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The term headache refers to pain in any part of the head. Headache pain can be described as being a sharp pain, a dull ache or feeling like a throbbing sensation.

Headaches can occur on one or both sides of the head, they can radiate into the temples and can also cause pain and tightness in the neck or across the shoulders.

Headaches can present differently from person to person and tend to be complicated.  Different kinds of headaches have their own set of symptoms and causes and therefore require different treatments.

There are more than 150 types of headaches but they can be divided into two main categories, primary and secondary.

Primary Headaches

Primary headaches are not caused by any other medical condition and have their own diagnosis.  The majority of headaches are primary headaches.

Secondary Headaches

Secondary headaches are caused by another medical issue such as trauma, infection or disease.

It is important for the healthcare practitioner who is treating your headache to determine if the headache is a primary or a secondary headache.  Effective treatment is dependent on proper diagnosis.  If you are suffering from a secondary headache, successful treatment is dependent on treating the underlying condition causing it.

Common Types of Headaches

Tension Headaches

Tension headaches are by far the most common type of headache.  The pain is often described as dull and achy with a sensation of tightness or pressure across the forehead or on the sides or back of the head.  Typically symptoms are felt on both sides of the head.  Alcohol, menstruating, stress, lack of sleep or not eating can cause tension headaches.

Sinus Headaches

A sinus headache is caused by a sinus infection in the sinus cavities behind the nose, cheekbones or forehead.  Having a cold or allergies increases the risk of developing a sinus infection.  This is because the increased mucous that builds up increases the risk of bacteria multiplying and causing an infection.

Sinus headache pain results in a dull headache behind the eyes, forehead, cheekbones or bridge of the nose, depending on which sinuses are affected.

Cluster Headaches

Cluster headaches are very painful and are less common than a sinus or tension headache.  Cluster headaches occur in cyclical clusters which can last several weeks before they subside and a pain free remission period occurs after which can last up to a year.

Cluster headaches tend to occur at the same time each year, most often spring or fall.

The cause of cluster headaches are unknown.

Symptoms include intense pain around the eyes, accompanied by redness, swelling or a dropping of the eye on the affected side.

Cervicogenic Headaches

Cervicogenic headaches are a secondary headache caused by a disorder in the neck or upper back area.  The disorder is either in the spine, discs or soft tissues of the neck.

Usually the pain is accompanied by a decrease in the range of motion in the neck and the pain is aggravated by movement.

Pain typically radiates up one side of the neck or in the  back of the head up to the top of the head, occasionally radiating behind the eyes.  Pain can sometimes be felt in the jaw.

Migraines

A migraine is a neurological disease that can cause severe throbbing pain that can leave you bedridden for days.  Movement, light and  sound can aggravate the migraine symptoms.  Other symptoms seen with migraines may include:

·  Seeing bright flashing dots or lights

·  Blind spots in your vision

·  Numb or tingling skin

·  Speech changes

·  Tinnitus (ringing in ears)

·  Temporary loss of vision

·  Seeing wavy or jagged lines

If you are suffering from headaches and would like to have a medical professional assess and treat your headaches, call our clinic and book an appointment with one of our physiotherapists at 905-428-7800.

Spring is in the air and the itch for working on our gardens is upon us. How do we work on our gardens without feeling the effects on our body after 6 months of hibernation? Moving those heavy bags, pushing a lawnmower or digging up our gardens can quickly exhaust our backs and cause us pain and discomfort.  Proper planning in advance, to space out our gardening over time, helps to decrease the effects on our body from overdoing it.

Some additional tips to keep in mind to help avoid injury include:

• Use your feet to move around when shoveling instead of rotating your spine.  Lift smaller amounts at a time to avoid overexerting those back muscles.
• Use knee pads or a mat to plant and weed. Avoid bending down with your hips or back. Sit on a small stool if you cannot kneel, thereby avoiding pressure on your knees.
• Avoid lifting heavy objects, especially after you have been kneeling or bending for prolonged periods of time. This will put excessive pressure on the discs in your low back and also fatigue the back muscles. Use a wheelbarrow or a wagon to transport those heavy bags and plants.
• Avoid repetitive activities such as clipping or pruning for long periods of time as it can lead to tendonitis.
• Pushing heavy objects is always easier than pulling.
• Avoid staying in one position for prolonged periods as this is always hard on our body.

When weeding for example, try to be on one knee and keep the other foot planted on the ground. Switch knees after half an hour or so to redistribute body weight and muscle tension to the other side of your body. This will help avoid muscle and joint pain from overstressing one side of your body.

