 degrees of hip flexion
      • Use a raised toilet seat
      • Use a cushion when sitting in a chair so that your hips are higher than your knees
      • Don’t lean forward from a sitting position ex. putting on shoes, use a shoe horn instead
    • No crossing your legs or ankles
      • Avoid twisting your body, move your feet to turn your whole body
      • Avoid sitting cross logged
      • Sleep with a pillow between your knees
      • Avoid sitting cross legged or one leg over the other

    How much weight can you put on your new hip?

    Your surgeon will decide your weight bearing status based upon the following:

    • The type of surgery and prostheses used
    • The condition of the your natural bone
    • How the prostheses was fixated to the natural bone

    Follow instructions from your surgeon at the hospital and at home upon discharge. Initially you will be advised to put a small percentage of weight on the affected leg and use a gait aid such as a walker or cane to help. With proper exercise and keeping safety precautions in mind, you should be able to restore strength to your new hip over time.

    Total Hip Replacement Treatment Guide for Weeks 1 to 4

    1) ANKLE PUMPS:
    Slowly point the toes as far as possible then pull them back toward you as far as possible.
    Repeat this exercise several times a day, as often as every 10 to 15 minutes.

    2) ANKLE ROTATIONS:
    Move your ankle inward toward your other foot and then outward away from your other foot.
    Repeat 5 times in each direction.
    Perform 3 to 4 sessions a day.

    3) BUTTOCK CONTRACTIONS/GLUTE SQUEEZE
    Tighten your buttock muscles.
    Hold for 5 second. Repeat 10 times.
    Perform 3 or 4 sessions a day


    4) HIP ABDUCTION
    Slide your leg out to the side as far as you can and then back.
    Repeat 10 times.
    Perform 3 or 4 sessions a day


    5) QUADRACIPS SET
    Tighten your thigh muscle. Try to straighten your knee. Hold for 5 to 10 seconds, repeat 10 times.

    6) STRAIGHT LEG RAISES
    Tighten your thigh muscle with your knee fully straightened on the bed. Lift your leg several inches off of floor. Hold for 5 to 10 seconds. Slowly return, repeat 10 times.

    STANDING EXERCISES
    Make sure you are holding on to a firm surface such as a bar attached to your bed or a wall when performing standing exercises.

    8) STANDING KNEE RAISES
    Lift your operated leg only few inches off the floor, below your waist.
    Hold for 2 to 3 seconds, and put your leg down. Repeat 10 times both legs.
    Perform 3 or 4 sessions a day.

    9) STANDING HIP ABDUCTION
    While standing, raise your leg out to the side. Keep your knee straight and maintain your toes pointed forward the entire time. Slowly lower your leg so your foot is back on the floor.
    Repeat 10 times on each leg.
    Perform 3 or 4 sessions a day.

    10) STANDING HIP EXTENSIONS
    Standing tall and keeping knee straight, extend one leg back without leaning forward or arching your back. Return to the starting position.
    Repeat 10 times for each leg.
    Perform 3 or 4 sessions a day.

    Progressing After 4 Weeks

    Always attempt any exercises within your pain tolerance. After 4 weeks, individual healing times vary and some people may be ready to attempt more demanding exercises and start getting back to physical activity. As a result of the variability of progression, it is recommended that you contact our Registered Physiotherapist at PhysioNow to help you with your safe recovery. They will be able to customize your program to your current level. Overall, hip replacement surgery can be a rewarding experience, as it will allow you to return to your daily living activities.

    Registered Massage Therapy is another excellent treatment after having had a Total Hip Replacement. The muscles in the low back and hip area tend to get quite tight after surgery and Registered Massage Therapists are very skilled at releasing this muscle tension. As a result, this will help your pain and may speed up your recovery time! We have Registered Massage Therapists available daily Monday to Saturday.

    If you are considering having hip replacement surgery, check out this link to the Mayo Clinic with some extra information that may be useful.

    Hand Pain, Physiotherapy, Sports Injuries, Wrist pain

    TFCC Injury and Wrist Pain

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    What is a TFCC (Triangular Fibrocartilage Complex) injury?

