Tag Archives: vestibular rehabilitation

Balance is for Everyone: How to Prevent Falls at Any Age

When we hear the word “falls,” we often connect it with an older generation.  While it is true that with increasing age the risk of falls also rises, it is a risk that can affect a person from any age group. Starting from childhood to young adulthood, from an athletic to or weekend warrior population. 

At our clinic, we consider balance training an integral part of every treatment, whether it is geared towards performance improvement, prevention, or rehabilitation. No matter which age or activity level group you belong to, good balance is important to injury prevention, stability, and confidence in how you move. 

Why should I care about balance?

Your ability to maintain control while you are still or while you are in motion is called balance. There are two types of it:

  1. Static Balance 
  2. Dynamic Balance 
An example of a more advanced static, or held, balance position.

Static balance refers to times when your body is still, and trying to maintain a position. Common examples include yoga poses, standing on one leg, standing with your eyes closed and more.

Dynamic balance includes when your body is moving or being acted on by an external force. For example, you’re using dynamic balance when you’re walking, playing a sport, or riding a bus. They can range from easier tasks like walking on flat ground, to more difficult such as single leg squats on a bosu ball. A well-trained dynamic balance system is especially important during for preventing injuries during sports and daily life.

Which systems are in charge of balance?

There are many systems which gets involved and work closely together while maintaining balance. These include the following structures/systems:

  • Connection between your muscles and joints
  • Eyes (visual input)
  • Inner ear (vestibular system)
  • Nervous system (communicating with other parts of your body, processing all the sensory information, and proprioception, or your body’s ability to sense where it is in space)

Unfortunately, if there is any disturbance with one or more of them it can severely affect your balance. For example injuries to your joints, a traumatic brain injury such as a concussion, an ear infection, or other vestibular disorders can all affect your balance.

Who’s at risk (besides seniors)?

Concussions are serious injuries that affect many different system within the body. Very commonly, the visual and vestibular symptoms experience disruption post-concussion.

Although anyone can experience balance problems, you may be more vulnerable if you:

  • Recently had a sprain or surgery, especially in the lower limb
  • Have or have had in the past a traumatic brain injury (ex. concussion)
  • Play competitive sports which required fast direction changes for example baseball, soccer, rugby etc. 
  • Have a history of vertigo or dizziness 
  • Have decreased or altered sensation in your lower limbs (ex. common in people with diabetes
  • Have severe or uncompensated vision issues

How do I know if I my balance needs work?

  • You find yourself tripping often
  • You constantly reach towards and grasp walls or pieces of furniture
  • You are scared or avoid uneven surfaces, curbs, or stairs without extra support
  • You lose your balance or feel dizziness while standing with closed eyes or in the dark
  • You feel “off while unsteady while walking or turning

There are also a few types of objective tests we usually perform to check your balance. It’s always advisable to perform under the guidance of professional or under supervision.

  1. Single Leg Stance Test: In this, we make person to stand on one leg for 30 sec or as long as they are able to. They are observed for any difficulties with balance or safety.
  2. Tandem Walk: We make them walk heel-to-toe in a straight line and observe for difficulties with balance
  3. Eyes-Closed Balance: In this one, we will have the patient stand with their feet close together and with the eyes open. We measure the time they can stand and then we repeat and compare it to their time with closed eyes 

How can physiotherapy help improve my balance?

Your Physical Therapist can help you get started by assessing the cause of your balance issue. Whether it’s from a previous injury, a vestibular disorder, post-surgery or more, each will have a different type of treatment. Your physiotherapist will use the assessment to identify your specific impairments and create a personalized Fall Prevention Plan. It will also be targeted towards your goals, whether its to get back to your day to day activities, a specific sport, or just to feel more confident in yourself. They will use a combination of strengthening and coordination exercises, Vestibular Treatment if necessary, and offer education and lifestyle advice to prevent injuries in future,

Tips to reduce fall risk at home!

  • Practice standing on one leg with some stable surface around and add it in to your day-to-day activities like cooking or brushing your teeth
  • Focusing on strengthening the muscles of your lower extremity and core
  • Try to walk on different surfaces to get practice and sensory feedback
  • Wear well-fitted and properly cushioned shoes 
  • Try to keep your rooms clean and cluttered free
  • Try to use bright lights around the house and staircases to avoid falls

Looking for more help?

