Tag Archives: physiotherapy

Headaches: Neck Pain, neck pain, Neck pain Treatment Mississauga, Physiotherapy

Tension Type Headaches: How do I stop them?

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What are Tension Type Headaches?

Tension type headaches (TTH) are one of the most prevalent types of headache. Unfortunately, they affect a significant portion of the population globally. When experienced, they feel like a dull, aching, type of headache that may wrap around the head. In fact, some patients describe it feeling like a tight band is compressing their skull. Unlike migraines that have symptoms like nausea, noise or light sensitivity, and visual manifestations, tension headaches do not have additional symptoms other than pain. Overall, frequent tension headaches could decrease one’s quality of life.

What causes them?

Tension Type Headaches are heavily influenced by stress and posture. You might be more likely to have them if your job is currently very demanding and you’ve been putting in many hours.

The exact cause of tension headaches isn’t known, but it has been linked to several factors including stress, posture, anxiety, muscle tension, poor sleep and more. The headaches may be be episodic as well as chronic, depending on the amount of time it is experienced in a month. To clarify, episodic means it is experienced for <15 days in a month, and chronic means it is experiences >15 days in a month for 3 months.

How is it diagnosed?

Your health provider will ask you questions about your medical history, triggers to the headache, type of symptoms, patterns and frequency of headaches, and more. As a result, this will help them rule in or out other causes of and other types of headaches.

Additionally, TTH requires a comprehensive physical assessment of the head and neck muscles to check for areas of tenderness, muscle tension and trigger points which are commonly associated with TTH.

How are Tension Type Headaches treated?

Physical Therapy treatment of the neck can help manage pain and provide relief from persistent headaches.

Physical therapy management for TTH is a comprehensive and effective approach. Firstly, patient education is a key factor in every case. It is important for patients to learn about their condition, factors that may trigger their headaches, and strategies for managing their symptoms. Additionally, other techniques may include:

  • Myofacial release technique and other manual therapies in the cervical structures
  • Research suggests cold packs can have a positive effect on relieving pain and discomfort
  • Stretching and strengthening of cervical muscles
  • Postural correction techniques
  • Lifestyle and stress management advice

Need help?

Look for PhysioNow! Whether you are looking for relief from neck pain, stiffness, or headaches, we can help you. Our expert team of Registered Physiotherapists, Manual Osteopaths, and Registered Massage Therapists are all equipped with the skills to take care of you. Locations from Burlington, Oakville, Mississauga, and Etobicoke, book with PhysioNow today for your first assessment and treatment!

Fees and Financing, General Category, PhysioNow, Physiotherapy

Direct Billing for Physiotherapy: PhysioNow FAQs

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At PhysioNow, we receive many inquiries from our patients about our direct billing services. If it is your first time using your insurance and are unsure about the whole process, this article should help you out. Additionally, you are free to reach out to us for more personal questions and our team of experienced administrative staff would be more than happy to help you out.

What is direct billing?

Direct billing means that the clinic can submit the claims on your behalf to your insurance provider. Ultimately, this results in a streamlined process for our patients as you no longer have to pay at the clinic, submit the claim, and then wait for reimbursement. Instead, you are only responsible for paying the amounts, if any, not covered by your insurance plan.

Which insurances can PhysioNow bill to?

We bill to all the top extended health care providers including Sunlife, Manulife, Desjardins, Canada Life, Blue Cross, Greenshield, Johnson and more. We are able to bill to a long list of extended health care providers, which you may find here. Please note, this is not an all-inclusive list but rather the most common providers. If you do not see your provider on the list, you may call our offices and have them check for you.

How much does my plan cover?

This will be dependent on your individual plan and extended health care provider. Usually, insurance providers only release information to the insured member. Sometimes, you may have to call them or they may have provided you a login to a portal where you can check on the status of your benefits. Generally, for a health care claim, plans have a maximum coverage total within the year (ex. $1000) and a per claim maximum either as a % or a set dollar amount (ex. covers 80% or covers up to $60 of each session).

What do I need to bring to my appointment?

An example of a Manulife insurance card with necessary details for direct billing.

