All posts by Palermo Physio

Don’t let your year end health benefits go to waste-Massage

The year 2022 is moving quickly as Halloween marks the last day of October.

Time does get away from us and things we have been thinking of seeking appointments for for ourselves often get put on the back burner. Most private insurance benefits end at the end of the calendar year and restart in January.

When it comes to treatment with a Physio, RMT, Chiropodist (foot specialist), and acupuncturist, people often think of seeing them when they have sudden or acute injuries, or after surgeries like knee replacements.

There are so many ways that these health care professionals can help benefit your quality of life.

Registered Massage Therapy (RMT)

Many of our patients see their massage therapists when they have tension in their neck and shoulders. They will also book RMT visits for low back pain and stiffness. Massage Therapists are so helpful with those things but they can also treat other things.

Sports Recovery / Maintenance:

Many runners, walkers, hikers, soccer players and hockey players benefit from seeing an RMT as they increase training frequency and difficulty. They find that treatment of the thighs, glutes, calves and feet help with recovery and injury prevention. People involved in weight lifting like CrossFit and HIIT training can benefit from regular recover massage on the back, chest, shoulders, forearms and quads etc.

oakville physio biking injury

Headache Management and Treatment

People who experience tension headaches and migraines keeping a regular massage schedule can help with the frequency and severity of headaches.

There are connections of muscles from our necks, shoulders and upper backs and even to our heads. Many people experience headaches when these muscles are tense, tight and sore. Having regular massage therapy can help break this cycle and keep those headaches less intense and possibly further apart.

Your RMT will also leave you with personalized advice for home care and self management for your headaches.

Help in Managing Stress

Often low back stiffness, and neck and shoulder tension has a driver behind them. Certainly last of motion and non-optimal posture on a daily basis can contribute to these issues. Booking regular massage in addition to other positive lifestyle habits can help manage these stress levels. Having set time during massage where you unplug, slow down your breath and feel your body relax into the treatment table helps downgrade your nervous system. People often comment on how they sleep better after they have had massage.

Your massage therapist may suggest a visit as well to a yoga therapist in breathing techniques, movement and meditation to help supplement your massage treatment.

Massage therapy post surgery

Post-Surgical Massage

We often move less or have compensations in our movements when we are going through recovery. Massage Therapy can help prevent pain associated with these things as well as help with recovery from the surgery as well.

At a certain stage of healing, usually ascertained by your medical specialist you will be able to have massage in the direct area of your surgery. Some people will have scar massage locally of lymphatic drainage massage to address swelling. Earlier in healing and recovery you may benefit from massage on areas further from your surgery site.

For example, after a rotator cuff repair or a shoulder stabilization surgery, you may be asked by your surgeon to keep your arm in a sling. As the shoulder will not be moving it may be helpful to have massage around the shoulder blade and neck area, as well as the hand and forearm. Your massage therapist will make adjustments to your positioning and may even have you in sitting for some of the massage. As you progress through rehabilitation and start strengthening exercises having massage therapy as part of your recovery will be beneficial. Post total knee replacement surgery and total hip replacement surgery Massage would have the same benefits.

Massage can also be helpful after surgeries that may not be “orthopaedic” in nature. They can help with stress management, with pain and stiffness of the body, with swelling and lymphatic drainage as well as around the scar tissue. If you are unsure of how an RMT may address your particular needs after a surgery contact us at our North Oakville clinic or an RMT that is local to you.

Progressive Health Issues or During Treatment

Having massage can help with issues that present from progressive health issues like Parkinson’s disease and MS or during treatment of things like cancers. Whether it be stiffness or pain your massage therapist will work with your particular needs.

Pediatric Massage

Children should be covered under the benefits of their parents. Many kids complain of growing pains that can be associated with their knees, feet and heels. Massage Therapists often work with physiotherapists in treatment of Sever’s Disease and Osgoode Schlatter’s, jumpers knee and plantar fasciitis.