• Finally,remember to always warm up and stretch before you start to garden. Just like you warm up before vigorous exercise, you should warm up before beginning a day of gardening. Take a few minutes to stretch your arms, wrists,hands, low back and shoulders.

If you are experiencing pain from gardening, you may need to seek treatment to help get you back to being pain free and enjoying the activities you love. Call Durham Orthopedic and Sports Injury clinic at 905-428-7800 and talk to one of our physiotherapists today.

Falls are the most common injury in older adults. The Public Health Agency of Canada estimates 20-30% of adults sustain an injury due to a fall each year. Falls can have debilitating and dire consequences for seniors.They are responsible for 40% of admissions in long term care homes. Ninety percent of hip fractures are due to falls.

There are three main factors which contribute to falls in seniors:

Personal

• Decrease strength in legs
• Decrease balance
• Visual defects
• Cognitive issues 
• Symptoms of dizziness
• Abnormal gait pattern

Environmental

• Stairs
• Loose area rugs
• Slippery surfaces
• Shoe wear that is not supportive

Social

• Increased solitude
• Depression
• Medication.Some medication may suppress the central nervous system and may contribute to falls by decreasing alertness and cause slower reactions and movements.

How to prevent falls?

Personal

• Stay physically active and strong. Join a seniors exercise class to help with your strength gains or see a physiotherapist to help get you stronger
• Have your eyes tested for any visual defects
• Use assistive devices such as a cane or walker to steady your gait
• See your doctor if you have concerns about a decline in cognition or dizziness symptoms 

Environmental

• Wear non-skid, rubber soled shoes that fully support your feet. Avoid backless slippers at home
• Remove electrical and phone cords from walkways
• Secure rugs with double sided tape, tacks or slip resistant backing or even remove all loose rugs from your home altogether
• Get rid of the clutter on the floor
• Immediately wipe up spills from the floor
• Use non slip mats in your bathtub or shower
• Keep rooms brightly lit and use nightlights in your bedroom, bathroom and hall
• Have grab bars in the shower, tub and next to the toilet
• Put non slip treads on your wooden steps

Social

• Learn about the side effects of your medication and discuss with your doctor an alternative medication if your medication makes you sleepy, dizzy, affects your balance or makes you confused
• See your doctor if you find yourself suffering with depression especially if it is affecting the quality of your life
• Seek out the company of others by joining community events, pick up new hobbies or even volunteer your services to help your community

If you or someone you know is at risk for a fall, our physiotherapists at the Durham Orthopedic and Sports Injury Clinic can help in reducing the risk from falling. Our physiotherapists can help with strength gains, improve mobility and improve balance. The physiotherapist can even assess whether a walker or cane can help improve the stability with walking. Call us now at 905-428-7800.

The key to a successful treatment for a whiplash injury to the neck (cervical spine) is early intervention. For those suffering from a whiplash injury that is more chronic, a positive outcome with treatment tends to be more of a challenge.

What is a whiplash injury to the neck?

The term whiplash is used to describe neck injuries associated with an acceleration – deceleration force to the head and neck. This most often is caused by a motor vehicle accident, a sports injury, a fall or any other strong jolting movement to the head and neck.

The rapid acceleration and deceleration of the neck with these injuries strains the muscles, ligaments (which are tough fibrous tissue which connects bone to bone) and nerves of the cervical spine.

Symptoms may include:

• Neck pain
• Loss of range of motion of the neck
• Headaches (usually starting at the back of the skull and may radiate into the head)
• Dizziness
• Shoulder and arm pain

Less common symptoms which may require you to see your doctor include:

• Blurred vision
• Numbness and/or tingling in your upper back and down your arms
• Ringing in your ears
• Depression
• Changes in your personality
• Weakness in your arms and/or hands

Evidence shows that most of the recovery after a whiplash happens in the first few months post injury. An early thorough assessment of your injury and proper treatment is imperative for a better chance at a good outcome.

If you have had a whiplash injury see our physiotherapists at the Durham Orthopedic & Sports Injury Clinic for a full assessment and proper treatment of your injury at 905-428-7800.

Our neck or also known as the cervical spine, is complex. It connects vital messages from our brain to our spinal cord which are important for most of our bodily functions.

Neck injuries can vary in seriousness from a minor discomfort to very serious and sometimes can even be fatal(after a severe trauma). Fortunately, the majority of neck injuries are not serious with neck pain being a common complaint seen at our physiotherapy clinic. Approximately 70% of the population experiences neck pain at some point in their lives and it can be successfully treated with massage or physiotherapy.