You will need your plan details with you in order to do direct billing at your first appointment. You may have a physical or digital insurance card with all the details that looks something like the image above that we can photocopy, or you can email to us. Then, you will proceed with the appointment and our administrative staff can bill your insurance while you’re inside. Once you’re done, our staff will be able to let you know how much your insurance covered (if you didn’t already know this information), and whether there is any co-pay to be covered by you. And that’s all! Direct billing makes the process very simple.

What if I have more than one type of coverage?

We can direct bill to multiple plans at the same time! We will submit to your primary plan first, and any outstanding balances we will submit to the secondary plan. This is true even if your benefits are from 2 different insurance providers. This is referred to as a coordination of benefits, or COB. It allows people with more than one benefits plan (whether from their own insurance, a spouse, or parent) to combine and thus, maximize their coverage.


What are the benefits of direct billing?

Now that we have been over the basic of direct billing, let’s talk about why it is important to you, and why our patients love it.

  • Convenience: It saves you the time and effort from having to navigate the claims website and submitting claims by yourself
  • Pay less upfront: You only have to pay the portion not covered by your insurance instead of paying the full amount and awaiting reimbursement
  • Predictable expenses: Knowing what your insurance covers right away can help you plan and budget for other expenses

Looking for treatment?

PhysioNow is here to help you get started. We offer direct billing for Physiotherapy and Massage Therapy so that you can get treated quickly and efficiently. Book with PhysioNow today for your first assessment and treatment!

Hand Pain, Physiotherapy

Trigger Finger: Why is my finger locking up?

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What is trigger finger?

Trigger finger is a hand condition where the finger can get stuck in a bent position. Afterwards, it may straighten suddenly with a snap. Usually, the fingers most often affected are the ring finger and the thumb, but the condition can affect any finger. Depending on the severity, the locking and popping open of the finger may be quite painful.

Why does it happen?

The tendon sheathe becomes swollen and blocks movement.

Trigger finger happens when the tendon that controls that finger can’t glide smoothly in the sheath that surrounds it. This may occur if part of the tendon sheath becomes swollen or if a small lump forms on the tendon. In many cases, repetitive and prolonged work with the hands such as typing, lifting, and grabbing can increase the risk of developing a trigger finger. The condition is most common in women over the age of 50. Additionally, you may be at higher risk of trigger finger if you have diabetes, low thyroid function or rheumatoid arthritis.

Symptoms of trigger finger

Symptoms of trigger finger may progress from mild to severe and include:

  • Finger stiffness, particularly in the morning.
  • A popping or clicking sensation as the finger moves.
  • Tenderness or a bump in the palm at the base of the affected finger.
  • Finger catching in a bent position and suddenly popping straight.
  • Finger completely locked in a bent position and unable to straighten.

Unfortunately, trigger finger can affect any finger, including the thumb. Not only that, but more than one finger may be affected at a time, and both hands might be involved. Triggering (getting stuck) is usually worse in the morning.

Treating a trigger finger

Treatment of trigger finger can include:

An example of a trigger finger splint by Vive.

  • Splinting

    • Trigger finger splints are designed to keep your finger in a straight position and minimize the amount of movement. This allows the finger to rest and can make the morning stiffness or locking more manageable.

  • Rest

    • Avoid or modify activities that require repetitive gripping, repeated grasping or the prolonged use of vibrating hand-held machinery until your symptoms improve.

  • Physical Therapy

    • Conservative treatment is always the first step. Your physical therapist will give you exercises to help keep the area mobile and strong, perform manual therapy, and use modalities like ultrasound or laser therapy to help your trigger finger.

  • Steroid injections

    • In some cases, an injection can provide an immediate relief in pain and locking. However, the improvements may be temporary so physical therapy should still be done at the same time to ensure a full recovery.

  • Surgery

    • As a last resort and in severe cases, trigger finger surgery can be done to restore the full range of motion in the finger. This is done by increasing the amount of space there is for the tendon to move in by performing a cut in the area. Afterwards, it is important to undergo physical therapy to ensure a full post-surgical recovery.

Need help?

If you are experiencing a trigger finger or any other kind of injury, look for PhysioNow! With locations across the GTA from Burlington, Oakville, Mississauga and Etobicoke, our expert physiotherapists are at your service. Book with PhysioNow today for your first assessment and treatment.

Athletic Therapy, Shoulder Injuries, Shoulder pain, Sports Injuries

Could Your Biceps be Contributing to Your Shoulder Injury?

