What is Physiotherapy

What is Physiotherapy?

A common question for people that have never visited a physiotherapist is the very basic question of “What is Physiotherapy?”. Physiotherapy encompasses rehabilitation, injury prevention and health promotion/fitness. The profession employs a holistic approach to treatment, looking at the patient’s lifestyle and engaging them in their own treatment.

Physiotherapy Definition

Physiotherapy can be defined as a treatment method that focuses on the science of movement and helps people to restore, maintain and maximize their physical strength, function, motion and overall well-being by addressing the underlying physical issues.

How to Become a Physiotherapist - Physiotherapy Canada

The healthcare professionals who provide physiotherapy are called physiotherapist. They are highly trained, with master’s degrees in physiotherapy, and are skilled at pinpointing the root causes of an injury, as well as treating them. Often, a problem originates in a completely different part of the body than the spot where the pain is centralized.

Physiotherapy is a registered profession in Canada. The Canadian Physiotherapy Association notes that physiotherapists:

  • Have met national entry-level education and practice standards;
  • Have successfully passed a standardized physiotherapy competence examination; and
  • Are registered with the college of physiotherapists in their province/territory.

Once they are certified and registered, physiotherapists can pursue the designation of clinical specialist. This program, run by the Canadian Physiotherapy Association, “certifies physiotherapists who have focused their careers and can demonstrate advanced clinical competence, leadership, continuing professional development and involvement in research in a specific area of practice.”

Candidates for the clinical specialist designation must have a minimum of five years of applied clinical experience and a minimum of 300 clinical contact hours per year for the past five years in the clinical specialty area.

Physiotherapists work in concert with other healthcare professionals, and physicians may recommend a course of physiotherapy after an injury, surgery (e.g., hip replacements) or such health issues as heart attacks or strokes.

Physiotherapy Treatment: What Conditions do Physiotherapists Treat?

As professionals, physiotherapists are experts at providing physiotherapy treatment for:

  • Preventing injury and disability;
  • Managing acute and chronic conditions;
  • Improving and maintaining optimal physical performance;
  • Rehabilitating injury and the effects of disease or disability;
  • Educating patients to prevent re-occurrence of an injury.

Patients may be referred to or seek assistance from a physiotherapist for a variety of health issues and receive valuable assistance.

Physiotherapists offer treatments relating to the following conditions:

  • Cardiorespiratory: providing support, prevention and rehabilitation for people suffering from diseases and injuries that affect the heart and lungs, such as asthma.
  • Cancer, palliative care and lymphedema: treating, managing or preventing fatigue, pain, muscle and joint stiffness, and deconditioning.
  • Incontinence: managing and preventing incontinence and pelvic floor dysfunction.
  • Women’s health concerns: addressing health issues surrounding pregnancy, birth, post-partum care, breastfeeding, menopause, bedwetting, prolapsed, loss of bladder or bowel control.
  • Musculoskeletal: preventing and treating clients with musculoskeletal conditions such as neck and back pain.
  • Neurological: promoting movement and quality of life in patients who have had severe brain or spinal cord damage from trauma, or who suffer from neurological diseases such as stroke, Parkinson’s disease and multiple sclerosis.
  • Orthopedic: helping patients prevent or manage acute or chronic orthopedic conditions such as arthritis and amputations.
  • Pain: managing or preventing pain and its impact on function in patients.

Physiotherapy Techniques: What Techniques do Physiotherapists Use?

Physiotherapists employ a variety of techniques, depending on the nature of the injury or problem they are treating. The most common physiotherapy techniques are:

  • Manual manipulation: Moving joints and soft tissue helps to improve circulation, drain fluid from the body, and relax overly tight or muscles with spasms.
  • Electrical nerve stimulation: Small electrical currents delivered to affected areas helps to suppress and block pain signals to the brain.
  • Acupuncture: Needles stimulate the nervous system and work to dull pain, release muscles, boost the immune system and regulate various body functions.
  • Demonstration: Teaching proper movement patterns allows patients to help heal themselves.
  • Functional testing: Testing a patient to assess his/her physical abilities.
  • Device provision: Prescription, fabrication and application of assistive, adaptive, supportive and protective devices and equipment.

