Tag Archives: Sports Physiotherapy

Exercise, Hip Pain, Knee Pain, Physiotherapy, Running

Runner’s Knee: How to Keep Yourself in Running Shape

It’s a dull, aching pain around your kneecap that you can’t quite touch. Runner’s knee, or clinically known as patellofemoral pain syndrome (PFPS), is a very common cause of knee pain. The good news is, it us very treatable especially if you catch it early. In this blog, we’ll break down what runner’s knee is, how it happens, and tips to avoid it whether you’re gearing up for a marathon of just getting into running.

What is runner’s knee?

Runner’s knee isn’t as specific of a diagnosis as say, a hamstring strain. It is an umbrella term for pain where the patella (kneecap) and the femur (thigh bone) meet and form a joint. Normally, our patella sits in a little groove on the femur, and slides up and down like a track. However, different forces can act on the patella, like a muscular imbalance or improper form, that causes it be pulled off track. This creates extra friction in the area which can lead to irritation, inflammation, and pain.

What are the symptoms of it?

  • Dull pain in the knee, usually for the first couple minutes of exercise or after exercise
  • Increased pain when walking downhill or down stairs
  • Pain after sitting with the knee bent for long periods of time
  • Grinding, popping, clicking in the knee

How does it happen?

Your knee alignment while you’re running or exercising can be a major factor in developing runner’s knee. A professional like a Physiotherapist will assess your whole body to determine the cause of the knee pain.

Usually, 1 of 2 things happens or a combination of both.

  1. Too much, too soon. You’ve recently increased your running mileage or intensity, and your body is not yet used to the new workload. The tissues in your body get overloaded, leading to injury and pain.
  2. Biomechanical imbalances. This causes tracking issues at the knee cap. Commonly, the hip stabilizer muscles are not activating well, causing the knee to fall inwards (aka valgus) when you put weight on the leg. In other cases, the foot collapses inward (aka flat feet or overpronation), creating a similar result. In either case, the patella is being pulled out of alignment which with repetition, can develop into a runner’s knee.

Tips for prevention of runner’s knee

Smart training habits can keep you out of trouble. First, follow a 5-10% rule when ramping up. As you increase your mileage, you should not increase by more than 5-10% from the previous week’s mileage. A gradual progression gives your body time to adapt, decreasing the risk of overuse injuries.

Secondly, make sure your footwear is in tip top shape. Recommendations include keeping a rotating set of 3 shoes to prevent wearing out too quickly, and to switch them out every 500-800 km. Over time, the shock absorption capabilities of your shoes will decrease, so keeping them fresh also helps to keep your joints healthy.

Third, a running assessment can be helpful if you notice irregularities in your gait. A trained professional like a Physiotherapist can watch your run pattern to see if it’s contributing to your pain. For example, factors that can be adjusted include position of the foot during heel strike, step length, correction of valgus or pronation, trunk position and more. Longer steps tend to put more force on the knee cap, and a Physiotherapist can help you make the required changes.

Finally, build in some cross training days. Don’t skip out on your strength training, strong muscles are resilient muscles. Additionally, don’t be afraid to give your joints a break while keeping your cardio up by hopping onto a bike for some sprints, or a treadmill for some incline walking. Cross training helps to give your commonly used running muscles a break while still being able to make progress in your training.

How is runner’s knee treated?

In a flared up runner’s knee, you will need to take some time off. If you jump on one leg and feel a sharp pain that you would rate a 4/10 or above, it’s your body’s sign to take a rest. Continuing to push through will only succeed in worsening the pain. Follow the principles of RICE (rest, ice, compression, elevation).

A Physiotherapist will help you assess the root cause of your knee pain, remember it can come from different sources even though the pain is happening at the knee. They will also give you rehabilitation exercises to start retraining your knee, and the associated muscles at the hip or ankle that are contributing to the issue. For example, teaching you glute activation and strengthening exercises, and how to keep the knee in good alignment while performing single leg activities. Other interventions will include manual therapies on the joint, soft tissue releases for tight muscles, and a personalized home plan including your rehab exercises and a back to run plan.

