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Concussion

A concussion is a traumatic brain injury that occurs when your brain is shaken inside your skull.

This incident can potentially damage the blood vessels in your brain or injure its tissue. Concussions are referred to as an ‘invisible injury’ since a concussion’s symptoms aren’t always easy to recognize and even MRI imaging isn’t perfect at identifying one. According to Scientific American, one blow to the head may increase your risk of developing a mental health disorder. All it takes is a hard tumble on the basketball court or a blow to your head, neck or body. Yes, that’s right — you don’t necessarily have to hit your head. For example, when your body jolts suddenly due to a hard tackle or a car accident, it can cause whiplash and a concussion.

 

Concussions and sports: When you need to step back and manage a concussion. 

 

Some people think concussions only happen if you black out. But nine out of ten concussions

don’t result in a loss of consciousness and some only cause a brief interruption in mental alertness. Studies find that most high school and college athletes don’t report concussions while playing football. They may not realize that a concussion can happen even if they don’t black out.

In the past, athletes in many sports returned to play too soon after suffering a concussion, sometimes even on the same day. But thanks, in part, to Rowan’s Law, sports and health organizations are starting to take these injuries much more seriously. Trainers, healthcare professionals and athletes themselves are watching more closely for concussions. They are also taking a more conservative approach to rehabilitation and return to play. This is an important change for the health of athletes everywhere. Here are some points to consider and steps you can take to reduce your risk of long-term effects:

 

  1. How can I tell if I have a concussion?

First, you need to know if you have a concussion. Effective concussion management starts with

recognizing the signs and symptoms, some of which may show up hours or days after your

injury. It’s important for parents, coaches, trainers and athletes to recognize the warning signs

and remove the athlete from play if any of them are present.

 

Check for warning signs of a concussion, which typically include:

-Difficulty thinking clearly, concentrating or remembering new information, headache, blurry vision, queasiness or vomiting, dizziness, balance problems or sensitivity to

noise or light, irritability, moodiness, sadness or nervousness, extreme sleepiness or difficulty falling asleep or remaining asleep.

 

It is important to note that concussion symptoms can vary widely from person to person. One person might suffer from pain, while another may experience depression and have difficulty sleeping.

 

Visit to a trusted and licensed healthcare professional as soon as possible:

 

Any athlete with potential concussion warning signs should see a medical doctor or nurse

practitioner as quickly as possible for a diagnosis. Remember, there is no simple test for a

concussion. You can miss a concussion if you rely only on a five-minute assessment done on the sidelines. (Note: If this incident did not occur during sport, another licensed health care

professional, such as a Chiropractor, is permitted to assess you and diagnose a concussion.)

 

Athletes, coaches, parents and healthcare professionals should all be up to date on concussion

safety. If you are not comfortable dealing with a concussion yourself, have a plan in place so you know exactly who to ask for help to identify and manage a concussion if someone shows

warning signs.

 

  1. What should I do immediately after to manage a concussion?

If you’ve had a concussion, the first 10 days are crucial. During this time, you’re at the greatest

risk for another. Not only that, the risk of a second concussion rises every time you have one. If

you can protect yourself in those first few days, you’ll have much better odds of a full recovery.

 

  1. When can I return to play?

Most people recover from a concussion within a few days to three months. The Zurich

Consensus statement on concussion recovery recommends the following five stages of

rehabilitation:

 

No activity – Focus on recovery. Rest your body and your mind.

 

Light aerobic exercise – Get your heart rate up with light activities, such as walking, swimming

and stationary cycling, but don’t go past 70% of your maximum heart rate. Your goal is to

increase your heart rate without risk of re-injury. Do not do any resistance training yet.

 

Sport-specific exercise – Add movement by re-introducing sport-specific movement, like skating

or running drills in soccer. Don’t do anything that might put your head at risk of being hit.

 

Non-contact training drills – Add more complex training drills to improve your exercise,

coordination and working memory (cognitive load). This can include passing drills in football or

hockey. You may start resistance training again.