Look for PhysioNow today! If you are having any issue with your balance, connect with our team of experienced therapists. You will be surprised with the results of how small steps can quickly give you the confidence to move better! With 10 spacious clinics across the GTA from Burlington, Oakville, Mississauga to Etobicoke, we are ready to get you started. Book with PhysioNow today for your first assessment and treatment!

How to Recover From Your Concussion With Physiotherapy

Concussions are one of the most prevalent and most misunderstood athletic injuries. Also known as an “invisible injury,” because it cannot be seen, but has a huge impact on brain function. Usually, a concussion happens when an individual suffers a direct or indirect force to the head that causes the brain to accelerate and decelerate rapidly within the skull. Unlike what people think, there does not have to be a direct blow to the head for someone to develop a concussion. While it can happen from a hit to the head from a ball, puck, or person, it can also happen from forceful blows to the body such as being tackled.

Concussions are not just the outcome of high-contact sports. Additionally, they are commonly seen in patients involved in motor vehicle accidents. It is important to diagnose and treat a concussion as soon as possible to increase the chances of a full recovery. 

What are the most common symptoms of concussions?

The symptoms vary greatly depending on the severity, a pre-existing history of concussion, and whether there was a loss of consciousness. Generally, more symptoms in higher intensities are associated with more severe headaches, especially if there was a loss of consciousness. Common symptoms include:

Changes in vision are common with a concussion, some may warrant a visit to the optometrist
  • Headaches
  • Balance problems
  • Difficulty regulating mood
  • Fatigue
  • Disorientation/confusion
  • Memory issues 
  • “Slower” thoughts
  • Nausea
  • Blurry vision
  • Light and/or noise sensitivity

As can be seen, there are a large number of symptoms that may or may not be present post-concussion. Concussions can affect a lot of different systems in the body including cognition, vision, balance, coordination and more. As a result, many different health care professionals may be involved during the duration of a concussion treatment.

How does physiotherapy play in role in concussion management?

Physiotherapy can play a significant role in the recovery process. After medical diagnosis, a physiotherapist will assess the primary symptoms of the neck, balance, visual system, and coordination system. We already discussed how not everyone with a concussion will develop the same symptoms. Accordingly, they will receive a personalized treatment protocol and plan. 

Musculoskeletal Symptom Management

First, neck and upper back symptoms are extremely common in concussion, particularly if the mechanism of concussion was a whiplash injury. Physiotherapists will treat these areas using manual therapy, mobility exercises, and soft tissue techniques in an attempt to reduce pain and headaches. Furthermore, concussions often affect the vestibular and visual systems. These, in turn, can lead to dizziness, balance problems, and difficulties with focusing the eyes.

Vestibular and Visual Symptom Management

Vestibular rehabilitation and oculomotor exercises attempt to retrain the brain to properly process vestibular motion and visual input. These may include habituation exercises, which slowly force the system to adapt and become less symptomatic over time. At the start, these exercises will be difficult and trigger the symptoms quickly. An important part of concussion management is knowing how much increase is okay, and when to take a break.

Back to School, Work, and Sport

In the past, it was assumed that rest, especially prolonged rest, is best for individuals who have suffered a concussion. The common image that people have of a concussion treatment is somebody sitting in a dark and quiet room, unable to do much. However, it is now well supported in the literature that light aerobic exercise, while respecting the symptoms, is the ideal path of recovery in early stages. Physiotherapists facilitate patients to resume activity with a structured, step-wise approach. This enables patients to have a framework to track symptoms and keep them under control as cognitive and physical activity demands are increased. Oftentimes, school or work are challenging for students or professionals to return to, as well as athletes returning to a sport. Physiotherapists help to gauge rates of recovery relative to cognitive endurance, visual tracking, and dual-task tolerance; all with the aim of having individuals enjoy a full recovery to daily activities.

Education

 Education is also a large component of physiotherapy. The parents or caregivers, and the patients themselves must be educated on symptom management, what to expect, and the time frames to return-to work/sport/school. Fortunately, there is good evidence that an early physio intervention leads to shorter recovery times, limits long-term complications, and assists with emotional well-being and additional return to their everyday life. If necessary, Physiotherapists may recommend a referral to a physician, occupational therapists, and other providers to provide patients with safe and confident return to sport and life. 

Looking for more help?

