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Christian Seguin

On The Case: Knee Pain

By Case Study, Treatment

In our new On The Case series, we’ll be taking a look at some of the real-life challenges our patients face and how we helped them regain their mobility!

About nine months ago, Henry* came to the clinic indicating pain on the inside of his knee. When he would climb small hills, take the stairs, squat, engage in other activities like gardening, he would experience pain for the rest of the day. This pain started affecting his regular activities like walking, golfing and curling. Henry also mentioned he experienced stiffness in his knee for the first 10 minutes of walking every morning. The inside knee pain wasn’t something Henry could shake off.

After consulting with his nurse practitioner, Henry went for X-rays which confirmed mild to moderate arthritis in his knee. He was given a referral for physiotherapy and he showed up, limping, at our office one morning last September.

On assessment, we observed that Henry had difficulty bending his knee past 90 degrees, climbing stairs and squatting lightly. He felt pain when we touched the inside of his knee and we also noted a weakness of the buttock muscle and poor control of the kneecap (patella) tracking.  This was a key finding for this arthritic knee.

 

Clinical tidbit:  Cases of mild to moderate knee arthritis are often accompanied with weak buttock muscles which result in poor thigh control. This condition puts a strain on the inside of the knee and contributes to  over-strained ligament and tendon structures.

 

After this preliminary evaluation, we worked to make Henry’s knee more comfortable and less stiff.  The intervention focused on improving range of motion, and also included a discussion on muscle flexibility, balance exercises and how to manage pain and activities at home. He was given a buttock strengthening program that would not increase his knee pain. And he was also fitted with a supportive knee brace. Henry reported a reduction in the pain which was a result of the compression and stabilizing design of the brace.

We saw Henry for a total of seven visits over a month-long period.  In the first week, he reported a 30 to 40% reduction of his knee symptoms. Over the course of his subsequent visit, we gradually progressed the strengthening and flexibility program and noted an improvement in Henry’s knee bending and straightening.

By the third week, Henry was not yet ready to walk his regular three to four kilometres but we encouraged him to find alternative or modified activities to accelerate the healing (and avoid further aggravation of the knee).

Our suggestions included:

  • Walking for the same amount of time in a pool would reduce the load on the knee
  • Throwing the rock with the curling stick would avoid the deep squat but keep Henry in the game
  • Golfing with a cart would avoid the excessive walking and hill climbing.

By the fourth and fifth week, Henry reported that 90% of his discomfort had dissipated.  This was a good spot to be in. In this phase of rehabilitation, strengthening of the legs (specifically gluteus, quadriceps and hamstring muscles) is key.  The common mistake here is to stop progressing the exercises. Failing to continue would most likely result in another flare-up. Luckily, Henry kept with the program and did his exercises once and at times twice daily.

At this point, he was able to resume one to two kilometre walks without symptoms, and could handle stairs and hills without knee pain—when not repetitious.  We provided Henry with a home exercise program and a follow-up visit for the next month.

One month later, Henry had returned fully to his activities. He integrated our prescribed exercise program into his weekly routine. Henry sometimes feels occasional knee stiffness when he increases load but overall, he reports he has been pain-free.

In Henry’s case, integrating flexibility and strengthening exercise changed the impact of his mild to moderate arthritic knee on his everyday activities.

If he should continue with his program, the effects will be long-lasting.

Let’s remember: Exercise is medicine. Not only does it allow us to function with fewer symptoms, but can prevent further progression of hip and knee arthritis. Ask me for the research on this—there is no shortage of it!

 

* Name changed to protect confidentiality.

Exercising During Pregnancy: A Primer

By Exercise

Whether you started your pregnancy off as a fitness guru or a Netflix queen, there are plenty of reasons to fit exercise into your daily routine. Don’t know where to start? It doesn’t —as long as you get moving!

According to the guidelines set out by the American College of Obstetricians and Gynecologists, healthy pregnant women should get at least 150 minutes per week of moderate intensity aerobic activity (the equivalent of brisk walking). The college also encourages exercise for sedentary women, as well as those with medical or obstetric complications but only after medical clearance.

 

Women with uncomplicated pregnancies can—and should—engage in physical activities before, during, and after pregnancy.

 

What are the health benefits of being active during pregnancy?

There are several physiological benefits for continuing to move throughout your pregnancy:

  • Reduced risk of excessive gestational weight gain
  • Reduced length of labour
  • Reduced  risk of conditions like gestational diabetes, preeclampsia and preterm birth

When it comes to your psychological state, there are benefits too. These include:

  • Reduced anxiety
  • Reduced depression
  • Reduced fatigue
  • Reduced stress

What are the dangers of exercising while with child?