 

Full-contact practice: Resume normal training once you attain ‘medical clearance’ to confirm it’s

okay. This will build your confidence and skills before returning to play. A medical doctor or

nurse practitioner can provide this medical clearance. A Chiropractor can also co-manage return

to play decisions and sports-specific guidelines.

 

If you experience recurring symptoms at any stage in your recovery, restart this process and

remain inactive until the symptoms cease.

 

Once you complete these five stages, you can return to play but only after a licensed healthcare

professional, who is trained in evaluating and managing concussions, gives you medical

clearance to do so.

 

What role does your healthcare team play?

A medical doctor or nurse practitioner can provide a thorough assessment, concussion diagnosis and manage your condition. They can also evaluate ‘when’ you can safely return to play and provide medical clearance for you to do so.

 

The value of an interprofessional care team:

In all cases, it’s valuable to have a team, with various healthcare professionals, working

together to help manage your concussion and get you back to your sport or activity safely, with an eye on your long-term health.

 

A Chiropractor is often on the sidelines at sporting events, as a trainer or team Chiropractor to

prevent and address spine, muscle or joint injuries. Chiropractors in Canada are not currently

permitted to diagnose a concussion that occurs during sport. However, they have the

competencies, including neurological assessment skills, to assess and give you an informed

referral to the appropriate healthcare professional for further evaluation/treatment. Your

Chiropractor will also work with your interprofessional care team to help manage your

condition, if needed.

 

While you’re resting and recovering, these injuries might resolve on their own. If not, a

Chiropractor can help you recover and work with your care team to co-manage your return to

play. As part of this process, a Chiropractor can evaluate your strength and physical function to

help you know when your body is ready to get back in the game.

 

Some of the best-known strategies for managing a concussion include education,

encouragement and a commitment to getting you back to your daily activities as soon as it is

safe and appropriate. It takes a committed approach from the right healthcare team, along with

your family and friends, to help you avoid or overcome many of a concussion’s negative results.



Author:  Dr. Marco De Ciantis, D.C.

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Cellulitis

As manual healthcare professionals, we tend to view large areas of a patient’s skin.  Often, the visualized skin is in areas that patients may not be able to regularly assess such as their upper and lower backs. As such, we often are able to view skin anomalies that the patient may not only not be experiencing symptoms from but even know exist.  Occasionally, these conditions can mimic (in appearance and symptomatology) regular run of the mill injuries. This is where our education, training and extensive testing methods become crucial in determining how to treat a patient and determining  the requirement of a specialist referral and/or testing. One of the conditions we often suspect is “Cellulitis”.

 

Cellulitis is a relatively common infection of the skin caused by bacteria accessing a break in the skin and spreading from that point. Breaks in the skin can occur during sporting events/activities, surgery or even a bone infection. The signs of Cellulitis include:  warm skin, pain, swelling, redness, leaking of yellow fluid/pus from the painful area and red streaking in the area of infection. Progression of Cellulitis can lead to a more serious cluster of symptoms including numbness in the area of infection, fever, chills, nausea, vomiting, enlargement and/or hardening of the area of infection.

 

Our treatment staff are trained to assess areas of injury and determine if there is a musculoskeletal issue present and rule out skin conditions such as Cellulitis. If Cellulitis is suspected, our staff would immediately refer you to the nearest ER for assessment and intervention.

 

Visit our website or call our head office at 416-385-0110 to book your next appointment today!

 

Author:  Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.

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Freiberg’s Disease

Freiberg’s Disease (FD) is not a usual term that we hear on a regular basis! 

 

FD is a relatively rare condition that predominantly affects the second and third metatarsal bones (i.e. foot bones). While FD is nonspecific to a particular age group, it is primarily diagnosed in those from adolescence to the 20’s. 

