airplane back pain

Preventing Back Pain for Flight Crews and Travellers

Air travel is a fact of life for many of us, whether because it’s our livelihood, our work demands it or we want to explore places that are most easily accessed by flying. There were 600 licensed air carriers in Canada in 2018 and just over 159 million passengers boarded and unloaded in Canada last year; 34.7 million of them were Canadians. In addition, for each of the flights that took off or landed in Canada, there were air crews to add to the totals.

Unfortunately, flights longer than an hour aren’t always the most comfortable for our backs and may cause or aggravate injuries. Back pain, as many of us know from personal experience, is no joke, and it is also fairly common. Statistics Canada notes that four out of five Canadians will experience at least one incidence of back pain during their lives, with the pain most likely to occur in those between the ages of 30 and 50. Back pain can impede mobility and affect quality of life, so it’s something we’d all like to forego.

Causes of Back Pain While Flying

Whether we’re flying for work or pleasure, knowing how to prevent and address the concomitant back pain is essential. For passengers, threats to our backs include long periods of sitting or standing, sleeping in an unnatural position, travel stress, lifting heavy objects, such as suitcases, and twisting the body while you’re lifting something.

For air crews, the list includes heavy lifting, reaching and lifting, twisting while lifting or holding a heavy load, lifting or carrying objects with odd shapes, sitting or standing for prolonged periods in one position, working in awkward positions, slipping on a wet floor and, perhaps, poor sleeping positions.

Preparing for the Flight

If you’re planning a trip, you can take some steps in advance to ensure that you won’t incur a back injury, or even a twinge:

  • Get a Doctor’s Note. Your physician can provide you with a letter requesting certain accommodations that will make travel smoother. These can include the ability to walk around during the flight, permission to lie down on the floor and rest, additional pillows and blankets and a possible upgrade to business class.
  • Contact the Airline. If you let your carrier know about any back issues, you can also request a wheelchair to take you from security to boarding, assistance with lifting and carrying luggage and help in boarding.
  • Pack Lightly. The fuller your bags, the heavier they are to lift and carry. Check your bags, if possible, so you have no need to hoist them into an overhead bin. If you do have a carry-on bag, ask one of the flight attendants to assist you in lifting it.
  • Adjust Your Schedule. If you have a choice, fly at a less-busy time of day so you’ll have more room to move about the aircraft and an easier time getting to the aisle, stand or stretch.
  • Prevent Inflammation. Pack your carry-on bag with ibuprofen or any other relevant medication that prevents back pain and reduces inflammation, especially if it’s an ongoing problem.
  • Keep Exercising. Maintain your exercise routine in the days leading up to a trip. Sitting in cramped quarters if you haven’t been exercising could cause muscles to spasm. Exercise keeps your muscles flexible.

Back Pain Prevention In Flight

No one is eager for a back injury, especially with the chance that it could become chronic. Here are some tips for coping with the standard discomforts as a passenger:

  • Keep Moving. Unless you’re one of those travellers who can sleep through a flight, try to book an aisle seat to make it easier to get up and walk around or stand. Doing so will help alleviate any pain and stiffness you feel from sitting in one position.
  • Recline Your Seat. Yes, it may crowd the person behind you, but it relieves the pressure on your discs caused by the standard sitting position. You will be supporting some of your weight with the backrest, rather than your spine.
  • Use a Back Support. Lumbar rolls and back braces can provide you with additional spinal support while flying. Use a roll (or a rolled-up sweater) that supports your lower back without pushing it away from the seat.
  • Stay Hydrated. Drink water and more water for a few days in advance of travel and during travel. Cabins are dry, which can exacerbate back problems. The gel in the inner discs of the spine is also susceptible to dehydration, so drinking water is a good preventive measure against tears and bulges.

Preventive Measure for Crew Members

Airline attendants are subject to different stresses and strains that can cause back injuries. These tips can help them to keep back injuries at bay:

  • Stay Fit. You’ll need good fitness to endure long flights with all of the standing, bending, lifting and reaching your job requires. A strong core, especially, is important for preventing back injury and pain. Cardiovascular fitness is also valuable.
  • Stand Properly. When you’re on your feet, keep your head in line with your shoulders and be sure your shoulders are in line with your pelvis. Draw your buttocks and abdomen in gently – a protruding abdomen puts undue pressure on your spine. Place your feet a shoulder-width apart to distribute your weight evenly. Don’t tense up – it may actually contribute to back pain.
  • Lift With Care. If you need to lift heavy loads, do so from hip level or lower. Bend at the knees, not from the waist, to prevent injury to your back. Your body isn’t designed to twist like a Gumby; avoid doing so when you lift. Move your entire body when you turn, rather than shifting only your upper body. Keep the load close to your centre of gravity – at your chest, rather than down near your hips.
  • Don’t Overreach. When you reach with one hand, be sure to find a stable anchoring point with the other.If you use your feet alone to balance while the trunk is tight and twisting, you can pull muscles in your lower back.
  • Watch Those Bends and Turns. If you need to bend, do so from the waist and don’t turn at the same time. Turn the entire body, rather than turning from the waist.

If you have concerns about back pain, either before or after your flight, your physiotherapist can be invaluable helping you address your concerns.

Is air travel causing you back pain?


warehouse work back pain

Warehouse Work Causing Back Pain

With the rise of Internet shopping, the warehouse – and the warehouse worker – has become a more visible part of the supply chain. When bricks-and-mortar stores were the usual destination for purchasing goods, it is unlikely that consumers gave much thought to where their goods had been stored before being displayed by a retailer. Today, however, as more and more people order goods online – 87 per cent of Canadians made at least one online purchase last year, according to the Canadian Registration Internet Authority — warehouses figure prominently in the packaging and delivery of those items and get more attention.

Warehouses and Back Injuries

Along with warehouse work come back injuries. Canada’s Workplace Safety and Insurance Board (WSIB), the organization that handles workplace injury claims, reported in 2017 that the lower back was the body part that resulted in the largest amount of lost-work time, accounting for 17 per cent of all claims.

Overexertion was the leading cause of injury for materials handlers, especially those ages 20-24, with the lower back the area most affected, usually by strains and sprains. However, warehouse workers are also subject to other injuries, such as pulled muscles and pinched nerves. It’s no real surprise, considering all of the bending, lifting, twisting and quick shifts in motion that are part of the job.

For example, bending down to reach low shelves and lifting heavy items up can be injurious. Warehouse employees also need to be constantly on the lookout for fallen objects, spills and moving vehicles so they can remain safely on their feet. In addition, vibrations from forklifts used to move boxes and crates cause wear and tear on the body.

Even sitting to do paperwork to document your work or standing around waiting for your next task can be tough on your back. Most of us don’t use proper posture when we’re in our chairs or on our feet and our backs suffer for it.

Prevention is Essential

That’s the bad news. The good news is there are things you can do to prevent back injuries. Your physiotherapist can develop a course of stretching and exercise designed to strengthen your back muscles and ensure you are prepared for the repetitive motions your job requires. It’s important to use the proper technique, because even minor injuries and a poor physical approach to your tasks can lead to recurrent or chronic back pain.

There are also other keys to maintaining a healthy back. Take note of these tips and you’ll have the best chance of keeping your back in good shape:

  • Stretch. Stretching loosens tight muscles and improves flexibility while preparing your body for periods of exertion, along with sitting and standing. Don’t simply stretch prior to the start of your workday; take regular breaks to do a few simple stretches. They’ll help reinvigorate your back muscles and banish those kinks that appear during the course of the day.
  • Lift and Carry With Care. If you need to lift heavy loads, do so from hip level or lower. Keep the load close to your centre of gravity – at your chest, rather than down near your hips. Bend at the knees, not from the waist, to prevent injury to your back. Avoid twisting when you lift; your body isn’t a corkscrew! Move your entire body when you turn, rather than shifting only your upper body.
  • Take Care of Your Tootsies. Your feet are important supports, especially in warehouse work, which requires you to stand much of the day. When your feet are uncomfortable, it places more stress on your back, so be sure you wear supportive footwear. Custom orthotics work well for people who spend most of the day upright. You don’t want to end your shift aching and in pain, so treat your toes well. You’ll feel the difference at day’s end.
  • Stand Properly. When you’re on your feet, keep your head in line with your shoulders and be sure your shoulders are in line with your pelvis. Draw your buttocks and abdomen in gently. Place your feet a shoulder-width apart to distribute your weight evenly. Don’t tense up – it may actually contribute to back pain.
  • Sit Correctly. If you spend part of your time doing paperwork, be as conscious of your seated posture as your upright stance. Place your feet firmly on the ground and your buttocks in the space between back in the chair and the seat. Align your knees with your hips. Make sure your chair allows you to rest your arms at elbow height. Keep your computer screen at eye level.

Finally:

  • Know Your Limits: Your employers don’t expect you to be Hercules, and you shouldn’t expect it of yourself. Excessive pride can lead to injury. If you need a hand in lifting something heavy, ask for it!
  • Don’t Ignore Pain: Pain is your body’s way of telling you something is wrong. If you feel even a twinge, accept it as a signal that you need to make an adjustment, whether in your lifting technique, your standing posture or your job itself. Don’t hesitate to visit your physiotherapist for an assessment and some solutions.

Is warehouse work causing you back pain?


shoulder pain

Why are my shoulders sore?

You’ve heard your friends describe someone by saying, “He carries the world on his shoulders.” It’s a saying that derives from Greek mythology and it refers to Atlas, the Titan god who held the sky aloft. When the Titans were defeated by Zeus, Atlas was condemned to carry the heavens on his shoulders and he is often pictured as a man bending forward, holding the Earth on his back. Now, who wouldn’t have sore shoulders from such a challenge?

While you don’t literally carry the world on your own shoulders, figuratively, you may feel as if you do. Life is full of stress and challenges and our shoulders absorb much of that tension. In addition, our shoulders are the joints with the greatest range of motion and are ripe for injury. Luckily, there are ways to ease your physical burden.

How do you relieve shoulder pain?

Naturally, some sources of shoulder pain require more serious remedies than others, but all are treatable. There is no need to suffer unduly. The appropriate treatment for your shoulder pain depends on:

  • Severity of the injury;
  • Location and type of injury;
  • How long ago it occurred;
  • Your own age and general health; and
  • Your usual activities.

If your shoulder pain is the result of an acute injury such as an automobile accident or a blow to the shoulder, don’t delay in seeking a medical evaluation and suggestions for appropriate treatment. Fractures need to be stabilized quickly so they can set properly.

Rest for a day or two and regular applications of ice to control inflammation and keep the pain in check are generally appropriate for all shoulder injuries. You may also want to take a non-steroidal anti-inflammatory device (NSAID), such as ibuprofen, to reduce the pain.

Physiotherapy

Your physician will undoubtedly suggest a visit to the physiotherapist once the pain and swelling have subsided a bit. A physiotherapist will assess the injury, its causes and the associated pain and will create a course of treatment. You can expect questions about the source and severity of your shoulder pain, as well as the factors that aggravate it or relieve it.

Your physiotherapist will also test your range of motion and shoulder strength before determining which exercises and other treatments will be most beneficial. Remedies such as moist heat and acupuncture are among the options available to supplement exercises.
sore shoulder

The anatomy of the shoulder

Your shoulder is a ball and socket joint that consists of three major bones: the upper arm bone (the humerus), the collarbone (the clavicle) and the shoulder blade (the scapula), bound together by tendons, ligaments and muscles. With so many moving parts, it’s no wonder that shoulders are easily injured. In addition, the joint overlaying the shoulder, the acromioclavicular joint, is also subject to injury.

What causes shoulder pain?

Shoulder pain can result from chronic ailments, such as osteoarthritis, or from an injury to the joint or its surrounding parts. Common causes of shoulder pain include:

  • Arthritis
  • Strains from overexertion
  • Tendinitis from overuse
  • Pinched nerves
  • Dislocation
  • Fractures to the collarbone or upper arm
  • Joint instability
  • Frozen shoulder
  • Pulled muscles (sprains) or injuries to the ligaments (strains)
  • Damage to one of the surrounding tendons (torn rotator cuff)
  • Poor sitting posture (hunching over a computer all day, for example)

Some of these injuries are acute and caused by trauma to the area. You may fall and land on your arm in an awkward position; you may twist or bend your shoulder abnormally, perhaps pitching in a pickup baseball game; or you may absorb a direct blow to the shoulder, falling on the stairs, for example.

In other cases, the injuries may be the result of overuse and sneak up on you. Overuse injuries result when too much stress is placed on the joint, through repetition of a motion or by overdoing an activity. Your tennis serve may put repeated stress on your shoulder until, finally, injury results.

In addition, there are seemingly benign sources of shoulder pain, including poor posture and muscle tension.

Can stress cause your shoulder to hurt? Yes, stress can accumulate in the shoulders as easily as it does in other joints.

Overuse injury symptoms

Naturally, if your shoulder injury is due to trauma, such as a tackle during a football game or a fall down the stairs, you’ll be able to identify the cause immediately. However, if your injury is due to overuse, these symptoms may be signs that you need treatment:

  • Limits to your range of motion;
  • Loss of strength in your shoulder;
  • Shoulder pain and stiffness;
  • Difficulty in doing everyday tasks, such as bathing, driving a car, dressing and sleeping comfortably; and/or
  • Problems with accomplishing tasks that require you to put one arm behind your back, such as zipping a dress.

How to prevent shoulder pain

Shoulder problems can usually be repaired without surgery. Nonetheless, why endure them at all when you can take some simple steps to prevent them:

  • Stay in shape: Eat a healthy diet and exercise regularly.
  • Warm up before exercise: Cold muscles are more susceptible to injury.
  • Watch your posture: Sit and stand erect. Get up from your desk every hour to move around and stretch.
  • Lift properly: Don’t strain to reach items you need. Step stools were created to help you.

No matter whether your shoulder injury is minor or major, it will heal with proper treatment. There’s no need to live like Atlas for the rest of your life!

Let's get you some relief for your shoulders!


neck pain

What Causes Neck Pain?

At one time or another, you’ve undoubtedly muttered to yourself, “What a pain in the neck.” Of course, you’re generally referring to an annoyance, not to a literal ache in the real estate that connects your head to your shoulders. Nonetheless, there will come a time when your neck does ache and you’ll wonder why and what to do about it. Let’s demystify neck pain so you know how to react when it occurs.

