Category Archives: Clinic Information / Updates

Growing Pains in Children – Should You See a Physiotherapist?

School has officially begun for the year and with that comes an increase in activity levels for many children. As the fall and winter season approaches, many kids will participate in school sports as well as extra-curricular organized sports and activities. This ramp-up in exercise levels can sometimes lead to aches and pains, particularly in young children who are still growing at fast rates.

The term “growing pains” refers to this sort of injury. This pain is muscular in nature and occurs because bones are growing and changing at a faster rate than the muscles can keep up, which puts added stress and tension on the muscles. This can be more prevalent in children who participate in sports all year long, or children who play multiple sports at the same time.

Common Growing Pains

  • Sever’s Disease: pain in the back of the heel where the Achilles tendon attaches.
  • Shin Splints: pain in and around the shins.
  • Osgood Schlatter’s Disease: pain below the knee from the quadriceps muscle pulling on the shin bone.

Symptoms of Growing Pains

  • Pain in the thighs, knees, shins, or ankles.
  • Pain after playing sports or engaging in activity.
  • Pain at night when sleeping.
  • Pain is described as an “ache” or “burning.”

Physiotherapy and Growing Pains

Physiotherapist Nada demonstrating stretches that can be relieving for Severs Disease

Physiotherapy treatment is a very effective way to treat and manage activity-related pains in growing children. The aim is to reduce inflammation and improve muscle flexibility and strength. This includes techniques like mobilizations, manual stretching, and soft tissue work. The physiotherapist can also instruct you on how to manage your symptoms at home and what exercises to do to effectively target the area.

Single leg step ups for Osgood Schlatter Disease
Single leg heel rises used for Severs Disease
Exercises that are beneficial in strengthening relevant muscles in individuals with Severs or Osgood Schlatter Disease

If your child is experiencing pain and discomfort with exercise, book an initial assessment here with one of our physiotherapists. They will design a treatment program individually tailored to your child’s needs, age, and activity level.

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What is a Concussion and How Can Physio Help?

A concussion is a traumatic brain injury. It can be caused by:

  • a blow to the head
  • impact from a fall
  • a sudden acceleration of the head and upper body (e.g., as your head and neck whip forward during a car accident). KEY NOTE – This means you don’t need actual head impact to have a brain injury! This is because the brain can still be injured by the impact against the walls of the skull.

Diagnosing a Concussion…

Signs (observable by others):

  • appears dazed and delayed in answering questions.
  • Easily confused, appears foggy.
  • Slow to respond, slow reaction times.
  • forgetful, no memory of the events prior to or immediately after the injury (usually short-term memory loss).
  • mood/behavior/personality changes (usually presenting as irritability and/or depression).
  • Loss of consciousness (rare).

Symptoms (reported by the patient):

  • Headache or “pressure” in the head
  • Nausea or vomiting
  • light sensitivity
  • noise sensitivity
  • Feeling foggy or in a daze
  • Concentration or memory difficulties
  • difficulty reading
  • unusual fatigue
  • disrupted sleep
  • low mood
  • Difficulty with balance/dizziness
  • Double or blurry vision
  • ringing in the ear
  • screen intolerance
Physiotherapists Testing For Balance and Vision Issues.

Signs and symptoms might not be immediately apparent. They may appear hours or days after the injury. Therefore, it’s important to keep checking in after a hit, fall, or whiplash-type injury for the rest of the week.

Sometimes, there can be more serious signs and symptoms indicative of a brain bleed that leads to a hematoma (a dangerous collection of blood that causes swelling in the area and compresses the rest of the brain).

When to call 911 / go to the ER:

  • One pupil is larger than the other.
  • Extreme drowsiness or not waking up.
  • A worsening headache
  • slurred speech, weakness, numbness, worsening coordination
  • continued vomiting.
  • seizures
  • loss of consciousness

Note – in infants and toddlers, any of the above signs, inconsolable crying, or continued refusal to feed should all be considered a red flag.

Timeline

Most concussion signs and symptoms resolve within two weeks. It is still normal to have lingering effects for up to 3 months.

However, it is always a good idea to get the concussion checked out by a medical professional (e.g., a family doctor) within the first week.

Do not wait to see if it will resolve before consulting your doctor. Concussions ARE brain injuries, and they can have long-lasting residual effects that affect your daily living.

What helps the healing process?

  • Get more rest than usual.
  • Pace your activities (e.g., break down into smaller chunks, take microbreaks, stop when symptoms increase).
  • hydrate more often.
  • Eat more whole foods and focus on food high in omega 3s and 6s.