    First, the Triangular Fibrocartilage Complex (TFCC) is a critical structure located in the wrist,
    specifically on the side of the pinky finger. It plays a role in stabilizing the wrist joint, particularly during activities that involve gripping or weight-bearing through the hands. It is comprised of a triangular fibrocartilage disc, ligaments, and associated structures. Importantly, the TFCC provides cushioning and stability between the 2 bones at the end of the forearm/beginning of the wrist (the radius and the ulna)

    A closer look at the TFCC

    The TFCC consists of several components, including the triangular fibrocartilage, the ulnar collateral ligament, and the dorsal and palmar radioulnar ligaments. These components work together to stabilize the wrist, absorb shock, and facilitate smooth movement between the radius and ulna. Especially, the complex is important for athletes and individuals who engage in activities requiring repetitive wrist motion or heavy lifting. Namely, it helps to prevent injuries in these high-stress situations.

    How does the TFCC get injured?

    TFCC injuries can occur due to various factors, primarily categorized into traumatic and degenerative causes. Traumatic injuries often result from a fall onto an outstretched hand, direct impact to the wrist, or sudden twisting motions. These injuries are common in sports such as gymnastics, football, and skiing. On the other hand, degenerative injuries, develop over time, often due to repetitive wrist motions or age related wear and tear. Medical conditions such as rheumatoid arthritis can also contribute to the deterioration of the TFCC.

    Symptoms of a TFCC Injury

    Individuals with a TFCC injury typically experience a range of symptoms. This can include but is not limited to:

    • Pain, localized to the ulnar/pinky side of the wrist
    • Worsened by gripping, twisting, or weight-bearing activities on the hand/wrist
    • Swelling around the wrist
    • Decreased range of motion in the wrist
    • A feeling of instability in the wrist joint
    • Clicking or popping sounds when moving the wrist

    How is a TFCC Injury treated?

    Wrist bracing can help reduce pain from a TFCC injury and increase the function in your wrist while it heals

    The treatment for TFCC injuries varies based on the severity and how it was injured. Primarily, conservative options are the first line of defense and often include rest, immobilization in a splint or brace, and physical therapy. Physical therapy goals include improving range of motion, strength, coordination, and a return to sport/activity plan. Pain management may involve the use of nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. In cases where conservative treatments are ineffective, surgical intervention may be necessary. Surgical options can include debridement, repair, or, in severe cases, reconstruction of the TFCC itself.

    Where can I find help?

    In conclusion, a TFCC injury can significantly impact wrist function and quality of life. Early
    intervention with appropriate treatment are the best options. The longer you leave the injury untreated, the trickier it becomes to return to your normal function and activities. Thus, if you are experiencing wrist pain, look for PhysioNow! We have 10 convenient locations across the GTA and many Registered Physical Therapists highly experienced at treating sports injuries. Book with PhysioNow today for your first assessment and treatment!

    Fees and Financing, General Category, PhysioNow

    Extended Health Care Benefits: Use Them or Lose Them!

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    It’s almost the end of the year, don’t forget to take advantage of your Extended Health Care (EHC) Benefits! Whether you’ve been putting off getting an ache, a pain, or stiffness looked at, or just looking for some rest and relaxation, PhysioNow has many different treatment options to suit your needs!

    What services does PhysioNow offer?

    PhysioNow is pleased to offer a variety of different services that are usually covered through EHC. This list includes:

    What conditions are treatable?

    There is no defined list, but the most common examples of conditions or reasons people come to get treated at Physiotherapy Clinics and their associated services include sports injuries, osteoarthritis, sprains/strains, over-use injuries, post-fracture, post-surgery and more. If you aren’t sure, you can book a 15 minute free consult with PhysioNow to determine whether your issue is something we are able to help. Some people do not know the source of their pain when they first arrive and that’s okay! You and your clinician can work together to discover the root of the problem and work on resolving it.

    I have an old injury/pain, is that okay?

    Yes, the date of injury does not matter under your extended health care benefits. Whether it is a new issue or an older reoccurring injury, you can find help at PhysioNow. Our clinicians are experts at assessing the body and can help manage and even resolve chronic issues.

    How do I use my insurance?

    Our clinic accepts and can direct bill to many insurance providers including to Johnson, Desjardins, Sunlife, Canada Life, Manulife, Claimsecure, Greenshield, and more!

    If you haven’t used your insurance before or it’s been a long time since you’ve done it, don’t worry! Our experienced staff has lots of experience and can easily walk you through the process. First, you should double check that you have coverage for the service you want, usually by calling your insurer or logging in to your account. Once you have that and your insurance information, all you have to do is give our front desk your information and we can directly bill your insurance. Ultimately, this saves you time and makes each appointment more efficient. You can also check out our Fees and Financing page and this page about Direct Billing for more detailed information.

    Why choose PhysioNow?

    PhysioNow offers clean, spacious, and private treatment rooms at each clinic.

