Target Therapeutics

Getting You Out Of Pain & Keeping You There | Kitchener-Waterloo Physiotherapy | Chiro | RMT

Target Therapeutics

Concussion Management

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ice hockey goalkeeper

What is a concussion?

A concussion is a type of traumatic brain injury caused by a direct blow to the head or by a hit to the body that causes the head and brain to move rapidly back and forth.

It considered a mild, reversible brain injury that affects the normal functioning of the brain.

What is so special about the brain?

The brain is made up of billions of neurons and the communications between these neurons are how we think, move, and feel. We want to protect these neurons and connections so we can accomplish our day to day activities and long term goals.

What should be done if a concussion is suspected?

If the signs and symptoms of a suspected concussion are observed, it is imperative to immediately be removed from the activity (whether it be work, school, or a sport).

The individual should first be evaluated for any signs and symptoms that would warrant a referral to the emergency department. There are many tools designed to help with the detection of concussion, including the Sports Concussion Assessment Tool 5 (SCAT 5) which is intended to be used by licensed healthcare professionals and the Concussion Recognition Tool 5 (CRT 5) which is intended for use by anyone.

These tools help with recognition of the signs/symptoms of concussion, removal from the activity as well as provide guidance surrounding the immediate care of a suspected concussion.

How do you manage concussions (based on the Berlin International Consensus Statement)

It is important to be assessed by a healthcare professional if a concussion is suspected.

The assessment for concussion is multifaceted and may include evaluation of cognition, balance/coordination, neurological function, neck joints & musculature, and temporomandibular (jaw) joints & musculature based on the symptoms being experienced.

After the assessment is completed, the 24-48 hours immediately following a concussion require both cognitive and physical rest to ease discomfort and decrease demands on the brain during the early stages of healing. After this immediate rest and the acute symptoms resolve, both physical and cognitive activities can then be gradually incorporated once again provided they do not increase symptoms.

There are designated Return to School and Return to Sport protocols that will help to gradually increase cognitive and physical demands. Although these protocols can be performed simultaneously, returning to cognitive demands (such as school or work) are to be completed prior to physical demands (such as sports or rigorous physical activity).

The majority of concussions resolve on their own within 14 days for adults and up to 4 weeks in children. However, if the concussion does not resolve as expected, rehabilitation can be done based on findings of an individualized assessment.

Concussion Treatment may include:

  • Cervicovestibular rehabilitation
  • Manual therapy of the cervical spine and temporomandibular joints and
    muscles
  • Adaptation, habituation, and balance exercises
  • Gait and head movement
  • Activity/sport-specific training drills”

Custom Orthotics vs. Store Bought Orthotics

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When weighing the options between a pair of custom orthotics vs. a pair of store-bought orthotics there are a number of things to consider.

The Pedorthic Association of Canada defines store-bought orthotics or over the counter foot orthotics as “mass-produced devices that are not unique to any person”.

Custom orthotics are defined as “an internal foot appliance which is manufactured from a three-dimensional image of the foot, and made from raw materials. Custom orthotics can accommodate bony deformities, and/or modify the movement pattern of the foot and lower limb”.

Store-Bought Orthotics

Store-bought orthotics are made with lower quality materials and are not very supportive through the arch.

Advantage: for a person with a lack of padding on their feet (i.e. fat pad dystropohy) or a person with normal feet who spends a lot of time standing or walking on hard surfaces, may find that a cushion may be all that is necessary.

Disadvantage: Materials break down faster than the higher quality materials used in custom orthotics.

Store-bought orthotics are made for an “average” foot shape and may not be ideal for all people.

Advantage: these orthotics provide a small amount of support for the average shaped foot.
Disadvantage: If the patient’s foot is not the same or similar to the shape of the store-bought orthotic then the level of comfort and support will be minimal if any is achieved at all.

Store-bought orthotics tend to be less expensive.

Advantage: They are less expensive which can be a good thing.

Disadvantage: Insurance companies will NOT cover the costs associated with store-bought orthotics and due to the wear and tear to the materials used, replacement is usually required every 3 to 6 months which is much more often than custom orthotics.

Custom Orthotics

Custom orthotics provide a large number of design options with respect to materials used so that the orthotic can be designed exactly to your needs.

This allows for a customized fit, feel and design for each individual and for the types of shoes that they wear. We can take into account the person’s foot, biomechanical control needs, the type of shoe the custom orthotic will need to fit into, the persons’ activities and any material allergies or discomfort the patient may have.

Custom orthotics tend to be more expensive.

Disadvantage: It is recognized that custom orthotics do have a rather large upfront cost

Advantage: When custom orthotics are made by a properly licensed professional, insurance companies will cover a portion, if not the entire cost, of the custom orthotics.