Causes of Neck Pain

Neck pain refers to pain that occurs anywhere in the region starting at the base of the skull and ending at the shoulders. The neck comprises the bones and joints of your cervical spine, otherwise known as your neck vertebrae; the muscles and ligaments that keep the cervical spine together; and the discs separating your vertebrae and serving as shock absorbers.

It’s not unexpected that your neck muscles, ligaments and bones are subject to the same wear and tear as the rest of your body. Overuse, poor positioning or injury can take their toll, leading to stiffness, soreness or extreme pain.

Chronic conditions are one cause of neck pain. Damage to the discs in your neck over time can lead to a pinched nerve, causing pain in one side of the neck that may involve tingling, numbness and pain that radiates down to your hand, while osteoarthritis can cause pain due to joint breakdown.

In addition, poor positioning of your neck may also cause pain or stiffness, and there are numerous culprits for such behaviour. You may spend a lot of time hunched over your computer or your cellphone; you may sleep with your neck at an odd angle; or you may angle your neck unnaturally, as required to hold a phone between neck and shoulder. In addition, dealing with a lot of stress often leads to neck tension.

Finally, injury can lead to neck pain, discomfort that is sudden and severe. Car accidents and the resulting whiplash, sports collisions at speed or direct blows to the back of the head are sources of acute injury and pain. Neck injuries must be approached with caution, because an injury to the spinal cord could be involved.

Treating Neck Pain

If you experience trauma to the neck, the injury could be serious. Your neck should be immobilized until you can be moved safely and evaluated medically to ensure that there is no spinal cord injury.

Chronic conditions require ongoing treatment that may include physiotherapy, while a garden variety stiff neck should first be treated with rest and ice to prevent inflammation – apply the ice during the first 24-to-48 hours after injury.

You may also want to take over-the-counter non-steroidal anti-inflammatory medicine to relieve the pain. Afterward, you may wish to use heat on the neck to stimulate blood flow and promote healing.

To speed your recovery and prevent a recurrence of neck pain, you’ll want exercises that stretch and strengthen the muscles in your neck, shoulders and back.

A physiotherapist will be able to guide you in appropriate therapeutic exercises. Your regimen will probably include isometric exercises, where neck muscles are tightened against and opposing force, and range-of-motion exercises that work to relax and lengthen your neck muscles.

Physiotherapists also employ treatments such as ultrasound, soft tissue release and joint mobilization. To keep the neck strong and flexible over with a good range of motion, you’ll want to continue prescribed exercises on an ongoing basis.

Preventing Neck Pain

Why court discomfort? If you have been dealing with a stiff neck, no doubt you don’t want to experience another one. There are a number of measures you can take to keep it from recurring.

  • At night, sleep on your side or your back, rather than on your stomach. People who sleep on their stomachs tend to twist their necks into awkward positions during the night. In addition, don’t use too many pillows in bed, because more than one pillow under your head can restrict its range of motion.
  • At work, don’t sit in one position for too long; be sure to get up and move around regularly so your neck isn’t stuck in an awkward position.
  • Ensure that your computer screen is at eye level so your neck isn’t tilted inappropriately; if you’re using a tablet, tilt the screen to a 45-degree angle or prop it on a pillow; if you leave it flat, your head will be bent down, stretching the ligaments.
  • If you spend a lot of time on the phone, wear a headset or an earpiece to prevent awkward positioning of your head and neck.

So, don’t let your pain in the neck debilitate you. Seek the treatment you need and commit to an ongoing prevention regimen.

Let's get you some relief for your neck pain!


shoulder separation

How to Manage a Shoulder Separation

References to shoulders generally touch upon strength: shouldering a burden requires it, as does carrying the weight of the world on your shoulders. However, those figurative tasks would be impossible to accomplish if your shoulder was in a weakened state, as it is when it’s separated.

What Is a Shoulder Separation?

A shoulder separation refers to an injury to the top of the shoulder where the front of the shoulder blade (acromion) attaches to the collarbone (clavicle), forming the acromioclavicular (AC) joint. A shoulder separation, also referred to as an AC joint injury, is an injury to one or more of the four ligaments that hold the two bones together so that the bones are no longer aligned properly.

AC separations can be caused by a traumatic injury, such a blow to the site, or by repetitive overuse of the shoulder. People under 35 are the most common victims of AC joint injuries, and men are five times more likely to sustain one than women. They are often the result of a sports injury, and people in the aforementioned age group are the most usual participants in contact sports or those where collisions are likely and can produce trauma, such as football, rugby, cycling and skiing.

Overuse of the joint through repeated stress from activities such as bench-pressing heavy weights or doing physical labour with the arms raised overhead may also lead to an AC joint injury.

Grading an AC Joint Injury

Shoulder separations range from mild to severe and are graded from I to VI, depending on which ligaments are damaged and how severe the injury is. AC joint injuries graded from IV to VI generally result from high-force collisions that occur during motor vehicle crashes and must be treated surgically. Most athletes and others suffer simple AC joint injuries, Grades I, II or III.

A Grade I separation is the mildest and most common AC joint injury; the ligaments may be stretched or partially torn and the joint still lines up properly. In a Grade II dislocation, the acromioclavicular ligament is completely torn, but the ligaments at the rear of the shoulder blade, the coracoclavicular ligaments, remain attached. A Grade III separation is the most severe of the simple types and is a complete separation of the joint. All of the ligaments and the capsule surrounding the joint are torn; the shoulder sags and the clavicle is pushed up, forming a bump on the shoulder.

Symptoms of a Separated Shoulder

If you suffer an AC joint injury, you will have general shoulder pain and swelling, probably accompanied by bruising. The area above the AC joint will be especially tender and swollen and your shoulder won’t feel as strong as usual; its range of motion will also be compromised. In addition, you may have a visible bump on your shoulder and feel pain when lying on the side where the injury occurred. When you move your shoulder, you may feel a catching sensation or hear a popping sound.

Treating an AC Joint Injury

Initially, for a shoulder separation, the goal is to reduce pain by immobilizing the shoulder in a sling and applying ice to the area for 20 to 30 minutes every two hours. Your doctor may also suggest taking an over-the-counter NSAID (non-steroidal anti-inflammatory). Rest is essential during the early stages of the separation. Once the acute stage of the injury has passed, you may begin rehabilitating your shoulder with the help of a physiotherapist who will help you return to your daily and desired activities. You can expect treatment to take at least six weeks.

Your physiotherapist will create a rehabilitation plan tailored to your particular injury and to your movement goals. The plan may include:

  • Strength training to strengthen the muscles in the shoulder area. Injury to the area weakens the surrounding muscles, and they must be retrained to work together properly;
  • Range of motion exercises to return the joint to proper functioning as swelling and pain recede. Reaching overhead or across the body are the motions that are most often affected by a shoulder separation;
  • Functional training that trains the shoulder to work properly in order for the AC joint to effectively bear the often-heavy load assigned to it; and
  • Manual therapy, hands-on manipulation that mobilizes and moves your AC joint and the surrounding muscles in order to improve flexibility, motion and strength in these hard-to-reach locations.

Preventing AC Joint Injuries

Once you’ve separated your shoulder, you’ll undoubtedly want to prevent it from happening again. Exercise and stretch your shoulder muscles regularly to keep them strong and ice your shoulder after physical activity. In addition, if you experience pain during a specific activity, stop immediately. As the saying goes, “An ounce of prevention is worth a pound of cure.”

Suffering from a Shoulder Injury?


driving night

How to Avoid Accidents This Winter

As fall shades into winter, we slowly adjust to the changes in the weather: the colder temperatures, the darkness that greets us each morning and falls early each afternoon; early morning fog; fallen, slippery wet leaves; and the snow that blankets the ground and leaves roads and sidewalks slick and icy. Drivers and pedestrians both are at more risk for car accidents than usual during this time of year, and it’s not only the road conditions that make navigation challenging.

What causes accidents in the winter months?

During the fall, the sun’s glare on the roads is often noticeable and its blinding effect can also lead to accidents. Cold mornings may be accompanied by fog, making visibility challenging. There are also deer migrating and mating and they can appear on the roads unexpectedly, especially at dawn or dusk.

In winter, there may be glare from the sun shining on snow to impair visibility and there is also danger from black ice, the invisible layer of slippery stuff that blends into the sidewalk or roadway, making falls or skids increasingly likely.

Given these hazards, it is incumbent upon drivers and pedestrians both to be aware of the increased risk and to adjust their behaviours accordingly.

A 2017 study conducted by Insights West for the Insurance Corporation of British Columbia (ICBC) indicated that 75 per cent of British Columbia drivers admitted to bad driving habits and 40 per cent admitted that they may not remember all the rules of the road. However, “While they remain frustrated at the actions of others, drivers still hold their driving skills in high regard,” Mario Canseco of Insight West told Global News. “In fact, two-thirds think their skills are above average.”

driving at night

Don’t take your skills for granted; drive defensively. Make sure your car is in good shape mechanically and stay focused on the road. Leave your phone alone when you’re behind the wheels and be prepared for the unexpected.

If you do get injured in an accident, remember that ICBC provides coverage for physiotherapy treatments for drivers, passengers or pedestrians that have been injured in a motor vehicle accident (MVA). For many injuries resulting from an accident, it is important to start physiotherapy as soon as possible to avoid future complications.

Fall Fixes

Weather in the fall is unpredictable, going from warm to cold at the drop of a hat. Your tires react to changes in temperature by expanding and contracting, causing them to lose pressure, so be sure to check tire pressure regularly. When fog descends, don’t turn on your high beams; they simply cause glare.

car crash accident icbc

Winter Watch

As the seasons turn, prepare to switch to winter tires if you live in a region where snowfall is a regular occurrence. Why not give yourself the advantage of extra grip in slick conditions? You can’t improve the challenges the weather poses to visibility, but you can improve it by clearing your windshields before you set out and by ensuring your windshield wipers are working properly and your wiper fluid reservoir is topped up. Also, be certain that you keep your gas tank full to prevent the gas from freezing in extreme temperatures.

Pedestrian Problems

ICBC notes that 43 per cent of all crashes involving pedestrians occur between October and January. A car – because of its size and weight – is usually the victor in any interaction with a pedestrian, so, unfairly, the burden of safety falls more heavily on anyone who is walking.

In B.C., 69 per cent of accidents involving pedestrians occur at intersections, so take extra care there. Take off your headphones or earbuds so you can hear and focus on oncoming traffic; put away your phone, too, so you can focus. Keep an eye out for drivers turning both left and right through the intersection. Try to make eye contact; don’t assume that they see you.

pedestrian safety

Visibility, in fact, is a major concern, because inclement weather decreases visibility, as does darkness. As a pedestrian, don’t jaywalk, because drivers may not see you, and try to wear reflective or light-coloured clothing in the dark to give yourself added insurance when crossing streets.

Drivers, the burden may be on pedestrians to keep themselves safe, but you need to do your part. Slow down at intersections and look carefully for pedestrians. In poor weather, they may be hard to see near streetlight posts and telephone poles.

Also, at transit stops, bear in mind that they may step out into the street to look for approaching vehicles, so cut your speed. If you’re not sure whether a pedestrian plans to cross or not, a short honk and a wave can give them the go-ahead.

All-Season Security

Before you turn on your vehicle’s ignition, take a moment to think about the driving conditions and precautions you can take to ensure you arrive safely. One factor you can control is your speed. ICBC notes that speed limits are determined based on driving in ideal conditions. If you’re driving in the snow, rain or fog, slow down and allow yourself twice the usual braking distance for stopping, given the slick surfaces and poor visibility.

You should also ensure that your windshield has no streaks or smudges; the glare of oncoming headlights or the sun can magnify these distortions and impair your ability to see the road. In addition, be sure that your lights and signals are working properly and use them so that others are prepared for your next move.

Yes, accidents happen during fall and winter, but if you follow some of these tips, you’ll be less likely to be involved.

Have you been injured in a car accident?


winter exercise

Stay Fit During the Winter

As the days get shorter and the outdoor temperature drops, there’s no avoiding the truth: Winter is coming. Many of us dislike the combination of dark and cold and tend to huddle indoors, curling up with a book, binge-watching TV shows or eating carbs for comfort. And, once the holiday season arrives, there’s so much shopping, cooking, baking and wrapping to do that there are even more reasons to get away from our healthier warm-weather exercise routines. Add holiday parties and their rich food to the mix and you have the perfect recipe for sluggishness and inactivity.

Holiday Calories and Temptations

This year, don’t give in to all of these distractions and excuses: Resist! Your body and your mind will thank you, because you’ll be fighting back against all of those additional holiday calories you’ve consumed and you’ll be producing endorphins, the feel-good hormones, through exercise, helping you to combat the winter blues that can be triggered by lack of sunshine and Vitamin D. In addition, you’ll fight off the weight gain that can accompany a sedentary winter routine and will find it easy to rock that bathing suit come summer.

Outdoor Exercise

If you’ve embraced the cold weather as a component of your Canadian identity, you will undoubtedly enjoy exercising outdoors. The air is crisp, the snow is beautiful and activity brings a healthy glow to your face. Even better: While you’re in motion, you won’t feel the cool temperatures, as long as you’re dressed properly.

For cold weather activity, dressing in layers is the best approach to remaining warm and dry. You can always remove layers if you are too warm or add layers if you aren’t warm enough. The layer closest to your skin should be made of fabric that wicks away moisture; cotton isn’t ideal because once it’s damp, it remains so. The outermost layer should resist both moisture and wind.

stay fit winter
Plan your outdoor exercise during the day, if possible, in order to take advantage of the warmer temperatures and sunshine. Exercising earlier in the day also allows you to check it off your schedule and forget about it for the remainder of the day. If your schedule only allows for exercise in the darkness, be sure to wear bright or reflective outer gear so you are visible to motorists and can stay safe.

Winter offers you the opportunity to engage in a variety of outdoors activities, so why not try a new one? Skating, sledding, snowboarding, snowshoeing and skiing are all available. There’s no need to rush out and buy equipment; rent it and take a lesson or two to test the new moves to see if they suit you. Running and walking can also be winter activities, although they require more care – you’ll need to choose routes that are reasonably free of snow and ice and you’ll want to watch your footing more closely.