Need help with a knee pain or a runner’s knee?

Look for PhysioNow! We have expert clinicians ready to help you get back on track. We have 10 locations across the West GTA including Burlington, Oakville, Mississauga and Etobicoke. Whether it’s a new or old pain, rest assured you can find help here. Book with PhysioNow today for your first assessment and treatment of knee pain!

Ankle pain, Exercise, Health and Wellness, Knee Pain, Physiotherapy, Sports Injuries, Sports Physiotherapy

Soccer Muscle Strains: Can They be Prevented?

Most of us have experienced a muscle strain at some point in our lives. It might have been after running too fast, changing directions quickly, picking up something too heavy. Muscle strains, especially in the hamstring, groin and calves, are common occurrences for soccer players. What about soccer stretches these muscles to and beyond their limits?

Why do soccer players experience muscle strains?

Muscles are composed of many different fibres that work together as a unit. Muscle strains occur when muscle fibres get overstretched or experience too much force. Due to the nature of soccer, these movements happen regularly.

For example, the quick starts, stops, and pivots all require muscles to be firing at full blast to generate and resist huge amounts of power. As these changes have to occur in split seconds, the muscles have to absorb then create this power in a very short amount of time, and repetitively over the course of the game. Additionally, the muscles will fatigue over time, reducing their capacity. All it takes is one moment for a muscle strain to happen.

Breaking down a soccer kick

At the finish of the kick, the hamstring has to put the brakes on the leg. The more powerful the kick, the more powerful the braking force has to be.

Muscles are the most vulnerable when there is a huge force going through them while they are lengthening. Let’s take a soccer player kicking a ball as an example. You may have seen someone kick a soccer ball hard, and then immediately grab the back of their leg as they feel a “pop” in the muscle. This is the muscle strain occurring. But what happened?

Your hip flexors and thigh muscles (quads) generate a big force to move your leg forwards and produce the kicking motion. But what happens to all that force? Where does it go after kicking the ball? Why does our leg stop instead of just continuing up and forwards? The answer is the hamstrings have to actively oppose the movement to slow the leg down. This scenario is exactly what we mentioned about where the muscles are the most vulnerable. The leg is straightening quickly during the kick, meaning the hamstrings are getting longer while also having to contract to stop the leg. If the hamstrings aren’t strong enough to oppose the kick, muscle damage will occur.

Can muscles strains be prevented?

We can never reduce the risk to absolutely 0, but yes, we can significantly reduce the chances of an injury happening! Sports physiotherapy is dedicated to not only treating sports injuries, but preventing injury in the long term as well. The general principles of prevention training include:

  1. Eccentric training: Muscles get strong specifically in the way we train them. Using our hamstring still as an example, this muscle normally bends our knee. A typical hamstring curl focuses on the bending phase. Eccentric training focuses on strengthening while the muscle is lengthening, or while the knee is straightening. In other words, we are teaching it to resist force as well as to generate it. This can include exercises like Nordic hamstring curls or eccentric focused Romanian deadlifts (RDLs)
  2. Dynamic warm ups: Before playing, a proper warm up has been scientifically proven to reduce the risk of injuries. It preps the nervous system and muscles for better movement patterns and body awareness. Specifically for soccer players, Fifa has developed a research-backed program to keep athletes healthy and at the peak of their game. Read more about the Fifa 11+ program here.
  3. Cross training: As with any activity, too much of one thing can be harmful. The repetitive stress on a muscle group can lead to an overtraining effect and put you at risk of an overuse injury. A well-rounded program will include strength and conditioning to ensure sufficient muscle strength, and other forms of cardiovascular activity other than running to give the lower body a break.

What happens if I get a muscle strain?

