Tag Archives: Registered Physiotherapy Long Branch

Acute Ankle Sprains

Acute Ankle Sprains

Acute Ankle Sprains

Acute Ankle Sprains

How do Acute Ankle Sprains happen?

Acute Ankle sprains are common injuries in people of all ages. They can happen in many different circumstances. However, they always involve some type of fall or twisting movement to the ankle. For example:

  • Going downstairs and missing the last step resulting in twisting the ankle
  • Landing on the ankle in a twisted position after coming down from a lay-up in basketball or in a Sports Injury
  • Slipping on an icy street while walking

In all of these situations, the ankle gets a sudden movement and/or trauma that causes it to twist more than its normal range of movement allows.

Acute Ankle Sprains

Acute Ankle Sprains

What structure gets injured with an acute ankle sprain?

The structures that are injured with acute ankle sprains are the ligaments around the ankle joint. Ligaments are soft tissue structures that connect two bones together. Their function is to prevent the bones from moving too far away from each other. Ligaments help maintain normal movement between the bones.

With ankle sprains, the ligaments get over-stretched beyond what they can tolerate which causes tears in their fibres. The ligaments that are involved in acute ankle sprains are present on the outside (lateral), inside (medial), and top of the ankle.

Are there different types of acute ankle sprains?

There are three main types of ankle sprains:

  • Inversion
  • Eversion
  • High Ankle Sprain

The terms relate to the direction of ankle movement that caused the injury to occur.

INVERSION ANKLE SPRAIN

  • An inversion sprain occurs when the ankle is forcefully turned inwards.
    • This type of acute ankle sprain is the most commonly occurring of the three because the ligaments on the outside of the ankle are generally weaker than the rest.
    • Another name for an inversion ankle sprain is lateral ankle sprain
    • A lateral ankle sprain injures the ligaments on the outside of the ankle.

EVERSION ANKLE SPRAIN

  • An eversion sprain occurs when the ankle is forcefully turned outwards.
    • This type of force injures the ligaments on the inside of the ankle.
    • The ligaments on the inside of the ankle are called the deltoid ligament
    • An eversion ankle sprain is also called a medial ankle sprain

HIGH ANKLE SPRAIN

  • A high ankle sprain is the rarest of the three types and it occurs when there is excessive twisting of the shin.
    • The ligaments that are injured with this type of injury are located above the ankle.
    • The location of the ligaments is why this injury is called a ‘high’ ankle sprain.

 

Are some people more at risk for Acute Ankle Sprains than others?

There are certain risk factors that may make ankle sprains more likely to happen. However, the research is a little inconclusive on why this is so. Some of these possible factors include:

  • Poor muscle strength/fitness
  • Increased weight
  • Decreased muscle-reaction time
  • Previous history of ankle sprains resulting in poor balance

Can there be different severities of Acute Ankle Sprains?

The severity of the ankle sprain depends on how much the ligament was overstretched in the process of the injury. Sprains are classified by different grades to explain the severity:

  • Grade I: mild stretching or tear of the ligament, with little or no instability at the joint
  • Grade II: incomplete tear of the ligament, with some instability in the joint
  • A Grade III: ligament is completely torn or ruptured and there is no stability in the ankle
Acute Ankle Sprains

Ligaments affected in Ankle Sprains

What should you do if you think you have sprained your ankle?

In all three types of Acute Ankle Sprains, it is important that you see a health care provider. The health care provider, whether it is a doctor or a Registered Physiotherapist, will first rule out the possibility of fracture. There is always the possibility of a fracture with Acute Ankle Sprains. The ligaments attach onto a bony area and if the twist is severe enough, it can pull off a chunk of the bone.  When this happens, it can cause a fracture. Signs and symptoms of a potential fracture include:

  • Lots of swelling
  • Increased bruising
  • Increased tenderness over specific areas of the ankle
  • Difficulty or inability to put weight through the injured ankle

When the signs and symptoms are suspicious of a fracture, then an X-ray must be completed. If there is no evidence of fracture, then your doctor may send you for an ultrasound.  In the end,  they should refer you for Physiotherapy treatment.  So ask your doctor to send you to Physiotherapy if they don’t think to recommend it themselves.