Minor Neck Injuries 

Minor neck injuries can often go away on their own or with treatment from a physiotherapist or massage therapist. Symptoms may last from 1-6 weeks. While they can be uncomfortable, frustrating and painful, a minor neck injury doesn’t need to send you into a panic. The most common symptoms of minor neck injuries are: 

• Swelling 
• Stiff Neck causing limited mobility and pain with movement
• Headaches
• Muscle spasm

How to Tell If You Have a More Serious Neck Injury

You should book an appointment with you family doctor or physiotherapist if you present with the following symptoms:

• Numbness/Tingling or loss of strength in arms and hands
• Shooting pain in the shoulders and down the arms
• Unrelenting pain lasting several days

The Most Common Causes of Neck Injuries Are

• Whiplash 
• Direct impact to the area 
• Poor Posture
• Car accidents
• Muscle Strains or injuries

If you have injured your neck and need to see a medical professional, call the Durham Orthopedic Sports & Injury clinic at 905 428 7800 and start your road to recovery today!

One of the most frequent questions a physiotherapist gets asked in the clinic is “what pillow is the best for sleeping?” The answer to that question is not straightforward with a number of factors that need to be considered.

To get a good night’s rest, you need to properly support your head and neck by ensuring your head and neck are in alignment with the rest of your body. It is important to find a pillow that keeps your neck in a neutral position.

There are many pillows in the market today with a built in curve for your neck to rest on. They  claim to offer the ideal support for sleeping. Keep in mind, when purchasing these pillows, that not everyone is built the same and measurements for making a pillow which supports our natural curve is not “one size fits all”. We all are built differently with shoulders being different widths and necks being different lengths. These pillows are therefore not suitable for everyone.

The main consideration when purchasing a pillow is to choose a pillow based on the position you like to sleep in at night.

Back Sleepers

Back sleeping puts your neck near its natural spinal alignment and so a pillow needs to just  properly hold the head level with the shoulders. A thinner pillow accomplishes this with support under the neck allowing the muscles in the neck to properly relax. A pillow that is too thin will cause the head to fall back too far while a pillow that is too thick tilts the head forward too much.

Side Sleepers

Side sleeping is a healthy position to sleep in. Care must be taken to keep the curves of the neck and weight of the body well supported for ideal spinal alignment. This requires a thicker pillow to keep the neck and spine in the neutral position. You will need a pillow with enough height for your head and neck that allows the pillow to fill in the gap between your shoulders and ear. The broader the shoulders, the higher the height of pillow that is required to fill this gap.

Stomach Sleepers

Stomach sleeping is not ideal for your neck no matter how the body and head are supported, with spinal alignment compromised with stomach sleeping.This is because your neck and head are twisted to one side for prolonged periods of time making a neutral spine impossible. If you must sleep on your stomach, choose a pillow that is flat so your head is not elevated too high.Opting for a cut out pillow that lets you sleep face down is another option.

If you have any concerns with neck pain while sleeping, call our physiotherapists at the Durham Orthopedic and Sports Injury Clinic at 905-428-7800 to have an assessment and get to the root cause of your pain.

Exercise is very important for optimal health, however exercising everyday may not always be ideal. Exercise, like most things in life, is about balance. Taking rest days should be a vital part of any exercise plan. Many people develop overuse injuries and compromise their fitness routine because they do not take enough time to rest between workouts.

The number of rest days each person needs varies,some factors that should be considered are duration of your workouts,age and fitness level.Some people may need more rest then others, but generally, the more intense the workout, the more rest the body needs. Two rest days a week is reasonable..

Benefits of Rest Days

Reduce Risk of Injury

Resting allows your muscles to recover and repair themselves. This is very important to our body’s overall health as the small microscopic tears that occur with our workouts heal during our rest days. Not resting between workouts can be the cause of overuse injuries, stress fractures and tendinopathies. 

Helps Muscles Grow

Resting can actually help your muscles grow. Those microscopic muscle tears that occur with exercise heal with rest and muscles grow back stronger. Studies have shown that three days of rest between strength training exercises can be beneficial for muscle recovery and growth. 

Can Help With Fatigue

Taking a day or two off from your workout regime is a great way to ensure you are not burning yourself out with exercise. When you exercise or workout everyday,  you may not be reaching your full potential. Taking a rest day gives your body and also your mind time to recover and recharge. Your muscles will be recovered and less fatigued and instead of just going through the motions of your workout, you will be much more apt to give your next workout the 100% effort it needs.

