Tag Archives: physiotherapy

acupuncture, Dry Needling, Physiotherapy

Trigger Point Dry Needling: A Physiotherapy Tool

October 2,2023 Sharon Tierney Leave a comment

Image by wavebreakmedia_micro on Freepik

Trigger Point Dry Needling (TDN) is a therapeutic technique that has gained popularity for its potential to relieve muscle pain and discomfort. Often compared to acupuncture, dry needling is a distinct approach to addressing muscle knots and trigger points in the body. In this blog, we’ll explore what trigger point dry needling is, how it differs from acupuncture, how it works, its potential pain level, and what to expect during and after the treatment.

What Is Trigger Point Dry Needling?

TDN is a therapeutic procedure that involves the insertion of fine, sterile needles into specific points in the muscles known as trigger points. Trigger points are tight knots of muscle fibers that can cause pain, limited range of motion, and discomfort. Consequently, this technique aims to release these knots, providing relief to the patient.

How Is Trigger Point Dry Needling Different from Acupuncture?

While both TDN and acupuncture involve the use of needles, they are fundamentally different in terms of their principles, goals, and techniques.

1. Theory and Philosophy

Firstly, acupuncture is a traditional Chinese medicine practice. It based on the belief that the body has a network of energy channels, or meridians. Thus, the needles are used to balance the flow of energy (qi) within these channels.

On the other hand, TDN is rooted in Western medicine. Specifically, it targets muscle knots or trigger points believed to cause pain, muscle dysfunction, and other symptoms.

2. Needle Placement

Primarily, Acupuncture needles are often inserted along the meridians, which may be quite distant from the pain site.

On the contrary, TDN needles are inserted directly into the trigger points or tight muscle bands responsible for pain or discomfort.

3. Goals:

Overall, acupuncture aims to address a wide range of health issues, not just musculoskeletal problems.

Conversely, TDN primarily focuses on musculoskeletal issues, targeting trigger points and relieving muscle tension.

How Does it Work?

Image by tonodiaz on Freepik

TDN works through several mechanisms:

1. Stimulation and Relaxation: Essentially, the insertion of needles into trigger points stimulates the muscle fibers, causing them to twitch and relax. This helps reduce muscle tension and improve blood flow.

2. Pain Reduction: Additionally, this technique can trigger the release of endorphins, the body’s natural painkillers. Consequently, this may provide immediate pain relief.

3. Improved Range of Motion: Furthermore, by releasing tight muscle knots, TDN can enhance joint flexibility and range of motion. As a result, it is a valuable therapy for athletes and those with mobility issues.

Is it Painful?

The level of discomfort experienced during TDN can vary from person to person. Some individuals may feel minimal discomfort, while others may experience a temporary, sharp sensation when the needle is inserted into a trigger point. However, this discomfort is typically short-lived and subsides once the muscle relaxes. It’s important to communicate your comfort level with your therapist during the treatment to ensure adjustments can be made if necessary.

What to Expect During and After Treatment

During the Treatment:

Initially, you will be asked to lie down, and the therapist will locate the trigger points through physical examination
Next, sterile needles will be inserted into these points, and you may feel a mild discomfort or twitching sensation
The therapist may gently manipulate the needles to stimulate the trigger points
Overall, he entire session can last from a few minutes to around 30 minutes, depending on the number of trigger points being treated

After the Treatment:

Some people experience immediate relief from pain and improved mobility
You may also experience temporary soreness or bruising at the needle insertion sites. Usually, it resolves within a day or two
Later, i’s recommended to stay hydrated, rest, and avoid strenuous activities on the day of treatment to allow your body to recover

In conclusion, Trigger Point Dry Needling is a Western-based therapeutic technique that focuses on addressing musculoskeletal issues by targeting trigger points in the muscles. While it involves the use of needles like acupuncture, the two practices differ significantly in their philosophies and goals. TDN can be an effective way to alleviate muscle pain and improve mobility, with the level of discomfort during treatment varying from person to person. If you’re considering TDN, consult with a qualified physiotherapist to discuss your specific needs and expectations.