Key Factors to Consider:

Durability: The “lifespan” of store-bought orthotics are shorter than custom orthotics due to wear and tear on the materials used.

Cost: Custom orthotics are much more expensive however some or all of the costs are covered by most extended insurance policies and custom orthotics last much longer.

Time Sensitive: Custom orthotics require time to be manufactured and there is a 2-3 week time period from the examination to dispensation. In moments of urgency, store-bought orthotics can help with immediate relief.

Biomechanical / Motion Control: custom orthotics can be designed with exact specificity to suit your needs. These features are not available in off the shelf orthotics.

For further questions give us a call and we would be happy to answer any questions that you may have.

Bursitis

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shoulder bursitis

What is a Bursa?

A bursa is a bag of lubricant which provides a low-friction, slippery and smooth interfaces between two tissues in your body eg a tendon and a bone.

Bursae are found throughout your body, where muscles and tendons glide over bones. You have more than 150 bursae in your body. Without your bursa between these surfaces, your movements would be painful due to friction. Much like the pain associated with bursitis.

What Causes Bursitis?

Your bursa can be injured via direct trauma, or more commonly via repeated irritation.

During painful bursitis, your bursa loses its painless and low-friction gliding capabilities. The added bulk of the swollen bursa causes more friction within an already confined space.

There are several common causes of bursitis. They include the following:

  • Repetitive bursa irritation
  • Traumatic injury
  • Systemic disease
  • Any bursa in your body

— And remember there are 150+ can be susceptible to repetitive trauma due to poor muscle control of movement patterns. Identification and correction of these poor movement patterns falls into the professional skill profile of physiotherapist. Please seek their professional opinion especially in longstanding or repeat episodes of bursitis.

Movements and activities can become painful from either the pain-sensitive chemical reaction within the bursa or the swollen bursa can provide additional frictional forces in the subsequent movements.

A fall and land onto your knee can acutely compress your prepatella bursa resulting in knee bursitis

Bursitis Treatment

Bursitis treatment has several phases:

  • Reduce the acute bursitis pain,
  • Reduce the bursa inflammation,
  • Assess the cause and rectify any reason that would predispose to bursitis,
    Reduce Bursa Inflammation & Pain

Bursa treatment will usually commence with treatment modalities that aim to reduce bursa pain and inflammation. Treatment options may include:

  • Ice
  • Anti-inflammatory Medications
  • Anti-inflammatory Gels
  • Electrotherapy
  • Deloading taping eg Kinesio taping
  • Assess Non-Traumatic Causes

Bursitis pain usually settles within a few weeks with the appropriate bursa treatment. All non-traumatic origin bursitis should be investigated to discover what is causing your bursitis.

Recurrent flare-ups or recalcitrant bursitis can be common and frustrating for the sufferer. The important thing when managing persistent bursitis is to delve deeply into WHY your bursa is inflamed. Once the reason is identified, controlling your bursitis becomes a much easier project.

Remember the source of recalcitrant bursitis might be your poor biomechanics, muscle weakness, tightness, movement patterns or postural habits that your physiotherapist can identify and help you to correct.

Secondly, the cause may be disease-related. If this is the case, please consult your doctor. If they deem it appropriate, they may advise some tests, eg blood tests, to eliminate or confirm a potential systemic cause of your bursitis.

Prevent a Recurrence

Bursitis is often a secondary symptom caused by many other factors. The best form of bursitis treatment is to identify, and then address, any abnormal biomechanical of muscle control findings, to reduce your likelihood of a bursitis recurrence. Your physiotherapist is highly skilled in identifying these deficits to help you recover quickly from bursitis and then prevent a bursitis recurrence. After thoroughly assessing you, your physiotherapist may prescribe a stretching, strengthening, movement correction/control program.

The 7 Most Common Running Injuries

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young African american woman runner with headphones jogging outdoors in nature beautiful summer night - Fitness, people and healthy lifestyle

How physiotherapy can help prevent the most common running injuries

As a runner, you know how to push through. From bad weather to blisters to stitches on your side, you’ve trained to let the little things slide in order to cross that finish line—even when that comes to pain.

Though the joy of running is unlike anything else, the repeated movements involved can be hard on the body. We’ve all heard the stories or maybe even experienced some of them firsthand—the full-blown injuries that keep a runner’s shoes in the closet for weeks or months.

Whether you’re running for pleasure or training for a race, you’re bound to have aches and twinges along the way. Injury prevention isn’t about the absence of pain; it’s about having the right reaction when that pain comes along. A timely response will help you avoid acute injuries that could pull you from the pavement for an indeterminate hiatus.

A physiotherapy appointment is a great way to get answers to the questions you have about your running pain:

  • Is it safe to run through the pain?
  • What are the signs it’s getting more serious?
  • How can I treat the pain at home?
  • What exercises will help me keep running?

