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Ankle injury and testing it’s impact on your balance

What to do following an ankle injury? How do you know if your balance has been affected?

Following an ankle or foot injury, proprioception can be negatively impacted and potentially increase the chance for future reoccurrence of injury or falls. Proprioception (or kinesthesia) is the sense though which our body is aware of where are our joints are in space. Common ankle and foot injuries that benefit from physiotherapy focused on strength and proprioception training include ankle sprains, plantar fasciitis, post ankle/foot fractures and tendonitis.

A study (Willems 2002) published by the Journal of Athletic Training looked at the effect of proprioception and muscle strengthening exercises in individuals with chronic instability and suggested that emphasizing on proprioception and strength training in the rehab program can help prevent recurrent ankle sprains.

The video below shows 2 examples of how to test your ankle balance. Make sure to try those with a stable surface close by for you to hold on to if you lose your balance. If you are unsure please do not try them.

Physiotherapist assess your range, balance, strength and your gait. Based on the assessment we provide you with a treatment plan including the appropriate exercises to help manage your symptoms and avoid re-occurrence of injury.

Contact us today to discuss if physiotherapy is right for you! Book your Free 15 minute meet & greet today!

Reference: Willems, T, Witvrouw E, Verstuyft J, Vaes P & Clercq DD, Proprioception and Muscle Strength in Subjects With a History of Ankle Sprains and Chronic Instability, Journal of Athletic Training (2002) Oct-Dec; 37(4): 487–493

By: Jie (Janet) Yang, Physiotherapist

Torticollis and Plagiocephaly: What is it? How can it affect your baby?

Baby in White OnesieTorticollis is a turning and/or tilting of the neck causing restriction in the available range of motion. This can cause the neck to be turned or tilted away from midline and difficult to move the head to a particular side. For example, the neck at rest can be turned towards the right and tilted towards the left, giving the appearance of a “twisted” position. Torticollis with this alignment can make it difficult to move the head in the opposite directions: rotating left and tilting right. The causes of torticollis can be from pain, stiffness, head/neck injury, or muscle spasm.
Torticollis can occur across the lifespan from newborns to adulthood. The difference for newborns and infants is that their skulls are largely cartilaginous and can be shaped. This combination of malleable shaping of the head and torticollis can result in a progressive flattening of a particular side or portion of the head due to any constant turning to a side, away from midline at rest. This flattening is referred to as plagiocephaly. Flattening can be congenital, developed in utero, or can be related to head position (i.e. with toricollis); in the latter case, the flattening is termed positional plagiocephaly and is often linked with torticollis. It is important to note that although toricollis and plagiocephaly affect the shape of the head, there are no direct affects on brain development or function.
If there are concerns with the baby’s neck range of motion or positioning, physiotherapy can help guide stretches and exercises to restore full range of motion. There are additional concerns with plagiocephaly, physiotherapy can help with establishing exercises are strategies to counteract this shaping.
Questions or concerns regarding your child? Book your 15 minute free consultation today! 

Remember to take care of you!

Coughing, sneezing and back pain- OH MY!

Lumbar spinal stenosis is a chronic condition characterized by a compression of the neural and/or vascular structures, which may lead to one side or two-sided pain/discomfort in the back, buttocks, thigh, calf and/or foot. Etiology: The compression arises as a result of a narrowing within the central spinal canal (as shown in the picture). This can be a result of traumas, motor vehicle accident, thickening of the osteoarthritic facet joints or bulging of degenerative discs.
Sign & Symptoms:
Tingling and numbness on both sides of low back, buttocks, thighs, calves and feet may lead to weakness with walking and prolonged standing aggravated by coughing & sneezing alleviated by sitting, prolonged rest or postural changes If you have any questions and concerns, please come in to see our physiotherapy team. We provide hands on treatment with individualized exercises program to get your back better and stronger!
If you have any questions or concerns, please do not hesitate to contact us today! 

Piriformis Syndrome- A Pain in the Butt (LITERALLY!)

Have you experienced buttock pain? Have you being told that you have sciatica? Do you know that piriformis syndrome can also cause pain that resembles sciatica?

Piriformis muscle is located in the buttock region. When it spasms/swells/gets tightened, it can irritate the sciatic nerve that passes through the muscle. This leads to tenderness in the buttock, tingling/numbness along the back of the leg, and sometimes into the foot. You might have increased pain after prolonged sitting, reduced movement of the hip and pain with walking up stairs.

There is a quick 2 minute video that describes piriformis syndrome and sciatica. Please come in for a 15 minute free consultation if you have any questions.

