Tag Archives: physiotherapy

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!

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!