Search Results: acupuncture

Functional Fascial Therapeutics – a new type of Acupuncture.

A couple of years ago I learned about a new technique called Functional Fascial Therapeutics – a new type of acupuncture (FFT) .  When I started to study it, I liked that it is a unique acupuncture modality which allowed me to target the superficial layer of fascia.   This is the tissue that wraps around muscles & joints. What’s unique about FFT is that it’s a non-intramuscular technique, which means the needle is inserted much shallower.  It goes between the skin and the muscle and does not enter the muscle itself.

 

The shallower insertion has several advantages:

  1. It allows the treatment to be combined with movement whereas traditional acupuncture requires you to stay still.
  2. It has much less discomfort than traditional acupuncture as the superficial fascia is not innervated by the nervous system like the skin and muscles. This allows more people to benefit from this technique.

Who will benefit from Functional Fascial Therapeutics?

I have found that Functional Fascial Therapeutics is especially useful when you have chronic tightness.  I have seen better outcomes in people who have years of postural adaptations which have prevented them from progressing with other treatments and therapeutic exercises due to lack of mobility/tissue pliability.

This modality is especially beneficial for people who:

  1. have pain
  2. difficulty stretching tissues
  3. adhesions from scar tissue/trauma

Why does fascia matter to my treatment?

In order for us to understand why we would consider this modality, let’s first talk briefly about fascia, its relevance and importance within the musculoskeletal system.

Fascia is described as the ” Connective webbing tissue of the body”.  It is composed of collagen – the most abundant protein in the human body. Collagen is found in our bones, muscles, skin, and tendons. It binds every cell in the body to its neighbours and even connects the inner network of each cell to the mechanical state of the our body.

Part of its connecting nature may lie in its ability to store and communicate information across the entire body. Think of Fascia as a 3D Matrix that wraps around muscles, organs, other structures, giving them a scaffolding-like support, and providing their shape.

The purpose of fascia

There are several types of fascia, ranging from superficial to very deep.  The Functional Fascial Therapeutic technique targets the “superficial fascia” which is the tissues that wrap around  individual muscles.

The easiest way to understand the role of fascia in movement is that: Muscles generate force, and Fascia transmits those forces throughout the body.  If the integrity of the ability to distribute tension (Tensegrity) is compromised, it will change the way force is distributed through our body and can result in pain and imbalances in our tissues.

Another way to look at this is that fascia is plastic whereas muscles are elastic.  Fascia will adapt to its environment (posture), and because the muscles are encapsulated in fascia, they are going to have a hard time contracting and doing their job if the “wrap” they are in is preventing them from transmitting and communicating those forces optimally.

Fascial tightness and cellular nutrition

The human body is basically” a pump”, with the healthiest tissues getting constant replenishments of fluids/nutrients going in and out.  The means that the tighter the fascia the more difficult it is to get nutrients into the cells.  This is why people who move more, generally have less physical discomfort.

How easily nutrients get into the target cell is largely determined by the density of the fibrous matrix, a.k.a fascia.  When the fibers are too dense (might be caused by prolonged adaptation to short & tight, long and tight musculature, lack of tissue mobility), or too dehydrated and viscous, then these cells will be less thoroughly fed and watered. This technique helps restore this balance.

 My approach

As a manual therapist I firmly believe that there is no one magic technique, no best modality, or single best tool to use for a given problem. The approach should always be catered to each individual based on their health history, their pathology/condition, their tissue tolerance and their willingness to explore different therapeutic avenues.  No two bodies are alike, no two nervous systems are alike, therefore there should not be a single approach.

Functional Fascial Therapeutics – a new type of acupuncture

The FFS modality is one of many techniques I use as it allows me to target the superficial fascia directly, affecting its tension instantly.  When I combine it with movement, cupping techniques and tissue pumping, it can disperse the fascial clogs/adhesions/tugs which will allow the tissue to resume its specialized “social” function,.

Please contact me if you would like to learn more about Functional Fascial Therapeutics – a new type of acupuncture contact Igal Untershats at  igalu@orthophysio.com or call 416-925-4687 to book an appointment..

Acupuncture

Does Acupuncture Work?Acupuncture

Medical acupuncture– is a therapeutic technique that involves inserting sterile fine needles into certain points on the body, encouraging the healing process and relieving pain. It is based on the points established along meridians (energy channels).

Service provided by: Taylor SiposIgal Untershats and Juliette Woodruff,

Electroacupuncture: is a technique that uses acupuncture needles to pass a pulsated current through the tissues to promote healing and/or reduce pain.  The current acts as a peripheral nerve stimulator for inhibited/weak muscles. It can increase the muscles activation/engagement and decrease pain.

Service provided by: Igal Untershats,

Dry needling (DN) or Intramuscular Stimulation (IMS)– this is a Western approach to acupuncture. In this technique thin needles are used to directly stimulate and release knots and trigger points in muscles. 

Service provided by:

Igal Untershats,

Tiffany Shi

Fascial needling –The technique is different than traditional acupuncture as the needles are inserted horizontally and more superficially. The technique targets the subcutaneous (below the skin) layer of tissue to stimulate change in connective tissues, Functional Fascia Therapeutics.

Service provided by: Igal Untershats

Medical Acupuncture

 Medical Acupuncture

Acupuncture treatment is insertion of single-use needle based on the points established along meridians (energy channels). Individual points are frequently targeted to treat various conditions. These points often resemble trigger points and/or motor points in the tissue. It utilizes the neurological pain control theory.

Dry Needling/Intramuscular Stimulation (IMS) Acupuncture

Dry Needling is an acupuncture-like treatment used in therapy. It is also known as intramuscular stimulation (IMS). The technique helps break down adhesions in tissues and muscles, relieving pain and tension.

Electroacupuncture

Peripheral nerve stimulation for inhibited/weak muscles’ activation to increase engagement/strength and decrease pain.

Who will benefit?

Pre/post surgical conditions, acute/chronic pain, increase performance and mobility.

Service provided by:

Taylor Sipos, RPT (Bio) provides medical acupuncture

Tiffany Shi RPT  (Bio) provides dry needling

Igal Untershats RMT, (Bio) provides medical acupuncture, dry needling, electroacupuncture treatments and functional fascial therapeutics

Juliette Woodruff RMT(Bio) provides medical acupuncture

More information: https://orthophysio.com/?s=acupuncture

https://orthophysio.com/latest-news/physiotherapy/acupuncture/

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

Acupuncture Description

 

Medical acupuncture

Medical acupuncture treatment is insertion of single-use needle based on the points established along meridians (energy channels).  Individual points are frequently targeted to treat various conditions. These points often resemble trigger points and/or motor points in the tissue. It utilizes the neurological pain control theory.

Dry Needling/Intramuscular Stimulation (IMS) Acupuncture

Dry Needling is an acupuncture-­like treatment used in therapy. It is also known as intramuscular stimulation (IMS). The technique helps break down adhesion in tissues and muscles, relieving pain and tension.

Electroacupuncture

Peripheral nerve stimulation for inhibited/weak muscles’ activation to increase engagement/strength and decrease pain.

Fascial needling –The technique is different than traditional acupuncture as the needles are inserted horizontally and more superficially. The technique targets the subcutaneous (below the skin) layer of tissue to stimulate change in connective tissues, Functional Fascia Therapeutics.

