Search Results: Yoga

Pilates and Yoga now available at The Orthopaedic Therapy Clinic

Aniela Amio – Pilates and Yoga Instructor, Reiki practitioner is joining our team at the Orthopaedic Therapy Clinic. Aniela brings extensive experience in injury rehabilitation through Yoga and Pilates. She is a certified instructor Pilates, Yoga and Reiki. Her focus is on spinal health and injury recovery as well as pre and post-natal care. https://orthophysio.com/pilates-and-yoga/

Aniela will be an integral part of the therapeutic team, along with our registered kinesiologist, John Gray, in helping you to advance your recovery to return to fitness while reducing your risk of injury.

Aniela’s passion is to empower people of all ages and abilities to improve how they to move and help them to take care for their own bodies.  She is interested in and continues to expand her studies with workshops on the mind body connection, chronic pain, scoliosis, fascia, pre and postnatal health and recovery as well as working with the aging population.  Aniela has had the opportunity to work with professional athletes, dancers, chronic pain suffers and those recovering from spinal injuries and surgeries.

Aniela will be at our clinic on Tuesday’s starting February 19, 2019. Call us  at 416-925-4687 to book an appointment or chat with your therapist to determine when you are ready to benefit from working with her.

New Services – Pilates and Yoga now available at OTC….more

PIlates and Yoga

Aniela Amio

Pilates, Yoga & Movement teacher, Certified Reiki Practitioner level 2

Aniela completed her yoga certification at The Yoga Sanctuary in 2011, adding courses in meditation, Yin Yoga and Restorative Yoga shortly after.  She then went on to become certified in Mat Pilates with Body Harmonics in 2013, Reformer Pilates with The Mindful Movement Centre and Leslie Parker. She is currently working towards her Comprehensive Pilates Diploma with Body Harmonics (2019) with a special focus on spinal health and injury recovery, as well as pre and post-natal care.

Aniela  empowers people of all ages and abilities by teaching them how to move and care for their own bodies.  She hopes her students find joy, safety and strength in their sessions which translates into better quality and functional movement in their daily lives.  She is interested in and continues to expand her studies with workshops on the mind body connection, chronic pain, scoliosis, fascia, pre and postnatal health and recovery as well as working with the aging population. Aniela has had the opportunity to work with professional athletes, dancers, chronic pain suffers and those recovering from spinal injuries and surgeries.

Aniela is excited to collaborate and learn from the team at The Orthopaedic Therapy Clinic to further her education.  She looks forward to being an integral part of your recovery and journey to health and vitality. To arrange an appointment please call 416-925-4687 or email: aamio@orthophysio.com

Recently she has added the following courses and certifications to her education.

  • Movement and Exercise for Pregnancy
  • Post-Natal Reconditioning and Diastasis Recti Repair
  • Towards a Healthy Pelvic Floor
  • Strength, Balance and Fall Prevention for Seniors
  • Handedness and Scoliosis
  • Kinesiology of Pilates

She is currently completing her Pilates Level 3: CCSB Cadillac Chair Springboard and Barrels which requires 275 hours of training.

When Aniela isn’t teaching or taking courses you can find her in the park with her dog, travelling, or in a plant store deciding which plant baby to add to her home.

 

5 things to know about Iliotibial Band Syndrome

Many of us turned to running as our primary source of physical activity when COVID-19 forced us to close gyms, yoga studios and other public and group-based exercise facilities. This gave many the opportunity to experience the unique thrills of running such as:

  • completing our first 5 km run
  • beating a personal best time
  • achieving the elusive “runner’s high”

Some of us who rapidly increased our training loads may have experienced outer knee pain after time. Many of these people may have experienced iliotibial band syndrome (ITBS).

ITBS is characterized as sharp pain on the outer aspect of the knee that occurs with movements where the knee is slightly bent, such as going down stairs. It usually presents after a large increase in training volume in a short period of time. ITBS is a poorly understood injury which can leave clinicians and patients frustrated. I would like to share with you 5 things you should know about ITBS and how you can prevent it in the 2021 running season.

1. What is the Iliotibial Band, and what does it do?

The iliotibial band (IT band) (FIGURE 1) is a thick piece of fascia which runs from the outer aspect of the hip to just below the outside of the knee. Fascia is a tissue found all over the body which functions to transmit forces produced by our muscles throughout the rest of the body. To learn more about the role of fascia, take a look at an article written by my colleague, Igal Untershats, on functional fascial techniques.


(FIGURE 1: The IT Band)

You can find the IT band by feeling the outside of your pelvis and running your fingers directly down the outer part of your thigh until you get to your knee. The IT band functions in a few ways:

  • Stabilizes the outer knee,
  • Acts as an attachment for muscles in the lower body
  • Functions like a spring to store and release energy during walking and running.

2. What happens to the IT band when ITBS occurs?

    Near the bottom of the outer thigh, the IT band runs over a projection of the femur (thigh bone) called the lateral epicondyle (FIGURE 2). This part of the IT band is highly innervated and is also subjected to very high levels of compression force when the knee bends to 30 degrees (FIGURE 3). In running, cycling and hiking, we are continually moving through this position. During every step we take when running and every pedal we make during cycling we are moving through this high compression zone.  If the relative amount of compression increases at a rapid pace, like it does with an increase in training volume, the highly innervated part of the IT band can become irritated and lead to pain.


    (FIGURE 2: Lateral Epicondyle of the femur)

     

     


    (FIGURE 3: The right knee is bent to 30 degrees flexion. In this position, the IT Band is under high loads near the knee)

    3. Who is more likely to get ITBS?

    Those of us who quickly increase our volume of exercise that involves the knee moving into 30 degrees of knee bending, such as running, cycling and hiking are more likely to experience ITBS. Research has also shown that male runners are more likely to experience the condition than female runners1.

    In the case of runners, technique matters! If you run with your hips in an adducted position (closer to midline) you are more likely to experience ITBS as this places more strain on the IT band (FIGURE 4). This adducted position naturally occurs during downhill running as well as in runners who tend to run with a narrower running pattern.

     

     

     

     

    (FIGURE 4: In picture “B” the hips are more adducted towards midline which places greater strain on the IT Band on the outside of the thigh)

    4. What can be done to reduce ITBS pain?

    There are a few things which can be done to alleviate ITBS pain:

    • Training modifications: You will most likely need to reduce your current training volumes and may even need to temporarily replace running with walking or uphill treadmill walking, both of which reduce movement into the problematic 30-degree knee bent position. Once pain has settled, you can gradually return to your previous training volumes. Be careful to slowly and progressively increase these volumes or it may lead to more irritation of the IT band.
    • Hip Abductor strengthening: The hip abductors are a group of muscles which are very important for stabilizing the pelvis in a single leg stance position (FIGURE 5). As running is primarily a single leg exercise, improving the capacity of these muscles is of utmost importance! Additionally, the hip abductors function to prevent excessive adduction during running, so strengthening and improving control of these muscles can prevent cumulative strain on the IT band.
    • Gait pattern modifications: Running patterns come in many variations and as illustrated previously, particular patterns make runners more prone to injury. Altering your running pattern to a wider stance can be helpful for ITBS pain. Additionally, increasing cadence, or the frequency of steps per minute, can be helpful. Take a look at this video to understand why!


    (FIGURE 5: The Gluteus Medius muscle functions to stabilize the hip and to prevent excessive adduction in a single leg stance position)

    5.      When should I see a therapist for ITBS?

    If you are experiencing pain with running, seeing a physiotherapist or rehab specialist can help determine if ITBS is involved.  The diagnosis is key to your recovery.

    A skilled therapist, with experience working with runners, can help guide you through training modifications, strengthening exercises, running pattern changes and more.

    If you have knee pain and are unsure if it is ITBS or want to develop a training program to prevent this injury, please contact the Orthopaedic Therapy Clinic at (416) 925-4687 and schedule an assessment with Taylor Sipos, Registered Physiotherapist. You can also email Taylor directly at tsipos@orthophysio.com.

    Citations

    1. Charles, D., & Rodgers, C. (2020). A LITERATURE REVIEW AND CLINICAL COMMENTARY ON THE DEVELOPMENT OF ILIOTIBIAL BAND SYNDROME IN RUNNERS. International journal of sports physical therapy15(3), 460.

    Photo Credits:

    FIGURE 1: https://www.selectchirowellness.com/blog/2018/1/10/it-band-syndrome
    FIGURE 2: https://stuart-hinds.com/blogs/performance-therapy/recognising-and-treating-iliotibial-band-syndrome
    FIGURE 4: https://www.physio-network.com/blog/iliotibial-band-pain-in-the-runner-part-1-etiology-and-assessment/
    FIGURE 5: https://www.amitypt.com/2018/09/24/medius-and-minimus-the-unsung-glutes/

    Safe Exercises for Back Pain 1A

    Healthy Back On-Line Exercise Series – Safe exercises for your back

    One of the challenges in this pandemic has been to stay fit, particularly when you have pain or injuries.  Your therapists at The Orthopaedic Therapy Clinic recognized how difficult this has been for our clients and have been working on a number of initiatives to help you to exercise safely.

    (Watch the Video)

    We know that many of you are selecting on-line programs.  Some of these programs are confusing and most are not back specific.  We would like our clients to exercise with people who understand how to get you stronger through exercise and to limit your risk for low back pain.

    We are excited by your interest in our live Healthy Back online back series and decided to make some changes to allow more people to participate.  Beginning in mid- April, we are offering 2 new on-line classes each week for people who have experienced low back pain when they exercise.

    Who should participate?

    These classes will be suitable for most backs as each exercise will be completed in a spinal neutral posture.  If your back is a bit more particular about its directional preference https://orthophysio.com/healthy-back-on-line-exercise-program-directional-preference/, you can still participate as each exercise will also include a reminder of a modification for flexion or extension preference.

    Who’s teaching?

    Your classes will be led by one of The Orthopaedic Therapy Clinic’s exercise professionals.  Aniela Amio, Pilates/Yoga instructor https://orthophysio.com/pilates-and-yoga/ and John Gray https://orthophysio.com/our-team/therapeutic-fitness-professionals/, Registered Kinesiologist both have extensive experience in helping people who have back pain to exercise safely.

     

    Class format

    Technique is critical to getting the most out of these classes with the least amount of discomfort.  To help this work for you we have enhanced our use of technology to allow us to provide more immediate feedback.  Now if anyone wants immediate feedback, just leave your video live and the instructor will correct any concerns with your technique.  We will not be recording the sessions.

    Sessions will be limited to 8-10 participants.  A minimum of 8 is needed to host the class.

    Which Safe Exercise class is right for you?

    Healthy Back Basic Mat On-line Class for Low Back pain

    If you are able to complete light exercises you should benefit from Aniela Amio’s, Pilates/Yoga Instructor, basic mat class for low back pain. (Watch the Video)

    This series of 6 weekly sessions is gentle however it will help you to build your strength as exercises will be progressed throughout the series.

