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Achilles Tendon

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What is the Achilles tendon?

 

At all Sports Specialist Rehab Centre locations, our staff frequently diagnose and treat Achilles tendon injuries. While injury to the Achilles tendon may be quite common, with questioning, even though our patients may be aware of where the Achilles tendon is located, few are aware or understand what the Achilles tendon is.

 

A tendon is connective tissue that attaches a muscle or group of muscles to a bone.  When a muscle contracts, the tendon pulls on the bone it attaches to and subsequently moves the bone resulting in joint motion.  

 

The Achilles tendon is the tissue formed from the union of tendons from the gastrocnemius and soleus muscles. These muscles primarily make up the “calf” muscle (located in the back part of the lower leg just below the knee). The Achilles forms just above half way down the back part of the lower leg and attaches to the calcaneus (i.e. “heel bone”).  As such, with contraction of the gastrocnemius and soleus muscles, the Achilles can drive the foot into a toe pointed down (i.e. “plantar flexion”) motion. In about 7%-20% of the population, individuals can have an “accessory” or additional muscle called the plantaris muscle. While the tendon of the plantaris muscle binds to the calcaneus as well, it may or may not be part of the Achilles tendon proper in these individuals.

 

If you have any questions regarding the Achilles tendon or believe that you may have injured it, please contact our head office today or book on-line in order to secure your assessment from one of our amazing staff!

 

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

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Exercises!

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Any Space, Anytime Exercises

 

With the onset of the COVID-19 global pandemic, most fitness centres across the country have been forced to temporarily shut down. These include yoga studios as well as specialized training centres for professional athletes. As such, many of us have turned to training and working out at home and outside, with the goal to achieve the same level of fitness success as prior to COVID-19. This, however, may increase the risk of injury due to a lack of supervision and unfamiliarity with the use of new space.

 

Exercising at Home

 

Here are some things to consider:

 

Footwear: Make sure 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.

 

Stools and benches: If using a stool or bench for support during your workout, make sure that it is stable and has a wide base of support.

 

Exercising outside

 

No equipment, no problem. As not everyone has access to a home gym or gym equipment, there are many household items that you can use to substitute for kettle bells, weights and dumbbells to get an effective workout.

 

Mobility drills

 

While exercising safely is important, it’s equally crucial to perform 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 two 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

Lie on your back on the ground or 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.

 

Enjoy your workouts!



Author:  Dr. Marco De Ciantis, D.C.

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Turf Toe

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With the summer in full swing and the days calling for outdoor activities and sports, we need to be aware of “Turf Toe”!

 

“Turf Toe” is a sprain of the metatarsophalangeal joint of the big toe. The “metatarsophalangeal joint” is the joint located at the base of the big toe where it attaches to the forefoot. A “sprain” is an injury of a ligament which is connective tissue attaching one bone to another. Turf Toe occurs as a result of the toe being forced into dorsiflexion (i.e. extension). This would occur if you got your foot stuck in the ground outdoors or when taking off into a sprint. As an aside, over time in American football, as games became increasingly played on artificial turf, more and more competitors began experiencing Turf Toe. This is due to the fact that grass has more give and is more shock absorbing compared to artificial turf which would contribute to the development of Turf Toe and the establishment of its name.

 

Depending on the severity of trauma, soft tissue damage at the area of the metatarsophalangeal joint can range from minor in nature to resulting in complete tears  and even dislocation of the joint. This extreme scenario would not only produce significant pain but also difficulty in moving the injured toe. In general, the severity of tissue damage will lead to variation in the signs and symptoms of Turf Toe. For example, there will be varying presentation of swelling, bruising and the distribution of pain as well as available motion at the big toe.

 

Any sport and/or activity whereby the foot is loaded when the heel is lifted off the ground and the big toe is forced into dorsiflexion can result in Turf Toe. Moreover, athletes whose sport is predominantly played on artificial turf (such as in American football) typically wear shoes that are softer and more pliable but consequently offer less support to the toe area of the foot. The combination of these factors can unfortunately contribute to the development of Turf Toe.