Who will benefit?

Pre/post surgical conditions, acute/chronic pain, increase performance and mobility.

Service provided by:

Igal Untershats, RMT, provides medical acupuncture, dry needling, electroacupuncture and fascial acupuncture treatments

Juliette Woodruff, RMT, provides medical acupuncture

Taylor Sipos, Registered Physiotherapist provides medical acupuncture

Tiffany Shi, Registered Physiotherapist provides dry needling acupuncture

More information: https://orthophysio.com/?s=acupuncture   https://orthophysio.com/latest-news/physiotherapy/acupuncture/

Book an appt: physio@orthophysio.com or call 416-925-4687

 

Hip bursitis treatment: steroid injection vs. Dry Needling & acupuncture

If you have been diagnosed with hip bursitis or tendinitis you may want to consider other options before committing to steroid injections. A new wave of research is suggesting that application of Dry Needling (DN) acupuncture, as an alternative to steroid injection for treatment of hip pain and functional limitations, is safe and just as effective1!

What is bursitis?

Bursitis refers to inflammation of the bursa. A bursa is a fluid filled sac that provides cushioning between tendons and/or bones around your joints2.

Although it is a common diagnosis, hip bursitis is an often-inaccurate term used in the medical field. The majority of cases described as hip bursitis actually have no inflammation in the bursa!  Muscle tears, tendon strains and trigger points can all cause pain in this area1.

The most common risk factor for pain in the outer hip area is overuse injuries (also referred to as repetitive stress injuries). Running and standing for long periods of time are common causes.

What are the symptoms of hip bursitis and tendonitis? 

This condition is characterized by tenderness to touch over the bony prominence on the outer aspect of the hip1. In more acute stages, pain is often described as localized and sharp. However, more chronic conditions can be felt as dull and achy.

You might also experience pain with certain movements or positions.  Your hips may hurt when you are standing and bearing weight. This pain can be more noticeable as you shift your weight to stand on the affected leg. This pain may occur when you are walking, climbing up/down the stairs, running, prolonged standing and cycling. You may also experience pain when there is simply too much pressure on your hips, like when are trying to sleep on the affected side.

How common is hip bursitis/tendinitis?

It is estimated that 10% to 25% of us will experience chronic hip pain within our lifetime1. You are more at risk for pain in this region if you have any of these issues:

  • low back pain
  • osteoarthritis
  • IT (iliotibial) band tenderness
  • excess body weight

What is Greater Trochanteric Pain Syndrome?

The term bursitis is often used as a catch-all term for pain felt in the outer aspect of the hip and thigh. We now know that pain in this body area can be caused by a number of issues. Bursitis, gluteal muscle tears, tendinopathy and trigger points in any of the muscles crossing the hip can all be a source of this discomfort1.

As we gain a deeper understanding of sensation and causes of pain, the complexity of understanding the source of the problem is leading us to prefer the term Greater Trochanteric Pain Syndrome (GTPS) over bursitis. This change reflects the fact that the bursa is not always the main source of the hip pain. It also helps us to consider more comprehensive solutions as it encompasses a wider variety of causes.

Is steroid injection beneficial?

YES! Therapeutic steroids – sometimes referred to as corticosteroids or cortisone – are helpful in treatment of a number of different conditions3 (such as hip bursitis). Therapeutic steroids are similar to the hormones your body releases to fight illnesses, injuries and help reduce inflammation in your body. Your physician or specialist will inject a small amount of steroid to control pain and inflammation in a bursa, joint, tendon or muscle. A local anesthetic is also commonly injected at the same time.

Are there any side effects to steroid injections?

Although rare, there are a number of adverse effects associated with steroid injections that should be considered. Side effects of steroid injections can include4:

  • mild allergic reactions
  • temporary increase in pain
  • swelling
  • blood sugar increase

More severe side effects may include weakening of tendons and ligaments with multiple injections in one area over a short period of time. Achieving  minimal relief after two injections is generally considered as a contraindication to having more injections4.

Are there any alternatives to steroid injection?  

Recognizing that hip bursitis is not the only cause of hip pain, other treatment options are being considered as alternatives to cortisone injections. Massage, stretching and appropriately selected exercises can all be helpful. A recent study1 shows that Dry Needling – also known as intramuscular stimulation (IMS) – is just as effective as steroid injection for treatment of GTPS (including bursitis and tendinitis)!

Dry Needling acupuncture can help!  

Dry needling (DN) is the Western approach to acupuncture. In this technique thin needles are used to stimulate local trigger points in muscles. DN treatment reduces muscular and myofascial pain, releases trigger points, and helps restore movement. (To learn more about Dry Needling technique and how it works, click here).

The key to an effective treatment is about appropriate diagnosis! By completing a detailed assessment, your physiotherapist will identify trigger points and muscles that carry excessive tone (i.e. are too tense). Once the right trigger points are identified, fine sterile needles are inserted through the skin to release these knot-like thickenings in the muscles and fascia. Muscles around the side and back of buttock region, muscles of your thighs and muscles of the lower back often respond well to dry needling for treatment of GTPS1.

When should you consider Dry Needling acupuncture for your hip pain?

Dry needling is a safe and effective alternative to corticosteroid injections for treatment of many types of hip pain.  It can be selected as an alternative when cortisone injections should not be used – such as drug allergies. Or if you prefer this type of approach, dry needling can be an appropriate substitute.

Dry Needling can benefit you if:

  • Hip pain is making your day-to-day function more difficult.
  • A steroid injection resulted in minimal or no relief.

Contact us if you are interested in learning more about alternative options to injections or would like to book a treatment for your hip pain.  Speak with Milad Bazaz-Jazayeri, Registered Physical Therapist –  mbazaz@orthophysio.com – to learn more about treatment options that fit your needs best.

 

 

 

 

References:

  1. Kindyle , Brennan , Allen Bryce, and Munoz Maldonado Yolanda. “Dry Needling Versus Cortisone Injection in the Treatment of Greater Trochanteric Pain Syndrome: A Noninferiority Randomized Clinical Trial.” (journal of orthopaedic & sports physical therapy) 47 (April 2017): 232-239.
  2. American Academy of Orthopaedic Surgeons. Hip Bursitis. March 2014. http://orthoinfo.aaos.org/topic.cfm?topic=a00409.
  3. Labrosse, Julie, et al. “Effectiveness of Ultrasound-Guided Corticosteroid Injection for the Treatment of Gluteus Medius Tendinopathy.” American Journal of Roentgenology 194, no. 1 (January 2010): 202-206.
  4. Cardone, Dennis, Alfred Tallia, and Robert Wood Johnson. “Joint and Soft Tissue Injection.” American Family Physician 66, no. 2 (July 2002): 283-289.

 

 

Dry Needling – A Western Approach to the Eastern Art of Acupuncture

Dry Needling is an acupuncture-­like treatment used in therapy. Also known as intramuscular stimulation (IMS), this treatment is used to reduce muscular and myofascial (1) pain, release trigger points, and restore movement.