    This Zoom group class starts on Thursday April 29th, from 5:30-6:10 PM.

    • CLASS 1: Thursday April 29, 2021 5:30 -6:10 PM – Click Here for class details
    • CLASS 2: Thursday May 6, 2021 5:30 -6:10 PM – Click Here for class details
    • CLASS 3: Thursday May 13, 2021 5:30 -6:10 PM – Click Here for class details
    • CLASS 4: Thursday May 20, 2021 5:30 -6:10 PM – Click Here for class details
    • CLASS 5: Thursday May 27, 2021 5:30 -6:10 PM- Click Here for class details
    • CLASS 6: Thursday June 3, 2021 5:30 -6:10 PM – Click Here for class details

    Healthy Back Intermediate Strength On-line Class for Low back pain

    If you need more challenge take John Gray’s, Registered Kinesiologist, intermediate-level strength class for backs.

    Watch the Video

    This series of 6 weekly sessions will build your strength as exercises will be progressed throughout the series.

    This Zoom group class starts on Saturday April 24th, 2021 from 10:00-10:30 AM

    • CLASS 1 Saturday April 24, 2021 10:00-10:30 AM – Click Here for class details
    • CLASS 2 Saturday May 1, 2021 10:00-10:30 AM – Click Here for class details
    • CLASS 3 Saturday May 8, 2021 10:00-10:30 AM – Click Here for class details
    • CLASS 4 Saturday May 15, 2021 10:00-10:30 AM Click Here for class details
    •  There is no class  on May 22 of the Victoria Day weekend
    • CLASS 5 Saturday May 29 2021 10:00-10:30 AM – Click Here for class details
    • CLASS 6 Saturday June 5, 2021 10:00-10:30 AM – Click Here for class details

    Fees

    The  fee is $105 + HST for the entire 6 week session.  Individual sessions will be offered at $20 + HST per session only if there is room in the class one week before the session date.

    Register at 416-925-4687

    More information

    If you have any questions about the program or would like more guidance on whether you should participate you can reach out to your therapist directly.  Or send an email to physio@orthophysio.com and this will be forwarded to the right person to assist you.

    We are looking forward to helping you to stay fit and healthy.  Look for our other new programs coming soon!

     

    Healthy Back On-line exercise program – Directional Preference

    We are excited to announce our Healthy Back On-line exercise program.  We started this program as we recognized that many people were participating in on-line exercise programs however most of these programs are not specific for people who have injuries or have had back pain.  What makes our program unique is that it’s based on knowing your back’s directional preference and selecting exercises specific to your type of low back pain.    We use a Directional Preference System for low back pain to match your exercises to what your back needs.  This allows you to select an exercise class that is right for your back.

    Click here for more information on registering in our back exercise classes.

    Directional Preference and Back Pain Recovery

    As we continue our War on low back pain and the back Attack/Acute pain finally subsides, most people begin to have periods where they have no pain.  At this stage in your recovery, you will find that some movements feel OK, or even make your back feel better, whereas other activities irritate.

    When this happens, it is an indicator that you are ready to exercise.  What’s most important is to exercise using a program which respects your back’s Directional Preference.  This means your program should include exercises your back “prefers” and limit exercises which irritate.

    The avoidance of irritation, combined with the benefits of exercising based on preferences, will help you to move forward to become stronger and return to a full and active lifestyle.

    Knowing Your Back’s Directional Preference

    Initially, most people will need their therapist or physician to help them understand the underlying pattern connecting these right and wrong movements. At first it may seem a bit random until the trained practitioner identifies the directionality.   However, once you understand the directionality, this knowledge will help you make better decisions on what to do or not do as you are recovering.  It will help you to choose exercises, safe cardio workouts and engage in everyday movements safely.

    Directional Preference Designations

    Most backs exhibit one of three Directional Preferences:

    1. Flexion preference – your back prefers forward bending
    2. Extension preference – your back prefers backward bending
    3. Neutral preference – your back is best if you keep it in neutral. It irritates if you go into more flexion or more extension.

    Our New on-line Classes are for All Types of Back’s

    We are launching our exercise series with videos and classes in  Mid April 2021. Click Here to learn  more about each class

    These classes will be suitable for most backs as each exercise will be completed in a spinal neutral posture.  If your back is a bit more particular about its directional preference, you can still participate as each exercise will also include a reminder of a modification for flexion or extension preference.

    Why use Directional Preference Rather than Diagnosis?

    Our therapists, and many physicians, use the designation of Directional Preference to choose exercise programs.  This well-established format is used world-wide.  It is successful at helping people become more active because it respects the fact that even two people with the same diagnosis can have completely different directional preferences!

    For  example, although most people with spinal stenosis will prefer flexion, there is a small group of people who will do better with extension.

    A diagnosis of discogenic back pain gives limited insight into the type of exercise you need.  Some backs will need flexion whereas others will do better with extension.

    These variabilities are why it is essential to know your Directional Preference to engage in safe exercise at this time in your recovery.

    Key to your Success

    The key to your success in this series is to:

    1. Respect your Directional Preference and use it throughout the series
    2. Commit to understanding the technique for each exercise.  Use the reference videos, or your therapist, to ensure you are getting the most out of the program.
    3. Apply the tips and activation strategies that work for your body to prevent/limit pain from exercise.  Recognize that not every tip works for every person.  This is why we provide you with several options on how to get the correct muscles working.  Once you learn what works for you, apply this throughout the exercise program.

    We look forward to helping you get more active with safe exercise.  If you need further assistance, please call us at 416-925-4687 or contact your therapist at the following emails:

    Healthy Back Flexion Program – Knowing your Back’s Directional Preference

    We are excited to announce our Healthy Back On-line exercise program.  ( See Video here) We started this program as we recognized that many people were participating in on-line exercise programs however most of these programs are not specific for people who have injuries or have had back pain.  What makes our program unique is that it’s based on knowing your back’s directional preference and selecting exercises specific to your type of low back pain.    We use a Directional Preference System for low back pain to match your exercises to what your back needs.  This allows you to select an exercise class that is right for your back.

    Click here for more information on registering in our back exercise classes.

    Directional Preference and Back Pain Recovery

    As we continue our War on low back pain and the back Attack/Acute pain finally subsides, most people begin to have periods where they have no pain.  At this stage in your recovery, you will find that some movements feel OK, or even make your back feel better, whereas other activities irritate.

    When this happens, it is an indicator that you are ready to exercise.  What’s most important is to exercise using a program which respects your back’s Directional Preference.  This means your program should include exercises your back “prefers” and limit exercises which irritate.

    The avoidance of irritation, combined with the benefits of exercising based on preferences, will help you to move forward to become stronger and return to a full and active lifestyle.

    Knowing Your Back’s Directional Preference

    Initially, most people will need their therapist or physician to help them understand the underlying pattern connecting these right and wrong movements. At first it may seem a bit random until the trained practitioner identifies the directionality.   However, once you understand the directionality, this knowledge will help you make better decisions on what to do or not do as you are recovering.  It will help you to choose exercises, safe cardio workouts and engage in everyday movements safely.

    Directional Preference Designations

    Most backs exhibit one of three Directional Preferences:

    1. Flexion preference – your back prefers forward bending
    2. Extension preference – your back prefers backward bending
    3. Neutral preference – your back is best if you keep it in neutral. It irritates if you go into more flexion or more extension.

    Our First on-line Classes are for Flexion Preference

    We are launching our exercise series with videos and classes for the Flexion Preference back however we expect to add Extension and Neutral preferences in the near future.

    As you are participating in this program as a client of The Orthopaedic Therapy Clinic, your therapist will be able to help you to determine which class you should participate in.  Reach out to your therapist directly if you have any question on your directional preference.

    Your assessment combined with the following elements of your history help us to know that you likely have a flexion preference back.

    1. Your back feels better when you sit.
    2. Your back feels worse when you walk
    3. Your back feels better when you bend forward or with pelvic tilt type of exercises
    4. Your back feels worse with back bending or cobra type of exercises

    Why use Directional Preference Rather than Diagnosis?

    Our therapists, and many physicians, use the designation of Directional Preference to choose exercise programs.  This well-established format is used world-wide.  It is successful at helping people become more active because it respects the fact that even two people with the same diagnosis can have completely different directional preferences!

    For  example, although most people with spinal stenosis will prefer flexion, there is a small group of people who will do better with extension.

    A diagnosis of discogenic back pain gives limited insight into the type of exercise you need.  Some backs will need flexion whereas others will do better with extension.

    These variabilities are why it is essential to know your Directional Preference to engage in safe exercise at this time in your recovery.

    Key to your Success

    The key to your success in this series is to:

    1. Respect your Directional Preference and use it throughout the series
    2. Commit to understanding the technique for each exercise.  Use the reference videos, or your therapist, to ensure you are getting the most out of the program.
    3. Apply the tips and activation strategies that work for your body to prevent/limit pain from exercise.  Recognize that not every tip works for every person.  This is why we provide you with several options on how to get the correct muscles working.  Once you learn what works for you, apply this throughout the exercise program.

    We look forward to helping you get more active with safe exercise.  If you need further assistance, please call us at 416-925-4687 or contact your therapist at the following emails:

    Safe Exercises for Back Pain – New On-line Exercise Classes

    Healthy Back On-Line Exercise Series – Safe exercises for your back

    One of the challenges in this pandemic has been to stay fit, particularly when you have pain or injuries.  Your therapists at The Orthopaedic Therapy Clinic recognized how difficult this has been for our clients and have been working on a number of initiatives to help you to exercise safely.  We are now ready to share the first in a series of new initiatives. (Watch the Video)

    We know that many of you are selecting on-line programs.  Some of these programs are confusing and most are not back specific.  We would like our clients to exercise with people who understand how to get you stronger through exercise and to limit your risk for low back pain.

    Beginning the last week in February, we are offering 2 on-line classes each week for people who have experienced low back pain when they exercise.  These classes are with Aniela Amio, Pilates/Yoga instructor and with John Gray, Registered Kinesiologist. These professionals have extensive experience in helping people who have back pain to exercise safely.

    Please join us. Your 1st session for both classes is free of charge! 

    Healthy Back On-line Exercise Class – Basic Mat Class for Flexion Preference Low Back pain

    Aniela Amio, our Pilates/Yoga instructor, is providing a Basic mat flexion preference exercise session via Zoom.  This group class will be held on Thursday from 5:30-6:10 PM.

    Maximum participation is 10 people.