Manual Therapy, Physiotherapy

IASTM: A Physiotherapy Tool

September 26,2023 Sharon Tierney Leave a comment

IASTM, or Instrument-Assisted Soft Tissue Mobilization, is a manual therapy technique used by physical therapists, chiropractors, and other healthcare professionals. It is used to diagnose and treat various musculoskeletal conditions. In this blog, we’ll explore what IASTM is, how it works, and the conditions in which it can be beneficial.

What is IASTM?

The hawk tool is a type of IASTM instrument that we frequently use at PhysioNow

IASTM involves the use of specially designed instruments, like above, often made of stainless steel or plastic, to assess and treat soft tissue abnormalities. These instruments have various shapes and edges that allow the practitioner to detect and treat adhesions, fascial restrictions, and other soft tissue abnormalities. Additionally, IASTM practices have been further refined into methodologies to be followed by clinicians, an example of which is called the Graston Technique.

How does it work?

The process typically involves the following steps:

1. Assessment: Firstly, the practitioner assesses the patient’s musculoskeletal condition. For example, they use the instruments to scan the skin and underlying tissues and identify areas of restricted mobility or dysfunction.

2. Treatment: Secondly, once problem areas are identified, the practitioner applies controlled pressure with the instrument over these areas. As a result of this pressure, it helps to break down adhesions and fascial restrictions, promoting better tissue function and blood flow.

3. Stretching and Range of Motion: Next, after treating the affected areas, the practitioner may incorporate stretching and range of motion exercises to further improve mobility and flexibility.

4. Reassessment: Finally, the practitioner reassesses the patient to determine the effectiveness of the treatment and to make any necessary adjustments to the treatment plan.

Conditions IASTM Can Help With:

IASTM can be beneficial for a wide range of musculoskeletal conditions and injuries, including:

1. Soft Tissue Injuries: Firstly, it is effective in treating conditions like muscle strains, ligament sprains, and tendonitis. It breaks down fascial adhesions and promotes tissue healing.

2. Chronic Pain: Secondly, patients with chronic pain conditions such as fibromyalgia or myofascial pain syndrome. Patients may find relief through IASTM treatments that target trigger points and muscle tightness.

3. Post-Surgical Rehabilitation: Thirdly, this technique can be incorporated into post-surgical rehabilitation programs. It will improve tissue healing, reduce pain, and enhance mobility.

4. Sports Injuries: Additionally, athletes often use this technique to address sports-related injuries like shin splints, tennis elbow, or rotator cuff injuries. Incorporation of this technique can expedite recovery and reduce pain.

5. Joint Dysfunction: Alternatively, this technique can also be used to address joint dysfunction by improving the mobility of surrounding soft tissues. Furthermore, this improvement can positively contribute to joint stability and function.

6. Neck, Hip and Back Pain: In addition, individuals suffering from chronic neck, hip or back pain may benefit from IASTM treatments to alleviate muscle tightness and improve posture.

How can I receive IASTM?

Overall, it’s important to note that IASTM should be administered by trained healthcare professionals who are knowledgeable about the technique. The intensity and duration of treatment can vary depending on the specific condition and the patient’s individual needs.

In conclusion, IASTM is a valuable manual therapy technique used to diagnose and treat various musculoskeletal conditions. It addresses soft tissue abnormalities by breaking down fascial restrictions, improving blood flow, and enhancing tissue mobility. Thus, it makes it a versatile and effective approach for many individuals seeking relief from musculoskeletal pain and dysfunction.

If you’re considering IASTM as a treatment option, consult with a qualified healthcare provider like a physiotherapist to determine if it’s appropriate for your specific condition. Book with PhysioNow today for your first assessment and treatment with a Registered Physiotherapist!

Pediatric physiotherapy, Physiotherapy

Physiotherapy for Children: Safe and Effective!

September 25,2023 Sharon Tierney Leave a comment

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Physiotherapy for children, also known as pediatric physiotherapy, diagnoses and treats a wide variety of conditions and disorders, just like in adults. For example, the usual pulled muscles, sprained ligaments, and broken bones are treated in children very similarly to adults and physiotherapists treat these with expertise. Additionally, some conditions are exclusive to, or more likely to be seen in infants, children, and adolescents. Thus, some physiotherapists specialize in pediatric physiotherapy, to treat these more chronic conditions. In this blog, we discuss the most common conditions seen in physiotherapy, and how a session may be structured differently in adults versus children.