It may be used to treat a chronic condition or an acute episode particularly when there is no obvious cause of injury, i.e. repetitive strain injuries (RSI). Every muscle in your body is comprised of numerous muscle fibers, which generally line-up in the same direction. This structure helps each of your muscles produce the greatest possible amount of power. To do this, the fibers need to glide and move freely. However, through a lack of mobility the fibers within the same muscle, or between different muscles located next to each other, can stick together and form what is felt as a thickening or knot.

These adhesions can also be felt as taut and tender spots in the connective tissue or in the fascia which surrounds muscles, resulting in myofascial knots and trigger points. These adhesions  can form when your muscles are held in a shortened position for a long period of time, such as sitting at a desk with poor ergonomic support. Trigger points can also result from contusions (bruises) or repetitive stress, such as the pain you may feel in your forearms due to typing.

Eastern vs. Western Acupuncture

Dry Needling is considered to be the Western approach to acupuncture. It focuses on the biomechanics of the body, emphasizing the importance of human body’s structures and movements; rather than the energy channels used in Traditional Chinese Medicine (TCM).

The practice of dry needling began in the 70’s when North American Physicians wondered what would happen if they stimulated trigger points in the muscles using only the needles, instead of injecting local anesthetics. The term dry needling was chosen because nothing was being injected through the needles.

Ever since its introduction a number of studies have shown there is as much benefit from dry needling in the treatment of musculoskeletal pain as there is with the injection of different substances, including corticosteroids and analgesics. 

These results prompted me to study dry needling as well as acupuncture to treat muscular and myofascial pain. Although I use both techniques, in my practice I have found dry needling helps my patients recover faster and I often use it in conjunction with manual therapy and other more traditional physiotherapy modalities.

What is the difference between acupuncture and dry needling? 

In TCM, besides the points established along meridians (energy channels), individual points (2) are frequently targeted to treat myofascial conditions. These points often resemble trigger points and/or motor points in the tissue. In contrast, dry needling directly targets localized trigger points regardless of their relation to meridians. Depending on your healthcare practitioner’s approach, Dry Needling and Acupuncture points may or may not be identical. However, even when the points are identical, the two techniques can be rather different. By inserting needles through the skin, fascia, and into tense muscle fibers, dry needling directly releases knots and trigger points. These fine needles are similar to – or often the same as – acupuncture needles. However, they are not left inserted in the muscles for an extended period of time. Instead, they are moved in and out of the trigger points to elicit a contraction, twitch or “popping” sensation in the muscle fibers.

How does Dry Needling work?

Dry needling restores your muscle fibers’ natural movements and reduces restrictions that impede mobility. It helps to restore muscle efficiency through contraction and relaxation of specific fibers. This technique can also release endorphins – the body’s naturally occurring morphine which reduces pain!

By inserting a needle into a tense muscle an involuntary contraction or twitch may occur. These local twitch responses (LTR) have been shown to improve treatment outcome (3). The quick contraction causes the adhesion in between muscle fiber to break down and improves the movement of the muscle.  As the fibers shorten and pull away from the trigger point the result is a release of tension and relaxation of the muscles.

Is Dry Needling painful?

Here at the Orthopaedic Therapy Clinic we commonly believe in a  “No Pain, More Gain!” model of treatment. However, Dry Needling is one of the few techniques in which some pain can result in more gain!

When inserted into a relaxed muscle at rest, needles face minimal resistance as they move through muscle fibers and there is little to no discomfort. However, the higher the tension, the more resistance there is to the needles entering the muscle. The result is that you may experience a quick cramp-like sensation with a local twitch response when trigger points are targeted directly. For this reason, some patients may find the application of dry needling more uncomfortable than traditional acupuncture. After a treatment you may feel a localized soreness for up to 48 hours after a dry needling treatment session. It is important to allow an adequate amount of time between dry needling treatment sessions to let your body’s natural healing process to take place after each treatment.  Treatments are typically scheduled once this localized soreness has resolved.

Who benefits from dry needling?

As a practitioner, I use both acupuncture and dry needling to treat acute as well as more persistent or chronic conditions. Considering that breaking down adhesion is not the primary focus of acupuncture, I find dry needling more effective when dealing with chronic tightness and cramps in muscles and fascia; particularly when there is a plateau in recovery with other treatment techniques. Dry needling is beneficial in combination with other physiotherapy treatments (strengthening muscles, manual therapy, soft tissue release, etc.). I recommend this technique for treatment of a number of conditions; including, but not limited to:

  • Conditions associated with poor posture (i.e. Postural dysfunction),
  • Tendonitis,
  • Headaches and neck pain,
  • Back pain,
  • Repetitive strain injuries,
  • Muscle strains,
  • Concussion related symptoms

If you experience knot-like pain in your muscles that does not settle with other types of therapy, restricted range of motion or functional limitations; or if you feel that you no longer get lasting relief from other types of treatment, contact Milad Bazaz at the Orthopaedic Therapy Clinic to set up an appointment for a thorough assessment and to discuss whether dry needling is a treatment option for you.

  1. Myofascia is a dense and thin layer of tissue that covers muscles and bones in the body.
  2. Called Ah shi points
  3. APTA (American Physical Therapy Association)

 

What is acupuncture and how does it work?

Acupuncture is a form of therapeutic modalities in Traditional Chinese Medicine – also simply referred to as TCM – that is used to treat pain and dysfunction. The TCM’s philosophy is based on the relationship between a person’s emotions and physical being with nature and having an integrative relationship between them as a whole.

What is acupuncture and how does it work?acupuncture_post
The practice of acupuncture involves insertion of thin needles through the skin and into the body. In TCM, acupuncture is used to stimulate specific points that are located on various pathways that are known as Meridians. Qi (pronounced Ch’i) is translated as “vital air” that flows in meridians, much like the oxygen that flows in blood vessels and supply the vital functions of the organs, bones, muscles, and nerves. In TCM, pain and dysfunctions arise from the blockages of Qi along the meridians. Acupuncture aims to restore the flow of Qi in order to reach physiological equilibrium, hence reducing pain
and dysfunction.
In western medicine the effect of acupuncture needles is explained as a technique to locally stimulate muscles, nerves and connective tissues below the dermis – the deepest layer of skin. In other words acupuncture stimulates the body’s natural healing response to relieve pain and restores the function of the affected region.

Does acupuncture work?
Acupuncture is most commonly used to treat local and systemic pain. Research suggests that the use of acupuncture can be beneficial for numerous conditions such as chronic low back pain, chronic neck pain, tension type headaches, chronic hip and knee osteoarthritis, shin splints, and chronic lateral elbow pain.
In western medicine the effect of acupuncture is often understood through the gate control theory. This theory indicates that an external stimulant – in this case acupuncture needles – can lead to an increased activation of neurotransmitters, which interfere with stress signals that are send to the brain. This closes the “gate” and the signal does not get through which alleviates the pain.
Acupuncture can target specific muscle pain, tightness, inflammation, and swelling via local needling traditionally but also through dry needling. Acupuncture also has global beneficial effects throughout the body. For example, points that can treat muscle soreness can also treat headache.
Acupuncture promotes circulation throughout the body (i.e. globally) which is beneficial for accelerating healing process and reducing pain. For example, patients with diabetes experience a slower rate of healing due to reduced circulation and its effects on the healing process. Hence the use of acupuncture can help facilitate this recovery process by promoting blood circulation. Increasing the circulation throughout the body can affect a person in ways other than physical well-being such as endorsing mental and emotional well-being.