If you do get a muscle strain, it’s not the end of the world. Most muscle strains can be healed conservatively and return to play with no issues. Timelines of healing range from weeks to a couple months depending on how severe the strain is. Because the severity can vary so much and muscle strains are very easily made worse or reoccuring with improper care, we highly recommend seeing a Sports Physiotherapist to assess your injury. Based on specific tests, they can determine the grade (I-III from least to most severe) of your injury, provide personalised advice on how to take care of it, and what you should and shouldn’t do.

Looking for help with a sports injury or soccer muscle strain?

Look for PhysioNow! We have 10 locations across the west GTA including Burlington, Etobicoke, Mississauga and Oakville. All our clinicians are experts in rehabilitative care and offer services in Massage Therapy, Physiotherapy, Manual Osteopathy and more! Don’t miss out on anymore of your season and get back to doing what you love fast with PhysioNow. Book here today for your first assessment and treatment!

Achilles tendon, Knee Pain, Physiotherapy, Sports Injuries, Sports Physiotherapy

Post Tournament Fatigue and Overuse Injuries

With the World Cup in full swing, the soccer season is in full swing. Even if you’re not a professional athlete, whether you’re playing in a league, drop in, or registering for a friendly tournament, you should always be on the lookout for overuse injuries. Most of us are familiar with that bone-deep fatigue after the final whistle blows or the timer hits 0, and the adrenaline comes to the end. It’s that legs shaking feeling, a pain that you didn’t notice or were able to ignore before that we call a post-tournament or post-game fatigue. In this blog, we’ll break down why your body feels this way, what it means to you, and how to take proper care of yourself so you don’t have to watch from the sidelines with an injury.

What is post-tournament fatigue?

Tournaments require a lot from your body, asking you to play at your peak several times in quick succession. This leaves your body without a lot of rest time to repair, resync, and replenish. That drained state happens because of:

  1. Nutrient depletion: Playing requires a lot of fuel, which comes from calories. Our body’s main source of fuel is stored carbohydrates and over the course of an intense series of games, the body’s storage can be depleted
  2. Muscle micro-tears: High intensity movements like sprinting, kicking, and jumping sends a lot of force through our muscles, causing micro tears. These micro tears are a normal part of training and how the body learns to adapt and build itself stronger. The issue comes when there is a huge increase in the volume of play, such as during a tournament. As your muscles accumulate all this damage without sufficient time to repair itself, they get less efficient and the risk of injury increases.
  3. Central nervous system fatigue: Just like our muscles, our nervous system can actually fatigue as well. Research has shown that the fatigue is associated with the neurotransmitters (chemical messengers) in the brain. Ultimately, the result is reduced physical performance and even brain fog.

What are overuse injuries?

Unlike an acute injury like a muscle or ligament strain, overuse injuries sneak up on you over time. They may start as just a mild nagging pain that comes and goes, then gradually becomes more frequent or more intense over time. If not treated early on, they can develop into bigger issues that affect your daily life and ability to play. Another name given to overuse injuries is repetitive stress injuries.

An easy way to think about it is that the demand (what you’re asking the tissue to perform) is overloading the supply (what your tissue is capable of). Like a rope that is supporting too much weight, it starts to fray and break. Thankfully, with the right training, overuse injuries can be caught early on and prevented.

How do I spot an overuse injury?

Overuse injuries tend to follow similar patterns even if the body parts can be very different:

  • Timeline of pain: Some muscle soreness, known as DOMS (delayed onset muscle soreness) is normal 24-48 hours after exercise. If there has been a recurrent or consistently present ache, stiffness, or discomfort, it is likely the start of an overuse injury
  • Warm-up pain: Usually worse after waking up, sitting for a long time, or first starting a workout. After moving around for a bit the pain goes quickly goes away, then may return worse in a couple of hours
  • Pinpoint pain: In a lot of tendon conditions, people are able to directly point towards the source of their pain. When that spot is pressed, it recreates their pain
  • Compensatory movements: If you’ve noticed that your running gait, the way you swing your racquet, or your overall performance has decreased, that could be a sign of general fatigue or an overuse injury in the making

What are the most common soccer overuse injuries?