Why you should see a Physio

Now that we’ve covered what a concussion is and its effects, let’s talk about why Physiotherapy can be an appropriate treatment.

Physio treatment involves:

  • Manual therapy (soft tissue and joint mobilizations).
  • Exercise therapy (range of motion, strength, stretch, cardio, balance, vision exercises).
  • education (on the recovery process, self-management strategies, relaxation techniques especially for improving sleep hygiene, return to work/sport/school).
Physiotherapist Kirsten Providing Manual Therapy on a Patients Neck.
An Example of Exercise Therapy to Work on Balance for a Concussion Patient.

A combination of these can help with post-concussive symptoms such as:

  • fatigue
  • Double or blurry vision
  • balance impairments
  • dizziness
  • neck pain                                                                                                                                            
  • headaches
  • low tolerance for activity (e.g. school, screentime, sports)

Return to activity.

Rest is recommended for the first 24-48 hours with very limited screen time and no exercise. After the first 48 hours, depending on the severity of symptoms, general activity and screen time should be gradually introduced, increasing them based on the level of symptom aggravation (typically mild to moderate symptoms are normal, while moderate to high symptoms indicate the need to stop the activity and wait until symptoms have settled before resuming).

This includes a return to work, whether it is a return to a desk job or a job that is more physically demanding.

Return to sport.

The table below is taken from the Zurich 2012 conference CONSENSUS STATEMENT: McCrory, Paul, et al. “Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012.

GRADUATED RETURN TO PLAY PROTOCOL
Rehabilitation StageFunctional exercise at each stage of rehabilitationObjective of each stage
1. No activitySymptom limited physical and cognitive restRecovery
2. Light aerobic exerciseWalking, swimming, or stationary cycling keeping intensity <70% maximum permitted heart rate. No resistance trainingIncrease HR
3. Sport-specific exerciseSkating drills in ice hockey, running drills in soccer. No head impact activitiesAdd movement
4. Non-contact training drillsProgression to more complex training drills, e.g. passing drills in football and ice hockey. May start progressive resistance trainingExercise, coordination, and cognitive load
5. Full-contact practiceFollowing medical clearance participate in normal training exerciseRestore confidence and assess functional skills by coaching staff
6. Return to playNormal game play

Contact us to learn more or book an initial assessment here to get started with your therapy today!

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“It’s Just A Sprain” – The Importance Of Physio For Ankle Sprains

An ankle sprain is a common musculoskeletal injury caused by a tear or damage to one of the ligaments surrounding the ankle joint. It is frequently the outcome of an event, such as a sports contact, a trip, or a misstep while walking. It can affect people of all ages and athletic abilities.

Ankle sprain symptoms can vary greatly in terms of the degree of pain, limitation of movement, and swelling present. These are usually determined by the location and severity of the sprain.

Physiotherapist Nada Testing For Mobility

However, regardless of the severity of your symptoms, if you suspect you have hurt your ankle, you should consult a physiotherapist as soon as possible. Ideally, within 36-48 hours after the injury, to ensure that the pain and swelling have a chance to settle before starting.  In the meantime, at home, use the R.I.C.E. routine (rest, ice, compression, and elevation) to promote the healing process.

Physiotherapy early on can reduce the chance of additional ankle issues such as persistent pain, stiffness, lack of movement, or strength. Your physiotherapist will be able to check the severity and instability of your ankle sprain, as well as any functional limitations, and rule out anything more serious, such as a fracture.

Nada Checking Pain, Swelling, and Stiffness of The Injured Ankle

Treatment with a physiotherapist will use a combination of exercise and manual hands-on therapy to improve strength, range of motion, and proprioception of the ankle.

In the case of most ankle sprains, rest alone is unlikely to be an effective treatment method. Being proactive and obtaining treatment will not only encourage and accelerate your ankle sprain recovery time but will also maximize ankle strength and prevent re-injury in the future. A physiotherapist can educate you and design an exercise program for you to restore the function of your ankle joint and surrounding muscles.

If you believe you have sustained an ankle sprain or are experiencing ankle pain, book an assessment with one of our qualified physiotherapists here!

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Balancing the Body’s Harmony: The Ancient Art and Modern Science of Acupuncture

Acupuncture is becoming increasingly popular, yet many people remain reluctant to use it as a form of treatment. So, what exactly is it, and how can it help you? We answer these and more below!

What Is Acupuncture?

Acupuncture is a therapeutic technique of inserting fine, one-time-use pre-sterilized needles into very specific points along the body to assist in pain management and healing of injuries. Patients often ask us if acupuncture is painful. The needles used for acupuncture therapy are extremely fine – patients likely feel a small poke but once the needle is inserted, most patients do not feel much pain.