What to expect from a visit?

Each session with a physiotherapist is unique, because it depends on the client’s health issues and needs. However, a visit to a physiotherapist generally includes:

  • Learning about the patient’s medical history;
  • Assessing and diagnosing the patient’s condition and needs;
  • Helping the patient set and reach physical goals;
  • Creating a treatment plan that accounts for patient’s health, lifestyle and activities;
  • Prescribing a course of exercises and necessary devices.

If you are experiencing issues with movement or function or are just seeking to optimize your health, why not check out a trusted resource like a professional physiotherapist.

Having issues with your MOVEMENT?

Shoulder Impingement Syndrome

What is Shoulder Impingement Syndrome?

How can you shoulder your burdens properly if you are suffering from shoulder impingement syndrome?!

All kidding aside, if your shoulder hurts when you try to reach behind your back or retrieve an object from a high shelf, you should see your physician. Since the shoulder comprises a number of bones, muscles and tendons that allow for a range of motion in your arm, it is vulnerable to a variety of complaints.

Shoulder impingement syndrome, also known colloquially as swimmer’s syndrome or thrower’s syndrome, is the irritation of the tendons in your shoulder caused by rubbing against bone. To understand how it happens, let’s first discuss how the shoulder operates.

Impingement Syndrome Shoulder

A Bit of Anatomy and Physiology

Three major bones comprise your shoulder: your upper arm bone (the humerus), the collarbone (the clavicle) and the shoulder blade, or scapula. The latter two bones create a socket for the humerus, which is protected at the top by muscles and tendons that hold your arm in place. These are called your rotator cuff.

A lubricating sac, or bursa, forms a protective covering between the rotator cuff and the upper bones of the shoulder. The lubrication allows the rotator cuff tendons to glide freely through the bridge created by these upper bones.

Shoulder impingement syndrome results when bone rubs on the bursa and tendons and irritates them. Eventually, it can lead to inflammation of the rotator cuff tendons (tendinitis) and bursa (bursitis).

Treatment for shoulder impingement syndrome is important; otherwise, the tendons may start to thin out and tear. We’ve all heard stories about professional baseball players needing to rehabilitate a torn rotator cuff.

Impingement Syndrome Shoulder – Who Is Susceptible?

Rotator cuff pain, including impingement syndrome shoulder, is common among both young athletes and middle-aged adults. Athletes who repetitively raise their arms overhead, such as swimmers, tennis players and baseball players are particularly susceptible. Among adults, those who repeatedly lift things overhead, such as construction workers or painters, are also at risk.

Impingement Shoulder Syndrome

Types of Shoulder Impingement

Shoulder impingement is classified as either internal or external.

External impingement refers to a structural abnormality or interference with the proper operation of the rotator cuff. Primary impingement is generally due to the abnormally shaped arch in the shoulder bones or to bone spurs that come with degeneration of the bone. Secondary impingement usually results from poor shoulder blade stabilization that changes the position of the arch and causes rubbing; it can also be a consequence of tendons weakened from overuse.

Internal impingement generally occurs in athletes whose sports focus on throwing, such as javelin or baseball. The underside of the rotator cuff tendons rubs against a different bone (glenoid labrum) to cause pain at both the back and front of the shoulder.

Ouch, It Hurts!

Initially, symptoms from shoulder impingement syndrome can be mild and sufferers may not immediately seek treatment. Athletes may have pain when throwing or serving a tennis ball, while others may experience sudden pain when they reach or lift. Pain may radiate from the front of the shoulder to the side of the arm. There may be minor pain both during activity and while at rest.

As the impingement becomes more severe, there will be pain at night and loss of strength and motion. Activities, such as zipping a zipper, that require an arm to reach behind the back will become difficult. When this happens, it’s definitely time to seek medical attention.