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Don’t Forget About Biceps

Rotator cuff injuries are a common cause of shoulder pain and dysfunction. It commonly affects athletes, manual laborers, and the general population alike. While the rotator cuff itself—the group of muscles and tendons stabilizing the shoulder joint—often takes center stage in discussions, the role of the biceps tendon in these injuries is equally significant yet frequently overlooked. This blog explores the relationship between the biceps tendon and rotator cuff injuries. It will shed light on diagnosis, treatment, and injury prevention strategies of the biceps tendon.

Anatomy and Function of the Biceps Tendon

The biceps muscle has two tendons at the shoulder: the long head and the short head. The long head of the biceps tendon originates from the superior glenoid tubercle of the scapula and travels through the bicipital groove of the humerus. This tendon plays a crucial role in shoulder stability and movement, especially during overhead activities.

The Relationship Between Biceps and Rotator Cuff Injuries

  1. Anatomical Proximity:


    The biceps tendon and the rotator cuff tendons are anatomically close, sharing the same space in the shoulder joint. This proximity means that injuries to the rotator cuff often involve the biceps tendon as well.

  2. Mechanism of Injury:


    Repetitive overhead activities, trauma, or degenerative changes can lead to injuries. When the rotator cuff is damaged, the biceps tendon can be subjected to increased stress and strain, leading to inflammation or tears.

  3. Pathophysiology:


    Inflammation of the biceps tendon (biceps tendinitis) often accompanies rotator cuff injuries. In some cases, the tendon may partially or completely rupture, exacerbating shoulder pain and dysfunction.
Diagram showing the close physical relationship between the biceps tendon and the rotator cuff tendon

Symptoms of Bicep Tendon Involvement

Patients with biceps tendon involvement in rotator cuff injuries often present with:

  • Anterior shoulder pain, particularly during overhead activities.
  • Weakness in shoulder movements.
  • A popping or catching sensation in the shoulder.
  • Tenderness over the bicipital groove.

How is this Diagnosed?

  1. Physical examination:

    Physical tests such as strength, range of motion, and special tests (ex. Speed’s test and Yergason’s test) can help identify biceps tendon pathology.

  2. Imaging studies:

    Ultrasound and MRI are crucial for visualizing the extent of tendon damage and identifying concurrent rotator cuff injuries.

Treatment Options

  1. Conservative management:


    Rest, ice, and anti-inflammatory medications.
    Physical therapy focusing on strengthening the shoulder muscles and improving flexibility.

  2. Medical management:


    Corticosteroid injections may be used to reduce inflammation and pain.

  3. Surgical Intervention:


    In cases of severe tendon damage, surgical options such as biceps tenotomy or tenodesis (reattaching the tendon to a different location) may be considered.
    Rotator cuff repair may be performed simultaneously to address both issues.

Prevention Strategies

Preventing biceps tendon involvement in rotator cuff injuries involves:

  1. Strengthening exercises:


    Focus on building shoulder and rotator cuff strength to support joint stability.

  2. Flexibility and Mobility:


    Regular stretching and mobility exercises to maintain a full range of motion.

  3. Proper Techniques:


    Ensuring correct techniques in sports and activities to minimize undue stress on the shoulder tendons.

  4. Gradual Progression:


    Avoiding sudden increases in activity intensity or duration to prevent overuse injuries.

Need more help?

The biceps tendon plays a critical role in shoulder function and is often implicated in rotator cuff injuries. Understanding the relationship between these structures is essential for accurate diagnosis and effective treatment. By combining clinical expertise with appropriate diagnostic tools and tailored treatment plans, healthcare professionals can significantly improve outcomes for patients with these complex shoulder injuries. PhysioNow is a leading provider of Physiotherapy Services. Whether it is a sports injury or long term shoulder injury, our therapists can set you on the road to recovery. Book with PhysioNow today for your first assessment and treatment!

 

Physiotherapy, Sports Injuries, Sports Taping

5 Benefits of Physiotherapy Taping

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What is Physiotherapy Taping?

Physiotherapy taping, also known as athletic or kinesiology taping, is a type of therapeutic technique used for rehabilitation and for enhancing sport performance. First, strips of adhesive tape are applied to the skin with the location depending on the area of injury or the goal of the treatment. A physiotherapist can help you apply the tape and teach you how to tape yourself at home as well!

