Tag Archives: Sports Injuries

Acute Ankle Sprains

Acute Ankle Sprains

Acute Ankle Sprains

Acute Ankle Sprains

How do Acute Ankle Sprains happen?

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

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

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

Acute Ankle Sprains

Acute Ankle Sprains

What structure gets injured with an acute ankle sprain?

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

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

Are there different types of acute ankle sprains?

There are three main types of ankle sprains:

  • Inversion
  • Eversion
  • High Ankle Sprain

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

INVERSION ANKLE SPRAIN

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

EVERSION ANKLE SPRAIN

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

HIGH ANKLE SPRAIN

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

 

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

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

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

Can there be different severities of Acute Ankle Sprains?

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

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

Ligaments affected in Ankle Sprains

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

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

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

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

What will happen during my first Physiotherapy appointment?

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

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

This will provide some baseline information for your Physiotherapist.

How can Registered Physiotherapy help treat Acute Ankle Sprains?

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

Immobilization

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

Physiotherapy Treatment in the acute phase?

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

Ankle Rotations for movement Recovery

Treatment in the later stages of Acute Ankle Sprains

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

Physiotherapy Mobilizations

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

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

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

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

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

Patellofemoral Pain Syndrome

Patellofemoral pain syndrome

            Patellofemoral pain syndrome

Patellofemoral Pain Syndrome

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

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

Causes of Patellofemoral pain syndrome or Anterior knee pain

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

Common Causes of Patellofemoral pain syndrome

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

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

Symptoms

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

Physiotherapy Treatment

Patellofemoral Pain Syndrome treatment

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

How long it will take to get better?

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

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

How to book an appointment with a Physiotherapist at PhysioNow?

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

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

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

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

TMJ syndrome

TMJ syndrome

TMJ syndrome is broadly classified into 2 syndromes.
The temporo- mandibular joint (TMJ) is the synovial joint that connects the jaw to the skull. These joints are located just in front of each ear.

TMJ syndrome

Classification of TMJ syndrome

TMD is broadly classified into 2 syndromes:
• Muscle-related TMD (myogenous TMD), sometimes called TMD secondary to myofascial pain and dysfunction
• Joint-related TMD, or TMD secondary to true articular disease

Causes of TMJ syndrome

• trauma
• disease,
• wear and tear due to aging
• oral habits, such as chewing gum, tobacco, candy or ice

  • grinding your teeth or clenching your jaw

 

Signs and Symptoms of TMJ syndrome

• Pain in the jaw
• Clicking and popping sound in the ear
• Pain while chewing the food
• Stiff and sore jaw muscles
• headaches

Treatment for TMJ syndrome

general

  • • including heat to the joint,
    • nonsteroidal anti-inflammatory drugs (NSAIDs)
    • avoiding chewing gum, candy, ice, or tobacco
    • stress reduction.

    • wear a mouth guard at night
    • avoid activities that require you to keep your mouth open such as fellatio
    • avoid eating food that is hard to chew such as steak

If you are interested in knowing a bit more about this syndrome, check out this link .

 

Physical therapy techniques for TMJ syndrome may include:

• Jaw exercises to strengthen muscles and improve flexibility and range of motion.
• Heat therapy to improve blood circulation in the jaw.
• Ice therapy to reduce swelling and relieve pain.
• Massage to relieve overall muscle tension.
• Transcutaneous electrical nerve stimulation (TENS),
• Movement of the temporomandibular (TM) joint to release scar tissue that restricts muscle movement and to improve range of motion.
• Ultrasound therapy- to reduce pain and swelling and improve circulation.

If you have any further queries please call PhysioNow. Our experienced Registered Physiotherapists would be happy to help you recover from TMJ syndrome.  There are Registered Physiotherapists at each of our locations that are trained specifically to assess and treat this injury.  Assessment takes about 40-50 minutes and each treatment typically takes about 30-40 mins.  Resolution of TMJ syndrome can be quite rapid with some patients only requiring a few visits for the pain the stop.

Call today!

Heat therapy

Heat and Cold therapy

How it works

When we apply Heat therapy, it improves circulation and blood flow to  that area due to increased temperature. Heat therapy can relax and soothe muscles and heal damaged tissue.

