Physio Blog

Person playing pickleball
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Common Pickleball Injuries

Pickleball has taken Canada by storm as the fastest growing sport in the country. Pickleball is easier on our body than most other sports, but, like any other sport, there is always the risk of injury that comes with playing.

Some of the more common injuries seen with pickleball include:

Ankle sprain

Most ankle sprains heal without any need for treatment.  Remember the R.I.C.E. principal to heal mild injuries, Rest Ice Compression and Elevation.  For the more serious ankle sprains, physiotherapy is indicated to improve your range of motion, reduce swelling, increase the ankle strength and improve balance.

Achilles Tendonitis

Achilles tendonitis is an overuse injury that develops from high impact exercise or repetitive stress to the lower leg.  It occurs when the tendon running down the back of the leg becomes irritated or inflamed.  Tendons, when injured or torn, create “scar tissue” in an attempt to heal and repair itself leaving the tendon compromised in terms of strength and elasticity.  It is important to see a physiotherapist to help regain normal strength and range of motion in the tendon and help avoid further injury.

Shoulder Strain

A common injury to the shoulder seen with Pickleball is rotator cuff tendonitis due to overuse of the shoulder.  Symptoms include swelling, tenderness and pain in the front of the shoulder.  Stiffness and loss of range of motion when raising the arm along with loss of strength are also common symptoms.  Physiotherapy helps with decreasing the inflammation on the tendon, and works on increasing the strength of the rotator cuff muscle group to help avoid reinjury.

Pickleball Elbow/Tennis Elbow

“Pickleball Elbow” is similar to tennis elbow and causes pain when the elbow is overused due to repeated movements of swinging the racquet.  This can put ongoing stress on the elbow over time.  Pickleball can cause soreness on the outside of the elbow and may be aggravated by gripping movements.  It is important to get treatment before it becomes chronic and more difficult to treat.

How to Avoid Pickleball Injuries

  • Stretch and warm up your body before you play
  • Wear proper court shoes that are comfortable and have rubber soles with a tread pattern conducive to quick lateral movements.  Pickleball shoes do have an expiration date, usually they should be replaced after 60 hours of play
  • Improve your conditioning.  Improving your overall strength and endurance will help prevent injury and improve your overall performance on the court.  Choose exercises that include balance, flexibility, strength and endurance
  • Avoid wet pickleball courts
  • Always communicate with your partner to avoid confusion on the court which may lead to accidents

If you sustain an injury playing Pickleball, contact one of our physiotherapists at the Durham Orthopedic & Sports Injury Clinic at 905-428-7800 to help get you on the road to recovery and back to playing your sport.

Pickleball racquet and ball
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Why is Pickleball so Popular

Over the last few years, pickleball has been rising in popularity and is one of the fastest-growing sports in Canada.

Pickleball is a cross between tennis, badminton and ping pong and can be played either as singles or doubles, although doubles is typically more popular.

It was invented in Washington and has gained popularity during the pandemic, growing almost 15% between 2020-2021.  More than half of the participants are 55 or older and a third are 65 plus.

There are many benefits to the sport including physical, psychological and social benefits.  

Physical Benefits

Pickleball is an easy sport to learn and is relatively low impact.  It allows you to work on our balance, agility, reflexes and hand-eye coordination.

One study shows that players burned 40% more calories during 30 minutes of playing than during a 30 minute walk, increasing their heart rates to within the moderate-intensity exercise zone.

Another study showed that people between the ages of 40-85 who played an hour of pickleball 3 days a week showed improvements in cholesterol, blood pressure and cardiorespiratory fitness.

Psychological Benefits

Evidence is increasing on the beneficial effects of exercise on mental health, possibly due to the increasing blood circulation to the brain, endorphin release and its effect on reducing stress.  Pickleball is no exception to that rule.  And, as a bonus, if you play outside, sunshine makes us feel good as well!

Social Benefits

Pickleball is a great social outlet.  It allows you to socialize more, combat loneliness and boosts mood.  Pickleball brings people together and fosters the development of new friendships which will benefit your mental health as well.

So how do you get started?  All you need is a paddle and a few balls.  You will soon make many new Pickleballer friends and the health benefits will follow.

If you need treatment for any injury, call the physiotherapists at the Durham Orthopedic & Sports Injury Clinic at 905-428-7800 and start your road to recovery today.

