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All Posts in Category: Rehabilitation

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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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Bone Contusion!

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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.

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Bursitis!

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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.

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A Stretch From Adriana!

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Try this delicious stretch from our Fascial Stretch Therapist Adriana!

 

This stretch comes from Eldoa, which aims to complete personal myofascial stretches from head-to-toe!  Your “Deep Fascial Back Line” starts at the bottom of your foot from your plantar fascia and continues up your calf, hamstrings, sacrum, erector spinae,  still further up to your neck and finally finishes behind your eyes!  You’re stretching from head to toe!

 

Breathe deep and hold for 20+ seconds! Enjoy!

 

Author:  Adriana Renton, Fascial Stretch Therapist

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Sprain vs. Strain!

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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.

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Floss Your Joints

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How often do you brush and floss your teeth?

Every day, right? You know it is important for the health of your teeth, and they go yellow and fuzzy if you don’t. Your partner will tell you when you need to brush your teeth, if you haven’t. But what about your joints? How often do you floss your joints for their health so you can move better and feel your best?

Having a daily mobility routine immediately improves and maintains your joint movement, reduces soft-tissue stiffness and allows for easier access to your active available range of motion (ROM). Everyday, just like brushing your teeth, you need to facilitate movement of every joint to keep it healthy until you are 100 years old. What if I told you that at the age of 70 we could get you back doing the splits again within a year? Yes, your body is malleable! 

When you were born, your body was at its most malleable. You can take a baby’s ankles and move them to do the splits in every direction with minimal resistance. Then as we grew up to start walking, running, playing soccer and sitting – we created the range of motion that our body now uses today based on our individual movement patterns and postures. If you don’t use it, you loose it! Those sitting positions restrict and don’t allow you to use your hips and their surrounding muscles and soft tissues to their optimal potential. What does your current ROM look like for your neck, shoulder, hips, ankles?

Your mobility is indicative of your quality of life. Do you have control of the range of motion that you have access to?

I believe in coaching through assisted stretching of Fascial Stretch Therapy in combination with Functional Range Conditioning with the goal of decreasing back pain, injury prevention in athletes, reducing stiffness in older adults and improving the quality of life of every patient on my table. Strength + control + breathe are prioritized as the pillars in order to expand upon usable ranges of motion, articular resilience and overall joint health and facilitate alterations in blood flow parameters as well as relative tissue glide. These principles in your prehab, rehab and training can be a game changer!

If you don’t brush your teeth, you get cavities. If you don’t articulate your joints, you get pain, decrease ROM and even joint degradation. Don’t just move more, move better and feel better!

Author:  Adriana Renton

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Acupuncture Can Help!

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Contemporary Medical Acupuncture

What is Contemporary Medical Acupuncture?
Contemporary Medical Acupuncture, sometimes also known as Neurofunctional Acupuncture or Electroacupuncture, is “a precise peripheral nerve stimulation technique, in which fine solid needles (acupuncture needles) are inserted into neuro-reactive loci, and stimulated manually or with electricity for the therapeutic purpose of modulating abnormal activity of the nervous system.”

How does it work?
There are several mechanisms by which acupuncture works to help patients move better and feel better. Our body really prefers to be in homeostasis, the tendency toward a relatively stable equilibrium between interdependent elements, especially as maintained by physiological processes. When an intervention like acupuncture is brought into the mix, it helps to precipitate the process of maintaining that equilibrium. This commonly happens by either up regulating or down regulating specific cellular processes based on the body’s need to “return to normal”. For example, if a muscle is “tight” or has high neural tension, the acupuncture will aid in reducing that tension.

Is it safe?
In short, YES. Of course, as with all treatments, there are some risks involved. However, in Ontario, practitioners who utilize acupuncture are all regulated healthcare professionals with extensive training in anatomy. Part of the training includes comprehensive discussions on the safest way to needle and how to best avoid any adverse events. Your safety, comfort and health are our top priority!

Does it hurt?
Generally, NO. However, at times, a patient may feel a dull ache or a twitch in the muscle; this dull ache is actually a positive thing and means we are affecting our target in the muscle. If there is ever too much discomfort, it’s important to let your practitioner know and things can be adjusted, or needles can always be removed.

What types of conditions can be treated with Neurofunctional Electroacupuncture?
Electroacupuncture can be used to treat a wide variety of neuromusculoskeletal conditions. Some of the more common conditions that respond well to acupuncture are:
Back pain
Neck pain
Headaches
Tennis elbow
Plantar fasciitis
Shin splints
Shoulder, hip and knee pain
Many more!

 

Author: Dr. Allie Dennis


Resources:
Elorriaga Claraco A, Fargas-Babjak A. Contemporary Acupuncture for Health Professionals. Handouts Unit 1-5. Fall 2016.

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Hurt versus Harm

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One question I hear from many of our patients at The Sports Specialist Rehab Centre is “Should physical activity be painful?”.  Generally, the answer is “No”.  

