Tag Archives: Sports Injuries

Olympics, Physiotherapy, Sports Injuries, Sports Physiotherapy

5 Winter Olympics Injuries and How Physiotherapy Treats Them

Many of us have been watching the Winter Olympics eagerly for the past couple of weeks. We’ve watched our athletes showcase thier speed, power, precision, and skill. However, the same forces that allow elite athletes to perform at world-class levels, also create predictable injury patterns.

For physiotherapy clinics, winter sports Olympics injuries are not limited to Olympians. Recreational skiers, snowboarders, hockey players, and winter runners frequently present with similar conditions. Below is a summary of the five most common Winter Olympic injuries and how physiotherapy manages them.

1. ACL Tears (Anterior Cruciate Ligament)

Common in: Skiing, snowboarding, ice hockey
Mechanism: Rotational force with inwards knee collapse (pivoting and cutting), high-speed decelerations, awkward landings from jumps

ACL injuries are strongly associated with downhill skiing and high intensity sports. High torsional forces between the ski and the knee create a classic non-contact mechanism. A well-known example is Lindsey Vonn, who sustained multiple ACL injuries yet returned to elite competition following structured rehabilitation. So let’s talk about how someone can recover from an ACL injury.

Physiotherapy Treatment

Post-operative or conservative rehab includes:

  • Early restoration of knee extension
  • Quadriceps activation
  • Progressive strengthening and weightbearing toleranc
  • Neuromuscular control and proprioceptive training
  • Plyometric progression
  • Objective return-to-sport testing (hop tests, tests between the injured and normal side should be ≥90%)

The return of strength alone is insufficient to return to sports. Realistically, when we’re moving during sports, our bodies are not going to stay in perfect alignment like during squats in the gym. As a result, movement quality and dynamic control are critical to reducing re-injury risk.

2. Wrist Fractures

Common in: Snowboarding
Mechanism: FOOSH (Fall On Outstretched Hand)

For example, snowboarders often fall backward or forward without releasing the board, leading to a fall directly onto the hand. This commonly results in wrist or hand fractures like a scaphoid or distal radius fractures.

Physiotherapy Treatment

After being immobilized for a couple of weeks, physiotherapy starts immediately:

  • Gradual wrist mobilization, most people are very stiff coming out of the cast
  • Edema (swelling) management
  • Grip strengthening
  • Fine motor movements
  • Progressively loading the wrist to increase function and strength
  • Functional reintegration (weight-bearing through hands)

3. Concussions

Concussions are common sports injuries that can arise from any impact or even acceleration/decelerations that are too quick. In hockey, this could be the impact from a fall, a puck, another player, or even just crashing into the sides too hard.

Common in: Ice hockey, snowboarding, figure skating
Mechanism: High-speed collision or impact

Concussion management has evolved significantly within the last couple of decades. Prolonged rest periods is no longer indicated for recovery. Athletes in winter contact sports experience both direct head trauma and acceleration-deceleration injuries. Many people are still not aware that there does not have to be direct head trauma for a concussion injury to be present. Unfortunately, the return to sport rehabilitation for concussion can be quite lengthy, and there will always be an increased vulnerability to future concussions.

Physiotherapy Treatment

Modern concussion rehab includes:

  • Cervical spine assessment and treatment
  • Vestibular rehabilitation
  • Oculomotor retraining
  • Aerobic conditioning appropriate to the current symptoms
  • Graduated return-to-school/work, then return to sport protocols
  • Education on symptom control to avoid overload

4. Shoulder Injuries (Dislocations & AC Joint Sprains)

Common in: Snowboarding, ice hockey, speed skating falls
Mechanism: Direct lateral impact or bracing fall

Shoulder dislocations and AC sprains can occur from a direct impact, like getting tackled or hitting another player. Otherwise, a fall and fall onto the arm, elbow, or hand can push the shoulder out of place as well. For the more severe injuries, the arm will look visibly dislocated and in the AC joint, a step deformity is obvious.

Physiotherapy Treatment

  • Acute phase pain control
  • Gradual restoration of ROM
  • Rotator cuff strengthening
  • Scapular stabilization and rotator cuff stability drills
  • Return-to-contact progression (for contact sports)

5. Groin and Adductor Strains

In skating sports, especially speed skating, the leg is often extended far to the side. This puts the adductor muscles in a stretched position, making them more vulnerable to strains if not trained properly.