 

For those suffering from FD, the head of the affected metatarsal essentially dies. As such, FD generally presents as pain, tenderness, swelling, reduced range of motion and stiffness of the forefoot. Over time, these symptoms can lead to the development of a limp. Furthermore, the symptoms tend to present while weight bearing, such as when walking. The exact cause of FD and the death of the affected metatarsal is not totally understood, however, what is known is that genetic and environmental or lifestyle factors may play a role. Also, acute or repetitive insults to the forefoot area and vascular (i.e. blood supply) compromise to a metatarsal bone are theorized as contributing factors in the development of FD.

 

Diagnosis of FD is usually made via special imaging such as x-ray, MRI, bone scan and/or CT scan. Blood tests may also be ordered by your healthcare team in order to rule out other similar diseases. Typically, FD can be managed conservatively by a Chiropractor or Physiotherapist to control pain, restore range of motion and provide applicable and safe rehabilitation.

 

If you think you may be suffering from Freiberg’s Disease, contact our office today to book your initial assessment!



Author:  Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.

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We just got nominated as Top Choice Wellness Centre of 2023 in North York!

Sports Specialist Rehab Centre is proud to announce that we are a 2023 Top Choice Award Nominee! WOOHOO! Now, we need your help to WIN! Voting is now open and if you feel that we have earned your vote, we would appreciate your support.

Winning the Top Choice Award is one of the largest endorsements a business can receive within North America, so this is a BIG deal! Your vote will automatically enter you into a draw for a chance to win 1 of 4 cash prizes of $500 given out by Top Choice Awards!!!!

You can vote for us here Vote for the 2023 Top Choice Awards Voting ends December 21st, 2022 at noon EST. If you believe we are your Top Choice, please show us some love and help us spread the word! 🙏 Thank you for your time and we appreciate your vote!

P.S your written feedback in the survey is very important to us, as it allows us to know what you love about us and what we can improve to continue serving you every day and providing the best customer experience possible. Many thanks in advance!

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Low Back Pain Tips

Get Your Back on Track with These Tips!

 

About 80% of the population will experience back pain at some point of their lives. But how can one tell if it is serious or not? Most low back strain and sprain injuries will resolve on their own with some help within a week or so. To determine if your injury is more serious, look for the following symptoms: pain in other body areas, numbness and loss of strength or co-ordination. These are all signs regarding when it may be necessary to seek professional help sooner rather than later. But back pain doesn’t have to hijack your sick days, try these tips to help yourself recover:

 

  1. While Recovering

A back brace or protective belt can be helpful in the short-term period following an injury but should be avoided in the long term. Long term use of back braces can promote muscle weakness. Until you recover, it’s best to set those high heels aside. High heels put excess strain on the lower back muscles, making them work harder to keep you from falling forward. Perform gentle stretching to the point where you feel some relief. Don’t stretch to the point where the pain is aggravated.

 

  1. Rest vs. Staying Active

If you’re injured, you may have been told to rest until your injury has healed. However, avoiding exercise is the worst thing you can do when you are experiencing minor back pain. It is important to stay active while recovering from an injury but it is best not to exert yourself. Reduce normal physical activities but continue to be as active as possible. Change positions often and try not to sit, stand or lay in the same position for prolonged periods. Resting in bed or remaining sedentary is only necessary if you’re in so much pain that you can’t move. Perform gentle stretching to the point where you feel some relief. Don’t stretch to the point where the pain is aggravated. At the end of the day, those who maintain active therapy recover quicker. Resting in bed or remaining

sedentary is only necessary if you’re in so much pain that you can’t move.

 

  1. Slipped Disc

Your spinal column is made up of 26 bones (“vertebrae”) that are cushioned by discs. These disks protect your vertebrae by absorbing the shock produced from daily activities such as from walking, lifting and twisting. Injury or weakness can cause the inner portion of your discs to protrude through the outer ring. This is known as a

“slipped” or “herniated” disc and can cause pain and discomfort in your lower back.

