Tag Archives: Sports Physiotherapy

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

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!

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.

Ankle pain, Sports Injuries, Sports Physiotherapy

Why is my Ankle Sprain not Healing? Know What’s Wrong

January 7,2025 Sharon Tierney Leave a comment

An ankle sprain is one of the most common injuries. Rest, ice, compression, and elevation, or the RICE rule, will be the go-to’s for ankle sprains. In most cases, ankle sprains heal between 4-12 weeks depending on the severity of the injury. Although the injuries will heal with time, a failure to seek treatment and physical rehabilitation for your ankle after just one injury is enough to leave it weaker. Consequently, this makes your ankle more vulnerable to future sprains or chronic instability. Interestingly, about 20% of ankle sprains are estimated to lead to chronic instability.

What causes you chronic instability after an ankle sprain?

After an ankle injury, there is damage to the ligaments, tendons, and potentially even the ankle joint itself. Here, the function of the ligament is to limit abnormal movement in the joint. Because of the injury, they will get lax (stretched out), making the ankle more unstable. Additionally, this will result in a loss of strength in the muscles, further increasing the instability of the ankle. Also, sensory receptors which communicate to our brain where your ankle is in space become impaired. Ultimately, this decreased sensation alongside structural weakness makes it hard to balance and control the ankle. This leads to chronic ankle instability.

How do you know if you have instability post ankle sprain?

Consider the questions below if you have ever sprained your ankle and feel that it has not been the same since.

• Does your ankle ever give out or feel like it might?
• Do you avoid walking on uneven surfaces out of fear of falling?
• Do you feel like you can’t “trust” the ankle?
• Do you try to avoid putting all your weight onto the affected ankle?

If you said yes to these questions, you may have chronic ankle instability.

Is it permanent?

Chronic ankle instability is not permanent. You can improve your ankle stability with the help of a Physical Therapist and an individualized exercise plan. However, if the injury is left untreated in its instability, it puts the ankle at risk for future injuries such as another tear, strain/sprain, or even a fracture. As a result of this, the first step to treatment will be a proper rehabilitation program with guidance from a health professional.

How is chronic instability treated?

Physical Therapists are the first step in the conservative management of chronic ankle instability. Due to loss of strength and proprioception, rehabilitation is very important. They perform a complete assessment of your ankle range of motion, strength, and balance assessing for any laxity or abnormalities, and guide you through the management.

Exercises re-strengthen the muscles, increase ankle stability and balance, and retrain the body awareness of the ankle. Moreover, Brace and/or taping may be recommended to support the stabilization of the ankle, especially for individuals who are engaged in high-risk activities like sports.

Finally, where conservative options are failing and the instability continues to be persistent, surgery may be an option. These surgical options usually involve repair or reconstruction of lax ligaments, or a tightening of the capsule around the ankle joint.

What happens if your ankle sprain and injury are left untreated?

Unfortunately, the instability may worsen over time and you will have a much greater risk of reoccurring injuries. In addition, it results in damage to the bones and cartilage within your ankle joint as the muscles weaken and fail to sufficiently support the joint. Therefore, it is highly recommended that you seek treatment from an expert to treat the issue before it results in a severe injury.

If you are having any instability or weakness with your ankle, which is stopping you from pursuing any hobbies, book with PhysioNow today for an initial assessment and treatment. We have a team of highly qualified Physical Therapists that will be able to help your ankle recover!

ACL Rehabilitation, ACL Tear, Sports Injuries, Sports Physiotherapy

ACL Rehab: How to Improve your Knee

December 17,2024 Sharon Tierney Leave a comment

ACL rehab is very important for you to get back to your normal life as well as your athletic activities. Frequently, sports injuries lead to pain, inflammation, and instability in the knee that can interrupt your daily life. However, working alongside a Physiotherapist, you will be able to recover and participate in physical activities again.

How does an ACL Injury occur?

The most common mechanism of injury is non-contact, such as a twist on a planted foot, coming down badly from a jump, or a sudden stop. Usually, ACL tears are very common sports injuries such as in soccer, volleyball and more. Due to the nature of these sports, both fast paced and with lots of quick direction changes, it increases the risk of an ACL injury. Alternatively, ACL injuries may happen traumatically, with a direct force against the lower leg. As may be expected, these are more common with contact sports such as rugby and football.