Is Acupuncture painful?
In TCM, De Qi is the sensation experienced by the patient or the practitioner while administrating acupuncture. This sensation usually differs from the pain of insertion itself and is often described as distension, numbness, soreness or heaviness at the site of insertion or along meridians. The thin acupuncture needles are designed to minimize the discomfort from the insertion of the needle. However, based on the location that these needles are applied, some tenderness may be experienced, which commonly
dissipates within few seconds. Some patients may find Dry Needling technique more uncomfortable as the needle directly targets tender spots.

Is acupuncture safe?
There are a number of potential risks associated with the use of acupuncture needles, such as infection, bent or broken needles and organs puncture however these side effects are managed through proper technique and equipment. Acupuncture needles are typically made of sterilized disposable stainless steel wire to limit infection. Your healthcare provider uses their sound anatomy knowledge to minimize the risk of serious injuries to the organs, blood vessels and nerves.
As a therapist, I often choose the application of acupuncture in conjunction with other treatment methods, such as manual therapy and exercise prescription. After a thorough assessment, and based on the specific condition that is being treated – i.e. pain, swelling, muscle tension –and the individual needs of the patient, acupuncture or dry needling techniques can improve the treatment effect. I tend to integrate both western and eastern point of view on healing and physical medicine to treat the body locally and as a whole in order to ensure a comprehensive treatment.
If you wish to consider acupuncture as part of your treatment plan, consult your healthcare provider (i.e. Physical Therapist, Chiropractor, TCM acupuncturist or massage therapist) to ensure safety and efficiency of this modality for you.

Acupuncture & Cancer Treatment

Acupuncture and Cancer Treatment

OTC_acupunctureAt the Orthopaedic Therapy Clinic our Registered Massage Therapists hold a dual certification in Massage and Acupuncture. They are trained to apply acupuncture by combining an evidence-based approach with Traditional Chinese Medicine. Acupuncture may be used as a treatment on its own or in conjunction with your massage therapy.

Acupuncture is helpful in relieving pain, promoting healing and creating a general sense of well-being. It can be beneficial at many different stages of healing and is used to improve the symptoms from chemotherapy and radiation treatment. We recommend acupuncture for:

  • Cancer-related pain
  • Nausea and vomiting
  • Fatigue
  • Dry mouth
  • Restoring a general sense of wellness
  • Increasing energy levels
  • Muscle pain and dysfunction
  • Joint pain
  • Hot flashes

 How does Acupuncture work?

Western scientific research has proposed mechanisms for the effect of acupuncture on pain relief. One of the theories is based on the well-regarded gate control theory of pain originated by Melzack & Wall in 1965. This theory proposes that one type of sensory input i.e. low back pain, could be inhibited in the central nervous system by applying another type of sensory input i.e. needling. There is also evidence that acupuncture may stimulate the production of biochemicals (endorphins, serotonin, and acetylcholine) that have a pain relieving effect[1].

When should I have acupuncture treatment?

There is increasing scientific evidence to show that acupuncture is effective in treating the following conditions:

  • Low back & neck pain
  • Shoulder pain
  • Wrist & hand pain
  • Facial pain
  • Headaches

Who will I see?

When you work with any of our Registered Massage Therapist you will be treated by a highly educated professional who has extensive post-graduate experience. Each therapist is a graduate of McMasters University Acupuncture certification course and has obtained an advanced level of training.

What can I expect at my appointment?

The initial assessment is scheduled for one hour and includes a physical assessment as well as a Traditional Chinese Medicine (TCM) assessment. The TCM assessment looks at physical symptoms and includes tongue diagnosis. Once the appropriate meridians are determined sterile, single use acupuncture needles will be inserted along these ancient locations based on organs. The needles are left in for 30 minutes while you rest.

It is always important to check with your oncologist to determine if there are any concerns before starting any type of complementary or alternative treatment. Your therapist should know your full medical history including blood work, and drug history. This information should be updated at every visit, especially if something has changed.

Are there any reasons I should not have acupuncture treatment?

There are several conditions where acupuncture should not be applied or should be applied with caution.

Blood clotting disorders:

  • Blood clotting issues are common with leukaemia and other haematological concerns i.e. haemophilia
  • Before beginning treatment it is preferable that you have a platelet count of over 20,000
  • Caution needs to be exercised with anticoagulants i.e. warfarin, and the needles should not be inserted into the joints

Low white blood cells: Acupuncture should not be used if you have an increased  risk of infection

Unstable spine: Needles cannot be inserted in the local area of an unstable spine if there is a risk of spinal cord injury

Skin conditions:

  • If you have an open wound, or an infection, the needles should not be inserted into this area
  • If you have lymphedema needles should not be inserted into the affected limb

Prosthetic implants or reconstruction: Needles should not be inserted into a prosthesis i.e. breast implant or into an area of reconstruction i.e. latissimus dorsi flap

Post bone marrow transplant: Following a bone marrow transplant, a 6-12 months waiting period is recommended before starting acupuncture treatment

What should I do after my acupuncture treatment?

Following a specific protocol after treatment can help to maximize the effects of your treatment. Here’s a list of things we find are helpful to do and to avoid after acupuncture:

  • Avoid activities that require exertion for up to two hours after treatment.
  • Try to rest when you get home from your treatment.
  • If you are being treated for pain, try to avoid strenuous activity for two days after treatment. This is important even if you are pain free.
  • Take your pain pills or other medication as directed by your doctor. It is helpful to keep a record of the amount taken to determine if the acupuncture is altering your need for medication.
  • Avoid any alcohol or caffeine for two hours after treatment.

What to expect

Some people will feel immediate relief whereas others may take a few hours or even a few days to experience a benefit. You may require a few treatments before you feel the benefit. If you are not feeling some improvement after several treatments you should discuss this with your therapist.

Occasionally symptoms become worse before they improve. Typically this will last only a day or two. If your symptoms persist for more than 2 days you should contact your therapist at The Orthopaedic Therapy Clinic.

Does acupuncture have side effects?

  • Drowsiness may occur after treatment and you should not drive until it passes
  • There may be minor bleeding or bruising
  • Pain during treatment is rare
  • Occasionally symptoms get worse after treatment. When this happens it is important to let your therapist know.
  • Some people faint from needles however this is most likely at the first appointment.

How many treatments will I need?

The number of treatments will vary with each individual and with the condition being treated. For complex or long standing conditions, one or two treatments a week for several weeks may be recommended. For acute problems you may only need a few treatments to see a benefit.


[1] Chu et al., 1979; Anderson, 1993; Stux & Pmoeranz, 1998).

Acupuncture 101

OTC_acupuncture

Acupuncture is one of many therapeutic modalities used in Traditional Chinese Medicine to treat pain, and dysfunction. Traditional Chinese Medicine (TCM) is an ancient healing system, dating back nearly five thousand years. The Chinese philosophy in acupuncture is based on the relationship with nature, our emotions, and our bodies, and having an integrative relationship between them as a whole. It looks at different aspects of our lives such as, environment, diet, lifestyle, and emotional state. These factors all influence the body’s ability to keep in harmony creating a well-balanced system. Read more…

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/

    Is your Rotator Cuff the cause of your Shoulder pain?

