Physio Blog

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.

With family Day right around the corner, we thought we would explore all the ways you can be active outside with your family in Durham Region. 

Ice Skating 

Ice skating is not only a great way to get your blood pumping, it can be a great way to spend the day building family memories. Durham region has a number of outdoor skating rinks for everyone to enjoy. Skating exercises many muscle groups including the glutes, your core and outer thighs. It is also a great cardio workout. 

Here is a list of outdoor skating rinks located in Durham Region and the GTA;

Winter Fun Guide: Outdoor Skating Rinks – Child’s Life

Snowshoeing 

Snowshoeing is lots of fun and a great  low impact muscle building exercise. Snowshoeing is also a great cardio workout that can burn 1000 calories in just one hour. Take your family for a day of snowshoeing in one of Durham Region’s beautiful forest trails.

Family Hike

If snowshoeing isn’t your cup of tea, trade in the snowshoes for a pair of hiking boots and hit the trails. Being outside in nature has many benefits for both your physical and mental health. Increased cognitive response, drops in stress levels and increased endorphins are a few ways that being out in nature can help our mental health. Walking in nature is another example of low impact exercise that is a good cardio exercise. 

Skiing or Snowboarding

If you are looking for more of an adrenaline rush this Family day weekend why not not take to the slopes? Skiing and snowboarding increase flexibility, burns calories, increases lower body muscles, is a great core exercise and it can be a great boost for your mental health. 

If skiing and snowboarding aren’t up your alley but you still want some adventure grab the family, a sled or toboggan and find the closest hill or ski resort.   

Durham Region has some great trails and ski slopes if you are looking for that perfect adventure this long weekend. 

https://www.durham.ca/en/tourism/news/top-ski-resorts-in-durham-a-thrilling-winter-experience.aspx

If you have been injured and want to see a physiotherapist. Call the professionals at Durham Orthopedic Sports & Injury Clinic at 905-428-7800 and start your road to recovery today. 

Overview

There has been extensive research that shows exercise improves the symptoms of osteoarthritis. GLA:D (Good Life With Arthritis, Denmark)  is a program supervised by a health care professional. It has been shown to address the muscle changes that occur with osteoarthritis of the knee and hip and helps reduce the symptoms of pain and decreased function that often occurs with this condition.

The GLA:D program consists of:

• Two education sessions with the goal of providing participants with a better understanding of osteoarthritis.

• Two one hour supervised exercise sessions per week for 6 weeks, each participant has the program modified to address their particular weaknesses.

• Two physical tests testing walking speed and repeated sit to stand , one done before the 6 week program starts and one on completion of the program

• Once the 6 weeks is completed, participants will have the knowledge and tools to continue on their own at home or in a gym setting.

GLA:D INFORMATION 

Clinical trials on the GLA:D program have shown that most participants see at least a 30-40% decrease in their pain and a significant improvement in their activities of daily living, such as stair climbing and walking. The GLA:D program is ideal for those that are not candidates for knee or hip replacement but have significant loss of function and pain due to the osteoarthritis in either their knee or hip. It is also helpful for those needing hip or knee replacement. By improving strength, function and range of motion before surgery, recovery after surgery is often quicker and improved. The GLA:D program puts all the pieces together for optimum rehabilitation and improvement from your symptoms associated with osteoarthritis. It incorporates education, strengthening and function by working on correcting the alignment of your knee and hip during the activities of daily living to minimize the stress to the affected joints.

HISTORY

Since the first GLA:D course for physiotherapist in Denmark in 2013, GLA:D has provided treatment to over 15,000 people in Europe, Canada and the US.

Durham Orthopedic and Sports Injury Clinic will resume in person GLA:D classes at the beginning of March 2022, supervised by a registered physiotherapist. Call our clinic to discuss the GLA:D program with our registered physiotherapist at 905-428-7800.

Snow shovelling is a common cause of back pain or it can often be the cause of flare-ups of pre-existing back conditions or injuries.  Recent epic snow falls have resulted in an increase in snow shovelling injuries at our clinic.  With 6 inches of snow fall, a person with a double driveway could be shovelling between 1100-1500 Ibs of snow and that repeated movement with all that weight can be hard on the back.

Using appropriate snow shovelling techniques can go a long way to prevent injuries.

To avoid low back injuries with shovelling:

• Avoid shovelling first thing in the morning as your muscles are not warmed up and we tend to be stiffer.  Also in the morning, spinal discs are maximally hydrated, which may increase the risk of injury.

• Warm-up your muscles by stretching your low back and hamstrings before shovelling.  This helps loosen the muscles and improve blood flow to these muscles.
  
• Use an ergonomic snow shovel designed to push the snow. A snow shovel that allows you to push the snow without having to bend and twist helps prevent injury.
  
• Keep your back straight at all times.  Avoid bending and twisting your back, instead lead with your hips and bend with your knees.·  When shovelling, be sure to take   a stretch break by bending backwards with the back, 3-5x’s, every 10 minutes or so.    

If you experience back pain with shovelling, it’s important to keep moving.

• Moderate pace walking, making sure to swing your arms helps keep the muscles moving and helps prevent the muscles from stiffening up.
  
• Gently stretch away from the direction of injury and hold the stretch 20-30 seconds
  
• Since shovelling involves bending forward, gently stretching backwards 5-10 times every few hours may decrease the stress to the low back.·  Ice helps reduce inflammation to the strained muscles.

If you hurt yourself, snow shovelling or have concerns with your technique contact our physiotherapist at the Durham Orthopedic & Sports Injury Clinic at 905-428-7800 to discuss these matters with our Physiotherapist.

Stretching every day has a wide variety of both physical and mental health benefits. As we get older, we tend to lose mobility if we do not keep up with the stretching. Stretching can also help to burn calories. 10 minutes of stretching can burn 27 calories.   

Physical Benefits of Stretching 

• Improved Posture 
• Increased Range of Motion and flexibility in the joints we are stretching
• Helps relieve post-exercise aches and pains
• Improved Balance
• Relief from sore muscles
• Decreased Risk of Injury
• Improved Circulation 

Mental Health Benefits of Stretching

Many people know the physical benefits of stretching, but stretching is also great for our mental health. Stretching increases our body’s levels of serotonin, which is the main hormone that impacts our happiness and well being.   

Yoga is a great example of stretching being used for both the body and the mind. Yoga focuses on deep breathing exercises while also improving your overall flexibility.   

Mental benefits of Stretching

• Ease symptoms of depression by aiding mindfulness which helps break up repetitive negative thoughts
• Reduce Stress and Anxiety by stimulating receptors in our nervous system that slow down production of stress hormones
• Clearer Mind
• Increased Endorphins which interact with receptors in your brain that reduce your perception of pain

Stretching Routines

Adding a daily stretching routine to your life doesn’t have to be a chore. There are many different types of stretching and routines for a variety of different people. A simple Google search can show you a number of different stretching routines whether you’re a runner, golfer, beginner or justy looking for a simple way to stay more active. 

If you have been injured and are looking to start your road to recovery today. Call the professionals at Durham Orthopedic Sports & Injury Clinic today!