What will happen during my first Physiotherapy appointment?

During the Physiotherapy assessment, your Registered Physiotherapist will assess everything to do with your Acute Ankle injury, including:

  • Pain intensity and location
  • Swelling
  • Sensation
  • Range of motion
  • Ankle stability
  • Strength
  • Balance

This will provide some baseline information for your Physiotherapist.

How can Registered Physiotherapy help treat Acute Ankle Sprains?

The treatment for acute ankle sprains depends on the type of sprain as well as the severity of the injury.

Immobilization

  • Because of their affect on ankle stability, a Grade II or III injury will require some immobilization. This is usually done through a removable walking cast.
  • The purpose of the immobilization is to protect your injured ligaments from movement and external stressors, so that they can heal.
  • The period of immobilization will depend on the injury and your health care provider will provide specific instructions.
  • A grade I sprain will not require any immobilization because the stability of the ankle is still intact. However, your Physiotherapist will recommend activity modification to help with the healing process.

Physiotherapy Treatment in the acute phase?

  • In the initial phase of the treatment, the Physiotherapist may focus on pain relieving modalities
  • Electrical modalities like IFC and Ultrasound can help relieve pain and swelling
  • The Physiotherapist will also prescribe gentle mobility exercises to help improve or maintain movement through the ankle
  • The length of the acute phase depends on the severity of the sprain
Registered Physiotherapy for Acute Ankle Injuries

Ankle Rotations for movement Recovery

Treatment in the later stages of Acute Ankle Sprains

  • Once the ligament healing is underway and the patient feels a little better with their pain, the treatment will get more progressive
  • It will focus on regaining mobility, strength and function through the ankle
  • Your Physiotherapist will prescribe exercises that are going to help regain the lost range of motion and strength.
  • Over several weeks, the exercises will be progressed as you improve.
  • Another important aspect of treating an ankle sprain is including balance re-training in the program.
  • Balance is very much affected after an ankle sprain and it is something that must be improved with specific exercises. This is very important no matter whether you are returning to Sports or just everyday living!  Balance Retraining is key to Falls Prevention!
  • We use our balance ability on a regular basis with walking on uneven surfaces or when trying to recover from a stumble. Therefore, it is important to improve balance ability to prevent any possible re-injury of the ankle.
  • If you have had an acute ankle sprain before, and DID NOT attend Physiotherapy, it is likely that you are at increased risk of reinjuring your ankle or falling again!
Acute Ankle Injuries

Physiotherapy Mobilizations

Do I need to get Physiotherapy treatment after Acute Ankle Sprains?

There are some people who have sprained their ankle multiple times and never sought out treatment for the injury. They usually give themselves some time for the pain to get better and then go about their usual activities.

This type of management is not usually recommended because multiple ankle sprains can affect the stability of your ankle. As a result, this may create problems in the future. Also, the reduced stability in your ankle may cause compensations in your knees and hips. This can complicate the picture and make your injury more complex.

It is therefore recommended that you seek out proper Registered Physiotherapy care to address an ankle sprain soon after it occurs. This ensures that your acute ankle sprain heals in a timely manner without added complications.  The most important part of treatment is regaining your balance.  If you do not do this, another injury in quite likely.

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

Shoulder Injuries

Shoulder Injuries

Shoulder Injuries

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

What Causes Shoulder Pain?

There are several reasons why people suffer from shoulder pain.