    Bianca Andreescu, the prolific tennis superstar, made Canadian tennis history by winning both the U.S. Open and Rogers Cup in the summer of 2019 (Figure 1). Prior to these incredible accomplishments, Andreescu suffered a rotator cuff tear which forced her to withdraw from competition and complete an intensive rehab program.  Many lessons on the nature of a rotator cuff injury and shoulder injury therapy can be learned from Andreescu’s journey.

    (FIGURE 1)

     

     

     

     

    Rotator cuff tears are a common shoulder injury which can present with any of  the following symptoms:

    • Pain in the front and/or outside of the shoulder
    • Pain with activities such as lifting the arm overhead
    • Decreased strength in the shoulder
    • Night shoulder pain

    Despite the prevalence of this injury, there are many misconceptions about rotator cuff tears and it’s treatment. This article will focus on helping you to understand the injury and how best to treat it.

    Shoulder Anatomy 101

    Our shoulder joint is a ball and socket joint.  This shape allows us to have very flexible movements (Figure 2), however it is also less stable than other joints.  The lack of stability makes it more dependent on the muscles to provide support.

    The rotator cuff is comprised of 4 muscles which are situated around the shoulder joint:

    • supraspinatus
    • infraspinatus
    • teres majory
    • subscapularis

    The primary function of these muscles is to stabilize the shoulder during movement (Figure 3). Specifically, while our larger shoulder muscles such as our pectorals and deltoids work to create movements such as lifting the arm, our rotator cuff muscles maintain and controls the positioning of the ball on the socket. This stabilizing function is critical to safe, pain-free movements of the shoulder

    (FIGURE 2)

    As the shoulder is a complex and mobile joint, we place lots of stress  on the rotator cuff throughout our lifetime. Eventually this cumulative stress can lead to a tear.  A cuff tear can also occur through a more traumatic mechanism such as a fall.

    (FIGURE 3)

    Do I need Imaging for my Rotator Cuff Injury?

    When our shoulder hurts we may be referred for an MRI or ultrasound imaging.  These tests are often prescribed to determine the presence, as well as the severity of a rotator cuff tear. However, recognize that when it comes to shoulder pain, imaging does not tell the entire story.

    In 2010, a study looked at the prevalence of rotator cuff tears in people with and without shoulder pain[1]. Imaging was performed on both shoulders. The results showed that 20.7% of people had a rotator cuff tear however 17% of these people had absolutely no shoulder symptoms whatsoever. Additionally, of the people who reported they had shoulder pain, only 36% of them had a tear seen on imaging. This study shows us that imaging is not a perfect tool in determining the cause of your shoulder pain.

    Diagnosing the cause of your shoulder pain

    A thorough examination is as important as imaging in helping to determine the factors contributing to your pain. To do this your therapist needs to consider many factors to pinpoint the problem.  Typically your examination will include tests for:

    • shoulder range of motion
    • muscle strength
    • stability
    • joint stiffness
    • postural analysis

    Additionally, understanding which activities aggravate your pain, your current activity level and past medical history completes the full insight into your injury. A thorough examination ensures a personalized rehab program that will help get rid of your shoulder pain and return you to the activities you love.

    Treatment for my Rotator cuff injury

    The final step in your recovery is a comprehensive rehabilitation program.  Your treatment will typically include 3 phases.

    1. Pain control.  This consists of using techniques such as therapeutic ultrasound, acupuncture and gentle soft tissue massage to reduce pain.
    2. Restore movement. Once pain levels are under control, the goal is for your movement to be returned to normal using therapeutic exercise and hands-on therapeutic techniques i.e. stretching, joint mobilization techniques.
    3. Restore strength. Strength training is critical to improve the structural integrity of the rotator cuff.  This allows your shoulder to function more effectively and reduces the risk of injury in the future.

    Andreescu’s Injury and her recovery

    Bianca Andreescu’s injury can be used as a discussion point on rotator cuff tears and rehabilitation.  Her injury caused her to retire from the 2019 Miami Open tournament[2]. The injury persisted for Andreescu and she was forced to withdraw from Wimbledon in June.

    It was later reported that she had suffered from a tear in her subscapularis, which is 1 of the 4 rotator cuff muscles.  The subscapularis aids in internal rotation of the shoulder, which is a movement primarily used in a forehand shot in tennis. Andreescu was able to manage the injury through a solid therapy program and go on to win both the U.S. open and the Rogers Cup in Toronto later that summer.

    Andreescu’s recovery is a good lesson for people experiencing their own rotator cuff-related pain. Her story shows that many cuff tears can be managed conservatively without the need for surgery, even in elite-level athletes who have incredibly high demands on their shoulders.

    What should do if you suspect  you have a Rotator cuff injury

    If you are having shoulder pain or think you have a rotator cuff injury, contact me, taylor Sipos, directly at Tsipos@orthophysio.com.  Or call us to make an appointment at 416-925-4687 During our initial assessment I will make sure to gain a comprehensive understanding of your pain and then work with you to determine the best personalized plan to get you back to your activity.

     

    [1] Yamamoto, A., Takagishi, K., Osawa, T., Yanagawa, T., Nakajima, D., Shitara, H., & Kobayashi, T. (2010). Prevalence and risk factors of a rotator cuff tear in the general population. Journal of Shoulder and Elbow Surgery19(1), 116-120.

    [2] Myles, S. (April 19 2019). “Small tear” in  Andreescu shoulder sets her back. Retrieved from https://tennis.life/2019/04/19/small-tear-in-andreescu-shoulder-sets-her-back/

    Jaskirat Cheema – Bio

    Jaskirat Cheema 

    Resident Registered Physiotherapist, MSc.PT, BSc 

    jcheema@orthophysio.com 

    Jaskirat completed her Master of Science in Physical Therapy at the University of Toronto. Prior to this she obtained her Honours in Human Kinetics degree at the University of Guelph.

    Jaskirat was inspired to become a Physiotherapist after watching her family members recover from various sports- and work-related injuries, with physiotherapy. This fueled her desire to help others recover and return to the activities that matter to them.

     

    To reduce pain, optimize function, and prevent re-injury, Jaskirat places emphasis on evidence-based and active approach to treatment through use of manual therapy, individualized exercise prescription, and patient education. She has a particular interest in back pain; during her final physiotherapy internship she was mentored by the clinic owner, Maureen Dwight, to perform comprehensive assessments and implement treatment plans for clients with complex injuries/conditions (chronic neck, back and post-operative spinal conditions).

     

    To advance her education and skills, Jaskirat is planning on completing her certification in level 1 orthopaedic manual and manipulative physiotherapy (Dec 2020) and contemporary/medical acupuncture from McMaster University (Spring 2021). She is also working on a special project that you will be hearing more about over the next few months.

     

    During her free time, you can find Jaskirat enjoying a Raptors game, playing basketball, and doing Muay Thai (Thai Boxing). She is also fluent in Punjabi.

    Meet our new Physiotherapists

    We are excited for you to meet the physiotherapists who have joined our team in the last few months.

