Physiotherapy

What Is Vertigo? How Do You Treat It?

October 1, 2020 by Target Therapeutics Leave a Comment

Defining Vertigo or BBPV (Benign Paroxysmal Positional Vertigo) and getting treatment in the Kitchener-Waterloo area.

Are you experiencing symptoms like dizziness when moving your head, imbalance when walking, visual disturbance when looking around, nausea from the perception of “the room spinning” around you?

You may have vertigo or BBPV (Benign Paroxysmal Positional Vertigo).

There are many other possible causes for these symptoms, like high or low blood pressure, low blood sugar, a viral infection of the ear (vestibular neuritis), migraines, stress, vision loss etc. However one of the most common causes that can be addressed through physiotherapy is Vertigo or BPPV, which is a shift of the little “rocks” (otoconia) found naturally in the inner ear, that helps us keep our balance.

Normally, when we move a certain way, such as when we stand up or turn our head, these little rocks move around. Sometimes these rocks move from an area in the inner ear called utricle into a neighbouring area, called the semicircular canals. When we move the head in certain ways, the rocks in the semicircular canal move as well. Sensors found in the semicircular canal are triggered by the little rocks, which causes a temporary feeling of dizziness.

We are more likely to develop BPPV when we are older. That is because parts of the inner ear start to degenerate, just like other parts of our bodies. Other possible causes of vertigo are ie. head impact, high impact physical activities, maintaining the head in the same position for extended periods of time, like holding the head down while working at the computer for hours on a daily basis.

The positive aspect of the BPPV is that it is a mechanical issue, and through some specialized exercises (Vestibular rehabilitation) we can help the loose “rocks” get back to where they belong. Once this is achieved, the symptoms should improve and, hopefully, clear out in just a few sessions. They should not return in the semicircular canals once they are back in their “home”, the utricle!

It is a good idea to come for therapy when the BPPV/Vertigo is active, as you can notice an immediate change in how you feel.

You can definitely expect a temporary increase in the symptoms for the duration of the treatment and it might be a good idea to have someone else drive you back home. Or simply make sure you are not in a hurry to leave the clinic after the treatment.

The treatments are booked one on one with the physiotherapist, for one hour.

4 Steps To Healthier Workstation Ergonomics

July 24, 2020 by Target Therapeutics Leave a Comment

Many workplace injuries due to improper sitting posture at a computer desk can be avoided.

Here is a four-step checklist that you can carry out at your workstation, to make sure you’re comfortable, safe and productive at the office.

STEP 1: Your Chair

Push your hips as far back as they can go in the chair.
Adjust the seat height so your feet are flat on the floor and your knees equal to, or slightly lower than, your hips.
Adjust the back of the chair to a 100°-110° reclined angle. Make sure your upper and lower back are supported. Use inflatable cushions or small pillows if necessary. If you have an active back mechanism on your chair, use it to make frequent position changes.
Adjust the armrests (if fitted) so that your shoulders are relaxed. If your armrests are in the way, remove them.

STEP 2: Your Keyboard

An articulating keyboard tray can provide optimal positioning of input devices. However, it should accommodate the mouse, enable leg clearance, and have an adjustable height and tilt mechanism. The tray should not push you too far away from other work materials, such as your telephone.
Pull up close to your keyboard.
Position the keyboard directly in front of your body.
Determine what section of the keyboard you use most frequently, and readjust the keyboard so that section is centred with your body.
Adjust the keyboard height so that your shoulders are relaxed, your elbows are in a slightly open position (100° to 110°), and your wrists and hands are straight.
The tilt of your keyboard is dependent upon your sitting position. Use the keyboard tray mechanism, or keyboard feet, to adjust the tilt. If you sit in a forward or upright position, try tilting your keyboard away from you at a negative angle. If you are reclined, a slight positive tilt will help maintain a straight wrist position.
Wrist rests can help to maintain neutral postures and pad hard surfaces. However, the wrist rest should only be used to rest the palms of the hands between keystrokes. Resting on the wrist rest while typing is not recommended.
Avoid using excessively wide wrist rests, or wrist rests that are higher than the space bar of your keyboard.
Place the pointer as close as possible to the keyboard. Placing it on a slightly inclined surface, or using it on a mouse bridge placed over the 10-keypad, can help to bring it closer.
If you do not have a fully adjustable keyboard tray, you may need to adjust your workstation height, the height of your chair, or use a seat cushion to get into a comfortable position. Remember to use a footrest if your feet dangle.

