Tag Archives: Sports Injuries

Foot Pain, Health and Wellness, Physiotherapy, Plantar fasciitis, Sports Injuries, Sports Physiotherapy

Foot Care for Runners: Physiotherapy Guidelines

October 17,2025 Sharon Tierney Leave a comment

Now that the hottest days are behind us, running outdoors is possible again. If you’re a runner, whether casual or marathoner, your feet are your most valuable training partners. Namely, they take the full impact of every stride, supporting several times your body weight with each step. But when your feet start to ache or feel tight, it can throw off your training and may be the precursor to an injury. The good news? With a few smart habits and guidance from a physiotherapist at PhysioNow, you can keep your feet ready to go the distance. Find out how to do foot care for runners!

Why does foot care for runners matter?

Running is repetitive and high impact by nature. Unfortunately, repetitive tasks are where our bodies tend to struggle. Over time, even small imbalances in running gait, strength, flexibility, or footwear can build up stress on the feet and ankles. For example, if you’ve ever noticed one side of your shoe wears out faster than the other, that’s a sign that you have an imbalance in your weight distribution. While this imbalance does not guarantee an issue, it certainly increases your risk for it. Healthy feet help you absorb shock more efficiently, maintain good running mechanics, and prevent compensations that can have a chain reaction that causes issues in the knees, hips, or back.

What kind of foot issues do runners have?

The plantar fascia is an important structure for runners, helping them both absorb shock and generate power.

While not exhaustive, these are some of the problems we see most often in the PhysioNow clinic:

Plantar fasciitis: Sharp heel pain that’s often worse first thing in the morning and the first couple of steps
Achilles tendonitis: Irritation and pain in the tendon connecting your calf to your heel
Blisters or calluses: Usually caused by friction or poorly fitting shoes
Stress fractures: Tiny cracks in foot bones from repetitive overuse
Shin splints: Often linked to weak foot muscles or improper footwear

It is important to note that issues are not limited to the feet either. It is a 2 way street and the rest of the body may be causing a foot pain, or vice versa. This is often why it’s important to see a health care professional when treating these injuries. You want to treat the root cause, not just the symptoms.

What does foot care for runners look like?

1. Choosing the right shoes

Your running shoes should match your foot type, gait, and mileage. A gait assessment from a physiotherapist or running specialist can help determine whether you need neutral shoes, stability support, or even custom orthotics. Read our other blog to find out more about the benefits of custom orthotics! Recommendations are to replace your shoes every after 600km to avoid worn-out cushioning. Another tip is to alternate between a couple pairs of shoes to extend the lifespan.

2. Warming up and cooling down

Foot care involves taking care of all the muscles around the area as well. Smaller rollers or foot rollers can be used on the tight muscles in the feet.

Don’t skip mobility and flexibility work! Often the most neglected part of a workout, gentle calf stretches, ankle circles, and a few minutes of dynamic movement before and/or after you run can help your feet handle impact better. Rolling the soles of your feet over a ball or frozen water bottle can also relieve tightness after a run.

3. Strengthening your feet and body

Strong feet are shock-absorbing feet. Here are some foot care exercises we use commonly in the clinic.

Towel scrunches: Use your toes to pull a towel toward you. Helps to strengthen intrinsic foot muscles
Single-leg balance: Stand on one foot for 30 seconds to train stability. You can make this harder by balancing on different types of surfaces
Heel raises: Build calf and arch strength. Progress by doing single leg heel raises

A physiotherapist can build you a progressive program that fits your training load. Remember that running is a whole body exercise and cross-training with resistance exercises and other forms of cardio is key. It is not enough to just be strong at the feet, your knees, core, hips and back are all contributing greatly during a run.

4. Listening to early signs of pain

A little muscle soreness is normal, but consistent pain, especially in the heel, arch, or top of the foot, isn’t. Addressing it early with physiotherapy can prevent a minor irritation from turning into an overuse injury.

5. Maintaining your feet

Basic foot care is a must! Keep your toenails trimmed, inspect your feet regularly for blisters or swelling, and use moisture-wicking socks to reduce friction. Pedicures are not just for looking good, they play a huge role in foot health as well can can help you manage rough spots on your feet. For more serious issues though, you should see a medical professional.

When should I see a professional?

If you’re noticing persistent foot pain, reduced performance, or recurring injuries, a physiotherapist or chiropodist can help. At PhysioNow, we have expert clinicians trained to assess gait, and that can also fit you for custom orthotics. Whether it’s a muscle imbalance, footwear issues, or running mechanics, we’ve got you covered. With hands-on treatment and a personalized exercise plan, you can get back to running comfortably and safely. PhysioNow has 10 locations across the west GTA including Burlington, Oakville, Mississauga, and Etobicoke. Book with PhysioNow today for your first assessment and treatment!

ACL Rehabilitation, ACL Tear, Knee Pain, Physiotherapy, Sports Injuries, Sports Physiotherapy

ACL Rehab and Why It’s a MUST After Injury

September 25,2025 Sharon Tierney Leave a comment

ACL REHAB is very important for you to get back to your normal life! Injuries, even minor ones, can lead to pain, inflammation, instability and a risk of further harm.

What is the anterior cruciate ligament (ACL)?

The ACL is a very important ligament in your knee that prevents your tibia (shin bone) from moving too far away from your femur (thigh bone). This ligament is used extensively in all our daily movements including walking and standing. During sports, it must withstand huge amounts of forces during acceleration, deceleration, cutting, pivoting, jumping, and more! As a result, it is crucial that any ACL injury gets addressed with a comprehensive sports injury rehabilitation plan.

What is the mechanism of injury?

Most ACL injuries happen from non-contact movements such as a sudden rotational force that occurs when the foot is planted on the ground. Other movements can include sudden deceleration or landing awkwardly from a jump. As a result, these injuries are very common in sports like soccer, basketball, and skiing. Secondly, ACL tears can happen from direct contact injuries, usually a blow directly to just below the knee.