  • Trauma

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

    • Motor vehicle accidents
    • Falls
    • Sports injuries
    • Violent incidents
  • Poor workplace ergonomics

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

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

Proper desk ergonomics

  • Poor posture

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

  • Good-Posture-vs-Poor-Posture

    Good-Posture-vs-Poor-Posture

  • Repetitive activities

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

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

 

  • Congenital or Developmental changes

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

Some Basic Shoulder Anatomy

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

Shoulder Injury

Shoulder Anatomy

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

The Soft Tissues around the Shoulder Joint

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

Bursae of the shoulder joint

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

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

Signs and Symptoms of Shoulder Injuries

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

 

Healing Times for Shoulder Injuries

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

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

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

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

Physiotherapy/Massage Treatment for Shoulder Injuries

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

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

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

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

Registered Physiotherapy for Shoulder Injuries

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

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

 

 

 

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

Registered Massage Therapy for Shoulder Injuries

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

    Registered Massage therapy for shoulder injuries

 

 

 

 

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

Call PhysioNow today to get treatment for your shoulder injury!

 

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome

            Patellofemoral pain syndrome

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome happens when your knee cap does not track properly.  The knee joint consist of two joints.  The tibiofemoral joint which is between the two long bones in your leg and the second one is the patellofemoral joint.  This  is between the femoral condyle (end of thigh bone) and the knee cap. The cartilage on the back of the knee cap glides on the cartilage on the front of the condyles of the femur. The knee cap usually sits in a snug groove at the end of the thigh bone.

Knee movements are controlled by a number of muscles connected to the knee cap. Your  thigh muscle helps to stabilize the knee cap and enables it to move smoothly in the groove.  When this is pulled out of the groove, you can develop Patellofemoral pain syndrome.

Causes of Patellofemoral pain syndrome or Anterior knee pain

Patellofemoral pain syndrome, is one of the most  common causes of pain in the knee. Pain is usually felt under the knee cap.  This is where it glides on the femur/thigh bone. If you have patellofemoral pain syndrome, it hurts when you bend and straighten your knee . There are a number of factors which can cause the pain.

Common Causes of Patellofemoral pain syndrome

  • Weakness in the hip and thigh muscles-Weakness in the thigh muscles can cause increased load which may lead to pain. Pain in your knees will further limit the activity of your muscles and over time can cause further weakness. Weakness of the inner thigh muscle  will affect the movement of the knee cap as you do your normal activities. Weakness in your hip muscles also can affect activities like climbing stairs and walking.
  • Excessive loading or rapid increase in the load for muscles around the knee-Depending on your usual activities, your knee will have a level of activity that is tolerated by your joint. Rapid increases in loading of activity may lead to a highly irritable or sensitive joint. This can cause Patellofemoral pain syndrome.
  •  Posture or position of hip, knee and feet-Flat feet or excessive turning in of feet can change movement mechanics further up the leg and cause excessive strain in your knee cap.
  • Tight muscles around the knee-Tightness in the muscles can reduce the movement of your knee and affect  how your joint works . This will lead to excessive loading during activities. The common muscles that become tight are your hamstrings, Quadriceps, Iliotibial band and calf.
  • Previous injury or dislocation of knee cap
  • Desk top work, where a lot of sitting can cause pressure on the kneecap.
  • Irritation of fat pad around the knee
  • Tendinitis of quadriceps tendon
  • Bursitis around the knee
  • Osteoarthritis

When poor biomechanics are repeated with each step of your walking and running it may lead to a highly sensitive joint and Patellofemoral pain syndrome.

Symptoms

  • The onset of  knee cap pain is normally gradual rather than traumatic.
  • Pain at the front, back and sides of the knee with or without swelling.
  •  Bending and straightening of knee can cause pain.
  • Pain after prolonged sitting or when you keep the knee bent for longer periods of time.
  • Clicking or grinding when you bend or straighten your knee.
  • Pain when you go up and down the stairs, up hill /down hill, squatting, running or jumping.
  • Poor knee control or stiffness

