Join the Ontario Chiropractic Association in celebrating the best in Chiropractic!
Please visit the link below to learn more about the award event and to nominate an Ontario Chiropractor for various catagories today!
Contact : 416-385-0110
Join the Ontario Chiropractic Association in celebrating the best in Chiropractic!
Please visit the link below to learn more about the award event and to nominate an Ontario Chiropractor for various catagories today!
Bones can bruise?!?
A “bone bruise” (a.k.a. “bone contusion”) is a relatively common injury, particularly in athletes. In order to explain how a bone can bruise, let’s talk about some anatomy first. “Periosteum” is a membranous tissue that surrounds bones, excluding the articular (i.e. “joint”) surfaces. You can think of periosteum as a type of bone “skin”. In the event of a trauma to a bone, for example, a force received while participating in a contact sport, the periosteum can be injured. This injury would result in the development of a “bone bruise”.
Bone bruises are not overt fractures of a bone but nonetheless, they can be quite painful. A diagnosis can generally be made through a detailed history and physical examination, not necessitating the use of special imaging or tests such as x-ray, CT and MRI scans. Conservative treatment from manual therapists such as from Chiropractors, Physiotherapists, Registered Massage Therapists and Fascial Stretch Therapists can help reduce pain, provide range of motion support and dispense the appropriate rehabilitation for proper recovery.
If you believe you may be suffering from a bone bruise, contact our office or book online in order to secure your next appointment today!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.
“Battle Sign” is a visual sign from a severe trauma to the skull resulting in a fracture and should not be taken lightly!
“Battle Sign” is the result of a “basilar skull fracture” or “basal fracture” (i.e. fracture of a skull at its base). Fractures of the skull at its base can include fracture of the bone behind the ears, at the base of the nose/nasal area and close to the spine. Basilar skull fractures are considered not only one of the most common but also one of the most severe types of fracture to the human skull. Trauma resulting in fracture of the aforementioned structures can place neurological and vascular tissue in the area at risk for injury which is why this type of fracture is considered a medical emergency!
One of the most apparent signs of a basilar skull fracture is the presence of distinct and severe bruising along the entire backside of the ears and possibly extending to the neck/cervical spine region. This is referred to as “Battle Sign”. Occasionally, individuals with Battle Sign may also present with “raccoon eyes” (i.e. bruising around the eyes). Additional signs related to Battle Sign can also include but are not limited to: clear fluid draining from the nose and/or ears, headache, dizziness and blurred vision. Due to its presentation, Battle Sign is often confused for a harmless bruise but, unlike a common bruise, it will not fade over time without other symptoms. Following a head trauma, Battle Sign may take a few days to present. One of the differentiating factors regarding the presentation of Battle Sign is that it appears at an area not directly related to the sight of injury, like a traditional bruise. The head trauma involved in producing Battle Sign can include sports, car accidents, falling off a bike without a helmet, motorcycle accidents as well as falls. These types of activities are very common in the spring and summer months and as such, we need to be very vigilant about the risk of head trauma and the presentation of Battle Sign.
Due to the risk of serious and possibly permanent neurological compromise, a suspected head injury resulting in Battle Sign warrants an immediate referral to the Emergency Room of a Hospital for assessment, treatment and monitoring. Proactively, this spring or summer, if you should be playing contact sports, riding a bike or operating a motorcycle, wearing a protective helmet is key to your safety!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.
“Stenosing Tenosynovitis” also commonly known as “Trigger Finger” is a relatively common and painful condition whereby sufferers will experience locking of one or more fingers, often getting stuck in a bent position. It is possible to also experience or hear an audible “snap” or “pop” sound with movement of the affected fingers or being stiff to active motion. The aesthetic effect of the condition makes it appear as if the injured finger is squeezing a trigger.
Trigger Finger is most often experienced by individuals who have occupations or hobbies requiring the frequent and repetitive squeezing action of the hand and fingers. The tendons (connective tissue that run from muscles and attach to bones) that are responsible for and allow for motion of the fingers can become inflamed and enlarged. This makes it difficult for them to easily and seamlessly run through tendon sheaths (connective tissue that surrounds the tendons and allow for smooth uninhibited motion). A bump or “nodule” can also develop on the affected tendons further exacerbating the issue. The symptoms are usually worse in the morning but dissipate over the day as the fingers and hand are used over the course of the day. Depending on how advanced the condition is, surgery can be required.
