Category Archives: Physiotherapy

Low Back Pain isn’t all Equal

Not all back pain is the same, so why would you follow generic exercises online?

Having a personalized Physiotherapy assessment allows your Physiotherapist to provide you with specific advise and specific exercises tailored for you and your issues. Whether it’s pain, stiffness, weakness, we are here for you. 

A physiotherapist will often work in collaboration with a Registered massage therapist or acupuncturist to help you optimize your recovery or management.  

There are many structures in your back that can lead to your pain or discomfort. 

Oakville Physiotherapy clinic fall prevention

Muscles- skeletal muscle help with movement. They can also help with stiffness (think someone trying to push you over). There are muscles that help with both. The muscles can be injured through getting pulled or a strain. It maybe from asking them to produce more force then they are able to all at one time (like lifting a car tire) or from repeated smaller lifts that make the muscles tired and can injure them at lower levels (shovelling dirt in the garden). The low back muscles can spasm or tighten aggressively to protect themselves or the other structures around them.

Joints – our spine is made of multiple joints. They slide over one another to provide movement when the muscles pull on the bones they are attached to. They help absorb force as well. In the low back the joints help with more flexion and extension (forward and backward bending), in the upper back the joints allow more rotational movements. The joints of the spine are largest in the low back around the pelvis because they are responsible for carrying more weight. They are smallest in the neck or cervical spine. When a person does head stands they are putting more force on these joints that was intended by our evolutionary development. Joints may, but not necessarily cause us pain when they have arthritis, they can also become acutely sore with a sudden injury like a car accident.

Discs- the discs are between the bodies of the vertebrae. They help absorb force and keep the joints nicely spaced apart. They give nutrition to the vertebral bodies above and below them. The outside of the disc is called the annulus it is very strong. Discs in the low back tend to be injured with heavy lifting type injuries that our bodies are not prepared for or when fatigued. 

Nerves – nerves send messages to and from the spinal cord and brain. They are generally irritated or injured with compression force, stretch (burner or stinger), or chemical irritation (inflammation). They are involved in sending pain messages. If the spinal nerve roots have one of the above issues, we can have motor (muscle strength /control) problems and /or pain /numbness in the area that those nerves supply. 

Brain-your brain is the keeper and senser or information. It is closely involved in how we experience pain. 2 people can have the same issue and have a very different pain experience. It’s important to address our thoughts and feelings about our pain and injury and how it affects our life. Previous life experience can also drive pain.

Organs – our organs actually have little local sensation and rather send messages further away. This is called visceral pain. Then most well known is probably the experience of a heart attack. It can be felt in the mid back, jaw, left shoulder and arm etc. When pain doesn’t make sense with a Physiotherapists assessment they will with your permission send information back to your primary health practitioner for potentially a closer look by them.

These sources of pain do not happen in a vacuum. Often there are a variety of sources of discomfort and one main driver. 

Your physio helps distinguish which is the driver of your issue and provides a treatment plan. Their role is to help in the acute (fresh /new) stage and help with function and management beyond that. 
Once you have had an injury or issue it is often true that it is more likely to happen again. This does not mean that you are damaged forever, or that you have a “bad back”. 

This may be because a person doesn’t optimize recovery and maintenance. Physiotherapists and massage therapists can help you with this. 

oakville physio clinic for joint replacement rehab and physio

Read our next blog post for tips on optimization.

Remember, not everyone is the same what works for you may not be of benefit to the next person. This is why an individualized assessment and treatment plan is important.

Contact us to get started with one of our North Oakville Physiotherapist’s, Acupuncturist and Registered Massage Therapists (RMT) (905) 582-9700

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Hip Dysplasia in Adults

In Canada, hip dysplasia is often identified early. The hips of infants are assessed in well baby checks. If there is an issue detected, imaging may confirm and early treatment can begin.

Hip dysplasia can sometimes be missed and identified later in life. This may be in children who limp when walking or running. This may in adults who experience hip pain.

The hip joint is a ball in socket joint. It is a joint between the socket of the pelvis and the head of the femur, or thigh bone. In hip dysplasia, the socket may be shallow, or the ball may not fit well in the socket. Due to this improper fitting, the hip joint may be less stable. It may also take more “wear and tear”. This can lead to pain and early onset of osteoarthritis.

In hip dysplasia the weight supported by the hip is likely distributed over a smaller surface area. This load can cause the joint cartilage to take the load asymmetrically and become damaged.