    CLASS ONE: Thursday Feb 25, 2021 5:30 -6:10 PM – Click Here for class details

    CLASS TWO: Thursday March 4, 2021 5:30 -6:10 PM – Click Here for class details

    CLASS THREE: Thursday March 11, 2021 5:30 -6:10 PM – Click Here for class details

    CLASS FOUR: Thursday March 18, 2021 5:30 -6:10 PM – Click Here for class details

    CLASS FIVE: Thursday March 25, 2021 5:30 -6:10 PM- Click Here for class details

    CLASS SIX: Thursday April 1, 2021 5:30 -6:10 PM – Click Here for class details

     

    Register by contacting us at 416 925 4687

     

    Healthy Back On-line Exercise Class – Basic Strength Training for Flexion Preference Low Back pain

    John Gray, Registered Kinesiologist will be offering a strength training session for people with flexion preference low back pain.  This group class will be held on Saturday from 10:00-10:40 AM

    Class 1 Saturday Feb 27, 2021 10:00-10:40 AM Click Here for class details

    Class 2 Saturday March 6, 2021 10:00-10:40 AM Click Here for class details

    Class 3 Saturday March 13, 2021 10:00-10:40 AM Click Here for class details

    Class 4 Saturday March 20, 2021 10:00-10:40 AM Click Here for class details

    Class 5 Saturday March 27, 2021 10:00-10:40 AM Click Here for class details

    Class 6 Saturday April 3, 2021 10:00-10:40 AM Click Here for class details

    Maximum participation is 10 people.

    Register by contacting us at 416 925 4687

     

    Who should participate?

    This class is targeted for people who have back pain with a diagnosis of  flexion directional preference.

    If you have this diagnosis, your current physiotherapy program will likely include pelvic tilt positions and exercises.   If you are not sure if this is your diagnosis and wish to participate, please reach out to your therapist to determine if this is the right class for you.

    What is the format?

    Each class will last 30 minutes and there will be an additional 10 minutes at the end of the class for you to ask questions.

    Each class will review:

    • finding your start position,
    • 3-5 strength and coordination exercises
    • 1-3 stretches and posture correction exercises

    The emphasis will be on technique and helping you to know when you are doing the exercise correctly.

    How much will it cost?

    We are offering the 1st class free.

    After that, the cost is $20.00 per session or you can sign up for the first 4 sessions in advance and get one class free at $60. The full price is $80 if sessions are bought individually.

    How to register

    Call our front desk team to register – 416-925-4687.  You will be sent a participation waiver and our Telehealth policy form.  Once these forms are completed, we will send you a Zoom link. These forms need to be received a minimum of one day in advance to ensure we can get the link to you in time.

    Privacy

    The sessions will be provided using Zoom pro.

    Each participant will be allowed into the session once their registration is verified.

    All participants cameras and microphones will be blocked during the exercise session as each session will be recorded for later viewing.  During the question period you can unmute and use your camera as this section will not be recorded, however you will be observed by other participants.

    More information

    If you have any questions about the program or would like more guidance on whether you should participate you can reach out to your therapist directly.  Or send an email to physio@orthophysio.com and this will be forwarded to the right person to assist you.

    What to do if these dates and times don’t work?

    Please let us know if these times and dates don’t work for you as we are planning to offer more classes once these dates have been launched.  Contact physio@orthophysio.com and give them the dates and times that work better for you.

    We are looking forward to helping you to stay fit and healthy.  Look for our other new programs coming soon!

     

    Core conditioning

    Core conditioning

    At the Orthopaedic Therapy Clinic, Core Conditioning is not just about the ab’s.  Core conditioning addresses the primary muscles that support the back and help reduce strain on many joints in the body.

    This service begins with an assessment to determine which of your core muscles need to be strengthened and whether you need to work on coordination.  It’s important to work on strength but more importantly you need to apply this strength to your sport and daily activities if you want to prevent injuries.

    Our team is highly-experienced in finding the underlying weaknesses and developing a program to restore your core support.

    Who will benefit:

    Core Conditioning can help with:

    • Recurrent low back or neck pain.
    • Improving your posture
    • Addressing why you get injured when you try to up your game in fitness, sport or just in everyday life.

    Service provided by: 

    John Gray RKin (Bio)

    Aniela Amio Yoga and Pilates Instructor (Bio)

    More information:

    For an appointment call 416 925 4687 or email:jgray@orthophysio.com

    The OTC Exercise Challenge

     

    Watch exercises our professionals recommend to help keep you moving for life!

    We want you to practice Safe Ex!  During lock-down many of you have given up exercises, increased your walking to 15,000 steps or suddenly subscribed to on-line classes.  Our Tele-Health appointments are telling us that you are getting injured by doing too much or too little.   We want you to stay active and be safe physically, mentally as well as virally.

     

    Creative ways to Exercise

    That’s why we have challenged our therapists to come up with creative ways to exercise while we are social distancing/isolating. See the links below for their videos and remember we are asking you to vote on them so they can win a prize!

    As we go along we will be adding to this by sharing exercise links that we like and let you know why we like them.

    Once we are out of isolation we will continue to provide you video’s on exercise through this page.  To continue with our theme of everyday activities and How Not to Get Hurt Doing Almost Anything we will be adding videos with specific techniques on how to do your exercises without getting hurt.

    Tips for practicing Safe Ex

    Tip #1 Exercise with professionals who understand your body.

    Work with your therapist or have your therapist provide parameters for your fitness people.  Take classes from the people you worked with before the lock-down as you know the technique and the level of the demand is right for you.  Many of them are on-line providing classes or Tele-health appointments

    Tip #2 Stop exercising when you feel fatigued.

    Technique matters more than reps.  When your technique falls apart the joints start to get injured.

    Tip #3 Avoid Group Ex.

    If you are just returning to fitness a group situation often encourages you to do more than you’re ready for or is too fast when you don’t fully understand the technique.  Start with one-on-one with a personal trainer who understands your needs or exercise on your own with a program provided by your therapy team.

    Tip #4 Don’t increase your program too quickly.

    Find a baseline program that works for you – no increased pain or joint strain but your muscles are being worked.  Then increase it by 10-15% every week.  If this is to much go back to your baseline and increase a bit slower (5-10%).  If you still can’t seem to progress – discuss this with your therapy team as often a small tweak to the program will  get you back on track.

    Tip #5 Recognize that daily fitness is not better than 3 x per week.

    You can walk daily and practice your therapy activation strategies daily but don’t do the same fitness program everyday.  Either plan for day on day off or split the program into two i.e. alternate upper body and cardio with core and lower body.

    Tip #6 Speak to your therapist when you are ready to leave the therapeutic nest

    Once you are feeling better and your therapy program is controlling your pain there is more work to do to get you back into life without re-injuring.  Now ideal time to speak to your therapist about next steps:

      1. Who should you exercise with? Your therapists can recommend good group exercise studios or personal trainers who are known to respect underlying conditions.
      2. Where to do Safe Ex? Discuss whether you should be in the pool, a gym or are best on your own.
      3. How often to do your program? See Point 5
      4. What type of Safe Ex is best for you? Gym and weights vs. Pilates/Yoga etc.
      5. Why do Safe Ex? Because you will feel great for it!!

    Click on our   YouTube channel to join our Safe Ex Challenge

     

    Igal’s Three Ingredient Recipe for Challenging Times

     

     

     

     

     

     

    Juliette’s  Safe  TRX Upper Body Exercises

     

     

     

     

     

    Taylor’s Couch Fitness: Safe EX Home Style!

     

     

     

     

     

    Maureen’s Safe EX Vacuuming!

     

     

     

     

     

    How to see more videos

    We will be posting new videos every week so watch for them by:

    Subscribing to our   YouTube Channel

    Liking us on Facebook

    Twitter Following us on Twitter

    And we are now on Instagram

    Vote on our Safe Ex Challenge

    They will also be on our Facebook, Instagram and Twitter accounts. Please vote by selecting like, retweeting or letting us know in the comments section what you find helpful. Your therapist is out to win it – so please help them to crush it.

    We want to hear from you!

    We would also like to hear what you are doing to stay fit and healthy. Let us know what you need guidance on and we will post a video on it.  Add that into our comments section and we will have a prize for the most liked reader recommendation.

    TeleHealth and Video Conferencing

    TeleHealth and Video Conferencing

    Virtual and Remote Therapy Sessions

    Self-care is more important than ever in these stressful times. We don’t want you to lose the progress you’ve made or get back into pain because of a change in routine. This is why  The Orthopaedic Therapy Clinic is now offering virtual and remote therapy sessions.

    This new service will allow us to see you in the comfort of your own home, not only now but also in the future!

    Watch Maureen Dwight RPT, Clinic Director explain how TeleHealth works: 

    What services can we provide?

    We can help you manage your pain, watch you exercise and check out your ergonomic set-up for your home computer or just how you are doing puzzles.

    You can call us at 416-925-4687 and leave a message or book with your physiotherapist directly at their email below to set up an appt. Plus, here are the inevitable forms we all have to look at and acknowledge: Telehealth Procedures and Informed Consent

    Maureen Dwight RPT mdwight@orthophysio.com

     

     

     

    Taylor Sipos RPT Tsipos@orthophysio.com

     

     

     

    Tiffany Shi RPT Tshi@orthophysio.com

     

     

     

    Who can we see?

    We can see any of our existing client’s or new clients who may benefit from this service. If you are unsure whether this will work for you we can set up a 10 minute free session to show you how it can benefit you.

    You must be located in Ontario at the time of the teleconference. If you have friends or family, outside of the Toronto area we can provide these services to them as well.

    Need help with getting motivated to exercise?

    Aniela Amio will be providing one-on-one Yoga, Pilates and Mindfulness sessions. She can also continue with your Physiotherapy assistant exercises under the supervision of the designated physio.

    Contact aamio@orthophysio.com

     

     

    JJohn Gray, Registered Kinesiologist RKin, MSc, CSCS Torontoohn Gray Reg. Kinesiologist will be providing one-on-one exercise sessions. He can also continue with your Physiotherapy Assistant exercises under the supervision of the designated physio.

    Contact jgray@orthophysio.com .

     

     

    How remote therapy sessions work

    It’s as easy as Facetime and Skype but more secure. We send you a unique link by email that brings you into a video conference. You can use your smart phone, tablet or laptop. Desktops can be used if you don’t need to move around during the appointment.

    Your privacy is paramount

    We have partnered with our Electronic Record Provider to make sure it’s compliant with privacy legislation (HIPIDA and PIPEDA).

    Planning your session

    Once you have set up a time, your therapist will send you the link. That’s all it takes other than a bit of pre-planning on your part to get the best visuals.

    Here are some things to consider prior to the appointment

    • Can your therapist see the area that hurts? This may mean you need to wear clothing that can be adjusted to show us the area.
    • Can we see you move? Make sure your technology can move to show us different views. We may need to see a full-length view or you lying on the floor/bed to do your exercises.
    • How much privacy do you need? Do you want to send your housemates on an outdoor walk while this is in process or have a videographer handy to help you with the technology?
    • How much privacy will the Orthopaedic Therapy Clinic provide? Our therapists will provide the sessions in a room separate from their colleagues.