Look for PhysioNow! Our clinic has 10 beautiful locations with free parking located across the GTA. From Burlington, Oakville, Mississauga, to Etobicoke, we have many expert clinicians ready to assist you in your recovery. Whether it’s a concussion, motor vehicle accident, or sports injury, we have the tools to get you back to your normal life. Book with PhysioNow today for you first assessment and treatment!

Images by FreePik

Vestibular Rehabilitation

Vestibular Rehabilitation Therapy

Vestibular Rehabilitation

Vestibular rehabilitation therapy is a therapeutical approach to deal with balance issues, dizziness caused due to vestibular dysfunction.

It is an exercise-based program to help with:

  • Gaze stability.
  • Postural stability.
  • Vertigo.
  • Balance
  • Gait.
  • Improving daily activities of living affected due to vestibular dysfunction.

Conditions treated:

  • Vertigo.
  • Post concussion related dizziness (MVA/Head injury).
  • Dizziness seen in Elderly due to vestibular hypofunction.
  • Psychogenic vertigo.
  • Dizziness with uncertain cause.

Conditions that would not benefit from Vestibular Rehabilitation Therapy:

  • Meniere’s disease.
  • Labyrinthine pathology.

Techniques used for Vestibular Rehabilitation Therapy:

CRP / Canalith repositioning procedure: It is a technique used when a client experiences vertigo due to BPPV, also know as Benign positional vertigo.  Thus, with this procedure, the therapist moves the client in a specific pattern with the head and neck supported to redirect the crystal back into its position, thereby reducing and abolishing the spinning sensation caused by BPPV. Additionally, the techniques vary depending on the canal affected. Furthermore, it might take 2-3 visits to resolve this concern, if there is no involvement of other components. A vestibular therapist can identify the side and the canal affected.

VOR exercises: This approach is for one experiencing dizziness with head movements, where the person feels difficulty stabilizing their vision.  Additionally, this approach includes exercises that would help in stabilizing vision with head movements. Furthermore, these exercises are progressed by increasing the speed, complexity of exercises. It usually takes 6- 8 weeks of 2 X week sessions to see significant changes.

Habituation exercises: Exercises used for vestibular hypofunction, where there is an imbalance between both ears function. The approach is to train the vestibular system to adapt to the demand so as to gain stability. Additionally, it ideally takes 6- 8 weeks of 2 X week session to help to retrain the system to adapt.

Gait training and balance exercises: To improve postural imbalance and thereby improving ADL. A proper gait analysis and assessing the lower extremity and core strength would help the therapist decide on the exercise program that would be client specific.

Home exercise program is equally important on a frequency of 3-5 X Day to see a consistent progressive recovery.

A vestibular therapist with a detailed assessment could rule out the possible reason for the dizziness and imbalance, with VRT which is client specific and condition specific.

Need Help?

If you are looking for vestibular rehabilitation therapy or any other physio needs, PhysioNow has many qualified registered physiotherapists that would love to help you out. Book with PhysioNow today for your first assessment and treatment!

Physiotherapy Etobicoke

Physiotherapy Etobicoke

Physiotherapy Etobicoke

How do I know what physiotherapy clinic to choose?

Physiotherapy is an important health care service in  Mississauga, Etobicoke and Oakville.  Many people need physiotherapy treatment to help with their pain and recover from their injuries.  Physiotherapy can help improve the quality of life for many people of all ages.

What are the problems that people run into with choosing a clinic?

In large cities like Mississauga, Etobicoke and Oakville, there is a lot of demand for physiotherapy.  As a result, there has been an increased number of clinics.  However, the problem that a lot of people have is that there are too many different clinics to choose from.    Unfortunately, there are quite a few clinics that do not provide good service and care for their patients.  Therefore, it becomes a guessing game as to which ones are actually good.

Things to consider

As someone who has never had physiotherapy before, it’s really hard to know which clinic to choose.  Is it important that it’s close to your home?  Should you choose the one that your family doctor recommends?  Do you ask your family and friends?  What about just searching on google?  There are so many options out there.  However, like many things in our lives, you have to find a good fit between what you need and what the clinic has to offer.

What are some of the characteristics that patients look for in a physiotherapy clinic?