Once you’re back indoors, unless you’re wet, keep your exercise gear on for 10 to 15 minutes as your body adjusts. Losing heat from your body too rapidly can lead to post-exercise hypothermia; your body reduces its production of heat because it’s in a warm environment, but it also loses its heat stores rapidly, so don’t shock it by stripping down quickly.

Indoor Exercise

For those who don’t find the cold endearing, Canadian identities notwithstanding, there are many indoor alternatives that will keep you fit during the chilly, dark winter. The gym is an obvious option. Gyms are readily available, and they generally offer exercise equipment for those who prefer solo workouts, as well as classes for those who like some company as they sweat. Try yoga or Zumba or Pilates or all three, for example. There’s no need to choose solo exercise over classes or vice-versa; switch up your routine to prevent boredom. Gyms allow you to do it all.

gym exercise
If you are a runner or a walker, treadmills are practical indoor substitutes. Or, you may discover an indoor mall walking group; they usually meet in the morning before a mall opens, so you’ll have some exercise under your belt before the rest of your day begins.

Indoor exercise doesn’t mean investing in a gym membership if your budget doesn’t allow it. Community centres offer drop-in fees to use their facilities, which may include a pool, a running track or fitness classes. You can also get yourself a workout DVD; do yoga or an aerobics routine in the comfort of your own home. Walking stairs for a designated amount of time is also a great workout, as is dancing to the radio. Who says exercise isn’t fun?

Whether you choose to keep moving outdoors or indoors during the winter, don’t forget to stay hydrated. You might not feel as thirsty as you do in summer, but you need water just as much. If you’re out in the cold, a thermos of herbal tea is a good substitute; it keeps you warm without any diuretic effects.

Remember, no matter what type of winter exercise you choose, the goal is to continue exercising regularly. Why lose that muscle tone you’ve worked so hard to build, just because it’s cold? There’s an exercise for everyone, so no excuses!

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piriformis syndromw

Piriformis Syndrome - a real Pain in the Butt

We’ve all heard people say it, no matter how impolite it may sound, “What a pain in the butt!” However, anyone who is suffering from piriformis syndrome can make that exclamation literally: Piriformis syndrome actually can cause your buttocks to hurt.

What is Piriformis Syndrome?

Piriformis syndrome refers to the irritation to the sciatic nerve caused by the piriformis muscle.

The sciatic nerve is the body’s longest nerve, running from the base of the spine to the feet. The piriformis muscle extends from your sacrum, the triangle-shaped bone between your hipbones, across your sciatic nerve to the top of your femur, the large leg bone running from hip to knee.

This muscle helps you move your leg from side to side. When it spasms, it can put pressure on the sciatic nerve and result in a variety of symptoms.

Therefore, piriformis syndrome is actually a form of sciatica, the blanket term for any irritation of the sciatic nerve. Harvard University researchers say it is estimated that five per cent of all sciatica cases can be attributed to piriformis syndrome.

sciatic nerve

How do you treat Piriformis Syndrome?

You may find relief from pain through over-the-counter non-steroidal anti-inflammatory medications such as ibuprofen or naproxen. You can also alternate applications of ice and heat to the area in 15-minute segments, repeated every few hours to relieve your pain.

If the piriformis syndrome doesn’t disappear on its own, which it often does, the next stop is physiotherapy. Your physiotherapist will recommend a course of exercise and stretching, the mainstays of treatment for piriformis syndrome.

The physiotherapist may focus on such treatments as

  • adjusting your gait;
  • exercises to stretch the muscle and those surrounding it;
  • improving the mobility of your sacroiliac joints;
  • strengthening your hip abductor muscles, those that move your leg outward;
  • acupuncture.

If your ailment doesn’t respond fully to such treatments, you may need an injection of corticosteroids to reduce muscle inflammation. An ultrasound, X-ray or other scan will help determine the proper site for such an injection to be effective.

You may also receive a transcutaneous electrical nerve stimulator treatment where a handheld device is used to send electrical charges through your skin to interrupt pain signals to the brain. In severe cases, which are very rare, surgery may be required.

What is the main cause of Piriformis Syndrome?

Piriformis syndrome can occur for a variety of reasons, including:

  • prior hip surgery;
  • injury;
  • abnormal alignment of the spine, e.g., scoliosis;
  • prolonged periods of sitting, especially if you have a wallet in your back pocket;
  • a piriformis muscle or sciatic nerve that has developed abnormally;
  • a discrepancy in the length of your legs;
  • foot problems;
  • a direct hit while playing a sport;
  • a wound that reaches all the way to the muscle;
  • overuse from frequent repetitive exercise, such as running;
  • a change from a sedentary lifestyle to a more active one.

Symptoms of Piriformis Syndrome

Initially, piriformis syndrome may appear to be hip bursitis or a herniated disc. A catalogue of symptoms during diagnosis should make it clear to your physician that the cause of the sciatic pain is piriformis syndrome.

Individuals suffering from piriformis syndrome will have:

  • trouble putting weight on one side of the buttocks;
  • spasms of the piriformis muscle;
  • sciatica-type pain if the hip is rotated outward when there is resistance;
  • piriformis muscle pain during a rectal exam;
  • difficulty sitting for long periods of time;
  • pain that increases the longer you sit;
  • leg and buttocks pain that increases when you are active;
  • tingling or numbness in the buttocks that extends down the back of the leg.

People who sit for long periods of time on the job or at home are at risk for piriformis syndrome, as are people who regularly do rigorous lower-body workouts.

Can MRI detect Piriformis Syndrome?

Although your physician may diagnose piriformis syndrome simply based on your symptoms, he or she may also order tests to support the diagnosis. Two that have proven useful are magnetic resonance imaging (MRI), which looks for nerve inflammation, and the FAIR test (flexion, adduction and internal rotation), which stretches your hip and puts pressure on the sciatic nerve.

The test measures the delay in sciatic nerve signals during muscle compression. An MRI can also help your physician to rule out arthritis or a ruptured disc as causes of the pain.

Prevention

The stretching exercises suggested by your physiotherapist to ease your pain are also good exercises to use regularly to prevent piriformis syndrome from recurring. You should also develop good form for any repetitive motion tasks you perform regularly; consult with your physiotherapist. In addition, don’t undertake exercise that involves the injured muscles until they have healed and practise good posture, which includes wearing shoes that fit well.

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coccydynia

Tailbone Pain: How can I relieve it?

The technical term for the tailbone is coccyx, which is derived from the Greek word for cuckoo. It was so named because the bone resembles the shape of the cuckoo bird’s beak. Now that we have that settled, let’s discuss tailbone pain itself. It is also known, technically, as coccydynia.

What causes Tailbone Pain?

Coccydynia is an injury to the tailbone, which is a multi-segmented bone that sits at the base of the spine immediately above the buttocks. The tailbone is small, but mighty. It helps to stabilize you when you sit and it is located in an area of the body full of tendons, muscles and ligaments.

Generally, tailbone pain sufferers experience dull, throbbing pain at the base of the spine reminiscent of a muscle spasm, but they may also feel sharp, stabbing pain when sitting for long periods of time or after being active. The pain may radiate up your back or down your legs and it may feel as if the injury is located in your tailbone itself or in the surrounding area. Sex and defecation may become painful, and women may also feel discomfort during menstruation.

Tailbone injuries have a variety of causes. A direct blow to the area that may be caused by a fall from your bicycle, for example, can result in coccydynia. Pregnancy and childbirth are also potential causes; in your last trimester of pregnancy, the ligaments in the area loosen to provide the baby with space, while a natural birth can cause trauma to the tailbone.

If you sit for long periods of time, especially if your sitting position is an awkward one or you are sitting on a hard surface like a bench, tailbone injury can result. Other potential causes include a weak pelvic floor, joint degeneration and straining due to hemorrhoids or constipation.

Tailbone Pain Treatment

Generally, coccydynia will disappear by itself in a few weeks or months. However, there’s no need to suffer unduly before the pain dissipates.

You can use over-the-counter non-steroidal anti-inflammatory medication to lessen the inflammation that is causing pain; acetaminophen, ibuprofen, naproxen or COX-2 inhibitors are helpful.

How can I relieve my Tailbone Pain?

You can ice the area immediately after the pain begins and do so for a couple of days to reduce inflammation. However, after the first few days, heat will be more helpful. Heat applied directly to the area with adhesive heat strips, a heating pad or a hot water bottle can relieve the muscle tension that causes or exacerbates the pain.

If the pain worsens during bowel movements or due to constipation, your dietary habits may require some changes. You’ll want to increase your intake of both fibre and water and you may want to consider using a stool softener.

If you are required to sit for long periods of time, a donut cushion can help relieve some of the pressure to the area; consider using one at home, at work and in the car. Whether you use one or not, make a conscious effort not to sit for long stretches of time; get up and walk around at least once an hour or consider switching to a standing desk.

Poor posture aggravates the pressure on the tailbone, so be sure to sit with your feet flat on the floor and your back against the back of the chair. When you sit down, lean forward.

tailbone pain treatment

Tailbone Pain Exercises and Stretches

A physiotherapist can also demonstrate ways to help reduce your pain and prescribe a suitable course of exercises that will alleviate tension and strengthen the surrounding muscles, including the stomach and the pelvic floor.

Once movement is less painful, your physiotherapist may recommend gentle aerobic activity to increase the blood flow to the area to promote healing. Aerobic exercise also stimulates the release of endorphins, which are your body’s natural pain-relieving chemicals.

A physician may suggest gentle massage to the muscles attached to the tailbone. He or she might also inject a local anesthetic into the tailbone to relieve pain for a few weeks.

Surgery to remove the tailbone is a last resort and won’t be suggested until all other avenues of treatment are exhausted.

If you have severe, unrelenting pain that persists, you shouldn’t ignore it; there may be a more serious underlying cause. Your physician will want to conduct diagnostic tests, such as X-rays or an MRI, to determine if tumours, cysts or bone spurs are causing the coccydynia.

Remember, it’s the tail that wags the dog, so to speak. If your tailbone hurts, you’ll feel like growling instead, so get treatment.

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groin strain

What is a Groin Injury?

The groin, perhaps because of proximity, isn’t a region that is mentioned often in polite conversation. In fact, although it is likely we can all refer to its general location, we have probably never tried to pinpoint it or define it.

However, it’s a challenge we’ll take up here, because the groin is an area of the body that is prone to injury – groin strains are common, but before we can treat them, we must be clear about what we’re discussing.

Where is your Groin?

Let’s take a look at groin anatomy. The groin, also called the inguinal region, is the area of the body between the abdomen and the thigh on each side of the pubic bone. It contains the adductor muscles of the hip.

Usually, groin strains, which are muscle tears, take place in the upper groin area near the pubic bone or at the front of the leg. Depending on their seriousness, groin strains are classified by grade.

A Grade 1 strain is a minor tear to the muscle that causes some pain or tenderness; a Grade 2 strain is the tearing of a larger percentage of your muscle fibres that causes tenderness, pain, weakness and, possibly, some bruising; while a Grade 3 strain is a severe tear that results in a lot of pain and bruising.

Causes of Groin Pain

A groin injury can occur when there is any forceful leg movement: changing directions while running, jumping or kicking, for example. A direct blow to the area, a fall or any movement that moves the groin at an unusual angle may cause a strain.

Athletes are always at risk for groin strains, which can occur while skating, kicking a ball or playing basketball. A groin strain may also result when you are pushing, pulling or lifting heavy objects. It may also result from overuse of your muscles or from exercising without warming up.

groin injury

Groin Strain Symptoms

When you strain your groin, you will generally feel a sudden pain accompanied by a snapping sound when you move your leg or your hip. Swelling and bruising will probably follow quickly. You may also have spasms and feel sharp pain if you try to lift your leg or bring your legs together.

With a Grade 1 sprain, you’ll be able to walk normally and the use of your leg won’t be impaired. A Grade 2 sprain will commonly lead to a limp and restricted use of your leg. With a Grade 3 strain, it will be very painful to put any weight on your leg and you will have difficulty using it. There may even be a dent in the muscle that is visible under the skin at the tear site.

How to treat a Groin Injury

Once you experience groin pain and realize you have sustained a groin injury, you’ll want to begin the standard RICE treatment — rest, ice, compression and elevation – and continue it for the first 24 to 48 hours. Try not to put weight on your leg and apply ice to the area for 15 to 20 minutes every two hours. Apply an elastic bandage to the area for compression and ensure it is cushioned by pillows to elevate it.

To get relief from the pain in your groin area, you can take an over-the-counter non-steroidal anti-inflammatory medication, such as acetaminophen or ibuprofen.

Your physician, after diagnosing the injury, should refer you to a physiotherapist for treatment. In assessing your injury, the physiotherapist will ask you questions about how the groin injury occurred and what you felt at the time.

They will test your muscle strength, move your leg away from your body and gently touch you to determine exactly where the tear has occurred. He or she may also do additional testing to ensure that your hip or your back aren’t injured, too.

Following the assessment, your physiotherapist will design a program of rehabilitation and recovery for you to allow you to heal quickly and return to normal activity as soon as possible. Your program will include exercises and stretches for groin pain that will improve strength, improve motion and hasten your recovery.

Prevention of Groin Injuries

You can certainly take steps to prevent a groin injury, although there are no guarantees, especially if you are involved in sports. Warm up your muscles by stretching or doing light exercise before participating in a game or more intense exercise.

If you don’t exercise regularly, take things slowly. You don’t want to exceed your comfort level or injury can result. Try to keep your level of exercise consistent, rather than doing some intense exercise on Monday and not exercising at all for three or four days. Take a hint from professional athletes who generally train year-round.

If you keep your leg muscles strong, you’re less likely to experience a groin injury.

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what is a heel spur

What is a Heel Spur?

Do you suffer from heel pain? If so, you’re not alone. Unfortunately, many people try to ignore the early signs of heel pain and keep on doing the activities that caused it. When you continue to use a sore heel, it will only get worse and could become a chronic condition leading to more problems.

It shouldn’t hurt to get to your feet in the morning or walk throughout the day. If you notice a sharp, stabbing sensation in your heel with each step you take, you may be suffering from heel spurs.

How do you get Heel Spurs?