Many children are active in more than one activity or sport and with the amount of activity during growth spurts can have aches and pains in the body. Having Physio and Massage Appointments to work on these areas and have advise of home care can make sports, dance, and cheerleading seasons more pleasant and successful.

Parents are asked to be present during massage treatments.

Contact us to book your Massage Therapy appointment today. We are able to bill directly to most insurance companies. You can also use our online booking for most practitioners.

FAQ: Do you Direct Bill for Insurance?

This is a question we receive frequently at our North Oakville clinic.

The short answer is yes. We are able to direct bill to insurance.

Here is the “long answer”

  1. We are able to direct bill to most insurance companies. Most private / work insurance companies allow us to direct bill on your behalf. In order for us to do this you need to fill out paperwork that allows us to do this.
  2. Most insurance companies allow us to direct bill for certain services. This includes physio, massage, and acupuncture. Chiropody, or foot care specialists generally do not allow this.
  3. Everyone’s insurance is different with regards to direct billing. This is based on your employer and their arrangements with the insurance. Not everyone with the same insurance provider has the same coverage or the same rules with regards to direct billing. For example, we may be able to provide direct billing for Sunlife for one person but not another due to coverage difference.
  4. Usually we are able to at the very least submit your physio or massage to insurance and they will reimburse you. This will still require you to pay after your treatment.
  5. Some private benefits require a doctors referral before the will start to reimburse you for massage therapy or physio treatments. Read HERE for more information on this.
  6. You are responsible for understanding your own private benefits. The coverage for each service may be different. You will have a total dollar amount per year available. Each service will also have a percentage coverage or maximum per treatment. For example you may have a maximum of $1000 per year for physiotherapy. Each physiotherapy visit may be covered for up to 80% or maximum of a certain dollar amount.
telehealth physio for pain and injury

While we do our best to direct bill on your behalf for physio, massage and acupuncture, what we are able to do for you is dependent on your own personal insurance.

Contact us at our North Oakville clinic if you have more questions or would like to book in with one of our Physiotherapists, RMT’s, Acupuncturist, Chiropodists (foot care specialists).

Yoga and Diabetes

In the West, Yoga is often thought of as simply physical exercise and stretching.

It is that. But only partly.

The movements are designed to prepare your body for meditation and mind work.

If you are attending a yoga class or participating in an online version. Don’t skip over breath work. It can be very helpful for your physical and mental well being.

For example, yoga and other mind-body practices have been shown in a study to help with blood sugar levels in Type II diabetics.

Yoga has also been shown to be helpful in managing pain and pain that persist.

yoga therapy in Oakville and Halton, virtual / private online yoga

If you do not know where to start or would like to try / start yoga but are unsure how you may modify or adapt a class for your own body or needs it may be helpful to start privately with a one one one / private yoga session.

Our North Oakville Physio, Massage, Foot Care, and Acupuncture clinic has a private yoga available with a yoga therapist. Whether you have a progressive health condition or an injury, one on one yoga is helpful for maintenance or progression.

Contact us to book in or learn more.

FAQ – Do I Need a Doctors Referral for Physiotherapy?

This is a common question we receive at our North Oakville Physio clinic. People are wondering if they require a physician note to attend physiotherapy assessments / treatments.

The short answer is NO!

You do not require a doctor’s referral to book an appointment with a physiotherapist in Ontario (and therefore Oakville / Burloak). Physiotherapy is direct access. This means that you can see a physio without seeing your family doctor / specialist first.

It is within a physiotherapists scope of practice to assess patients with musculoskeletal issues and to communicate a diagnosis. For example, your elbow has been getting more sore and painful with activities like gripping and typing. After trying some home remedies you decide your elbow is not getting better and in fact, it is getting worse.

What do you do?

At this point booking in to see your physiotherapist would be a great idea. They can provide you with personalized education and treatment to get you started right away. In cases like these, your physio would communicate with your physician and send you for medical assessment if they feel that it is necessary, they may suggest this as well if you do not seem to be improving with treatment.