Why do people receive Physiotherapy Taping?

There are many benefits to using physiotherapy tape, we’ll describe some common applications of taping to help you understand why taping has become so popular!

Physiotherapy tape being used to support an athlete after a shoulder injury
  1. Stability or support: While watching professional athletes, you may notice tape around their bodies. The tape acts as an external support and adds stability to a joint or muscle, minimizing the risk of injury. For example, many athletes have had repeated ankle sprains resulting in laxity, (allowing excessive movement) at the ankle ligaments. They may use tape to provide the support that their ligaments can no longer give. This can help prevent too much turning in or out of the ankle and limit their risk of re-injury.
  2. Pain Relief: Taping can provide pain relief to an injured area. It can improve blood circulation to the area where tape has been applied, reduce pressure on injured tissues, and can modify our nerve receptors to reduce the sensation of pain. As a result, it is often a popular treatment choice for overuse injuries as well such as tennis and golfer’s elbow.
  3. Postural Correction: The tape may be applied in a certain alignment to help an individual correct poor posture such as slouching or rounded shoulders. For example, the tape is applied in an upright posture with high tension. Next, when a person slouches, they feel the tape pulling on them as a reminder to sit back up. In this way, taping can help reduce and prevent posture-related pain and discomfort.
  4. Improved Awareness: Another benefit of taping is by enhancing our sense of proprioception. In other words, proprioception is our body’s ability to know where it is in space and its relative position. For balance, this is a very important ability to have. This helps individuals connect more with their muscles and joints, improving their ability to move.
  5. Non-restrictive: One of the favourite things about tape from our patients is it is non-restrictive. Unlike a brace, the tape is very subtle and allows them to move freely. The tape can stay on for several days at a time and will eventually come off on its own.

Where can I find physiotherapy tape?

Tape is relatively easy to find. You may look for it online or at some drug stores, pharmacies, and health-related stores.

There are many different brands of tape that you can use. Some of them are more rigid while others are more flexible. If you are confused on where to start, you can seek help from a sports physiotherapist. They can teach you the techniques for your specific goal and ensure you perform the tape job correctly.

Looking for more help?

Many different tape jobs exist and some of them can be trickier than others. Consider learning from a health care professional like a physiotherapist to ensure the tape has been applied correctly.

Look for PhysioNow! Sometimes a tape job isn’t enough to treat your condition and you want an expert opinion. We have experienced sports physiotherapists and athletic therapists that can assist you. Whether you want injury prevention, relief, or to enhance your performance, we have the skills to help you out. Book with PhysioNow today for your first assessment and treatment!

Ankle pain, Physiotherapy, Sports Injuries, Sports Physiotherapy

Rolled Your Ankle? 5 Exercises to Prepare it for Sports

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If you have had a sprained/rolled ankle recently, you may have felt like it isn’t quite the same anymore. Usually, after an injury, there is a loss in strength and coordination of the ankle. While this may not affect you as much in your day-to-day life just walking around, you can notice a difference when you play your sport. The following are a list of 5 potential exercises that may help your ankle get back in tip-top shape!

  1. Ankle Alphabets

After an injury, the ankle loses some fibers called proprioceptors. These proprioceptors give us our sense of proprioception, which is our ability to determine where our ankle is in space. For example, whether it is facing up, down, in, out, and to what degree. As you may imagine, this proprioceptive ability is essential to sports in order for us to jump and land safely, change directions quickly, and run.

Ankle alphabets are where you use your foot to draw the alphabet from A-Z. Imagine your big toe is the tip of a pencil, and you’re writing the letters in a space in front of you. To start, you may keep the eyes open so you can see what you’re doing. However, if you’re looking for a challenge, close your eyes and try to use just the sensation from your ankle to complete this exercise. It’s more challenging than it seems!

2. Balance on an unstable surface/Bosu Ball

Athlete balancing on bosu ball

Athlete balancing on a bosu ball during their ankle rehabilitation

When we’re playing sports or running, the ground is not always even footing. Subconsciously, your ankle is always making slight corrections for this. Unfortunately, after an injury your ankle may not be able to perform this as well. Ligaments are designed to prevent excessive movements of the ankle but with multiple injuries, they can become lax.  Thus, training on an unstable surface reteaches the ankle how to correct for the environment. Ultimately, this will reduce your risk of reinjury. Additionally, try adding in other challenges like catching and throwing a ball to really give yourself a workout.