STEP 3: Screen, Document, and Telephone

Incorrect positioning of the screen and source documents can result in awkward postures. Adjust the screen and source documents so that your neck is in a neutral, relaxed position.
Centre the screen directly in front of you, above your keyboard.
Position the top of the screen approximately 2-3” above seated eye level. (If you wear bifocals, lower the screen to a comfortable reading level.)
Sit at least an arm’s length away from the screen and then adjust the distance for your vision.
Reduce glare by careful positioning of the screen. Position source documents directly in front of you, between the screen and the keyboard, using an in-line copy stand. If there is insufficient space, place source documents on a document holder positioned adjacent to the screen.
Place screen at right angles to windows
Adjust curtains or blinds as needed
Adjust the vertical screen angle and screen controls to minimize glare from overhead lights
Other techniques to reduce glare include the use of optical glass glare filters, light filters, or secondary task lights
Place your telephone within easy reach. Telephone stands or arms can help.
Use a headset and speakerphones to eliminate cradling the handset.

STEP 4: Pauses and Breaks

Once you have correctly set up your computer workstation use good work habits. No matter how perfect the environment, prolonged, static postures will inhibit blood circulation and take a toll on your body.

Take short 1-2 minute stretch breaks every 20-30 minutes. After each hour of work, take a break or change tasks for at least 5-10 minutes. Always try to get away from your computer during lunch breaks.
Avoid eye fatigue by resting and refocusing your eyes periodically. Look away from the monitor and focus on something in the distance.
Rest your eyes by covering them with your palms for 10-15 seconds.
Use correct posture when working. Keep moving as much as possible.

If you’re sore, tight, or in pain and you think your desk job is the culprit, it can’t hurt to make an appointment with one of the highly trained and experienced Physiotherapists, Chiropractors, or Registered Massage Therapists at Target Therapeutics. We’ve been serving the Kitchener Waterloo community faithfully since 2006.

Physiotherapy & Chronic Pain Management

July 6, 2020 by Target Therapeutics Leave a Comment

Chronic pain management can be a real challenge. The highly skilled physiotherapists from Target Therapeutics in Kitchener Waterloo weigh in on natural and lasting pain relief through physiotherapy.

Physiotherapy For Pain Management

There is no question that Canada needs to address chronic pain in a more effective fashion.

More attention must be paid to drug-free forms of treatment like physiotherapy. Studies confirm time and time again the effectiveness of physiotherapy for the management and resolution of a wide variety of orthopaedic syndromes that cause pain. In physiotherapy, patients take an active role in the treatment and they are empowered with strategies to increase their control over their pain.

Physiotherapy provides an avenue to address and treat the underlying cause of the pain instead of simply masking it with medication. Functional goals are set collaboratively with the patient to determine success.

Canada needs to do something about its costly opioid epidemic. Canada needs to take a more natural approach to pain syndromes that focus on alternatives to opioids such physiotherapy.

Does Canada Have an Opioid Epidemic?

OxyContin has annual sales of over $35 billion in the US! How? The book Crooked by CJ Ramin, explains in detail the conspiracy behind the opioid industry that continues on an international basis to this day.

The studies seem to deliberately fail to report on the true addiction and death rates related to these drugs

They ignore the fact that four out of five heroin users in the US report that their opioid use began with medically prescribed drugs. In 1986 a paper was published in the journal Pain concluding that opioids could be safely and effectively prescribed with relatively little risk of adverse effects.

It was stated that just 1% of the patients who were treated had become addicted. This paper was used by the pharmaceutical industry to promote to MDs the prescription of opioids. It was not until recently that the paper originally published in 1986 was denounced as incorrect and not a real “study”, however to date, that paper has been cited in 635 other studies.

In their propaganda, the industry marketed to MDs that opioid therapy for chronic pain was no different from providing insulin to a diabetic. It has taken two decades for the Cochrane collaboration to find no significant benefit for opioids over NSAIDs or over-the-counter Aleve. Finally, now the American Academy of Neurology states that the risks of opioids in the treatment of musculoskeletal chronic pain patients far outweigh the benefits.