 

The great news is that Turf Toe can be assessed and treated effectively by conservative methods from Chiropractors and Physiotherapists. Special tests such as x-rays may be ordered in order to rule out the presence of fracture or joint anomalies as a result of trauma.

 

If you think you may be suffering from Turf Toe, contact our head office at 416-385-0110 or book your next appointment online today!



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

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Running Shoes

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Your running shoes should protect your feet from the stress of running, while permitting you to achieve your maximum potential. Selecting the right shoe for your foot can be confusing without the proper knowledge.

 

What’s Best for Your Low or High Arched Feet?

If you have low arches, called “pronators”, you’ll need a shoe that provides stability. However, if you have high arches, called “supinators”, you’ll need a shoe with good cushioning. Check your arches to determine the most appropriate shoes for your feet.

 

When you’re shopping for your next pair of running shoes, choose a store (in person or on-line) with knowledgeable staff with a wide variety of available shoes. Don’t hesitate to consider a range of brands and styles of shoes, what works may surprise you. There are three main features you need to consider when selecting the best running shoe for

your needs: shape, construction, and midsole.

 

  1. Shape

To find out a shoe’s shape, look at its sole. Draw a straight line from the middle of the heel to the top of the shoe. If you have low arches (“pronators”), this line should pass through the middle of your toes, making it a straight-shaped shoe, with the added stability you need. If however you have high arches (“supinators”), this line should pass through the outer half of your toes, making it a curve-shaped shoe, your most comfortable fit.

 

  1. Construction

Take out the insole and look at what type of stitching is used on the bottom. If you have low arches (“pronators”), board construction shoes, which have no stitching on the bottom, are built specifically for you. If you have a mild low (“pronators”) or mild high arch (“supinators”), combination shoes, which have stitching that begins halfway, are the best construction for you. If you have high arches (“supinators”), slip-constructed shoes, which have stitching running the entire length of the shoe provide you with the flexibility you need.

 

  1. Midsole

The midsole determines most of a running shoe’s cushioning and stability. If you have low arches (“pronators”), dual-density midsoles will give you shock absorption, as well

as some stability. If you have high arches (“supinators”), single density midsoles offer the good cushioning you need but without the extra stability you don’t need.

 

A Chiropractor can also assess your gait, as well as the mobility of the joints in your feet, legs,pelvis and spine to help you avoid developing running-related problems. To ensure your body is moving properly, consider visiting a Chiropractor!



Author:  Dr. Marco De Ciantis, D.C.

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Summer Fit Tips

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Summer Fit Tips

 

During the summer months, we often turn our attention to the great outdoors with activities, such as golfing, gardening or running.

 

Being active can help you maintain your flexibility and good posture, build strong bones, and relieve stress. Recreational activities are a great way to enjoy these benefits while having fun. Whether you pick up a garden rake, a golf club or pound the pavement in running shoes, the important thing is to get moving! Remember to keep your back in mind, as you gear up for a fun-filled summer.

 

Here are 8 tips to keep your back healthy as you exercise and enjoy the great outdoors this summer:

 

Warm up

 

Before hitting the links or even the back garden, consider a short activity to warm up first, like going for a short walk. Make sure to do gentle stretches to limber up muscles and joints before lifting, digging or swinging that golf club.

 

Learn the Proper Technique

 

Learn the correct technique for your activity, right from the beginning. Poor technique can cause injury to joints and muscles. For example, be sure to kneel, not bend, when planting your garden. For golfers, take professional lessons to rid yourself of bad habits in your golf swing that could hurt your back.

 

Maximize Your Flexibility

 

Maintaining good mobility for muscles and joints will contribute to your athletic ability and help prevent injury. Restrictions in muscle and joint function can hamper your technique and lead to strains and sprains. If you are a runner, take the time to stretch out calf and thigh muscles before hitting the road.

 

Drink Fluids

 

Drink plenty of fluids before, during and after physical activity. Remember that once you are thirsty, you are already starting to dehydrate. Dehydration affects your energy level and your physical functioning.