3. Star Excursion Balance Test

The Star Excursion Balance Test is a rehab tool for ankle dynamic balance

The athlete stands in the middle on the indicated limb, and must slide the other leg out while maintaining balance

The Star Excursion Balance Test is one of the best exercises to use with athletes and physically active individuals. It is a challenging test that can also be used as a training tool afterwards. This exercise involves the balance, postural control, and proprioceptive systems.  First, the athlete begins by standing on one leg and trying to reach out with the other leg as far as possible in the pattern (see the image). Fortunately, this exercise requires minimal to no equipment which makes it a great choice to do at home.

4. Hopping and multidirectional movements

Once you return to your sport, your ankle will need to be able to withstand forceful movements in multiple directions. Some great examples of exercises might include skater lunges, fast lunges in multiple directions, step hops, running with pivoting, or quick starts and stops etc. Ultimately, there are many options to choose from.

5. Sport specific movements!

The best way to train for your sport is through practice of that sport! For example, if you have a sport on skates, you will need to practice being on those skates again in a controlled environment. Maybe your sport requires a lot of switching directions, or kicking a ball. Make sure you practice these things first! Don’t dive back into a competitive match right away but take the time to break up your sport into some smaller skills you can practice individually.

Need help?

If you are trying to recover from an ankle injury, it is always best to get assessed by a health care professional. Here at PhysioNow we have many knowledgeable Physiotherapists that can get you started on a rehabilitation program. Book with PhysioNow today for your first assessment and treatment.

Back Pain, General Category, Low back Pain, Physiotherapy

Lower Back Strain/Sprain: What’s the Difference?

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Anatomy of the “back”

In order to understand a lower back strain/sprain, a small anatomy lesson must be done. The back is a complex structure of bones and muscles, supported by cartilage, tendons and ligaments. “Back” is a common term which can include portions of the neck, thoracic spine and lumber spine. The back—especially the lumbar, or lower portion of the back—bears much of the body’s weight during walking, running, lifting and other activities.

Defining a strain vs. sprain

A strain is a general term for an injury that affects a muscle or tendon. Then, the location of the injury or which muscle or tendon is affected is then specified. For example, a lower back strain means muscles or tendon that are attached to lower back have been injured and may involve tears in the tissue. Alternatively, a hamstring strain means that specific muscle has been injured.

Unlike a strain, a sprain means an injured or torn ligament. Ligaments are non-stretchy bands of tissue which attach bone to bone. Primarily, their job is to prevent excessive motion or hypermobility at a joint, and give extra stability to our joints.

How does a lower back strain/sprain happen?

  • Quick or unusual movement: Quickly moving or twisting the back puts extra force through the muscle, especially if there are heavy weights involved
  • Improper lifting/bending: Repetitively overstressing the back muscles can lead to injury E.g. weightlifting with bad form in the gym. Consequently, a chronic (long-term) strain usually results from overuse after prolonged, repetitive movement of the muscles and tendons.
  • Trauma: Unfortunately, a fall on the back or a forceful blow to the it can move the joints more than their normal range, generating shear forces that strain/sprain the tissues of the lower back. Accordingly, this kind of trauma usually affects more then one muscle or tendon.
  • Poor posture: Repetitive and excessive time spent in improper postures or underlying conditions like scoliosis (excessive curvature in the spine) can put extra stress on muscles and ligaments and make them more prone to injuries. Thus, poor sitting and postural habits can makes the muscles weaker.
  • Obesity: Excessive body weight adds extra load and therefore, stress, on the back. This may make it more sensitive to injuries.

What does a lower back strain/sprain look like?

  • Pain in the back
  • Swelling, warmness and/or redness around the painful area
  • Reduced range of motion
  • Certain activities are painful like getting up in the morning, putting socks on, etc.
  • Muscle spasms or cramps
  • Prolonged sitting, standing or walking increases pain
  • Sometimes, radiating pain down into the hips or glutes

How is it diagnosed?