Canada has one of the highest per capita consumption rates of prescription opioids in the world

A staggering 21.7 million prescriptions for opioids were dispensed in Canada in 2015 alone. In Ontario, there has been a 1,566% increase in methadone maintenance treatment enrolments in the last 20 years. This increase in treatments co-insides with the rise of opioid prescriptions, suggesting a strong correlation.

There is no question that in some cases, medication is a necessity. But it isn’t always and many medications come with so many serious side-effects that can be worse than the pain itself.

Find a Highly Qualified Physiotherapist in the Kitchener Waterloo Region

At Target Therapeutics, our expertly trained and highly educated physiotherapists work diligently with you to get you out of pain without causing more problems down the line. They are among the best physiotherapists in the Kitchener-Waterloo region and our years of service in our community speaks for itself.

Call to speak to someone or book an appointment for physiotherapy.

Physiotherapy & Chiropractic as Preventative Medicine

June 9, 2020 by Target Therapeutics Leave a Comment

As humans, we often have to be motivated in some way before we actually take to action on so many tasks. Life is busy and our “list” of “to do’s” can seem endless and can add considerable stress to our lives.

PAIN is not only a great motivator to call us to action to address the health problems we face, but it is also considerable stress. When we are in pain, our ability to function is compromised and it can become impossible to cross many things off that “list.”

It may be surprising to know that physiotherapists and chiropractors and massage therapists have extensive training not only in treating existing painful dysfunctions but in preventing these dysfunctions from manifesting by identifying predisposing factors and working on their correction.

Senior couple spending time in their garden on a sunny day, planting flowers.

An experienced practitioner brings so much to the table when it comes to prevention because they have spent abundant time dealing with the causal factors of physical dysfunction and addressing those factors effectively and efficiently with symptomatic patients. Good, experienced physiotherapists and chiropractors routinely treat many conditions that could easily be prevented with education or a stretch or two or a few sessions of manual therapy.

Part of the problem is individuals accept “pain-free” as optimal. This is false. The majority of individuals who invest in their health on a preventative basis whether it be with therapy or some form of suitable exercise will not only FEEL much better than the status quo — they will BE better than the status quo.

This investment will likely also make them more productive and less stressed on a number of levels and time frames.

Perhaps it is time to reassess your priorities. How important is your body to you? Is your body more important than your car? How much do you put into preventative maintenance on your car each year? How much are you investing in the longevity of your body?

You may have heard the saying: “An ounce of prevention is worth a pound of cure.” I would like to provide a brief illustration of this as it relates to tight hip muscles.

Reduced flexibility of the hip musculature can come on for a number of reasons including past traumas, prolonged daily sitting postures, strength training, and degenerative disc disease. When the hip muscles are tight, the hip joint capsule can also become restricted and if this is not addressed, osteoarthritis develops and progresses.

When the hip capsule is tight, the knee joint, which is a hinge joint has to take on stresses for which it is not designed. This causes the cartilage of the knee joint to wear out (osteoarthritis) and the space between the thigh bone and the shin bone in the knee is reduced. Then the ligaments in the knee become lax because of the reduced joint space and the process of cartilage breakdown accelerates in the knee as it absorbs not only its own stresses but inappropriate stresses transmitted from the restricted hip.

Now an individual has knee pain for which they may seek therapy. This pain can be managed, but osteoarthritis is irreversible. Addressing the restricted hip now may reduce the knee pain to a degree, but stretching the hip with an unstable osteoarthritic knee is a substantial challenge.

Acupuncture and micro-current may now be necessary to loosen the hip in order to, in part, address the stresses prompting the knee pain. If this same individual saw an experienced physiotherapist before the onset of pain on a preventative basis years earlier, the hip restriction could have been identified before the onset of osteoarthritis in the hip and knee.

With 5 minutes of simple independent stretching 3 times a week, initially instructed by the physiotherapist and carried out at home by the patient, this scenario could have been averted. This is just one of many examples of the value of preventative physiotherapy and chiropractic care.

As regulated health care practitioners, it falls to us to serve our public by increasing awareness of the importance of prevention. Let us address your low back pain, hip osteoarthritis, etc., etc., before it becomes low back pain and osteoarthritis and curses you with debilitating symptoms and functional limitations. A much larger proportion of our caseloads should be patients who are attending for preventative measures to preserve physical health and optimal function.