Shoulder Impingement Syndrome

Diagnosis of Shoulder Impingement Syndrome

When your doctor examines you, he or she will test your shoulder for range of motion. You may also be required to undergo an MRI test, since they are useful for soft tissue injuries and may show the inflammation. An X-ray may be taken if bone spurs are the suspected cause of the impingement.

Shoulder Impingement Syndrome Treatment

Shoulder impingement syndrome treatment will generally begin with non-surgical options, including rest from activities that are suspected causes; non-steroidal anti-inflammatory medicine to reduce swelling and pain; and physiotherapy.

Your physiotherapist will work with you towards restoring the normal range of motion. Shoulder impingement syndrome exercises may include stretching exercises to relieve pain and improve motion. Once the pain in your shoulder begins to subside, your physiotherapist can work with you on strengthening your rotator cuff muscles so the shoulder impingement syndrome doesn’t recur.

If this course of shoulder impingement syndrome treatment doesn’t alleviate your pain, you make receive a shot of the steroid cortisone, since it is a powerful anti-inflammatory.

When all else fails, surgery may be necessary to create more space in your body for the rotator cuff. Generally, the surgeon will remove the inflamed portion of your bursa and may also remove a piece of the arch bone that rubs against the rotator cuff.

If surgery is required, you will probably need to wear a sling for a period of time to support the shoulder as it heals. Physiotherapy will then assist you in regaining motion and strength.

Remember, don’t ignore pain in your shoulder, because your body is signalling that something is wrong.

Suffering from SHOULDER PAIN?

Soft tissue injuries

What is a Soft Tissue Injury?

Coping with a soft tissue injury can be hard, depending on its severity. For active people, it can mean being out of commission for six weeks or more. Without giving rest and recovery their proper due, however, soft tissue injuries can easily recur.

Soft Tissues and Soft Tissue Injury Explained

The term soft tissues refers to muscles, ligaments, tendons and fascia, the connective tissues that bind the body together. Injuries to these tissues are generally tears, pulls or contusions and may occur as the result of a one-time incident, such as a misstep; though repeated use over time, such a work-related injury; or through overuse of fatigued muscles, such as running too soon after a marathon.

Soft tissue injuries are categorized into three grades:

Grade 1: Mild. Usually involves no more than 10 per cent of the muscle or ligament and will heal in a week or two.

Grade 2: Moderate. Involves 10 to 90 per cent of the tissue structure. Healing takes several weeks.

Grade 3: Severe. Severe tears; complete rupture of muscle or ligament. Will require physiotherapy over time to rehabilitate.

Common Soft Tissue Injuries

Some common soft tissue injuries include:

  • Back strains and sprains
  • Ankle strains and sprains
  • Torn ligaments in the knees, shoulders and ankles
  • Plantar fasciitis
  • Carpal tunnel syndrome
  • Tennis elbow
  • Bursitis
  • Tendinitis

Soft tissue injury back

How Bad Is It?

If any of these conditions apply to your injury, you should have it assessed by a physician:

  • You are unable to put any weight on the injured area
  • The injured area now has an unusual shape or looks deformed
  • You heard a pop or crack when the injury occurred
  • Any of the surrounding bones feel painful
  • You feel numbness or pins and needles around the injury or anywhere else

Soft Tissue Injury Treatment: First Steps to Recovery

If you injure yourself, you want to contain the damage and start the healing process as soon as possible. During this acute phase of the soft tissue injury, while the swelling, bleeding and pain are at their height, you want to protect yourself from further injury.

Soft tissue injury treatment

The first step of your soft tissue injury treatment is to stop the activity you were doing when the soft tissue injury occurred and following the RICE method: rest, ice, compression, and elevation.

Rest: Take any load off the injured body structure. Avoid all activities that cause pain and allow yourself time to recover.

Ice: Reduce the pain and swelling by applying ice to the injured area in the form of cubes or crushed ice wrapped in a towel; frozen peas – they mould nicely to the injured body part; or a sports ice pack. Ice for 20 minutes every two to three hours while you’re awake.