What are the symptoms of an ACL tear?

Instability and pain during movements, especially when walking and coming down stairs
Decreased balance, strength and control in the muscles
Decreased ability to put weight on the injured side
Pain and locking of the knee associated with MCL and meniscus injuries, commonly injured together with the ACL

ACL rehab or surgical repair?

Unfortunately, there isn’t a straight answer to this question. The response after injury will depend on the severity of the tear. Surgical repair may be needed for a fully torn ACL, depending on the level of physical activities you want to return to. With minor injuries, it is possible to avoid surgery if proper ACL rehabilitation is done with a skilled Registered Physiotherapist.

Custom knee braces for ACL rehab

A Custom Knee Brace for ACL tears that can be worn during ACL rehab

In addition, wearing a custom knee brace can allow you to fully support your knee without having to do surgery. Custom knee braces can be very helpful once the initial swelling goes down. They can allow you to return to all or most of your previous activities without surgery. A Custom Knee Brace “replaces” the support and stability lost from the torn ACL ligament. Alternatively, individuals wear these braces while awaiting their ACL surgeries, and post-surgery can wear them as extra support when they start returning to normal activities. There are several types of Custom Knee braces available in the market. The most popular brands are DonJoy, Bledsoe and Ossur. At PhysioNow, we carry off the shelf knee braces and Custom Knee braces from all of the major suppliers.

Check out this link for a few of the braces we currently offer at PhysioNow in Mississauga.

How can physiotherapy help with ACL rehab after a tear?

In the early rehab for a tear, the role of a physiotherapist after an ACL tear is:

To control pain
Increase/maintain ROM
Control swelling
Early muscle activation and strengthening
Protect the injury by providing aids like crutches, splints etc

Pain is controlled by using different modalities such as ultrasound, and interferential therapy. A graduated exercise program will help you to improve your movement. Here is another interesting article about ACL REHAB.

Exercises will focus mainly on:

Strengthening quadriceps and gluteal muscles
Restoring normal range of motion in the knee
Proprioception techniques (you will likely lose some of your natural ability to balance after an ACL tear),
Stretching of the hamstring muscles.

Possible ACL REHAB Exercises

Please do not attempt these exercises at home without the advice of your doctor or a skilled Registered Physiotherapist!

Eventually, you will progress past these exercises but since rehab is on such an individual basis and dependent on your goals, the following exercises might look very different! This is where the Physiotherapist comes in as they can create a personalized plan for you specific to your interests and current abilities. Then, they can supervise you and ensure you are safe and controlled at all times in your rehab.

Looking for some help>

If you or someone you know has had an ACL tear, we at PhysioNow would be happy to help! If you want to discuss Physiotherapy Treatment or to see if a Custom Knee brace might be helpful for you, book with PhysioNow today!

Pediatric physiotherapy, Physiotherapy, Sports Injuries, Sports Physiotherapy

Safe Play: Physiotherapy for Kid’s Sports Injuries

September 18,2025 Sharon Tierney Leave a comment

Physiotherapy for kid’s sports injuries is becoming more and more relevant. Recently, we have seen that children and teenagers are becoming more active than ever. Whether it’s taking part at the level of competitive, clubs, camps, or recreational activities, most children are involved in some way. As we know, physical activities are great for their physical, mental and overall development. However, it also puts them at risk of certain injuries. As a child’s bones, muscles, and ligaments are still growing and developing, this makes them vulnerable to certain injuries that can be different from adults. Sports physiotherapy plays a vital role in helping young athletes recover fast, return to sport safely, and prevent future injuries.

What are common sports injuries in children and teenagers?

Concussions are traumatic head injuries are very common in contact sports, and an increasingly large body of research continues to support how serious these types of injuries are

Sprains and strains: Ligament sprains or muscle strains are seen commonly in kids who play competitive or fast paced sports with sudden changes in direction, starting, and stopping
Growth plate injuries: In children their bones are not completely developed. At the end of long bones is where we find growth plates, which are softer than matured bones. As a result, they are more vulnerable to injury, whether it is from a trauma or repetitive stresses
Overuse injuries: Repetitive stress from the sports can leads to injuries such as stress fractures, shin splints, and tendinitis
Fractures: Falls or collisions can cause breaks that require immobilization and careful rehabilitation
Concussions or neck injuries: In some contact sports kids get injuries to their head and neck which might require medical attention and specialized concussion rehabilitation

How does physiotherapy help kids sports injuries?

For young children, physiotherapy looks a little more fun! Oftentimes, the exercises will incorporate games or fun activities to help keep them involved.

1. Accurate assessment and individualized care:

A Physiotherapist who has experience and expertise with kids can help you by assessing the nature of the injuries. They will create an individualized plan after taking into account age, growth stage, and the type and level of sport they have to return to. They collaborate and coordinate with the team including parents, coaches, and other medical professional.

2. Pain relief and early management

Initially, the focus is to reduce the pain and inflammation using a combination of resting, icing, modalities like therapeutic ultrasound, or immobilization using braces or splints. Your Physiotherapist can help you plan out modifications so your kid can still participate in school and day to day activity safely, while protecting the injured area.

3. Restoring mobility and strength

Afterwards, once pain and swelling reduces, the focus of the treatment shifts to gaining the range of motion, flexibility and strength of the injured and surrounding structure. In kids, rather than performing traditional ways of exercises the exercises are designed to be fun, age-appropriate and sports related. Overall, this helps to keep them motivated and take an active role in their own recovery.

4. Preventing re-injury

While treating your child’s injured and painful area, the Physiotherapist will also address the causes of pain which leads to this issue. Sometimes it can be from a muscle imbalance, training error or poor form during movement. They help your child create a comprehensive exercise routine for you involving a proper warm up, mobility, balance, and strengthening work, and finally may recommend specific drills related to your sport.