In most cases, a slipped disc will revert back to its position spontaneously but it can take 4-6 weeks to fully recover. You may have heard it’s best to rest your back if you have a slipped disc. However, remaining moderately active is ideal to keep muscles and ligaments warm and reduce the risk of creating more tension in your back.

 

  1. Hot vs. Cold

Most people believe that a hot bath reduces back pain. The reality is that even though it may sound soothing, getting into a hot bath when muscles are inflamed can make matters worse, increasing the inflammatory response associated with an acute injury.

Use ice, not heat, to soothe the painful area. Where there is pain, there is inflammation. In the case of back injury, the inflammation may not be visible the way swelling of a sprained ankle might be. A good rule is to remember the word inflammation includes the word “flame” because where there is heat, there is inflammation and pain. Ice can cool down the heat associated with inflammation. It is better to apply ice to an injury for 15 to 20 minute intervals during the first 48 to 72 hours after the injury.

 

  1. Massages

When people have back pain, they often book a massage as soon as they can. The truth is, when you’re in pain, a massage may help in some cases and hurt in others, depending on the cause of the back pain. For instance, your low back may feel tight because of a muscle spasm occurring in an unstable region. If you then massage this area, without truly assessing the source and the reason for its tightness, you can

inhibit the body’s natural protection. The result will cause more instability and more pain.

 

  1. Back Pain and Aging

No matter how many birthdays you celebrate, back pain should not become a normal part of aging. As we age, it‘s true that we can become more susceptible to certain types of painful back conditions. However, with all of the treatment options available today, back pain does not have to be a part of the aging process. 

 

  1. Slow and Steady

Over a recovery period of a week or so, you should experience slow and steady improvement. While in the recovery phase, take a look at your daily routine and consider whether your activities might be contributing to your back pain and slowing your recovery. A Chiropractor or other healthcare professional can help you identify potential triggers. For example: Are you performing too much lifting, bending, or repetitive activities? Are you sitting for long periods of time at home or work without changing positions? If you have to carry items, are you dividing the load to prevent stress on your lower back? Carry two smaller bags, one in each hand, rather than one large bag in one hand or on your shoulder.



Author:  Dr. Marco De Ciantis, D.C.

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Home and Outdoor Exercise

 

Top Tips for Safely Exercising At Home and Outdoors

 

For over a year, COVID-19 has continued to force fitness centres and studios to be shut down across the province, leaving people to find alternative ways to stay active. With the warmer months around the corner, many are already or will be taking advantage of the outdoors to practice yoga, run, cycle, weight train and perform other exercises to stay mentally and physically fit. However, this may increase risk of injury if not performed properly. For example, exercising outside could increase your risk of injury if you are not careful about your surroundings such as holes in the ground, slippery surfaces during or after rain and excessive heat or sun exposure. Also, injuries are more likely if you use unsafe substitute items for weights and dumbbells.

 

If you’re performing physical activity outdoors, such as weightlifting or yoga, be sure to check that you have adequate space and that your training surface is clear of any debris such as rocks, branches, and waste. Select clothing to match the temperature outside. For example, if it’s hot, wear something breathable and light. Make sure to bring an extra water bottle as well so you can properly hydrate.

 

No equipment, no problem:

There are many items that you can use to substitute for kettlebells, weights, and dumbbells to get an effective workout. Here are a few examples:

-laundry detergent jug

-bag of potatoes or soil

 

Trees and tree branches: 

Be kind to mother nature! Make sure to choose trees and branches appropriate for your weight.

 

Park benches:

 Ensure the bench is balanced and stable before using it for an activity. Here are some things to consider-

-Footwear: Ensure your choice of footwear is tailored to the type of exercise you’re performing in order to prevent slips and falls. You should either be wearing shoes or be barefoot if you’re using a mat.

-Space: Make sure the space around you is clear of objects you can trip on, such as toys.