It is easy to delay treatment that could be helpful by waiting for a doctors appointment where they may only provide a prescription for medications and or imaging. THEN you wait for the imaging results and / or a specialist referral, while you could be getting the help of a physiotherapist, and THEN you may be referred to physiotherapy.

In an ideal situation you’re already seeing a physio even IF you need the above. This prevents further decline in strength or function. This also prevents a decrease in quality of life.

Are we saying to not consult with your family doctor?


Please do consult and keep them in the loop. In fact, as physiotherapists we often send off assessment and progress reports to your medical team to let them know what is going on.

Keep in mind that some insurance companies (ie. private benefits) require a doctors prescription for them to pay for your physio, or massage appointments. Every insurance is different so it is best to familiarize yourself with your own insurance by either calling or looking through your booklet.

Our North Oakville Physio, Massage, Acupuncture and Foot Clinic is able to provide direct billing to most insurance companies. Again, this depends on your personal insurance.

Contact us to book in with one of our awesome physiotherapists!

Knee Pain? It Could be “Jumper’s Knee”

Our Oakville Physiotherapy team treats knee pain from acute sprains to rehab after surgeries such as ACL repair and total knee replacements. Commonly we see people with knee pain that creeps up on them.

Have you been experiencing annoying knee pain at the front of the knee that doesn’t seem to go away? Did it seem to come on slowly and you can’t recall a specific event where you injured it?

You may have an injury called Jumper’s Knee also referred to as patellar tendinopathy. 

What is Jumper’s Knee / Patellar Tendinopathy?

Jumper’s knee is an overuse injury of the knee caused by repetitive stress on the patellar tendon- the tendon that connects your kneecap (patella) to your shin bone (tibia). As the name implies, any activity associated with lots of jumping, landing, or cutting (fast direction changes) can put you at risk for developing Jumper’s knee.  It is most common in active individuals who play quick intensity sports such as basketball, volleyball, track, skiing, or running. However, anyone who is active and has recently changed or increased their workout intensity, frequency or training surface can be affected. 

Soccer player standing on soccer ball showing sports physio in Oakville

Symptoms of Jumper’s knee include a dull, aching pain in the front of the knee just below the kneecap. Pain is often worse with activity and especially those involving bending the knee – running, jumping, squatting, or lunging. The knee may also be aggravated by prolonged sitting. 

Since Jumper’s knee is an overuse injury, it is important to learn how to use and load the tendon properly so the tendon can heal and avoid injury in the future. A physiotherapist can thoroughly assess your knee to determine if your symptoms are consistent with Jumper’s knee, or another cause. They can also show you how to safely exercise in order to optimize the strength and recovery of your patellar tendon in a way that is personalized to you. 

Oakville rep basketball sports injury clinic and knee pain

Whether knee pain is keeping you from playing rep basketball or soccer, or from maintaining a healthy lifestyle with activities of enjoyment, our Physio’s are here to help!

If you are currently experiencing knee pain, please contact us to book with one of our physiotherapists. 

If you Have RA a Chiropodist is an Important Part of your Team

RA or Rheumatoid Arthritis is a type of inflammatory arthritis where the immune system attacks the tissues of the joint lining. This can cause painful inflammation during “flairs” and stiffness.

It is common for many people with RA to develop these symptoms in the joints of the foot and ankle. It can be painful and swollen in the joints of the toes, ankle and even ligaments of the feet. Nodules, or lumps can occur on the heel, ball of the foot or the achilles tendon.

If left untreated deformities of the toes and feet can occur such as hammertoes or claw toes. Cartilage between joints can break down and cause changes in the shape of the foot, toes and ankles. It can be a cycle of pain and stiffness and visible changes.

A Chiropodist as Part of your RA Team:

In addition to managing your inflammatory levels with the help of a rheumatologist and possibly other health care practitioners such as a Naturopathic Doctor, a Chiropodist can help you protect your feet. Working closely with a Chiropodist allows them to help manage pressure, and prevent joint breakdown and deformity.