 

By: Jie (Janet) Yang, PT.  

 

If you have any questions or concerns, please don’t hesitate to contact us today for you FREE 15 minute meet and greet!

My MRI shows a rotator cuff tear! What does that mean? Now what?

Rotator cuff muscles are our shoulder stabilizer muscles that also assist with shoulder movement. Our rotator cuff is made up of 4 muscles (supraspinatus, subscapularis, infraspinatus and teres minor). We often see patients with shoulder pain that come in with imaging showing a tear in one or more of the rotator cuff muscles. Some patients are able to recall a specific incident or injury that may have caused the tear and some can’t. It is important to recognize that the pain experienced may or may not be due to the rotator cuff tear as some people have rotator cuff tears and have no pain! A study found that out of 96 individuals that had no shoulder pain: magnetic resonance imaging (MRI) identified 33 of them that had rotator cuff tears including full- and partial- thickness tears1.  The study stated that the participants were able to do functional activities without any pain1. From clinical experience people with rotator cuff injuries sometimes have pain related to other muscles that have been compensating for the initial injury and are being overused. After an injury, it is natural for us to guard and protect our shoulder from painful activities but sometimes that can turn into a habit. That’s when we notice a loss of strength, range of movement, pain and various compensation strategies. Physiotherapy treatment is focused on decreasing pain, improving your range of movement and strengthening your shoulder to regain any functional limitations experienced. Remember that even patients with pain associated with a shoulder tear can return to pain-free activities. It’s important for patients to realize that they may have always had a rotator cuff tear and shoulder pain may or not be associated with the tear. Imaging is a valuable tool however we have to use and interpret findings carefully as structural changes picked up through imaging doesn’t always directly correlate with symptoms.

 

Reference: 1. Sher J.S, et al. Abnormal findings on magnetic resonance images of asymptomatic shoulders. The Journal of Bone and Joint Surgery. American volume. 1995 Jan; 77(1):10-5

 

By: Nelly Temraz, PT.

 

If you have any questions or concerns, please don’t hesitate to contact us today for you FREE 15 minute meet and greet!

What is Pelvic Floor Physiotherapy?- Video

“1 in 3 women suffer with incontinence but only 1 in 12 report it to their Health Care Practitioner. So bladder leaking is very common but it is never normal. Neither is painful sex, pelvic pain or urgency and frequency of urination. Pelvic health physiotherapists can help you address these problems and get you to live the life you deserve.

Please watch this short video and if you need some help please book an appointment.

 

By: Kate McCormick, PT

If you have any questions or concerns, please don’t hesitate to contact us today for you FREE 15 minute meet and greet!

Paediatric Milestone series: Activities in Supported Standing

Before we discuss independent standing and standing up without using support, it would be appropriate to consider simple exercises when the child is standing at the couch, ottoman, coffee table, etc. In fact, this is quite a critical period for the child to master their body in space when trying to stand and balance at their support surface.

 

Once the child is up and standing at their preferred support surface, placing toys or any other item of interest just out of reach on the couch is an excellent activity to practice weight shifting and challenging the boundaries of their balance while they are well supported. During a single lateral reach, the child will shift their body and take more weight on the same-sided leg and foot. This simple and subtle movement is so important because this allows the child to unweight the opposite leg and foot. With progression and strengthening, complete lifting of the opposite foot from the ground will be achieved to reach even further. Mastery of this combination of weight shifting and balancing is incredibly important because this skill is absolutely necessary for walking; weight shifting onto a single leg, lifting the opposite leg, and progressing the unweighted leg and foot forward to walk.

 

For continued balance and strength development, encourage rotation and reaching away from their support. Start by using a toy on the couch or table and slowly pull the toy out of reach along the surface and more towards the side of the child to encourage reaching away from their support. Continue to repeat this to both sides and within their tolerance, ensuring to give breaks as needed. Gradually increase how far the child reaches in an arc around their reaching radius until they can almost reach behind by rotating at the trunk and waist with a hand still on their support. Again, this exercise is working their ability to weight shift and balance at the same time; however, with rotating and balancing as well, we are working on trunk strengthening with movement to build strong core muscles to support the trunk and upper body when it is time for standing and walking independently.

 

Of course, during these activities it is important to give plenty of positive reinforcement and feedback to demonstrate the importance and excitement of standing, reaching, rotating, and moving.

 

We will take another detour before we get to independent standing up; we will first discuss cruising along their support on the next blog post.

 

By: Chris Dahiroc, PT.

 

Questions or concerns regarding your child’s development? Contact us for your free 15 minute meet and greet today!