Diagram depicting patellar tendinitis with the patellar tendon highlighted in red to show inflamation
  • Patellar tendinopathy: Also known as Jumper’s Knee. This is an overuse injury of the patellar tendon right below the knee cap. Constant sprinting, stopping, jumping puts a lot of pressure on this tendon. Most people will have a warm up pain and find it hard going down stairs
  • Achilles tendinopathy: The Achilles tendon is one of the strongest tendons in our body that helps us to generate and accept force through our ankles and feet. Most people complain about pain when doing anything high impact such as jumping or jogging
  • Shin splints: Your shin bone (tibia) and the surrounding musculature can become inflamed from repeated high impact stress. If left untreated, shin splints can turn into stress fractures.

How should I take care of myself after a tournament?

The immediate 48 hours after should be relatively restful. Light gentle active recovery such as walking and stretching are great to help blood flow and recovery, without contributing excess pressure to already compromised tissues. Lots of sleep, hydration, nutrition and sleep is essential during this stage.

Afterwards, if there are any pains lasting or sharp pains present, a rehabilitation plan should be considered with Physiotherapy to address them. Overuse injuries are always easiest to heal the earlier you address them. When you let them progress, you run the risk of it becoming a more serious issue and might even have to take time off from your sport. Pushing through is not always the solution.

A Physiotherapist can help you identify any weak points in your training, muscle compensations, faulty movement patterns, and more. They will use various treatment methods including manual therapy, therapeutic exercises, modalities like shockwave therapy and more depending on your unique circumstances.

Dealing with a stubborn overuse injury?

Don’t wait any longer, come to PhysioNow to get started on your recovery. Summer is flying by fast and we want you to make the most of your soccer season and stay away from any other sports injuries. We have 10 locations across the West GTA including Burlington, Oakville, Mississauga, and Etobicoke. Book with PhysioNow today for your first assessment and treatment! Or contact us at Email: applewood@physionow.ca or Phone: 289-724-0448 for more information.

ACL Rehabilitation, ACL Tear, Acute Ankle Sprains, Physiotherapy, Sports Injuries, Sports Physiotherapy

Soccer Injury Rehab: A Physiotherapy Guide

Soccer is a demanding sport. The quick sprints, sudden pivots, and powerful kicks that make the game exciting also put a lot of stress on your body. As the weather starts to warm up in the GTA, we know more of you will be getting outside and returning to the field. As a result, we always expect to see more injuries during this time, especially for our soccer players. Here’s what you need to know about soccer injury rehab, and how to stay off the sidelines this spring and summer.

Why do injuries happen at the start of the season?

Cleats are specifically designed for traction and structural support. Depending on your level of play, you may need to switch them out every 6-12 months

Understanding why injuries happen is important to preventing them. Injuries usually stem from mechanical overload (too much force at one moment), training overload, (too much activity over time), pre-existing imbalances and injuries, and improper gear or technique. Let’s discuss each one briefly.

  1. Mechanical overload
    • Soccer has a lot of high speed movements like kicking and sprinting. In these movements, huge amounts of force are generated in the tissues in a very short amount of time. Because of this, this is often where they are the most vulnerable to strains and sprains.
  2. Training overload
    • In other words, doing too much, too soon. If you go from the couch to a 90-minute match without a progressive build-up, your tissues might not be ready for the load
  3. Muscular imbalances and old injuries
    • It could be as simple as an old twisted ankle that you never rehabbed. As a result, it’s not as stable or strong as it should be, leaving it and other areas vulnerable to injury
  4. Gear and technique
    • Having ill fitting or worn out shoes can increase the risk of falls, slips, and other traumas. Having improper technique such as with kicking the ball can put excessive strain on muscles and joints.

What are the most common soccer injuries?