Fact: Physical activity in pregnancy has minimal risks and has been shown to benefit most women.

That said, you’ll need to pay attention to telltale warnings that will signal when you should stop exercising.

If you experience any vaginal bleeding, dizziness, headache, chest pain, muscle weakness, calf pain, decreased fetal movement or amniotic fluid leakage, you should terminate physical activity until you get medical clearance from your healthcare practitioner.

How might my changing body affect my exercise routine?

Your body will undergo an amazing shift as it grows another human being. It’s important you recognize how this change could impact your activities.

Here are a few things to keep in mind:

  • Weight gain and a shift in your centre of gravity can lead to an increase of force in your joints. Hormonal changes during pregnancy can also increase joint laxity, which can put you at a higher risk for injury.  
  • Your blood volume, heart rate, stroke volume and cardiac output are usually greater during pregnancy and your enlarged uterus can obstruct diaphragm movement. So you might require higher cardiorespiratory effort and a decrease in the performance you’re used to.

Given how your body will change throughout the pregnancy, there’s no doubt that you’ll need to adapt your activity to accommodate your changing body to keep both you and baby safe.

What physical activity can I participate in and how much can I do?  

The activities you partake in during your pregnancy should include the same elements as non-pregnant women.

DO: Exercise 30 minutes a day (or three 10 minute walks) on most, if not all, days of the week. This is the recommended frequency of exercise.

DO: Engage in aerobic exercise. This can consist of activities that use large muscle groups for example, walking, jogging/running, dance, swimming, cycling, and rowing.

Warning: Aerobic or recreational activities that can increase the risk of falls such as skiing, gymnastics, and horseback riding. These could result trauma and should come with cautionary advice for most pregnant women. The same applies to activities with high potential for contact such as hockey or soccer.  

DO: Incorporate resistance exercises into your routine. Relatively low weights with multiple reps—lifted through a dynamic range of motion—can be safe and effective. The American College of Sports Medicine recommends that intensity should be 60 to 90 percent of your maximal heart rate.  If you didn’t participate in regular exercise before pregnancy, aim for 60 to 70 percent of your maximal heart rate (equivalent to a 4 or 5 on the perceived exertion scale, or RPE). If you were fit and exercised regularly before your pregnancy, then consider aiming for 70 to 90 per cent of your maximal heart rate (equivalent to a 7 on the RPE).

DO: Make sure you’re properly nourished and hydrated before you go for a run or do your zumba class. Enjoying a yogurt, some trail mix or a nice juicy peach before you hit the road will help boost your energy and blood sugar. And when you’ve finished up your exercise activity, be sure to drink a refreshing glass of water.

 

The most important takeaway for pregnant women is this: Listen to your body and exercise smart!

 

If you need some advice on how to modify your exercises or activities while you’re pregnant, get in touch with us. We’re happy to help!

 

walking-health-benefits

Walking Towards Better Health

By Prevention, Walking

Most of us are now enjoying the warmer season and all of the outdoor activities it accommodates. Summer sports, such as golf and tennis, are a great way to increase physical activity but on your quest to increase your health and wellbeing, do not overlook the simple yet highly beneficial act of walking. Walking is one of our basic functional movements, yet half of Canadians walk less than 30 minutes a day. These numbers are especially concerning, as walking just half an hour a day can have significant health benefits to your body and mind.

A recent study found that walking 30 minutes a day, five days a week, can reduce your chances of coronary artery disease by up to 30%.

Walking has also been shown to stimulate and protect brain tissue, reducing the risk of dementia by up to 40%. Still not convinced? Here’s another fact: Daily walking is linked to a reduction in depression and anxiety and an increase in overall feelings of wellbeing.

 

How Much is Enough?

So how do we know how intensely we need walk to reap the benefits mentioned above? After all, walking can be as slow as someone browsing an isle at a grocery store, or as fast as the Olympic speed walkers. The American College of Sport Medicine recommends that in order to gain the most from walking, we must be exercising at a level of ‘moderate’ intensity. To gauge this intensity, you can use the ‘talk test’. This means that you should walk at an intensity light enough to be able to carry a conversation, but not so easy that you would be able to sing. If you don’t have much time in your schedule, divide your walks into three sets of 10-minute bouts, at least five days a week.