Common in: Ice sports
Mechanism: Repetitive lateral push-off under high load

The skating stride demands strong eccentric and concentric adductor (inner thigh muscles) activation. If you’ve ever gone skating and then felt really sore here afterwards, you’ll understand. These are muscles that are not used often in our daily lives. Without adequate strength and load training, the muscles can easily get overwhelmed or strained during high speed movements.

Physiotherapy Treatment

  • Load modification
  • Isometric adductor strengthening (early phase)
  • Copenhagen progression exercises
  • Core stability integration
  • Gradual skating reintroductio

What if you’re a recreational athlete?

You do not need to compete at the Winter Olympics to experience these injuries. Recreational ski trips, adult or youth hockey leagues, and icy sidewalks create similar environments. Whether you’ve had a recent sports injury, are looking for prehab, or looking to get a long time pain corrected, Physiotherapy is a great choice!

Physiotherapy provides:

  • Accurate diagnosis and differential screening
  • Evidence-based rehabilitation
  • Return-to-sport criteria
  • Injury prevention programming
  • Strength and movement correction
  • Individualized care

PhysioNow provides comprehensive care to all levels and ages. We have 10 clinics located across the west GTA including Burlington, Oakville, Mississauga, and Etobicoke with extended evening and weekend hours to make it easy for you! Whether you’ve had an injury listed above or something new, come get started with your rehab today! Book with PhysioNow today for your first assessment and treatment, and stop missing out on your favourite activities. We can also be reached at P: 289-724-0448 or Email: applewood@physionow.ca with any questions or concerns.

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

Lindsey Vonn: Resilience and Rehabilitation

The Winter and Summer Olympics are awaited eagerly by both viewers and athletes across the world. We get to witness amazing feats of athleticism and elite performance across all kinds of sports! For a competing athlete, the Olympics can be everything to them. It’s the ultimate goal, allowing them to push through pain, injuries and intense stress, all for the chance to prove themselves on the world stage. For one incredible Team USA athlete, their leadup into the Olympics was one of resilience and determination. This is the story of Lindsey Vonn.

What is Lindsey Vonn’s story?

Lindsey Vonn is one of the most decorated alpine skiiers in history, winning over 84 World Cup titles across different disciplines of alpine skiing. She has consistently been competing (and competing successfully!) at the highest level despite numerous and severe injuries including fractures and ligament tears. She made a decision to retire in 2018, citing her history of injuries. However, she decided to return to competitive skiing in 2024 after receiving a knee replacement surgery. She became the oldest downhill skiing World Cup winner in 2024, at the age of 41. This brings us close to the present day, the 2026 Winter Olympics.

At the World Cup in Jan 2026, she crashed and had to be airlifted off the mountain. Later, it was revealed that she had ruptured her left knee’s ACL. Despite this, she communicated her intent to still compete in the Olympics 1 week later. Unfortunately, at the Olympics, she had another crash where she had to be airlifted off the mountain. Afterwards, she stated that she had suffered a complex tibia fracture requiring several rounds of surgery.

How did Lindsey Vonn manage to compete with her injuries?

A case like Lindsey Vonn’s is instrumental to showing the importance of sports rehabilitation. Throughout her career, she sustained multiple serious knee injuries, including anterior cruciate ligament (ACL) tears, medial collateral ligament (MCL) injuries, tibial plateau fractures, and meniscal damage. She underwent several reconstructive surgeries, particularly on her right knee.

High-level alpine skiing places extreme forces on the knee joint. For example, cutting, rapid deceleration, torsional loads, and high-speed turns require not only strength, but joint stability and proprioception. Returning to competition after ligament reconstruction demands months of structured rehabilitation, often 9-12 months or longer. Her career illustrates that prior injury does not automatically end athletic performance, but it does require lots of dedication to a rehabilitative program.

How did Lindsey Vonn’s pre-existing injuries affect her?

Previous injuries pre-dispose athletes to further injuries, due to changes that happen through out the body. For Lyndsey Vonn, the rupture in her ACL tendon definitely affected the strength and stability around her knee. Some of these changes include:

1. Strength asymmetries

Muscles around the injury tend to get weaker. For example, quadriceps inhibition and hamstring weakness are common long-term consequences of knee injury. Even subtle asymmetries can affect force generation during high intensity sports and movements.

2. Proprioception and neuromuscular control

Tissue injury disrupts mechanoreceptors responsible for the sense of proprioception, or joint position awareness. This awareness gives your joints stability which is especially important during movements like pivoting and cutting.