    PhysioNow has been providing exceptional service to the GTA region for 2 decades. We are proudly created and owned by a Physiotherapist. Starting with just one clinic in the Mississauga region, we have grown to include 10 clinics across Burlington, Oakville, Mississauga, and Etobicoke. Each clinic can offer:

    • 1 on 1 time with your clinician guaranteed at each session
    • Direct billing services
    • Private and spacious treatment areas
    • Evidence-based treatment techniques
    • Flexible appointment times including early mornings, late evenings, and weekend hours
    • A large quantity of free parking at each clinic

    Find out why PhysioNow has been a leading provider in the last 2 decades. Book with us today for your first assessment and treatment!

    Back Pain, Health and Wellness, Low back Pain, Physiotherapy

    Low Back Pain: 5 Tips for Prevention!

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    Low back pain is one of the most common reasons people visit a Physiotherapist. It can happen to anyone, at any age, and it often shows up without warning. However, the good news is that there are ways to relieve your pain and minimize the chances of it coming back. In this blog, we will explore what causes this type of pain, how to treat it, and how to keep it from becoming a regular problem.

    What causes low back pain?

    Minimizing risk of lower back pain
    Infographic demonstrating a proper and improper lifting position for the back

    There are many reasons why you might have pain in your lower back. For example, some of the most common causes include:

    1. Poor Posture: Sitting or standing with poor posture can put a lot of strain on the muscles and joints in your back. Consequently, over time, this can lead to pain and discomfort.
    2. Muscle Strain: Lifting something heavy, twisting awkwardly, or overdoing it during exercise can strain the muscles in your lower back. This can cause pain that may last for a few days or weeks.
    3. Inactivity: If you spend too much time sitting or lying down, your back muscles can become weaker. Weak muscles are more likely to get tired and painful, especially when you try to do something active again.
    4. Injuries: Falls, accidents, or sudden movements can injure the structures in your back, including the muscles, ligaments, and discs. Furthermore, these types of injuries can lead to long-lasting pain if not treated properly.
    5. Age-Related Changes: As we get older, our spine changes. Namely, the discs between our vertebrae can wear down, and arthritis can develop. This is called degenerative disc disease or osteoarthritis, and it can lead to low back pain.

    Tips for Preventing Low Back Pain

    Here are some simple steps you can take to minimize the risk and chances of having low back pain:

    1. Stay active: Regular physical activity keeps your muscles strong and flexible. For example, walking, swimming, and yoga are all great low impact ways to keep your back healthy.
    2. Lift safely: When lifting heavy objects, bend your knees and keep the object close to your body. Additionally, avoid twisting while lifting, as this puts further strain on your back in an already vulnerable position.
    3. Take breaks from sitting: If you work at a desk or sit for long periods of time, make sure to stand up and stretch every 30 minutes. Importantly, this helps reduce the pressure on your lower back. Alternatively, you may choose to have a standing desk so that you can switch between both positions.
    4. Sleep in a comfortable position: Sleeping on your side with a pillow between your knees can help keep your spine in a comfortable position. Additionally, make sure your mattress provides enough support for your back.
    5. Maintain a healthy weight: Extra weight, especially around your belly, can put more stress on your lower back. As a result, eating a balanced diet and staying active can help you maintain a healthy weight.

    How can physiotherapy help?

    Manual therapy is one of the potential treatment techniques used by physiotherapists to manage lower back pain

    Despite your best efforts to prevent it, if you are struggling with Low Back Pain, Physiotherapy is one of the most effective ways to manage a stubborn pain. A physiotherapist can help in the following ways:

    1. Pain relief techniques: Physiotherapists use various methods to help relieve pain, such as heat or ice
      therapy, massage and manual therapy techniques, or electrical stimulation. These treatments can help reduce your pain and make you feel more comfortable.
    2. Exercises to strengthen your back: Specific exercises can help strengthen the muscles in your back,
      core, and legs. Strong muscles support your spine better and reduce the risk of future pain. Your
      physiotherapist will show you exercises that are safe and effective for you.
    3. Stretching: Next, tight muscles can contribute to back pain. Your physiotherapist will guide you through stretches that help improve flexibility in your back, hips, and legs, which can ease the pain and improve your overall movement.
    4. Posture correction: Importantly, learning how to stand, sit, and move correctly can make a big difference. A physiotherapist can teach you how to maintain good posture and reduce the strain on your back during everyday activities.
    5. Education: Sometimes, understanding what is causing your injury or condition can help reduce your worries about it. Accordingly, your physiotherapist will explain what’s happening in your back, what that means for you, and how you can manage the pain.