Because soccer involves constant change of direction and explosive movements, most injuries affect the lower body. Here are the most common ones that we see in the clinic:

  • Ankle sprains: Usually caused by rolling the ankle on uneven turf
  • Hamstring strains: Often happen during a full-out sprint or a high kick
  • ACL Tears/Knee sprains: These frequently occur from a sudden pivot or change in direction.
  • Groin pulls: Common when changing direction quickly or reaching for a ball.
  • Shin splints: An overuse injury often felt by players increasing their duration of play or playing on hard surfaces.

Soccer injury rehab and prehab

Physiotherapy doesn’t just tell you to rest and ice. It can help even before you’re injured in a new mindset known as prehab.

What is prehab?

The best injury to treat is the one that never happens. Prehab, short for prehabilitation involves:

  • Screening: Identifying your specific movement impairments to address areas of risk
  • Strength & balance: Building “bulletproof” joints that can resist common injury patterns
  • Sport specific drills: Improving your body’s ability to decelerate, pivot, and other soccer techniques

What is rehab?

Soccer injury rehab ensures full return of speed, power, agility, strength, and coordination.

If you’re already hurt, we focus on a phased return to play. We aim to get you back as quickly and as safely as possible. There is no reason to rush a return if it will only result in another, and potentially more severe injury.

  • Phase 1: Pain management: Using manual therapy, heat, ice, and gentle movement to reduce swelling and regain range of motion
  • Phase 2: Loading: Gradually introducing weight and resistance to the injured tissue so it learns to handle stressors again
  • Phase 3: The final push: This is where we get sport-specific. We’ll have you sprinting, jumping, and kicking in a controlled environment to ensure you’re 100% ready for game day.

Need help with soccer rehab or a sports injury?

Then look for PhysioNow! We have an expert team of health professionals ready to help you get back into the game. Whether you’re preparing for the season or looking to rehab an injury prior to starting, we’ve got you.

We have locations at 10 clinics across the West GTA including Burlington, Oakville, Missisauga, and Etobicoke. With extended evening hours, Saturday hours, and free parking, we make sure that our clinics are accessible for everyone. Don’t let your pains stop your participation this summer, get it treated fast! Book with PhysioNow today for your first assessment and treatment! Or find us at P: 289-724-0448 or Email: applewood@physionow.ca

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!

Knee Pain, Performance, Physiotherapy, Sports Injuries, Sports Physiotherapy

Training Tips: Leg Extension vs Squats

What’s the difference between leg extension and squats, and which ones better for you?

If you find are an avid gym goer yourself, you’ve probably heard some version of this argument. When discussing leg workouts, there is much debate surrounding the importance of leg extension versus squat movement. Although both of these exercises can be performed in a gym setting, they provide different results based on how each exercise incorporates various types of movement patterns into your workout regimen. 

Breaking down leg extensions vs squats

Let’s begin with understanding the basis of these two exercises.

Man performing a barbell squat to show involvement of multiple muscle groups
Woman performing leg extension on machine to demonstrate the quad isolation of the movement

Leg extensions are a targeted movement for the quads (your big thigh muscles), providing an extremely isolated contraction. In this context, isolated means that the quads are the only muscles performing major work, the other muscles groups contributions are minimal. Consequently, the result is a complete and intense contraction of your quads at the end of each rep. If you want to develop a teardrop shape in your quad muscles, leg extensions are a great exercise to add to your routine.

On the flip side, squats are the undisputed king of compound movements. They engage your entire lower body and core, making them the perfect exercise for building overall strength and functional fitness. Plus, squats are just plain awesome for building those glutes and hamstrings, in addition to quads. Because of this difference, leg extension and squat exercises cannot replace one another and serve different purposes in your leg training program.

Comparing the pros and cons of leg extensions vs squats

The benefits of leg extensions are their ease of use and isolation. Leg extension machines require little balance and coordination since the movement is machine guided and non-weight bearing (seated). Thus, leg extension devices are excellent for beginners or after an injury (rehabilitative) if prepared correctly. Leg extensions enable direct overload of the quadriceps without the involvement of other muscle groups and can help to correct imbalances in muscle development and increase volume in the quadriceps at the end of a workout.

