Physio Blog

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.  

Daily activities can often be quite painful and debilitating for those suffering from sciatica. 

Symptoms of sciatica include but are not limited to:

• sharp shooting pain in the back of the leg
• the location of the leg pain may change and move from higher up the leg near the buttock region, to down into the lower calf and foot, as a rule, the further down the leg pain is, the more aggravated the nerve is

Sciatica is radiating pain in the leg that originates from the lower back.  It follows the pathway of the sciatic nerve as it goes down the leg. The pain is not felt in the front of the leg or into the thigh.

Those living with sciatica usually discover fairly quickly which movements or positions aggravate their leg pain. Often these aggravating symptoms are used to help with the diagnosis.

There are numerous causes for sciatica. Two of the most common causes are:

Discogenic Pain

Discogenic pain is caused by mechanical or chemical irritation from the discs in our spine.

Symptoms include:

• increased pain with coughing or sneezing
• various neurological symptoms including numbness or weakness in the legs
• increased leg pain or low back pain with sitting or bending forward
• standing or walking decrease the symptoms

Stenotic Pain

Stenosis is a degenerative condition and it commonly affects people who are typically 60 or older. It is caused by narrowing of the spinal canal resulting in compression of the sciatic nerve.

Symptoms include:

• increased pain with walking or sitting
• sitting or bending forward usually decreases the leg symptoms
• cramping in the calves with walking, requiring frequent sitting breaks to decrease the pain
• pain or weakness or numbness in the leg, calves, or buttocks

We have listed two of the more common causes of sciatica, but there are many other causes as well. It is important to see a physiotherapist to get a proper diagnosis of the causal factor contributing to your particular sciatica and subsequently gear treatment to your individual diagnosis.

Book an appointment at the Durham Orthopedic and Sports Injury Clinic (905-428-7800) to see one of our registered physiotherapists to help develop a specific plan of treatment for your specific sciatic pain.

Participating in sports is a great way to keep healthy and active, it can improve your cardiovascular system, build and maintain muscle, and help boost your immune system. If you have played sports, you are likely aware of the increased risks of injuries. Here are some of the most common sports related injuries:

Tennis Elbow

Tennis elbow is a fairly painful condition involving the tendons which attach to the outside of the elbow. Those tendons may become inflamed or can develop degenerative tears where the tendon attaches to the bone making gripping and lifting painful.

There are many causes of tennis elbow

• Overuse
• Trauma
• Racquet Sports

Strains and Sprains

Strains and sprains are among the most common injuries you can get while playing sports.

A muscle strain is an injury to a muscle or tendon.Strains occur when a muscle is overstretched or overused.

Small strains can occur when you:

• Lift something heavy
• Not stretching or warming up before physical activity
• Losing your footing or slipping
• Jumping

Sprains

A sprain is a stretching or tearing of ligaments. Ligaments are strong bands of tissue
which connect two bones together in your joints and prevent excessive movement.
Ankles and knees are the most common joints that are sprained in sports injuries

Broken Bones

Broken bones or fractures are defined as any loss of continuity of the bone.

There are 5 main types of breaks or fractures.

• Closed or open fractures
• Displaced Fractures
• Complete Fractures
• Partial Fractures
• Stress Fractures

The most common body parts that fracture or break during sports are;

• Wrist
• Fingers
• Hands
• Tibia(shin bone)
• Ankles
• Collarbone

Concussions

Concussion diagnoses are becoming more common, especially with children between the ages of 10-14 years old. This is largely due to increased recognition and research on the condition, which has led to testing and concussion protocols being implemented in professional and recreational sports. Blows to the head, slips and falls and hits to the body causing whiplash are some of the common ways of sustaining a concussion in sports.

Symptoms

There are a wide range of concussion symptoms but the most common are;

• Headaches
• Problems Focusing
• Balance Issues
• Nausea
• Brain fog or a dazed feeling

Torn ACL

A torn ACL is a tear of the anterior cruciate ligament, the tissue that connects your femur to your tibia in your knee. Torn ACLs are extremely painful and have been known to incapacitate the person with the injury. When someone tears their ACL there usually is a popping sound and extreme pain in the knee.

If you have been injured and want to see a physiotherapist. Contact the professionals at Durham Orthopedic Sports & Injury Clinic at 905-428-7800.

Foam Rollers are one of the most popular pieces of equipment individuals use to help release
those tight muscle knots or trigger points that many of us are plagued with.

These are called myofascial adhesions and are inflexible areas in our muscles that can be
caused by injuries, prolonged sustained postures or muscle imbalances. Foam Rollers are effective in alleviating the tightness in the myofascial tissues which can lead to
chronic pain if not addressed.

When shopping for a foam roller, there are three main considerations.

Density

• Foam Rollers come in different densities.Using a Foam Roller that is too soft may result in not enough pressure to have the best result on the muscle which you are Foam Rolling. Using a Foam Roller that is too dense may cause bruising and trauma to the muscle resulting in increased pain after use.
• If you are new to Foam Rolling, it is advisable to start with one that is softer and progress to a more dense roller as your muscles adapt to rolling.
• The colour of the Roller indicates the degree of density with white being the softest and black being the firmest.

Surface Texture

• Foam Rollers are either smooth or they have ridges and knobs.
• Smooth Rollers provide even pressure across the entire length of the roller.
• They are especially ideal for someone that is just starting out with rolling as the pressure is not as intense as textured rollers.
• Textured rollers have ridges and knobs and offer a more targeted approach to working out the tight parts of a muscle.There are a variety of textures that offer varied amounts of pressure.

Length

• Longer Foam Rollers are probably the best choice for foam rollers as they are long enough to work on your back.They are also more stable than shorter rolls when you are working on your leg muscles.
• Shorter foam rollers are better to target muscles in the arms and calves.

Foam Rollers are one of the many tools that your physiotherapist may have you use at home to help you manage your pain.

In addition to providing education on how to manage your pain, our physiotherapist will use hands-on manual therapy techniques to help speed up your recovery. Call the Durham Orthopedic and Sports Injury Clinic to schedule an appointment with one of our physiotherapist or massage therapist to help with treatment of your aches and pains at 905-428-7800.