Heat therapy

Types

  • Dry Heat therapy includes sources like heating pads, dry heating packs, and even saunas. This heat is easy to apply.
  • Moist Heat therapy includes sources like steamed towels, moist heating packs, Theratherm heating pads that take moisture from the air, or hot baths. Moist heat may be slightly more effective as well as require less application time for the same results.

Contraindications

  • diabetes
  • dermatitis
  • vascular diseases
  • deep vein thrombosis
  • multiple sclerosis (MS)

 Heat is useful for relieving:

  • osteoarthritis
  • strains and sprains
  • tendonitis, or chronic irritation and stiffness in the tendons
  • warming up stiff muscles or tissue before activity
  • relieving pain or spasms relating to neck or back injury, including the lower back

Cold therapy

How it works

Cold therapy is also known as cryotherapy. It works by Louis- hunting reaction theory. When we apply Ice to an injured site, it reduces the blood flow by vasoconstriction. After some time, it causes vasodilatation and increases the blood flow to the area. This process goes on continuously. This reduces inflammation and swelling that causes pain, especially around a joint or a tendon. It can temporarily reduce nerve activity, which can also relieve pain.

Types of Cold Therapy

There are a number of different ways to apply cold therapy to an affected area. Treatment options include:

  • ice packs or frozen gel packs
  • coolant sprays
  • ice massage
  • ice baths

Cold treatment can help in cases of:

  • osteoarthritis
  • a recent injury
  • gout
  • strains
  • tendinitis, or irritation in the tendons following activity

Contraindications

  • people with sensory disorders
  • uncontrolled diabetes
  • You should not use cold therapy on stiff muscles or joints.
  • Cold therapy should not be used if you have poor circulation.

Here’s a general guide that helps you to decide which to use heat or ice : https://www.healthline.com/health/chronic-pain/treating-pain-with-heat-and-cold#cold-therapy

In General,  use ice for the first few days after an injury.  Beyond that, heat usually does the trick.  There is some evidence that suggests that using ice beyond the first few days can actually slow down injury healing.  It pushes away the healing agents that help you to get better.

If you have been injured and need advice or treatment, please call PhysioNow today.  We are always happy to help!

Benefits of massage therapy 

Benefits of Massage Therapy

There are many Benefits of massage therapy.  Below you will find some of the injuries that benefit most from massage therapy.

  1. Whiplash Injury

    A common injury from a motor vehicle accident, whiplash is a neck sprain resulting from the sudden forces typical of a car crash.

    Symptoms

    • Neck stiffness
    • Headache
    • Dizziness
    • Paresthesia
    • Shoulder, back or arm pain

    Benefits of massage therapy

    Massage therapy can be used for the treatment of both acute and chronic conditions. RMTs can work with a wide variety of patients, of all ages, in the treatment of illness, injury rehabilitation and disability.

  2. Fibromyalgia

    Fibromyalgia is associated with widespread chronic pain, fatigue, memory problems and mood changes. It occurs more often in women than in men. It is not a disease, but rather a syndrome that can be managed.

    • Benefits of massage therapy
    • The first will be relaxation to improve sleep.
    • The second benefit is improved muscle tonicity
    • A fifth benefit is diminishing the effects of any anxiety or depression
  3. Low Back Pain.

    The low back is susceptible to strain because of its weight-bearing function. Connection in movements, such as twisting and bending can cause Low back pain. Muscle strain is caused when muscle fibers are over-stretched or torn. Inflammation is common at the site of injury.  This is usually accompanied by pain with movement.

    Causes

    • Facet joint disease
    • Osteoarthritis
    • Muscle strain
    • Mechanical pain
    • Degenerative disc disease

    Benefits of massage therapy

    Some benefits of Massage therapy for Low Back Pain include the following:

    • Reduced pain.
    • Improved joint mobility.
    • Improving circulation.
    • Improving lymphatic drainage.
    • Reducing muscular tension.
  4.  

  5. Pregnancy

    Massage Therapy performed during pregnancy can:

    • Reduce anxiety
    • decrease symptoms of depression,
    • relieve muscle aches and joint pains,
    • improve labor outcomes and newborn health.

If you or someone you know could benefit from Massage Therapy,  please call PhysioNow. Our highly experienced Massage Therapists would be happy to help you!