Compression: Wrap with a bandage that doesn’t obstruct blood flow or cause additional pain. This helps keep the area stable.

Elevation: To reduce pain and swelling, raise the injured area above the level of your heart, supporting it with pillows or a sling, as needed.

During the acute phase of injury, it’s also important to avoid HARM: heat, alcohol, running and massage. You don’t want to increase the blood flow too soon – it will only increase damage. This phase, during which the soft tissue injury settles, generally lasts a day or two.

Moving Toward Full Recovery

Once your soft tissue injury has stabilized, your body will enter the sub-acute phase, repairing itself by laying down new tissue that strengthens over time, reducing the need to protect the injury. During this phase, a physiotherapist will usually assess your soft tissue injury and oversee your soft tissue injury treatment.

Soft tissue injury

You will likely be given a mix of passive treatments, hands-on mobilization, rehabilitative exercises and support. Rehabilitation time depends on the severity of the injury, your own physical health and your age.

Passive treatments stimulate the injured area to promote the healing response by increasing energy to the site using electrical stimulation, ultrasound, magnetic field therapy or laser stimulation. Your physiotherapist may also manipulate your joints and will assign you exercises designed to help return your body to normal functioning. You may need to wear a brace or strap your injury to provide it with additional support as it heals.

Remodelling Yourself – Soft Tissue Injury Healing Time

Six weeks after injury, your body enters what is often termed the remodeling phase. Your new tissue is fairly strong, but it hasn’t stop regenerating. If the tissue isn’t strong enough to handle the level of activity you require, it will continue to stimulate the growth of more tissue so that your body can support you properly.

Remember: your treatment and soft tissue injury healing time depends on your injury, your age and your body. Don’t measure your progress against anyone else’s because everyone’s body is unique. Follow the advice of your physician and your physiotherapist and your body should return to its recognizable self.

Think you have a SOFT TISSUE INJURY?

frozen shoulder

What is a Frozen Shoulder?

It’s understandable if the thought of a frozen shoulder sends a chill down your spine, because it is a condition that equates to loss of mobility, something no one wants to experience. Frozen shoulder, also known as adhesive capsulitis, is a condition resulting when there is injury and inflammation in the soft tissues surrounding the shoulder.

The shoulder is a ball and socket joint, and the head of the upper arm bone, the humerus, fits into a cavity created by the shoulder bone, the scapula. The inflammation in this capsule makes movement more difficult and painful. The joint may also lose some of the synovial fluid that lubricates it.

However, reduced movement causes capsule to thicken and contract, leaving less room for the shoulder joint to move around, so it is actually a vicious cycle: the shoulder is painful, so you move it less often, but the less you move it, the more likely the capsule is to contract. In advanced cases, scar tissue can form between the upper arm bone and the capsule.

What is the main cause of Frozen Shoulder?

Frozen shoulder often occurs when a person doesn’t undergo therapy after an injury or a bout of tendinitis. It can also happen following a period of enforced immobility, such as being bedridden after a stroke or heart attack, or occur following a fall or an automobile accident.

Adults over 40 are most susceptible to frozen shoulder, and more women experience it than men. Diabetics are also susceptible. The condition may appear without any obvious injury or inflammation.

Frozen Shoulder Stages: A Three-Stage Concern

The development and healing of frozen shoulder is generally divided into three stages: the freezing stage, the frozen stage and the thawing/healing stage.

During the freezing stage, the inflammation has occurred. The shoulder stiffens and hurts and movement becomes challenging. The pain is generally worse at night. There are five symptoms generally associated with inflammation: pain, swelling, heat, redness and loss of function.

Once the shoulder is frozen, the inflammation begins to subside, because the shoulder capsule has thickened and reduced range of motion.

“Thawing” a frozen shoulder refers to eradicating the conditions that caused it, allowing for movement and disappearance of pain. Once inflammation has subsided, it is possible to move the shoulder more; this action allows for the lubricating synovial fluid to being flowing again and work its way into the shoulder capsule. As the shoulder moves more, scar tissue begins to break up and becomes reabsorbed by the body.