Custom Orthotics and guidance on proper footwear help support the joints of the foot and ankle. Orthotics will also help support joints above that can also be affected by Rheumatoid Arthritis, such as knees and hips. Custom orthotics help manage joint pressure as well as joint alignment.

oakville physio clinic for joint replacement rehab and physio

Most private benefits cover visits / assessments with Chiropodists (foot specialists) as well as Custom Orthotics.

Contact us to book your consultation / assessment with one of our North Oakville / Halton Chiropodists.

Palermo Physio and Wellness Thanksgiving -2022

The team at North Oakville’s Palermo Physiotherapy And Wellness Centre would like to wish everyone a happy and safe Thanksgiving long weekend.

Our clinic hours are as follows:

Saturday October 8, 2022 – OPEN 8-1pm

Sunday October 9, 2022 – CLOSED

Monday October 10, 2022 – CLOSED

Tuesday October 11, 2022 – OPEN regular hours.

We hope that you are able to enjoy the fall weather and beauty of the changing leaves around Oakville, Burlington, Milton and the Escarpment! All the best from our front desk team, and our team of Physio’s, RMT’s, Chiropodists, Acupuncturist and Yoga Therapists.

Oakville physio, massage, acupuncture and foot clinic

Common Causes of Foot and Heel Pain in Kids

Just like adults, children can experience foot and heel pain. They may not be able to communicate what they are experiencing or feeling.

Parents may notice that their child complains of their shoes feeling stiff or tight. They may also notice their child walking differently, limping or having a change in activity level.

In children these complaints or changes may be are result of:

  • Sever’s Disease (an inflammation of the growth plate of the heel bone)
  • overuse injury
  • stress fracture
  • plantar fasciitis
  • achilles tendinitis
  • Poor fitting footwear
  • flat feet / high arches
  • Plantar warts
  • Ingrown toenails
  • Athletes foot / fungal infections

If your child has been complaining of foot pain or you believe they are experiencing one of the above issues, our Oakville Chiropodists are experienced in working with children and their parents.

Most private insurance benefits cover foot care visits to Chiropodists.

Contact us to book with one of our North Oakville Chiropodists / Foot Specialists.

Thumb Pain and Injury – How Physio can Help

In a previous blog post we spoke about thumb pain and chronic issues associated with the thumb. These included things like osteoarthritis and trigger thumb. Trigger thumb like most things are helpful if addressed early.

Accessing physiotherapy early for thumb pain or issues can help delay or avoid needing injections or less conservative care from an orthopaedic surgeon or plastic surgeon.

Thumb injuries and issues can also be more acute or sudden. Changes or an increase in activity or things like contact or a fall can often be culprits of thumb injuries.

De Quervain’s Tenosynovitis

For some this can be thumb pain that strikes seemingly out of nowhere. This pain may happen when moving the thumb, gripping, turning the wrist, or lifting something. The pain is located n the thumb side of the wrist / forearm and may also be tender to the touch.

This thumb pain is caused by the swelling of the tendons that help move thumb out / extend the thumb. The tendons of the thumb when swollen and inflamed take up space in the sheath they run through.

The type of thumb and wrist pain is more common than you think. It is classified as an overuse type of injury, and is often brought on with new activities or increasing intensity of activities. Many post-partum women experience it from lifting, moving and carrying their babies and carriers in different, new, and repetitive ways.

yoga stretching poses from an oakville virtual physio

Your Physiotherapist will do a through assessment to ensure that this is the cause of your thumb pain. They will try and get to the root cause in order to provide education, possibly bracing, and advise on activity modification. They may provide supportive taping if it is impeding in your sport or daily activities.

In some cases less conservative treatment is warranted. Physiotherapy afterwards to work on scar tissue, strength and mobility can be helpful.

Like most things it is important to have your thumb pain addressed before if it is not improving or if it is impacting your activities and life negatively.

Skiiers Thumb / Game Keepers Thumb

This is the result of s sudden injury. It is a sprain of the inside ligament of the thumb or the ulnar collateral ligament. If it is not treated properly, it can result in long term problems of the thumb.