However, due to their isolation nature, leg extensions have a number of limitations. Leg extensions are performed with a seated base and a fixed movement pattern, which do not replicate the natural leg movements we undergo in our daily lives or the leg movements performed in sports. Also, leg extensions place a large amount of stress on the knee joint, mainly when they are performed with heavy weights or with poor technique.

Conversely, squats are considered one of the best lower body exercise options available. They imitate the motions we use each day, like sitting down and standing up, lifting objects from the floor and more. They also help improve joint range of motion especially at the hips, ankles, and knees and developing strength usable throughout life. Additionally, squats recruit multiple muscle groups to perform an activity. This allowss for maximum overall strength development, an increase in muscle mass, and a higher volume of calories burned. As physiotherapists, we refer to squats as functional movements due to their real world carry over and ability to reduce the chance of injuries.

So which one is better?

So now the question arises, which type of exercise will best suit you? Most people who exercise should include squats in their routine as the foundation of their leg workouts. Squats allow the development of overall leg strength as well as improve balance, and when done correctly, squats promote good long-term joint health for those doing a lot of sitting and standing. Although not every person who trains their lower body will be an athlete, having strong legs is an important aspect of staying active and fit. A strong leg foundation is also beneficial to those who are trying to lose fat or improve daily movements, as good leg strength helps create a solid base of stability for any physical activity.

While squats are excellent for developing strength and balance, leg extensions also have a place in a complete lower-body workout program and can be an effective way to work on isolated quadriceps strength, to address a specific weakness and for increasing muscle definition without putting a high demand on the rest of the body.

Instead of trying to choose between squats and leg extensions, the most effective approach is to combine the benefits of each exercise, so everyone benefits from both improving their lower-body strength and developing good muscle definition. Prioritizing squats while supplementing with leg extensions will enable everyone to build strong and functional legs while still having a strong focus on building muscle, thus giving the best overall performance and appearance.

Have more questions?

Look for PhysioNow! We have expert clinicians ready to assist you with any training questions you may have. If you are struggling through any kind of knee pain, leg pain, or even anticipating an upcoming surgery whether it is a total knee replacement or an ACL repair, we will help you through it all! One of the most important parts of training is learning how to stay injury free, so book with PhysioNow today for you first assessment and treatment! Look for us at one of our 10 west GTA locations including Burlington, Oakville, Mississauga, and Etobicoke! P: 289-724-0448 Email: applewood@physionow.ca

Custom Knee Bracing, Knee Pain, Sports Injuries, Sports Physiotherapy

Meniscus Strain: How to Treat Your Knee Pain

When knee pain shows up, it can impact everything from walking, climbing stairs, playing sports, even just sitting comfortably. One of the most common reasons people feel that sharp or nagging pain inside the knee is a meniscus strain. The good news? Many meniscus injuries heal well with the right care and guidance.

Let’s break down what the meniscus does, how strains happen, and how physiotherapy helps you get back to moving confidently.

What is the meniscus?

Diagram of a right knee depicting the menisci along other structures
The menisci are optimally located between the 2 bones to provide support and cushioning.

The meniscus is a C-shaped piece of cartilage inside your knee. Think of it like a cushion to help reduce friction and pressure. Each knee actually has two sitting side by side, one closer to the inside of your knee (medial meniscus) and one closer to the outside outside (lateral meniscus).

These small but important structures help your knee by:

  • Absorbing shock
  • Improving stability
  • Distributing weight evenly
  • Guiding smooth movement

When the meniscus is irritated or stressed, it can quickly lead to noticeable knee pain.

What is a meniscus strain?

A meniscus strain means the tissue has been stressed or mildly injured, not fully torn. A meniscus tear is a more significant injury where the cartilage fibers are completely disrupted.