How Does It Work? – Traditional Chinese Medicine

Acupuncture was developed more than 3,000 years ago in China. In Traditional Chinese Medicine (TCM), injuries or illnesses are believed to be the results of an imbalance of energy within the body, specifically within meridians, which are channels of energy flow throughout the body. Acupuncture is used to help restore energy balance by placing fine needles at specific points along these meridians.

How Does It Work? – The Gate Control Theory of Pain

Although acupuncture is an ancient practice in Eastern medicine, its use in Western medicine is relatively recent. Though the exact reason why it works is not totally clear, Western medicine has several different theories as to how acupuncture helps with injury recovery. One of those is the Gate Control Theory of Pain.

The Gate Control Theory of Pain outlines how pain signals reach the brain from the spinal cord. In simple terms, if the ‘gate’ is open at the level of the spinal cord, a pain signal can pass through, reaching the brain where the pain is perceived. If the ‘gate’ is closed, a pain signal cannot pass through, and therefore the brain does not perceive pain. So, using this theory, applying a non-painful stimulus when someone experiences a painful stimulus can activate the closing of the gate and decrease the pain signal to the brain. An example of this would be if someone bangs their knee against a hard surface. Usually, our first instinct is to rub the knee (a non-painful stimulus), which helps us feel less pain.

What Injuries Can Be Treated With Acupuncture

Acupuncture can help in the healing process of many muscle and joint injuries. However, it is important to note that it won’t exactly heal these injuries. For example, if a muscle is torn, acupuncture will not repair the tear. However, it can assist in the symptoms associated with the tear, primarily by decreasing pain. Acupuncture has been used to aid in the recovery of a number of injuries, such as rotator cuff tendonitis, tennis elbow, and mechanical neck and back pain.

What Are The Risks Associated With Acupuncture?

The risks associated with acupuncture treatment are relatively minimal. The most common side effect is soreness and/or bruising in the region where the needles are inserted. The risk of infection is extremely LOW since the needles are pre-sterilized and used once. Some people might feel light-headed or dizzy after acupuncture treatment, so it is important to make sure you are well-hydrated and have eaten before your treatment session. If you are pregnant or have had other medical conditions (ex., cancer, stroke, etc.), there are certain points or areas that your practitioner will avoid. This is why it is extremely important to be thorough when reporting your medical history to your practitioner.

If you would like to learn more, ask your practitioner to discuss whether it would be an appropriate option for you, or book an initial assessment with us here!

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Is it Sciatica?

Chances are, if you’ve had back pain or leg pain, you’ve heard the term Sciatica.

So what is it?

Sciatica refers to an injury to or compression of the Sciatic Nerve. This is a very large nerve that originates in the lower back and runs down the back of each leg.

To give a bit of background detail… nerves innervate our whole bodies, and via electrical impulses, provide both power to the muscles and sensation to the skin. When a nerve is injured or compressed, we can experience symptoms of pain, weakness, numbness, or tingling.

Symptoms of Sciatica:

Pain that can go down the back of the leg (from the gluts, down into the back of the thigh, into the calf, and into the top or sole of the foot)

Numbness along the same area

Weakness in the leg with certain movements (e.g., does your foot get caught tripping as you walk? Are you able to walk on your toes?)

Tingling along the same area

Causes of Sciatica?

Disc bulges or herniations in the lumbar spine (the disc can press on the nerve)

Spinal stenosis (the canal through which the Sciatic nerve travels has narrowed due to arthritic changes and that can cause pressure on the nerve)

Piriformis syndrome (muscles in the glut area can get tight and compress the nerve as well)

If you are experiencing any Sciatic symptoms and they are not improving/worsening after 2-3 days, then Physiotherapy can likely help!

We do a thorough assessment to find the source of the nerve compression and provide:

Manual therapy techniques to relax tight muscles and help the nerve glide more easily

Additionally, manual therapy techniques can help take the pressure off from disc bulge or herniation and improve joint mobility

Exercise therapy to strengthen the back and core, stretch the tight musculature, and glide the nerve more freely

There are exercises we can show you that also help take the pressure off the nerve if the compression is happening in the spine

PT Kristina performing the slump test

If you’re not sure, you can always give us a call and ask one of our physiotherapists!

Other recommendations in the meantime:

Performing gentle stretches like the image above can help relieve symptoms!