Most Common Conditions and Disorders

1. Osgoode Schlatter’s Disease: Firstly, pain is caused by inflammation of the patellar (knee cap) tendon at the bone below the knee. It most commonly affects adolescent, athletic males.

2. Orthopedic conditions: Includes conditions affecting bones, muscles, and joints ex. Fractures or scoliosis

3. Developmental Delays: Unfortunately, some individuals have delays in hitting their motor milestones. Luckily, physiotherapists can give exercises to help develop key skills like crawling, walking, and running.

4. Neurological disorders: This includes conditions affecting the nervous system like traumatic brain injuries or spina bifida.

5. Torticollis: Affects infants and causes their heads to rotate and sit tilted towards one side

6. Cerebral palsy: Importantly, it is the most common motor disability in childhood and results in impairments in an individual’s abilities. For example, it affects their mobility and capacity to maintain balance and posture. In addition, there may be other related problems with vision, hearing, and capability to learn.

Overall, these are just a quick overview of some of the most common conditions treatable with physiotherapy. However, there are other, and rarer, conditions that were not listed.

What does a treatment look like?

1. Evaluation and assessment: Firstly, the physiotherapist assesses the child’s movement patterns, strength, and motor milestones. For example, flipping from their stomach to back, crawling, standing balance, coordination and posture.

2. Tailored treatment plan: Next, depending on the child’s age, the treatment plan is modified appropriately for them. For example, young children have difficulty doing traditional physiotherapy exercises. Instead, physiotherapists use a play-based approach using toys or games. As a result, the sessions are fun and enjoyable. The child must be engaged to improve their skills and strength in pursuit of the physiotherapy goals.

Image by Freepik

3. Family involvement: Notably, in pediatric physiotherapy, parents and caregivers are heavily involved in the process. This inclusion is crucial to the child’s success. As a result, families are educated on techniques and exercises to perform with their child. Accordingly, they develop a unique daily routine to work on therapeutic goals at home.

4. Collaboration: Oftentimes, for chronic pediatric conditions, collaboration is necessary with other healthcare professionals. For example, a pediatrician, speech language therapist, occupational therapists and more may be included. They work together to recommend assistive equipment like gait aids, wheelchairs, home equipment, braces, splints and more, depending on the condition.

If you are interested in learning more about pediatric conditions or think that your child may benefit from physiotherapy, our expert Registered Physiotherapists at PhysioNow are happy to help you. Book with PhysioNow today for an initial assessment and treatment!

General Category, Pelvic health physiotherapy, Physiotherapy, Pregnancy

Why You Should Do Pelvic Floor Muscle Training During Pregnancy

September 19,2023 Sharon Tierney Leave a comment

Pelvic floor muscle training, when done in a structured way, helps to prevent certain complications during pregnancy and labour. These changes occur due to hormonal and anatomical changes. The complications that usually occur are incontinence, perineal tears, pelvic organ prolapse, less active pushing required during second stage of labour.

Why is pelvic muscle training important?

Pelvic Floor Muscles

The pelvic floor is a set of muscles attached to the spine at the back and to the pubic bone at the front. Importantly, these muscles are the key supporter for the uterus, bladder and bowel. Some activities of daily living help women maintain their pelvic floor strength to functional level. Unfortunately, pregnancy and childbirth lead to the potential injury and weakening of these muscles. As a result, pelvic floor dysfunction is common after childbirth. This includes urinary incontinence, pelvic organ prolapses, dyspareunia and perineal tears. Significantly, this reduces the quality of life in women and cause them to withdraw from fitness.

Structured pelvic floor training help to prevent or reduce these complications. First, it helps to elevate pelvic organs and the resting position of bladder to improve incontinence and prolapse. Also, training during the antenatal phase reduces the active pushing required during the second stage of labour. Additionally, it improves incontinence by improving co-contraction of the pelvic floor muscles as the abdominal pressure increases. Overall, correct pelvic floor muscle contraction is the key factor to achieving the benefits of pelvic floor muscle training.