 

-Props: Use proper household items to substitute for weights and dumbbells, such as water or laundry detergent jugs.

-Stools and Chairs: If using a stool or chair to support your workout, make sure that it is stable and has a wide base of support.

 

Mobility drills for warmup and recovery:

While exercising safely is important, it’s equally crucial to do a few stretches before and after a workout. A great way to build a comprehensive exercise regime is to incorporate mobility drills that can help manage pain and reduce the risk of injury. Here are 2 examples of excellent mobility drills

 

Drill #1: Active hip flexor mobility

Begin in a split kneeling stance with the legs bent to roughly 90 degrees. Staying tall, squeeze your glute muscles and lean forward until you feel a stretch on the front of your

Hip. Move in and out of the stretch repeatedly. To increase the challenge of the stretch, you can bend the back leg and hold it with your hand. This is a great exercise for improving hip mobility and may even help those with back pain.

 

Drill #2: Active shoulder mobility

Lay on your back on the ground or atop a foam roller. Using a band or towel in your hands, pull it apart to create a light tension. While maintaining tension, slowly bring your arms overhead until you feel a stretch in your shoulders or chest, neck and back. This is a terrific drill for improving upper body mobility and reducing shoulder and neck tension.

 

Everyday tips for success:

Whether you’re training at home or outside, take it slowly and be gradual–adding intensity such as increasing the amount of reps, sets or time of exercise–by 10% every 1-2 weeks. This gradual progression will help reduce the risk of an overtraining injury.

 

Make a plan to maintain consistency and see gradual progression over time:

Your plan should be specific to your needs. For example, if you’re a runner or cyclist, consider performing alternative exercises, in conjunction with your primary activity. This will benefit other areas of your body and reduce the chance of an overuse injury.

 

Incorporate mental imagery:

Research in this area suggests that mental imagery can improve sport performance while giving your physical body a chance to recover. This can be as simple as closing your eyes, slowing down your breathing and imagining the details of practicing or playing your sport. If you’re exercising for general health, 5 minutes of focused and purposeful breathing may also help reduce stress, tension and anxiety.

 

Workout “together”:

Finally, consider exercising with your friends over a video conference call. This is a great way to increase motivation and make your workout more fun, and, always be sure to follow the latest safety guidelines, such as wearing a mask and maintaining social distancing.



Author:  Dr. Marco De Ciantis, D.C.

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The Right Office Chair

Tips on How to Choose An Appropriate Office Chair

 

When shopping for the best ergonomic office chair, finding a chair that fits your unique needs should be the top priority. Not every chair labeled “ergonomic” has all of the adjustment features necessary to truly be considered ergonomic. Here are the top 5 features you need to consider to make the best selection possible:

 

  1. Seat pan comfort and shape-

When you sit on the chair, the seat pan should be at least 1 inch wider than your hips and thighs on either side. Also, the seat pan should not be too long for your legs otherwise it will either catch you behind the knees or it will prevent you from leaning fully back against the lumbar support. Most ergonomic chairs possess a seat pan with a waterfall front that prevents the seat from catching you behind the knees. The seat pan should also be contoured to allow even weight distribution and finally, it should be comfortable to sit on.

 

  1. Think adjustable-

Always ensure that your chair is pneumatically adjustable so that you can adjust the seat pan height while you are sitting on the chair. You should be able to adjust the height of the seat pan so that the front of your knees are level or slightly below level while your feet are firmly on the ground. In most cases, there should be no need for you to use a footrest. The mechanism to adjust the seat height should be easy to reach and operate when you are seated.

 

  1. Lumbar support is key-

Many chairs have cushioned lumbar supports that can be adjusted up and down and forwards and backward in order to best fit your shape. If the chair will be used by multiple users then this level of adjustment may be required. However, if you are the primary user of the chair then a fixed lumbar support may be acceptable if it feels comfortable.

 

  1. Don’t forget about the hips-

A chair that doesn’t provide enough hip room can make you sit too far forward on the seat pan. This will not provide enough thigh support while you are sitting on the chair.