    Will your insurer cover this?

    These sessions are noted as telehealth on your invoice and many of the insurers are committed to funding these sessions. 

    Early insurance adopters:

    Sunlife announced that they consider telehealth/virtual appointments the same as in office sessions

    Telus Health is the portal for many insurers. They have confirmed that their insurance companies will pay for telehealth/virtual appointments, however it’s always good to check with your insurer directly.

    How is this paid?

    We will call you to get a credit card to bill your session and email the receipt to you so you can submit it to your insurer. We are currently exploring options for online payments.

    If you have any questions please call us at 416 925 4687, email your physio directly at their address above or email physio@orthophysio.com and we will get back to you promptly!

    Be Safe and Be Well

     

    How to shovel snow without injuring your back

    types of snow shovels

    Winter can be a tough season for back pain sufferers.  For many people shoveling snow is almost certain to cause low back pain.  Perhaps surprisingly, as a former back pain suffer, I look forward to this season. I enjoy being outside in winter weather and view snow shovelling as a great recreational alternative to going to the gym.  What better than a heavy shovel of snow to raise my pulse, tax my obliques and work on my glutes.  The fireplace and a rewarding glass of wine after can also be a great motivator.   Heres how to shovel snow without injuring your back:

    TEC

    Whether these demanding activities will improve your fitness and strengthen your core, or cause you to need an appointment with your favourite physiotherapist, is often determined by how you approach the activity.  Here are a few easy tips which can prevent low back pain which I find can be easily remembered by using the acronym TEC:  Technique, Ergonomics and Core.

    T-Technique avoids snow shoveling back injuries

    Technique relates to how you shovel.  Whenever activities are heavy or repetitive the technique you select becomes more important. Video 

    Warm-up

    Too often it’s our head space that causes our injuries.  We dive in full force, trying to get the job done quickly when our body is not at the same level of readiness as our head. 

    When it comes to demanding activities, it is essential to prepare by warming-up if you want to shovel snow without injuring your back. 

    Don’t confuse this recommendation with stretching.  Although these terms are frequently used interchangeably, warming-up really means you should raise your body temperature.  This is easily done by starting an activity slowly and avoiding the hard stuff until you feel your body is prepared to work.  You will know you are ready to work harder when you feel warmer and your breathing and heart rate start to increase.  Save the stretching for after the work-out, when your tight muscles need to relax. 

    Take breaks

    The second mistake we make is trying to get a heavy activity done as quickly as possible.  If an activity takes two hours to complete, doing it all at once is not the same as breaking it into two one-hour sessions.  Instead plan for a 15-minute break to allow your body to recover.  This reduces your risk of injury from fatigue. Always remember that the heavier the activity, the more breaks you need. 

    Building strength, not injury

    The third most common exercise mistake I see is repeating an activity before your body is ready.  Exercise only makes us stronger if we allow our body to rebuild from the strain. Hard work breaks our muscles down and during this period we are weaker than before we started the exercise.  No matter what type of exercise you do, make sure you build in post-exercise recovery. 

    The need to recover is why we shouldn’t repeat the same demanding exercise two days in a row.  This allows sufficient time for our muscles to rebuild. Repeating heavy exercise before our muscles have had time to complete this physiological process raises our risk for injury.  

    Ideally, we should exercise on alternate days but when it snows three or four days in a row you may not have a choice.  When this happens try to reduce the intensity by taking more breaks or lifting smaller loads.   Alternatively, perhaps the kid next door needs to earn a few extra dollars.…

    To maximize recovery, take a page from the playbook of athletes and make sure you are well hydrated and consider your post-activity nutrition requirements.  In moderation foods that contain both sugar and protein provide your muscles with what they need for recovery i.e. low fat chocolate milk. http://www.rechargewithmilk.ca/compare-it.php

    Learn the technique of lifting with your legs as the key on how to shovel snow without injuring your back

    If you want to shovel snow without injuring your back you should “lift with your legs”.  Although I find that most people can recite this mantra they don’t actually execute it all that well. Rather than keeping their torso over their legs they lean forward.  When you are lifting in this posture it increases the difficulty of the task as you are now lifting the weight of the snow, the shovel as well as the weight of your upper body.  This can add 40 or 50 lb to a lift.   Keeping your shoulders over your hips reduces the strain on your back. 

    This video shows a difficult snow shoveling task .  The area is bordered by a shoulder height barrier.  The shoveller is bending her knees and lifting smaller loads to reduce the strain of the task.

    Use the right muscles

    As you squat to lift the snow, pause for a moment and feel which muscles are working.  You should be using both your thigh (quadriceps) and buttocks (gluteus maximus) muscles.  Many people who are at risk for low back pain don’t use their buttocks and overuse their back muscles.  The high strain on the back  muscles causes spasms.  

    Limit twisting 

    Your spine is able to twist but twisting while you are lifting a heavy load is a quite another matter.  In snow shoveling, twisting can be avoided by pushing the snow forward rather than throwing it over your shoulder.  If you need to twist, keep the load lighter and take more breaks.     

    types of snow shovels

    E-The right Equipment avoids back injuries

    Always take a moment to look at which tools you can use for the task.  A larger shovel will get the job done faster but it will also add to the strain.  A lighter, smaller shovel will take a little longer to complete the task however a few extra minutes is well spent in preventing an injury.  You can also consider one of the ergonomically designed, bent-handled snow shovels as they can make a substantial difference in the effort needed to push snow (see picture). 

    C-Good Core avoids back injuries 

    Despite following the best advice on technique and ergonomics some people will still get injured.  As a treating physiotherapist I have found this can often be traced back to mismatches between what you need to do the task and what strength your body has available.  Video

    Before you start the snow season, make sure your abdominals, buttocks and thigh muscles are up to the task. If the snow arrives before you have gotten your core muscles working it is even more important that you focus on the T and E in TEC as this will limit the likelihood of injury.  On non-snow days work on targeted exercises to gain the lifelong support you need to prevent injury.

    Next year start your pre-season fitness program in the fall, rather than waiting for the new Year.  Better yet keep the program going all year long as each season has its challenges and activity rewards.

    Need more advice

    If you need a fitness program our Kinesiologist, John Gray, or our Pilates/Yoga instructor, Aniela Amio can help you find your core.  They can also teach you the technique of how to snow shovel to without hurting your back.   If your back hurts even thinking about snow shoveling book to see one of our physiotherapists to get you on the right track.  Call us at 416-925-4687 or email physio@orthophysio.com to book an appointment.

    Safe exercises for scoliosis

    In my last blog I looked at exercises for adolescents with scoliosis, but what about adults?  How do you stay in shape, actively age and limit pain? Are there safe exercises for scoliosis?

    Up until recently there has been very little guidance for the adolescent who likes to exercise, and even less for the adult. Many people with scoliosis are nervous about exercising.  Will the wrong exercises make my scoliosis worse? Will the right exercises make the curves smaller?  Does exercising cause or prevent pain?

    Most activity advice is based on opinion and is often conflicting.  Some experts believe that the only exercise you should ever do is ones that are tailored to your specific curves.  This approach recommends you work with therapists who know Schroth, Scoliologic [1]or other Physiotherapeutic Scoliosis Specific Exercises (PSSE’s).  Some people believe you can do everything.  Others tell you to leave it well enough alone and do nothing.

    Fortunately, research is slowly providing more clarity and in October I was pleased to sit in on a paper presented at the World Low Back Pain Congress[2] in Antwerp which proposed guidelines for choosing safe exercises for adults with scoliosis.  The authors pulled together an expert group to review the existing research and used this to develop guidelines that can assist in making better decisions.   I find the advice pragmatic, although sometimes complex to execute.

    Here are the three factors they recommend you take into consideration when choosing exercises:

    Recommendation #1 – Pain

    Many people with scoliosis don’t have pain or any other symptoms.  If you have pain, the recommendation is to see a scoliosis specialist prior to starting a general exercise program.

    At The Orthopaedic Therapy Clinic we recommend seeing one of our physiotherapists prior to starting an exercise program.  This will ensure that the source of pain is assessed and appropriate modifications can be incorporated into your program.

    Recommendation #2 – Control your curves while you exercise

    It’s important to not allow your curves to increase as you exercise.  This requires good core support and body awareness to limit the compression on your spine.  Visually the curves should not be seen to collapse during the exercise

    At The Orthopaedic Therapy Clinic we recommend that you initially work one-on-one with a good core specialist as this will help you to develop sufficient postural control to reduce the demands on your curves.  All of our physiotherapists, kinesiologists and Pilates/Yoga instructor are trained in core control and can help you to become aware of how to support your spine while exercising.

    Recommendation #3 – Exercise in neutral if your scoliosis is complex

    This is the most difficult of the guideline recommendations to execute.  Much of the information required to categorize your scoliosis as complex or non-complex is not readily available.  It requires specialized tests and possibly exposing you to unnecessary X-rays.  In addition to the standard scoliosis measures of degree and location of the curve, this recommendation requires advanced measures  [3] such as sacral slope and pelvic incidence angle.  I seldom see these measures standardly included on a scoliosis X-ray however if you are having imaging completed you can ask these measures to be calculated by the radiologist.

    In the absence of complete information, the authors give us another option.  You can exercise in neutral providing your curve is in the lumbar or thoraco-lumbar area.  This eliminates the need for an X-ray as a therapist with experience in scoliosis can visually determine the location of your curves.

    Practically, this option is quite restrictive.  It means that almost everyone with scoliosis, who doesn’t have their curves fully documented, should exercise in neutral.  This restriction can be unrealistic as many sports require the spine to be in more extreme postures i.e. tennis serves, golf rotation. In Yoga and Pilates this would eliminate positions such as Downward Dog or Cobra.  Applying this restriction would rule out many enjoyable sports activities.

    What are safe exercises for scoliosis?

    People with scoliosis should stay active.  Good bone health and strong muscles are important throughout all of our lives and exercise helps to build this.

    Ultimately the choice of activity is yours as these guidelines are based on expert opinions and the authors indicated that they did not find any high-quality studies which showed a problem caused by exercises performed out of neutral.

    In my practice I prefer to help people stay active. Here is an overview of my advice for adults with scoliosis:

    1. Modify any activities that cause pain during, or shortly after exercise.
    2. Learn to control your curves through Scoliosis Specific Exercises or Core control exercises.
    3. Avoid postural extremes if you choose to go out of neutral i.e. try ½ Cobra and not full, work with a golf pro to learn a more limited swing, etc.
    4. Be aware that competitive sports increase your risk for back pain.  Irrespective of whether or not you have scoliosis, high-level competitive sports are hard on the spine.