 

Don’t Overdo It

 

If you have a big day of yard work planned, consider breaking up different activities into smaller chunks to avoid overloading your body. With a return to summer sports, consider a smaller training session first rather than a longer one (i.e. a trip to the driving range before that first round of golf).

 

Cool Down

 

Cooling down after any physical activity is just as important as warming up. Take 20 minutes for a brisk walk or a slow jog, and stretch out your muscles and joints before heading for the shower.

 

Treat Injuries Promptly

 

If you suffer an injury or experience pain from your summer recreational activities, ice the area to reduce swelling and inflammation, but don’t apply the ice directly to the skin so you avoid a burn!

 

Have a great summer!



Author:  Dr. Marco De Ciantis, D.C.

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Mallet Finger

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Mallet (a.k.a. “Baseball”) Finger is a common injury that occurs at the end of a finger. Despite its alternative name, this injury is not limited to those who only play baseball! 

 

Mallet Finger occurs when a finger makes forceful contact with an immobile/unyielding object. As such, the extensor tendon that is responsible for straightening the last joint of a finger (or thumb) snaps as the end of a finger is forced to bend farther than it can under normal conditions. Muscles end in a tendon which attaches to a bone so that when a muscle contracts, a bone/joint moves. In Mallet Finger, when a tendon snaps, the end of the affected finger will take on a bent appearance and an individual will not be able to straighten it under their own power (but it can be straightened by using your other hand). In some cases, the tendon may not rupture but the bone where the tendon binds to may be pulled off (a.k.a. “avulsion fracture”). In this scenario, the end result is the same but caused by a fracture as opposed to a tendon snapping. 

 

Typically speaking, the dominant hand middle, ring and small finger are the most likely to suffer from Mallet Finger. Aside from the obvious immobile bend in the affected finger, the area may also be painful, swollen and/or visibly bruised. In the scenario that there is blood beneath the  nail of the affected finger or if the nail is detached, seek an ER immediately.  In this scenario, there can be a potential infection risk as there may be a nail bed rupture or “open fracture” present. 

 

Regarding treatment, an x-ray of the affected finger may be ordered in order to ensure a fracture isn’t present. Mallet Finger can be treated conservatively with few cases requiring surgery however, you may want to seek treatment as soon as possible so as not to risk resulting in a permanent deformity. Typically, treatment requires the temporary use of a splint until the tendon and/or bone heals. After enough time, rehab can be initiated!  

 

If you think you may be suffering from Mallet Finger, book an assessment with one of our treatment staff today!



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

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Pregnancy and Pain

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Your Whole World is on Your Shoulders

A study in the Journal of Orthopaedics reported that 50-90% of pregnant individuals will likely experience lower back pain. This pain may persist after giving birth if you don’t take action.

Here are some ways to reduce the risk of back and neck pain:

Lighten your load-

Choose a diaper bag that distributes weight evenly across your body to limit the stress of isolated muscles.

Stretch your body-

While your baby is old enough for tummy time, join them on the floor and do some exercises to stretch your neck and back.

Feed comfortably-

When nursing, avoid hunching and keep your baby close to you. Also choose a comfortable, upright chair with a pillow.

Keep your baby close-

Don’t stretch your arms out – bring your baby close to your chest before lifting. Consider wearing your baby on your front so you can alleviate the strain on your back.

Keep tub trouble at bay-

Avoid reaching or twisting when bending over a tub. When kneeling, use a non-slip mat to protect your knees.

Exercises/stretches to help alleviate your back pain at home:

Shoulder opener

Breathing deeply and calmly, relax your stomach muscles. Let your head hang loosely forward and gently roll from side to side. Bring your hands up to your neck and gently massage the back of your head and neck. Drop your arms to your sides, relax your shoulders; slowly roll them backward and forward for 15 seconds.

Crossover

Standing with feet shoulder width apart, raise your hands. Bring your right elbow across your body while lifting your left knee. Touch elbow to knee, remaining upright and repeat alternating sides for 15 seconds. 