5. Gradual return to play

Returning to sport too soon is a major cause of re-injury. A physiotherapist monitors progress and gradually increases intensity in training, mimicking sport movements to ensure the child is ready for full participation. Then, they will coordinate with the coaches to slowly permit back to play.

6. Education for parents and coaches

Parents and coaches play important parts in the recovery process. A physiotherapist will update them about progress and current restrictions. Additionally, they will educate them about appropriate footwear, training intensity and loading and motivating strategies for kids. For example, it is important that both your child and you understand the signs and symptoms of worsening symptoms when starting return to play, so that you may catch and prevent a potential injury early.

Benefits of “prehab” and physiotherapy for young athletes

Preventing an injury is the ideal situation. Because of this, the idea of “prehabilitation” or “prehab” for short focuses on assessing potential risks for an athlete and minimizing them. For example, this could be a young athlete who a Physiotherapist notices relies more on one side over the other, or performs a movement with poor form. Early coaching and addressing these issues can prevent or lessen the impact of an injury farther down the line. Assessment and treatment at early stage can help to reduce recovery time and complications. Early physiotherapy management can help to prevent future complications like chronic pains, poor movements and damage to growing bones and muscles

Physiotherapy is not just for adults; it plays part in different age group people’s life. For young athletes, it can mean the difference between a minor setback and a long-term problem. With a child-friendly approach, physiotherapists help kids recover faster, improve their confidence in movement and safe return to the activities they like.

Looking for help with a kids sports injury?

If your child has been injured playing a sport or other athletic activity, look for PhysioNow! We have many experienced sports physiotherapists with expertise across a whole range of different sports. Our team will help you and your kids to create a treatment approach to get them healthy and back in the game! With 10 locations across the west GTA, PhysioNow is here to support you and your family. Book with PhysioNow today for your first assessment and treatment!

Frozen Shoulder, Physiotherapy, Rotator Cuff tear, Shoulder Dislocation, Shoulder Injuries, Shoulder pain, Sports Injuries, Sports Physiotherapy

Top Causes of Shoulder Pain in Adults Over 40 & How Physiotherapy Can Help

July 16,2025 Sharon Tierney Leave a comment

Shoulder pain is one of the most common reasons adults over 40 seek treatment at our clinics. Whether it’s that persistent dull ache while lifting your arm, a sharp pain when reaching overhead, or stiffness when trying to sleep, shoulder pain can significantly disrupt your daily life.

At our clinic, we often see patients who don’t realize how much shoulder physiotherapy can help—both to relieve pain and prevent long-term issues. Usually, people will come in for help once it starts to affect their sports and physical activity, or when they can no longer perform every day tasks like reaching a high shelf or putting on a jacket. Shoulder pain is treatable, even if it is has been there for months. However, we always recommend coming in as early as possible to have the highest chance of resolving your issue in the shortest amount of time possible. In this blog, we’ll break down why shoulder problems are so common, the most frequent causes of shoulder pain, and how shoulder physiotherapy can help you recover and stay active.

How does the shoulder joint work?

On the left, an image of a right side shoulder viewed from the back. On the right, an image of a right side shoulder viewed from the front. The end of the humerus is rounded (ball), to fit into the scapula (socket). Then, the 4 rotator cuff muscles and a joint capsule hold it all together

First, a brief anatomy lesson to help you understand where problems can come from. Importantly, the design of the shoulder joint, (ball and socket joint) makes it the most mobile joint in your body. However, this mobility comes with a cost. It’s greatest strength is also its weakness, since its huge range of motion translates to large amounts of instability in the joint.

Next, at the center of shoulder function is the rotator cuff, a group of four muscles and tendons that keep your shoulder joint in its socket generates joint movements. The rotator cuff includes:

Supraspinatus (most commonly injured)
Infraspinatus
Teres minor
Subscapularis

These muscles work together to help you lift, rotate, and control your arm. They also support your shoulder during everyday activities like reaching, pushing, or pulling. Proper shoulder kinematics, the way your bones, muscles, and joints move together, is essential for pain-free function. When part of this system is injured or weakened, it often leads to shoulder pain and limited movement.

What are common causes of shoulder pain in adults over 40?

If you’re over 40, you’re more likely to experience shoulder pain due to natural wear and tear, previous injuries, or changes in lifestyle. Some of the most common causes include:

1. Rotator cuff tendinopathy and tears

These refer to the four muscles we talked about in the previous section. Over time, the rotator cuff tendons can weaken, leading to inflammation (tendinopathy) or tears. This is one of the leading causes of shoulder pain in adults over 40, and one of the diagnoses we make most often in our clinics. This condition can develop acutely (from a specific injury or a moment in time), or slowly over time, usually from overuse.

2. Biceps tendon tendinitis/tears

The biceps tendon, which runs through the front of the shoulder, can become inflamed or torn, contributing to shoulder pain, especially with lifting or carrying. Due to its proximity to the rotator cuff tendons, issues may appear in both areas at the same time.

3. Frozen shoulder (adhesive capsulitis)

Still with a widely unknown cause, frozen shoulder causes the joint capsule to stiffen, leading to severe restriction of motion and ongoing shoulder pain. This condition has been thought to have autoimmune involvement, but research is ongoing. Frozen shoulder follows a very predictable pattern of stages known as the freezing, frozen, and numbing stages, each usually lasting several months.

4. Shoulder osteoarthritis

Age and activity-related cartilage and joint surface degeneration can lead to osteoarthritis, resulting in stiffness, loss of range of motion, and joint pain. Usually rare for it to happen in the 40’s, if you have had a previous history of traumatic shoulder injuries or surgeries, you are at greater risk.

5. Calcific tendinitis

Calcium deposits in the rotator cuff tendons can cause sudden, intense shoulder pain, often limiting movement. Common and highly effective treatment for this condition is shockwave therapy to break down the deposits.