Meniscus strains commonly happen from:

  • Twisting or pivoting on a bent knee (very common in sports)
  • Deep squatting or lifting heavy weight with poor form
  • Sudden stops or quick changes in direction

While strains are less severe than tears, they can still be painful and limit how much you can bend, straighten, or put weight through your knee.

What are the signs and symptoms?

You may be dealing with a meniscus strain if you notice:

  • Pain on either the inner or outer side of your knee, along the joint line
  • Swelling or stiffness after activity
  • A feeling of catching, locking, or buckling
  • Reduced range of motion, especially with maximal bending
  • Discomfort when bearing weight or twisting your knee

If symptoms are sharp, persistent, or increasing, it’s important to get checked. After even just a minor strain, the body can lose significant amounts of strength. Unfortunately, this can predispose you to another injury, including a full tear. As a result, it is crucial to rehab your knee after a meniscus strain.

How is a meniscal strain diagnosed?

Health care provider palpating a patient's knee

A physiotherapist or healthcare provider will usually:

  • Ask about how the injury happened
  • Assess how your knee moves
  • Assess your strength
  • Perform special tests like McMurray’s or Apley’s that check for meniscal injury specifically
  • Recommend imaging (like an MRI) if a tear is suspected

The goal is to understand what movements are contributing to your knee pain, and develop a treatment plan to help you recover to your full strength.

How does physiotherapy help?

Most meniscus strains do very well with conservative treatment (non-surgical treatment), and physiotherapy plays a major role in reducing pain and rebuilding strength.

1. Early Phase (0–7 days)

Focus: Reduce swelling and protect the knee from farther injury

  • Resting from painful activities
  • Ice, compression, bracing
  • Elevating the leg to manage swelling
  • Light, pain-free range-of-motion exercises
  • Early muscle activation (like quad sets or easy straight leg raises)

2. Recovery Phase (1–3 weeks):

Focus: Get your knee moving more seriously again

  • Low-impact cardio like cycling or swimming
  • Controlled bending and straightening exercises
  • Balance work (single-leg stance, gentle weight shifting)
  • Building early strength in the quads, hamstrings, and glutes

3. Strength & Return-to-Activity Phase (3–6+ weeks)

Focus: Continue building stability and prepare for real-life movement

  • Resistance training for the lower body
  • Functional exercises like step-ups and mini-squats
  • Sport-specific drills (if needed)
  • Education to prevent re-injury

Your timeline will vary based on pain levels, pre-injury fitness, and how severe the initial injury to the meniscus was, but gradual, guided progress is key.

Can I prevent a meniscus strainB?

It is not possible to completely remove the chance of injuries, but you can lower your risk with a few simple habits:

  • Engage in a thorough warm up before sports or workouts
  • Strengthen your lower-body muscles, especially glutes, quads, and hamstrings
  • Avoid sudden twisting or pivoting under load
  • Use proper lifting technique
  • Give your body rest when it needs it

Looking for help with knee pain?

Look for PhysioNow! Our expert Physiotherapists, Manual Osteopaths, Massage Therapists and Athletic Therapists can help you recover from knee pain, sports injuries and more! We have 10 locations across the west GTA including Burlington, Oakville, Mississauga, and Etobicoke. Please feel free to contact us by phone: 289-724-0448 or email: applewood@physionow.ca with any inquiries. Book with PhysioNow today for your first assessment and treatment!

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 orthotics, Foot Pain, Foot Pain Management Mississauga, Foot Pain Treatment Mississauga, Physiotherapy

Foot Injuries: How Physiotherapy Gets you Back on Your Feet

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Most of us don’t think twice about our feet until they start to hurt. Yet our feet work harder than almost any other part of the body. Everyday, they carry our weight from the moment we get out of bed to the second we crawl back in at night. They let us walk, run, balance, jump, and absorb high forces with every step. Ultimately, it’s no wonder foot injuries are among the most common problems we see at PhysioNow.