Physiotherapy Treatment

Patellofemoral Pain Syndrome treatment

  • Physiotherapy is the most effective treatment for short- and long-term management of Patellofemoral pain syndrome. Your Physiotherapist will fully assess you on your first visit to identify your functional limitation. They will also help to set goals and identify contributing factors for the pain.   They will  provide a customized rehabilitation program.
  • In the initial phase of rehabilitation, treatment is directed towards reducing the pain, swelling and muscle inhibition. To do this PhysioNow will  use electrotherapy modalities, acupuncture, rest, taping, gentle motion or joint mobilization and muscle setting exercises.
  • Once the pain and swelling reduces, treatment is focused towards modifying the  factors that have been identified as a cause for the problem.
  • Rehabilitation typically emphasizes increasing strength and pain free movements.  It also will address postural correction, improving the  stability of the pelvis, balance and functional abilities.
  • Stretching exercises to address the tight muscles and strengthening the weak muscles will improve your load tolerance.
  • Successful rehabilitation requires adherence to your exercise program .
  • You will also need to reduce the aggravating movements and slowly build the endurance and strength for those activities over time.
  • Prior to discharge you will be given a safe progression of exercises and functional activities.
  • For long term management, your foot and knee control will be assessed by your Physiotherapist.
  • As a result, you may require  custom foot orthotics to correct your foot position.
  • This will  help to improve foot and knee control.
  • Others might need a hip stabilization program and your Physiotherapist will be happy to discuss with you the long term rehabilitation plans if this is needed.Custom orthotics for Patellofemoral Pain syndrome

How long it will take to get better?

We expect to see improvements with Physiotherapy over a 3 to 6-month period.   Further improvements continue beyond this period. Adherence to your specific exercise program is important in maintaining the improvement. Most people will get back to their normal function with rehabilitation in the short term. Many patients can continue in their chosen activity during rehabilitation.  Some modification of activity may be all that is needed.

If you play sports, you will need to do sports specific exercises to ensure a safe return to sports. It is good to wear proper supporting footwear to help keep your feet in a good position.  This will  improve alignment of your knees.

How to book an appointment with a Physiotherapist at PhysioNow?

We have four Physiotherapy clinics of which three are located in Mississauga and one is in Etobicoke. You can call 289-724-0448 to book into any of these clinics  for an appointment with a Physiotherapist.

Most of the time we can arrange your initial visit on the same day in a location which is nearest to you. Your initial appointment will be a one to one 40-60 minute session with a Physiotherapist which includes treatment as well on the first day.

Your follow up appointments  will typically take  40 minutes.  Normally, we would recommend 2 to 3 sessions per  week depending on the factors identified on initial assessment, treatment plan and your goals.  If you have limited funding available, we will be happy to work with you to develop a home exercise program.

Please call today to get started on your treatment for Patellofemoral Pain Syndrome at PhysioNow!

Sciatica

Sciatica Treatment Mississauga

Sciatica

Sciatica

Sciatica is a term that gets used quite frequently in the physiotherapy world. This refers to pain, tingling and/or numbness that goes down the back, hip or entire leg.

Who can get Sciatica?

  • It can happen to both younger and older adults for a variety of reasons.
  • For some, it starts after a traumatic event like a slip and fall or after a motor vehicle accident.
  • It can seem like pain develops out of nowhere for others.
  • Pain can start gradually then suddenly increase in severity.
  • The majority of the time, sciatica is a condition that starts with some mechanical changes in the low back that build up gradually over a period of time.

What is Sciatica?

  • The term sciatica itself refers to irritation of the sciatic nerve
  • It is the largest nerve in our body
  • This nerve has its roots at the lower levels of the lumbar spine
  • It  runs through the buttock area, and down the back of the thigh
  • Around the level of the knee, the sciatic nerve splits up into several smaller nerves that run down to supply the muscles of the lower leg, ankle and foot

What are the symptoms of Sciatica?