Mild strain/ sprain can be diagnosed from:

  • Subjective history like how the injury occurred, signs and symptoms reported
  • Physical examination by health care provider like a physiotherapist or physician
  • X-ray to rule out fractures
  • Ultrasound
  • MRI

How is it treated?

 

Manual therapy is one of the treatment techniques used by physiotherapists for a lower back strain/sprain

The following management will help you to recover from back injuries.

1) Icing: Firstly, immediately after the injury within 48-72 hours, icing helps to  reduce pain and swelling

2) Medication: Medication prescribed by the family doctor can help
manage pain and inflammation

3) Reduce painful movement: Additionally, limiting or modify aggravating movements which cause back pain for some time. This is necessary to give the muscle or ligament time to heal

4) Modalities: Electrotherapies like IFC and ultrasound will help reduce pain and inflammation

5) Soft-tissue work: Gentle massage or soft-tissue work will help muscles stiffness and pain

6) Brace: Sometimes, using a back belt/brace temporarily will reduce excessive movement occurring at the back to minimize pain. However, it is important not to become reliant on the brace as long term use can result in weakening of the core muscles

7) Strengthening exercises: Once pain has been reduced, back and core muscle strengthening exercises will help return you to your previous function and in the prevention of future injuries.

8) Stretching exercises: Stretching of tight muscles will help reduce stiffness and gaining your mobility back again

9) Postural Correction: Similarly, postural exercises will teach the most efficient postures to induce the least strain and stress on muscles. As a result, this should minimize the risk of reinjury

10) Proper technique and ergonomics: Finally, learning proper techniques for lifting, bending, carrying or how to properly set up your work desk are very important to reducing stress on your body

Minimizing risk of lower back strain/sprain

Infographic demonstrating a proper lifting position for the back

Need help?

If you have experienced a back strain/sprain or recent back issue, look no further than PhysioNow. We have many expert Registered Physiotherapists in 9 locations across the GTA from Burlington to Etobicoke. We would be more than happy to assist you with any questions or to get you started on an individualized treatment program. Book with PhysioNow today for your first assessment and treatment.

Shoulder Injuries, Shoulder pain, Sports Injuries, Sports Physiotherapy

Rotator Cuff Tendinitis: Are You Treating it Properly?

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What is the rotator cuff?

The rotator cuff is made up of a group of 4 muscles which control shoulder movements in all directions. Each rotator cuff muscle takes part in a slightly different anatomical shoulder movement like flexion, abduction, or rotation. In addition, they are all used in combination for movements like sport=specific movements. For example, in overhead, throwing, and racket sports such as badminton, tennis, volleyball and basketball.

The 4 muscles involved in the rotator cuff are as follows:
1) Supraspinatus
2) Infraspinatus
3) Teres major, teres minor
4) Subscapularis

What is rotator cuff tendinitis?

Rotator cuff tendinitis usually means there has been overuse/repetitive strain of the one of the tendons or group of tendons of the muscles listed above. As a result, inflammation has developed in that tendon, causing pain and loss of function. This condition may start as mild pain at the beginning but if left ignored and untreated, can worsen quickly and affect your ability to participate in sports.

How do I know if I have this condition?

The following are a list of the most common signs and symptoms:

1) Pain, discomfort, soreness, tightness with shoulder movement
2) Certain angles of shoulder movement reliably recreate the sharp pain. E.g. picking up a glass of water, overhead activities, reaching the arm backwards to put a jacket on
3) Stiffness in shoulder, especially in the morning
4) Sleeping discomfort while sleep on the affected side
5) Swelling in or around the shoulder
6) All overhead activities- painful, sharp pain and may radiate pain down the arm

If this list matches your symptoms, we recommend coming in to be assessed by a health care professional. Our physiotherapists are experts with shoulder pain and can help you understand your condition.

Is it possible to prevent tendonitis?

Yes, proactive and mindful care/training can reduce your chances of developing tendonitis.

Regular stretches and a proper warmup before playing sports always helps in prevention of injuries. There are various kinds of stretches to choose from like static, dynamic, yoga, deep tissue or foam roller stretches. Additionally, strengthening exercises and mobility work of the shoulder and thoracic spine are essential. The muscles must be strong enough to keep up with the high amount of force they withstand during play. Finally, ensuring that you are taking sufficient rest is equally as important. Many injuries are the result of increasing activity levels too quickly and the body fails to adapt.