Common symptoms in adult hip dysplasia:

  • Pain in the groin region (may or may not radiate into thigh
  • Pain in the side of the hip
  • Sensation and description of popping or catching in the hip with activity
  • Pain that worsens with certain activities
  • Limping
  • Increasing challenge with more strenuous activities (sports or life)
Physiotherapy for hockey players

Confirmation of hip dysplasia is through imaging. This is usually with an x-ray but occasionally MRI’s or CT scans are used.

The imaging will help direct the specialist in terms of treatments. Often more conservative measures of explored first.

More conservative measures for the treatment of hip dysplasia in adults includes:

  • Physiotherapy – Exercises that help strengthen the muscles around the hip and core. Joint mobilization and movement exercises to optimize motion of the hip. Activity modification for a time and graduated return to activity depending on the goals of the patient.
  • Massage Therapy (RMT) – In conjunction with Physio, helps with pain management. Massage can help optimize recovery from rehabilitation exercises. The massage therapist will also treat tight muscles in the hips and low back that may have been compensating for pain and walking / running patterns.
  • Acupuncture – to help with pain and inflammation. Our North Oakville Acupuncturist treats many people for arthritis related pain management.
  • Injections – Your sports medicine specialist, rheumatologist, orthopaedic surgeon may suggest something like a steroid injection (cortisone injection), to help with pain related to inflammation. This can be helpful if your pain is limiting you from participating effectively in your physiotherapy rehabilitation. For some people this is the last option in “conservative measures” before surgical interventions.

It takes time and effort to gain strength around a joint. This means that positive change happens over time. More consistent pain management should occur in the early stages of rehabilitation, but true strengthening and functional recovery with Physio happens over time with effort.

Showing a man doing video / virtual physio for injuries from a car accident / whiplash and low back pain.

This doesn’t mean that you will need to have treatment weekly. As your physio for hip dysplasia and hip pain progresses, your physiotherapy visits will likely space out. You will be asked to work on your rehab program at home independently if you are safe to do so. If you are not able to commit to a plan independently, it may be in your best interests to access follow-up physio with one of our North Oakville Physiotherapists more consistently.

Contact us to book in with one of our North Oakville Physiotherapists, Massage Therapists and Acupuncturist to help get you started in your hip pain / hip dysplasia rehabilitation. We are able to treat the whole family at all ages and stages.

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Hip Dysplasia in Infants – and a Physio’s Role

“Put your hands on your hips!”

A lot of people’s response is putting the hands on the waist at the top of the pelvic bones. The true hip joint from a Physio’s perspective is basically where the legs attach into the torso. The crease of the groin delineates this. You can also landmark by placing the heels of the hands at the top of the pelvis and the finger tips reach the greater trochanter of the long bone of the femur.

The hip, like the shoulder is a ball in socket joint. The joint is made of the hip socket, or the acetabulum of the pelvis), and the ball-like top of the thigh bone (the femoral head). The shoulder is more mobile and the hip joint is more stable. It is surrounded a cartilaginous labrum, strong ligaments connecting bone to bone, and big strong muscles.

What is developmental dysplasia of the hip (DDH)?

Hip dysplasia in babies occurs when the socket, or acetabulum is too shallow to cover the head of the femur / thighbone. The issue can also be with the femoral head. Dysplasia of the hip can range in severity and can affect one or both hip joints. Babies with dysplasia may have minor looseness of the hip to joints that come easily out of the socket.

It is common during well baby checks for babies to have their hips checked. This means that most babies are diagnosed with hip dysplasia in the first few months. This also means that treatment or monitoring can begin early.

If there are concerns of hip dysplasia in infants it is usually diagnosed with an X-ray or ultrasound imaging.

Common Symptoms of Developmental Hip Dysplasia:

  • One leg may appear to be shorter (this is the affected side)
  • The folds of the skin at the buttocks or thighs may look uneven from right to left
  • With movement of the hip there may be a sensation of popping
  • Less mobility or movement on one side
  • Limping once a child is walking
  • Toe walking
  • Waddling or duck-like gait.

As a parent or caregiver if you notice these and the baby has not been identified as having hip dysplasia, bring it to the attention of your paediatrician or family doctor for monitoring. It is important to identify and treat hip dysplasia early for best outcomes.

Causes of Hip Dysplasia?

It is not always know what the case of hip dysplasia is in infants. It is believed that there are many factors that can lead its development.