The symptoms produced by sciatica follow the pathway of the nerve and can reach all the way down to the toes. The symptoms can range from:

  • pain
  •  pins and needles
  • numbness
  • weakness in the leg or all of the above

ACUTE Sciatica

  • Sciatica can be very debilitating when it is in the acute stage.
  • Pain can be quite sharp and severe.
  • As a result, sciatica can limit your movement and function completely.
  • A lot of patients at this stage will rate their pain intensity at a 9 or 10 out of 10.
  • Any position or movement may be pain producing.
  • Anything you try, including over the counter medication, may not help with the intensity of pain.
  • You may feel very helpless and scared at this stage.
  • The sudden onset of intense pain may make you wonder if there is something seriously wrong.
  • You may even feel that you need to go to the emergency room because the pain is so severe.

Should you go to the Hospital for Sciatica?

  • It is not necessary to go to the Hospital for Sciatica.
  • Typically, most people with Sciatica can recover quickly with the help of a trained Registered Physiotherapist!
  •   PhysioNow has trained professionals standing ready to help you Now!
  • We do not need a doctors referral to see you at PhysioNow.
  • However, you may  require a doctor’s note for your insurance plan to cover your treatment.
  • Our Physiotherapists will screen for any serious issues and send you to a doctor if they find any ‘red flags’ with your Sciatica.
  • We will direct bill to your Extended Health Plan if your plan allows us to do so.

However, if you feel more comfortable seeing a doctor first, head to the Hospital or your family doctor.

At the hospital, the standard procedure will be to rule out anything potentially serious. Some of the more serious causes of severe low back pain can include:

Fracture
o History of significant trauma
o If there is osteoporosis present, then minor traumas are risk factors
o Loss of function with all movements making pain worse

• Cancer
o 55 years of age or older
o Previous history of cancer
o unexplained weight loss
o Increasing levels of pain that are not relieved by rest

• Infection
o Fever
o Malaise
o Constant pain
o All movements make the pain worse

Cauda Equina Syndrome
o Severe low back pain
o Pain, numbness or weakness in one or both legs
o Saddle anesthesia – loss of or altered sensations in your legs, buttocks, inner thighs, backs of your legs, or feet
o  Sexual dysfunction
o Sudden changes in bowel or bladder functions – difficulty with relieving yourself or difficulty with holding it in

The role for Physiotherapy in Sciatica

  • Any of the above-mentioned conditions would require emergency treatment, which the hospital would provide.
  • Thankfully, for most patients, their sciatica is not from anything  serious.
  • Most incidences of sciatica are mechanical in nature and can be treated with Physiotherapy.
  • Once the hospital has ruled out anything serious, they will likely prescribe some medication for pain management and provide a referral for physiotherapy.
  • For most people, sciatica can be treated with conservative treatment such as physiotherapy.
  • The important thing about treating sciatica effectively is to determine the correct source of the pain and address those specific areas.

What is causing the Pain from Sciatica?

  • With most sciatica patients, the pain is coming from pressure on one or more of the roots of the sciatic nerve.
  • The pressure on the nerve affects the proper function of the nerve and causes the symptoms to go down the leg.

What about if I have Tingling and Numbness? Is that more serious?

  • The tingling, numbness and weakness that a patient may experience is not something that will be permanent in most cases.
  • A good analogy for this process is like when someone is stepping on a water hose.
  • The pressure from the foot stops the water from passing through the hose.
  • However, once that foot comes off the hose, the water will flow through without any issues.
  • Similarly, the symptoms along the leg will get better once the pressure is removed off the nerve. Physiotherapy will help with this!
  • This pressure on the nerve may be caused by an injury to the disc or bony changes in the area.
  • An experienced physiotherapist will be able to perform a thorough assessment that will determine the potential cause of the sciatica.

Physiotherapy Treatment

  • Once the cause of your sciatica is established, the Physiotherapist will be able to provide the most appropriate treatment to take the pressure off the nerve.
  • Lots of research out there has shown that passive treatments such as heat, ice, and electrical modalities, like IFC and ultrasound, do not provide long term solutions.
  • These types of modalities may be useful in the acute phase to help with the management of pain.
  • They can be combined with other treatments as part of the overall treatment plan for sciatica.
  • However, on their own, they are unlikely to make any significant and long-lasting changes.
  • Specific movements are usually the most effective at shutting off your Sciatica Pain!
  • Your Trained Physiotherapist will determine the best movement for you to shut off your Pain!