6. Bursitis

Bursae are like little cushions in our body that sit in areas where there is a lot of friction or pressure. Usually, they sit under or between tendons to help them glide and offset the friction. During arm movements, they can sometimes be pinched or with repetitive activities they can become irritated and inflamed. Thus, bursitis, or inflammation of a bursa. Oftentimes, people will report pain with overhead movements in this condition.

7. Fracture, dislocations, and separations

These are more severe injuries that usually occur from traumatic, high speed or force accidents such as a sports injury or car collisions. Shoulder fractures happen frequently in the humerus or clavicle (collar bone). Dislocations may happen between the humerus and scapula, where the head of the humerus gets hit out of the socket. Separations occur at the clavicle when the ligaments that normally hold it down are torn.

Why is shoulder pain more common in adults over 40?

Several factors make shoulder pain more common as we age:

Age-related wear and tear: Tendons naturally lose elasticity over time, increasing the risk of injury
Repetitive overuse: Years of overhead work, sports, or manual labor can lead to chronic shoulder problems
Poor posture: Slouching or rounded shoulders can change how the shoulder joint moves, leading to strain and discomfort
Previous injuries: Old injuries can lead to compensation patterns due to lost strength and mobility
Comorbidities: Diabetes, thyroid disease, and other conditions which increase in likelihood with age are linked to frozen shoulder and tendon problems.

How can physiotherapy help my shoulder pain?

Whether you’re dealing with an existing injury or trying to prevent shoulder pain, shoulder physiotherapy is one of the most effective treatments available.

Preventative shoulder physiotherapy or prehabilitation:

Prehabilitation is a newer term used to describe a proactive approach of preparing for physical activity. This involves improving overall fitness with the goal of minimizing the risk of injury while optimizing performance. Your physiotherapist will do a detailed assessment to determine the areas you need to work on. The treatment may include things like:

Posture correction: Improving shoulder and overall body alignment to reduce strain on the shoulder
Rotator cuff prehab: Building a stronger rotator cuff and shoulder blade muscles to stabilize the joint
Stretching and mobility: Maintaining or restoring full range of motion for daily life or sport, to prevent compensation patterns
Ergonomic advice: Learning how to avoid repetitive stressors at work, during daily activities
Technique corrections: Sport specific or exercise corrections to form to reduce injury risk and improve muscle performance

Rehabilitative shoulder physiotherapy:

This form of physiotherapy is usually more familiar to individuals, and happens after a pain or injury has happened. The goal is to restore normal strength, movement, and function the the shoulder, so the individual can continue their normal work, physical activities, and hobbies. The treatment may include things like:

Pain management techniques: Using manual therapy, massage, electrotherapy, ice/heat, and specific exercises to reduce shoulder pain
Guided exercise programs: Safely rebuilding strength and mobility under professional supervision
Movement retraining: Addressing faulty movement patterns to protect the joint during recovery
Education and long-term care: Learn how to keep your shoulders healthy with maintenance protocols and prevent future injurie

Ready to get started?

Look for PhysioNow! We have many expert shoulder physiotherapists that are ready to get you started no matter what your goal is. Don’t let your shoulder trouble you any more! With 10 locations across the GTA from Burlington, Oakville, Mississauga, and Etobicoke, our team is ready to serve you. Book with PhysioNow today for your first assessment and treatment!

Images by Freepik

Exercise, Health and Wellness, Physiotherapy, Sports Injuries, Sports Physiotherapy

Do You Play Pickleball? How Physiotherapy Can Help You Stay Injury-Free

July 1,2025 Sharon Tierney Leave a comment

Pickleball has exploded in popularity in the last couple of years across North America, with outdoor courts and racquet clubs popping up everywhere. The appeal is obvious as a fun, competitive or casual, social sport that can accommodate all ages and fitness levels. Whether you’re previous athlete or just trying for the first time, the greatest draw of pickleball is it’s accessibility. As Physiotherapists, we have also encountered a lot more pickleball-induced injuries recently. In this blog we’ll discuss the most common ones we see and a couple of tips to help you stay injury free this summer!

What are common pickleball injuries?

Tennis elbow, or lateral epicondylalgia, is one of the most common pickleball injuries that we see in the clinic

Pickleball is a sport with fast movements, quick changes in direction or starting and stopping, and repetitive plus powerful arm motions. As a result, the most common injuries tend to be:

Rotator cuff strains/sprains: Either an overuse or acute injury, overhead shots and smashes put a lot of strain through the shoulder joint and muscle
Knee strains/sprains: Overuse injuries can be like ITB syndrome, PFPS from muscular imbalances, or more acute injuries from sudden movements like a ligament or meniscal injury
Ankle ligament sprains: Common methods of injury include rolling/twisting your ankle, landing from a jump, or starting/stopping movement too quickly
Tennis/golfer’s elbow: This is an overuse injury of the muscles of the forearm, where a lot of the strain from holding and swinging the racket is directed
Achilles tendon problems: The strongest tendon in our body at the back of our heels, it is responsible for absorbing the stress of jumping, landing, changes in direction, running and more. Issues can be acute or from overloading the tendon

Staying injury-free with Physiotherapy

Physiotherapists are movement experts, and whether it is rehabilitation, injury prevention, or optimizing performance, we can help you with your game! Our recommendations for our pickleball athletes are as follows:

1. Ensure that your equipment and footwear is in good shape

Poorly maintained or fitting equipment can greatly increase your risk of injury. Ensure that your shoes fit well and provide enough grip to prevent slipping on the court.

2. Have a movement analysis done

Whether by a Physiotherapist or a coach, they can evaluate your technique and help you identify any issues. They can assess your movement patterns, running, jumping, swing, and how you hold your paddle For example, improper or over gripping can change the amount of stress on the forearm muscles and predispose them to injury.