What happens to the pelvic floor during pregnancy and childbirth?

First, pregnancy usually leads to the decrease in levator ani strength (one of the major pelvic floor muscles) and anatomical changes occur such as downward movement of the bladder neck, increase in bladder neck mobility, downward movement of pelvic organs, and decrease in urethral resistance due to increased pressure from the growing uterus. As the gestational age increases, so too does the weight of the uterus leading to the pelvic floor being oppressed. As a result, there can be damage to the muscles and nerves.

Secondly, during pregnancy a large amount of progesterone is secreted to maintain pregnancy. Notably, progesterone is a smooth muscle relaxant. The pelvic floor has high amounts of smooth muscle, meaning progesterone may decrease pelvic floor support and urethra tension. In conclusion, the mechanical and hormonal changes of pregnancy may have an irreversible effect on the pelvic floor. They need to be addressed at the right time through pelvic floor muscle training which is achieved through pelvic health physiotherapy.

Also, during labor, when there is vaginal surgical delivery (episiotomy), a large fetal head or a long second stage of labour, it will lead to damage in the pelvic floor muscles if they are too tight or the perineal area has less flexibility. Vaginal surgical delivery, large fetal head circumference and a prolonged expulsive stage are risk factors for a labour-associated pelvic floor injury.

Effect of pelvic floor muscle training during pregnancy and after childbirth

Firstly, training during pregnancy helps to prevent developing urinary incontinence and can significantly improve the strength of pelvic floor muscles.
Secondly, exercises with a perineometer in the post-partum period are helpful in restoring the function and tone of the muscles. Importantly, this aids in preventing early cystocele and rectocele by limiting the movement downwards and improving the vaginal muscles for the retention of contraceptive diaphragm. The “Perineometer,” is an instrument that provides a visual guide to the patient during her exercises.
Perineometer for pelvic muscle training
Next, training improves the neuromuscular activity of the pelvic floor in many motor tasks after a partial denervation of nerves in after the first pregnancy.
Furthermore, training helps to treat nonspecific low back pain and pelvic girdle pain during pregnancy as pelvic floor muscles provide stability to the spine.
Additionally, training helps to shorten the second stage of labour and reduce perineal tears by improving the flexibility, strength and motor control. Overall, this may reduce the need of assisted delivery through forceps and episiotomy.
Lastly, female sexual dysfunction after delivery can be treated by pelvic floor muscle training as it increases the flexibility of the pelvic floor to help the vagina feel looser and relax.

Considering all the positive effects of pelvic floor muscle training during and after pregnancy, it is highly recommended to see a trained pelvic floor physiotherapist. They will guide and train the pregnant women at the right time to prevent or treat any of the pelvic floor disorders.

If you are experiencing pelvic pain or are interested in pelvic floor muscle training, PhysioNow has experienced pelvic health physiotherapists that would love to assist you. Book with PhysioNow today for your first assessment and treatment!

Back Pain, Physiotherapy

I Have a Herniated Disk: Physio 101

September 14,2023 Sharon Tierney Leave a comment

Herniated discs may also be referred to as slipped discs, or disc bulges. They can be a source of pain and fear for many people. To understand a herniated disc, a quick anatomy lesson is needed, we have included a picture below to help.

Between each of our vertebrae in our spine, there is a disc with a soft inner core (nucleus pulposus, and tougher outside (annulus fibrosus). The herniation refers to the soft layer protruding out, and may vary in size. In larger protrusions, it may put pressure against other structures in the area like the nerves, causing a variety of symptoms in the areas the nerve root gives sensation and motor function to. Herniated discs can occur anywhere along the spine but are are most common in the lower back (lumbar) region.

What are the causes of a herniated disc?

Firstly, age-related degeneration. With age, the intervertebral discs get stiffer which makes them more susceptible to injury when exposed to even minor strains.
Secondly, trauma or injury. For example, a fall or heavy lifting with a twist are strong external forces which can cause a herniation.
Additionally, repetitive strain. Jobs or activities with repetitive bending, twisting and lifting expose the disc to lots of pressure, increasing the risk of herniation

Do I need an x-ray/MRI?