If you have a pedometer (a step counter), aim for 10,000 steps per day. Research has shown a target goal of 10,000 steps/day is enough to stimulate desired health benefits.

 

5 Tips to Get Started

  1. Incorporate walking into your day: If you schedule daily walks, it will become routine. Walking to and from work, or going for walks on your lunch break are good ways to get started.
  2. Start a walking group: This is a great way to get motivated. Social interaction and peer support can give you the extra kick you need to get out there and get going.  
  3. Dress for success: There is no such thing as bad weather, only bad clothing! Dress in layers to allow you to adjust to changes in weather. Waterproof boots, big umbrellas, sunglasses, and hats, can give you that extra bit of protection that will make your walk more enjoyable.
  4. Get extra support with walking aids: Walking poles, which look similar to ski poles, will give you extra support. Using these while walking increases your base of support, giving extra stability to those concerned about balance. They also help promote good posture by encouraging an upright stance while walking. Last, but not least, they promote upper extremity involvement, contributing to a whole-body workout. You’ll find walking poles at most major pharmacies.
  5. Be creative: Walking can take place around your neighborhood, around your workplace, or through forest trail. To keep things interesting, don’t be afraid to take advantage of the many paths and trails available in SD&G and surrounding area. The local bike path offers a safe and scenic walking trail by the water. Gray’s Creek Conservation Area, the Bird Sanctuary, or the Summerstown Trails, offer cleared paths through the forest. Outdoor walking trails in different areas can be found on Alltrails.com. If the weather is not cooperating (which tends to happen around here), the Civic Complex and the Benson Centre have indoor walking tracks. It is not uncommon to use the halls of a shopping mall, such as the Cornwall Square, either!

 

If you’d like more information on how to incorporate walking into your daily life, talk to your physiotherapist at Active Sport Physiotherapy!

avoid-golf-injuries

Get a Grip on Common Golf Injuries

By Golf, Prevention

It’s that time of the year again. The Masters Tournament has wrapped and some of us are dusting off our clubs in anticipation of a sunny, golf-filled summer. I thought this would be the perfect occasion to talk about common golf injuries—how they happen and what you can do to prevent them.

On the surface, golf might seem like an injury-less sport but statistics show that 1 in 4 golfers who tee up in North America play with some type of injury. Golfers over the age of 50 have a much higher likelihood of injury. Even PGA tour professionals are at risk—they average two injuries per year.

So why do golfers get hurt?

When it comes to injuries, the biggest factor is the ability for tissues in the body to withstand the forces applied to them. Factors such as age, gender, and conditioning play a big part in how the tissues handle this force. Injuries come when tissues can’t withstand the force and break down.

You can develop an injury from a single traumatic force or from repetitive movement (accumulation of force). When it comes to the golf swing, both these instances are possible.

When it comes to a golfer’s body, there are a few common areas where damage occurs: the lower back, the shoulders, and the upper arm (wrists and elbows). Low back injuries are prevalent across all golfers, whereas shoulder injuries are the second most common injury for males; for females, the secondary injuries are to the wrists and elbows.

Here’s a rundown on what’s happening when you hurt yourself playing golf:

Low Back

The rotational stress of the golf swing puts the small joints, discs and muscles of the back under considerable loads that can often lead to failure. Combine that with the posture of leaning over your club, and the repetition that a round or practice session requires, and it’s not hard to understand why this is the most common area of injury. The best ways to minimize stress through your low back is to make sure to distribute the rotational stress through your legs, hips, pelvis, low back, upper back and neck. When one area doesn’t move well, the other areas have to pick up the slack. Most often, stiffness occurs in the hips and thoracic spine. When these two areas don’t rotate well, it means that your body will try to create as much rotation from your lumbar spine as possible and you’ll get hurt.  

To prevent this, develop an exercise program that will improve the areas that are stiff in rotation and strengthen the core and back muscles to help your low back take on those loads. Work on a proper setup posture to achieve a neutral spine position before your swing, then work to maintain that spine position throughout your swing.

Shoulders

The muscles of your rotator cuff stay active throughout your golf swing, but where they are put under the most stress is at the top of your backswing and through impact. Swing plane and proper trunk rotation during your backswing are very important in minimizing this stress. The more rotation your body can comfortably go through in your backswing, the less reaching your shoulders need to do.

There are ways to minimize stress on your shoulder: improve the rotational capability and force production through your spine and/or take a shorter backswing. Many of us try to generate force through impact solely through our arms and this is when a shoulder injury. Working on the length of your backswing to match your body’s ability, perfecting your swing sequence, and exercising your trunk to improve rotation should be your priority if you have persistent shoulder problems persist.