How to Spend Your Rest Day

Spend your day doing another activity you love doing.  If you like being outdoors, a rest day is a perfect excuse to get outside and walk, hike or ride a bike.Try a yoga class or go golfing. These are called active rest days. If you are feeling injured it is important to have a full rest day. Spend your time with ice and heat if need be, read a book or cook a healthy meal. Allow the injury to fully heal before resuming your exercise regime.

If you have been injured call the experts at the Durham Orthopedic and Sports Injury Clinic for an assessment to determine the cause of your injury at 905-428-7800.

The ITB(iliotibial band) is a fibrous, non elastic tissue running from the outside aspect of the hip to just below the outer part of the knee. It functions to help stabilize the hip and knee and aids in posture control.

ITB irritation is one of the most common causes of knee pain experienced by runners. It can also be the cause of pain with activities which require you to repetitively bend and straighten your knee, such as cycling, hiking and walking long distances. Irritation of the ITB comes from friction of the ITB and the underlying structures.

The main complaints include:

•  A nagging pain on the outside of the knee
•  Popping or snapping may be felt 
•  Pain continuing after the aggravating activity, worst with walking or going down stairs

There are multifactorial causes for ITB irritation. These can be divided into three categories.

Physical Conditions

• hip abductor weakness leading to decreased stability in the knee with prolonged activities
• tightness in the outer thigh muscles(specifically the outer quadriceps muscles)
• excessive foot pronation
• bowed legs

Training Techniques

• Not warming up or cooling down enough after your activity
• Pushing too hard or going too long without adequate time to build up to the new level of activity
• Wearing worn out shoes

Training surface

• Running downhill
• Running on a banked surface, such as mainly running on one side of the road. Roads slope towards the curb, making your outside foot lower, causing increased stress to the knee

Treatment

Treatment is focussed on the underlying cause of the irritated ITB and may vary from individual to individual. 

Treatment may include:

• strengthening of the weak hip abductor muscles of the affected knee
• manual therapy involving hands on work to help lengthen and stretch out the tight outer quadriceps muscle
• functional training exercises focussing on teaching you how to perform controlled and coordinated movements specific to your sport or activity of daily living and help you learn the correct way to move without aggravating your knees
• with excessive pronation, the issue can be addressed with foot muscle strengthening exercises, adjustments in footwear, or possibly orthotics

If you are experiencing knee pain call the experts at the Durham Orthopedic and Sports Injury Clinic for an assessment to determine the cause of your knee pain at 905-428-7800.

Shoulder injuries are one of the most common injuries seen in physiotherapy clinics, doctors offices and the ER. A shoulder injury is any injury to any of the structures in the shoulder joint including bones, muscles, tendons, ligaments and cartilage. 

Shoulders are easily injured because the shoulder joint has a very wide range of motion which makes it more unstable. Some of the more common shoulder injuries include: 

Shoulder Dislocation 

A shoulder dislocation is a traumatic injury where the ball (humeral head) of the shoulder is forced out of its socket. 

Symptoms include: 

• a visibly deformed out of place shoulder 
• inability to move the shoulder in any direction 
• intense pain 
• often pins and needles and numbness in the shoulder and down the arm
• bruising 

Rotator Cuff Tears 

A rotator cuff tear is a full or partial tear of one or more of the four rotator cuff muscles or tendons which surround the shoulder joint. The cause may be overuse or traumatic. 

Symptoms include, but are not limited to the following: 

• difficulty and pain reaching up over your head or reaching back behind your back
• a sensation of arm weakness 
• pain deep in the shoulder 
• shoulder pain that is worst at night 
• popping and clicking sounds in your shoulder with movement 

AC joint injury 

An AC joint injury is an injury to the ligaments which holds the tip of the collar bone (clavicle) to the front of the shoulder blade (acromion). Most often these injuries are traumatic and are caused by: 

• a direct fall on the shoulder 
• a fall on an outstretched arm 

Symptoms include:

• pain on the top of the shoulder 
• a visible step deformity if there is a separation 
• swelling and bruising may be seen 
• some loss of range of motion in the shoulder 

Shoulder Fracture 

There are three places that you can fracture a bone in the shoulder, the clavicle (collar bone),the proximal humerus (the long bone located in the upper arm) and the scapula (shoulder blade). These fractures typically are caused from: 

• falls 
• contact sports 
• sudden impact 

Symptoms include: 

• a cracking or snapping sound with the injury followed by extreme pain 
• the shoulder becomes bruised and swollen 
• increased pain with movement and significant loss of use of the arm 

If you have injured your shoulder call the professionals at  Durham Orthopedic and Sports Injury Clinic (905-428-7800) to see one of our registered physiotherapists to help develop a specific treatment plan and start your road to recovery today.