The great news is that Trigger Finger can often be treated conservatively by manual therapists such as Chiropractors and Physiotherapists. Our treatment staff are trained to identify and treat Trigger Finger!
If you think that you may be suffering from Trigger Finger, book your appointment today for an assessment.
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.
My name is Daniel and I am a 4th year Kinesiology student at the University of Guelph-Humber. As part of the curriculum for my degree, I was required to complete two field placements, one in 3rd year and one in 4th year. The program allows students to gain more than 200 hours of workplace experience through chosen placements in the health and fitness industry, clinical, rehabilitation setting, education or research. Due to the COVID-19 pandemic my journey of finding a placement for the semester looked a little different than expected but I would not have had it any other way.
I reached out to Dr. Marco DeCiantis at the Sports Specialist Rehab Centre and had the privilege to work with him through a virtual placement from September – December 2020. Although our time together was completely remote, the learning experience was tremendous. We met 3x a week over Zoom in which Marco mentored me on various aspects of being a clinical professional. He guided me through providing quality patient care, and how to effectively diagnose and treat various conditions. Through our discussions, he familiarized me with consultations, assessments and patient care. He truly gave me insight into the day to day work of being a health care professional. He consistently provided me with learning objectives to complete on my own time to further my knowledge on the topics discussed. Usually, this involved researching different conditions, symptoms and treatment methods. An example would be us discussing scenarios that are deemed Red or Yellow flags, examples of contraindications, and discussing the importance of consent. Furthermore, he discussed and educated me on clinician protocols such as patient history, orthopedic neurological examinations, motor/reflex testing etc.
Another component of my placement occurred every Wednesday for 1 hour. Marco gave me the opportunity to sit in on meetings for a volunteer program that aims to provide sustainable healthcare to rural under-serviced populations through education and training. The meetings consisted of approxiimately 10 clinicians from Canada and Africa in which we would provide education to the health officers regarding various conditions, treatments and tools to improve their skills in the healthcare field. We would routinely go through clinical rounds and work through cases with them creating informative presentations. This sparked discussions on formulating diagnosis, treatment plans and educating patients. Marco would then have me investigate further into cases on my own time to see if I could help with the scenarios. I learned all about conditions varying from mechanical back pain, ankle sprains and fractures all the way to infectious diseases. That portion of the placement was by far my favorite and really provided me with a different perspective on worldwide healthcare. To have the opportunity to virtually meet with health officers in Africa was an unmatched experience. Working with Marco greatly furthered my education and I am very happy with how my semester proceeded.
Myositis Ossificans! That’s a mouthful!
“Myositis Ossificans” (MO) sounds like a fictional term but it is by no means a rare condition. MO, for lack of a better term, is when muscle tissue begins to ossify (i.e. turn to bone) following a traumatic injury. Generally, a direct, forceful trauma is involved (eg. a hockey player receives a knee-on-thigh injury during a game). Typically a large, deep muscular group is involved, such as the quadricep or hamstring muscles. In most cases, one would see a large discoloured area associated with a very significant bruise following the trauma. Internally, the body will begin to turn muscle to bone at the healing site. Over time, a “hard” lump can be palpated (as the body lays more and more bone) at the injured area. The reason why MO occurs is not well understood at this time. The thought is that following the injury the body gets “confused” and as a result it begins to lay bone at the site of injury. As more bone is laid down, the function of the muscle may become affected leading to pain as the muscle is used. This can prevent athletes from returning to sport or even end careers!
In order to minimize the likelihood of developing and/or exacerbating MO, after an acute traumatic event to a muscle, an individual should not return to sport and should ice and immobilize the affected area. I also recommend immediately booking an appointment with a healthcare provider so that the injury can be thoroughly examined and assessed. The healthcare provider can determine if you are at risk of developing MO or if it is in progress. Also, the healthcare provider can provide advice and offer conservative (i.e. “non-surgical”) interventions to manage the tissue trauma. However, in serious or not properly managed cases, surgery may be indicated in order to remove the bone from the affected muscle.
If you think you may be at risk of developing MO, please contact our office to book an assessment with one of our amazing therapists!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.
A “contusion” is the medical term for a bruise. Bruises usually occur at the site of an injury where blood vessels have been damaged resulting in leakage of blood from these vessels. This leakage produces the characteristic discolouration we all associate with bruising.