  • The shape of the pelvis may have a genetic component. If there is a family history of hip dysplasia, such as a biological parent or close relative.
  • Girls are more likely to have hip dysplasia
  • Left hip. The left hip is more commonly affected than the right.
  • Birth order – babies who are born first are more likely than later Bronte babies to have hip dysplasia. This is because the uterus is a tighter fit.
  • Birth weight over 9lbs
  • Decreased amniotic fluid volumes
  • Twins. Infant twins are more likely to have hip dysaplsia for the same reasons as above.
  • Feet down or breech positioning during pregnancy. The legs may stay extended rather than tucked up in the fetal position. Staying in a straight position may inhibit the hip joints from developing properly.
  • Swaddling the infant tightly with the legs extended. This may inhibit the healthy / natural joint development .
yoga stretching poses from an oakville virtual physio

Non-Surgical Treatments for Hip Dysplasia:

Observation / Wait and See

If the baby is less than 3 months of age and the hip joint is stable a wait and see approach is often taken. Education regarding swaddling, positioning and gross motor skills are helpful here. This may be done through the paediatrician or specialist as well as a Physiotherapist who works with babies. It is possible for the hip joint to form well on its own as the baby grows and develops.

Harness or Brace:

If the hip joint is unstable or more shallow it may be recommended that they wear a harness or brace. A harness called the Pavlik harness is used for babies under 4 months. It holds the hips in place and allows the legs some movement. It is generally worn 24 hours a day over 8 to 12 weeks. They will be monitored using ultrasound over this time. after the use of the harness they will be monitored over the next few years depending on the severity of the original dysplasia.

What is the Role of a Physiotherapist in Treating Hip Dysplasia in infants?

Physio for hip dysplasia depends on the age of the patient. It also depends on the chosen course of treatment.

Physio can be used to strengthening the muscles around the hips and work on gross motor skills. Gross motor skills include things like rolling, meeting feet to hands, crawling, and sitting. This is important if the baby is also slightly delayed by use of the brace or harness.

If the baby is not braced or harness, the Physio will comment on ideal hip positioning. Avoiding straight legs with knees together and encouraging the hips to fall apart to the sides. This is called a jockey position, or frog position. Using a baby sleep sack is another way to help this natural positioning.

Your Physiotherapist can help identify the positioning that looks best for your little one as well as baby wearing positions or carrying positions. They will also discuss how to optimally swaddle to avoid the tight legs extended position for your baby.

Some of our North Oakville Physiotherapists have a special interest in helping your little ones along. We do see and treat infants and children in our North Oakville Physio and Massage clinic. We are also able to provide follow-up Physio treatments and consultations via video. Private Physiotherapy for infants and children can be covered by your extended health plans. We are able to direct bill to most insurance companies.

Contact us to book in with one of our Halton Physiotherapists who treats infants and children also.

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Post Concussion Physiotherapy

A Physiotherapist can help you recover after a concussion.

Concussions, or mild traumatic brain injury, can be caused by any type of injury with a bump or jolt to the head and/ or neck. The majority of people who sustain a concussion recover from symptoms in a few weeks with proper care. There is a small percentage who take longer to recover from concussion and experience symptoms for a longer period of time.

A Physiotherapist can help in both cases.

Some Concussion Myths:

Common myths or misconceptions is that you need to hit your head or have lost consciousness to have experienced a concussion. Many people believe that if you are wearing a helmet at impact, you could not have experienced a concussion.

This is not the case.

Your brain is protected by your skull and the surrounding fluid (cerebrospinal fluid). It is also protected in a way by the surrounding neck musculature that keeps your neck from moving. Aggressive movements or impacts to the head that cause the brain to move in the skull may cause a concussion.

Signs / Symptoms of Concussion:

Everyone experiences a concussion differently. Signs and symptoms of a concussion can include one, or any combination of the following.

  • Headache
  • Neck pain
  • Light sensitivity
  • Dizziness
  • Problems with balance
  • Nausea / Vomiting
  • Difficulty with reading (comprehension / retention)
  • Memory disruption
  • Difficulty sleeping
  • Fatigue
  • Irritability

Symptoms of concussion can last for days to months. It is important to have a strong medical team including a Physiotherapist to help manage these symptoms and guide you through recovery.

What does Physio Treatment for Concussion look like?

Physiotherapy for concussion rehab looks different based on the person. It depends on a persons symptoms and goals.

One of the biggest roles of a Physiotherapist in post concussion treatment is education. Education of the patient and their family on progressing activity and how to manage the above symptoms is important. They will give you tools based on where you are in your journey.