Wrists/Elbows

Very similar to the shoulders, issues for your wrists and elbows come from your swing sequence and where you generate power in the swing. Golfers who try to set up power with their arms only are more likely to experience injury in these areas. Females tend to have a slightly higher incidence in the wrist and elbows (versus the shoulders) because they have smaller bone structure and less muscle mass in these areas. That means there’s less adaptability to stress through impact.  

Equipment can also play a big role for injuries. Make sure 1) your clubs are the right size and weight for your body and strength, 2) your grips on your clubs fit your hand size 3) your grips are not worn so there is no excess grip pressure are all ways to reduce arm stress.   

Working on your swing sequence as to not cast the club or release the hands too early can also minimize stress on the wrist and reduce the chance of hitting a shot fat.

The bottom line

The biggest way to help minimize your risk of injury on the golf course is to make sure you take the proper amount of time to do a warm-up. Increase the blood flow into the muscles you will be using for the swing, make sure your body feels supple and is moving well prior to repeated swings and practice.

 

Need help with your swing? Contact us to find out more about our mobile biomechanical analysis lab. We can analyze your movement, identify technique errors and help you avoid injury!

injury-prevention

5 Common Spring Injuries…and How to Avoid Them

By Physiotherapy, Prevention

Spring is now in motion and as the temperatures start to rise, we all want to start moving a little more. We tend to want to dive into spring cleaning, take up running or biking, head to the golf range to drive balls and start throwing to get our arms ready for ball season.

This invigorating time also coincides with an increase of visitors to the clinic. Typically, this is when I start seeing more people who show up with predictable problems:

  • Our patients  with lower back issues are usually those who had an ambitious session of cleaning out the garage or basement or shed
  • Those with knee problems typically jumped back into running to quickly
  • People with lower back, wrist or elbow pain are often the golfers who couldn’t wait to get swinging
  • Sufferers of shoulder pain typically have been throwing too hard, too fast and too soon and show up with rotator cuff irritations

Unless you’ve been very active all winter, start all your spring activity slowly and deliberately over several days. Let the body adapt to the increase in movement and work.  Your muscles and joints will not cooperate if you jump in cold turkey at high intensity and for long periods. Your joints will get stiffer and so will your muscle—the perfect recipe for an injury.

Follow our tips to avoid hurting your body:

For spring cleaning

Start with light objects earlier in the day to warm up. Let your body get used to walking, squatting repetitively and lifting.  Your muscles and joints will loosen up and will be able to take on bigger tasks and loads as the day progresses—without the risk of overuse or sudden injury.

For running

When the weather warms up, the pavement dries out and the birds start singing, it’s as if you’ve been given a natural invitation to start running. But if you start too quickly and go too far, you will set yourself up for shin splints, knee pain, calf and achilles tendonitis. The best way to avoid these injuries is to alternate between walking and running, and to keep your distance low for the first few weeks.  Walking 2 minutes and running 30 seconds is a very good way to getting accustomed to your “new” running legs. Over the following three weeks, you can increase the running time and decrease the walking time. Looking for a good running program? We like this one, from The Running Clinic.

For biking 

When you start riding your bike in the spring—whether it’s a road, mountain or upright bike— the first kilometres will result in a sore buttock, and generalized soreness to your neck, shoulders and back. At the beginning of your season, avoid hills, get used to a regular cadence, and only ramp up the distance travelled once your body is well adjusted. If you’re new to cycling, you’ll find a good primer for beginners here.

For golfing

When springtime arrives, there’s a strong pull to get to the golf course to swing some clubs.  Having good game when it comes to golf means consistency: same velocity, same angles, same technique, same arc of swing. But this consistency can lead to overuse injuries. So before you jump onto the course, make sure your lower extremities are flexible or else your low back spine will take the torque and stress at the end of your swing. Also, for the first few weeks of play, avoid your full swing. You need to make sure you build up your functional range before pushing the depth of your swing. Check out this slideshow of some of the best exercises that can help improve your game.