Don’t let pain be your only motivator. Our practitioners are great “body mechanics.” Take the initiative to call us today — we can help not only take you out of pain but keep you out of pain before it starts.

Make an Appointment At Target Therapeutics Today.

Myofascial Trigger Points

May 12, 2020 by Target Therapeutics Leave a Comment

Our bodies are covered by soft tissue called fascia, and the fascia that surrounds the muscle is called myofascia. When we end up injuring our muscles or overusing them knots can form. These knots are actually adhesions that have formed within the myofascia itself.

These knots can cause a variety of issues ranging from pain all the way to limitations in movement. They can refer pain into varying parts of the body and can be mistaken for more serious conditions such as a stroke or a heart attack. ‎

Trigger points are more prevalent than most people would think. They are often the cause of neck and back pain that most people suffer from and our own posture has a major role in creating these knots. Our homes and offices are major reasons that these trigger points form as well as they often cause us to slouch or strain to see the monitors. Repetitive actions such as typing, using a mouse, or construction work is also conducive to trigger points with working in odd positions and a very repetitive work environment.

What can we do to help prevent trigger points?

Start by paying attention to your posture. That is a very key step in preventing trigger points.

Core strengthening is a major player in preventing lower back pain caused by trigger points formed from overused or overstretched muscles.

Correct your monitor or television so they are set at a proper angle as to not strain your neck muscles.

One of the best things to do is to have a professional health care provider who is trained in trigger point therapy to work on your trigger points.

Treatment For Hip Disorders: Osteoarthritis & Bursitis

April 2, 2020 by Target Therapeutics Leave a Comment

Our hip joints allow us to do an amazing number of things – walk on two legs, pivot, squat, even kick a ball. It is an engineering marvel to combine the stability required to balance the weight of the torso over a structure the size of a golf ball, with the substantial degree of mobility available. The high demands on the hip joints can, however, take their toll over a lifetime.

Osteoarthritis is the most common hip disorder affecting adults. Primary osteoarthritis (OA) has no recognizable cause, while secondary OA is thought to occur due to altered joint mechanics or following joint trauma. Obesity, excessive loading due to occupational or sport demands can contribute to the breakdown of articular cartilage. There is likely a genetic component as well. Muscle imbalances around the hip are also predisposing factors, as shearing forces or high compression load will cause abnormal wear and tear. Alignment issues of the low back, pelvis and leg can also contribute to abnormal forces around the joint.

Muscle imbalances occur as a result of weak, tight, or inappropriately recruited muscles. Our neuro-muscular system can develop certain abnormal pathways of firing, creating suboptimal movement, and potential damage to joint structures. If these are retrained before the cartilage damage is severe, it can halt the progression and reduce the symptoms of arthritis.

One of the most important groups of muscles for maintaining optimal compression and centring the ball, (or head) of the femur in its socket are the Gluteal muscles on the lateral side of the hip. Core strength and balance are also very important components of optimal hip health.

A second common diagnosis of hip pain is trochanteric bursitis. The most prominent lateral point on the hip bone is called the greater trochanter. It was commonly thought that the bursa overlying this point was the most common local cause of lateral hip pain. However, in a recent study, using real-time ultrasound, 80% of patients with lateral hip pain did NOT have bursitis. 50% of the 877 patients studied had tendinosis of their gluteal muscles, ie. a degeneration of the deep hip rotators tendon’s collagen in response to overuse, occurring when other stabilizer muscles weaken. It is part of what has been labelled Greater Trochanteric Pain Syndrome (GTPS).

Symptoms of both OA and GTPS can be similar. Pain from OA is usually felt in one or more of the following areas: the groin (most common), over the greater trochanter, or down the front of the thigh and knee. Usually, arthritis pain is reported with or after activity, progressing to pain at night or at rest.

With GTPS, point tenderness is noted at or behind the greater trochanter, typically worse at night, especially when lying on the affected side. Lateral hip pain with repeated stair climbing and squatting is more likely due to GTPS.

Maintaining adequate strength and flexibility of the hip muscles is an important component of treatment and prevention of both hip osteoarthritis and trochanteric pain syndrome. Physiotherapists are trained to assess these disorders. They can prescribe individual exercise where deficits in strength, mobility and balance are noted.