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Stretches to Improve Your Balance

Stretching daily can help improve balance and coordination in the older population by improving overall ease of movement. As we get older, we often experience increased stiffness in our joints and muscles resulting in decreased flexibility, decreased balance and coordination resulting in an increased risk of falling.

A recent study in the  International Journal of Health  Sciences concluded that a 10 week program of lower extremity stretching was effective in improving balance and coordination in the elderly, thereby decreasing falls.

When stretching, stretch until tension is felt, but not to the point of pain. You need to stretch until you feel the muscle lengthen, but not enough that it hurts.

Give the following stretches a try to help improve your balance and coordination

Quadricep Stretch

  1. Stand with a sturdy chair for support, holding on with your left hand to the backrest of the chair.
  2. Bend your right leg and grasp your right ankle. If you cannot reach your ankle, place a belt around the ankle and pull your foot up to your buttock with the belt.  Hold for 20-30 seconds, repeat 3-5 times, then switch legs.
  3. Stand upright with a straight back and do not lean forward.

Tip: For improved balance try to stare at motionless object

Calf Stretch 

  1. Keep one leg back with your knee straight and your heel flat on the floor.
  2. Bend your front knee. 
  3. Move hips forward until you feel a stretch in your calf.
  4. Hold for 20-30 seconds, repeat 3-5 times.
  5. Switch legs

Hamstring Stretch 

  1. Shuffle to the front of your chair.
  2. Place one leg in front of you with the knee straight and keep your knee pointed to the ceiling
  3. Ensure you remain upright with a straight back and lean forward at the hips
  4. Hold for 20-30 seconds, do 3-5 repetitions and then do the same with the opposite leg.

Doorway Pectoral Stretch

  1. Stand in a doorway and place your forearms against the doorframe.  Keep both arms at 90 degrees.
  2. Step forward with one foot. You should feel the stretch in the front of your chest. These pec muscles cross your ribcage. When you take deep breaths, that will expand the entire rib cage and will create an even bigger stretch across the front of your chest.
  3. Try to stay neutral through the spine.  It is really common for people to go into spinal extension during this stretch.

If you have been injured or trying to recover from an injury, call the Durham Orthopedic & Sports Injury Clinic at 905-428-7800 to start your physiotherapy or massage therapy treatment and get on the road to recovery today.

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Osteoporosis

Osteoporosis is a bone disease that is caused by the loss of calcium in the bones, resulting in them becoming more brittle. This leads to a decrease in bone strength and bone structure resulting in an increased risk of fracture, especially in the hip and spine.  It is a major cause of disability, causing pain and affecting one’s quality of life.

Bone is living tissue and there is a balance between the natural cycle of degeneration and regeneration of bone.  In osteoporosis, bones weaken when not enough new bone is formed (regeneration) and too much bone is lost (degeneration). 

Most at Risk Groups

Post-menopausal women are at the greatest risk of developing osteoporosis and have a greater risk of developing osteoporosis, especially if:

  • They are Caucasian or Asian
  • Have a small frame
  • Are inactive
  • They are smokers
  • Have a family history of osteoporosis
  • Have used medications such as steroids or thyroid hormone for a long period of time
  • Have calcium or Vitamin D deficiency

How is Osteoporosis Diagnosed

Osteoporosis is best diagnosed through a specialized x-ray called the DXA which measures bone density.  Other methods of measuring bone density may include an x-ray, ultrasound or CT scan.

Treatment

Physiotherapy can offer personalized treatment to help improve your overall bone health and help you avoid fractures.  The exercises help with bone building by sufficiently stressing the bone.  Bone gets stronger with exercise just as muscles get stronger with exercise.  The three types of exercises used are weight bearing exercises, resistance exercises and postural exercises.

Weight-bearing exercises may include:

  • Walking
  • Dancing
  • Hopping or stomping
  • Easy jogging

Resistance exercises may include:

  • Weight lifting in proper spine and lower extremity alignment
  • The use of resistance bands
  • Gravity resistance exercises such as push ups, squats, standing yoga poses

Postural exercise:

  • Exercises to reduce or stabilize the increased kyphosis (hunchback) that is often seen with people with osteoporosis
  • Education on correct posture and exercises to help maintain ideal posture
  • Exercises to improve your balance to avoid falls

Contact the Durham Orthopedic & Sports Injury Clinic at 905-428-7800 if you are seeking help from our physiotherapist managing your osteoporosis.

Senior woman doing physiotherapy
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Physiotherapy for Seniors

Physiotherapy for seniors  is a great way to help keep an active lifestyle and help promote independent living. Many seniors deal with daily or chronic pain or loss of function with activities of daily living that can be managed by physiotherapy. Physiotherapy can help prevent disease and disability. 