For throwing

Seasonal athletes like baseball or football players are definitely at risk for injuries when it’s time to ball-up!  If you’re tempted to try a deep throw right off the bat, know that you’re guaranteeing yourself a trip to the physiotherapy clinic. Most throwing injuries are rotator cuff related. The solution is simple:  make sure you return to throwing gradually over several weeks. Engage in a resisted shoulder workout program. Rest properly between throwing sessions. And finally, adjust the intensity of the game to YOUR capacity. (Remember, you’re not playing in the World Series!)  If you’re looking to get ready balling, check out this off-season program that will help

 

We leave you with these words of wisdom (and common sense): An ounce of prevention goes a long way to ensure a long and enjoyable lifestyle for the whole summer season.  Enjoy!

Don’t forget that we offer biomechanical analysis services at our clinic. If you’d like us to assess your golfing, running or swimming technique with our mobile lab, let us know. We can help you perfect your form and avoid injuries! Get in touch to find out more!

Get Support: The Importance of Good Bracing

By Bracing, Treatment

Bracing is a topic we often discuss at Active Sport Physiotherapy Clinic—with our patients and amongst our staff. It’s a therapy option that we sometimes recommend to our patients when they’ve experienced an injury or injury, or suffer from a chronic condition that requires extra support for their joints or limbs.

Since we get asked a lot of questions about bracing, this month’s post answers some of your most frequently asked questions.

Q: What are the benefits of using a brace?

A: Whether you’re an athlete or not, wearing a brace can help keep your joints moving naturally and help prevent injury. For those who have sustained previous injuries, a brace can provide added support and stabilization so you can return to sports or work, accomplish everyday tasks without pain or weakness. Apart from the physical benefits, the right brace can also give you the confidence to move more freely, without the worry of hurting yourself again.

Q: Are there different types of braces or are they all the same?

A. Not all braces are designed for the same purpose.

For ankles, knees, and joints, the options are:

  • Supportive braces are designed to support your joints or limbs after you’ve injured yourself and until you’ve completely recovered.
  • Functional braces allow an earlier return to sport or activity and can reduce the chance to re-injury.
  • Rehabilitation braces are used temporarily to allow for progression range of motion of your joint. These are typically used after surgery.
  • Light Arthritic or Proprioceptive braces are designed for light support and compression. These come in the form of braces, sleeves or wraps.
  • Immobilization braces are meant for splinting, partially or completely immobilizing your joint.

Lower back braces sit in a category of their own. They can help you remain comfortable in an acute state. But be cautious: research has shown that back braces do not reduce the chance of injury.

Back braces have various grades of support:

  • The lighter compressive model is meant for comfort and spasm prevention
  • The medium compression model can immobilize your back to a certain extent and will prevent you from moving in a painful manner.
  • The last and sturdier model is meant to immobilize you if you’ve suffered from a back fracture or other acute and severe back conditions.

Q: What about slings?

A: Slings are meant to be used for upper arm injuries—things like supporting the arm and unloading the shoulder. Using a sling can help with your recovery while avoiding constant re-aggravation.

  • A generic sling supports the forearm with a padded strap over the shoulder and sometimes a strap around the waist to avoid movement of the arm when walking.
  • Some specialized slings have “pie shaped” cushion between the body and the forearm to position the shoulder at the desired angle—those slings are typically used after rotator cuff surgeries.
  • Some other slings have a variation of shoulder straps to spread the load of the arm and avoid neck pain.

Q: Why is fit so important?

When buying a brace, fit is important but so is making sure that you get the right brace to address your injury and that the design works for you.

The right brace will help with proper joint alignment, support your injured area and/or help restrict movement that could further injure you or cause you pain.

Q: How do I know what brace is right for me?

A: Our team is here to help identify the best bracing options for your condition, as well and measure and fit your brace appropriately. We’ll make sure you have the optimal support you need.

Q: What is the cost of a good brace?

A:  Depending on your needs, your slings or brace can range in cost. Until we know exactly what type of support or stabilization, it’s difficult to say. An off-the-shelf brace option is the most affordable option but we only recommend these in the right conditions.  When an off-the-shelf brace isn’t right for you, the custom brace is the best solution though it does comes with a higher price tag.  Remember: you can’t put a price on extra support for your joints and limbs!

Q: Do I need to go to Ottawa or Montreal to buy my brace?

A: We make a point of carrying top of the line braces here at our Brace Corner in Cornwall so you can avoid travelling out of town. We offer off-the-shelf and custom support and orthotics, including ankle supports, knee braces, tennis elbow straps, post-surgical braces and slings, and more.

If you have any other questions about bracing, reach out to us. We’re here to answer all your questions!

shoveling

Avoiding Injury: 7 Shovelling Tips

By Prevention

It’s wintertime. And we all know what that means—shovelling.