Try ice or heat on your back or gluts

Speak to your primary physician regarding pain management options

Avoid exclusive backrest

If you are doing any exercises that aggravate your symptoms, STOP them temporarily

Reduce your general activity i.e. “take it easy” for the first few days

Alternate positions (sit, stand, walk) rather than doing one for a prolonged time

Do not lift anything heavy, e.g. >20 lb, especially from the floor

Do not ignore this issue for weeks because it likely WILL get worse and it will then take longer to heal…

If you would like to learn more or book your initial physiotherapy assessment along with treatment, book your appointment now.

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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?

NO!

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!

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Palermo Physio and Wellness Labour Day Long Weekend Hours – 2022

We hope that everyone has a safe and fun labour day long weekend.

Please find the clinic hours below for Palermo Physiotherapy and Wellness Centre.

Saturday September 3, 2022 – OPEN 8am-1pm

Sunday September 4, 2022 – CLOSED

Monday September 5, 2022 – CLOSED

Tuesday September 6, 2022 – OPEN regular hours

Please contact us at 905-582-9700 or info@palermophysio.ca to book an appointment or if you have any questions.

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Oakville Physio Nada – Team Tuesday at Palermo Physio and Wellness

As a Senior PT at or North Oakville clinic, Nada has been a practicing physiotherapist for 10 years after having graduated from McMaster University with her MScPT in 2012.

Prior to becoming a physiotherapist, she completed her Bachelor of Science degree also at McMaster. Nada believes in continuing education and is always learning formally and informally Her further training includes acupuncture training from McMaster University and certification in Selective Functional Movement Assessment.  Nada hopes to continue her education by adding skills in areas such as manual therapy and soft tissue techniques. Nada choose the field of physiotherapy as she has always had a passion for sports science and rehabilitation.

Nada believes physiotherapy treatment should be client-centred and individualised to meet each patient’s particular needs. She is committed to providing evidence-based patient care and her ultimate goal for physiotherapy treatment is to facilitate independence and function. She enjoys working with a variety of patients from those who are post-surgical (rotator cuff repairs and total knee replacements etc.), post-fracture, and patients with a neurological focus (Parkinson’s disease, post-stroke Physio).

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

Nada treats patients of all ages and stages! She has recently taken part in continued physio training for pediatric patients. Somehow Physio Nada landed in the House of Slytherin from the sorting hat even though she is super kind and empathetic!

Nada has a special interest in working with patients who are going through cancer related treatments and surgeries such as post mastectomy.

She has recently taken part in a Yoga Teachers Training further skills she can help patients with, as well as for her own enjoyment!

Contact us to book in for a Physiotherapy assessment with Physio Nada.

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Josephine (Acupuncturist & RMT) – Palermo Physio & Wellness Team Tuesday

Josephine has enjoyed practicing Massage Therapy since 2009 when she graduated from Sutherland-Chan School and Teaching Clinic and is registered as a member of the College of Massage Therapists of Ontario. She has also completed the Contemporary Medical Acupuncture Program at McMaster University in 2012.

Josephine has since gone on and worked hard to become accredited in Traditional Chinese Medicine (TCM) Acupuncture.

Josephine’s massage therapy treatments are tailored according to the client’s needs in order to ensure the best results possible. She has vast experience in areas such as Swedish massage, prenatal and post-natal massages, sports recovery massage, trigger point therapy, deep tissue massage, Tuina, and acupressure. She enjoys helping patients with longer term pain relief through massage.

Josephine is passionate about health and massage therapy and as such is always looking for opportunities to advance and continue her education to provide the best massage and massage outcomes for her patients. Josephine loves to go for walks and enjoys different types of exercise!

Contact us to book an Acupuncture or Massage Therapy appointment at our North Oakville clinic.

Nature and greenery in an afternoon light.

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Brayden (RMT) – Palermo Physio & Wellness Team Tuesday

We would formally like to welcome a new (ish) member of our Oakville Physio and Wellness team to the clinic!

Brayden is a Registered Massage Therapist (RMT) who graduated from Sutherland-Chan in 2021. He is also a Registered Kinesiologist since 2017, with previous experience helping clients rehabilitate from long term disability and work injuries.

North Oakville RMT and kinesiologist

His passion for helping people led him to become an RMT. He enjoys working with clients to overcome musculoskeletal injuries, relaxation, postural corrections, sports injuries, and pain management.  He holds certifications in chronic pain management, functional ability evaluations, and ergonomic assessments.

In his spare time, Brayden enjoys reading and participating in a wide range of sports including tennis, squash, hockey, baseball and golf.

Contact us to book in with RMT / Kin Brayden or if you have any questions in how he can help you!

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