Heel spurs develop over time; they don’t magically appear. Repetitive strain on your muscles and ligaments in the foot and heel can lead to a heel spur, a bony buildup of calcium on the heel that can form and cause pain.

There are two types of heel spurs: an inferior calcaneal spur, which results from ongoing stress to the bottom of the heel and grows between the heel and the arch of the foot; and a posterior calcaneal spur, which is the result of repeated trauma to the back of the heel where the Achilles tendon is attached.

The posterior calcaneal type of heel spur is often visible to the eye and can be easily felt, but the inferior calcaneal spur is trickier to diagnose, because the pain it causes can be mistaken for plantar fasciitis.

Generally, an X-ray is required to ascertain that a heel spur is, indeed, the cause of the pain you are experiencing.

What causes Heel Spurs?

Common causes for heel spurs include heel bruising, arthritis, shoes that fit poorly, the effects of excess weight, footwear with minimal support (e.g., flipflops) and gait issues that put too much pressure on the heel bone and surrounding ligaments and nerves.

Aging can also be a contributing factor, because the plantar fascia become less flexible and the heel padding becomes thinner. Flat feet or high arches may also lead to heel spurs, as can diabetes or work that requires you to spend most of the day on your feet.

heel spur

Heel Spur vs Plantar Fasciitis

Heel spurs often co-exist with cases of plantar fasciitis. The plantar fascia are the fibrous tissues that run from the heel to the ball of the foot and inflammation of these tissues is called plantar fasciitis. However, plantar fasciitis can be cured, but once heel spurs develop, they remain in place, although their impact can be minimized.

Heel spur sufferers may experience a sharp, knifelike pain when they stand up; the pain generally lessens and becomes a dull ache. You may feel heat radiating from the area and see inflammation and swelling.

Walking barefoot may be difficult due to tenderness at the bottom of the heel. Often, the heel spur itself is not the cause of the pain; the pain comes from the injury underlying it.

Heel Spur Treatment

As mentioned, heel spurs may be easily confused with plantar fasciitis, so your physician will generally request an X-ray before making a diagnosis. Heel spurs don’t dissolve or disappear, but you can mitigate the pain and discomfort they generate.

  • How to relieve Heel Spur Pain
    Your physician may suggest one or more possibilities to relieve heal spur pain. The easiest is the use of over-the-counter pain medications, such as ibuprofen, acetaminophen or naproxen. Icing your heel will also help reduce any swelling or inflammation.
  • Heel Spur Exercises
    Physiotherapy is another useful option. Your physiotherapist will do an analysis of your gait and can prescribe a course of exercises that will help correct any imbalances that allow your heel spurs to grow. They may also use a combination of manual therapy and ultrasound to break down calcification. Acupuncture may also be employed to help reduce pain. To reduce the stress on your foot’s muscles and tendons, your physiotherapist may use strapping or taping techniques in the area.
  • Orthotics for Heel Spurs
    Your physician or physiotherapist may also prescribe custom orthotics, inserts that are placed in your shoes to assist in correcting your gait and suggest that you wear cushioned sports shoes to alleviate pain.Custom orthotics often have a well cut in them to provide extra cushioning to the affected area to reduce the impact of walking or being active on your heel.

Most sufferers of heel spurs recover from the pain and discomfort with nonsurgical treatments. However, if the discomfort persists after nine to 12 months, surgery may be necessary.

Remember: a heel spur is a chronic condition, so it will be up to you to manage it. By following your physician’s recommendations and doing the exercises prescribed by your physiotherapist, you should eventually be able to forget that they exist.

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core stability

Why is Core Stability important?

Your core refers to the midsection of your body, front, rear and sides; it connects the upper and lower regions of your body. The core’s major muscle groups include the transversus abdominis (your six-pack abdominal muscles), the pelvic floor muscles, the internal and external obliques, the rectus abdominis, the multifidus, the erector spinae, and the diaphragm, which is crucial for breathing.

Core Strength and Stability

The core supports your spine and pelvis and is integral to motion, transferring force from one area to the other. Having a strong core is important for movement, because weak or inflexible core muscles can interfere with the proper functioning of your legs and arms. Strong core muscles also provide you with balance and stability and help prevent falls and injuries.

What Is Core Stability and Why Does it Matter?

Core stability refers to the ability to keep your spine from moving during physical activity, such as walking, running, swimming, etc. Your core helps you control your body effectively, helping you use your arms and legs to the best advantage and preventing your spine from bending or flexing unintentionally. Core stability is important because stability is crucial to your everyday activities.

Signs of a Weak Core

If you haven’t really thought about the importance of core strength until now, it’s time to pause and assess yourself. If you have a weak core, you needn’t simply sigh and fret; you can do core stability exercises to strengthen it.

There are a number of signs of a weak core. One of the major indicators is lower back pain that isn’t the result of another back issue. You need strong muscles surrounding your spine in order to properly support its vertebrae and discs. Without them, the forward curve of a normal spine won’t be possible and you may have pain in the surrounding tendons and muscles.

Another indicator is poor posture. Your spine and pelvis are held in place by the muscles in your abdomen and lower back. If they aren’t strong, your posture will suffer and the resulting slouch will strain muscles. Sitting or standing erect for long periods of time will be problematic. Often, people with lower back issues also have posture problems and vice-versa.

Strong core muscles are the key to stability, so if you are having trouble with your balance, your core may be the weak link. Test yourself by standing on one leg with your eyes closed for ten seconds; try this with each leg. If you can’t hold the position, it’s a sign that your core needs strengthening. If you stumble, a strong core can help you remain upright, so it’s important to exercise those muscles.

The hollowing test is another way of checking your core strength. Take a deep breath and pull your stomach muscles back toward your spine as you exhale. If you can’t manage to hold them there for 10 seconds, it’s another indicator that more core strength is required.

If you have ever practised yoga, you are familiar with the plank position, one that challenges your abdominals and tests your core strength. Try it by assuming doing a push-up, resting your weight on your arms, elbows and toes with your hips held level and steady. If you can’t remain in this position for 50 seconds, guess what? Your core needs strengthening.

Finally, general muscle weakness may be an indicator of inadequate core strength. Your core provides the power for motion and stability, too. If your arms and legs aren’t being accommodating, it may be due to a weak core.

core stability exercises

Why is Core Stability Essential for Seniors?

Core stability is integral to a wide range of daily activities, from walking to reaching for cans in the kitchen cupboard. It underpins almost everything you do throughout the day, so it is crucial to your quality of life.

A stable core allows you to have more control over your body, whether you are in motion or sitting still. A healthy core is important in preventing accidents and injuries; seniors are often vulnerable to falls, so stability is especially important as you age. A healthy core also helps you fight pain and maintain balance, co-ordination and good posture. It even assists with breathing and digestion.

If you’re determined to stay as healthy as possible as you age, having a strong, stable core is an essential ingredient.

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RICE method

Rest, Ice, Compression, and Elevation - The RICE Method Explained

RICE is the acronym that stands for Rest, Ice, Compression and Elevation. It’s a mnemonic, or memory device, that helps you remember quickly what to do when injury strikes a ligament, a tendon or a muscle.

The RICE method can generally be used even before checking in with your physician or physiotherapist. It is generally effective if employed as soon as possible within the first 24 hours following injury and continued for up to 48 hours. It’s simple to do and the benefits are evident, because sprains are often painful and swell rapidly.

Rest

If you think you’ve sprained an ankle or pulled a muscle in your back, it’s time to stop any activity that aggravates the injury and causes you pain. Especially if it’s a limb, avoid moving it and keep weight off it to prevent further damage. Crutches or a brace may be necessary if your leg is involved.

You may be able to exercise other muscles to prevent de-conditioning, but handle the injured area with care; in fact, it would be wise to check with your physiotherapist to determine which exercises won’t be harmful under the circumstances.

Ice

Cold is useful for its ability to prevent or limit swelling. It can also numb the affected area, which is a blessing if you are in pain. In applying cold to the injured area, be sure the frozen item has no direct contact with your skin; place ice or a cold gel pack or frozen peas or corn – which mould nicely to the shape of an ankle or knee – in a dishtowel to protect your skin from freezer burn.

Try to apply the cold/ice to the injured area as soon after the injury as possible and continue to do so for 20 minutes at a time, eight times each day, for the first 48 hours.

Compression

Compression also helps decrease swelling in the injured area. Use an elastic or tensor bandage to wrap the affected area, but don’t make it so tight that you prevent proper circulation in the area. If you wrap it too tightly, you’ll probably see swelling BELOW the bandage. Other signs that the compression bandage is too tight include numbness, tingling, coolness or increased pain.

Use compression to treat your injury for 48 to 72 hours. If you have a more severe injury, your physician may suggest an air cast or splints to provide more support while assisting with compression.

Elevation

Elevation reduces blood flow to the injured area, consequently reducing swelling and keeping bruising down. Raise the injured area above your heart, if possible – especially when icing it – and cushion it with a pillow. Try to elevate the injured area for two to three hours daily.

Of course, depending on the injury, the RICE method is likely to be only the first stage in treating it. In general, you’ll want to have your physician assess the injury, especially if you can’t put any weight on the area or if the area is numb or misshapen. You may also want to take non-prescription non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain.

Once the swelling has gone down, your physician will probably suggest you see a physiotherapist to rehabilitate the injury through targeted stretching and strengthening exercises.

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contusion

What is a Contusion?

There shouldn’t be any confusion about a contusion. In plain English, it’s a bruise. We’ve all had them, especially as children: bumping into the dresser in the bedroom or getting tackled on the soccer pitch, for example. Contusions are very common workplace injuries and sports injuries, almost as common as muscle strains. They can be painful, but generally, they’re not dangerous to our long-term health.

Contusion Definition

A contusion is an acute direct muscle injury result from blunt trauma to the tissue, accompanied by an accumulation of blood. You may sustain a blow in a sport or you may bump into a fixed object; either way, both your muscle fibres and small blood vessels (capillaries) become injured. Blood from the capillaries leaks out and settles under the skin, although the skin isn’t broken.

The size of the bruise depends on the force involved in the injury, as well as the cause. The greater the force or the larger the object involved, the bigger the contusion.

A contusion also may not be visible immediately; it may take time to develop. It also may not appear directly at the site of the injury, since gravity can send the leaking blood to the lowest portion of your limb; hence, trauma to the knee may result in a contusion near the ankle.

Contusion Symptoms

Bruises add a bit of colour to our complexions, albeit not the most attractive sort. The contusion will also change colour over time. Initially, a bruise usually looks red in colour due to the new blood leaking into your tissues. It contains both oxygen and hemoglobin, a protein that is rich in iron.

Shortly afterward, the blood loses its oxygen and your contusion turns a blue or purple colour. As the red blood cells break down, they leak hemoglobin and iron, often turning the contusion a darker purple or a black colour.

Since a contusion doesn’t usually involve muscle tears, you may be able to ignore it and continue on with work or a sporting activity. However, the area may be tender and there may be some swelling and soreness to the touch. Contusions do have an impact upon muscle function, so your range of motion in the area may be limited.

Contusion Treatment

When it comes to how to treat a contusion you’ll want to adopt the PRICE protocol in the first 72 hours following an injury that causes a contusion. PRICE is an acronym standing for protect, rest, ice, compress and elevate and is useful in controlling bleeding, pain and swelling. If the injury occurs during a sporting contest, stop playing immediately to prevent further damage.

The term, rest, is a relative one. You shouldn’t keep the area immobilized – it’s important to get it moving – but you should do so gently without exerting undue force.

Icing should be done on and off for 15 to 20 minutes at a time. The cold reduces pain while preventing additional tissue damage. Be sure to wrap your ice or cold pack in a towel to prevent damage to the skin.

Using a compression bandage can also assist in keeping swelling down and improving circulation, although it is important not to bind the contusion too tightly.

Elevation is also useful for 10 to 20 minutes at a time; it helps to reduce swelling and promote circulation and healing.

Once you get past the 72-hour mark, you’ll want to begin promoting movement and improving the function of your injured muscle. A physiotherapist can be very helpful at this stage in prescribing exercises that increase strength and pain-free range of motion.

These movements will help increase circulation and healing, clear the area of cellular debris and prevent the buildup of scar tissue. A physiotherapist may also employ hands-on techniques to speed recovery, such as massage, or electric modalities, such as ultrasound.

How Long does a Contusion Last?

You can expect a contusion to heal in about two to three weeks, depending on the severity of the injury. As you begin to heal, your physiotherapist will eventually introduce resistance exercises and sport-specific exercises that ready you for a return to sport, if that is your goal.

hematoma

Complications

Most contusions are straightforward and heal as expected over time. However, in rare cases, there may be complications, especially with more severe contusions. You’ll want to consult with a physician if these develop.

Your contusion may develop a hematoma, or a blood clot, which feels like a hard lump in your muscle that is evident fairly early on in the recovery process. Generally, it is absorbed back into the tissue.

Once in a while, a contusion leads to deep vein thrombosis, a blood clot that forms deep in the veins. It is a very serious condition, because there is always a risk of a piece of the clot breaking off and travelling to the lungs.

You can help prevent such clots from forming by ensuring that you begin moving the affected area of the body early, regularly and gently.

Luckily, complications are, as noted, rare, and you should be healed and raring to go in a matter of weeks.

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whiplash

What is Whiplash?

In Canada, whiplash accounts for more than $2 million in insurance claims each year that cost the economy about $600 million in lost work productivity, sick leave and medical care.

Let’s take a look at some of the most common questions surrounding whiplash including:

  • What is whiplash?
  • What are the symptoms of whiplash?
  • What does whiplash feel like?
  • How long does whiplash last?
  • How to treat whiplash?

Whiplash Definiton

The Physiotherapy Association of British Columbia defines whiplash as “an acceleration-deceleration mechanism of energy transfer to the neck. It may result from rear end or side impact motor vehicle collision but can also occur during diving or other mishaps. The impact may result in bony or soft tissue injuries (whiplash injury), which in turn may lead to a variety of clinical manifestations called whiplash-associated disorders (WAD).”

Anatomically speaking, the mechanical forces that occur when the head and neck are whipped forward and back place major stress on the cervical spine. As the head is thrown backward, then forward, the cervical spine is first hyperextended and then hyperflexed; these movements are outside the normal range. The discs can rupture and soft tissue damage can occur. The muscles and ligaments in the neck can become stretched, nerves may be damaged and, in rare cases, bones may break.