Physio that combines treatment for your symptoms is important. This may include some combination of visual rehabilitation, vestibular physio, treatment for the neck joints and muscles as well as exercise therapy. These all help retrain the brain and connected systems effectively.

baseball player showing post ACL reconstruction rehab at Oakville Physio clinic

Our North Oakville Physiotherapists are trained in Physio treatment for concussion. We are happy to help and get you going. Whether it is a week, or months post concussion, our Physio’s are here for you and your concussion recovery.

Contact us to book your Physio appointment with one of our North Oakville Physiotherapists.

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Most common issues people are experiencing during the pandemic!

Ever since we re-opened our physical doors on June 1st, 2020 (during the initial lockdown, we were only available for virtual therapy!) some cases have stood out more than others…

  1. A lot of neck / upper back / shoulder / arm pain as people are working exclusively from home
  2. Injuries resulting from people taking advantage of being home to exercise more, specifically by running (e.g. Achilles issues)
  3. Chronic issues resurfacing because people have not being able to work out regularly at the gym (e.g. back pain)

1. Neck / upper back / shoulder / arm pain

The first issue has been directly as a result of the change in ergonomics and working longer hours! Think about it. If you didn’t have a home office, you probably ended up working at the kitchen table, or from the couch. Sitting for eight hours in a kitchen chair, or sinking into the couch the whole time, can get quite uncomfortable.

Plus, at home we don’t have meetings in conference rooms… we don’t drive to see clients… we don’t get up to go talk to someone at another desk… There are lot less breaks from sitting and a greater opportunity to work longer, especially when there is no commute back home!

So… we end up spending longer time in positions that are less than ideal, and end up putting stress on certain muscles or joints.

Not to mention the stress associated with a pandemic! You don’t know how long it’s going to last and it affects your life in so many ways both work and non-work related… And stress causes us to tense up, raises our heart rate and blood pressure, reduces our adaptability and immune system…

It’s no wonder we start having pain!

So what can you do about this?

The pandemic is not going away any time soon. If you haven’t already, it might be a good time to invest in your workspace at home. Here are some suggestions about how to optimize your workspace:

  • Desk and chair height should allow for your forearms to be parallel to the ground while keyboarding and mousing
  • Ideally, chair height should allow your feet to comfortably rest on the ground
  • Seat depth and distance from desk should allow for you to sit as far back as you can, so that you are taking advantage of the backrest
  • Backrests for the full back are preferable to backrests that only go up halfway
  • Backrests with adjustable lumbar support are preferable
  • Screen(s) should be at eye level so you are not constantly looking down
  • If you use a laptop only  consider getting a riser table so that the screen is at eye level, and a wireless keyboard so that your forearms can still be parallel to the ground
  • Consider setting up reminders on your phone to get up to move and stretch, or get a drink of water
  • If possible, consider switching for half an hour to the kitchen island with your laptop so you spend some time standing instead of sitting. Or, when you have conference calls, taking them standing.
physio blog at palermo physio about common injuries and pains during pandemic, discussing tips for home ergonomics
An optimal workspace ergonomic setup at home can make a huge difference!

These ergonomic modifications can make a difference over time. But if your pain has been worsening, let us know so we can help! We are considered an essential service and remain open during lockdown for all of our services: physiotherapy, massage therapy, yoga therapy, chiropody, and acupuncture!

2.  Injuries from exercising more

A lot of people have been walking more, especially in the past Spring and Summer. There have also been a lot more runners and cyclists. This is great news! These are activities that don’t require much (or any) fancy equipment and can be done alone, or with family.

However, when you are adding a new activity for exercise, overdoing it is a concern.

Here are some tips when adding in new exercises to your routine:

  • Do not go from 0 to 100! If you never used to run, start with 2-3x week, not every day.
  • Do not push yourself right off the bat! Start with light jogs, or a run-to-walk ratio. Think more about endurance (pacing yourself) rather than speed. Same goes for biking.
  • Fit bits and 30-day challenges are great motivators. However, pushing yourself to the limit for the sake of hitting a mark can cause more issues than it’s worth. If you are getting pain, do NOT push through it! If you really don’t want to skip the day, replace or modify the activity.
  • Recovery days are just as important as workout days. Whether it’s a full day of rest, or a lighter activity like yoga, recovery days are important to let your tissues recuperate and adapt. What’s more, exercise normally increases your heart rate, blood pressure, and muscle tension. Recovery activities are meant to reduce these metrics so your system is in more balance. This reduces the risk of injury.