Notably, many people have no symptoms from herniated discs, and are usually unaware they even have one. Oftentimes, many people will receive imaging reports that show varying level of degeneration and even disc herniations in the back, which may seem alarming. It is important to note that this is actually a normal part of life, many people will have “positive” findings. In other words, even though these things appear on imaging tests, they are not necessarily a problem or correlated with pain. Therefore, it is crucial not to put too much stock in imaging and let the symptoms guide your back pain management instead. Choosing Wisely Canada has a great article about why imaging may not always be included in the treatment plan.

What are the symptoms?

Firstly, back or neck pain is usually the first sign. It can be mild or severe, stay in one spot or travel down the legs. Usually, the pain is more on one side.
Secondly, numbness and tingling down the arms or legs is a sure sign of nerve involvement. In a disc herniation, the bulge may be putting pressure on the spinal nerves.
Next, muscle weakness may be present due to nerve compression as above.
Additionally, changes in reflexes where they are either exaggerated or reduced. For example, the common example of the reflex is when your doctor hits the reflex hammer beneath the knee on the patellar tendon and your knee automatically kicks out straight.
Finally, pain is dependent on activities and is commonly worsened by certain positions. Usually prolonged sitting, bending, lifting, coughing, and sneezing.

The symptoms of a herniated disc will vary depending on location and severity. Not everyone will experience every symptom, many disc herniations occur with nerve involvement as they do without nerve involvement.

Can a herniated disc be treated?

Back pain from a herniated disc can be treated safely through physiotherapy treatment. Common treatments may include education about how to avoid aggravating your condition, movements or positions that may give you relief, electrotherapy, heat or cold therapy, manual therapy, stretch and strengthening exercises. The specific treatment plan is unique to the individual and the direction of the herniation and will be modified appropriately by your physiotherapist as you get better. Eventually, once your pain has been managed, your physiotherapist will work with you to get you back to normal function and doing the activities you love while remaining pain free. In some cases, they may not respond to physiotherapy in which case further medical management may be required.

If you are experiencing low back pain PhysioNow has many experienced physiotherapists to help you find relief. Book with PhysioNow today for your first assessment and treatment!

Falls Prevention, Neurological, Physiotherapy, Posture

5 Ways Physiotherapy Can Help Manage Parkinson’s Disease

September 9,2023 Sharon Tierney Leave a comment

What is Parkinson’s Disease?

Parkinson’s Disease is a progressive neurological condition resulting in difficulty starting and maintaining movements in the body. Importantly, there is a loss of some neurons (brain cells) that contribute to coordinating muscles and creating smooth movements. As a result, individuals with this condition experience a range of symptoms that impair their strength, mobility, flexibility, and posture.

4 hallmark features

Tremors: Firstly, tremors are usually the initial symptom. The tremor is mostly when the body is resting, such as sitting, but may worsen over time to affect the individual while they’re performing other tasks like writing, eating, or shaving.
Rigidity: Secondly, rigidity refers to stiffness of the muscles and joints. In Parkinson’s, it can affect the arms, legs, trunk, and even the face.
Bradykinesia: Next, bradykinesia means slowness of movement which may include stopping or hesitating during movements.
Postural Instability: Finally, difficulty balancing and correcting postural faults which results in an increased risk of falls.

Additionally, if you are interested in a more detailed overview of Parkinson’s Disease and its symptoms, the Parkinson’s Foundation is a great resource.

The role of physiotherapy in Parkinson’s Disease

Unfortunately, there is no cure for Parkinson’s Disease currently but there are ways to manage the condition both from a medical and physical therapy point of view. Importantly, this will help an individual improve their quality of life and mobility. Physical therapy for this condition will focus on a variety of areas including:

Enhancing strength and flexibility through a home exercise program containing stretching exercises and resistance training.
Additionally, mobility training will focus on walking and balance exercises and strategies to overcome freezing episodes.
Not to mention, postural correction and postural awareness. Parkinson’s Disease commonly results in a very stopped and rounded posture which can create pain and discomfort.
Next, fall prevention is a crucial part of management. Namely, balance training, functional training, education on techniques and habits to minimize falls, and a home safety evaluation may all be included in this part of the treatment.
Finally, the condition will be managed by a team of health care professionals that will collaborate closely. Using each profession’s specialty, they will create a comprehensive and holistic plan to promote the optimal quality of life.