Sciatica Treatment

Positions and Movements that can Help with Sciatica Pain

  • More importantly, there has to be an evaluation of what positions and/or movements are pain producing and which are pain relieving.
  • A physiotherapist who has lots of experience working with low back issues will be able to help make this discovery.
  • Therefore, the results of the movement assessment will allow for the prescription of the appropriate exercise to help take the pressure off the nerve roots.
  • For example, if you feel less leg symptoms when you arch your back backwards, then that means your nerve is less irritated with that movement.
  • As a result, your treatment plan will then include exercises that involve various forms of backwards movements that continue to improve your leg symptoms.
  • Possible Sciatica Treatment

What Does Centralization of the Pain mean?

  • As the pressure on the sciatic nerve improves, the pain will move upward towards the low back in a process called centralization.
  • In general, these changes may happen quickly for most patients.
  • However, with more complex cases, it can take longer to ease the pain and regain function.
  • As a result, any movements that  produce centralizing symptoms are going to be beneficial in reducing pain.
  • In the majority of cases, pain can be resolved completely, and you can return to your normal level of activities quickly.

What do I need to know to keep the pain away?

  • It is important that the physiotherapist provides proper education.
  • They should give you  a good home exercise program for the continued maintenance of your sciatica condition.
  • As a result of the pain, some patients will continue to avoid certain activities or movements because of their experience with sciatic pain.
  • Therefore, it is important that your physiotherapist  work with you to regain full function and confidence with your mobility.

PhysioNow has highly trained Registered Phyiotherapists ready to help you with Sciatica.  We have same day emergency appointments available.  Call today to help with the Sciatica Pain! 289-724-0448.

Fracture Rehabilitation

Fracture Treatments Mississauga, Etobicoke & Oakville _ PhysioNow

Fracture types

Fracture Rehabilitation


Fractures are common injuries .  They can happen to people of all ages, from the very young to the very old.  The majority of fractures occur with trauma to the bone.  It could be  either from a fall or a blunt force.  Most people can readily feel that they have a broken bone. This is because the signs and symptoms can be very obvious.

Some of these indicators of Fracture are:

  • Swelling or bruising over a bone
  • Deformity of an arm or leg
  • Pain that gets worse with any movement or added pressure
  • Inability to put any weight through the injured area
  • Protruding bone through the skin (in the case of open fractures)

In some cases, however, fractures can be less obvious.  Some ankle fractures may look a lot like ankle sprains. You may not even know that it was a fracture until it shows up on an X-ray.

Spine Fractures

Fractures through the spine may feel a lot like back pain initially.  This is due to the  make-up of the spine.  Bony injuries to the back do not produce any of the obvious signs and symptoms .  However, one of the key components of a spinal fracture is that it occurs after some sort of trauma. This is most commonly a fall.  Therefore, if there is a traumatic event reported, the physiotherapist  will rule out any potential spinal fracture. They will  do a thorough assessment.  If the   Physiotherapist suspects a potential fracture, we will refer you back to your doctor to get X-rays done.

Fragility Fractures

In people with osteoporosis, fractures can happen with very minor stumbles or movements.  Osteoporosis is a condition where the bones become fragile or brittle from loss of bone.   Fractures associated with osteoporosis are called fragility fractures.  They occur due to the weakness of the bone itself.

If you have Osteoporosis, your bones can be injured with small traumas that would not normally affect the average person.  If you have  back pain and you have had trauma, the Physiotherapist will ask whether you have osteoporosis. This is to rule out potential fragility fractures.

Diagnostic tests for a Fracture

In any incident where there is a suspicion of a fracture, X-rays are necessary.  This will confirm the presence of the fracture, its exact location and severity.  However, in some cases, an X-ray may not be sensitive enough to show the fracture.   In these situations, if a fracture is still suspected, more sensitive tests like a CT, MRI or bone scan may need to be completed.