Common Causes

Although motor vehicle accidents are the most common cause of whiplash, it can result from a number of other activities that can yield a strong impact on the cervical spine, such as contact sports like hockey, football, rugby and boxing; roller-coaster rides; horseback riding or bicycling accidents. Any direct hit to the head by a large, heavy object may lead to whiplash.

whiplash injury

Whiplash Symptoms

Whiplash injury symptoms may not appear immediately upon impact. They usually develop within 24 hours of injury, but they may disappear and return after a day or two. They are usually confined to the upper, or cervical, spine and to the middle of the back (thoracic spine), but pain may radiate into the arms, shoulders and head.

If you have whiplash, you may have restricted movement in your neck and your head may feel heavy. Common symptoms include neck stiffness and decreased range of motion; an aching or painful neck or back; fatigue; arm pain and weakness; headaches that generally attack the base of the skull; shoulder pain and stiffness; and jaw pain. The pain is usually dull but may worsen depending on your movements.

Whiplash sufferers may also experience cognitive symptoms as a result of their injuries. You may suffer from ringing in your ears; memory problems; dizziness; difficulty sleeping; irritability; difficulty concentrating; and blurred vision or other visual disturbances.

If your symptoms are painful, spreads to the shoulders or arms, causes numbness or tingling or interferes with everyday activities, you should seek treatments. Medical advice and physiotherapy can help you get back on track.

How to Treat Whiplash

When you meet with your physician and with your physiotherapist, it is useful for them to have a catalogue of your symptoms and the movements that create pain.

Generally, it takes about three months for the neck to heal completely, although the pain will subside much sooner.

After the initial injury, you may want to ice your neck and consider non-steroidal anti-inflammatory medicine that is available over the counter.

In the past, it was believed that rest was essential to recovery from whiplash and sufferers were given foam neck collars to wear in order to prevent movement. However, it has been demonstrated that this approach does more harm than good; the neck needs to be strengthened in order to aid recovery.

Whiplash Exercises

Your physiotherapist will help you strengthen your neck muscles and make them more limber by giving you exercises targeted to your whiplash injury. Not only will this help you heal, but it will make you more resistant to future neck strain.

Starting physiotherapy and its attendant neck exercises as soon after injury as possible will help you recover completely. It will also forestall you from adopting poor posture and overarching your neck to avoid pain. Doing so can create long-term neck problems.

In addition to prescribing a course of whiplash exercises, your physiotherapist may use ultrasound therapy to improve function and decrease pain, while enhancing cartilage repair. Deep tissue massage may be used to treat muscle stiffness that results from the tension that can result from whiplash, and electrical stimulation can assist in relaxing muscles that are tight or having spasms.

As you heal from whiplash, you’ll undoubtedly be eager to prevent it from occurring in the future. If your injury is related to an automobile accident, be sure to buckle your seatbelt when driving and to adjust your headrest to the proper height to give yourself the best chance of avoiding whiplash during an impact.

Have you experienced Whiplash?


abnormal gait

Abnormal Gait and Balance Problems

Most of us give little thought to walking; it’s movement that seems to come as naturally to us as breathing – except when it doesn’t.

Walking takes strength, balance, sensation and co-ordination. Think about babies: first, they gain enough strength to raise themselves to their hands and knees to crawl. Next, comes pulling themselves up by grabbing a chair. Finally, they merge their newfound strength with co-ordination and manage to propel themselves forward, albeit awkwardly. It takes time and practice for them to find a natural gait.

As adults, we tend to forget how intricate this process is and how easily it can be disrupted. However, normal gait and balance rely on the proper functioning of various body parts, including the ears, eyes, brain, sensory nerves and muscles.

Injuries or problems with any of these parts can result in an inability to balance or to an unsteady gait, which can lead to falls or injuries if the causes and symptoms aren’t addressed.

Common Causes for Abnormal Gait

If an injury or illness has impaired your ability to walk normally, you may need gait training to improve your motion. Potential causes of problems with gait and balance include:

  • Aging: With a natural decrease in strength and flexibility comes impairment to your balance.
  • Musculoskeletal Problems: If your range of motion, strength, endurance and mobility are impeded for any reason, your gait may be affected, since you need a certain level of balance and strength to walk properly.
  • Impaired Cognition: You are less able to adapt to a situation if your judgment or safety awareness decreases, your attention is poor or you process information more slowly than before.
  • Impaired Neuromuscular Responses: Disruption in the signals between the brain and the muscles can affect gait and balance. The disruption can result from a variety of issues, such as a stroke, Parkinson’s disease or multiple sclerosis.
  • Impaired Sensory Processes: If your body’s sensors are unable to collect information about the environment, it can lead to balance and gait issues. Sensory disabilities may be caused by glaucoma, cataracts or diabetic retinopathy, to name just a few possibilities.

Gait Analysis

Your physiotherapist may diagnose your gait as abnormal after reviewing your medical history, discussing your symptoms and doing a walking gait analysis. She or he may use a gait scan device to assess the biomechanical function of your feet.

gait exercises

Gait and Balance Training

Gait and balance training is a type of physiotherapy that helps you learn to walk normally again. The benefits of gait and balance training include:

  • Improving your balance and posture;
  • Strengthening your joints and muscles;
  • Developing muscle memory;
  • Increasing your endurance;
  • Retraining your legs to participate in repetitive motion; and
  • Increasing your mobility while decreasing the risk of falling.

It also offers other health benefits; because you are mobile rather than stationery, it can improve your overall health, prevent increased osteoporosis and keep heart disease at bay.

Your gait and your balance are inextricably linked, both relying upon the body’s cognitive functions, the eyes, the ears and joints, muscles and nerves. Gait and balance training helps these parts work in harmony.

Gait and balance training is also very helpful to people recovering from a variety of health issues, such as a spinal cord injury, a joint replacement or a stroke. Learning to walk properly again requires determination and practice. Training also helps prevent injury, assists with posture and keeps related aches and pains to a minimum.

Before you start gait and balance training, you must be healthy enough to take part in physical activity and your joints must be strong enough to support you. The activities your physiotherapist will instruct you to do will depend on your diagnosis and physical abilities. Gait training exercises often include walking on a treadmill, combined with strength and mobility exercises.

Orthotics

In addition to your gait and balance training, your physiotherapist may suggest custom orthotics for your shoes. Custom orthotics are not the casual shoe inserts that you can buy at any drugstore to add extra cushioning to your shoes. They are custom-made, prescription medical devices that you wear inside your shoes to correct biomechanical foot issues – unstable or impaired gait when walking or running. These prescription inserts are useful in helping improve your gait and correcting the appropriate problem.

If you’re having trouble walking or are recovering from an injury, it is worthwhile to consider gait and balance training to get you back on your feet and on the right track.

Let's get you back on your feet!


degenerative disc disease

What is Degenerative Disc Disease

The discs that reside in our spinal columns are a vital part of our anatomy, acting as shock absorbers for our vertebrae and allowing our spines to bend and twist. These discs are located between vertebrae and are actually tire-shaped pieces of rubbery cartilage with gelatin filling the hole.

Degenerative Disc Disease Causes

The prevalence of disc degeneration in people under the age of 50 has been shown to be 71 per cent in men and 77 per cent in women; for those over 50, it is present in 90 per cent of both men and women.

So lets take a look at some of the degenerative disc disease causes. As we age, our discs naturally degenerate. They lose fluid, making them flatter and narrowing the distance between our vertebrae. This means that the discs are less able to absorb shocks and render us less flexible.

The outer layer of the disc may also be subject to tiny tears or cracks, allowing the gelatin in the centre to seep out. This may cause the disc to bulge, rupture or break into pieces. Bone spurs may also form or the disc’s rough surfaces may rub against each other, given the decreased space between them; this may result in pain and inflammation.

In addition, the nerve roots, the points where spinal nerves leave the spinal column to extend to other body parts, may get irritated or become compressed. The condition and these related maladies are lumped together under the term degenerative disc disease (DDD).

Disc degeneration doesn’t always lead to tearing and subsequent pain. It is most likely to do so if you have a history of smoking; do heavy physical work; don’t get much exercise; or are obese.

Symptoms

There are various ways the discomfort of degenerative disc disease pain can manifest itself.

  • Cervical Degenerative Disc Disease Symptoms. You may have back or neck pain that travels to the extremities; it can be mild or severe. You may find that your arms and shoulders are numb or tingling if the degeneration affects your cervical spine.
  • Lumbar Degenerative Disc Disease Symptoms. If your lumbar spine is affected, you may have numbness in your legs, back or buttocks. If your ribcage hurts, your thoracic spine is likely responding to DDD. Bending over, reaching up or twisting may increase your pain, and it may worsen if you remain in one position for a long period of time. It may also be worse early in the morning.

The onset of pain may result from a major injury, such as a car accident, or a minor injury, such as falling from a stepping stool. However, it may also appear for no apparent reason.

degenerative disc disease pain

How to Treat Degenerative Disc Disease

If your physician suspects that you have degenerative disc disease based on your symptoms, he or she may try to pinpoint the source of your pain; measure the range of motion of your spine, your arms and your legs; perform muscle strength and sensation tests to determine if a nerve is affected; and examine your posture and observe your gait.

So what is the best treatment for degenerative disc disease?

At home and at work you can get some pain relief for degenerative disc disease by applying heat or cold to the affected areas and take acetaminophen or a non-steroidal anti-inflammatory medication.

To achieve ongoing relief, physical therapy is the most common treatment. It helps in managing degenerative disc disease pain and improving range of motion, strength and flexibility. It assists patients in strengthening muscles that can help assume some of the load previously handled by the discs; it also increases blood supply to the injured area, bringing more oxygen and nutrients that can assist in repairing the damage done.

Degenerative disc disease exercises may include stretching and flexibility exercises that help you to improve movement in your joints and muscles, which generally aids in pain relief.

Strengthening exercises will strengthen both your core, which provides support to your spinal joints, and your extremities, which can assume some of the workload usually done by the spinal joint. Aerobic exercises may also be added to the program, since they improve mobility, relieve pain and help you maintain a healthy weight.

In addition, your physiotherapist may use spinal traction and some hands-on techniques, such as massage, to loosen tight muscles and stiff joints so they can move better. He or she will also give you instructions about sitting, standing, bending and sleeping properly to ease your pain.

If none of these methods produce results, talk with your doctor. In severe cases, surgery may be required.

Remember: disc degeneration is a normal part of aging; you can’t prevent the march of time but you can manage the changes with proper advice from trained professionals.

Let's get you some relief!


muscle cramp

How to Get Rid of Muscle Cramps

Our muscles are the body’s gateway to movement. They are the only tissues in our body that can contract and move the other parts of our body, so we rely on them heavily.

It is skeletal muscles that allow for physical motion. These striated muscles are attached to bone in at least one place, and many reach across a joint and connect to bones at each end. They are the key to all of our conscious movements.

Muscle Cramps

Given our reliance on muscles for movement, when a muscle cramps, we’re dismayed, because, for a brief period, they don’t function. A cramp is a tightening or painful, strong contraction of a muscle that happens suddenly and involuntarily and lasts for a few seconds to a few minutes. It prevents the muscle from functioning properly.

Most people experience muscle cramps in legs, calfs, and feet. They may manifest themselves as a lump of hard tissue visible under the skin’s surface. Some people are prone to muscle cramps at night – the tightening of muscles in the calf, thigh or foot that often occur as they are awakening or falling asleep.

What Causes Muscle Cramps?

While all of the causes of muscle cramps aren’t known, they are sometimes related to an underlying medical condition, such as nerve compression, mineral depletion and inadequate blood supply. Generally, people are more susceptible to muscle cramps as we age, because they lose muscle mass and the remaining fibres are overstressed more easily.

  • Muscle cramps can happen if a muscle is injured or overused or they can occur during exercise.
  • Mineral depletion, often due to the use of diuretics prescribed for high blood pressure medication, can lead to cramps, as can a dearth of calcium, potassium and magnesium in your diet.
  • Muscle cramps in pregnancy are common due to the need for additional minerals in the diet during pregnancy.
  • If you are dehydrated or exposed to cold temperatures, especially cold water, your muscles may contract.
  • Standing on a hard surface or sitting in one place for an extended period of time can cause cramps, as can sleeping with your legs in an awkward position.
  • In addition, if you are taking certain medications, such as birth control pills, or steroids, you may be more prone to muscle cramps.

muscle cramps in legs

Home Remedies for Muscle Cramps

For most people, you can address the cramps yourself using a variety home remedies for muscle cramps:

    • If you find one of your muscles cramping, first try massaging it and stretching it.
    • Heat may alleviate some of the discomfort, so take a warm bath or shower or apply a heating pad to the affected area.
    • If you’d prefer to try ice, use an ice pack on your muscle, but don’t place it directly on the skin; use a dishtowel as a barrier.
    • Taking non-steroidal anti-inflammatory medication may also help ease the pain, and these are readily available over the counter.
    • Finally, ensure that you aren’t dehydrated; drink fluids. Sports drinks can be helpful in easing leg cramps.
    • If your cramp is a leg cramp, try jiggling your leg or walking around. You should also stretch your calf muscles, either while standing or sitting.

Generally, your cramps will ease as a result of one or more of these home remedies. However, consider seeing your physician if the cramps don’t improve with self-care; occur frequently; prompt redness, swelling or changes to your skin; cause severe pain; or don’t seem to bear any relation to exercise, overuse or any particular cause.

How to Prevent Muscle Cramps

If you want to prevent muscle cramps, staying hydrated is your first line of defence. Drinking fluids allows your muscles to contract and relax. Maintain a healthy diet, rich in magnesium, potassium and calcium.

Stretching both before and after exercising is also a good preventive measure. You may want to consult a physiotherapist about the best prevention exercises to use.

Let's get rid of those muscle cramps!


calf strain

How to Treat a Calf Strain

The area of the leg behind the knee that reaches to the ankle is called the calf, deriving from the Old Norse word, kalfi, which referred to muscles in the lower leg.