If you’ve taken up running have you been having any foot, ankle, knee, hip, or back pain? If you’ve been cycling, any wrist or elbow or shoulder pain?

Oakville Physio clinic showing shoe tying
Running and walking are great activities during the pandemic to stay active.

Let us know so we can help! If you’re not comfortable coming in due to COVID-19 concerns, we continue to offer Telehealth services (video calls). Click here for more information.

3. Chronic issue resurfacing because we are not going to the gym

Do you have any chronic neck or back issues? Did you have a regular workout routine prior to the pandemic? Was this routine interrupted as a result and you’ve been noticing your old issues creeping back in?

If so, you are not the only one!

A lot of people manage certain conditions with regular exercise. They usually notice that if they are not as diligent about their exercises, their pain and mobility may worsen.

Unfortunately, access to gyms has been spotty. Even when lockdown restrictions were lifted in Summer and Fall, gyms were operating at limited capacity and by appointment-only. Unless you have all or most of your workout equipment at home, you were likely affected.

While investing in a new desk or office chair is cheaper and more pressing, investing in workout equipment is not. You may buy some free weights, or splurge on a stationary bike, but you likely are not replacing all the equipment you used to use at the gym.

Or perhaps it’s not the equipment that you miss, but the dynamic and instruction of group exercise classes.

Unfortunately, in-person exercise classes are gone for a while, but there are other options!

So what can you do?

Even if you don’t have chronic pain but would like to get back to being active, here are some ideas:

  • Accept that your workouts do not have to look like what they used to be. A lot of shoulder, core, and leg exercises have equipment-free alternatives that rely on body-weight resistance only!
  • If you have some free-weights but you used to use machines, the free-weights are still better than nothing!
  • If you miss the group classes, a lot of places have online classes. It may not be the same but it’s still better than nothing! Sometimes, it just takes a while to get into a new routine.
  • Take the opportunity to try a new form of exercise that doesn’t require gym equipment (just make sure you follow the tips outlined in the previous section!)
  • If you find it hard to get motivated at home, consider what puts you in the right state of mind… what kind of music do you like working out to? Is there a time of day that works best? Do you like having the motivation of peers? Then ask if some friends want to join you in a remote challenge! Are they free 2-3x week to attend an online class with you? Do they want to check in at the end of each week or each day to make sure everybody is meeting their activity goals?
  • If you need 30-60 minutes on your own 3x week for your health and well-being, have this conversation upfront with family members about helping you do this and how it’s going to work! You don’t have to do this alone!

If your chronic issue has flared up because of the lack of maintenance, let us know! We are here for you whether it’s an in-person appointment or virtually!

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What is Thoracic Outlet Syndrome?

It is easy to mistake the symptoms of Thoracic Outlet Syndrome (TOS) for other things.

TOS is a complex issue that can take time to diagnose. This is because the symptoms can be seemingly diffuse and difficult to pinpoint.

Thoraoc Outlet Syndrome is a condition affecting the upper extremities. There are a number of arm symptoms.

TOS is caused by the compression of structures in what is called the neurovascular bundle. The name is just what you think. This bundle contains nerves and vasculature (veins and arteries) that move together. They are responsible for sending messages to and from the brain and spinal cord, and blood to and from the heart.

The area of compression of these structures is in the thoracic outlet. The thoracic outlet is made of the area above the first rib, at the side of the neck, between the collarbone and rib and between the top ribs and the muscle of the pectorals minor.

Some Facts:

  • TOS is more common in women
  • Structural anomalies, can contribute to the development of TOS. This includes having an extra rib, or differences where some neck muscles attach.

Types of TOS:

  1. Vascular – Is less common. It affects the blood supply in the thoracic region.
  2. Neurological – Is broken into true neurological and symptomatic subgroups.
  3. True Neurological – is called true, because it can be confirmed using imaging.
  4. Symptomatic TOS – is the presence of symptoms without finding anything in the imaging. This is the most common type of TOS by far. Because of this many people are lead on a “wild goose chase” of tests and imaging, even before being sent to Physio, Massage, or Acupuncture.

Signs and Symptoms of Thoracic Outlet Syndrome:

The signs and symptoms can vary between people. They can fluctuate and range from an annoyance to very painful.