3. Load tolerance

Cartilage and meniscus damage can reduce shock absorption capacity. Sufficient strength and coordination of muscles must be retrained to compensate

4. Psychological readiness

Fear of reinjury (kinesiophobia) is a well known barrier to return to sport, whether you’re a competitive or recreational athlete. Confidence in your body and its ability to resist injury is necessary to achieve your full potential.

In Vonn’s case, repeated returns to elite skiing required not just healing, but continuous adaptation. Competing with a history of knee reconstruction often means meticulous strength programming, external bracing support, and careful monitoring of training volume.

What does this mean for a recreational athlete?

Even if you’re not at an elite level for sports, you should still rehabilitate each of your sports injuries. Not only will it reduce your risk for future injury, but it can help you achieve new levels of performance. Many recreational players experience similar injury patterns. For example, ACL tears, meniscal injuries, ankle sprains, rotator cuff tears, and stress fractures are common across many sports including soccer, basketball, skiing, running, and CrossFit.

A common misconception is that once pain decreases, the injury has resolved. In reality, pain reduction often precedes full tissue healing and neuromuscular recovery. Returning to sport too early without restoring the necessary strength and control, can create a cycle of recurrent injury.

If you have a pre-existing sports injury, consider:

  • Are both sides equally strong?
  • Can you perform single-leg movements with control?
  • Can you perform all the necessary movements of your sport?
  • Do you have the endurance to play a full game/session of your sport?
  • Do you have the same jumping/hitting power as before the injury?
  • Are you following a structured strengthening program?

Sports physiotherapy addresses these gaps systematically.

Need help with a sports injury?

Then look for PhysioNow! Lindsey Vonn’s career is proof that sports injuries do not have to be the end. If you have suffered a recent or even a long time injury that’s affecting or stopping you from playing or participating, there is help. Our expert physiotherapists are avialable at 10 locations across the west GTA from Burlington, Oakville, Mississauga, Etobicoke, and offer Physiotherapy, Massage Therapy, Manual Osteopathy and more! Book with PhysioNow today for your first assessment and treatment!

Acute Ankle Sprains, Ankle pain, Physiotherapy, Sports Injuries, Sports Physiotherapy

Ankle Mobility Matters: A Hidden Reason Behind Back, Hip and Knee Pain

Ankle mobility, or rather the lack of it, is often overlooked. Many people assume ankle problems only matter if they’ve had a sprain or fracture. In reality, limited ankle mobility can affect your entire body, from your knees and hips to your lower back. At physiotherapy clinics, it is very common to see patients with knee pain, hip pain, or back pain where the root cause is actually poor ankle movement. Understanding ankle mobility and how it ties into the whole body can help you proactively prevent pain and reduce your injury risk.

What is ankle mobility?

Ankle mobility refers to how well your ankle joint moves. Normally, the ankle joint moves into dorsiflexion (bringing the foot closer to the ankle), plantarflexion (pointing the foot away from the ankle), inversion (sole of the foot towards the middle), eversion (sole of the foot away from the middle), and a combination of these movements. There are relative “normals” for each movement recorded in degrees, but ultimately, there are lots of individual variations of normal. Usually, we talk about restricted ankle mobility in something being different for that specific person, such as between their left and right sides. Healthy ankle mobility is essential for:

  • Walking
  • Running
  • Squatting
  • Going up and down stairs
  • Maintaining balance
  • Absorbing shock during movement

Why is ankle mobility so important?

In our daily movements, ankle mobility is key. As seen above, a deep squat requires a lot of dorsiflexion mobility.

To sum it up, when ankle motion is restricted, your body is forced to compensate elsewhere. For example, the ankle is one of the first joints that contacts the ground while moving around. If it does not have the mobility to perform its job as a shock absorber properly, them the joints above it must work harder. As a result, they will experience a greater proportion of stress. For another example, somebody without sufficient dorsiflexion in their ankle has a very hard time going down stairs. Instead, a lot of pressure goes into the knee as it has to bend much more to compensate for the ankle. Try it yourself at home! Can you go down the stairs without bending your ankle? Instead, you might find this happening when ankle mobility is limited:

  • The knee collapses inward or twists
  • The hip rotates excessively
  • The lower back moves more than it should
  • Balance becomes less stable
  • Muscles fatigue faster

Over time, these compensations increase stress on other joints and tissues, leading to pain and injury.