In any case, our calves comprise two major muscles: the soleus and the gastrocnemius. The gastrocnemius is the large, diamond-shaped muscles that gives our lower legs their bulge. The soleus muscle is a flat muscle that lies beneath the gastrocnemius. They taper and merge with our Achilles tendon, which inserts into our heel bone. They are responsible for the downward motion of our foot. The calf muscles pull the heel up to allow for forward motion.

Calf Strain Symptoms

The most common injury to our calf muscle is a calf strain, which is also called a pulled calf muscle and a calf muscle tear. In actuality, the two conditions refer to different degrees of the same problem. They result from overstretching the muscle and tearing some or all of the fibres. The difference is in severity.

The most severe injury is a rupture, in which the muscle is completely torn away from the bone. The least severe is a Grade 1 strain. Strains can be cumulative, resulting from injuries over time, or instantaneous, occurring as the result of a particular movement or injury.

With a Grade 1 calf strain, the muscle is partially stretched; a few fibres may be torn. The muscle may feel tender or painful, but your motion isn’t impaired and you can walk normally.

A Grade 2 calf strain is a moderate injury with more stretching and more muscle fibres torn. You may feel a snapping or pulling sensation when the tears occur and you’ll probably feel tenderness and some pain. You’ll find a loss of strength in the calf and may find yourself limping as you walk.

A Grade 3 calf strain is a severe tear of your muscle fibres; it may even be torn all the way through. This is called a rupture and the muscle itself may collapse or roll up into a ball that can be seen under the skin. You should feel extreme pain and won’t be able to walk.

Calf strains mean injured muscles and disrupted cells, leading to bleeding and bruising under the skin. Bruising may extend down the leg toward the ankle as gravity forces some of the blood lower. There will likely be swelling in the area and the muscles may feel tight.

calf muscle injury

Common Causes for a Calf Muscle Injury

Often, a calf muscle injury occurs during a sporting activity when you push off on your foot quickly to achieve a burst of speed. Athletes in sports such as tennis, baseball, soccer and track are often subject to strains, as are gymnasts and dancers.

In general, calf muscle injuries are caused by sudden or forceful, uncontrolled movement, and can occur instantly – an acute injury – or over time – an overuse injury. As we age, our calves become more vulnerable to injury.

Calf Strain Treatment

When a calf strain first occurs, take care of it during the first 24 hours by adopting the RICE method: Rest, Ice, Compression and Elevation. This includes resting on your couch, elevating your injured leg, icing it every two hours for about 20 minutes and wrapping it tightly in an elastic bandage. If you must walk, heel lifts in your shoes are recommended.

For Grade 2 or 3 strains, you’ll probably want to see your physician for an accurate diagnosis. A Grade 3 strain may require surgery to repair the tear, and you may need to undergo an MRI (magnetic resonance imaging), a CT (computed tomography) scan or a calf muscle ultrasound to confirm the diagnosis.

For Grade 1 and 2 strains, your physician will probably suggest a course of physiotherapy to help you rehabilitate your injured calf. Your physiotherapist will design a course of treatment that will encompass minimizing pain, improving motion and strength and minimizing recovery time. To minimize pain, a combination of hands-massage, ultrasound, electricity and taping may come into play.

Initially, your physiotherapist may gently manipulate your calf to allow gentle motion; you’ll progress to exercises and stretches. You’ll also start to do strengthening exercises, possibly employing weights or machines to work your calf appropriately. Your physiotherapist will work with you to achieve your goals of returning to activity and participating in the sports you love.

Any injury takes time to rehabilitate, so the best strategy is to prevent it from occuring in the first place. Be sure to do warmup exercises before participating in a sport and follow a stretching and strengthening program during the off season. Wear shoes that fit properly and don’t increase the intensity of your activity too quickly. There are no guarantees that injuries won’t happen, but these measures will make it less likely.

Let's get your calves some relief!


osteoarthritis hip

What is Osteoarthritis of the Hip?

With our aging population here in Canada, you may have noticed an increasing number of people walking with canes or limping as they walk. Aging translates to wear and tear on our bodies, and our joints are very susceptible.

One of the most common ailments as we age is osteoarthritis or arthritis of the bones, often called “wear and tear” arthritis. Osteoarthritis can occur in any of our joints, and the hip is one of its most common locations.

A 2009 Statistics Canada survey found that arthritis affects 10 per cent of the Canadian population ages 10 and up. Of those 20 and older, 37 per cent of arthritis sufferers said osteoarthritis was their sole arthritic condition; two per cent experienced hip pain; 29 per cent had knee pain and 29 per cent experienced both. These numbers certainly don’t prompt us to cheer, “Hip, hip, hooray!”

Osteoarthritis Hip Pain Explained

The hip is a ball and socket joint; the head of the upper leg bone, or femur, fits into the socket created by the acetabulum, a section of the large pelvis bone. The surfaces of both bones are generally covered with cartilage, a slippery substance that protects and cushions them. Between the bones, there is also a thin layer called the synovium, which produces fluid to lubricate the cartilage to ensure that movement happens smoothly. The cartilage also helps to absorb any shocks that aren’t dispersed by your hip bones.

With osteoarthritis, the cartilage begins to wear away and becomes rough in the process. The protective space between the two bones shrinks and, without cartilage, the bones may rub against each other. Bone spurs may also pop up, attempting to compensate for lost cartilage. It’s a slow process, but one that is increasingly painful.

sarthritic hip joint

Risk Factors

Although the actual cause of hip osteoarthritis and deterioration hasn’t been identified, you are more likely to suffer from it if you have one or more risk factors, including aging; heredity or congenital defects; previous trauma to the joint, such as a broken hip from years earlier or effects of sporting activities; obesity – the hip experiences six pounds of pressure for every pound we gain; and gender – women are more likely than men to experience it.

Osteoarthritis Hip Symptoms

Because hip osteoarthritis is an ailment that develops slowly, people often ignore it until it affects their daily activities. If you have hip osteoarthritis, you may have stiffness in the groin, buttocks or thigh after sitting or lying down for long periods of time, including when you arise in the morning.

You’ll will likely have pain that will worsen over time, especially when you put weight on the hip; it may radiate down the thigh to the knee. You may have some swelling, which can weaken the muscles supporting the joint. Your hip joint may lock or stick periodically and there may be a sensation of bones rubbing against each other – a crunching or popping sensation.

Walking may be painful and you may unconsciously avoid putting weight on the hip, giving your gait a limping or lurching motion. You may have some loss of function – tasks that require bending, such as tying your shoes, may become difficult, and it may be a challenge to get into a car or a chair.

Treatment for Osteoarthritis of the Hip

In addition to discussing your history and doing an examination, your doctor will test your range of motion and check for pain points. He/she may order an MRI or an X-ray to confirm the diagnosis.

It isn’t possible to reverse the damage done to your hip by osteoarthritis, but you can slow its progress and address the symptoms. Relieving pressure on the joint through weight loss and/or muscle strengthening are common approaches. For more severe cases, injections and surgery may be suggested.

Any approach to treatment should aim to reduce pain and ensuring that you can function well enough to carry on with your daily activities. You’ll need to find the proper balance between activity and rest; inaction simply exacerbates the condition. You can also use a cane in the opposite hand and/or wear cushioned shoes to relieve some of the pressure on the hip when walking.

Non-invasive treatment should be your starting point, and physiotherapy is a useful tool to strengthen your surrounding muscles, increase range of motion and reduce pain. Your physiotherapist will start by manipulating your hip, moving on to designing a course of stretching and strengthening exercises.

Osteoarthritis hip exercises can also decrease stress on the hip and increase stability. They may also help you modify your gait. You’ll want to minimize activities, such as running, that cause pain and try those, such as swimming, that don’t place stress on the hip.

More Invasive Treatments

You may also consider more invasive options. Your physician may suggest steroid injections to reduce swelling or hyaluronic acid injections that provide lubrication to the joint to make movement easier. They don’t work equally well for everyone, but if they are successful, the impact lasts anywhere from six months to a year.

Surgery is the most drastic response to hip osteoarthritis. If the osteoarthritis is having a major impact on your lifestyle, you may want to consider it. There is arthroscopic surgery that can be used to remove bone spurs or loose pieces of cartilage; osteotomy that reduces friction by aligning bones properly; and total hip replacement, which replaces your joint with an artificial one. Discuss these possibilities with your physician if the osteoarthritis becomes severe.

Finally, don’t take your condition lying down (you’ll get stiff!). Be proactive in addressing it by staying active, losing weight and adopting a course of exercise that will strengthen the muscles around the hip.

Let's get you some relief!


hamstring injury

How to heal a Strained Hamstring

If you work for a large organization or are required to deal with one, you may have been hamstrung – prevented from taking action – by the endless bureaucracy. But hamstrings? What is a hamstring? Where is your hamstring located, and is there a relation between the two words? Let’s talk about hamstring anatomy first.

Hamstring Anatomy

The hamstrings are the long, tendonlike muscles that run along the back of your thigh from buttocks to knee. The first syllable comes from the Old English ham or hom, meaning the hollow or bend of the knee; the strings refer to tendons. Put the syllables together and you have hamstrings: the tendons at the bend of the knee.

If you are hamstrung, technically you have been crippled by these tendons being cut; less literally however, you have been prevented from acting or being efficient.

Hamstring Muscle Group

Your hamstrings are crucial to your body’s motion. There are three hamstring muscles that extend from your buttocks to your knee. Your hamstring muscle group consists of the biceps femoris, the semitendonosus, and the semimembranosus. This trio of muscles is the grouping that is primarily responsible for straightening your hip and bending your knee.

hamstring anatomy

Hamstring Injuries

Hamstring injuries generally result when the muscles come into contact with excessive force. The sudden starts and stops that athletes make while running or the cutting or jumping movements they make when playing soccer or basketball may cause hamstring strain.

Overstretching the muscles while lifting something heavy or while hurdling or kicking can also result in injury to your hamstring group. The muscles may even become overloaded which can result in a hamstring tear. A sudden increase in the intensity of exercise or training can lead to hamstring injuries, as can running on hard surfaces, poor pelvic alignment and stress on the body due to obesity.

Hamstring strains come in three flavours, or degrees or seriousness:

  • A Grade I hamstring strain (or tendinitis) is a mild overload with minimal muscle tearing involved; it will feel like a muscle pull or cramp.
  • A Grade II hamstring strain is a moderate strain with partial tearing of the muscle that may be accompanied by a stinging or burning feeling at the back of your thigh.
  • A Grade III hamstring strain, the most severe, is a completely torn muscle that may leave a knot or lump at the spot where the tear has happened.

What does a hamstring strain feel like?

If your hamstring strain is a mild one, you may not even notice it until you stop exercising or until the next day when there might be tightness, soreness and bruising; however, the strength of your hamstring shouldn’t be affected.

More severe hamstring injuries include symptoms that may include a sharp, sudden pain in the back of your thigh or in your buttocks; a sensation of popping or tearing in the muscle; swelling; bruising; tenderness when touched; the inability to straighten your leg or lift it when lying down; and challenges in walking or in sitting comfortably.

With a Grade II strain, you’ll lose some leg strength and if the strain is a Grade III strain, you’ll likely be unable to use your leg.

hamstring strain

Hamstring Treatment

How to treat a strained hamstring depends on the severity of the strain. Mild strains can be treated at home, similar to any other minor sports injury. The RICE approach works well: rest, ice, compression and elevation. Avoid physical activity; apply cold packs to your hamstring for 15 to 20 minutes every few hours; use an elastic bandage to wrap and compress the thigh to reduce swelling; and keep your leg raised on pillows to further minimize swelling. You can also take over-the-counter painkillers, such as non-steroidal anti-inflammatory medicines.

If the strain is severe, surgery may be required to repair the tear. Consult with your physician if you suspect a Grade III strain.

Once the initial pain and swelling are through, you’ll undoubtedly want to return to physical activity. However, it’s wise not to rush yourself. You shouldn’t consider returning to your previous level of activity until you can move your injured leg as freely as the other leg and it feels just as strong. You shouldn’t feel pain as you walk or accelerate. Don’t push yourself; you don’t want to impair your muscle’s function permanently.

A physiotherapist can help you rehabilitate your hamstrings. He or she can help you learn to move in a way that doesn’t put pressure on the injured area and assist you reach your movement goals. Your physiotherapist can prescribe a course of muscle strengthening exercises to focus on weak areas. He or she can also provide support through manual manipulation of areas that are difficult to reach.

Injury prevention

Those who have experienced a hamstring strain have a chance of it recurring, since the muscles have been weakened. However, everyone can take steps to prevent a hamstring injury by warming up properly before exercising; avoiding the temptation to ramp up the level of a new activity too quickly so the body has time to accustom itself; and knowing and learning proper movement techniques for both sports and lifting/moving heavy items.

Did you injure your hamstring?


facet joint syndrome

What is Facet Joint Syndrome?

When we think about our joints, it’s the larger ones that usually come to mind: hips, knees and shoulders, for example. We rely on them to keep us moving, but we generally don’t think about them unless they aren’t working well.

We do have other joints, however, that are equally important to our well-being, although we’re not usually aware that they exist. They are called facet joints and are located on the back of the spinal column.

Facet Joint Anatomy: What is a Facet Joint?

Each vertebra has two facet joints, one on each side of the spine. They are the joints responsible for spine stability and flexibility and make it possible for you to bend and twist.

The facet joints in each area of the spine are angled and shaped differently in each region of the spine: cervical, lumbar and thoracic. When they are healthy, they are cushioned by cartilage, allowing them to move smoothly against each other and are lubricated by synovial fluid to prevent wear and tear.

Like any joint, your facet joints are subject to injury or pain. When these joints become painful and swell, the result is called facet joint syndrome.

The joints can also be injured; the stiffening of facet joints is called hypomobility; excessive joint motion is called hypermobility. Facet joints can also lock in place, impeding movement in the opposite direction.

Facet joint syndrome can generally be attributed to the combination of injury, excessive pressure and aging. Discs in the spine can degenerate and collapse, affecting the alignment of your facet joints. The misalignment wears on the cartilage, which is eventually destroyed, along with the lubricating synovial fluid, leaving bone rubbing on bone.

Facet joint problems are common causes for neck, back and thoracic spine pain. Generally, 55 per cent of facet joint syndrome sufferers have pain in their cervical (neck) region, while 31 per cent have problems in their lumbar (back) area.