  • Pain – in the neck, shoulder, arm or chest.
  • Tingling and Numbness – in the arm and / or hand
  • Swelling, coolness, visible discolouration of the arm / hand are more rare symptoms.
  • Tension or thickening in the side neck muscles (called the scalenes).
Man at desk showing tennis elbow being treated by an Oakville Physio

Yes we Treat TOS at our North Oakville Clinic:

We benefit form working in a multidisciplinary clinic where we can work together to help the same person. We are able to collaborate and bounce ideas off of one another (with a patients permission of course).

Our Oakville Physiotherapists, Massage Therapists, and Acupuncturist are able to work within their scope of practice. This allows us to help a person with TOS manage their symptoms as well as improve.

TOS is generally treated conservatively. This means through the use of medications prescribed by your physician, exercises, and some hands-on treatment. Most cases do improve over time with consistent treatment including a home program.

Exercises for TOS focus on postures, nerve mobilizations, muscle strength and control of the shoulder blade muscles. Physiotherapists may provide some stretching, soft tissue techniques of tight muscles and mobilizations of the ribs and neck. Your Massage Therapist will offer gentle stretching, and massage of areas of tension. Your acupuncturist may provide acupuncture along the course of the nerves affected. This may help decrease the numbness and tingling, relax muscles, help with pain and help with inflammation.

photo showing Massage Therapy in Oakville

If you have been having pain, tingling, and numbness in the arm, we are here to help.

Contact our North Oakville Clinic. We service our local areas of Milton, Oakville, and Burlington within clinic and our Physiotherapists are able to “see” and treat patients virtually all over Ontario.

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The Role of Physiotherapy in “Long-Covid” and how to advocate.

We are learning every day about how Covid-19 affects our bodies. So much has been identified with regards to the common symptoms, whether mild or severe.

We go through a list of Covid-19 symptoms with every patient, at every appointment in our North Oakville clinic. We see the lists upon entering our local grocery stores.

There has been a little confusion with regards to mild symptoms. Many people have assumed because the symptoms they have been experiencing have been like their colds, that it couldn’t be COVID-19. This is not necessarily the case. This is also why our Physio’s, RMT’s, Acupuncturist and Chiropodists will not see you in person with any of these symptoms whether mild or severe. This is also why our PPE (personal protective equipment) standards are so high and why we ask you to wear masks to your appointments and wash / clean your hands upon entering the building and clinic.

But, that’s not the purpose of this blog.

The purpose of this post is to explore the role of community based Physiotherapists in treating patients who are recovering from COVID-19 or who have “long lasting COVID”.

In hospitals, Physio’s work to mobilize / move patients, they may provide breathing exercises, and as a person recovers they get them moving to prepare them for home or a rehabilitation facility.

Physiotherapists in the community such as us, work with patients to increase their quality of life, help with balance, increase strength and endurance, progress activities of daily living, help with various neurological symptoms.

Part of learning how Physiotherapists can help with COVID -19 recovery comes with learning more about what the long-term effects are.

Slacklining picture to show oakville and burlington physio and yoga clinic

Some people’s experience of the effects of COVID-19:

General Functional Limitations

Intensive care acquired weakness.

Weakness from immobility / bed rest at home / hospital.

Joint and body pain.

Chronic Fatigue Syndrome

If symptoms post-covid of fatigue, don’t resolve in 4-5 months of the infection, it may be diagnosed as Chronic Fatigue Syndrome. This is also known as Myalgic Encephalomyelitis.

Disturbance of Sleep

Cognition Deficits

Mood Changes / PTSD

Surprisingly, 86% of people with Long Covid report relapses over 7 months. Physical activity, stress, exercise and mental activity being the most common reported triggers of relapses.

Having decreased function and decreased ability to participate in activities of daily living are risk factors in hospital admission or readmission. Physiotherapist in the community have a role in helping keep people at home.

Physiotherapists in the community also will help optimize the recovery of patients who have experienced COVID-19.

There has been recent light shed on the fact that in general out-patient physiotherapy is not covered under OHIP in Ontario. It has been many years since it has been delisted and the people who qualify is quiet narrow. The amount of clinics who are able to take OHIP patients for physiotherapy treatment has been limited to a small number per capita. These clinics are “grandfathered in” and most of them are owned by large corporations, including hospitals.

As there are more people with a variety of symptoms as COVID long-haulers that could benefit from physiotherapy treatment that do not have access to them as noted in a recent CBC Marketplace article.

In the UK the NHS has invested in specialty clinics to focus on the health and recovery of COVID-19 long-haulers.