3. Engage in a cross training routine

We highly recommend engaging in cross training, especially the more frequently you begin to play pickleball. Cross training helps to give the muscles primarily stressed by pickleball some rest, while still allowing you to work towards getting stronger, faster, and more cardiovascular fitness. While it may be tempting to play pickleball everyday, remember that your body needs a rest as well to repair itself. Cross training activities we recommend include resistance/weight training and another form of lower impact cardio like the elliptical, rowing, or swimming.

4. Regular body maintenance

Preventative care is key! Stopping an injury before it can even happen is our primary goal.

If you’re playing often, we recommend some focus on recovery whether its through Massage Therapy, Physiotherapy, or Manual Osteopathy. Not only does this help with injury prevention, but it can help you understand and engage in techniques like active recovery, soft tissue work or stretching and mobility work to reduce muscle inflammation and soreness.

5. Treating old injuries and impairments

It is important to address any pre-existing issues or injuries to ensure you’re in the best shape to play. For example, individuals who have had previous shoulder problems or lack mobility/strength in their shoulders are more likely to develop pain due to overuse in their forearm. As can be seen, a weakness in one area requires compensation with a different area of the body. Alternatively, If you are someone who struggles with mobility and has a hard time getting their arms overhead and behind your ears, you’re going to have a hard time hitting those overhead shots. Physiotherapy can help you work on these problems with a personalized treatment and training protocol.

Ready to level up your pickleball game?

Look for PhysioNow! We have many expert professionals (many of which love pickleball themselves!) that are ready to help you on your journey. Whether you’re looking for help with an injury, prevention, or looking for performance tips, we can help. Book with PhysioNow today for your first assessment and treatment. We have 10 locations across the GTA from Burlington, Oakville, Mississauga, to Etobicoke ready to serve your needs!

Images by FreePik

Knee Pain, Physiotherapy, Sports Injuries, Sports Physiotherapy

World Star Neymar’s Injury: A Physio’s Take on What Could’ve Gone Better

May 9,2025 Sharon Tierney Leave a comment

A slew of setbacks, most notably a serious knee injury and the resulting muscular strains, are the cause of Neymar’s physical issues. In October 2023, Neymar ruptured his meniscus and anterior cruciate ligament (ACL) in his left knee while playing for Brazil. Consequently, he was out of commission for about a year which needed a surgery and prolonged rehabilitation. Afterwards, he returned in October 2024, making a fleeting appearance for his team, Al Hilal, in a Champions League game. However, Neymar sustained a thigh injury in a Champions League match against Esteghlal FC barely two weeks after his return. After just 29 minutes of play, he was forced to leave the field. Al Hilal acknowledged that he had to miss up to six weeks of action due to a hamstring issue.

These recurring injuries highlight the challenges athletes face when returning to play after significant injuries. Doctors had warned Neymar about the risks of muscular issues following his ACL recovery, emphasizing the importance of a gradual return to full fitness and sports.

As a physiotherapist, it’s crucial to understand that after a major injury like an ACL tear, the body undergoes changes that can affect muscle strength and flexibility. These changes can increase the risk of further injuries, especially if the return to play is not carefully managed.

In Neymar’s case, his rapid return to competitive play may have contributed to his recent muscle strain. A more cautious approach, focusing on strength and conditioning, and full muscle coordination could have potentially reduced the risk of such injuries.

What could have been done differently for Neymar?

1. Slower, more controlled comeback

Sport specific drills are an important part of returning an athlete to sport to retrain coordination, movement patterns, endurance and more

After a major ACL tear and surgery, the body isn’t just healing — it’s relearning how to move, balance, and absorb force. Neymar’s return happened about a year after surgery, which sounds like enough time, but:

His movement patterns may not have fully normalized
He may have skipped some deeper neuromuscular retraining — stuff that helps the brain and body sync up under game-speed pressure

What could’ve been better: A longer ramp-up period with progressive match play at lower intensity (practice games, partial matches, etc.) could’ve helped

2. More emphasis on strength & muscle balance

After knee surgery, the entire leg can weaken — not just the injured spot

Imbalances between hamstrings, quads, glutes, and calves often creep in
In Neymar’s case, this likely contributed to his hamstring tear shortly after returning

What could’ve been better: More time spent rebuilding muscle symmetry and not just getting match-fit.

3. Psychological readiness

Elite players often feel pressure to return fast — for club, country, or personal goals.

But fear of re-injury or hesitation can subtly alter how they move
That can throw off mechanics and stress certain muscles or joints more than usual

What could’ve been better: Ensuring he felt 100% mentally ready and confident in his knee, not just physically cleared

4. Better load management

After return, his match minutes should’ve been strictly limited and monitored.

He played 29 minutes before the muscle strain — possibly more than he was ready for at that intensity
High-level games put maximum demand on recently healed tissues
Athletes may perform new or extreme maneuvers they did not train or practice sufficiently

What could’ve been better: A stricter minutes cap and more use of recovery tools like GPS tracking, force plates, or isokinetic testing to guide decisions

The Bottom Line on Neymar’s Injury

Even with world-class care, the biggest trap is thinking, “He’s cleared, so he’s good to go.” But high-level return to sport needs to be ultra-gradual and individualized. If you are experiencing something similar and looking to return to sports, look for PhysioNow! Our experts Sports Physiotherapists across the GTA can create a personalized program for you, your sport, and your level to ensure a safe and successful return. Don’t miss out any longer, book with PhysioNow today for your first assessment and treatment!

Hip Pain, Physiotherapy, Sports Injuries, Sports Physiotherapy

Hip Sports Injury: Identify your Hip Pain!

March 1,2025 Sharon Tierney Leave a comment

The hip joint is one of the most important joints for athletes, it is used in movements such as running, jumping, changing in direction, and kicking. In high impact sports, the chance of injuring the hip increases. For example, this can range from minor muscle strains to major structural pathologies, including fractures. Even with the best preventative strategies, hip injuries do occur in sports either from overuse or acute trauma. However, athletes can get back to full recovery and performance if the injury is diagnosed early and managed appropriately.