In conclusion, physiotherapy is a crucial component of the management of Parkinson’s disease. The goals are to help individuals maintain their independence and minimize the loss of function and negative impacts on the life. If you or someone you know has Parkinson’s disease and is looking to take control of their life back, PhysioNow is ready to help you. Book with us today for your first assessment and treatment with a Registered Physiotherapist.

Registered Physiotherapy Mississauga, Sports Injuries, Sports Physiotherapy, Sports Taping

Osgood-Schlatter’s Disease

August 30,2023 Sharon Tierney Leave a comment

Osgood-Schlatter’s disease (OSD) is a fairly common condition in adolescents that results in knee pain and loss of function. Typically, it is characterized by pain and inflammation just below the knee, especially in individuals that are active and engage in sports and other physical activities. As a result, this condition can be quite disruptive to a young athlete, who suddenly finds themselves unable to participate fully in practices or games due to pain. Specifically, in this blog, we will discuss causes, symptoms, and effective physiotherapy treatment of OSD.

What causes Osgood-Schlatter’s Disease?

OSD is primarily an overuse injury causing the tendon under the knee, the patellar tendon, and the part of the bone it attaches to, the tibial tuberosity to become painful and inflamed. Eventually, the tendon and bone experience repetitive traction and strain through high intensity movements such as running and jumping, and the tendon pulls on the still developing bone. As a result, OSD is one of the most common causes of knee pain in adolescents.

Risk factors include:

Participation in sports like basketball, soccer, volleyball, gymnastics, track and field and similar activities
Males 12-15, girls 8-12
Experienced a recent growth spurt

In summary, here is a link that you may find helpful: https://www.hopkinsmedicine.org/health/conditions-and-diseases/osgoodschlatter-disease

What are the signs and symptoms of Osgood Schlatter’s Disease?

Occasionally, a bigger bump than normal at the tibial tuberosity
Painful to put pressure on the tibial tuberosity
Knee pain located just below the kneecap
Pain that worsens with pressure around the tibial tuberosity and with physical activities
No acute trauma, pain came on slowly over time

How does physiotherapy help?

If you think that your child is experiencing OSD, consulting a physiotherapist is essential for an accurate diagnosis. Your physiotherapist will perform a complete assessment including evaluating the knee strength, range of motion, functional abilities like squatting, and will help you rule out other potential issues.
Next, your physiotherapist will assist your recovery using some of the following treatments. Notably, treatment will vary depending on each individual.

1. Firstly, education on rest, and how to modify the sport and other high impact activities to give the knee
time to heal

2. Secondly, a home exercise program: They will address any muscular imbalances in the body and will assign
a variety of stretching and strengthening exercises to help recovery.

3. In addition, a brace with a patellar strap to relieve tension on the tuberosity (as shown above)

4. Equally, taping may help provide additional support to the knee and reduce strain

: Taping for Osgood Schlatter’s Disease

5. Additionally, a movement assessment may be necessary to teach the proper ways to perform skills and correcting form to minimize the stress on the knee

6. Lastly, a return to sport plan: Will be graduated and closely monitored to ensure safe and effective return to sport while preventing the risk of injury

In conclusion, if you think your child is experiencing Osgood-Schlatter or any other type of knee pain, PhysioNow has many experienced physiotherapists that would love to help! Meanwhile, book with PhysioNow today for you or your child’s first assessment and treatment!

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Chronic Ankle Instability Could Cause Your Ankle Not To Heal

July 20,2023 Sharon Tierney Leave a comment

Chronic Ankle Instability

Ankle sprains are one of the most common injuries. Rest, ice, compression and elevation, or the RICE rule, are the go-tos for ankle sprains. In most cases, the ankle will heal between 4-12 weeks. Many people will allow the ankle to heal on its own but a failure to seek treatment and physical rehabilitation for the ankle after just one injury is enough to leave it weaker and more vulnerable to future sprains. Which in turn could result in chronic ankle instability.