    Taylor Sipos

    Registered Physiotherapist, MPT, BKin, 

    tsipos@orthophysio.com

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

    Since graduation, Taylor has taken numerous courses to enhance 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 empathy and compassion for his clients. He strives to provide evidence-based therapy with a strong focus on self-help through exercise and education. He believes in motivating his clients to take 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 weight-lifting, playing hockey and cycling.

     

    Tiffany Shi

    Registered Physiotherapist, MSc.PT, BSc

    tshi@orthophysio.com

    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 to return to the activities they love. She uses a thorough history and a comprehensive physical examination to identify the root cause of the condition. Her treatment approach includes manual therapy to address restricted tissues and she promotes self-help by prescribing exercises that are tailored to the needs and goals of each client.

    Tiffany is committed to life-long learning. She is continuing her training with education in 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 sabre fencing and refereeing at competitions. She also enjoys photography, sewing, life drawing and reading. She is bilingual and is happy to provide service in Mandarin if needed.

     

    Functional Fascia Therapeutics (FFT)

    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 than 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 is trained in Functional Fascia Therapeutics. 

    To arrange an appointment please call 416 925 4687 or email: igalu@orthophysio.com

    Taylor Sipos Bio

    Taylor Sipos,

    Registered Physiotherapist, MPT, BKin, 

    tsipos@orthophysio.com

     

     

    Taylor completed his Master of Physical Therapy degree from Western University after earning his Bachelor’s degree in Kinesiology from McMaster University. Taylor’s passion for physical therapy developed as he grew up participating in competitive sports. Watch Taylor’s video here
    Since graduation, Taylor has taken continuing education courses to enhance his skills and advance his professional development. These courses include:

    • Mulligan Concept Lower Quadrant course
    • Soft Tissue Release
    • Level I Acupuncture through Acupuncture Canada
    • Temoporomandibular Management: Modern Manual Therapy
    • Temporomandibular Management: Advanced Physical Therapy Education Institute (APTEI)
    • The Hip Complex: Breaking down barriers to better outcomes

    In addition, Taylor currently has his Level I certification within the Orthopaedic division of the Canadian Physiotherapy Association’s manual therapy levels and intends to complete all 5 levels to become a fellow of the Canadian Academy of Manipulative Physiotherapy (CAMPT). Furthermore, he has received training in concussion and vestibular rehab. Taylor is also interested in pursuing courses in dry needling, McKenzie low back management and treatment for running injuries.

    Taylor’s treatment strategy always revolves around the functional goals of his patients. One of the first questions he asks upon working with a new client, is “What would you like to get back to doing?”. Once a goal has been established, Taylor works in collaboration with his clients to achieve these goals. 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 addition to his emphasis on self-management, Taylor utilizes his skills in manual therapy and acupuncture as an adjunct therapy to help his patients return to what they love participating in.

    Taylor has always been passionate about sport and in his youth he competed in hockey, lacrosse and cross country running. Now 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 weight lifting, playing hockey and cycling.

    Winning the WAR on Low Back Pain – Managing the attack

    One day it starts.  Your back hurts even though you did nothing to injure it.  The pain is intense.  You feel sharp pain shooting down your leg.  You bend forward and your muscles spasm.  It’s almost impossible to straighten up.   When you feel like this you have probably missed the warning signals and have entered the Attack stage in the WAR on low back pain. Watch the you tube video here:  https://www.youtube.com/watch?v=z75EFc9unHk

    man with low back pain

    Signs of the Attack 

    In may last blog I reviewed the stages of low back pain and gave you a guideline for recovery. Each stage has it’s own strategies and it’s important to know whether you are in the Warning, Attack or Recovery Stage (WAR).

    Although it may seem obvious, the symptoms of  the Attack stage can be confused with the initial stages of Recovery.  The key characteristics that tell you that you are in a full-blown Attack are:

    • Unrelenting pain. The pain may wax and wane but you are never pain free.
    • Short term relief with changing positions however the improvement doesn’t last.
    • Symptoms present less than 3 months.

    How long will the pain last?

    When you are in the Attack stage you need to be prepared that your symptoms are not going to disappear overnight.  They may last for a few weeks or even a few months.  Fortunately, the odds are in your favour as you have a 95% chance that within 3 months your pain will be better.

    Three months can feel like forever. I understand that no one wants to hear that they may be in pain for this long, but believe me it is comforting to know that, when the pain doesn’t immediately abate, time is truly a healer.

    You can also expect your pain to progressively lessen and become more intermittent over this period.  However if you want to avoid this hiatus of life – next time pay attention to the warnings!  Right now the most important thing you can do is avoid becoming a prisoner of the pain.

    Prisoner of pain

    This stage is caused by your emotions.  When the pain is intense you worry that something serious is wrong or whether this will be how you will feel for the rest of your life.

    The problem with these emotions is that it’s hard to heal when you are worried and it’s even harder to be logical when making decisions to manage the pain.  This can make the pain last even longer. Your job at this stage is to stay relaxed – despite the pain.

    The key to avoiding becoming a prisoner is to know that most causes of low back pain are not serious and that the pain will end.  Education, medication and relaxation strategies such as breathing can all help. It is important to keep reminding yourself that you will get better with time.

    Although it may take the full 90 days, many people will be much better within 2-3 weeks.  I often recommend you mark the days on a calendar as you can expect parole no later than 3 months, and it may be sooner for “good behavior”.

    What have I hurt?

    We all want to understand what is causing our pain. When we Google low back pain  it seems a diagnosis is critical to know how to get better.

    This perspective can be problematic, as at the beginning of the Attack stage it can be difficult to determine exactly which structure is hurt.  The difficulty in getting an exact diagnosis can be unsettling.  You may interpret this as meaning you have something unusual or unknown, when the real reason we can’t tell you what you’ve injured is that the cause of the pain is somewhat generic.  Irrespective of whether you have herniated a disc, sprained a facet or pulled a back muscle, most back pain initially has the same cause.

    Almost every injury starts with a stage that is variously referred to as nociceptive (pain), chemical or inflammatory.  These terms reflect that the pain you are experiencing is caused by the release of chemicals[1]. These chemicals irritate the surrounding tissues however they are not all bad as they also help you heal.  The most important thing to know is that as long as they are present you will be in pain.  Your rehab plan should include strategies to avoid prolonging this stage by limiting activities that provoke the tissues to release more chemicals.

    Do I move or do I rest?

    The pain makes you want to rest however the internet tells you to move.  Both are wrong!

    Second only to whether to use ice or heat, the decision to move or rest can be one of the most confusing decisions in back pain recovery.  When we look online, our research tells us that core is essential to recovery however during the Attack-stage strengthening your core will not cure the pain. Too much movement or exercise can cause more irritation and prolong our recovery.

    However don’t think this means you should take to your bed.  You need to move but you should also avoid substantial increases in pain from being too active before you’re ready. Movement is the key to flushing the chemicals out of your body by enhancing your circulation.

    Determining the right level of activity

    Start with gentle everyday movements like walking or light activities around the house i.e. dishes. As you transition out of this stage, exercise will become more valuable. Leave going to the gym until the basic movements are feeling better.

    As you get moving it is normal to feel a mild increase in pain however the increase should not be intense nor last for longer than 30 minutes.  I find this guideline helps to determine whether you are doing too much or too little.

    What about medication?