Is physio helpful for the elderly?

As we age, our mobility, stability and muscle strength starts to deteriorate. Physiotherapy helps to restore and improve our muscle strength and balance. This can help to prevent falls, slips and injuries in the elderly and help maintain independent living. It is NEVER too late to start working on improving our physical health.

Physiotherapy is also a safe way for seniors to exercise. Exercising under the direction of a registered professional makes physiotherapy a great exercise idea for seniors and the elderly. This can help reduce the risk of exercise related injuries. 

Common Ailments in he Elderly

The most common reasons seniors may want to see a physiotherapist are; 

Improved Blood Flow

Physiotherapy can also help to improve blood flow also by using a variety of stretches and low impact strengthening exercises. Typically, your physiotherapist will give you a list of stretches and exercises that you can do at home under the supervision of the physiotherapist.

Exercises to increase blood flow

Aerobic exercises have been found to be the best types of exercise to increase circulation and blood flow. These may include:

  • Walking 
  • Aerobics Classes 
  • Swimming
  • Cardio classes 
  • Biking
  • Tennis or pickleball
  • Lawn Bowling 

Other treatments your Physiotherapist might provide are; 

  • Strength Training
  • Mobility Training
  • Balance training 
  • Massage Therapy
  • Mobility Aids 

In conclusion, physiotherapy is a safe and effective way for seniors to exercise and is a great way to improve your overall health. 

If you have been injured or are trying to recover from an injury, call Durham Orthopedic Sports & Injury Clinic to start your treatment and get on the road to recovery today!

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What is Plantar Fasciitis?

Plantar Fasciitis is a fairly common ailment that causes pain and inflammation along the bottom of your foot. It frequently causes pain localized in the heel and is the most common reason for heel pain. 

The plantar fascia is a band-like ligament that attaches from the heel and stretches to the toes. It supports the arch of the foot and absorbs pressure with weight bearing activiies.

The repetitive motion of pushing off with your feet can injure the plantar fascia and cause symptoms ranging from a feeling of a mild bruise on the bottom of your foot with walking to a sharp, intense pain that causes you to limp.The pain tends to be worst in the morning when you first get up or after prolonged periods of inactivity.


Symptoms

The main symptoms of Plantar Fasciitis are; 

  • Pain at bottom of the heel
  • Pain in arch of the foot
  • Swollen Heel
  • Tightness in the calf muscle
  • Pain that is worst in the morning or when you stand after prolonged sitting.
  • Increase pain after exercise, it is not as common to have pain during exercise.


Causes

The plantar fascia is designed to absorb the stresses and strains that we continuously place on our feet. Occasionally the excess pressure we place on these tissues damages or tears them. Our body’s natural response to injury is inflammation. Damage or irritation  to our plantar fascia causes heel pain due to this inflammation.

Some of the factors which may increase the risk of developing plantar fasciitis may include:

  • Age. Plantar  fasciitis is most common in people between 40-60 years of age.
  • Certain types of exercise that place increased stress on the plantar fascia such as running, jumping or dancing can contribute to plantar fasciitis.
  • Obesity. Increased weight can put extra stress on the plantar fascia.
  • Occupations that keep you on your feet for prolonged periods of time may predispose you to plantar fasciitis. Teachers or factory workers who spend most of their day walking or standing have an increased incidence of  plantar fasciitis.
  • Altered biomechanics of the feet may contribute to heel pain, such as flat feet or very high arches
  • Wearing shoes that don’t support your feet properly such as flip flops
  • Tight calf muscles


Treatments

There are many different ways to treat foot pain or plantar fasciitis; 

  • Taking NSAIDS to help with the pain and the inflammation.
  • Icing
  • Putting orthotics in your shoes to support the foot and education on proper shoe wear to help the fascia heal.
  • Night splint. Some find wearing a nite splint helps with the heel pain from plantar fasciitis.
  • Rest. Stop doing the activities that make the pain worse, which include such activities as running or jumping.
  • Roll feet with a can or frozen water bottle to stretch the fascia
  • Physiotherapy. Exercises are prescribed that stretch the calf muscles and the facia and strengthen the foot muscles which make the foot more stable. Ultrasound helps decrease the inflammation and taping helps support the foot and take the pressure off the plantar fascia, allowing it to heal.
  • Icing the foot

If you have been diagnosed with plantar Fasciitis call the professionals at Durham Orthopedic Sports & Injury Clinic to speak to a registered physiotherapist today. 