Facet Joint Pain Symptoms

Unfortunately, facet joint inflammation can be confused with other conditions. In the cervical region, the symptoms may be similar to those of a herniated disc or a torn spine muscle. Abdominal problems and neck issues may also mimic the symptoms of facet joint issues, so a careful diagnosis is imperative.

Symptoms of facet joint problems may include:

  • Acute, intermittent episodes of pain in the lumbar or cervical regions of the spine that occur a few times a month or year;
  • More discomfort when leaning backward than forward;
  • Low back pain that radiates through the buttocks and the back of the upper legs, but not the front of the legs or below the knees;
  • Pain in the shoulders and upper back that doesn’t affect the arms or lower back; and/or
  • Pain points above the facet joints and loss in spinal muscle flexibility.

If you have facet joint syndrome, you may have difficulties in bending or twisting your spine. Issues with the facet joints in your neck may make it challenging to turn your head left or right, while problems with facet joints in your back may make rising from a chair hard to accomplish. Lumbar facet joint syndrome will also make sitting and riding in a car challenging.

Diagnosing Facet Joint Syndrome

Facet joint syndrome will be diagnosed by your physician based on your symptoms, your history, an examination and tests: an X-ray, a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan.

Treatment

Your physician will probably refer you to a physiotherapist to help you rehabilitate your joints, restore your range of motion and alleviate your pain.

Your physiotherapy treatment will generally include a course of exercises to restore movement, strength and flexibility, along with soft-tissue massage; acupuncture is also an to alleviate localized pain. Potentially, spinal traction and  joint manipulation will also be recommended.

Your physician may also suggest non-steroidal anti-inflammatory drugs to alleviate pain quickly and prescribe muscle relaxants. If the pain continues, your physician may give you a steroid injection for temporary relief.

Prevention

Although facet joint syndrome is partially a consequence of aging, it is possible to make lifestyle choices that reduce your chance of developing it as you age. By exercising regularly, maintaining a healthy weight, eating a nutritious diet, practising good posture, and avoiding tobacco and excessive alcohol consumption, you can slow down the forces that cause it.

Suffering from Facet Joint Syndrome?


post concussion syndrome

What is Post-Concussion Syndrome?

Hard hits to the head in any sport, including ice hockey and football, can cause mild traumatic brain injury, which is essentially how a concussion is defined. Violent shaking or the impact of a car crash can also lead to a concussion.

Post-Concussion Syndrome

As if an injury to the brain isn’t worrisome enough, there is also the possibility of developing post-concussion syndrome. Post-concussion syndrome refers to the persistence of various concussion symptoms long past the time of injury.

Researchers haven’t yet identified the reasons why some concussion victims suffer from post-concussion syndrome and others do not.

Some researchers believe the syndrome is caused by structural damage to the brain or disruption of the messaging system within the nerves, resulting from the impact that first resulted in a concussion. Others contend that the causes are rooted in psychological factors, since a number of the most common symptoms are also seen in people with anxiety, depression or post-traumatic stress disorder (PTSD).

Both the physiological impact of a concussion and the emotional reaction to it can contribute to post-concussion syndrome. You may be more susceptible if you have a history of PTSD, depression or anxiety, or if you have significant life stresses, poor coping skills or poor network of social supports.

How long can Post-Concussion Syndrome last?

Most people who suffer concussions recover within a few months, but, for others, symptoms linger on. These varied symptoms are generally labelled as post-concussion syndrome, a poorly understood and often misdiagnosed condition that can greatly affect quality of life.

Post-Concussion Syndrome Symptoms

Post-concussion syndrome is a difficult condition to diagnose because its symptoms can often be attributed to other causes and may also be vague.

Some of the most common post-concussion syndrome symptoms are

  • Headaches
  • Dizziness
  • Problems with sleep

Other symptoms – physical, emotional and cognitive – include:

  • Irritability or aggression on little or no provocation
  • Apathy or lack of spontaneity
  • Changes in personality
  • Difficulty finding words
  • Trouble in busy environments
  • Light sensitivity
  • Noise sensitivity
  • Nausea/vomiting
  • Difficulty following conversation that includes several people
  • Difficulty initiating tasks
  • Persevering at tasks.

In making a diagnosis, your physician may consider your history of head injury and symptoms, conduct a physical exam and request a magnetic resonance imaging (MRI) or computed tomography (CT) scan to check for any structural abnormalities in the brain. They may also attempt to rule out other causes of the symptoms, such as bleeding in the brain or infection.

Post-Concussion Syndrome Treatment

There is no standard way of treating post-concussion syndrome. Your physician will provide and/or recommend treatment tailored to your individual symptoms. Everyone has a different mix of symptoms that occur with different frequencies. Education is a powerful tool in addressing post-concussion syndrome, because addressing the fears about the condition often help ameliorate symptoms.

If you have headaches, some of the medications used for migraines or tension headaches seem to be effective. Be aware that overuse of over-the-counter and prescription medications may lead to continuing symptoms.

For cognitive symptoms of post-concussion syndrome, time may be the best healer. Cognitive therapy may also be helpful, especially if it focuses on areas that need strengthening. Cognitive symptoms may increase with stress, so learning stress management techniques may lessen them; relaxation therapy is another option.

For cases of post-concussion syndrome that exhibit symptoms of depression or anxiety, the sufferer may opt for psychotherapy or request treatment with anti-depressants.

To improve quality of life, a course of physiotherapy may be suggested. Patients with post-concussion syndrome recover faster with physiotherapy than with rest alone, researchers have found (Schneider KJ et al. 2103). Physiotherapists may use various techniques, depending on symptoms. Manual therapy may calm the nervous system and acupuncture may improve sleep and headaches. Exercise therapy may help with balance and sensory reintegration.

Concussion Prevention

There are no guaranteed ways of preventing post-concussion syndrome, but it is possible to take precautions against suffering a concussion in the first place.

Suggestions include:

  • Avoid motor vehicle collisions: drive defensively and eliminate distractions such as phone calls or eating.
  • Be cautious when playing sports: wear appropriate safety gear and avoid head collisions.
  • Avoid tripping and falling by keeping clear paths indoors: be careful of throw rugs, watch placement of pet dishes and be aware of loose flooring.
  • Educate yourself on concussions: be aware of risk factors, signs and symptoms, and how they can affect your health.

Your brain is precious – take good care of it and don’t return to your routines until you are completely symptom-free.

Suffering from Post-Concussion Syndrome?


spinal stenosis definition

What is Spinal Stenosis?

Referring in frustration, to a “pain in the neck” is a figurative way of calling someone annoying. However, it’s also an apt descriptor for cervical spinal stenosis, an ailment that literally can cause a pain in your neck – and other places, as well. So, what is spinal stenosis?

Spinal Stenosis Definition

Spinal stenosis refers to the narrowing of the spinal canal, which houses the spinal cord, and the openings in it that provide passage for peripheral nerves that thread their way to other parts of the body. This narrowing can choke the spinal cord and/or the roots of your nerves.

There are two types of spinal stenosis: cervical spinal stenosis, which affects the spinal column in the neck region, and lumbar spinal stenosis, which narrows the spinal column in the lower back.

What Causes Spinal Stenosis?

Aging is the most prevalent cause of spinal stenosis. As you age, your spine gradually degenerates. The discs between your vertebrae lose height through dehydration; your bones and joints may enlarge due to increased stress on them and destruction of cartilage, potentially leading to bone spurs that occupy space in the spinal canal; and your ligaments may thicken and calcify, encroaching on the space in the nearby canal.

Middle-aged and elderly people are also subject to osteoarthritis of the spine, or spondylosis, which is chronic and the result of wear and tear on the spine. It can also lead to the formation of bone spurs that constrict the spinal canal and cause spinal stenosis.

Although people over the age of 50 are the most likely to suffer from it, younger people who suffer a spinal injury or are born with a narrow spinal canal are also subject to spinal stenosis.

spinal stenosis

What are the Symptoms of Spinal Stenosis?

Spinal stenosis may be present without your being aware of it. The spinal canals of many people over 50 narrow, but it only becomes apparent when the nerves are squeezed and they feel the resulting symptoms. It may take time for the symptoms of spinal stenosis to develop.

Your family physician will generally be able to diagnose spinal stenosis based on your symptoms and your medical history, using appropriate tests to confirm the diagnosis. The doctor may order a magnetic resonance imaging test (MRI), X-rays or computed tomography (CT) scans to rule out other possible causes of the pain.

What is Cervical Spinal Stenosis?

With cervical spinal stenosis, you may feel some stiffness, pain, numbness or weakening in your hands, shoulders, neck or legs. You may find that you have problems with co-ordination and balance, causing you to stumble when moving or shuffle as you walk. There may be problems with fine-motor skills, such as typing or buttoning a shirt. You may also experience some incontinence.

What is Lumbar Spinal Stenosis?

If you have lumbar spinal stenosis, leg pain when you’re in motion will usually be your primary symptom, since the nerves in the lower spine extend into the legs. It is often more severe when your spine is extended: for instance, when you are standing straight or leaning backward. The pain generally eases when your spine is flexed: whenever you are sitting, riding a bicycle or bending over your shopping cart.

Lumbar stenosis also manifests itself through additional symptoms, including low back pain; cramping, weakness or numbness in the legs, feet or buttocks; thigh and leg stiffness; and possible loss of bowel or bladder control.

Spinal Stenosis Treatment Options

Once a diagnosis is made, your physician will probably suggest physiotherapy as a spinal stenosis treatment option that will ease the symptoms. In extreme cases, surgery is warranted to relieve pressure on the spinal cord and nerves, but, usually, you can address the symptoms through other means.

At home, you can use non-steroidal anti-inflammatory drugs to ease the pain and reduce the inflammation. Your physiotherapist will do the same for you, using methods that may include ice, unloading taping techniques, electrotherapy, soft tissue massage and acupuncture.

Spinal Stenosis Exercises

Once the inflammation settles, your physiotherapist will help you focus on range-of-motion and alignment exercises, as well as muscle strengthening.

Spinal stenosis exercises will usually take the form of lower abdominal and core stability exercises, since you want to strengthen the muscles that control and stabilize the movement of your spine.

Cervical spinal stenosis exercises will aim to maintain flexibility and strength and improve posture.

Spinal Stenosis Prevention

There are some basic things you can do in order to prevent symptoms to manifest themselves or recur:

  • Maintain a healthy body weight.
  • Develop or maintain good posture.
  • Exercise regularly, including stretching exercises, such as yoga.
  • Don’t smoke, since smoking decreases bone density and increases risks of fracture and bone deterioration. It has also been linked to disc problems.

Spinal stenosis should be taken seriously; if you follow the guidance and treatment plan you receive, you usually should be able to make your pain disappear within a reasonable timeframe.

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what is sciatica

What is Sciatica?

Do you have pain radiating from your buttock to your calf? Perhaps you have discomfort running from groin to knee. Interestingly, both of these diverse problems may fall under the rubric of sciatica. So, what is sciatica and what causes sciatic nerve pain?

Sciatica Pain

Sciatica is not actually a medical diagnosis; it is a term that refers to any type of pain or weakness that is caused by irritation or injury to your sciatic nerve. Sciatica pain is most prevalent among people 30- to 50-years old.

The sciatic nerve is the longest nerve in the body. It comprises a number of nerves that exit your lower spine and meet up. The sciatic nerve runs from your lower back through the buttocks and hamstrings into your lower leg.

Sciatica Symptoms

Sciatica manifests itself in a number of ways, usually occurring only on one side of the lower body. Some of the most common sciatica symptoms are:

  • Weakness or numbness in moving your foot or leg.
  • Constant pain in the rear calf.
  • A tingling or burning sensation in the leg.
  • A “pins and needles” sensation in the leg.
  • Shooting pain in the leg, making walking or standing up a challenge.
  • Constant pain in the buttock that may radiate down the leg.
  • Pain that decreases when walking or lying down, but ramps us while sitting or standing.

Your sciatica symptoms may intensify when you sneeze, cough or make other sudden movements or when you change positions.

Sciatica Causes

There are six injuries that are most often implicated in sciatica:

  1. Degenerative disc disease. Although our discs normally degenerate a bit with age, the weakened discs in some bodies irritate the nerve root, causing sciatica. Disc degeneration may also lead to bone spurs, which may press against a nerve and result in sciatica.
  2. Lumbar spinal stenosis. A narrowing of the spinal canal is relatively common in adults older than 60 and can cause pressure on the sciatic nerve through one or more factors, including bulging discs, overgrown soft tissue and enlarged facet joints. Spinal arthritis often accompanies spinal stenosis and can contribute to sciatica.
  3. Herniated lumbar disc. Herniated discs result when the fluid inside the disc leaks out beyond the core and irritates the nearby nerves, causing sciatica.
  4. Sacroiliac joint dysfunction. The sacroiliac joint is located at the base of the spine, and anytime it is irritated, the nerve that lies on top of it is also subject to irritation, causing leg pain similar to sciatic pain.
  5. Piriformis syndrome. The sciatic nerve runs under the piriformis muscle in the buttocks and may be subject to irritation or pinching by the muscle, causing sciatica-like pain.
  6. Isthmic spondylolisthesis. A small stress fracture in a vertebra can cause the vertebra to slip forward onto another, collapsing disc space and pinching the sciatic nerve.

sciatic nerve

Sciatic Nerve Pain Treatment

In order to treat sciatic nerve pain, your physician or physiotherapist must determine the underlying problem that is causing it. This can be a challenge, since two cases of sciatica can easily have the same symptoms but different causes. You may need an X-ray, a CT scan or an MRI to assess potential problems with your vertebrae.

Once this is accomplished, the focus can shift to relieving pain and pressure on the sciatic nerve and restoring the range of motion:

  • Ice. Icing the affected area can help to reduce inflammation. Ice should be wrapped in a towel and applied for 20 minutes at a time.
  • NSAIDs. Non-steroidal anti-inflammatory medications such as ibuprofen help to reduce the inflammation that may be a source of irritation for the sciatic nerve and surrounding tissues.
  • Physiotherapy. Your physiotherapist will prescribe a course of stretching exercises to loosen any muscles that may be placing pressure on the sciatic nerve, as well as joints and tendons, plus strengthening exercises to help prevent a recurrence of the pain. Physiotherapy treatment for sciatic nerve pain may also include:
  • Acupuncture. Long recognized for its effectiveness in relieving back pain.