If you’re dealing with sore heels, painful arches, a sprained ankle, or more, you’re definitely not alone. Let’s take a closer look at why foot injuries happen, which ones are most common, and how physiotherapy can help you heal and get back to the activities you love.

What causes foot injuries?

Ankle and foot injuries are especially common during basketball. Players frequently change directions quickly, and jump and land in awkward positions.

Feet are incredibly complex structures with lots of little pieces, just like our hands. Each foot has 26 bones, and over 100 muscles, ligaments, and tendons working together. When one part is out of balance, overworked, or injured, it doesn’t just affect your foot, it can throw off your entire body.

Some of the underlying reasons behind foot pain or injuries include:

  • Poorly fitting or unsupportive footwear
  • A sudden increase in activity (like starting a new sport or over training)
  • Placing your foot down wrong or landing improperly
  • Abnormal foot posture such as flat feet or very high arches
  • Spending long hours on your feet (common in many careers)
  • Previous ankle sprains or untreated foot pain

Which injuries do we see most often in the clinic?

While not necessarily an “injury”, Physiotherapists are very capable at treating bunions to help relieve pain, strengthen weakened muscles, and help restore normal walking and daily life capabilities
  • Plantar fasciitis: That sharp heel or arch pain, especially first thing in the morning
  • Ankle sprains: A twist or roll of the ankle sprains a ligament, leading to swelling, pain, and sometimes instability.
  • Achilles Tendonitis: Pain in the back of the heel or lower calf caused by inflammation and overuse. Can lead to thickening of the achilles tendon.
  • Bunions & Misalignment Issues: Structural changes in the feet that can be painful and make walking difficult
  • Fractures: A break in the bone, usually from a trauma
  • Morton’s Neuroma: Characterized by tingling or burning between the toes or in the ball of the foot, due to pressure on the nerve from a growth

How does physiotherapy help with foot injuries?

The good news? Most foot injuries respond really well to physiotherapy and don’t require surgery. Here’s how we typically help:

1. A comprehensive assessment

We don’t just look at your foot, we assess your whole body. That includes posture, gait (the way you walk or run), and movement patterns to figure out the source of the pain and how to correct it. For example, your foot pain may actually be from weakness at the hips or knees and must be treated accordingly.

2. Pain management strategies

Hands-on therapy, gentle mobilizations, taping, and sometimes ice, heat, ultrasound, or electrotherapy can help settle irritation and get you moving more comfortably.

3. Personalized exercise programs

We’ll design a plan for both in clinic and at home exercises. That might include stretching tight calves, strengthening small stabilizing muscles in your foot, or building up your arches for better support. Each person’s plan will be different depending on their goals, activity levels, hobbies, and area of pain

4. Footwear and orthotics guidance

The right shoes and custom orthotics can make a big difference. We’ll recommend what works best for your body and activity level.

5. Balance and proprioception training

Especially after ankle sprains, retraining your balance helps protect against future injuries and keeps you steady on your feet. Even minor ankle sprains negatively affect your body’s balance so it’s important to give them the proper care to stop things from worsening.

6. Lifestyle and training adjustments

From modifying how you train, to building in active recovery, to simple posture fixes, we’ll help you make small changes that support long-term foot health. This may involve taking a temporary break from your activities, and then slowly building back up to give your body time to adapt and get stronger. If your workplace requires you to be on your feet, we can talk about strategies like fatigue mats, adjusting work postures, or specialized shoes and orthotics to give you relief.

Looking to get rid of your foot pain?

Look for PhysioNow! Don’t let your foot pain get in the way of your life or sports anymore, you can live pain free again! Whether you’re looking for help with a new, chronic, overuse, or sports injury, PhysioNow’s expert clinicians can help you. With 10 locations across the west GTA including Burlington, Oakville, Mississauga, Etobicoke, we are never too far away. Book with PhysioNow today for your first assessment and treatment for foot health and pain.