Shovelling is an inevitable reality that we must endure in wintertime. It’s hard work, and it puts heavy stress on your body. You’ll be at risk for all kinds of injuries, from slips and falls to sprains and strains. So it’s important to take safety precautions.

Here are our 7 tips for preventing injuries from shovelling.

1. Warm up.

Start slowly for the first 10-15 minutes. Brush down your cars or shoveling the stairs is a good way to get started.

2. Use the right shovel.

You might be tempted to use a bigger shovel so you can maximize your shoveling capacity. But bigger is not better.  The bigger the shovel, the harder to push and the harder you will lift. Find a shovel, a scraper or a scoop you can handle using for half an hour without straining or overexerting.  

3. Get a grip.

If it’s icy out, consider staying in. If that’s not an option, as so often is the case, wear snow cleats that fit over your regular boots. These will grip the ice and prevent falls. You can find these at local stores like Canadian Tire, Sport Chek, and Walmart and they will range in price from $30 to $80.  

4. Prioritize pushing.

If you can, push the snow instead of lifting it. Lifting can add a great deal of strain to your back. If you absolutely have to lift, face forwards and don’t rotate your trunk. You want to pivot your whole body to move the snow to its new location.

5. Plan ahead.

At the beginning of your “workout”, you should never tackle hard tasks like moving heavy snow left behind by the plow. Why? Because you’re not warmed up. You also don’t want to save this type of heavier task until the end either because you’ll be tired and more likely to injure yourself. So, plan ahead and do this heavy work mid-workout when you’re still feeling strong and are maintaining good shoveling form.

6. Break it up.

Take regular mini-breaks to give your muscles a chance to recuperate. I like to think of this as an opportunity to look around and appreciate the beauty of winter!

7. Stay active.

If you’re a skier, a skater, a snowshoer or just enjoy tobogganing with your kids, get out there and enjoy winter! If you’d rather stay indoors, there are plenty of other options too. You can join sports activities—think tennis, pickleball, volleyball, etc—or stick to walking at the Benson Centre and Civic Complex, or even the mall.

A half hour of activities per day can help prevent injuries, ailments, and diseases. And it can help you stay fit so you can keep up with all the shoveling you’ll need to do!

 

As a final note, I’d like to thank the people who help relieve my shovelling duties: my generous neighbours with snow blowers, Yvon and Ron, who come to my rescue when needed, and also my 17-year-old son, Nathan, who shows great skill in this department.

weekend-warrior-injury

How to Avoid Weekend Warrior Injuries

By Prevention

So many people have schedules filled to the brim with full-time work, family duties, household responsibilities, and other commitments, so squeezing in regular recreational activities can be a real challenge. Many of us have become weekend warriors, managing to carve out some time to recreate on Saturdays and Sundays. As a result, we tend to push our activities to the limit in hopes of making the best of them. The problem is the remaining five days a week we spend sitting at a desk or in a car commuting back and forth to work or our kids’ activities. Despite this imbalanced schedule,  we still expect our bodies to work in the same way they did when we were younger. Unfortunately, this type of schedule can increase our risk of injury.

There are a few things that you can do every day that can help to minimize your injury risk and help prepare your body and its tissues to better manage the occasional sport-related stress you place on it.

1. Warm up right.

When it comes to warming up our bodies before activity, it seems the older we get the lazier or more complacent we become. For example, we might get to the rink strap on the pads and jump into a game and expect our bodies to hold up. Or we decide to go for a run and start at race pace and wonder why our feet or knees hurt after the first kilometre.

There are many benefits to a proper warm-up that can help our body prepare to the needed workload.

These include:

  • Improving blood flow to working muscles, which allows them to be more pliable and accepting for stretch or loading.
  • Gradually increasing the heart rate and blood pressure, minimizing the chance of getting a rapid spike.
  • Improving oxygen and nutrient transport to the muscles and joints.
  • Improving neuromuscular efficiency and coordination.
  • Mentally preparing you for the upcoming task and increasing your focus.

A good warm-up should consist of a minimum of 10-15 minutes of dynamic movements involving the muscles you will be using for the upcoming activity.A good resource to use is the FIFA11+ warm-up routine, which has strong support for injury prevention behind its program. If you’re unsure about which movements should be included, speak with a healthcare practitioner, kinesiologist, or personal trainer—like our experts at Active Sport Physiotherapy Clinic—to help design something specifically for you. 