What are the signs symptoms of an ACL tear?

Feelings of instability or giving out of the knee
Difficulty with weight bearing activities such as walking, stairs, squatting
Pain in and around the knee
Weakness and atrophy of the muscles around the knee
If other structures are involved, locking of the knee in a certain position

Is surgical repair required?

Surgical repair may be needed for a fully torn ACL depending on the severity of the injury and level of physical activities you want to return to. In both surgical and non-surgical cases, rehabilitation with a skilled Registered Physiotherapist is essential to recovery.

Custom knee braces for ACL rehabilitation

Custom Knee Brace

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 swelling around your knee is managed. These are very sturdy braces that can allow you to return to all or most of your previous activities without surgery. A Custom Knee Brace provides and substitutes as the support for the torn ACL ligament. 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 Burlington, Oakville, Mississauga, and Etobicoke.

How can physiotherapy help after an ACL tear?

Primarily, the role of physiotherapy after an ACL tear is:

Pain control
Restore range of motion to the knee
Strengthen the affected muscles
Improve balance and motor control of the knee
Improve power, coordination, and speed in the context of your sport

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 rehabilitation.

Exercises will focus mainly on:

Strengthening quadriceps, hamstrings and gluteal muscles
Proprioception techniques (you will likely lose some of your natural ability to balance after an ACL tear)
Improving mobility of the joint and stretching muscles around the knee

Possible ACL REHAB Exercises

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

Looking for help with your ACL rehab?

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, please contact PhysioNow today!

Athletic Therapy, Physiotherapy, Sports Injuries, Sports Physiotherapy

Hamstring Strains and the Young Athlete

November 7,2024 Sharon Tierney Leave a comment

Hamstring strains are a common injury among young athletes, particularly in sports that involve sprinting, jumping, or sudden changes in direction. Importantly, the hamstrings, a group of muscles located at the back of the thigh, play a crucial role in movement and stability. When these muscles are overstretched or torn, it can lead to pain and functional impairment, impacting a child’s ability to participate in sports and other activities.

Causes of Hamstring Strains in Young Athletes

Hamstring strains are usually a result of an injury at a particular moment in time. It can be a fall, or an awkward movement that causes excessive stress and/or overstretching in the muscle. As a result, you get a strain or tears in the muscle fibres. Several factors contribute to the risk of hamstring strains in children:

Overuse and repetitive stress: Young athletes often push themselves during practices and games. Consequently, overtraining without adequate recovery can lead to muscle fatigue which increases the likelihood of injury
Insufficient conditioning: Many kids may not engage in structured strength training or flexibility exercises, making them more vulnerable to strains. A strong, well-conditioned muscle is less likely to be injured
Poor technique: Inexperienced young athletes might have proper form for their sport’s movements which can place excessive strain on the hamstrings. Thus, teaching proper techniques from an early age is essential for long term injury prevention
Fatigue: As children tire during a game or practice, their muscles can become less coordinated and more susceptible to injury. Fatigue can reduce a child’s awareness of their body, leading to poor movement choices
Previous Injuries: A history of hamstring injuries can predispose young athletes to future strains due to weakened muscles or improper rehabilitation

Symptoms of Hamstring Strain

Recognizing the symptoms of a hamstring strain is crucial in order to treat it as soon as possible:

Sudden pain: Often described as a sharp pain at the back of the thigh, occurring during activity
Swelling or bruising: Visible swelling or discoloration may develop in the affected area, depending on the severity of the strain. Additionally, it may travel farther up or down the leg than the area of pain
Limited range of motion: They may struggle to fully extend or flex the knee due to pain and stiffness
Weakness: Difficulty running, jumping, or performing activities that require the leg to straighten. In severe cases, you may have trouble putting weight on the leg or walking

Treatment Strategies

When a hamstring strain occurs, prompt treatment is the key to quick recovery:

Rest: The injured athlete should avoid activities that cause pain. Depending on the severity, rest is usually for a couple days but the modification or avoidance of sports and physical activity may last longer
Ice: Initially, for the first couple of days post-injury. Applying ice packs to the injured area for 15-20 minutes every few hours can help reduce swelling and numb pain
Compression: Using an elastic bandage or compression wrap can minimize swelling and provide support
Elevation: Keeping the leg elevated above heart level can help reduce swelling
Physical therapy: Once the initial pain subsides, physical therapy may be beneficial. A physical therapist can design a rehabilitation program that includes strengthening and stretching exercises tailored to the child’s needs.
Gradual return to activity: Physical Therapists can also assist with return to sport planning and decide when and how much is appropriate. Athletes should ease back into their sports gradually, starting with light activities before progressing to more demanding exercises and games.

Prevention Strategies

Preventing hamstring strains is vital for young athletes. Implementing the following strategies can significantly reduce the risk:

Proper warm-Up: Encourage kids to engage in a thorough warm-up that includes dynamic stretches and light aerobic activity before practices or games
Strength training: Incorporating strength exercises focused on the hamstrings, quadriceps, and core can help improve overall muscle balance and stability
Flexibility exercises: Regular stretching routines can enhance flexibility, making muscles less prone to injury. Static stretching should be included in the cool-down phase after activity
Education on technique: Coaches should emphasize proper running and jumping techniques to reduce undue strain on the hamstrings
Adequate rest and recovery: Ensure that young athletes have sufficient recovery time between practices and games to allow their muscles to repair and strengthen

When to Seek Medical Attention

If a child experiences severe pain, significant swelling, or if symptoms do not improve with home treatment, it is important to consult a healthcare professional. A doctor may recommend imaging tests, such as an Ultrasound or X-Ray to assess the extent of the injury and develop a comprehensive treatment plan.

Hamstring strains can pose significant challenges for young athletes, affecting their performance and enjoyment of sports. If you or your child are experiencing a hamstring strain or any other kind of sports injury, look for PhysioNow. With 10 locations across the GTA, our Registered Physiotherapists are ready to assist you in getting healthy again! Book with PhysioNow today for your first assessment and treatment.

_{Photos by FreePik}

Foot Pain Treatment Mississauga, Sports Injuries, Sports Physiotherapy

Turf Toe: Recovering From Your Sports Injury

July 16,2024 Sharon Tierney Leave a comment

What is turf toe?

Turf toe is a type of sports injury that occurs in athletes with a lot of pushing off or changes in direction in their sport. Anatomically, turf toe is a hyperextension injury of the joint of the big toe. Essentially, the toe is forced past its normal range of motion. Unfortunately, this results in injury of the joint and tissues around it.

How does it happen?

The big toe is one of the most important joints for generating speed and power in our lower body. When we land on or push off from a surface, the big toe is often the first or last point of contact. As a result, it undergoes a high amount of force. Injury can happen due to:

Turf toe — _{Some studies found a higher incidence of turf toe with players who played on artificial turf}

Sports with quick starts/stops and changes in direction: This happens in a lot of sports like basketball, football, soccer, lacrosse, field hockey, and more.
Inappropriate footwear: Having a pair of ill-fitting or overly flexible shoes can increase the risk of the toe being hyperextended
Type of terrain/playing surface: The name turf toe comes from increased chance of this injury occurring when playing on artificial turf.

What are the signs and symptoms?

Pain around the big toe
Big toe joint is sore and tender to the touch
Pain with movement of the big toe or with pressure on it
Joint may be swollen, red, bruised
Difficulty walking or running

How is it treated?

In the acute stages, turf toe can be treated with the RICE principle and it is recommended and safe to start sports physiotherapy as soon as possible.