    When should you see a physiotherapist for low back pain?

    If your lower back doesn’t get better within a couple days to weeks, or if it continues to worsen, it’s a good idea to see a physiotherapist. Also, you should also seek help if you have other symptoms, such as pain going down your leg, numbness, or weakness. Fortunately, a physiotherapist can assess your condition and create a treatment plan that’s right for you. With the right treatment, education, and some simple lifestyle changes, you can manage the pain and get back to doing the things you love. If you’re struggling with low back pain, look for PhysioNow! Book with us today for your first assessment and treatment!

    Hip Pain, Physiotherapy, Total Hip replacement, Total Hip Replacement Surgery

    I’m having a hip replacement! Do I need physiotherapy?

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    A hip replacement can be daunting but with the right information and preparation, you can make the recovery very smooth. In this blog we’ll describe the essentials you should know before, during, and after your surgery, and the importance of Physiotherapy Treatment throughout the process. If you are worried about your upcoming surgery, read on to ease your fears!

    What is a hip replacement?

    A total hip replacement, or Total Hip Arthroplasty (THA), is a procedure that replaces damaged bone and cartilage and replaces it with prosthetic components. Specifically, there are two techniques.

    1. Cemented: For more elderly populations or patients who have more sedentary life
      style
    2. Uncemented: For a younger population or patients that have a more active lifestyle

    Usually, an uncemented style is preferred as it usually results in more natural movement of the hip and less complications after the surgery. However, it takes a lot longer to heal than a cemented technique. Usually, it takes about 3+ months for there to be a strong fixation between the implant and the bone, whereas cemented is almost instantaneous at the sacrifice of future mobility.

    Physiotherapy rehabilitation before the surgery

    You may have been seeing a Physiotherapist prior to the surgery to maximize your function, strength, and mobility. In some cases, Physiotherapy Treatment can delay or even remove the necessity of a hip replacement! However, in the cases where we know surgery is inevitable, Physiotherapy Treatment helps you preserve and “prehab” the hip to ensure you come out of the surgery as easily as possible. In this case, treatment may include:

    • Manual therapy for pain relief and mobility
    • Other pain-relieving strategies like electrotherapy, cryo and heat therapy
    • Therapeutic exercises to maximize your hip’s potential prior to surgery
    • Gait and balance training
    • Braces, gait aids and other movement strategies to minimize pain and fatigue

    Physiotherapy rehabilitation after a hip replacement

    Total hip arthroplasties (THAs) are highly effective procedures with a very smooth recovery process these days. Most patients are able to leave the hospital after a day if there are no complications. Furthermore, there can be immediate improvements in function and pain, especially in patients that had severe hip arthritis or hip joint damage prior to the surgery. However, as amazing as the outcomes can be, post-operative rehabilitation is crucial to ensure that you get there.

    In the immediate post-operative phase

    The immediate post-operative phase begins as soon as you wake up from anesthesia. Initially in the hospital, Physiotherapy starts right away and gets you moving as soon as possible. Hospital Physiotherapy may look like:

    • Gentle exercises to promote blood circulation and minimize swelling
    • Starting early muscle activation with exercises
    • Assessing and preventing complications such as deep vein thrombosis (blood clots)
    • Early functional movements such as moving in bed, sitting or standing at the bedside, walking with a gait aid, stairs
    • Assessing you for discharge from the hospital and ensuring it is safe for you to return to your home
    • Teaching you your hip restrictions (if any, and as indicated by your surgeon)

    In the early rehabilitation phase

    The early rehabilitation phase spans the first few weeks after surgery. During this period, you will likely be attending an outpatient Physiotherapy clinic. In Ontario, you are entitled to some coverage under OHIP after a THA. Hospitals will give you a referral to Physiotherapy clinics in the area where you may continue your rehab after leaving the hospital. Our clinic, PhysioNow sees many post-operative patients just days after their surgery. In this stage, areas of treatment include:

    A Physiotherapist helping their patient with their range of motion into hip flexion
    • Increasing the intensity and difficulty of exercises
    • Scar/incision care and how to manage it at home
    • Increasing the weightbearing ability of your hip
    • Gait, coordination, balance training
    • Education on using gait aids like walkers, canes, rollators
    • Effective pain management using modalities or manual therapy

    Intermediate Rehabilitation Phase

    The intermediate phase, typically from 4 to 12 weeks post-surgery, aims to build on the progress made in the early phase. Physiotherapy sessions become more intensive, and the focus shifts to normalizing your strength and mobility and starting to reintroduce activities of your normal life and hobbies that you enjoy. Physiotherapy Treatment may include:

    Treatment will start to include more weightbearing exercises
    • Incorporating resistance training, weights and functional exercises such as stairs practice
    • Cardiovascular training with lower intensity activities including stationary biking, swimming, walking
    • Gait training without mobility aids, or swapping to aids that give less support
    • Harder balance exercises including dynamic balance with movements, unstable surfaces
    • Manual therapy to try to restore full range of motion in the hip

    Late Rehabilitation Phase

    The late rehabilitation phase, typically beyond 12 weeks post-surgery, focuses on
    preparing the patient for a full return to normal activities, high intensity activities and, if applicable, sports. Physiotherapy sessions will include:

    Whatever your sport or preferred activity is, the goal of Physiotherapy is to get you back to it!
    • Advanced balance and proprioception exercises mimicking complex movements and environments
    • A back to sport plan that will gradually expose you and increase your tolerance to high impact activities ex. running, jumping for basketball or volleyball
    • Practice of specific sport skills in the clinic ex. plyometrics, quick direction changes
    • Education on how to take care of your hip long-term

    Having a hip replacement surgery soon?

    Look for PhysioNow! It is important to make sure that your hip is as strong as possible prior to the surgery. After the surgery, your Physiotherapy will be a progressive process tailored to your individual needs. PhysioNow accepts OHIP patients after a hip or knee surgery, and also offers direct billing for extended health care benefits if you need to continue your treatment for longer. We have 10 spacious locations across the GTA from Burlington to Etobicoke and in between. Book with us today for your first assessment and treatment, or a free 15 minute consult!

    Motor Vehicle Accidents, Physiotherapy

    Just had a Motor Vehicle Accident? Get Treatment with PhysioNow!

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    Is there treatment available after a Motor Vehicle Accident (MVA)?

    Yes, treatments provided by Registered Physiotherapists are available to help you manage your pain and impairments after the accident. Usually, this process starts by contacting your insurance company and reporting the incident. In Ontario, individuals are entitled to $3500 of treatment which usually covers 4-5 months of treatment. Additionally, coverage may be extended more depending on the severity and extent of the injuries. Not every Physiotherapy clinic accepts MVA referrals, but PhysioNow is one of the leading providers of MVA rehabilitation across the GTA!

    What is MVA rehabilitation?

    Car accidents are unique because they result in injury to multiple larges areas of the body at the same time. Fortunately, MVA rehabilitation will address any and all of those impairments, and the Physiotherapist may refer out to other health care professionals if necessary. For example, injuries can range anywhere from one to multiple of:

    • Fracture
    • Concussion
    • Whiplash
    • Soft tissue strains, sprains and tears
    • Internal injuries (requiring immediate medical attention)
    • Chest injuries/bruising
    • Other traumatic brain injuries
    • Injuries requiring surgical repair

    How long is MVA treatment?

    Treatment will address any impairments from the accident, the most common of which are neck and back pains

    As mentioned before, the treatment is usually around 4-5 months for individuals with minor injuries. If you are qualified for a major injury guideline (requires approval from your adjustor and usually medical documentation), the treatment can cover you for years. Overall, injuries sustained from MVAs can take quite a long time to heal. However, many individuals will recover quicker than the entire duration of the treatment.

    How do I get started?

    After reporting the incident, your case will be assigned a case number. Usually, your adjustor or Motor Vehicle Insurance will have the clinic contact you directly to set up the first appointment, so all you have to do is await a phone call from us! In some cases, they may give you a list of clinics in the area that accept MVA patients, and you can contact us yourself. From there, we just have to find a date and time that works for your initial assessment.

    What can I expect from the first Motor Vehicle Accident Physiotherapy appointment?

    You will be asked to fill out some paperwork on your initial visit, but don’t worry, our PhysioNow staff are very experienced with MVA procedures and can easily walk you through it. Usually, we ask our patients to come 30 minutes early to the initial assessment to ensure that the paperwork does not impact your appointment time with the Physiotherapist. Next, your physiotherapist will conduct a comprehensive assessment of the injured areas. Finally, they will create a personalized treatment plan using your input to ensure the quickest recovery time possible.

    If you have more questions or are looking for a clinic to start your Motor Vehicle Accident Treatment at, look for PhysioNow! We have 10 locations offering MVA services across the GTA including Burlington, Oakville, Mississauga, and Etobicoke. Get in contact with us today!