There are many Physiotherapists and other health care practitioners who are willing and able to assist these patients but there is a gap in many people’s ability to access care.

When we opened 6 years ago in North Oakville, we tried to apply to be able to accept OHIP and were told they were not giving out any more licences.

The good news is that we are able to assess and treat anyone because we are direct access. This means that we can assess and treat a person without a Doctor’s referral. We accept payment from private payers (yourself) as well as insurance companies other than OHIP.

The bad news is that there are many people who are not able to afford to pay out of pocket for care, especially right now.

What you can do:

It is easy to feel helpless these days. Your voice does matter.

shows woman receiving Telehealth / tele rehabilitation in Milton, Oakville, Burlington Ontario for pain.
  1. Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re’em Y, Redfield S, Austin JP, Akrami A. Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact. medRxiv. 2020 Jan 1.

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Trigger Finger and Physiotherapy / Massage

Your hand and fingers are a complex system of muscles and pulleys. These pulleys act as anchors for the tendons that pass under them and allows you to use your fingers in different positions. With these systems, your hand is able to make different shapes. These shapes and different fists allow for hand function in a variety of ways!

Trigger finger is also known as stenosing tenosynovitis. The finger or thumb when you open and close your fist may click or catch. The finger or thumb may close and get “stuck” in that position or open and be unable to close.

When trigger finger happens, the flexor tendons of the finger , or pulley may be thickened or enlarged and become “stuck” during movement. The area may have local pain and a thickening or bump may be felt.

Most commonly this will happen where the finger attached to the palm. Many may recognize this as the palm side of the knuckle. It can happen less commonly further up the finger at the palm side of the joint, or where the finger bends.

If it is left untreated, the locking and catching may worsen and increase in frequency. It can also affect the range of motion and function of the hands and fingers.

What Causes Trigger Finger?

The cause of trigger finger isn’t always known. This is called idiopathic. It has been linked with diabetes, rheumatoid arthritis, previous trauma, and carpal tunnel syndrome.

How can Physiotherapy and Massage help with Trigger Finger?

Our Oakville Physiotherapists will be able to assess your trigger finger for its stage of “triggering”. They’ll also discuss a plan of action with you.

Many people leave a trigger finger until it starts becoming more stuck and they have more functional problems with it. As with most things, early intervention and treatment are important.

Physiotherapists are direct access. This means you can book an assessment with one of our Oakville Physio’s without requiring a prescription from your doctor. Your private insurance may require one, so it is best to check.

Treatment may include activity modification, using a splint / brace, self massage, heat, and exercises that promote mobility of the fingers.

Your massage therapist will massage that area, the forearm musculature and may provide stretching as well.

You should avoid letting the finger lock or click, as best you can.

Oakville Physio clinic for sports injuries
Physiotherapy for Hands and Wrists

Please do not be discouraged if your trigger finger is slow to change and improve. It takes time for the tissues to adapt in such a way where it triggers. It takes time and consistency for the tissues to adapt and tigger less / stop triggering. We generally believe it is best to begin conservative measures and if this is ineffective over the

If you suspect that you have trigger finger of are developing trigger finger, contact us at our North Oakville clinic. Our Physiotherapists will be happy to assess you and discuss a treatment plan with you.

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Why we Love Animal Walks for Kids! – Oakville Physio

When our Oakville Physiotherapists are giving a home program for little ones, they often don’t follow the same “rep / set” scheme as teens and adults. They often resemble more play based activities!

These exercises for our young patients are given for different reasons and have bonus outcomes!

We love giving different animal walking exercises!

Benefits of Animal Walking:

  • Bilateral coordination – using both sides in a coordinated way.
  • Upper body strengthening
  • Lower body strengthening
  • Core strengthening
  • Vestibular input (input into the brain, inner ear and eye systems)
  • Positive carry over into other areas of your child’s activities.
  • They’re fun!

A Physiotherapist that works with kids may have a specific purpose for giving a specific animal walking exercise, but all of them are fun to try!

Examples of Animal Walking:

  • Bear crawls
  • Crab walks
  • Frog jumps
  • Bunny hops
  • Cat crawls
  • Snake slither
  • Duck waddles
  • Donkey kicks
  • Elephant swings
  • Flamingo hops
  • Horse galloping
  • Inchworms
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If your little one has a lot of trouble with one, not to worry, keep trying and focus on some easier ones to start. These are great for indoor activities in poor weather and on short breaks with virtual learning.