Common causes of ankle restrictions

Following the use it or lose it principle, immobilization is one of the biggest causes of ankle restrictions. After getting it off, it is essential to start moving immediately to regain range of motion.

Ankle stiffness can develop for many reasons, even without recent injury. For example, many people don’t realize their ankle never fully recovered after an old sprain. It might have recovered 90% of the way so that they don’t notice it day to day, but over the course of years the effects from that can build. Common causes include:

  • Previous ankle sprains (even years ago)
  • Immobilization in a boot or cast
  • Tight calf muscles
  • Muscle contractures
  • Scar tissue
  • Prolonged sitting
  • Wearing unsupportive footwear
  • Reduced activity levels
  • Arthritis
  • Poor movement habits

Signs that you may have limited ankle mobility

You may have ankle mobility issues if you notice:

  • Heels lifting off the ground during squats
  • Knee pain doing stairs or lunges
  • Feeling stiff in the ankles, especially in the morning
  • Poor balance on one leg
  • Recurrent ankle sprains
  • Feel like you have “tight calves” despite stretching a lot
  • Pain during walking or running
  • Feeling unstable on uneven surfaces
  • Back or hip pain with no clear cause or changes in range of motion

How do I improve my ankle mobility?

Physiotherapist helping their patient regain dorsiflexion range of motion

Physiotherapy is a great way to learn your areas of weakness or vulnerabilities and get help addressing them. Specifically for the ankle, you can focus on restoring ankle mobility and correcting compensation throughout the body. At PhysioNow, treatment typically includes:

  1. Comprehensive assessment: Your physiotherapist assesses range of motion, muscle length and tension, biomechanics, gait patterns, balance and coordination, muscular strength and more. This helps identify the extent of your ankle stiffness and how its affecting the rest of your body.
  2. Manual therapy: Hands on techniques can reduce stiffness, improve flexibility, break down scar tissue, reduce pain, and more. The specific techniques used will be decided based on the results of the assessment
  3. Home exercise plan: Targeted exercises focusing on your areas of need and goals will be given. These may includes stretching, mobility, functional, strength, balance, speed, coordination, power exercises and more! Your physiotherapist will work with you personally to decide.
  4. Movement retraining: If you have been compensating for a long time, you will have to unlearn your old compensatory habits. For example, you may have to readjust to proper mechanics for squatting, walking, running, sports movements and more.

Looking for help with an ankle?

Look for PhysioNow! We can help with sports injuries, ankle, back, knee, hip pain, and so much more. We have 10 beautiful locations across the west GTA including Burlington, Oakville, Mississauga, and Etobicoke. Our experienced clinicians can answer any questions you have and get you back to feeling and doing great. Find us at P: 289-724-0448 or E-mail: applewood@physionow.ca. Book with PhysioNow today for your first assessment and treatment!

Elbow injuries, Fracture, Fracture Rehabilitation, Fracture Treatment, Physiotherapy

Broken Arm? How to Treat a Distal Humerus Fracture

What is a distal humerus fracture?

A distal humerus fracture is a break near the elbow end of the upper arm bone (the humerus). It is one of the more complex types of broken arm injuries because it affects the elbow joint, which is a highly mobile and delicate structure. When this area fractures, it often involves the joint surface, making the injury more complicated than a mid-shaft arm fracture. Fractures can range from simple cracks to severe, multi-fragment breaks, and this will affect healing time and the need for surgical treatment.

Recovery from a humerus fracture requires proper fracture treatment and guided physiotherapy rehabilitation. Otherwise, your arm will not recover to the level it was at prior to injury. For example, untreated injuries frequently result in a loss of range in the elbow, and greatly reduced strength in the affected arm.

What are the common causes of these fractures?

A fall onto an outstretched hand, commonly referred to as a FOOSH injury, is one of the most common ways to fracture the humerus. It occurs a lot in sports where falling is common, such as roller blading, skateboarding and more
  • Falling directly on the elbow or onto an outstretched hand
  • Road traffic accidents
  • Sports injuries, especially contact sports
  • Weak or fragile bones due to osteoporosis, especially in older adults

What are the typical symptoms?

  • Severe pain and swelling around the elbow
  • Bruising or visible deformity near the joint
  • Inability to bend or straighten the elbow
  • Numbness or tingling in the fingers, hand and forearm if nerves are affected

If you experience these symptoms after a fall or impact, you should seek medical attention for an x-ray right away. Early diagnosis and proper protection of a fracture are essential for effective healing.