What causes ankle instability?

After an ankle injury, there is damage to the ligaments, tendons, and potentially even the ankle joint itself. Ligaments function to limit the normal movement in the ankle, and once they are injured, they may get lax (stretched out). Resulting in the ankle being more unstable. Additionally, the injury results in a loss of strength in the muscles that control the ankle movement, further increasing the instability of the ankle. Finally, it also results in a loss of sensory receptors in the ankle that communicate to our brain where our ankle is in space. This decreased sensation makes it harder to balance and control the ankle which contributes to the ankle instability.

How do I know if I have chronic ankle instability?

Questions to ask yourself include:

Does my ankle ever give out?
Do I avoid walking on uneven surfaces out of fear of falling?
Do I feel like I can’t “trust” the ankle?
Do I try to avoid putting all my weight onto one ankle?

If you said yes to these questions and you have had a severe ankle injury or a history of multiple ankle sprains, you may have chronic ankle instability.

Is it permanent?

Chronic ankle instability is not permanent it can improve with the help of a physical therapist and individualize exercise plan. An untreated ankle injury may be chronic when it is not given sufficient time to heal and is constantly being reaggravated. Thus, the first step to treatment will be a proper rehabilitation program with a health professional.

Who treats ankle instability?

Physical therapists are the first step in conservative management of chronic ankle instability. Your physical therapist will perform an assessment on your ankle range of motion, strength, and balance and will assess for any laxity, or more movement than is normal, within the ankle and ankle ligaments.

After an ankle injury, there is a loss in strength and proprioception (awareness of the position of the body in space). So exercises are given to re-strengthen the muscles, increase ankle stability, balance, and retrain the body awareness of the ankle. Furthermore, a brace and/or taping is recommended to support the stabilization of the ankle, especially for individuals who engage in high-risk activities like sports.

Chronic Ankle Instability Brace and Tapping

Chronic Ankle Instability Exercises

However, not all injuries are capable of recovering with conservative management. Thus, in very severe cases, surgery may be an option to repair the injured ligaments and give the ankle stability.

What happens if its goes untreated?

Without treatment, an individual will continue to have difficulties balancing, walking on uneven terrain, and putting weight onto the ankle. Subsequently, the instability may worsen over time and will have a much greater risk of reoccurring injuries to the ankle. Thus making it more challenging to recover from these injuries. Additionally, it can result in damage to the bones and cartilage within the ankle joint as the muscles weaken and fail to support the joint. Therefore, to avoid severe injury it is highly recommended that individuals seek expert treatment.

If you are having stability problems with your ankle, book with PhysioNow today for an initial assessment and treatment. We have many capable physical therapists that will be able to help your ankle recover!

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Trigger Finger? What can you do about it?

July 20,2023 Sharon Tierney Leave a comment

Trigger finger? What to do

Trigger Finger

Lately you’ve noticed that your finger seems to be clicking, and maybe it also catches or locks into a bent position. Sometimes you may need to use your other hand to help you “unlock” your finger. What is this? We call this condition trigger finger.

Your finger locks in a flexed position. The position it locks in resembles the position of a finger when it is pulling a trigger.

If you have trigger finger, you may also have:

Stiffness and swelling, especially in the mornings.
Painful or painless clicking, catching, locking into the bent position then popping straight.
Loss of full range of motion of the fingers into flexion and extension (bent and straight).
Nodule is felt with other hand.
Pain that radiates to the tip of the finger and/or into the palm.

Why does Trigger Finger happen?

An exact cause is unknown, it develops spontaneously or consequently to another disease, repetitive hand movements during a job, or recent trauma to the hand.

The condition occurs due to inflammation and narrowing in the “pulley” system in the hand. As seen in the image below, the tendons of our muscles must pass through a band of tissue in order to control the fingers. The tendon normally glides through this tunnel without issue but the tissue of the tunnel can thicken and narrow, combined with enlargement of or nodules developing in the tendon itself, resulting in impaired movement and the tissues blocking each other.