Manual testing and imaging will help in diagnosing the degree of sprain. The thumb should usually be protected from range of motion with a cast-like splint for a set period of time. During this time physio can start in a controlled way. If surgical repair is needed the surgeon will clear a person for physiotherapy after a certain amount of time to begin range and motion exercises and eventually strengthening.

oakville basketball thumb injury and physio

Fracture / Broke thumb

Thumb fractures (or breaks) can happen in variety of ways. Falls, sport impact or getting caught in a door are some common ways people break bones in their thumbs.

If you are losing time from sport / activity due to having your thumb immobilized, a physiotherapist can help provide ways to move your body without negatively impacting your healing bone.

Once your cast or splint is removed and your are cleared for activity based on your x-rays, Physiotherapy can help you restore normal thumb, hand, and wrist movement, manage pain, increase strength and return to sport / activity.

baseball player showing post ACL reconstruction rehab at Oakville Physio clinic

Contact us at our North Oakville Physiotherapy, Massage, and Foot Clinic. We are happy to help you recover from pain and injury that is impacting your life and activity.

Thumb Pain – from an Oakville Physio

For being a small joint, having pain or issues in our thumbs can cause us big problems!

Our thumbs help us grip, and grab in fine ad gross motor tasks. From carry a baby seat to holding your hand open in a baseball mitt, to knitting and chopping dinner, you don’t realize how important you thumbs are until you have thumb pain that prevents you from doing these things comfortably.

Even though it’s a small area, your Physiotherapist and Massage Therapist take your complaints seriously. Like all injuries and pains in the body your physiotherapist will take a thorough history of our health, habits, the onset of the issue and how it is presenting. They will take you through movements and special tests to rule in and rule out various issues and types of tissues.

Like many issues in the body thumb issues and pains can from the joints (where the bones meet), the tendons, the muscles, and the ligaments. In some cases it can be more than one thing contributing to the pain.

Chronic Thumb Pain / Issues

With chronic or ongoing thumb pain Physiotherapists often look to the joints or the tendons as a primary culprit.

Osteoarthritis (OA) – the carpometacarpal joint of the thumb can cause ongoing thumb issues. As Physiotherapists we look to patterns of pain. The thumb joint may have a squaring type of change and the joint line may be tender to the touch. Your physiotherapist will work with you on your goals to help you protect the joint, manage your pain and get you closer to activity. Having osteoarthritis does not mean you cannot improve your pain.

Tendinosis – The tendons of the thumb connect the muscles to the bone. They act as a pulley system. These tendons over time and with repetitive loads can wear and thicken. Although less common than other areas of the body this can be an issue in the thumb. Your physio or massage therapist may suggest working on these tendons and the surrounding muscles. They may provide you with exercises to strengthen the area as well. Sometimes modifying what you do can also be part of the trick.

Trigger Thumb – Having the thumb catch and get stuck during movement can be painful, or not. When you move your thumb into a fist and then try and open it it may catch or click. For some people, they have to use their other hand to open the thumb back up. This can also happen in the fingers and is aptly named “trigger finger”. This is also known as “stenosing tenosynovitis”. The tendons move through the tendons sheaths and a series of pulleys. In trigger thumb or finger, an enlarged flexor tendon gets trapped or caught up in the pulley system. The area of entrapment may be closer to the palm than the area that gets “stuck”. This area of entrapment can be painful, but is not always. Your physiotherapist or massage therapist will give you treatment depending on how this presents and how it is affecting your daily life.

Like most things, these painful thumb issues are best treated early. If you have been having thumb pain that is new, not going away, is impacting your activities of enjoyment, or is worsening, it is helpful to have a thorough physiotherapy assessment. If the issue has been there for longer or there has been an increase in pain, physiotherapists are also a part of your team.

Our next blog post will talk about more acute, or sudden injuries of the thumb.

Contact us at our Oakville Physio, Massage, Yoga, and foot clinic to book with one of our trained practitioners.