RICE
- Rest: Modify your activities to include less weightbearing and avoid putting pressure on the joint as much as possible to give the joint time to heal
- Ice: For 24-48 hours after the injury, applying ice can help manage the pain, swelling, and inflammation in the area
- Compression: Applying compression to the injured toe can help limit the swelling in the joint.
- Elevation: Keeping the foot elevated as much as possible will help stop fluids from pooling in the leg and creating uncomfortable amounts of swelling
Sports physiotherapy
- Physiotherapy is an essential part of getting you back to your sport as soon as possible and as safe as possible.
- Modalities: For example, ultrasound, cryotherapy, laser therapy, or electrotherapy may be used to help with tissue healing, inflammation, and pain relief.
- Manual Therapy: Your physiotherapist may use manual techniques like joint mobilizations, massage and more to help reduce stiffness, increase your range of motion, and reduce pain.
- Exercises: Eventually, when your joint has healed enough you can start exercises. Your physiotherapist will help you determine an appropriate place to start. Additionally, they will tailor the exercises to your specific sport, and assess your movements to see if there are any deviations that may be increasing your risk of injury.
- Back to play advice: Your physiotherapist will give you suggestions on how to go back to your sport safely. For example, you will not be able to jump back into play 100% at first, it may start by having you attend some shorter practices before eventually playing in some games.

Need help?

If you are experiencing a turf toe or any other kind of injury, look for PhysioNow! With locations across the GTA from Burlington, Oakville, Mississauga and Etobicoke, our expert physiotherapists are at your service. Book with PhysioNow today for your first assessment and treatment.

Achilles tendon, Heel Pain

Physio 101: Achilles Tendinopathy

July 8,2024 Sharon Tierney Leave a comment

Achilles tendinopathy is a common condition that affects the Achilles tendon, which connects the calf muscles to the heel bone. This tendon plays a crucial role in walking, running, and jumping, making it essential for various physical activities, especially high intensity ones. Achilles tendinopathy can be significantly painful and uncomfortable and disrupt not only your athletic performance but daily life as well. In this blog, we’ll explore the causes, symptoms, and treatment options for Achilles tendinopathy.

What Causes Achilles Tendinopathy?

Achilles tendon stages and progression from a normal tendon, to tendinitis, to tendinosis, to potential rupture

Diagram showing the different stages of Achilles tendon problems

Achilles tendinopathy occurs when the Achilles tendon is subjected to repetitive stress and overuse. For example, Several factors can contribute to this condition including:

Repetitive movements and overuse – Firstly, engaging in activities that involve repetitive motion, such as running, jumping, or intense physical training, can lead to micro-tears in the tendon.
Sudden increase in activity level – Rapidly increasing the intensity or duration of physical activity without adequate preparation can strain the Achilles tendon. Alternatively, starting a new training regimen without proper load management can also contribute to the issue.
Improper footwear – Wearing shoes that lack proper support or cushioning can increase the strain placed on the tendon
Biomechanical issues – Abnormal foot mechanics, such as flat feet or high arches, can place additional stress on the Achilles tendon.
Age and degeneration – Naturally, as people age, the Achilles tendon can become less flexible and more prone to injury due to natural age-related changes

Signs and Symptoms

The symptoms of Achilles tendinopathy can vary depending on the severity of the condition. However, the most common signs and symptoms include:

Pain and Stiffness – Pain is typically felt along the back of the leg near the heel. Most often, it is more pronounced in the morning or after periods of inactivity.
Swelling and tenderness – The affected area may become swollen and tender to the touch.
Restricted mobility – Flexing the foot or standing on your tiptoes may be difficult due to pain and stiffness in the area

Diagnosis

A healthcare professional like a physiotherapist will typically diagnose Achilles tendinopathy based on a physical examination and your subjective report of your experiences. Imaging tests, such as ultrasound or MRI, may be used to assess the extent of the tendon damage if deemed necessary.

Treatment

Shockwave therapy has shown to be effective treatment in Achilles tendonitis

Treatment for Achilles tendinopathy focuses on reducing pain, promoting healing, and preventing further injury. Here are some effective treatment options:

Rest and activity modification: Reducing or avoiding activities that make the pain worse is crucial. Switching to low-impact exercises, such as swimming or cycling, can help maintain fitness without putting excessive stress on the tendon while it heals.
Ice and compression: Applying ice packs to the affected area and using compression bandages can help reduce swelling and pain in the acute stages.
Stretching and strengthening: Physical therapy exercises that focus on stretching the calf muscles and strengthening the Achilles tendon can aid in recovery. Eccentric exercises, where the tendon is lengthened under load, are particularly beneficial.
Orthotics and Proper footwear: Wearing supportive shoes and using orthotic inserts can help alleviate pressure on the Achilles tendon.
Shockwave Therapy: This non-invasive treatment uses shockwaves to stimulate healing in the tendon. Clinical research supports the greater benefits with shockwave combined with physical therapy.
Surgery: In severe or chronic cases that do not respond to conservative treatments, surgical intervention may be necessary to repair the damaged tendon. This is usually a last resort, and many patients recover through conservative treatments under the guidance of a physical therapist.