 

Physical activity can be loosely defined as a voluntary activity performed by an individual for a specific purpose that leads to movement and force generated from the body.  This can include exercise, sports or rehab.  The forces generated during physical activity can place stress upon the muscle tissue, joints and supportive tissue.  As such, it is common and sometimes expected that during physical activity, there can be some discomfort (i.e. “hurt”).  For example, if I am playing tennis, I would expect some minimal discomfort in my wrist, elbow and possibly shoulder.  That said, this “hurt” does not necessarily translate to damage of body tissue.  However, if a physical activity is ever painful (i.e. “harm”) while being performed, generally, that is not a good sign.  This may indicate that you are damaging tissue as opposed to just engaging it.  As such, should a physical activity ever become painful, please stop the activity immediately!  The age old adage of “no pain, no gain” is not a fruitful one.  The pain generated while performing an activity could represent significant trauma to an area and could have long term and far reaching implications. 

 

Everyone’s definition of pain is completely subjective.  So you, the individual, become the best judge at deciding when an activity becomes harmful, and not just a bit hurtful.  If you should have any questions or questions regarding when an activity is hurtful versus. harmful, please don’t hesitate to contact one of our therapists who would be more than happy to explain!

 

Be active but be safe!

 

Dr. Paolo De Ciantis

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Dr. Paolo’s Morning Shake

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I love to begin each day with a hard workout session! Following that session, I need a high energy, hearty and protein filled shake in order to get may day going! Here is what I found works best for me, try it out if you like:

1. 710 mL (about a pint and a half) of cold water.

2. 1 large banana (or 1 cup of frozen unsweetened mixed berries)

3. 1 tsp of ground unsweetened cocoa pods

4. 1 tsp of ground turmeric

5. 2 cups of ground rolled unsweetened oats

6. 1 tsp of ground cinnamon

7. 2 tbsp of ground flax seed

8. 1 avocado

9. 1/2 scoop of whey protein isolate (I prefer chocolate or vanilla flavoured)

Enjoy!

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Breathing is Important!

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How important is breathing?

The short answer is…. VERY!

I know this sounds like a silly question and silly answer – of course breathing is important, without oxygen our bodies wouldn’t survive. But I’m here to explain why breathing is not only vital to living, but is important for pain management and musculoskeletal health.

The first important piece of information is to know and understand what the diaphragm is. The diaphragm is our main breathing muscle. It sits at the bottom of our rib cage and when our brain tells us to breath in, it gets the diaphragm to contract, pulling it downwards and leading to decreased pressure in our chest cavity. This change in pressure allows air from the outside to flow into our lungs with ease. When we breath out, the diaphragm relaxes, pushing the air back out of the lungs.


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I assess breathing in almost every patient I have, especially those with low back and neck pain.

In patients with low back pain, there is often a large focus on core stability and core strengthening. What you may not realize, your diaphragm is really the top part of that ‘core’ that we talk about so much. By focusing on your diaphragm while breathing and allowing it to work optimally, you are training your core. There is evidence showing faulty breathing patterns in a significant number of patients with low back pain, compared to their pain free counterparts.


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In patients with neck pain, there tends to be a lot of ‘chest breathers’. Instead of using their diaphragm to control breathing, these patients often use their accessory breathing muscles in the neck that really only need to be activated when we’re exercising very hard and need to have hard, rapid breathing. So again, by focusing on your diaphragm while breathing and allowing it to work optimally, you are allowing those accessory breathing muscles in the neck to have a break so they can stop taking on another muscle’s job.


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Finally, breathing plays an important role in pain management. When we are in pain, our sympathetic nervous system turns on (i.e. fight or flight response). This tells our brain that something bad is going on and every sensation becomes amplified. When our sympathetic nervous system is amped up, we tend to use shallow, rapid breaths; this is not the most efficient way to oxygenate our tissues. By taking some time to focus on diaphragmatic breathing, and taking slow, deep breaths, we are actually able to ‘trick’ our brain and tell it that everything is okay, by turning on our parasympathetic nervous system instead (i.e. rest and digest response). This allows for a decrease in sensitivity to painful stimuli which really just means that our brain will tell us we have less pain than we did before.


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So in summary, BREATHE! It will help you in more ways than you even knew.


Author: Dr. Allie Dennis

Resources:
Roussel N, Nijs J, Truijen S, Vervecken L, Mottram S, Stassijns G. Altered breathing patterns during lumbopelvic motor control tests in chronic low back pain: a case-control study. European Spine Journal. 2009; 18: 1066-1073
Chaitow L. Breathing pattern disorders, motor control, and low back pain. Journal of Osteopathic Medicine. 2004; 7(1): 34-41.
Cagnie B, Danneels L, Cools A, Dickx N, Cambier D. The influence of breathing type, expiration and cervical posture on the performance of cranio-cervical flexion test in healthy subjects. Manual Therapy. 2008; 13(3): 232-238.
Jerath R, Edry JW, Barnes VA, Ferath V. Physiology of long pranayamic breathing: Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Medical Hypotheses. 2006; 67(3): 566-71.

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