How is a distal humerus fracture treated?

The best fracture treatment depends on the type and severity of the injury. Treatment usually falls into one of two categories.

Every suspected fracture will be x-rayed upon arrival to the hospital to determine the location and type of fracture. This will help the doctors determine the next steps of your treatment.

Non-surgical (conservative) treatment

If the fracture is stable or minimally displaced, doctors may recommend immobilization using a cast or brace for several weeks, usually at least 6. This allows the bone to heal naturally while keeping the elbow protected. You will be given some simple range of motion exercises to maintain your shoulder, wrist, and fingers while the elbow heals. After a follow-up x-ray by the fracture clinic, you will be cleared to begin physiotherapy and should start immediately to get the best outcomes.

Surgical treatment

More complex or displaced fractures often require surgery (open reduction and internal fixation). Surgeons use metal plates, screws, or pins to realign and stabilize the bone. Surgery restores joint stability, but physiotherapy afterward is even more important to regain strength and movement.

No matter which approach is taken, starting physiotherapy at the right time is critical to avoid stiffness and recover full function in the arm.

What does physiotherapy look like after a fracture?

Rehabilitation after a distal humerus fracture happens in several key phases. Each phase has specific goals that help your arm recover safely and efficiently.

Phase 1: Immobilization and early healing (0-6 weeks)

Goals: Protect the fracture, reduce pain and swelling, and maintain general fitness as much as possible
Physiotherapy focus (at the fracture clinic):

  • Learn proper sling or brace use
  • Gentle hand, wrist, and shoulder exercises
  • Ice therapy and elevation to control swelling
  • Light isometric (non-moving) muscle contractions to prevent weakness

Phase 2: Early mobilization and strengthening (~6 weeks)

Once your surgeon confirms bone healing through an X-ray, gentle movement can begin
Goals: Regain safe elbow motion and prevent stiffness
Physiotherapy focus (outpatient physiotherapy):

  • Gradual elbow bending and straightening within a pain-free range
  • Gentle forearm rotation exercises (supination and pronation)
  • Continued shoulder and wrist strengthening, gentle forearm, biceps, and triceps strengthening
  • Try to use your hand during normal activities as tolerated, especially if it is your dominant side
  • Manual therapy and soft tissue techniques to reduce stiffness and regain mobility

Phase 3: Strengthening and functional recovery (6–12 weeks)

Goals: Rebuild muscle strength, coordination, and endurance for daily tasks
Physiotherapy focus (outpatient physiotherapy):

  • Active range of motion through full movement
  • Gentle resistance training using light weights or bands
  • Upper limb and shoulder blade strengthening
  • Proprioception (joint awareness) training
  • Gradual return to activities like dressing, typing, and cooking

Phase 4: Advanced strength and return to activity (3–6 months)

Goals: Restore full function, stability, and confidence for work, sports, or hobbies
Physiotherapy focus:

  • Progressive resistance and endurance exercises
  • Sport- or job-specific movement training
  • Weight-bearing and closed-chain exercises for elbow stability
  • Posture and ergonomic guidance for long-term recovery

What challenges can happen during recovery?

Recovering from a distal humerus fracture takes patience and consistent effort. Some common challenges include:

  • Elbow stiffness and a loss of range (usually straightening) caused by scar tissue or long periods of immobilization
  • Weakness from muscle loss during healing
  • Nerve irritation, especially of the ulnar nerve, leading to tingling in the ring and little fingers. Some people recover from this over months to years, some people have permanently altered sensation
  • Fear of movement or anxiety about re-injury leading to lack of use in the arm, stalling recovery

Thankfully, a qualified physiotherapist can help you overcome these issues through a supervised exercise program, manual therapy, and education to rebuild your confidence and function. They will guide you through each step of the process and make a personalized plan that supports your unique goals and situation. If you’re recovering from elbow pain, or a recent fracture, look for PhysioNow! We have many expert Physiotherapists ready to help you recover. We have 10 locations across the west GTA including Burlington, Oakville, Mississauga, and Etobicoke, so please stop in! Alternatively, give us a call at 289-724-0448, or click here to book your first appointment!

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

Foot Care for Runners: Physiotherapy Guidelines

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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!

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

ACL Rehab and Why It’s a MUST After Injury

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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

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.

ACL REHAB
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

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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!

        Shoulder Injury
        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

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        Shoulder Injury

        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

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        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

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        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!