How is rotator cuff tendinitis treated?

Rotator cuff tendinitis treatment

Taping may be a part of treatment for rotator cuff tendinitis

Rotator cuff tendinitis is best treated conservatively, with the help of a physiotherapist. While some people may benefit from medical intervention, most people are successful with athletic rehabilitation and sports therapy.

1) Rest: Avoiding over-exercising will prevent the condition from worsening and allow the muscles to recover and helps in healing.

2) Stretching: Stretching the major shoulder joint muscles can reduce the stress on the rotator cuff and also increases the flexibility of the muscles.

3) Modalities: Electrotherapy like TENS, IFC and/or ultrasound will help reduce pain and inflammation.

4) Pendulum exercise: This helps in preventing shoulder stiffness by increasing space at the joint and also maintains the mobility of the joint. This can be modified with adding more weight like carrying a dumbbell in your hand while performing it.

5) Joint mobilization: Working on the shoulder joint can reduce inflammation, pain, and help improve range and quality of motion of the shoulder.

6) Range of motion exercises: Various ROM exercises with or without assistance, depending on pain levels and current function ex. with the help of a cane, wall, or pulley to off weight the arm and help regain lost ROM in the shoulder.

7) Strengthening training: Depending on the specific condition or based on an individual’s current strength, resistance training can be done using weights and resistance bands to strengthen the rotator cuff.

Man completing exercises for rotator cuff tendinitis rehabilitation

Light dumbbells are often used to train specific muscles around the rotator cuff

8) Functional training: This includes working on the daily activities you may have trouble with, such as lifting a bag or throwing a ball using proper shoulder mechanics. This type of training prepares you to return to your normal activities, including preparing for return to sport.

Looking for athletic therapy?

Whether it’s your shoulder or another injury limiting your ability to participate, PhysioNow can help! We offer sports physiotherapy for athletes, with experience treating a wide variety of sports injuries. Our sport physiotherapists are ready to help you get back into play. Book with PhysioNow today for your first assessment and treatment!

Achilles tendonitis Shockwave therapy
Modalities, Physiotherapy, Shockwave Therapy

Stubborn Pain? Try Our New Shockwave Therapy!

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Shockwave therapy

What is shockwave therapy?

Shockwave therapy is also known as extracorporeal shockwave therapy. It is a treatment which uses low energy acoustic wave pulsations. The modalities can be directly applied to the area of injury using a gel as a medium. Lately, it is becoming one of the common treatment modalities seen in physiotherapy clinics.

Why is shockwave therapy used?

Importantly, shockwave can be beneficial in treating many musculoskeletal conditions, especially chronic ones. Firstly, it is used to stimulate the body’s natural healing process. Additionally, it can help you to decrease your pain levels by stimulating the nerves around an injured area. Also, the therapy increases blood circulation to the area and can also accelerate protein synthesis, cell growth, and break down stubborn calcium deposits in tissues.

How does shockwave therapy work?

The machine generates shockwaves, which is mechanical energy, throughout the tissue. Consequently, this stimulates a chain reaction or response in the cells which promotes tissue regeneration. The mechanism of action is quite complex as it happens at the cellular level but overall, results in a positive healing response and pain relief effect for the body. The shockwave therapy machine includes different interchangeable heads with different penetration capacity.

What type of injuries can be treated?

Shockwave therapy applied to a patient's heel

The foot is one of the most commonly treated areas with shockwave therapy

Shockwave was initially used to disintegrate renal stones in the 1980s. From there, it was discovered to be effective at treating bone spurs and calcified tissues. The following are a list of injuries that are most commonly treated by shockwave. Even if your injury is not on this list, shockwave may still be an option for you!

  • Planter fasciitis
  • Patellar tendinopathy
  • Upper extremities tendinopathy
  • Lower extremities tendinopathy
  • Tennis elbow
  • Golfers elbow
  • Hamstring injuries
  • Achilles tendinopathy
  • Rotator cuff injuries
  • Sports injuries

When to avoid it:

Shockwave therapy should not be used if you have the following conditions:

  • Active cancer
  • Pregnancy
  • Open wound
  • Infection
  • Pacemaker
  • Blood clotting disorders

Is it painful?