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5 tips For Faster Workout Recovery

It is not unusual to feel pain in your muscles after a workout. Muscle soreness after a workout is
often called Delayed Onset Muscle Soreness or DOMS and is a side effect of stress put on
muscles after exercise. It is a completely normal reaction to exercise. Muscle soreness is a sign that your workout was successful and that you are getting stronger. When you stress your muscles with exercise, the muscle fibres break down.  As fibres repair themselves, they become larger and stronger. DOMS usually begins within 6-8 hours after exercise and can last 24-48 hours after exercise. There are ways to ease some of the post work-out muscle soreness.

Hydrate

Our bodies are made of 60% water so it should be no surprise that hydration is a key component
to recovery.  To flush damaged muscles out, you need fluid.  Ideally, drink 8 ounces of water
every 15-30 minutes of exercise.  A tip as to how much water you require for your workout
recovery:  step on a scale before and after your workout.  Did you lose weight?  Drink 8 ounces
of water for every pound lost.

Balanced Diet

A balanced diet is key to any person who exercises or is working out on a consistent basis. 
Fruits and vegetables not only provide nutrients for our body, they can also help hydrate our
bodies during recovery.  Carbohydrates are a great source of food for our bodies and they can
help restore glycogen levels.  Proteins help with the repair of muscles.

Warm Up


Take a few minutes to stretch out your muscles before exercise with some stretching exercises
followed by a light aerobic activity such as a slow jog or a brisk walk.  This helps increase the
blood flow to the muscles.

Massage

Massaging a sore muscle helps decrease the tightness.  It also increases blood flow to the
muscles and helps push out pooled fluid out of the muscles and helps speed recovery.

Cool Down

One of the most ideal ways to cool down is to reverse the order of your warm up.  At the end of
your workout, slow down your workout rather than stopping cold turkey, ie. end your run with a
slow jog or a brisk walk.  This helps with the blood flow to the area and pushes pooled fluid out
of the body.

If you have been injured or trying to recover from an injury, call the Durham Orthopedic &
Sports Injury Clinic
at 905-428-7800 to start your physiotherapy or massage therapy treatment
and get on the road to recovery today.

Man drinknig bottle of water
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Summer Exercise Tips

With the first day of summer finally here, it’s no surprise that after a long winter, people want to get outside and be active. Everyone knows that there are great psychological and physical health benefits to exercising, but exercising in the heat can be dangerous if you are not taking the necessary precautions. Here are some exercise tips to survive the summer heat. 

Hydrate

Water is important for our bodies. Drinking 8 ounces of water before exercising in the heat is a great way to make sure your body does not get dehydrated during exercise. It is recommended you drink another 8 ounces of water within 30 minutes of finishing your exercise. If you are doing an activity which requires you to be outside for a prolonged period of time, keep water with you and take frequent water breaks.Eight ounces of water every 15-20 minutes is what is recommended. By the time you feel thirsty, you are already well behind in your fluid replacement. Dehydration is a primary contributor to heat exhaustion.

Sunscreen 

Sunburns are not fun to deal with on the best days, trying to workout or exercise with a sunburn can be even worse. Remember to always wear waterproof sunscreen when doing an outdoor activity or exercise.

Avoid the hottest part of the day 

The hottest time of the day is typically between 10am and 3pm. Planning an early morning or evening exercise is a good way to ensure your body does not overheat, while still keeping up with your daily exercise routines. An ideal way to exercise in the heat is to go for a swim. 

Swimming is great way to; 

  • Keep your heart rate up
  • Provides a full body work out 
  • Keep your heart and lungs healthy 
  • Great way to build muscle 

Take it Easy 

On extremely hot and humid days, look for lighter ways to exercise. A brisk walk over a jog is one way to make sure you are not pushing yourself too hard in the heat. Over exercising  in the extreme heat can cause a heat stroke. When this happens the body can no longer control its temperature. The body’s temperature rises quickly because you stop sweating. This results in the body being unable to cool itself down. Signs of heatstroke include shortness of breath, fast breathing, confusion and can progress to seizures and loss of consciousness.

If you have been injured or are trying to recover from an injury, call Durham Orthopedic Sports & Injury Clinic to start your treatment and get on the road to recovery today!

Woman holding sides of her head
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Headaches

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.

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Tips to avoid Gardening Injuries

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.