2. Maintain a regular stretching and mobility routine at home.

Stretching doesn’t have long, drawn-out process. It can be as simple as five to 10 minutes each morning to get your body prepared to move for the day. Target major muscle groups and movement patterns that you will be using during the day, as well as muscle groups that may get neglected given your work environment. For example, those of us who spend the majority of the day in a seated position should look to stretch the hip flexors and lumbar spine to keep them from shortening over time.

3. Cool down.

It’s important to cool your body down after you’ve engaged in an activity. This doesn’t mean cool off the body with a cold adult beverage after the game (though that does sound good, doesn’t it?). Take the time after a workout to gently stretch the major muscles you used during your workout or activity.

A cool down period helps to:

  • Prevent blood pooling in the extremities.
  • Promote clearance of lactic acid from the muscles.
  • Restore your regular heart rate, blood pressure, and breathing rate.

4. Stay on the move.

It’s important you take the time to get up and move throughout your day. Recommended guidelines suggest that you should stand up at least once per hour if working in a seated position. This can be as simple as getting up for a drink of water or going to the bathroom. But remember, the more you move, the better your body will feel. Having regular bouts of activity throughout your day will help keep your muscles from adapting a shortened position and improve circulation into your lower extremity.

So there you have it, weekend warrior. You may not have the chance to engage in high-energy activity throughout the week but by staying active and healthy, taking the proper precautions to keep your body prepared to handle the stresses you place on it on the weekend, you’ll minimize the risk of injury. If you have any questions about what you can do to prevent injuries, reach out to us by email here or give us a call at 613-936-0676. We’re happy to help!

How to Recover from a Concussion

By Homepage, Physiotherapy, Treatment

No doubt you’ve heard lots about concussions in the news. Perhaps you’re already aware that hits to the head could result in concussions and the symptoms that accompany them:  headache, pressure in the head, neck pain, nausea or vomiting, dizziness, blurred vision, balance issues, visual disturbance, sensitivity to light, memory loss, concentration issues, confusion, depression, emotional changes and sleeping disorder. That’s the short list. There are many other symptoms, too many to name.

The way concussions are managed has changed greatly in the past five years,  especially in the past year.  Concussion management has become a multidisciplinary approach that addresses more than headaches and difficulties related to concentrating.  

Concussion care is a multidisciplinary venture involving child, parent, coach, teacher, physiotherapist, physician, nurse practitioner and optometrist.  When needed, neurologist, ENT specialist, psychologist, neuropsychologist and other medical specialist may be called in to help.

Recognize the signs

The first thing to do is to recognize the signs and remove the person from playing whatever sport they are engaged in. Continuing to play could aggravate the condition and has been shown to double the recovery time. For parents, coaches and trainers, there is a Concussion Recognition Tool (for use with adults and children) that can be downloaded hereIt’s a good idea to carry a printout in your first aid kit!

 

Seek out a professional assessment

If you’re the person who has suffered the concussion, it’s important to have the get a full assessment from a physician, physiotherapist or nurse practitioner trained in concussion assessment to acquire a post-injury baseline and to monitor changes over the following weeks.  Typically, they’ll use the SCAT 5 (Sport Concussion Assessment Tool – 5th Edition), developed by world leaders and researchers in the field. It’s important to note that SCAT 5 is endorsed by the Canadian medical community, the International Olympic Committee and several international sport federations.

 

Have a rest period

It is important to have 48 hours of rest following the injury. This is very important.  (Note: Sometimes the concussion signs can be delayed and a longer rest period is needed.)  Following this rest period, if appropriate, your medical practitioner may decide on a return to light activities—walking, occasional text or email, occasional reading can be introduced during a trial period.

Children affected with concussion need to be assessed differently – they are not simply smaller adults.  It is important to prioritize a symptom-free return to school before a symptom-free return to sports/activities.

 

Progress to light activities, cardio and tasks

If symptom-free, your medical practitioner will help you progress gradually in intensity. First attempt light activities and light cardio, then move on to sport-specific light tasks.  Make sure you work with a health professional trained in concussion management to monitor you for headaches and other symptoms of concussion, balance, endurance, visual disturbances, concentration, processing and memory.

 

Be patient

At times, symptoms are persistent despite your best effort to rest and resume normal daily activities. Things don’t always progress quickly or at least as quickly as you’d like. A trained medical personnel needs to establish if the persistence of symptoms is due to neck troubles, vestibular dysfunctions (inner ear) or if you require Cognitive Behaviour Therapy (for depression, mood or behaviour issues).

