Physio Blog

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. 

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.

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.