Frozen Shoulder Diagnosis

After discussing the symptoms with you, your physician will test your range of motion to see where the limitations in movement occur and assess the pain you are feeling. Frozen shoulder doesn’t allow for a great range of motion, either passively – when someone else moves your shoulder – or actively – when you move your own shoulder.

frozen shoulder exercises

X-rays or magnetic resonance images (MRIs) may be used to rule out other potential causes of your pain and restricted movement, such as arthritis or a torn rotator cuff.

What is the best treatment for a Frozen Shoulder?

Frozen shoulder doesn’t heal overnight, so patience is required; full recovery can take up to three years. Many patients respond to simple treatments to control pain and restore motion. The goal of treatment is to alleviate pain and restore motion with the help of physical therapy.

Initially, assistance comes in the form of pain management. Your physician will probably suggest a non-steroidal anti-inflammatory pill that is available over the counter: Aspirin, ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn). Gentle massage may also be useful.

If you don’t respond to the non-prescription painkillers, your doctor may inject a corticosteroid into the shoulder joint or the surrounding tissue.

Concurrently, you should be working with a physical therapist to stretch the joint capsule and, later, to strengthen the surrounding muscles. Physiotherapy is a major key to recovery; your physiotherapist will determine how far you can push yourself and teach you frozen shoulder exercises that you can ultimately practise at home, including both stretches and range of motion exercises for frozen shoulder. Sometimes, heat is applied to loosen the shoulder prior to exercise.

Surgery for Frozen Shoulder

In extreme cases, surgery may be required to loosen the shoulder capsule. This most commonly means either manipulation under anesthesia or arthroscopic surgery or a combination. During manipulation, the doctor forces shoulder movement, tearing scar tissue and allowing healing to begin. Arthroscopy requires small incisions to cut through the joint capsule to loosen it. Post-op rehab physical therapy is necessary after frozen shoulder surgery to maintain the gains that it achieved.

If you suspect that you are suffering from frozen shoulder, consult with your physician so that the proper course of treatment can be followed. After all, it’s no fun to ask for help in reaching objects on a high shelf or putting on your coat.


Intimidated by the Gym?

Working out at a gym is a normal, and often even daily route for many Canadians. Some go to the gym to maintain a healthy exercise routine, others work on strengthening and toning their muscles, enhancing their endurance on a treadmill or exercise bike, or head do the gym as part of a weight-loss program. Many tend to the gym to perform their exercise routines that have been put together for them by their physiotherapist to treat certain conditions.

For those that go to a gym regularly, it seems very natural, and they are completely at ease with the gym environment and how to use the equipment. However, a recent Ipsos Reid Poll shows that many Canadians are actually intimidated by the gym, amongst those, many British Columbians. While some are afraid other people will watch them, others feel too overweight to go to the gym.

Find out more in our “Intimidated by the Gym?” Infographic:

Intimidated by the gym

Feeling intimidated about an EXERCISE PROGRAM?

infographic 15 interesting foot facts_ft

15 Interesting Foot Facts

Look down at your feet, and, most likely, what you’ll see is 10 toes wriggling or flexing. Now, if you had X-ray vision like Superman, you’d soon realize that there’s much more to your feet than meets the naked eye.

According to the American Podiatric Medical Association, your feet are a marvel of engineering that, as a pair, contain more than 50 bones – about one quarter of all the bones in your entire body! Working together with those bones are 60 joints and more than 200 muscles, tendons and ligaments that allow your feet to move.

Given their complexity, it’s not surprising that your feet can give you trouble. After all, they have a tough job. Foot pain and a sore back are very common conditions!

An average day of walking around pounds your feet with hundreds of tons of force – and that’s not taking into account your exercise regimen, whether your job requires you to stand all day or whether you’ve squashed your feet into shoes that are a bit too small because they look stylish.

See our infographic for 15 surprising and interesting foot facts:
infographic 15 interesting foot facts

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Suffering from FOOT PAIN or a SORE BACK?