Keep it interesting by having them choose a card with an animal walk, make small scavenger hunt using different movements to go from station to station etc!

Our North Oakville Physiotherapists see kids both in clinic and virtually for physio assessment and treatment. Some things we treat are: development coordination disorder, delayed gross motor skills, hypotonia, toe walking, recovery after broken bones and being immobilized in a cast.

Contact us to book in!

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Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) is condition many people have heard about. Because it is so commonly spoken about, many pain and nerve issues involving the hand and wrist may be mistaken for CTS.

Carpal tunnel syndrome is a condition that affects the median nerve in the wrist, on its way to supply the hand. The median nerve can be squeezed in an area called the carpal tunnel. This area is on palm side of the wrist between the tops of the wrist bones (carpals) and the ligament that covers the space.

The median nerve supplies a sensation and motor component to the hand. The median nerve supplies sensation to half of the palm on the thumb side of the hand, the palm side of the first two fingers and the thumb side of the third finger. It also supplies sensation to the tips of the back parts of the same fingers.

In addition to sensation, there is also a motor or muscle component from the median nerve. It supplies some muscles of the palm surface of the forearm, wrist, and thumb. The muscles bend the wrist down, turn the palm down and help move the thumb.

Symptoms of Carpal Tunnel Syndrome:

CTS involves the median nerve, as such it can commonly produce symptoms of tingling, numbness or burning in the area mentioned above. The symptoms may appear gradually. Often people experience symptoms at night when they’re in positions that “squish” or compress the carpal tunnel.

The muscles the median nerve supplies may also be affected over time. This can produce atrophy (muscle shrinking) and weakness.

Causes of Carpal Tunnel Syndrome:

Many people experience symptoms of carpal tunnel over their lifetime.

Women tend to experience carpal tunnel syndrome more than men.

Jobs that require increased use of the hands and wrists can place people more at risk for CTS. Exposure to long-term vibration from tools, heavy or repetitive material handling, or repetitive bending and straightening of hands and fingers can increase the risk as well.

Medical issues such as having type I or 2 diabetes increase the chances of a person developing carpal tunnel syndrome. Pregnancy increases the chances of developing CTS. Other risk factors to developing carpal tunnel syndrome includes, menopause , hyperthyroidism and being overweight.

Occasionally recovering from a wrist fracture (break), strains and sprains can lead to carpal tunnel symptoms.

Carpal tunnel syndrome may also not have a direct traceable cause.

Diagnosing Carpal Tunnel Syndrome:

As Physiotherapists, it is within our scope of practice to assess and communicate a diagnosis to patients. The most common way we do this is through a thorough history of the issue as well as specific testing.

A physio will review a the history of the issue, your medical history, ask about your symptoms, and then test the wrist ads well as the areas above and below the wrist.

The physio will do special testing to try to bring on the symptoms you have been describing as well as to see if they can make a positive change.

Your family physician may oder tests before sending you to physiotherapy. This can include imaging of the area and other lab tests.

If the issue persists with conservative treatment, you may be referred to a nerve conduction study. This test analyzes the ability of the median nerve to transmit signals along its course to the muscles.

Treatment for Carpal Tunnel Syndrome:

The steps of care for carpal tunnel syndrome do not always make sense.

As physiotherapists we tend to suggest a progressive approach to treatment. More conservative to less conservative.

This would mean physiotherapy as a start and surgery as a last resort. Some people see a surgeon before attempting physiotherapy.

Recent studies have shown that physiotherapy for carpal tunnel syndrome can be just as effective, if not more, in treating carpal tunnel syndrome. Patients who see a physiotherapist sometimes improve more quickly after one month in comparison to people who have surgery,

Physiotherapy treatment for CTS may include hands-on techniques to help stretch and massage tight muscles and mobilizations to help loosen stiff joints. You Physiotherapist will also provide you with exercises and techniques for a home program to help manage your carpal tunnel syndrome.

North Oakville Medical Building Directory - showing Vitruvian Man

The surgery for carpal tunnel syndrome generally cuts through the ligament that covers the carpal tunnel. This should allow more space for the nerve. Full recovery as these tissues heal can often take months even though symptoms may be relieved initially.

If you have been experiencing the symptoms of carpal tunnel syndrome or have been diagnosed, it is advised to book in with a physiotherapist. They can help confirm the diagnosis and get you started with treatment.

If you would like to schedule an appointment with one of our North Oakville physiotherapists or acupuncturist to help treat and manage your symptoms please contact us.

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