Types of Hip Injuries

Muscle Strains

Kicking is a common method of injury to the muscles of the hips due to the high level of forces involved in the movement

First, the most common type of injury are muscle strains. A strain involves tearing of the muscle fibers due to overstretching, sudden changes in direction, speed, or sudden twisting movement. The most frequently affected muscles are:
• Hip flexors – injured in sprinting and kicking sports
• Groin/inner thighs – normally injured in soccer and hockey
• Hamstrings – pulled in sports including quick starting/stopping and kicking
• Glutes – might get injured during jumping activities

Bursitis (Trochanteric or Iliopsoas Bursitis)

Bursae are small, fluid-filled sacs that decrease friction between bones and soft tissues. Overuse, repetitive motion, or direct injury can result in inflammation of these bursae, thus causing pain and stiffness. The most common hip bursitis’ are:
• Trochanteric bursitis – pain and tenderness on the outer side of the hip, common in runners
• Iliopsoas bursitis – pain and tenderness in the front part of the hip

Hip Fractures and Stress Fractures

Fractures are not as common in young populations but can be happen with traumatic accidents, such as a fall or during a full contact sport. Stress fractures can also be seen from repetitive impacts, such as running or jumping.

Hip Dislocations

With some high impact sports, the head of the femur can come out from the socket with a fall, a tackle/check or any direct blow to the hip. It can lead to severe injuries to the surrounding musculoskeletal tissues and immediate medical attention is necessary.

Sports Hernias

In sports hernias, also known as “Athletic Pubalgia”, there is injury to soft tissue in the groin and lower abdominal area. Unlike a traditional hernia, where there is bulging in the abdominal wall, a sports hernia is simply a tear/strain of the soft tissue. Usually, this pain increases with activity, especially sports that involve twisting movements or sudden changes in direction.

Labral Tears

Labral tears are an injury to the cartilage around the hip socket. Normally, the labrum is an important structure for stability and movement without dislocation of the hip joint. It can get injured with repetitive movement or high impact activities.

What are common symptoms of a hip sports injury?

Pain around the hip joint, including radiation to the groin, front of the thigh or glutes
Swelling
Tenderness to the touch around the joint
Decreased range of motion in the hip
Clicking during hip movements
Weakness at the hip
Pain with weightbearing activity or movement
Instability, locking or giving out feeling at the hip

How is a hip sports injury diagnosed?

To diagnose the accurate condition your Physiotherapist and/or doctor will use a combination of physical examinations and diagnostic testing.

Clinical Examination

For the examination, they will ask a series of questions to create a subjective history which includes the mechanism of injury, current symptoms and complaints, pre-existing or previous injuries, and relevant medical history. Next, they will conduct physical/objective testing for the range of motion, strength, and function of the hip. They will perform some special tests to try to reproduce your pain and rule in and rule out certain conditions.

Imaging Tests

MRIs are used to obtain highly detailed images of the body

If further detail is required, then imaging may be necessary. Then, your doctor might request that you go for an x-ray, ultrasound, MRI or CT scan, depending on the structures involved.

How does Physiotherapy rehabilitate a hip sports injury?

Initial phase

The focus of this stage is to reduce the pain, inflammation and swelling around the area, and preventany further damage.
• Rest – Stop activities that stress the hip or make the pain significantly worse
• Ice – Icing the injury 15-20 minutes 3-4 times a day helps with swelling and pain
• Compression – Elastic bandages may help manage pain and swelling
• Elevation – Keep the foot and knee elevated, if possible, to reduce swelling from travelling down the leg

Sub-acute and recovery stage:

In this stage the focus shifts towards improving range and strength for the patient. Using the combination of:

• Stretching and range of motion exercises – To maintain flexibility and prevent stiffness

• Strengthening – Focused on core and hip stability

• Balance and proprioception training – Restore coordination and balance in the affected side

• Sport-specific drills – Gradual return to sport-specific, quick, and high impact movements

• Return to sport – Finally, returning the athlete back to their sport safely, and giving them strategies to prevent future injuries

• Surgery: In some cases where conservative management fails, or in big traumatic accidents with extensive injuries, surgical procedures may be necesasry.

Need help with a hip pain?

If you are experiencing these symptoms or pain around your hip, look for PhysioNow! We have many expert Physiotherapists that can support your recovery. Book with PhysioNow today for your first assessment and treatment. With 10 clinics across the GTA from Burlington, Oakville, Mississauga, to Etobicoke, you can get help quickly!

Health and Wellness, Modalities, Sports Injuries, Sports Physiotherapy

Should I Put Heat or Ice on my Injury?

February 19,2025 Sharon Tierney Leave a comment

Both ice and heat therapy are commonly used in Physiotherapy clinics and at home for pain relief and injury recovery. Each therapy has its own mechanism of action (how it works) and advantages. Read more to find out how each therapy affects you, and which one may suit your situation more.

What are the effects of ice therapy (cryotherapy)?

Slows blood flow: First, the main mechanism in how cold therapy works is by constricting blood vessels (vasoconstriction). As a result, this can help reduce bleeding, bruising, and swelling after an injury
Reduces inflammation: Additionally, through vasoconstriction, cold therapy minimizes the inflammation response in the immediate aftermath of an injury
Pain relief: Cold therapy can numb the area and does so by slowing or stopping the transmission of pain signals to the brain. Ultimately, this provides temporary and local pain relief
Facilitates early rehabilitation: By numbing the area to decrease pain and managing excessive swelling, it may allow better performance of gentle rehabilitative exercises. Overall, this can lead to a quicker recovery time
Useful for acute injuries: Especially beneficial within the first 48 hours post-injury, where the pain, inflammation, swelling, and bleeding tend to be the greatest

What are the effects of heat therapy (thermotherapy)?