    Here’s a link to the article I wrote for the Canadian Orthopaedic Division that has more information on exercise and scoliosis.  If you have any questions on how to exercise with scoliosis or are having back pain, please contact us at 416-925-4687 to book an appointment or physio@orthophysio.com

    [1] Maureen Dwight is a certified Scoliologic practitioner

    [2] Stolze H, Berdishevsky H, et Al, Safe exercises for adults with Scoliosis:  A Scoping review with Proposed Algorithm, presented Antwerp 2019 low back pain congress.

    [3]Schwab S, Unger B, et al, Scoliosis Research Society -Schawb adult spine deformity classification, Spine 2012, May 20:37 (12), 1077-82

    Athletes and the Actively Aging Reduce injuries and Stay Fit with Pilates

     

    You’re recovering from an injury and it’s taken much longer than you expected but now it’s time to get going again.  You really want to get active but you don’t want to go through the pain again.  A friend is running a marathon, your neighbour is going to spin class.  Every fitness magazine is preaching a new workout trend.  You’re unsure of where to go next and are worried you might aggravate the injury you’ve been working through. You know you need to keep moving ahead on your health and wellness journey, but where to next?

    If this sounds like what you are going through, then I would recommend trying Pilates to help reduce injuries and stay fit.  Pilates is a type of movement system used by elite athletes, that is also amazing to help recovery from injury. You may have seen the recent article on Canuks player, Brandon Sutter,  turning to Pilates to reduce his injuries.

    The great thing about Pilates is that it knows no age barrier.  it is helpful for the young as well as the actively aging.  It works because it’s not just another type of workout but rather helps you to restore the fundamental way of “how” your body is supposed to move.

    Reduce Injuries and Stay Fit with Pilates

    Pilates was developed by German born Joseph Pilates in the early 1900’s.  His focus was rehabilitation. Throughout the years it has evolved.  Input by  Kinesiologists, Physiotherapists and many other movement-based sciences have helped it to further develop as a system that is safe for all bodies and levels of practitioners to help you reduce injuries and stay fit.

    Pilates is designed to help you move better, period! It focuses on changing how you move.  learning how to move your body well translates into all areas of your life.  From how to stand with easy upright posture to bettering your golf game.  The effects of Pilates reach far outside the work you do in the studio. Not only will it help the continued healing of your injury, but it will also help to strengthen and balance all the other joints in your body, reducing wear and tear injuries in the future.

    The hour you spend in the Pilates studio will spill over into the other 23 hours of your day; the principals you will learn and hone-in-on will stay with you for a lifetime of good movement.

    How do you get started?

    First you need to find the right Pilates teacher.  A good Pilates teacher has a thorough biomechanical understanding of the body, or in other words “how things move”.  They can teach you how to do it as best as you can for your body’s current state.  This is particularly important if you are recovering from an injury.

    Pilates can be done on a mat, on equipment, and with props that modify exercises to your needs. It can be done at home or in a studio.  Sessions are designed to target the whole body with special focus on core strength, breathing mechanics, posture, and balance all with a mindful approach fostering mind body connection.

    You may notice many of the exercises are similar to what you have done with your Physiotherapist or Kinesiologist and help you to continue the good work you started with them.  At the Orthopaedic Therapy Clinic our clients often progress from their therapeutic exercises into Pilates or other more independent programs with our kinesiologists so that they can continue to get stronger, better, more resilient.

    Private or group sessions?

    To get the most out of your Pilates practice you will want to start with a private session.  This can be done as a one-off to introduce you to group classes or as the first step back into any type of exercise. It’s important to start this way if you have pain.  The personal modifications and movement strategies you learn in your session can make you a smarter mover for life.

    Group classes can be fun, motivating and empowering.  Keep in mind it’s best to talk to your physiotherapist before jumping into anything new; classes are designed for the average body.  Go early to your class to set up and discuss your injury with your teacher so that they can offer you modifications and assistance as needed.

    With Pilates exercising less can often be more!

    We’re always telling you to do your exercises daily and we know you find it hard so if you are looking for another way to help get better recent research presented at the Low Back Pa9j  world congress in Antwerp[i] showed that you can benefit with as little as 2-1 hour sessions per week.  People with persistent low back pain (pain lasting longer than 6 months) improved substantially with Pilates exercise done only twice per week. If you find it hard to do your exercises on a regular basis it can help to commit to booked sessions.  You can try a mix of class and individual depending on what you need or enjoy.  Who knew that exercise that helps you recover from injury can even be fun!

    Aniela has been teaching movement and Pilates for over 10 years.  She specializes in rehabilitation and mindfulness.  She is at The Orthopaedic Therapy Clinic on Tuesdays and Thursdays providing private instruction.  She can also help you to transition into group settings, use of equipment and home programs.  She has experience in scoliosis, post-operative spine surgery and persistent low back pain.  She also has worked extensively with pregnancy and post-partum clients.  She is currently certifying in Pilates Level 3: CCSB Cadillac Chair Springboard and Barrels which requires 275 hours of training. If your goal is to reduce injuries and stay fit, please contact her at 416-925-4687 to make an appointment or at aamio@orthophysio.com if you would like to know more.

    Collins, JS, A study to determine the effectiveness of Pilates exercises on pain and function in people with chronic low back pain http://www.worldcongresslbp.com/site/assets/files/1129/lbp_program_book.pdf

    Meditation improves your pain and your brain – just ask Bianca Andreescu

     

    The Canadian teen Bianca Andreescu, visualized herself playing tennis, using  meditation to  create a positive mindset. After defeating Serena Williams in the US open she said, “I think your Biggest weapon is to be as prepared as you can. I really think that working your mind is important because at this level, everyone knows how to play tennis”.

    Regardless of whether you are an athlete preparing for your sport, a job interview, reducing stress, or helping with pain management, having a positive mindset produces positive effects on our brains.

    My journey with meditation

    I was guided to meditation after the passing of my lovely mother. I was very close to her and was not coping very well with the emotional grief and it was affecting different aspects of my life. I tried the traditional methods: grief counselling or seeing a psychologist although I always left the session feeling worse (raw) after therapy that I did not want to go back. A client suggested Reiki therapy. I was curious as I had heard of it’s many benefits, so I made an appointment with Dr. Adonis Makris, a functional  medicine chiropractor. My session was unlike anything I had ever had before.  I’m not sure exactly how to explain the experience however it helped and I felt better, lighter, I was hooked! It helped me to feel calmer and clearer in my thoughts, enough that I was able to start to incorporate mediation into my daily practice.

    Once I became consistent with my meditation and practiced for longer periods of time, I started to become mindful of my daily thoughts, emotions and how I was responding to the interactions in my life. I became less stressed, calmer and was no longer only reacting with my emotions.  I started to recommend it to my client’s and found that it helped them with their recovery from pain and their daily life stresses.

    Why Meditate?

    Meditation is a skill that can be learned and practiced.  It is one of many tools used to induce calmness, slow brainwave patterns and increase grey matter.  Numerous research papers show that slowing the frequency of brainwaves causes reduction of cortisol. (10)

    Benefits of meditation:

    There are so many benefits that occur with daily practice of meditation.  Here are just a few:

    • reduces age-related brain degeneration and improving cognitive functions (1).
    • improves focus, spatial tasks, new learning (2)
    • improves sleep (3),(11)
    • helps with anxiety/depression (4, 6)
    • promotes awareness of self and surroundings (6)
    • improves cardiovascular health (3,5)
    • promotes emotional health (3,4)

    How Much Do I Need To Meditate?

    From personal experience, it takes time and practice.  As with most new skills, the more you practice meditating or being mindful of your thoughts, the easier and better it becomes.  Your goal should be to work up to a 1/2 hour per day.  When I began to meditate, I started with five minutes and increased the time as I developed the skill. I noticed more changes began to occur when I was meditating for longer periods of time. I was focused on consistency at the beginning to develop a positive daily pattern.

    Why Does Meditation Works?

    Studies show positive effects of meditation on our physical and emotional health. At the root of all our thoughts, emotions and behaviors is the communicating system of our neurons within our brain. Brainwaves are produced by synchronized electrical pulses from masses of neurons communicating with each other.

    Neuroscientist Dr. Joe Dispenza, stated, “we on average have over sixty thousand thoughts per day. If our thoughts are stressful then our body releases stress hormones that change our biological system and the gene expression therefore leading to disease and illness”. (8)

    New research shows that meditation literally rebuilds grey matter with a half hour of daily meditation, practiced for two months. It’s the very first study to document that meditation produces changes in grey matter over time.

    The Center for Mindfulness at the University of Massachusetts conducted an eight week Mindfulness-based stress reduction program in which participants practiced mindfulness for an average of 27 minutes a day.  This study also showed increased grey matter density.  It affected the hippocampus, the area of the brain known for learning, memory, structures associated with self-awareness, compassion, and introspection. It also showed that stress decreases the density in grey matter in the amygdala, the area known to play a significant role in anxiety and stress. (10)

    What Brainwaves Mean to You

    Meditation influences brainwaves. Our brain wave profile and our daily experiences of the world are inseparable. Studies show that when our brainwaves are out of balance, there will be corresponding problems in our emotional or physical health. (3,4).

    Our brainwave balance is key because the brain mediates our perception of the world – every emotion, thought, every sensation you have corresponds to activity in your brain. The brain drives our:

    • ability to pay attention
    • emotional balance
    • central nervous system tone
    • autoimmune functions
    • and so much more!

    The brainwaves are classified from fast to slow (gamma, beta, alpha, theta and delta). Each type of brainwave corresponds with a certain frequency which stimulates different parts of the brain. These brainwaves reflect different functions when they occur in numerous locations in the brain.  The most beneficial health changes are when the brainwaves are consistently in a theta frequency. (9)

    Theta waves occur most often in sleep and are also very active in deep meditation. Theta is our gateway to improving learning, memory, and intuition. During the presence of increased Theta wave activity, our senses are withdrawn from the external world and focused on signals originating from within.

    Having a positive mindset creates greater brain efficacy. (7) If your  brain works better then you will feel better. At the same time, traditional meditation approaches emphasize that there needs to be a clear intention and an elevated emotion to be able to change your energy and to change your life. In short, how you think and how you feel creates your reality.

    Finding your own way to Meditate

    Mediation is a great tool, that can be done anywhere. There are many different forms of meditation (Buddhist meditation, transcending meditation, mindfulness meditation, tapping, singing bowls, etc.).  I recommend you explore different types until you find the one you connect with.

    I found guided meditation helpful for me, being able to focus on the voice with guided instructions. It was very hard for me to sit still with silence or even with music.

    What works is individual. For some people, a walk in the forest or nature (forest bathing) is a great way to relax and enjoy the fresh air while calming the mind and exercising the body. Below are some suggested apps and podcast that might help you get started.