 

  1. Have a long-term strategy-

Think about how the chair will feel after 60 or 120 minutes. Low-density foam seat pans can become permanently deformed after long term use which can affect cushioned support leading to discomfort, imbalance, and hip and back fatigue.

 

And one bonus tip!

 

  1. Chair covers 101-

On the market, there is a variety of upholstery materials available, each of which has benefits and concerns. Vinyl and vinyl-like coverings are easy to clean and spill resistant, but they don’t breathe. As such, if the chair begins to heat up under the thighs, uncomfortable amounts of moisture can accumulate. Cloth upholstery on the other hand is the most common covering, but it is less resistant to spills and more difficult to clean. A cloth-covered seat pan can also become warm and moisture-laden. Also, over time, cloth-covered foam seat pans can become a significant source of dust mite allergen. When selecting your chair covering, think about cleaning and maintenance in order for you to plan and decide appropriately.



Author:  Dr. Marco De Ciantis, D.C.

 

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Freiberg’s Disease

Freiberg’s Disease (FD) is not a usual term that we hear on a regular basis! 

 

FD is a relatively rare condition that predominantly affects the second and third metatarsal bones (i.e. foot bones). While FD is nonspecific to a particular age group, it is primarily diagnosed in those from adolescence to the 20’s. 

 

For those suffering from FD, the head of the affected metatarsal essentially dies. As such, FD generally presents as pain, tenderness, swelling, reduced range of motion and stiffness of the forefoot. Over time, these symptoms can lead to the development of a limp. Furthermore, the symptoms tend to present while weight bearing, such as when walking. The exact cause of FD and the death of the affected metatarsal is not totally understood, however, what is known is that genetic and environmental or lifestyle factors may play a role. Also, acute or repetitive insults to the forefoot area and vascular (i.e. blood supply) compromise to a metatarsal bone are theorized as contributing factors in the development of FD.

 

Diagnosis of FD is usually made via special imaging such as x-ray, MRI, bone scan and/or CT scan. Blood tests may also be ordered by your healthcare team in order to rule out other similar diseases. Typically, FD can be managed conservatively by a Chiropractor or Physiotherapist to control pain, restore range of motion and provide applicable and safe rehabilitation.

 

If you think you may be suffering from Freiberg’s Disease, contact our office today to book your initial assessment!



Author:  Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.

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Text Neck

Text Neck and How to Avoid It

 

Our modern digital age has gifted us with many conveniences. Smartphones, tablets, and e-readers make it possible for us to communicate or be entertained with the push of a button. While technology can improve our quality of life, it comes with a price; being huddled over our devices for long periods of time can do more harm than good.

 

Using certain devices for extended periods of time can easily lead to neck strain, headaches, as well as pain in your shoulders, arms and hands. If you’ve used a smartphone or tablet for an extensive amount of time, you’ve probably experienced the strain it puts on your upper body. These conditions even have their own name, “Text Neck”.

 

Four Strategies to Help You Avoid “Text Neck” Strain:

 

  1. Take frequent breaks:

Take frequent breaks and look up from your device. This will give your neck some relief from the pressure of looking down.

 

  1. Sit up straight:

It’s important to sit up straight while texting. This way, you can maintain good posture, relieving your back and shoulders from the strain of being hunched over.

 

  1. Hold the phone a little higher:

Holding the phone closer to eye level helps maintain a healthy posture and puts less strain on your neck. Consider using a stand for devices, even periodically, to change the way that you hold and look at your device.

 

  1. Stretch:

Be sure to stretch often between long periods of extended use of devices. Put your hands at your sides and rotate your shoulders to relieve tension. You can also tuck your chin down to your neck and then lookup. This action helps relieve some of the tension built up in your neck due to the forward-down position we often adopt when looking at our devices.



Author:  Dr. Marco De Ciantis, D.C.

 

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