Your physiotherapist can help you with information, advice, and treatment
to keep you running, injury-free.

Here are the 7 Most Common Running Injuries and When to Book a Physio Appointment.

1. Runner’s knee

While it can affect other athletes, runners are the most commonly afflicted with this pain or tenderness in and/or around the kneecap.  According to a University of Calgary study, this type of pain accounts for 57% of all knee problems in Canadian runners— if you’re having pain in this area, it’s most likely runner’s knee.

Book a physio appointment when: You’re having twinges on the outside or inside of the knee when you begin your run, but then seem fine throughout, only to flare up afterward or during prolonged sitting—this is a sign that things could get worse without physio treatment.

2. Achilles tendinitis

Up to 20% of runners are affected by this injury, which appears when the Achilles tendon (connecting the two major calf muscles to the back of the heel) comes under too much stress. The tendon tightens and gets irritated, leading to the pain in the back of the foot.

Book a physio appointment when: You’ve got a dull pain in your heel during and after a run, but at home remedies like ice usually take care of it—book a physio appointment before this pain shows up even when you’re not running

3. Hamstring issues

Your hamstrings make up the majority of the muscles in the back of the thighs, propelling you forward during your run; injuries involving this group can be an issue of flexibility or strength. Hamstring strains are common and take a lot of time to heal—re-injuries often occur without the proper physiotherapy and if the re-introduction of training is rushed.

Book a physio appointment when: You have a constant ache or tightness in the back of your legs when you run, which you try to ease with a slower pace or a shorter stride—you’ll want to get physio before there’s a pop, snap or bruise.

4. Plantar fasciitis

Foot pain accounts for 15% of all running injuries, with plantar fasciitis mat the top of that list. This injury involves small tears and inflammation of the tendons and ligaments of the foot, resulting in pain that might feel like a dull ache or bruise along your arch or heel.

Book a physio appointment when: You’re having foot pain when you first get out of bed, walking around after sitting or the first few strides of a run. It may disappear after that, but you’ll want to avoid having that constant pain by consulting with a physiotherapist as soon as possible

5. Shin splints

Also known as medial tibial stress syndrome, this achy pain down your shins makes up about 15% of all running injuries. It may seem small, but these are actually tears happening around your shinbone and can develop into something more serious.

Book a physio appointment when: You can walk and even jump without pain, but there’s a tightness and ache around your shin when you run. Before it becomes too tender to touch (or walk), see a physiotherapist for simple ways to correct the issue.

6. Iliotibial (IT) band syndrome

When the band that runs along the outside of your thigh—connecting hip to knee and shin—gets irritated, runners experience a pain down the outer area of the knee joint. At 12% of all running injuries, it’s often mistaken for a knee injury.

Book a physio appointment when: Two to three kilometres into your run, you start experiencing pain and tightness on the outside of your knee. If you walk it out, the pain disappears, but this means it’s time for physio—before you hear the clicking or popping sensation of the IT band snapping against the joint.

7. Stress fracture

For runners, the constant impact of activity can cause too much strain on the shins, feet or heel bones and lead to a stress fracture—the most serious of all running injuries. Different than an acute fracture that happens in one brief moment, stress fractures happen gradually, which means they can be prevented.

Book a physio appointment when: You’ve got pain when you run, but also sometimes when you’re on your feet for too long. Like any progressive injury, it’s key to listen to your pain and respond early—a physiotherapist can help make sure you’re on track to prevent or recover from stress fractures caused by running.

Prenatal (Pregnancy) Massage. What Are The Benefits? Are There Any Risks?

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Congratulations! You are expecting.

pregnant mother applying cream on her belly

Some of our Registered Massage Therapists have special training along with years of experience and can provide the most effective and beneficial Massage Therapy treatments for you and subsequently, your baby.

With pregnancy, changes to your body are inevitable and are often accompanied by discomfort.

As your baby develops, it changes your center of gravity which results in the pushing and pulling on many tissues.

Our Registered Massage Therapists can address these concerns and help you be as comfortable as possible as your body goes through these changes.

Studies have shown that Massage Therapy is not only beneficial to the expectant mother, but it is healthy for your baby as well.

Quite simply, when the expectant mother feels well and is pain-free, these benefits are felt and positively affect your child.

In addition to the overall benefit to the mother and child, there is also evidence that Massage Therapy has positive effects on the labour and birthing process by:
– decreased pain in all stages of labour
– reducing the mother’s stress and anxiety
– increase the quality of your experience of the childbirth experience

Our Massage therapist will use ergonomic cushions and supports along with performing some or all of your massage treatments in side-lying positions, to ensure your safety and comfort during your Massage Therapy treatments.

We will work with you to develop a treatment plan that will complement the care you are receiving from you other health care providers and we will be happy to communicate with them if needed.