Trigger Finger Nodule and Tendon

How to treat trigger finger?

The first line of recommended treatment for any condition is conservative care. A physiotherapist can help you recover your hand function and quality of movement. These treatments
may include:

Soft tissue techniques, joint mobilizations, and stretches to try and increase the mobility in the
area.
Modalities like ice, paraffin wax, and electrical stimulation to help with pain, inflammation, and swelling.
A home exercise program that focuses on increasing range of motion, strength, and gliding of the tendons
Education on wearing a splint (as shown below) which blocks the finger from moving excessively, allowing you to go about your daily life without aggravating the condition. Wear this between 6-10 weeks and your physiotherapist may ask you to wear them at night, during work, or as much as possible during the day.

What options do you have for treatment?

In some cases, this condition may be persistent and medical management with your primary provider. For example, options
may include corticosteroid injections to reduce inflammation and the frequency of the finger locking. Unfortunately, patients may require further intervention when conservative treatment fails, in which case a surgical release of the finger may be indicated. When combined with physical therapy after the surgery, there is usually a rapid and significant improvement in function at relatively low risk. However, there are always increased risks to surgical procedures compared to conservative treatment and where possible, trigger finger should always be treated with non-surgical strategies first and surgery as last resort.

Need some help?

Let us manage your trigger finger. Here at PhysioNow, we have many highly knowledgeable physiotherapists that can assist you with your issue. If you think you have trigger finger or have been diagnosed with it, book with PhysioNow today for your first assessment and treatment!

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Headaches? See how Physiotherapy can help you!

June 15,2023 Sharon Tierney Leave a comment

How do Headaches occur?

There are many different types of headaches with many different causes. Many people may blame it on the weather, stress, or work, and feel like it is out of their control and that nothing can help their headaches. If this sounds like you, there is treatment available and you do not have to live with your pain. Headaches that stem from your neck or jaw are treatable through physiotherapy and can result in a decreased intensity and frequency or even stop them completely. However, migraines can also be manageable with rehab.

What are headaches from the neck?

Cervicogenic Headache

Headaches that stem from the neck are known as cervicogenic headaches and are a type of referred pain. Referred pain means that the pain actually originates from another part of the body, and not the place where you actually feel the pain. Moreover, the head pain is actually coming from problems in the tissues and/or joints in the neck.

Common symptoms of cervicogenic headaches include:

Firstly, one-sided headaches
Second, neck stiffness
Decreased motion in the neck
Radiating pain to the eyes, shoulder, or arms
Lastly, they are triggered by certain neck positions or movements

What are headaches from the jaw?

Headaches stemming from the jaw result from dysfunction in the jaw joint, anatomically known as the temporomandibular joint (TMJ). This joint connects your lower jaw to the skull and is used in actions such as talking and chewing as it allows the opening and closing of the mouth. Therefore, headaches are one of the common symptoms of jaw dysfunction. Though they are lesser known, it is commonly missed as a source.

Common symptoms of TMJ dysfunction include:

Clicking on the jaw
Pain or tenderness with jaw movements (biting, talking, chewing, etc)
Headaches, especially in the morning (due to grinding and clenching of the jaw during the night)
Also, neck stiffness

How can physiotherapy help?

Your physiotherapist will provide a comprehensive assessment of your neck and jaw to determine a specific treatment plan for you. The evaluation may include observing your resting posture, and the way your jaw and neck move. Also, how much movement is available in your jaw and neck, and more.

Your treatment plan may include strengthening weak muscles, correcting posture and faulty movement patterns, stretching and mobility exercises, manual therapy techniques like soft tissue massage and joint mobilizations to reduce pain and increase range of motion. They may use modalities like heat, electrotherapy and acupuncture as well depending on your condition and goals of treatment. Your physiotherapist will work closely with you to develop an individualized plan of treatment including a home exercise program, and education on self-management of your condition at home. They can also inform you and help you get in contact with other healthcare practitioners that may need to be involved in your care.

If you are experiencing persistent headaches, book with PhysioNow today for your first assessment and treatment!