    Meditation App:        

    Insidetimer, Headspace, Calm, Sadhguru, Mooji

    Podcast:

    A New Earth, Dr. Joe Dispenza, Eckhart Tolle, Sadhguru, Mooji, Allan Watts

    Resources at the OTC:

    While I am still learning and perfecting my skill with meditation, Reiki is a great therapy to balance the energy, calm the mind and help you get started. Our chiropractor, Adonis Makris is very gifted and I would highly recommend him as a resource. Yoga is very calming and for those of you who like to move, Aniela Amio is a great instructor, as well as being trained in Reiki.  Call us at 416-925-4687 to make an appointment or email physio@orthophysio.com if you have any questions on how we can help you get started.

    References:

    1. Meditation and music improve memory and cognitive function ( text)
    2. Does mindfulness training improve cognitive abilities? A systematic review of neuropsychological findings ( text)
    3. Strengthening sleep-autonomic interactions via acoustic enhancement of slow oscillations. (text)
    4.  Alpha power, alpha asymmetry and anterior cingulate cortex (text)
    5. Guided meditation as an adjunct to enhance postoperative recovery after cardiac surgery: study protocol for a prospective randomized controlled feasibility trial (text)
    6. Effects of mindfulness-based cognitive therapy on body awareness in patients with chronic pain and comorbid depression. (text)
    7. Mindfulness practice leads to increases in regional brain grey matter density (text)
    8. Stress Hormone Causes epigenetic changes/national (text)
    9. Positive emotional experience: Induced by vibroacoustic stimulation using a body monochord in patients with psychosomatic disorders associated with an increase in EGG-theta and a decrease in EEG-alpha power (text)
    10. Distinct Trajections of cortisol response to prolonged acute stress are linked to affective responses and hippocampal gray matter volume in healthy females. (text)
    11.  EEG sleep slow-wave activity as a mirror of cortical maturation (text)

    We are Hiring!

    Experienced Pelvic Floor Physiotherapist Required

     

    The Orthopaedic Therapy Clinic Inc. is looking for an experienced Pelvic Floor Physiotherapist for a  Part Time position. Existing pelvic floor case load and orthopaedic clients.

    You will be joining a physiotherapist-owned, multidisciplinary clinic. Our team includes highly qualified physiotherapists, massage therapists, chiropractor, kinesiologist and a yoga/pilates instructor. Our physiotherapy team includes: clinical musculoskeletal specialist, Scoliosis, and FCAMPT  certifications.   Our clients are highly motivated with a wide variety of musculoskeletal injuries.

    You must be Registered in the Province of Ontario enjoy a team approach to helping patients get well, show continuing education and a desire for learning,

    This is the right position for you if you are looking to contribute to a strong team, enjoy collaborating and are looking to be challenged to grow. Send us your resume and show us what you’ve got, (references included please).

    While you’re at it, look at our web site at www.orthophysio.com to get an understanding of why our practice has thrived for over 30 years. We are located at 1075 Bay Street in the heart of downtown Toronto.

    Forward your resume to Maureen Dwight, Clinic Director at mdwight@orthophysio.com

     

    Winning the War on Low Back Pain – Recovery or Recurrence?

    One of the biggest problems I see when you are recovering from low back pain is that you are tricked into thinking you are completely  better when the truth is that you still have a long way to go.  After weeks of intense, unrelenting pain you wake up one morning and there’s nothing.  No pain.  No stiffness.  It’s gone!  You are thankful for the lack of pain and vow to take your life back.  You immediately start doing everything you used to do.  You go to the gym, book a Yoga class, take up running, find core strength video’s on YouTube, etc.  only to begin to hurt again.

    Click here for the Video Winning the war on low back pain – Recovery or Recurrence

    Relief changes to despondency.  Not realizing that the problem is your lack of a rehab plan you start to worry that whatever is wrong with your back is serious and for life.  You go into an emotional tailspin – reinforcing your return to being a  Prisoner of the Pain.

    Avoiding mistakes in recovering from low back pain

    The most common mistake I see in the Recovery stage of winning the WAR on low back pain is trying to do too much too quickly. This happens because we equate the absence of pain to full recovery.  The reality is that pain often abates when strength is around 40% of normal.

    Whenever pain lasts for more than a few weeks most people are weaker than they realize.  If you have had a pinched nerve the weakness is compounded by loss in the strength in muscles supplied by the nerve. This weakness can be quite profound, causing;

    Even when the pressure comes off the nerve the muscle may not immediately regain strength.

    These are often the reasons your recovery fails.  Unless you understand these imbalances and look to correct the impact they are having on your body, your recovery can be very hit or miss.

    3 Stages of Low Back Pain Recovery

    The changes caused by low back pain and nerve pressure mean you need to make good decisions in your recovery from low back pain.  Your decisions need to build logically on each other until you return to your full and active lifestyle with a step-by-step plan.  These decisions start with the knowledge that recovery has 3 stages.

    1. Resolution
    2. Robust
    3. Resilience

    Most people go through each stage sequentially however the stages typically overlap.  Each stage requires a change in therapy and should become progressively more demanding as you regain your strength, stamina, flexibility and coordination.

    Recovery Stage 1 – Resolution

    The hallmark of this stage in your recovery is that the pain is intermittent. Typically, the pain is provoked by certain activities and feels better when you do other things.

    You may have trouble identifying the links between what makes the pain better or worse.  At this stage what is most likely happening is that your back is exhibiting what is called a “directional preference”. This technical jargon simply means that your back prefers certain positions and is made worse by other movements.

    Most commonly the back has one of two preferences – it either likes to flex (bend forward) or extend (bend backward).   The therapy goal of this stage is to control pain  through movement. This is often when you can reduce or eliminate medication.  Your exercises will make you stronger and more flexible but most importantly they should make you feel better or at least not worse.

    Flexion (bend forward) preference:

    Flexion preference typically achieves pain relief with sitting and is made worse by walking.  The most likely structures at fault are the facet joints or spinal stenosis.  If this is your pattern, exercises such as knees to chest, Figure 4 stretch and stationary bike are the places to start.

    It is  important to avoid/limit the direction you back doesn’t like.  In this case we term it an extension intolerance.  This means you should limit activities that put your back into an arch such as standing for too long, Yoga cobra poses or deciding this is the exact moment you need to paint your ceiling.

    Extension (bend backward) preference:

    Extension preference is often associated with pain relief from walking.  It is typically made worse by sitting. The most likely structures at fault are the discs or tight hip muscles (psoas, quads). Exercises such as Yoga cobras, sloppy push-ups, bridging and lots of walking can substantially reduce your pain.

    In this early recovery stage you should avoid activities that put your back into flexion such as toe touches, hamstring stretching or deciding that you finally have to beat your high school sit-up record.

    Recovery Stage 2 – Robust

    The marker that you are entering the next stage in recovery is that you have minimal pain with basic activities such as sitting, walking, standing etc. It is still relatively easy to aggravate your back with heavier or sustained activities.

    At this stage it may feel OK to bend forward to pick up a muffin or a Kleenex box but you still hurt if you go to the gym or lift the laundry basket.  You know you’ve overdone it when you pick up a case of beer for the long weekend and feel an immediate urge to crack open a bottle to relieve your back muscle tension.  In other words the intensity of the activity is the limiter, not the direction of the movement.

    Often at this stage your pain gets worse as the day goes on. The more tired you are, the more you hurt.

    These symptoms indicate that the intensity of the activity and fatigue are the irritating factors.  This tells us that it’s time to make a plan to resume cardio, strengthen your core and restore your flexibility.

    At the start of the robust stage you may be still be exhibiting a directional preference.  You can still exercise however the strengthening and flexibility must respect the preference i.e. strengthen in extension.  As you progress you should be able to restore some  degree of the opposite direction of movement.

    Recovery Stage 3 – Resilience

    Resilience is about our ability to recover from our mistakes.  We all do it.  The weather improves and we decide to go for a two hour walk when the longest walk we have done in the last 6 months is 20 minutes. We decide to clean up our garage or return to gardening when the heaviest thing we have lifted in the last month is our coffee cup.

    The problem with these decisions is that you have increased your physical demands too quickly.  However pat yourself on the back if you only experience mild discomfort or stiffness and recover from your low back pain within a day or two.  Mild symptoms and a quick recovery are indicators that you have restored some degree of resilience.

    To fully  restore resilience your recovery plan needs to uncover and correct compensatory patterns.  We need to identify those pockets of profound weakness that the pinched nerve left behind and bring these muscles back to normal strength and coordination.  The failure to restore normal movements and efficient, coordinated movement patterns is what I find is the most predictive of recurrence and of your recovery not resolving within the expected 3 months.

    How do you know you need to restore resilience?

    1. Exercise dependency. Your back exercises really help but whenever you stop them the pain returns.
    2. Inability to return to exercise, sports or household chores without provoking pain.
    3. Constant, low grade pain. The intense pain has lessened but now the pain never leaves.
    4. Your pain is still intense after 3 months

    To get to the truly resilient stage you may need to find a spine therapist who understands how to find and correct the weaknesses and compensatory patterns left behind by your injury.  If you have pinched a nerve and the symptoms have lasted for longer than 3 months I can almost guarantee that these imbalances will be there. You and your therapist need to determine what is missing in your recovery and specifically address these imbalances.

    Over the next few blogs I will explore each one of these stages more thoroughly and help you to find your own direction of recovery and to assist you in creating a dialogue with your spine therapist to partner in winning the WAR on low back pain.  Please contact us at 416-925-2687 or physio@orthophysio.com if you need assistance in putting your Recovery plan into place.

     

    Aniela Amio – Bio

    Pilates, Yoga & movement teacher

    Certified Reiki Practitioner level 2

    Aniela completed her yoga certification at The Yoga Sanctuary in 2011, adding courses in meditation, Yin Yoga and Restorative Yoga shortly after.  She then went on to become certified in Mat Pilates with Body Harmonics in 2013, Reformer Pilates with The Mindful Movement Centre and Leslie Parker. She is currently working towards her Comprehensive Pilates Diploma with Body Harmonics (2019) with a special focus on spinal health and injury recovery, as well as pre and post-natal care.

    Aniela  empowers people of all ages and abilities by teaching them how to move and care for their own bodies.  She hopes her students find joy, safety and strength in their sessions which translates into better quality and functional movement in their daily lives.  She is interested in and continues to expand her studies with workshops on the mind body connection, chronic pain, scoliosis, fascia, pre and postnatal health and recovery as well as working with the aging population. Aniela has had the opportunity to work with professional athletes, dancers, chronic pain suffers and those recovering from spinal injuries and surgeries.

    Aniela is excited to collaborate and learn from the team at The Orthopaedic Therapy Clinic to further her education.  She looks forward to being an integral part of your recovery and journey to health and vitality. To arrange an appointment please call 416-925-4687 or email: aamio@orthophysio.com

    Recently she has added the following courses and certifications to her education.