Increases blood flow: First, heat promotes circulation (more blood flow). This occurs in a process called vasodilation which means the blood vessels become wider. As a result, more blood flow is able to reach that area which can aid in healing by delivering more oxygen and nutrients to tissues
Muscle relaxation: Additionally, heat can improve the flexibility of tissues. When combined with the effects of improved circulation, it helps to relax tight or tense muscles
Enhances mobility: Similarly, warmth can also improve range of motion, making it easier and/or less painful to move stiff body parts
Pain relief: Heat also has an analgesic effect through various interactions in the body. Ultimately, it can temporarily alleviate discomfort and pain especially in chronic conditions, like arthritis.
Promotes healing: Increased blood flow can help speed up recovery from muscle strains and chronic conditions by allowing more nutrients to reach the target tissue

When do I use heat or ice?

As can be seen, both therapies have roles in pain relief. In fact, throughout the course of an injury, you may even use both. Generally, ice is preferred in acute situations (in the first 2 days after injury), to help manage inflammation and swelling. However, in some cases such as post-knee replacement or other surgeries, icing may be recommended for longer periods of time such as 1-2 weeks. On the other hand, heat is ideal for longer term or chronic pain, and situations involving a lot of tension and stiffness. Your choice will depend on the goal, how recent the injury is, and can also boil down to personal preference as well. For example, you may be picking ice as a pain relief strategy even though it has been more than a week since your initial injury because you find it works better, and that’s okay! As a quick summary:

Ice: Best for acute injuries, inflammation, and swelling
Heat: Ideal for chronic pain, muscle tension, and stiffness

What are contrast baths?

You may have heard of this treatment called contrast baths before, as it is quite popular with athletes. Contrast baths involve alternating a body part (usually a limb) between hot and cold water in a short time period/within a single treatment session. The switching causes alternating narrowing and widening of the blood vessels, creating a “pumping” effect. This is often used to help improve circulation, muscle recovery, and for swelling, soreness, and inflammation management. Here’s a breakdown of the advantages and disadvantages:

Advantages

Improved circulation: The alternation between hot and cold stimulates blood flow, promoting circulation and aiding in healing
Reduced inflammation: The cold component can help reduce swelling and inflammation, while heat can relax muscles. Also, the pump effect may help remove inflammatory waste products from the injured tissues
Pain relief: Many people experience relief from pain due to the effects of both heat and cold.
Enhanced recovery: Athletes often use contrast baths to speed up recovery after intense exercise, as it can help reduce muscle soreness

Disadvantages

Time-consuming: Usually, setting up and performing a contrast bath can take more time than other methods of therapy
Not suitable for everyone: Individuals with certain medical conditions (e.g., cardiovascular issues, neuropathy, infected/open wounds, diabetes) may need to avoid contrast baths.
Potential discomfort: The rapid temperature changes can be uncomfortable for some individuals
Requires equipment: Access to a tub or a setup that allows for temperature control can be a barrier for some

I need help with my injury!

If you are struggling with an injury or pain, whether it is new or old, look for PhysioNow! We have many expert clinicians including Registered Massage Therapists, Physiotherapists, Athletic Therapists, and Manual Osteopaths. With 10 clinics across the GTA from Burlington, Oakville, Mississauga to Etobicoke, we are ready to help you today. We encourage you to get started as quickly as possible, please reach us at 289-724-0528 or through our online services. We are looking forward to helping you achieve your best health again!

Knee Pain, Sports Injuries, Sports Physiotherapy

Hamstring Injuries Caused by Deadlifting: Prevention and Recovery

January 16,2025 Sharon Tierney Leave a comment

Deadlifting is a highly effective exercise for building strength, especially in the posterior chain (glutes, lower back, and hamstrings). However, improper technique or a lack of foundational strength can lead to injuries, especially in the hamstring. If you are an avid lifter or just looking to get started with deadlifting, here is a quick guide on preventing and recovering from hamstring strains related to deadlifting.

What do the hamstrings do in a deadlift?

The hamstrings are a group of three muscles located at the back of your thigh: the biceps femoris, semitendinosus, and semimembranosus. These muscles are primarily responsible for bending the knee and extending the hip. During a deadlift, your hamstrings play a key role in two ways:

Hip extension: As you stand up with the barbell, your hamstrings work alongside your glutes to extend your hips (bringing them forwards).
Knee flexion: While not as heavily involved as in hip extension, the hamstrings also help stabilize the knee during the lift, especially in the bottom position of the deadlift.

Because deadlifting places significant load on these muscles, improper technique or weak hamstrings can increase the risk of injury.

How do the hamstrings become injured during a deadlift?

1. Poor form

Firstly, one of the most common reasons for hamstring injuries during deadlifting is improper form. Usually, deadlifting requires precise movement mechanics to avoid unnecessary strain on the muscles. If you are unsure about your form, you can always ask for help from a fitness or exercise professional such as a licensed personal trainer, athletic therapist, sports physiotherapist and more. For example, a few common form issues that can lead to hamstring injuries include:

Rounding of the lower back
Overextending at the top of the lift
Incorrect hip positioning over top of the bar

2. Weak hamstrings or muscular imbalances

Secondly, weak hamstrings can be a contributing factor to injuries. The hamstrings may not be able to handle the load, especially when lifting heavier weights. Alternatively, if other muscles in the lower body are weaker or have been injured, the hamstrings may compensate for them by taking on excessive load.

3. Sudden increase in load or frequency

Additionally, jumping into heavy deadlifts without gradually increasing the load can overstress the hamstrings. Consequently, progressive overload and sufficient rest, both key principles of exercise training, are essential for proper muscle growth and injury prevention.

4. Lack of mobility or a warm-up

Finally, a lack of proper warm-up can leave the hamstrings (and other muscles) stiff and more prone to injury. Neglecting mobility work or stretching can lead to tightness or stiffness, limiting your range of motion and increasing the risk of overstretching the hamstrings during the lift. For example, during deadlifts some people lack sufficient hamstring flexibility to perform the lift with proper form. As a result, when they go to bend forward in the lift, it is already stretched maximally or past its safe limit, putting it in a vulnerable position.