How to Prevent Sciatic Nerve Pain

Unfortunately, sciatica has a tendency to re-occur, and bouts of sciatica can last as long as six weeks. You can play a part in preventing an episode of sciatica by playing an active role in your own physical health:

  • Regular exercise. Make exercise part of your routine, focusing on activities or routines that strengthen the back and abdominal muscles. Swimming and Pilates are ideal; ask your physiotherapist about individual exercises.
  • Posture. Keep an eye on your posture when sitting and standing. You may want to request an ergonomic assessment at work to ensure your chair, computer and desk are arranged to minimize inappropriate stresses.
  • Sleep posture. Consider sleeping with a pillow between your knees or at your side so that your back is supported.
  • Movement. If you have a desk job, make sure to get up and move every 20 to 30 minutes. Walk to the photocopier, the coffee pot or just up and down the hall.
  • Lifting. Be sure that you lift heavy objects by using your leg and hip strength.

Sciatica is unpleasant, but the pain can be addressed. Treatment that occurs during the first 48 hours of onset will shorten the time you are indisposed.

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tmj disorder

What is Temporomandibular Joint Disorder (TMJ)?

Here’s a topic worth jawing about: temporomandibular joint disorder, or TMJ disorder (TMD), a facial joint disorder that is painful, rather than fatal; however, it can be uncomfortable.

When people who suffer from TMD open their jaws, the movement may provide “musical” accompaniment in the form of clicks or popping sounds that they are unable to prevent. But what is TMJ?

TMJ Disorder (TMD)

The temporomandibular joints are the joints connecting the temporal bones of the skull to the mandible, or jaw bone, hence the name. It is commonly referred to as the TMJ. There is one on each side of our heads.

These joints, which are lined by cartilage and contain a fibrogelatinous disc between the bones, open and close like hinges. They allow the jaw to move both up and down and side to side, making them among the most complicated of the body’s joints.

A TMJ disorder refers to problems with the jaw joints, muscles or fibrous tissues that connect them. TMJ disorders are most prevalent among women in their early 20s or during their 40s and 50s, while undergoing menopause. Men are affected by TMD less frequently.

TMJ Symptoms

Common TMJ symptoms include:

  • Pain. Pain while moving the jaw is an obvious symptom of TMJ disorder, but the disorder may also cause headaches or migraines, earaches, neck aches and back aches. The earaches may be accompanied by ringing or buzzing your ears. Your chewing muscles will generally be tender and painful when touched.
  • Minimal movement. Limited movement may prevent you from fully opening your mouth or from moving your jaw in particular directions. For example, non-sufferers can generally hold their index, middle and ring fingers horizontally and insert them easily between the upper and lower teeth. People with TMJ disorders will generally find it difficult to open their mouths so wide.
  • Noise pollution. TMJ disorders are often accompanied by sounds that occur when you talk, eat or open your mouth. The noises may be clicking, popping or grinding sounds and will be present concurrently with the pain or restricted movement. If the noises are not linked to one of the other symptoms, they are generally harmless.

tmj exercises

What is the main cause of TMJ?

TMJ disorders are often caused by a combination of anatomical joint problems and muscle tension.

The disorders may result from jaw injuries, stress, arthritis, autoimmune diseases, misalignment of teeth, disc dislocation or genetic, overuse or environmental factors. For example, violinists are prone to TMJ disorders, because they steady hold their instruments under the jaw, potentially causing strain.

Here are more in-depth explanations of some of TMJ disorder’s potential causes:

  • Osteoarthritis. The cartilage in the TMJ is not as strong as cartilage elsewhere in the body, and it can degenerate, something that usually happens to people at age 50 or older.
  • Infectious arthritis. An infection in the bloodstream or one that has spread from another area of your body can cause stiffness in the TMJ.
  • Rheumatoid arthritis. About 17 per cent of people who suffer from this autoimmune condition where the body attacks its own cells, leading to inflammation, also experience TMJ disorder.
  • Hypermobility. The jaw is looser than usual, due to stretching in the ligaments that hold the TMJ together.
  • Ankylosis. The joint loses range of movement due to fusion of the bones or calcification of the surrounding ligaments.

tmj pain

Diagnosis

A TMJ disorder will generally be diagnosed by a doctor or a dentist based on a physical examination in combination with a review of the patient’s medical history. Depending on the outcome, a magnetic resonance imaging (MRI) test for your disc, an X-Ray of your teeth or a Computed Tomography (CT) scan of your bones may be required.

What is the best treatment for TMJ?

You may be able to treat mild or moderate TMJ disorder at home by making lifestyle changes. TMJ home treatment may involve a reduction in joint movements and more rest for the jaw by avoiding chewing gum and tensing the jaw and by eating only soft foods. The application of ice or moist heat may also be useful, along with non-steroidal anti-inflammatory drugs.

Reducing stress in your life may also be helpful; yoga and meditation are often good ways to alleviate stress, and counselling (therapy) can be useful, too. You may also wish to try biofeedback or acupuncture to help relieve pain.

Is there physical therapy for TMJ?

A visit to your physiotherapist is recommended if symptoms are not relieved with home treatment and are related to muscle tension. Your physiotherapist can prescribe a program for you that includes learning and practicing techniques for regaining normal jaw movement.

TMJ exercises may relieve pain, reduce tension and strengthen the jaw area in order to prevent future flare-ups. Your physiotherapist will be able to recommend an appropriate series of exercises that begins with massaging the area to reduce tension and pain. You’ll move on to relaxation, strengthening and stretching exercises. They may also use ultrasound treatments.

If none of these approaches proves effective, your physician or dentist may suggest a corticosteroid injection, arthroscopy or open joint surgery.

Remember: pain is your body’s signal that something isn’t right. If your jaw begins to ache regularly, don’t ignore the feeling. The sooner you obtain treatment, the sooner you’ll feel like yourself again.

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carpal tunnel wrist

What is Carpal Tunnel Syndrome?

On a daily basis, we don’t give much thought to our wrists, unless we are putting on a bracelet, affixing cufflinks or buttoning a sleeve. They are simply connectors, bringing more important body parts – hands and arms – together so they can do their work.

We do sit up and take notice, however, if those wrists begin to hurt. It’s only then that we realize how important they are to the smooth functioning of our upper extremities and how frustrating it can be when they aren’t working properly. Carpal tunnel syndrome (CTS) is a common reason for wrist pain, so it’s worth examining in more detail.

Carpal Tunnel Syndrome Definition

Carpal tunnel syndrome results from the compression of the meridian nerve, a nerve on the palm side of the wrist. The meridian nerve is located in a “tunnel” created by a wrist ligament and the carpal, or wrist, bones. The tunnel, which is about the width of a thumb, is also crowded with the tendons that allow us to bend our fingers. Compression is generally caused by pressure on the nerve due to crowding or irritation.

What Causes Carpal Tunnel?

When looking into carpal tunnel causes, a frequent culprit is continued finger use, especially in situations that include vibration, and extreme wrist positions can contribute to CTS, as can repetitive motion. In today’s technology-focused world, we tend to associate CTS with working at a keyboard all day, but people working on assembly lines are three times more likely to develop it.

Other conditions that may lead to carpal tunnel syndrome, include:

  • Wrist injuries, such a sprains and fractures;
  • Swelling and inflammation of the wrist tendons;
  • Metabolic or hormonal changes, including pregnancy, menopause and thyroid imbalance;
  • Scar tissue from repeated traumas;
  • Degenerative or rheumatoid arthritis: and
  • Diabetes.

carpal tunnel wrist

Carpal Tunnel Prevention: Minimizing Stress to Hands and Wrists

There is no surefire way to prevent carpal tunnel syndrome, but there are actions you can take to minimize the stress to which you subject your hands and wrists as an attempt to keep it from developing:

  • May the force NOT be with you. Reduce the amount of force you use when doing work with your hands; most of us apply more than is necessary. For writing, use soft-grip implements.
  • Ergo, it’s ergonomic. Have your work station assessed from an ergonomic point of view to ensure that is suited to your height, posture and work you do.
  • Wrist readjustment. At a keyboard, keep your wrists extended, rather than flexed upward or downward to ensure that you don’t put undue strain on your nerves and tendons.
  • Perfect your posture. Keeping your torso, neck and shoulders aligned can help ensure that you position your hands and wrists properly.
  • Create warmth. Hand pain and stiffness happen more easily in the cold, so keep your work environment warm. If you can’t adjust the temperature, wear gloves to warm your hands and wrists.
  • To your health. Overall good health is important to keeping diseases that may lead to carpal tunnel syndrome at bay, so take good care of yourself.

Signs and Symptoms of Carpal Tunnel Syndrome

So, what does carpal tunnel feel like? If you experience any of the following, they may be signs that you are suffering from carpal tunnel syndrome:

  • Pins and needles that affect the thumb and first two fingers;
  • Numbness in the wrists or fingers;
  • A clumsy feeling in the affected hand; or
  • Weakness of the hand or in grip strength.

You may notice the feelings more clearly at night and may be awakened by the pain.

Diagnosing Carpal Tunnel Syndrome

Oftentimes, your physician or your physiotherapist can diagnose CTS without much trouble if you have the standard carpal tunnel symptoms, but there are also some tests that can be used to confirm its presence, including:

  • Finger and thumb grip strength testing;
  • Wrist and hand range of motion testing;
  • Reflex hammer testing; and
  • Electrical studies showing nerve transmission.

wrist brace

Carpal Tunnel Treatment

Carpal tunnel syndrome doesn’t require surgery, except in the most extreme cases. Initially, your physician will suggest physiotherapy as a carpal tunnel treatment. There are a number of simple carpal tunnel exercises that can relieve the pain and strengthen the wrist to prevent a recurrence of CTS.

Depending on the severity of the compression and inflammation, your physician may suggest wearing a resting carpal tunnel brace at night to prevent your wrist from assuming an injurious position and/or a working wrist splint for carpal tunnel to wear during the day. A steroid injection may reduce inflammation and its effects may last for weeks or longer.

Carpal tunnel syndrome is a minor injury with major consequences for our daily routines. It’s wise to take action as soon as symptoms appear so that the injury doesn’t progress. Ice the affected area and take frequent work breaks, and seek treatment if it continues.

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laser therapy

Laser Therapy for Pain

“No pain, no gain,” says the common saying, but those who are victims of physical pain would undoubtedly agree that this aphorism refers to growth and emotional pain. Physical pain, by contrast, is a hindrance to growth.

When you are hemmed in by pain, your options become more limited; you are unable or unwilling to use your body in many of the ways you once took for granted. It’s a frustrating feeling and you are keen to explore all options for banishing that pain and expanding your opportunities. And that’s where laser therapy enters the picture.

What is Laser Therapy?

Laser therapy is a non-invasive method of treatment that relies on light beams of various wavelengths delivered by a laser to reduce pain. It helps to heal soft tissue and provides pain relief.

Laser therapy relies on the laser, a device based on a theory first proposed by Albert Einstein in 1916, the Theory of Light Amplification through Stimulated Emission of Radiation (LASER).

Hungarian physicist Andre Mester was the pioneer in using a low-powered laser for medical treatment, beginning in 1967, only a few years after the first working laser was produced.

How does it Work?

Laser light on the infrared spectrum interacts with the body’s tissues, generally absorbed by the skin through a handheld laser device that targets a specific area. The light emitted by the laser creates physical changes in the cells in a process called photobiomodulation.

It passes through the layers of skin and interacts with the light-sensitive elements in a cell, increasing internal metabolic activity and increasing the flow of nutrients across the cell’s membrane.

In other words, the laser brings light to living tissues and its energy increases circulation, which in turn brings nutrients and water to the cells to create an ideal healing environment for pain and inflammation reduction, stiffness and muscle spasms.

Benefits Produced by Laser Therapy

The benefits of laser therapy are many and varied, extending beyond pain relief:

  • Acceleration in tissue repair and healing.
  • Analgesia (reduction of pain).
  • Angiogenesis (new vascular supply formation).
  • Improved nerve function Inflammation reduction.
  • Increased cellular metabolic activity.
  • Reduction in fibrous tissue (scar tissue) formation.
  • Stimulation of acupuncture points and meridians.
  • Stimulation of immune cell activity.

In addition, there are clinical benefits. Laser therapy can offer an alternative to surgery in many cases: it’s non-invasive, it can be effective for conditions that are difficult to treat using more traditional methods, it’s easy and, it is backed by scientific proof of its effectiveness. Numerous research studies have been undertaken to illustrate the success of laser therapy.

laser therapy for pain

Conditions that Benefit from Laser Therapy

Laser therapy can have a beneficial effect on a variety of conditions that involve muscles, tendons and ligaments, including:

  • Low back pain
  • Neck pain
  • Arthritis pain
  • Plantar fasciitis
  • Tendonitis
  • Carpal tunnel syndrome
  • Fibromyalgia pain

Laser therapy can reduce healing time, thanks to an increase in intercellular metabolism. Generally, the sooner laser therapy is employed after injury or after pain becomes intolerable, the better the healing and the more quickly the pain dissipates and the healing takes place.

The more chronic the condition, the slower it may be to respond to laser therapy. The treatment is cumulative, so the patient generally needs a series of treatments to eliminate pain and promote healing.

Undergoing Laser Therapy for Pain

When you decide upon laser therapy for pain, you’ll have an initial consultation with the clinician who delivers the therapy, whether a physician, physiotherapist or other healthcare professional, to determine the extent of your injury or condition.

Treatment will follow. There is no reason to be fearful of the experience. It is painless. Treatments usually last for 5 to 20 minutes, depending on the acuteness of the injury and the size and depth of the affected area, since these high-powered lasers can deliver energy quickly.

You can expect the laser therapy practitioner to use a handheld device about the size of a flashlight that he or she will run over the skin above the affected area. The laser often has changeable heads that are geared toward effectiveness in various areas of the body.

Often, you will feel a soothing, warming sensation as the photons of light pass through the skin. When the practitioner attaches a massage ball head to the laser, patients often compare the experience to a massage.

In Conclusion

In a number of provinces, including British Columbia and Ontario, laser therapy is covered by provincial healthcare plans, making it easy to choose. Given the ease of treatment and its beneficial effects, why not give Laser Therapy a try?

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