  • Physiotherapists who are properly licensed
  • Multi-disciplinary practice
    • The team includes other health care professionals who complement physiotherapy
    • Examples include massage therapists, kinesiologists, osteopaths
  • Clean and organized
  • Easily accessible location
  • Direct billing to extended health care providers
  • Extended hours available to accommodate patient schedules
  • Pleasant and friendly team to provide a positive patient experience
  • Positive online reviews
  • Community recognition
  • Positive reviews from family and friends

Why choose PhysioNow?

PhysioNow is a company that meets all these characteristics.  The company has been in business for over 15 years and has brought high quality services to the community.  We strive to go above and beyond to offer the best possible care for our patients.

What does PhysioNow Offer?

  • Registered Physiotherapists
    • Our physiotherapists are registered and in good standing with the College of Physiotherapists of Ontario
    • The team at PhysioNow is very experienced and able to work with a variety of different injuries, including motor vehicle accidents, workplace injuries and sports injuries
    • Our therapists also have extensive training in specialized areas of practice, including:
      • Concussion Rehabilitation
      • Vestibular Rehabilitation
      • Pelvic Health
      • Acupuncture
      • Mechanical Diagnosis and Therapy
      • Neurological Rehabilitation
      • Custom Knee Bracing
      • Custom Orthotics

Multidisciplinary Clinic 

      • All of our clinics are multi-disciplinary and offer both physiotherapy and massage therapy services to our patients
        • A lot of our patients see both our physiotherapists and massage therapists
        • These 2 health care services are complementary, and patients do well with their recovery when both services are incorporated into their treatment plan

Clean and Safe

        • Our clinics are also very clean and hygienic to make our patients feel safe and comfortable
        • We have taken extra Covid-19 precautions to meet all of the province guidelines
          • Firstly, we have installed plexiglass in our office space
          • Secondly, our beds and equipment are all sanitized after each patient
          • Additionally, we have our treatment rooms spread out so there is a safe distance between patients
          • Lastly, our on-site laundry allows us to keep our linens and towels fresh and clean
          • Our physiotherapy assistants do a wonderful job of keeping the clinic sanitized and organized

Easily Accessible  

        • All 4 locations are in easily accessible areas of Mississauga, Etobicoke and Oakville
          • They are close to major intersections and highways
          • All the locations also offer free onsite parking for our patients

Direct Billing  to Insurance Companies

        • PhysioNow also offers direct billing to most insurance companies
          • This is a very convenient service for patients because they do not have to worry about submitting their own claims
          • There are some exceptions depending on the insurance company and the patient’s specific policy
          • But for most patients, the insurance company will pay us directly and that saves the patient from having to pay out of pocket
          • Our staff can help with the details of a patient’s insurance plan

Convenient Hours

          • All the locations also offer convenient hours so that patients can make it work around their busy schedules
              • We have morning and evening hours available
              • The Mississauga locations also offer Saturday hours for those patients who are unable to attend during the week

Positive Patient Experience 

            • One of the biggest compliments we receive at PhysioNow is our commitment to providing a positive patient experience
              • All our staff members including administrators, physiotherapists, massage therapists and physiotherapy assistants are very friendly and outgoing
              • We all try to make every patient feel comfortable and enjoy their treatment experience
          • Positive Patient Reviews

            • All our clinics have great online reviews on Google
              • Our reviews are honest and from current and past patients
              • One of PhysioNow’s biggest source of referrals is through our existing patients who refer their friends and family
              • There is no higher compliment than someone referring their friend or family
              • It is a great sign of their trust in the care and services we provide

Community Recognition 

            • Since there are so many physiotherapy clinics across Mississauga, Etobicoke and Oakville, it is a special honour when there is community recognition
              • Specifically, our Etobicoke location was nominated for a 2019 GEM award
              • We were nominated by our patients who are residents of the Etobicoke-Lakeshore area
              • Unfortunately, we did not win the award, but it was an honour to be nominated and thought of so highly by our patients
              • In addition, our clinics have also been nominated for the Top Choice Awards for 2019 and 2020

Choose PhysioNow

All these wonderful aspects of our company have allowed us to succeed and grow over the last 15 years.  Therefore, we continue to work hard to make sure that we provide the best possible care for our patients.  As a result, our patients see results and finish their course of treatment feeling overall better and stronger.  In conclusion, PhysioNow ensures that our patients are able to get back to their life including home, work and play.

Call today to book your appointment at PhysioNow!