There is no time for back pain in parenthood. Consult a Chiropractor so that you can stay on your toes and a step ahead of your toddler. In Ontario, you don’t need a referral to see a Chiropractor!

 

Author:  Dr. Marco De Ciantis, D.C.

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Get The Word Out!

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A little while ago, did you happen to see us on The Social on CTV?

Here’s a little secret – we didn’t do it by ourselves. We worked with a publicist, Lisa Simone Richards, who showed us how to do it, and she gave us a lather-rinse-repeat system to keep getting exposure for our business!

She’s hosting a free visibility building workshop this month that will help you get started on your path to publicity too.

You can find out more about it at www.finallygetthewordout.com

We’ve learned that it’s easy to ‘borrow’ other people’s audiences to get exposure. And now that we have a clear message and a clear method, we just put it on a megaphone over and over again.

You’ll learn how to do that too at the Get the Word Out workshop!

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De Quervain’s Tenosynovitis

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“De Quervain’s Tenosynovitis” sounds like a mouthful but this is a relatively common condition that many have experienced before albeit unknowingly. 

 

First some anatomy!  Tendons are a tissue that connect a muscle to a bone. As a muscle contracts, the tendon pulls on a bone and a limb or joint can subsequently move. In order to ensure a smooth and as frictionless as possible motion of a tendon, the tendon is wrapped in a sheath. When this sheath gets irritated or inflamed, it is referred to as “tenosynovitis”. With tenosynovitis, the tendon sheath may become thickened and swollen which can affect the motion of the tendon within it.

 

De Quervain’s Tenosynovitis can occur with overuse of the thumb or wrist. The tendon sheaths covering the tendons running from muscles that move the thumb become irritated and inflamed. This can occur with repetitive activities involving overuse of cellphones, with sporting activity or even with household activities. Symptoms generally include pain at the thumb (including its base), swelling, difficulty with using the thumb and/or wrist or a “sticking” sensation with thumb activity. 

 

The good news is that De Quervain’s Tenosynovitis can be treated non-surgically by conservative methods from Chiropractors and Physiotherapists! If you believe you may be suffering from De Quervain’s Tenosynovitis, visit our website or contact our head office today to book your next appointment today!

 

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

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Back To Gardening!

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Back to Gardening!

 

Plant and rake without the ache! Gardening is a great way for you to stay active and have fun in

the sun. Unfortunately, many Ontarians sustain injuries during gardening that can be easily prevented with a little know-how. To tend your garden and protect yourself from injury, follow these tips to loosen-up and lighten the load on your back.

 

  1. Warm up:

Before you begin any physical activity, warming up is your first step to prevent an injury. Take a

walk, even on the spot, 10 to 15 minutes should do it. Don’t forget to lift your knees and gently

swing your arms.

 

  1. Stretch before you start:

To plant and rake without the ache, do each of these stretches for your upper and lower body

5 times. Don’t bounce, jerk or strain. Stretches should be gentle and should not cause pain.

 

Upper Body Stretches-

For Your Sides:

Extend your right arm over your head.

Bend to the left from the waist.

Hold for 15 seconds and repeat on the other side.

 

For Your Arms and Shoulders:

Hug yourself snugly.

Slowly rotate at the waist as far as is comfortable to the left, then to the right.

 

For Your Back:

In a seated position, bend forward from the hips, keeping your head down.

Reach for the ground.

 

Lower Body Stretches-

For Your Thighs:

Face a wall or tree and support yourself against it with one arm.

Bend your right knee and grasp your ankle or pant leg with your left hand.

Hold for 15 seconds and repeat on the other side.

 

For Your Hamstrings:

Stand.

Reach your hands to the sky.

Then bend at the waist and reach toward your toes.

Hold for 15 seconds.

 

To tend your garden and protect yourself from injury, follow these additional gentle rules:

-Kneel, don’t bend, to plant.

-Change your body position often.

-Take frequent breaks.

-Alternate between light and heavy chores.

-Drink lots of water.

-If you suffer an injury, visit a Chiropractor so you can get back to doing the things you love to do, like gardening!

 

Author:  Dr. Marco De Ciantis, D.C.

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