Need help with Achilles tendinopathy?

If you suspect you may have Achilles tendinopathy or are experiencing any kind of ankle or pain, look for PhysioNow. We have many experienced Physical Therapists who would love to help you out. With 9 locations across the GTA including Burlington, Oakville, Mississauga and Etobicoke, you can get help fast. Book with PhysioNow today for you first assessment and treatment!

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

Marathon Training: 8 Tips to Keep You Injury-Free

June 18,2024 Sharon Tierney Leave a comment

So you’ve decided to be part of the 1% that completes a marathon, an incredible achievement! Training for a marathon is demanding on both your physical endurance and mental resilience. One of the most common dangers comes from experiencing a sports injury during your training. This could be overuse injuries, strains, sprains, and more. Ultimately, these can hinder your progress and even affect you on race day itself. To help you keep your body as healthy as possible, here are some essential tips to avoid sports injuries while training for a marathon:

1. Start Slow and Build Gradually

Tip: Avoid the temptation to ramp up your mileage too quickly. Gradually increase your weekly mileage, and it is best to follow a structured program to avoid overtraining.
Why: Rapid increases in mileage or intensity are the most common cause of overuse injuries such as stress fractures, tendinitis, shin splints and more. Your body needs time to recover and adapt to the new loads you are placing on it.

2. Listen to Your Body

Tip: Pay attention to any signs of pain, discomfort, or fatigue. Don’t ignore persistent pain or push through it, it’s a sign that something may be wrong and need attention
Why: Ignoring pain or pushing through discomfort can make injuries and lead to longer recovery times. Additionally, addressing it early can save you weeks of pain and frustration.

3. Warm Up and Cool Down Properly

Tip: Always start your runs with a dynamic warm-up to increase blood flow and flexibility in your muscles. After your run, perform some stretches and easy mobility movements to cool down and improve flexibility.
Why: Proper warm-up and cool-down routines reduce the risk of muscle strains and improve overall flexibility and range of motion.

4. Implement Cross-Training

Tip: Incorporate strength, mobility, agility and other exercises into your routine. Cross-training activities like swimming, rowing, or cycling can your running muscles a break.
Why: Strengthening supporting muscles and varying your workouts helps prevent overuse injuries while still improving overall cardiovascular fitness

5. Good Footwear

Tip: Wear proper running shoes that fit well, are comfortable, and support your foot. Replace your shoes regularly as they wear out.
Why: Ill-fitting shoes or worn-out gear can lead to foot injuries, shin splints, and other issues that may impact your training.

6. Stay Hydrated and Eat Well

Tip: Hydrate properly before, during, and after your runs. Maintain a balanced diet that supports your training regimen, including adequate protein and carbohydrates.
Why: Your body is burning a lot more energy now and needs the proper fuel to function at its peak performance

7. Rest and Recovery

Tip: Schedule rest days into your training plan to allow your body to recover and repair. Incorporate some deloading or lighter weeks to prevent burnout and overtraining.
Why: Rest is essential for muscle repair and growth. Overtraining increases the risk of injuries and can compromise your overall performance.

8. Seek Professional Guidance

Physiotherapists and can assist with sports injuries

Tip: If you’re new to running or have specific concerns about your training, consider consulting a professional like a physiotherapist.
Why: Professional guidance can help you develop a personalized training plan, correct your form, and address any underlying or current issues.

By following these strategies, you can reduce the risk of sports injuries and increase your chances of crossing the marathon finish line! If you are experiencing some pain while running, look for PhysioNow. We have many expert physiotherapists that would be happy to help you with your sports injury. Book with PhysioNow today for your first assessment and treatment. Happy running!