Fracture Classifications

There are 4 main classifications of fractures:

  • Displaced – the bone snaps into 2 or more parts and moves so that the two ends are not lined up straight.
  • Non-displaced – the bone breaks partly or all the way through, but the ends remain lined up
  • Closed – the bone breaks but there is no puncture wound in the skin
  • Open –the  bone breaks through the skin

Types of Fractures

There are also 7 different types of fractures to describe the specific nature of the break line:

  • Greenstick – incomplete fracture, where the broken bone is not completely separated
  • Transverse – the break is in a straight line across the bone
  • Spiral – the break spirals around the bone, common in a twisting injury
  • Oblique – the break is in a diagonal line across the bone
  • Compression – the bone is crushed, causing the broken bone to be wider or flatter in appearance
  • Comminuted – the break is in three or more pieces
  • Segmental – the same bone is fractured in two places, so there is a ‘floating’ segment of bone

Fracture Treatment

In terms of management of fractures, the treatment depends on the type of fracture.  The fractured ends of the bone must be set in their proper place and held there for the bone to heal properly.  This process is called reduction.

Fracture Repositioning

Most fractures are repositioned without the need for surgery. This  is called closed reduction.  Once the bones are positioned properly, the joint is casted .  The length of casting is usually 6 weeks.  This is how long it typically takes the fractured bones to heal.  There are circumstances where the period of casting may be either shorter or longer. This depends on the nature of the fracture.  If it is an ankle or foot fracture, the doctor may also recommend that you wear an aircast boot to stop your foot from moving.

PhysioNow carries a full supply of these aircast boots if you need one.

Open Reduction (Surgery) after Fracture

Open reduction (surgery)  is done for fractures that are more complicated. The repositioning of the bones wil be done with surgery in this case.   The surgeon will use screws and or plates to keep the bone fragments in proper position. This  allows for proper healing.   Following open reduction, you will have a period of immobilization .  The length of time for a fracture thathas required surgery will depend on the bone that was fractured. It also depends on  the severity of the fracture.  Also, depending on the fracture and the needs of the patient, the hardware may either be left in permanently or taken out with another surgery.  If removal of the hardware is necessary, it will happen once the fractured bone has completely healed.

Spinal and Rib Fractures

There are however some fractures that cannot be effectively immobilized such as spinal and rib fractures.  For these types of fractures, the affected area is protected with avoiding certain activities or postures.

Healing times for Fractures

In terms of healing times, most uncomplicated fractures take approximately 6 weeks for the bones to fuse.  Although medically, the fracture would have healed,  there may still be a lot of limitations. For fractures that are more complicated and required surgery, the healing times may be a little longer due the surgery.

Delayed Healing of Fractures

There are also some people who will heal at a slower rate because of various health conditions or medication use.  So, if you have diabetes, osteoporosis or are a long time user of prednisone, you may fall into this category.  Scaphoid Fractures also may have delayed healing because there is a poor blood supply to the bone.

Registered Physiotherapy after Fractures

Once the fracture itself is healed, there may still be some remaining problems from the injury.  Since the fracture would have been immobilized for several weeks, there will be a significant loss of movement and strength around the broken bone.

It is important to follow up with Physiotherapy for Fracture Rehabilitaton.  This helps to ensure that there can be a safe return to all previous activities.  A Registered Physiotherapist will be able to assess the limitations.  They will prescribe the necessary range of motion and  strengthening exercises and  then you can get back  to  all of your normal activities quickly!

PhysioNow Etobicoke and Mississauga

PhysioNow has highly trained Registered Physiotherapists on staff to help you after a Fracture.  We are open evenings and weekends to help meet your needs.  We also do direct billing to your insurance plan if you have one and if they allow us to do so on your behalf.

Call today to get started on your Fracture Rehabilitation!