    • Movement and Exercise for Pregnancy
    • Post-Natal Reconditioning and Diastasis Recti Repair
    • Towards a Healthy Pelvic Floor
    • Strength, Balance and Fall Prevention for Seniors
    • Handedness and Scoliosis
    • Kinesiology of Pilates

    She is currently completing her Pilates Level 3: CCSB Cadillac Chair Springboard and Barrels which requires 275 hours of training.

    When Aniela isn’t teaching or taking courses you can find her in the park with her dog, travelling, or in a plant store deciding which plant baby to add to her home.

    Therapeutic Exercise1A

    Therapeutic Exercise

     Therapeutic Fitness is a new concept in exercise available at The Orthopaedic Therapy Clinic. It combines personal training with the expertise of highly-trained professionals who are experienced in working with individuals who have more complex fitness requirements i.e. osteoarthritis, low back pain, joint replacement surgery, high blood pressure, etc. Under the experienced care of our registered kinesiologist we tailor an individualized exercise program to help the recovery from orthopaedic and neurological conditions.

    Who will benefit?

    These programs can be used to treat and prevent re-injury as well as improving levels of performance in your sport.  It is ideal for individuals who are recovering from injury, are trying to stay fit while injured or have other conditions which interfere or limit fitness i.e. arthritis.

    Service provided by:

    John Gray RKin               (Bio)

    Aniela Amio, Pilates, Yoga & Movement teacher (Bio)

    Taylor Sipos, RPT             (Bio)

    Tiffany Shi, RPT                (Bio)

    More information:
    https://orthophysio.com/latest-news/physiotherapy/therapeutic-fitness-with-john-gray/

    To Book an appointment call 416 925 4687 or email jgray@orthophysio.com

    Healthy Aging1A

     

    Healthy aging

     

    There is no doubt that physicality changes as we age, however there are some changes we should never accept.  Keeping or restoring these physical abilities will not only help your quality of life, however in addition many of these activities are predictors of longevity and independence. Therapeutic exercises helps to remove barriers to exercise and activity which result from ageing.

    Who will benefit?

    Anyone who is age 50 plus and is active and wants to continue to exercise, be active and prevent injuries.  

    Service provided by:

    John Gray RKin                              (Bio)

    Aniela Amio, Yoga and Pilates      (Bio)

    More information: https://orthophysio.com/?s=healthy+aging

     

    Igal Untershats – Bio

    Igal Untershats

    Registered Massage Therapist

    igalu@orthophysio.com

    Igal is a graduate of Sutherland Chan School of Massage.  As a registered Massage Therapist he brings a passionate interest in the application of soft tissue therapy for recovery after injury, restoration of health and injury prevention. Watch Igal’s video here

    Igal applies a focused and goal-oriented approach to determine the best techniques for maximizing your recovery.  Using myofascial release, Swedish massage, positional release, as well as several other techniques, he provides targeted treatments to reduce soft tissue adhesions and muscle tightness.  As an integral member of The Orthopaedic Therapy Clinic team he collaborates with your therapist to determine the most comprehensive approach to maximize your recovery. 

    Igal has a particular interest in sports injuries and deep tissue massage.  He has worked with marathon runners and cyclists to reduce scar tissue and restore tissue resiliency after injury.  He has provided massage therapy for young athletes including the National Girls Gymnastics competition for young athletes between the ages of 5 and 15.

    During his training he provided treatment to assist better breathing and relaxation for lung cancer patients at Princess Margaret Lodge Cancer Outreach Program.  He has helped patients with Multiple Sclerosis reduce pain and spasticity. 

    Prior to training as a massage therapist, Igal was a jet-engine mechanic with the Israeli air-force and a high-rise carpenter.  He enjoys swimming, yoga and lifting weights. He is a percussionist and plays with an Afro-Brazilian percussion group.  Igal is fluent in Russian and Hebrew. 

    Check Your Stretch

    Ask anyone why they stretch and you will usually get a pretty consistent answer.  We want to “loosen up”, improve movement in some part of the body, recover faster/reduce pain, and avoid sore muscles.  However, you may find it surprising that your trusty stretching routine you’ve been doing for years could be limiting your progress in the gym, field, or court.  Should we be surprised that a generic list of stretches probably won’t do much for these specific goals?

    It is often misunderstood in fitness and health that in stretching, one size does NOT fit all.  Just like those exercises your trainer gave you to improve your game, your stretching program should meet your needs to help you reach your goals.

    So if you’re feeling stiff or sore and it’s not getting better, take a minute to identify your goals for stretching.  Here are some of the major reasons I see in the clinic and on the field, and a look at some of the strategies to make them work for you.

    1. Stretching for pain relief and recovery
    2. Stretching for increased flexibility and range of motion
    3. Stretching for injury prevention and performance

    Stretching for pain relief and recovery:

    People who are recovering from a muscle tear, have had surgery, or a chronic condition such as stroke or Parkinson’s are often prescribed stretching to improve mobility and aid in recovery.  They experience muscle tightness and pain that is caused by overactive nerves holding the muscles in a tightened, protected, state.  Since the muscles are constantly under tension, these people have a much higher risk of muscle injury and inflammation during activities and exercise.

    The goal of stretching for pain relief and recovery is to get the muscles to quiet down.  This involves gentle stretches that are low effort and free of pain.  A study by Kubo et al. (2001) showed that consistent gentle stretching caused something called “stress relaxation” of the muscle. Stress relaxation occurs when sensory receptors in the muscle, called golgi tendon organs (GTOs), react to increases in muscle tension.  As a response to protect against potentially damaging stresses, they send a message to the brain to lower the activity of the muscle, causing a relaxation and decreasing muscle tension.  In other words, after stretching the muscle allowed the joint to move more freely through its full range.  The authors suggested that this may be a possible mechanism for a reduced risk of injury with stretching exercises.

    Stretch techniques for pain relief and recovery

    In order to maximize the results of stretches for pain and recovery, start conservatively but work up to performing your stretches multiple times, as long as you avoid pain.  Always remember that the first priority is to not cause any more pain and swelling (inflammation) in the tissues.  As a muscle lengthens from a stretch, its tension will rise.  The key to stretching for pain relief is to ease the nervous system before muscle tension rises high enough to cause any pain.  That’s why it is very important to slowly progress the number of times you stretch to make sure you don’t get a negative reaction.

    You can put this into practice yourself by holding your stretch for 20 seconds so that it you feel a gentle pulling in the muscle, but that does not cause discomfort.  After 3 consecutive days of doing this, you should be confident you can do more without irritating the muscles.  At that time, you can try performing the stretch a second time with at least a minute between stretches for the same muscle.  Continue this strategy until you are able to perform the stretch three times pain free on a daily basis.

    Stretching for flexibility and  improved range of motion:

    Prolonged postures and repetitive movements can cause our muscles to adapt at the cost of our mobility.  In these cases, the muscles are still normal and healthy, and may not even be sore or painful.  Yet some will have shortened to accommodate the body’s “new normal”.  Improving range of motion is possible by using prolonged stretching that is just “before” the onset of pain, and held for a longer duration than for pain relief.

    Laboratory studies on stretching have shown that stretching can promote changes at the microscopic level and make your muscles actually longer.  Sarcomeres are the muscle fibre’s building blocks that are lined up end-to-end to give it its length.  Sarcomeregenesis is a term used to describe an increase in the length of the muscle fibre (Martins et al., 2013).  When applied enough times for long-enough duration, a stretch actually stimulates the body to build more sarcomeres. The more sarcomeres, the longer the muscle fiber, the looser the muscle, and the more flexible you will be.

    In order to successfully increase range of motion, the focus must move toward the muscle itself, meaning that tissues need to be able to handle more tension for a longer duration without becoming painful.  Still, the most important rule is to avoid painful stretching habits at all costs.

    Stretching to the point of pain makes the muscle fight back against the stretch as it contracts to stop the excessive movement.  In turn, golgi tendon organs won’t help lower muscular tension, and sarcomeregenesis becomes physiologically impossible.  In fact, five of seven studies evaluated in a recent meta-analysis (Apostopoulos et al., 2011) showed that stretching to discomfort and pain produced no improvement in range of motion regardless of the population studied.

    Stretch techniques for flexibility and improved range of motion

    If you have a muscle that is limiting your mobility but otherwise normal and pain free, you can try the following approach.  Find a comfortable body position that does not involve supporting your bodyweight over the part you are stretching, so that you can relax and use a minimum of effort to hold the stretch position.  Perform your stretch and hold it for approximately 1 minute, repeating it 3 times with at least a minute rest between each repetition.

    Stretching for injury prevention & performance:

    Despite popular belief for some, stretching doesn’t show any overall effect to reduce overuse injuries.  However, there may be a benefit in reducing acute muscle injuries in running, sports that involve sprinting, or other repetitive dynamic muscle contractions.

    Surprisingly, the current research indicates that stretching before exercise may help prevent muscle injuries in sports with a sprint running component but not in endurance-based running activities, where overuse injuries are more common.  They key is to incorporate at least a 10-minute warmup that includes movements in your sport, just at a lighter intensity.

    Stretch techniques for injury prevention & performance

    Active people who participate in sports and exercise regularly generally don’t have limited movement and do not experience muscle pain as described earlier.  They can stretch more intensely before experiencing pain, and hold a stretch for a longer-duration may have a greater potential to decrease injury risk.  A meta-analysis by Behm et al (2016) observed that several studies on this topic have indicated a 54% risk reduction in acute muscle injuries associated with pre-activity stretching followed by a specific warmup.

    Setting Your Stretching Goals

    So if the problem is that you stretch and stretch, but never get better, then something in your program is not supporting this long-term adaptation of your muscle fibers.  Start by checking your body position, the intensity you are using to stretch, and the both the frequency and duration of the stretches.  For athletic events, make sure you are fully warmed-up by doing dynamic movements that mimic the sport itself, but are at a controlled speed.

    Other important factors that can contribute to tightness and pain include imbalances in your muscles.  Imbalances can get in the way of the normal physical response to appropriate stretching, and should be assessed by a trained musculoskeletal therapist.

    If you would like more information or would like to find out how you can improve your range of motion, reduce muscular pain, or improve performance, please feel free to contact John Gray at jgray@orthophysio.com, or call us at The Orthopaedic Therapy Clinic at 416-925-4687.

     

    Announcements

    Announcements:

    OTC Social Media Platforms

    We have been working hard to develop content that helps you to manage your injuries and pain by making better choices on exercises, products and even how you manage your therapy type i.e. Telehealth. You can keep in touch with us on the following platforms:

    Fee changes due to COVID

    Please note that effective August 18, 2020 the fees will be increased by $10 per 1/2 hour appointment or $20 per 1 hour appointment. This reflects the increased costs of COVID control. You can read about our process here

    If you have any concerns about the fee change, please contact Maureen Dwight directly at mdwight@orthophysio.com?