A “bone contusion” (i.e. “bone bruise”) is when there is trauma to bone, but not severe enough to result in a fracture. Bone is wrapped in a thin tissue called “periosteum” (kind of like a “bone skin”). The periosteum is composed of dense connective tissue and does not cover the articular (i.e. “joint”) surface of bones. Periosteum is rich in nerve endings (which can result in pain) and blood vessels. With a significant enough trauma, you can damage the periosteum leading to a bone bruise. Symptoms can include, but are not limited to, pain (generally more severe and longer lasting than a solely soft tissue injury), swelling, stiffness and possibly discolouration. Generally speaking, bone contusions will not present on x-ray examination but x-rays may be required in order to rule out a fracture. The soft tissue surrounding the bone contusion may also be injured in the same traumatic event. A bone contusion can be present for days, weeks or even months!
If you think you may have received a bone contusion, don’t waste time to book an appointment with one of our talented therapists who would be able to examine you today!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.
I’m suffering from bursitis? What’s that?!
“Bursa” is not a common word that many of us hear outside of the healthcare community. However, many of us have suffered from “bursitis” in our lifetime.
Let’s begin with some anatomy! Bursa are small fluid filled sacs. They are strategically placed by the body in areas where tendons make contact to bones. As such, they are designed to allow for a frictionless gliding movement of tendons on bones during muscle contraction. This will prevent damage from occurring to a tendon and makes the motion of a joint painless and smooth. Bursa are placed all over the body and are generally named for the location they are located. For example, the “subdeltoid bursa” is placed near the shoulder joint in the region of the deltoid muscle.
“Bursitis” occurs when the bursa is inflamed. When the bursa is inflamed, motion of the tendon (due to muscle contraction) can cause pain with movement of a joint. What’s worse is that this activity can further irritate the bursa, exacerbating the problem! The bursa can become inflamed for a variety of different reasons that include, but are not limited to, direct trauma or overuse of the muscle and/or joint.
The good news is that manual therapists such as Chiropractors and Physiotherapists are trained to treat bursitis! If you have been diagnosed with a bursitis or suspect that you may be suffering from it, don’t hesitate to contact our office today to book an examination!
Author: Dr. Paolo De Ciantis, B.Sc. (Hons.), M.Sc., D.C.
Plantar Fasciitis (PF) is a common foot condition affecting the plantar (i.e. sole) aspect of the foot. The “plantar fascia” is thick fibrous connective tissue that runs along the sole of the foot the length of the heel to the toes. PF occurs when the plantar fascia is inflamed. This is primarily experienced as pain in the heel of the foot. The plantar fascia can become inflamed for a variety of different reasons ranging from wearing ill-fitting shoes to trauma associated with sports activity. Very commonly, sufferers will experience the most pain with the initial steps out of bed in the morning with progressive reduction of pain over the course of the day as they move around. However, pain can intensify after rise form a prolonged sitting period or movement following a prolonged standing period. Sufferers can also experience PF in both feet simultaneously!
The good news is that manual therapists such as a Chiropractor or Physiotherapist are trained to determine the presence of PF and to treat it conservatively. This can involve manually working directly on the plantar fascia and surrounding tissue as well as incorporating lifestyle modifications and rehabilitation.
If you think that you may be suffering from PF, don’t hesitate another moment to contact our office and book your examination today!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.
Is it a sprain or a strain? What’s the difference?!
I am confident that most of us have been told at one time or another that we have experienced a “sprain” or “strain”. However, what do these terms really mean?
Quite simply, a “sprain” refers to injury of a ligament (i.e. dense fibrous connective tissue that connects one bone to another bone) while “strain” refers to injury of a tendon (i.e. dense fibrous connective tissue that connects a muscle to a bone). Medically, injury to a ligament (“sprain”) or a tendon (“strain”) is classified on a scale of 1 to 3. Grade 1 or “first degree” refers to minor injury of the ligament or tendon. Generally, there is little to no actual tissue compromise and, as a result, little bruising, bleeding or swelling but some pain. Grade 2 or “second degree” sprains or strains result in tearing of the ligament and/or tendon. As you can imagine, there is generally more pain and some moderate swelling and bruising. Finally, Grade 3 or a “third degree” injury refers to a complete tear of the ligament and/or tendon. This generally results in the most pain as well as significant swelling and bruising. Depending on the area affected, there may also be mechanical compromise of the joint or limb.
Your Chiropractor and Physiotherapist are trained to assess for the presence and degree of ligament and tendinous injury. They can also determine if the severity of your injury may warrant a referral to a medical specialist. If you think you have a “sprain” or “strain”, don’t hesitate to contact our office to book your next appointment and have one of our therapists assist you today!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.