    Medication can be helpful during the Attack stage.  It can make  the pain more manageable.  This allows you to move more easily and worry less.

    Take what you need, but don’t make the mistake of thinking that intense pain needs intense medication.  Sometimes surprisingly low doses of over-the-counter medication can manage your pain.

    See your family physician and discuss whether pain medication is right for you. Recognize that most medication for low back pain does not cure the problem.  The main purpose is to allow you to move more comfortably and to get more sleep.

    What about Therapy?

    In the Attack stage the primary focus is pain control and staying active as tolerated.  Gentle hands-on treatments and pain-relieving modalities (ice, heat, acupuncture, laser etc.) can help you to get through this stage.

    If treatment doesn’t immediately relieve the pain, don’t despair.  Have your therapist help you to develop a treatment plan.  Discuss which home-based strategies are right for you i.e. heat, ice, etc.   Plan to come back for a review in a few weeks as the most value in winning the war of low back pain is to see your therapist for their guidance during the Resolution stage.

    If you need more advice on managing your low back pain or preventing another WAR, contact us to book an appointment at  physio@orthophysio.com or 416-925-4687.

    [1] One of these chemicals has the self-evident name of pain substance.  Many of the other chemicals are related to inflammation.

    Winning the WAR on Low Back Pain

    One morning you wake up, get out of bed and find it difficult to straighten up.  Your back is stiff.  It’s hard to bend forward to put on your shoes.  You sit down and find that your leg suddenly won’t bend enough to reach your foot.  You take a hot shower and within an hour you begin to feel better and go to work.  You forget about it until the next day the same thing happens.   Whether you are 25 or 65 you may decide that this is just a sign of age when what it is telling me is that you are going to W.A.R. with your body.  These are the early signs of low back pain and unless you recognize them you may go onto a full back pain attack.

    Stages of Low Back Pain

    View Video, WAR on low back pain https://youtu.be/7E0Tc0i-ZxQ

    W.A.R. is the acronym I chose to represent the struggle of the mind and body that is an integral part of this injury and because it is a helpful for understanding the 3 stages of recovery. Like with any war, there are stages of engagement.  Each stage has different characteristics and strategies.  Ultimately, winning this WAR will be determined by identifying which stage you are in and applying the treatments that work for that stage.

    3 Stages of Low back pain:

    1. W- Warning
    2. A – Attack
    3. R – Resolution

    Choosing your treatment

    The most common mistake I see made in the recovery or prevention of low back pain is when the wrong treatment is selected for your stage of recovery.  Well-meaning friends, therapists or Dr. Google tells you about some amazing recovery from a certain type of treatment.  Maybe it’s exercise, manipulation or strong stretching techniques like ART.  Testimonials will encourage you to try it, but what is often unclear is whether it’s right for you.

    While there is no doubt that each of these treatments can help reduce low back pain, if you want to win this WAR it’s critical to match the right treatment to where you are in your healing.  The wrong treatment at each stage can have a profound effect on both your speed and resilience of recovery.  The first step is to determine your stage of back pain recovery before you choose your treatment.

    Stage 1 – Warning

    Back pain often starts with subtle warnings. These warnings may go unrecognized or are ignored until suddenly you under Attack.  The result of missing these cues can be a full-blown episode of back pain which puts your entire life on hold for weeks or even months. To win this WAR your first goal should be to avoid the full-blown Attack.  This is best done by recognizing the Warnings and immediately making lifestyle changes.

    Warning Symptoms:

    Some of the most common symptoms of an impending back attack are:

    • Back stiffness in the morning
    • Back stiffness at the end of the day or after exercise
    • Back discomfort rising out of a chair
    • Back discomfort when standing. [1]
    • Muscle tightness in your hamstrings or calves when you haven’t worked-out

    When you feel any of these symptoms, recognize that they are warning you that your back pain may escalate and seek some help in managing this stage.  Most people don’t need much treatment at this stage and prevention can be quite simple.  The focus of therapy should be to identify your risk factors and to understand which modifications can make a difference.

    Correcting factors such as a sedentary lifestyle, tight muscles, poor core, etc. can go a long way to avoiding the Attack.  For many people preventing WAR can be as simple as reducing the length of time you are sitting and ensuring you are walking enough i.e. >8,000 steps per day. It can also be about ensuring you have a good ergonomic set-up for your computer and that you stop working on your laptop in bed or at the coffee table.

    Attack

    This is the stage that we all want to avoid however it is the one most people get to before they seek treatment.  It’s not surprising that this is what takes you in to your therapist, as the pain can be overwhelmingly intense.

    The intensity of the pain may make this stage seem quite obvious however it is important to determine whether you are really in a full-blown Attack or already in the first stage of Resolution. Some people skip the full Attack stage or progress into the Recovery stage very quickly.  I find that these two stages are often confused and the treatment strategies are very different depending on where you are in your WAR.

    Attack Symptoms:

    The key characteristics of the full-blown Attack are:

    • Unrelenting pain. The pain may wax and wane but you are never pain free.
    • Short term relief may be felt from shifting positions but doesn’t last.

    When you are in a full Attack the primary goal is to end it as quickly as possible.  Managing this stage is best addressed by never going to WAR in the first place, however if you find yourself in the middle of the Attack, the most important elements of treatment are management of the pain and avoidance of becoming mentally incarcerated as a prisoner of pain. This is when you should discuss medications with your physician, pain relieving strategies with your physiotherapist i.e. acupuncture, manual therapy and educate yourself on recovery strategies.

    I find that the most common mistake made is over-exercising  during this stage. Knowing that core exercise is good you choose this moment to start your return to fitness.  Remember you need to move but you should also avoid substantial increases in pain.  My rule is that the pain should not increase for more than 20 minutes after movement or exercises.

    Recovery

    Your final goal is to achieve full resolution. To do this you need a treatment plan which ensures your recovery is robust and resilient.  This is what will allow you to return to all your favourite activities and avoid future WAR’s.

    The most common mistake I see at this stage is a failure to recognize the early signs of recovery. Many of us use pain as our guide, expecting to get active once the pain stops.  However pain doesn’t always shut off like a tap. The early signs of recoverycan be subtle.  There are changes in the quality, location and in what provokes the pain.  These changes tell me when you are ready to enter the final stage in the battle and really participate in therapy.

    Signs of Resolution:

    1. Pain intensity lessening and/or becoming intermittent
    2. Pain localization (less leg or buttock pain)
    3. Pain improving with specific activities/directional preference i.e. walking or sitting
    4. Increasing function with no need to increase your medication

    The second most frequent mistake I see is that we don’t focus enough on ensuring full resolution.  This is the stage when you should really start to exercise.  Restoring your core, re-establishing coordinated movements and strength is critical. You should be able to start weaning off medication and therapy shifts from pain relief to restoration of lifestyle.

    Avoiding Future Wars

    Depending on how well we manage the resolution stage determines whether we will keep going to WAR or whether our life returns to full and pain free.  Many people come out of the Attack stage only to have it replaced with constant low-grade discomfort and stiffness.  When you try to return to full activity or resume sports the Attack returns. You see numerous practitioners and no one can give you a clear answer why you can’t get rid of your pain.  MRI’s, X-rays and other tests all fail to explain your ongoing symptoms.  This reinforces the prisoner of pain.  You begin to worry that something permanent is wrong with your back – which no one can find!