Usually, most patient do not find it painful, but they may feel some kind of discomfort during the application of it. Discomfort also tends to vary based on the area of treatment, with some being more sensitive than others. After the treatment, patient might feel some soreness and notice some redness around the treatment area. However, this is perfectly normal and will go away within a couple of days.

What does a treatment look like?

During your visit the physiotherapist will check your appropriateness for shockwave therapy. Firstly, they will conduct an assessment to rule out any contraindications and precautions for your injury and other overlapping conditions. The one session for therapy is usually between 10-15 mins, depending on the area and condition. Oftentimes, patient feels the difference in their symptoms with just a few sessions, some even immediately after treatment! Usually, your therapist will start with lower intensities and will gradually increase it with respect to your pain tolerance. Our goal is to ensure each patient is comfortable and knows what to expect with treatment. Additionally, shock wave therapy is used alongside other physiotherapy treatments like manual therapy and therapeutic exercises to get the best results.

Need help or more information?

If you are interested in receiving shockwave therapy or want to learn more about it, please contact us at PhysioNow. Fortunately, we have many experienced physiotherapists across Burlington, Oakville, Mississauga and Etobicoke who would love to answer your questions. Currently, shockwave therapy is available at our Applewood location located just off the QEW at the Cawthra exit!

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Fractured Bone? 5 Things You Should Know

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Being diagnosed with a fracture can be a challenging experience, but proper care and attention to your recovery can significantly impact the healing process. Here are five important things to do after being diagnosed with a fracture:

1. Follow Medical and Surgical Advice:

fractured bone types

Types of fractured bones

Listen carefully to your healthcare provider’s recommendations and follow their prescribed treatment plan. This may include wearing a cast or brace for a set number of weeks, taking medications as prescribed, and attending scheduled follow-up appointments. Additionally, if you had a surgical repair, your surgeon may have additional instructions for you to follow. Compliance with this advice will ensure that there are minimal interruptions to the healing stage, and any issues can get caught and managed quickly.

2. Rest and Protect the Fractured Area:

Give your body the time it needs to heal by resting the affected limb or body part. For example, avoid putting excessive weight, movements, or stress on the fractured area. Follow any mobility restrictions to prevent further injury and support the healing process. The most common ways these instructions are communicated are as following:

    1. Non-weightbearing (NWB): No weight is allowed on the limb at all.
    2. Toe-touch weightbearing (TTWB): Only the lightest touch is allowed for balance.
    3. Partial weightbearing (PWB): Usually given as a percentage like 25, 50, or 75%.  This indicates how much of your full weight you can put on the area.
    4. Weightbearing as tolerated (WBAT): You can weight bear as much as it feels comfortable, your limitation will be based more on your pain and/or fatigue.
    5. Full weightbearing (FWB): You can use your full body weight, there are no restrictions.

3. Use Supportive Devices:

Crutches used after a fractured bone

Crutches used after a fractured bone

If your healthcare provider recommends assistive devices such as crutches, a sling, or a walking boot, use them as instructed. These devices are designed to help you move safely while minimizing stress on the fractured bone. Proper use can prevent complications and promote healing.

4. Monitor for Complications:

Keep an eye out for potential complications, such as signs of infection (increased redness, swelling, warmth, or discharge at the fracture site) or circulation problems (numbness, tingling, or changes in skin color). Report any concerns to your healthcare provider immediately.

5.Engage in Rehabilitation and Physical Therapy

Once your healthcare provider gives the go ahead, engage in rehabilitation and physical therapy. These activities are designed to improve joint mobility, strengthen muscles, and enhance overall function. Rehabilitation plays a crucial role in restoring normal movement and preventing long-term complications from your fractured bone.

Overall, it’s important to maintain open communication with your healthcare provider throughout the recovery process. Additionally, report any unusual symptoms, such as increased pain, swelling, or changes in sensation, promptly. Most of the time, follow-up appointments and imaging studies may be necessary to monitor the progress of your bone’s healing.

Recovering from a fracture takes time, and patience is key. It’s essential to prioritize the injury, adhere to medical guidance, and seek support from healthcare professionals to ensure the smoothest recovery. If you have recently experienced a fracture and are looking to start your rehabilitation, PhysioNow has many experienced clinicians to assit you. Book with PhysioNow today for your first assessment and treatment!