    Functional Fascia Therapeutics (FFT)

    In 1996 Zhonghua Fu, PhD, invented a technique which inserts needles under the skin into the fascia.  The technique is different from traditional acupuncture as the needles are inserted horizontally and more superficially.  Only one needle is inserted at a time and the therapist provides the treatment by gently moving (swaying) the needle. The technique is relatively pain free.

    The technique is used to reduce tightness in the myofascial system.  Its effect can be an immediate increase in mobility.

    The theory behind the response is that the collagen tissues are most abundant in the subcutaneous layer of the body.  As the technique targets this layer of tissue it stimulates more change in connective tissues.

    At the Orthopaedic Therapy Clinic we find that this technique is most effective when paired with soft tissue treatments that assist your full myofascial system to lengthen i.e. massage, soft tissue manipulation.  This technique, coupled with therapeutic exercises and posture change awareness creates a comprehensive catalyst for recovery from persistent musculoskeletal restriction.

    Igal Untershats therapist at Orthopaedic Therapy Clinic in TorontoIgal Untershats is trained in Functional Fascia Therapeutics. To arrange an appointment please call 416 925 4687 or email: igalu@orthophysio.com

     

     

    Welcome to our new Registered Physiotherapists!

    Please join us in welcoming Taylor Sipos,  Tiffany Shi to the team at The Orthopaedic Therapy Clinic. 

    Taylor Sipos Registered Physiotherapist MPT, BKin

    Taylor completed his Master of Physical Therapy degree from Western University after earning his Bachelor’s degree in Kinesiology from McMaster University. His passion for physical therapy developed as he grew up participating in competitive sports.

    Since graduation, Taylor has taken numerous courses to improve his skills and advance his professional development. These courses include the Mulligan Concept Lower Quadrant course, Soft Tissue Release and Acupuncture. He plans to complete his manual therapy levels through the Orthopaedic division of the Canadian Physiotherapy Association.

    Taylor delivers treatment with a great deal of empathy and compassion for his clients. He strives to provide evidence-based therapy with a strong focus on exercise and education. He believes in motivating his clients in taking an active approach in their rehabilitation to meet their individual goals.

    In his spare time, Taylor participates in mid and long-distance running and as such, he has a keen interest in the rehabilitation of running-related injuries. In addition to running, he also enjoys weightlifting, playing hockey and cycling.

    For an appointment please call The Orthopaedic Therapy Clinic at 416 925 4687 or contact Taylor at tsipos@orthophysio.com

     

     

     

     

    Tiffany Shi Registered Physiotherapist, MSc.PT, BSc

    Tiffany graduated from the University of Toronto with a Master of Science in Physical Therapy in 2019. Prior to pursuing a career in Physiotherapy, Tiffany obtained a Bachelor of Science degree in Honors Biochemistry from McMaster University in 2017.

    Tiffany is passionate about helping people recover from their conditions and return to the activities they love. She loos to obtain a thorough history and a holistic physical examination of patients to identify the root cause of the condition. Tiffany’s treatment approach includes manual therapy and evidence-based exercise prescription tailored to the different goals of each client.

    Tiffany is a strong believer in life-long learning. She is interested in continuing education in areas of manual therapy, acupuncture/dry needling, concussion rehabilitation, and pelvic health. She has recently received her certification in level 1 orthopaedic manual and manipulative physiotherapy.

    In her spare time, Tiffany is busy practicing in sabre fencing and refereeing at competitions. She also enjoys photography, sewing, life drawing, and reading. Tiffany is bilingual, she is happy to provide service in Mandarin if needed.

    For an appointment please call The Orthopaedic Therapy Clinic at 416 925 4687 or contact Tiffany at tshi@orthophysio.com

    Announcing:  Aniela Amio – Pilates and Yoga Instructor, Reiki practitioner

    We are excited to announce Aniela Amio is joining our team at the Orthopaedic Therapy Clinic. Aniela brings extensive experience in injury rehabilitation through Yoga and Pilates. She is certified in Pilates, Yoga and Reiki. Her focus is on spinal health and injury recovery as well as pre and post-natal care. Aniela will be an integral part of the team, along with our registered kinesiologist, John Gray, in helping you to advance your recovery to return to fitness while reducing your risk of injury.

    Aniela’s passion is to empower people of all ages and abilities to improve how they to move and help them to take care for their own bodies.  She is interested in and continues to expand her studies with workshops on the mind body connection, chronic pain, scoliosis, fascia, pre and postnatal health and recovery as well as working with the aging population.  Aniela has had the opportunity to work with professional athletes, dancers, chronic pain suffers and those recovering from spinal injuries and surgeries.

    Call us  at 416 925 4687 to book an appointment or chat with your therapist to determine when you are ready to benefit from working with her.

    Scoliosis Presentation

    Maureen Dwight presented a paper on scoliosis at the National Orthopaedic Division Conference held  in London Ontario.  This will represent her third presentation to treatment professionals on managing and treating scoliosis.  These engagements have been based on the paper she  co-authored on scoliosis treatment.  Although primarily written for treating professionals, it is available on our website at https://orthophysio.com/?s=scoliosis. These efforts are helping to raise the awareness of treatment professionals on evidence-based treatments for scoliosis.  Maureen also attended the International scoliosis conference (SOSORT http://sosort2018.com/ ) in Dubrovnik Croatia.

    Reduce Stress – You Deserve It

    Reduce Stress – You Deserve It –

    Adonis Makris Registered Chiropractor

    May 31 2017, 12:15-1 pm

     

     

    Many of us are too busy to take care of ourselves.  We know we need less stress in our lives but just the thought of taking the time to learn, let alone practice, these techniques causes more stress.

    Provided by Dr. Adonis Makris Registered Chiropractor, this 40 minute session provides easy, practical and quick techniques for reducing stress at home and in the work place.  Simple changes in diet, application of techniques such as tapping and breathing can help you to bring the stress down and improve your general sense of wellbeing.

    Format:  Lecture and practical format

    Maximum number: Limited to 15 participants

    Dr. Adonis Makris D.C.

    amakris@orthophysio.com

    Dr. Adonis Makris is a graduate of the University of Victoria with a Bachelor of Science in Exercise Physiology. In 1998 he became a Doctor of Chiropractic. He has studied a mix of modern and ancient healing arts. He is a Master in Medical Qigong.

    Avoiding the Exercise Hangover – Muscle Soreness

    This morning I woke up suffering from DOMS.  You may be wondering why a health and wellness blog is writing about avoiding self-inflicted excess but the lesson in this case is not to moderate my consumption of expensive champagne but rather to reconsider my approach to exercise.  Good pain, sweet pain or the more formally designated term Delayed Onset Muscle Soreness (DOMS) refers to sensations of stiffness, discomfort or pain that doesn’t come on immediately, but is felt for several days after exercise.

    Some consider these sensations as essential.  They don’t believe they have had a good enough workout unless this deep ache reassures them that they have taken it to the Max.  Although these pains are not uncommon when starting a new workout, like the hangover, DOMS is a marker that not only did we reach our limit, we have overdone it.

    Why do I feel muscle soreness after exercise?

    Looking at DOMS from the cellular level provides insight into the cause of these sensations as they are markers that the intensity of your workout has been sufficient to destroy muscle cells.  It is the process of myonecrosis (muscle death) that comes from tearing tissues which creates the irritation you feel. Fortunately, unless you have over done it, this localized tissue injury does not affect the entire muscle. This micro-trauma acts as a catalyst, telling your body that these muscles need to be rebuilt stronger to prevent future strains.

    Rest builds strength

    Creating a catalyst to build strength is the primary goal of exercise however it is not the exercise that builds the strength but rather whether you have provided sufficient time for recovery.  It is important to shift your thinking to recognize that exercise causes weakness. During the process of myonecrosis you have fewer muscle cells to draw on and your strength is less, not more. During the DOMS period you are more prone to injury and the harder you have exercised the longer you are at risk.

    Our knowledge that this initial period of weakness is followed by the rebuilding of the muscle is why most exercise programs are built on a day on, day off strategy.  Providing you have not done too much damage, following this format will give your muscles sufficient time to repair before you expose them to the next catalyst – when we demand even more than we asked for the last time. The key is to repeat the exercise to keep getting stronger, but not until the DOMS is gone.

    Although it is occasionally okay to experience DOMS in an exercise program I prefer to avoid it in therapy.  I find the period of waiting for DOMS to abate slows your recovery as it can take days or weeks before your recovery allows us to apply the next catalyst.  I also find that for some people the line can be too fine for avoiding injury if we select the maximum level to build strength.  Working at a lower intensity still gets me what I want, and lowers your risk for set-backs.

    This perspective is permeating the training world as even for athletes the presence of DOMS is now controversial.  My exercise physiology text tells me that a good workout prevents DOMS, not causes it.  In other words, you may get some soreness when you first start a program but the right exercises ultimately protect you from these symptoms.

    How to build strength and avoid injury

    To build strength and avoid DOMS I use the following guidelines:

    1. Begin by thinking about your current level of strength. How active have you been recently?  What does your activity APP tell you about the number of steps you have been taking per day[1]?  This provides a baseline for the intensity of your program.
    2. If you are returning to exercise after an hiatus consider having a fitness assessment with a knowledgeable fitness professional. This should help you to select the initial level of demand.
    3. If you are returning to fitness after injury or have had difficulty avoiding injury when you exercise, then I recommend you work with a health professional who looks for underlying problems.  Often injuries leave behind specific weakness, tightness and/or compensatory patterns which need to be corrected before you can successfully engage in a general fitness program.
    4. Tax your muscles at a level to create the catalyst to build strength but below the level of DOMS. As my colleague, John Gray referenced in his recent Blog you should increase your exercises by 5-10% to avoid re-injury.  Working at a 4-6/10 effort level is another good rule which I find prevents over-strain.
    5. Use a higher repetition, lower load format. A good general rule is if you can’t do at least 8 reps, the exercise is too hard.  If you can do over 25 – you are likely dogging it, go to the next level.
    6. Always build in recovery time. The harder you exercise the longer you need to recover.  If you want to work out every day have more than one workout.  A well-planned program will allow you to rest one set of muscles while you work out another.

    Training for success

    Right now I am rethinking my exercise strategy.  As my DOMS recedes I know I dodged the bullet.  I pushed to the Max but fortunately avoided injury.  However I don’t plan to keep testing my luck even though I am still planning to go back to that killer Yoga class. Right now I am including some treatment with our registered massage therapists as research shows that this treatment hastens exercise recovery. I am starting to do a bit more work on my own.   I plan to take some instruction from my physiotherapy colleague and Yoga instructor to improve my technique.  This prep will help me to raise my strength and limit my exercise hangover.

    Moderation learned!

     

     

    [1] Your goal should be to average between 8-10,000 steps per day.