How to Prevent Hamstring Injuries When Deadlifting

1. Master proper form

Initially, ensuring you have proper technique is the number one way to prevent injuries, including hamstring strains. For example, key tips for deadlifting with proper form include:

Start with your feet shoulder-width apart and the barbell close to your shins
Maintain a neutral spine (no rounding of the back) throughout the lift
Keep your core tight and engage your glutes and hamstrings as you lift
Use your hips, not your back, to initiate the movement, and make sure your back remains straight as you stand
Focus on hinging at the hips rather than bending at the waist

Proper form in a deadlift includes keeping the bar close to your body, and maintaining a neutral spine as seen above

2. Strengthen your hamstrings

Additionally, incorporating other exercises that strengthen the hamstrings can help prevent injury. Some of the most effective exercises for hamstring strength include:

Romanian deadlifts: These focus on the hip hinge and engage the hamstrings
Leg curls: Using machines or resistance bands to isolate and strengthen the hamstrings
Glute-ham raises: A great bodyweight or weighted exercise to target the hamstrings and glutes

Ultimately, building hamstring strength and addressing muscle imbalances can help your body handle all loads more safely.

3. Gradually increase weight, take rest days

To avoid overstretching or overloading the hamstrings, progressively increase the weight you’re lifting over time. Also, avoid training the same muscle group 2 days in a row, especially if you’re lifting heavier. Even experienced lifters can suffer from overtraining, everybody needs rest days! Instead, think about doing some cardio or training a different body part while the hamstrings recover.

5. Incorporate mobility work

Hamstring flexibility and mobility are crucial for preventing strain. Regular stretching, yoga, or foam rolling can help maintain or improve the flexibility of not just the hamstrings but the hips, knees and ankles as well. If you take care of your body properly, you’ll reduce the risk of injury during deadlifts.

I need help with a hamstring injury, what do I do?

If you have experienced a hamstring injury while deadlifting, first follow the R.I.C.E. protocol (rest, ice, compression, elevation) immediately after the injury. Some strains may heal on their own, but it is always recommended that you engage in a rehabilitation program afterwards to ensure you recover full mobility and strength.

For more serious strains, or if your function is impaired after, such as difficulty walking or putting weight on it, you should consider Physiotherapy. Your Physiotherapist will work with you to help you safely recover from your injury and then return to your normal activities and sports. If you are looking for help with a hamstring injury or any other sports injury, look for PhysioNow with clinics across the GTA. Book with PhysioNow today for your first assessment and treatment.

Exercise, Health and Wellness, Knee Pain, Sports Injuries

Prevent Injuries to your Knee: Quads Strength is the Key!

January 2,2025 Sharon Tierney Leave a comment

Strengthening the quadriceps is crucial for minimizing the risk of knee injuries. Notably, the quadriceps (the group of muscles on the front of your thigh) play a key role in stabilizing and supporting the knee joint. As a result, regular training and maintenance of this muscle group is crucial for knee health. The following are 6 reasons why you should train your quads strength!

1. Stabilizes the knee joint

The quadriceps are the primary muscles that help extend your knee (straighten your leg). They work in tandem with the hamstrings (muscles on the back of the thigh) to provide balance and stability to the knee joint. Proper quadriceps strength helps to control and create motion of the knee, especially during activities like walking, running, jumping, or climbing stairs. If weak, the body may be forced to compensate with other muscles like the calves, glutes or hamstrings which may lead to overuse/strain injuries.

2. Absorbs shock and reduces load on the knee

Strong quadriceps muscles help absorb impact and control the load placed on the knee joint, especially during weight-bearing activities. For example, when you perform high-impact movements (like running or jumping), the quadriceps cushion some of the forces that otherwise would be transferred directly to the knee. This reduces wear and tear on joint surfaces and cartilage and helps manage conditions like osteoarthritis, patellafemoral pain syndrome, or bursitis.

3. Helps maintain proper knee alignment

The quadriceps contributes to maintaining the alignment of the knee, particularly in preventing the knee from collapsing inward (known as valgus) or being pushed outward (known as varus). These misalignments can put excessive stress on the knee joint and ligaments, increasing the likelihood of injuries such as meniscal tears, ACL or MCL tears/sprains, or patellofemoral pain syndrome.

4. Protects the knee ligaments

The quadriceps play an important role in protecting the knee ligaments, particularly the anterior cruciate ligament (ACL). Weak quads can lead to poor control of knee motion, increasing the strain on the ACL and potentially causing tears, especially during cutting, pivoting, or landing from a jump. In other words, strengthening the quadriceps can improve dynamic knee stability. Consequently, allowing you to better control the forces that act on the knee during athletic movements.

5. Improves functional movements

Strong quadriceps improve your ability to perform daily functional movements, such as stairs, squatting, bending, and standing up from a chair. Weak quads make these movements more challenging and can lead to compensation patterns that strain the knee or other body parts. Especially as we age, ensuring we build enough strength for our daily activities is the key to maintaining a good quality of life.

Quads strength influences our ability to go up and down the stairs, especially quickly

6. Prevents chronic conditions

Chronic weakness in the quadriceps can lead to altered gait patterns, which may increase stress on the knee joint over time. This abnormal stress can contribute to the development of degenerative conditions such as knee arthritis or chondrosis that wears away joint and cartilage surfaces in the knee joint. Overall, strengthening the quadriceps helps to alleviate some of that excess stress and reduce the progression of arthritis.

Looking for help?

As can be seen, quads strength is vital for knee health. Whether you’re an athlete or someone or just enjoying activity recreationally, quadriceps strength can make a significant difference in knee performance and injury prevention. If you want to get stronger or having problems with your knees, PhysioNow has many experienced Physical Therapists to help you out. Book with PhysioNow today for your first assessment and treatment!