 

Understand what physiotherapy will do for you

When you first visit your physiotherapist, they’ll inventory your symptoms and how they affect you.  As the neck can be a contributor to headaches and dizziness, they’ll assess the impact of its dysfunctions on your symptoms.  

They’ll follow that up with a series of balance tests to identify the source of the lack of balance and/or dizziness.  Remember that your physiotherapist’s role is to treat neck dysfunctions and labyrinth (inner ear)/balance problems. If they detect dysfunctions outside their spectrum of care, they’ll be sure to refer you to another specialist.

If they do identify neck or balance problems, or general conditioning issues, they’ll engage in a series of interventions to address these.

 

Don’t do it alone

Recovering from a concussion can be overwhelming and the symptoms can affect physical and mental health. Your progress need to be monitored objectively and medically.  Assessment and follow-up with your physician/nurse practitioner is essential. Working with a sport physiotherapist trained in concussion management, (like those at Active Sport Physiotherapy Clinic), is an important part of getting you back on your feet quickly.

 

Get trained

If you are a coach, athletic therapist, trainer, first aider or parent, you might be interested in booking a  FREE Concussion Recognition and Management Clinic. Please reach out to learn more.  It’s part of our community service program!

Why Physiotherapy is Beneficial for Everyone

By Homepage, Physiotherapy

We’ve all experienced muscle or joint pain after exercising or following a hard day’s work. But when these pains extend one or two days past the workout and limit normal everyday movements, you’ll need to see a physiotherapist.

 

What happens when you injure yourself

During exercise, your muscles, joint and tendons warm up and fill with blood—a process that provides nutrients and oxygen, and releases lactic acid and CO2. This process allows the body to optimize body tissue repair and maintenance.

When you engage in a light level of activity, your body repairs itself automatically and adapts to new works loads. Your body’s structure become more efficient and geared towards performance.  It’s a process called overload exercise principle.

But…things can go wrong. In your attempt to work harder or exercise beyond what you’re used to, muscle tissue and joints can breakdown. When you take things too far, your body’s structure become red, swollen and painful on the inside, and are subject to small micro-ruptures. This results in overuse injuries.

So, it doesn’t matter if you’re a worker or an athlete. Injuries happen. Physiotherapy is there to help repair the damage. Your physiotherapist—like the friendly physiotherapists at Active Sport Physiotherapy Clinic—can help you identify the affected structure and mechanism of injury, analyze the faulty biomechanics (movements) to correct and prevent re-injury, and set you up with a stretching and strengthening program. Their goal is to help you recover and return to your regular activities.

 

What happens when you don’t listen to your body

When you have repetitive irritations, inflammation can become chronic.  What could have healed in a period of two to six weeks may linger for three to six months.  This  happens when a simple inflammation—a mix of redness, heat, pain and tissue irritation—that would normally heal in a few day/weeks changes in chemistry resulting in vulnerable tissue. In other words, when you don’t listen to your body, you can injure yourself more easily!

 

The four-step solution

There are ways to avoid injury in the first place.

  1. Identify the aggravating factors and minimize them.

This sounds easy but can be complicated, especially when those aggravating factors come from tasks we need to complete for work, or for everyday living like walking, holding, carrying, lifting and so on. A physiotherapist can help you make ergonomic choices to avoid motions that irritate your body.

  1. Support the structure.

When it makes sense, you can use a brace for a wrist injury, tendonitis, carpal tunnel, shin splints, chronic ankle sprain or any other overuse injuries. These supports will help you reach a speedy recovery. (As an aside our Bracing Corner has all the bracing you might need.)

  1. Stretch the affected structures.

When inflamed, a tendon or muscle shortens as it heals (similar to how a skin scar pulls inward). You need to heal these in an elongated position to avoid constant re-tearing and re-irritation of the injury. You do this by stretching!

  1. Strengthen to prevent recurrence.

Once lengthened, your tissues are less vulnerable to movement and are ready to get strong again. By strengthening it over several weeks to months, you will gradually reverse the process of chronic inflammation and allow the tissue to receive load once more.

 

Why should you see a physiotherapist?

A physiotherapist is a specialist in movement, function and body mechanics, trained in various sub-specialties including orthopedics, sports, ergonomics, occupational injuries, neurology, and cardiovascular conditions.  These are the experts who know how to identify and treat problems using the most effective modalities, who can set up and support you through programs, and can also help you avoid future injuries. They’re trained to help everyone—from the everyday worker to the amateur athlete to the high-performance professional.