    If you are having repeated episodes of low back pain and all your tests are clear, this tells me that your back is structurally healthy.  If you are in the resolution stage you are ready to engage in therapy.  If there is no structural damage of significance i.e. herniated discs, stenosis, there are also no significant restrictions to recovery.  Even if you have structural changes your recovery can be good, it just takes a more thoughtful approach to planning your program.

    The Recovery phase often requires the guidance of a knowledgeable spine therapist. Someone who understands which factors are challenging your recovery and can guide you into starting your exercise at the right level.  Remember if your pain has lasted longer than 3 months you are now out of shape.  You have also begun to lay down permanent motor memories which impact on your ability to recover.  A solid approach to fitness and restoring coordination are critical at this time.

    Join me in the WAR on low back pain

    I would like you to help win the W.A.R. on back pain.  Over the next series of articles, my goal is to help you become educated about recognizing what your body is telling you. This will help you to find the right therapist to guide you in your recovery.  It will also help you to know when it’s time to make a change in approach.  Winning this W.A.R. is also about helping you, your friends and even your children to avoid your first episode.

    My next few blogs will explore each one of these stages more fully.  I will provide a more in-depth look at the symptoms and which treatments are likely to help. In the interim please contact us for more information or call 416-925-4687 to book an appointment if you need assistance in managing or preventing your own personal W.A.R. on back pain.

     

    [1] This one is harder to recognize as may people mask this symptom by avoiding standing activities such as cocktail parties, museums, shopping or cooking

    Cupping Therapy Relieves Pain

    Many athletes and artists use cupping treatments to relieve pain and enhance recovery.  The awareness of this treatment increased dramatically at the Barcelona Olympics

    when Michael Thorpe launched the ancient treatment of cupping into the limelight.  Many people wondered what the bruises or “hickeys” seen all over his body were and what might be the purpose of these treatments?  

    Although it may seem new, the knowledge that cupping therapy relieves pain has been known for centuries in China and is commonly used as an effective part of their medical treatments.  Watch Igal Untershat’s video explaining the benefits and use of cupping- click here.

    What is cupping?

    Cupping is used to improve circulation.  The mechanism of effect is not fully known however theories base results on activating the body’s natural mechanisms.  The rush of circulation mimics an injury response and the tissue mobilizes a response to get “healed, renewed”.

    In medicine we typically use silicone or glass cups.  They create a vacuum (negative pressure) which draws the circulation to the surface. When the cups are removed the circulation flushes creating the therapeutic effect.

    Who benefits from cupping?

    Cupping is recommended for many types of musculoskeletal conditions or injuries as it stimulates the fascia (coating on the muscle), increases blood flow and affects myofascial trigger points.  It is a great compliment to manual therapies, such as massage, as it enhances the effects of physical manipulation of the soft tissue.

    What can you expect after a cupping treatment?

     In addition to feeling relief of tension and improvement in your pain you will also notice a change in the skin where the treatment was applied.  These changes mimic an injury and the tissue can look irritated, however this is what the treatment is supposed to do.  You will typically notice the following changes that will last a few days to a little longer than a week:

    • Redness in the tissue.  This results from extra circulation in the area/bringing blood to the surface.
    • Round bruises may appear.  These may occur in areas when cupping was done for longer than a few min.  It results from collapsed superficial blood vessels in the skin.  They will resolve on their own, typically in less than a week.
    • Increased sensitivity in the area where the tissues were treated.  You may experience more sensitivity to touch or feel a bit bruised when you lie on the area.  This increased sensitivity typically lasts for a few hours post treatment.
    • Mild irritation or itching during the treatment.  This results from the effect on the circulation and nerves.  It may last for a few hours post-treatment.

    When not to use cupping:

    Cupping is a safe modality when used by a trained healthcare professional.  However there are sometimes when it should not be used.  Your professional will screen you for these conditions prior to applying the treatment.  Always let the practitioner know if you

    • Bruise easily
    • Take blood thinners
    • Have sensitive or thin skin
    • Are allergic to plastic or silicone (the cups are typically comprised of these materials)
    • Have an open sore
    • Have a bruise or mark from an unknown cause
    • Have a skin disease/condition i.e. psoriasis, eczema

    The research on cupping

    In health care one of the most important types of studies are systematic reviews.  This is where many articles are reviewed for quality and the researchers evaluate and conclude on the overall strength of the evidence.  These types of reviews give us more confidence in ensuring our practices are based on the best evidence available.  In addition to the great results I have seen from my practice, I was pleased to find this systematic review supported it’s use in managing pain

    In summary the research supports cupping is particularly effective in managing:

    • neck pain
    • low back pain
    • shingles-related nerve pain

    The results were even better when combined with acupuncture and manual therapy, all of which I have found useful in my practice.   I also find it useful to manage tight muscles, particularly after work-outs or in injury management, which might be why Michael Thorpe uses it too!

    If you would like to try this technique and are having back pain, neck pain or muscle tightness, please contact me at 416-925-4687 or by email at igalU@orthophysio.com

     

    TMJ1A

     

    TMJ – Temporomandibular Joint Dysfunction

     Determining the best program to relieve pain in the jaw begins with an assessment of your jaw joints, facial muscles, neck, posture and work habits. Our Registered Physiotherapists and Registered Massage Therapists work closely with your treatment team of dental professionals to find solutions to your jaw pain. In addition to direct treatment a home program of self-treatment strategies is often provided.

    Who will benefit?

    You may benefit from therapy if you have any of the following symptoms:

        pain with opening and closing your mouth

        pain when chewing/talking

        clicking, popping sounds

        limited range of motion of the jaw

    Treatment approaches may include:

        Soft tissue release (massage therapy)  

        Joint mobilizations

        Acupuncture                                                

        Craniosacral therapy

        Home exercises                                                           

        Correcting posture

        Coordinating treatment with your dental professional

    Service provided by:

    Taylor Sipos, RPT (Bio)

    Juliette Woodruff RMT      (Bio)

    Igal Untershats RMT (Bio)

    More information:
    https://orthophysio.com/?s=TMJ  https://orthophysio.com/latest-news/massage-therapy/jaw-discomfort-tmj/

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

    Jaw Discomfort With TMJ (Temporo-mandibular joint dysfunction)

     

    Do I have TMJ?

    Juliette Woodruff – Bio

    Juliette WoodruffJuliette Woodruff

    Registered Massage Therapist and Acupuncture Practitioner

    jwoodruff@orthophysio.com

    Juliette joined The Orthopaedic Therapy Clinic Team in 2004. She is a graduate of the Sutherland-Chan College of Massage Therapy. After graduating her ongoing commitment to professional development has led her to complete studies in manual lymph drainage, craniosacral therapy and receive certification in contemporary/medical acupuncture from McMaster university.

    Juliette is an integral member of our treatment team working to find solutions to pain and helping to relieve the barriers limiting recovery. She has worked with a diverse range of people including athletes, expectant mothers, and business professionals. She is particularly interested in treating conditions such as scoliosis, spinal stenosis, TMJ, and the thoracic spine. She believes in helping her clients to become an active participant in their own healing process through body awareness, postural education, and self-care exercises.

    Juliette has a personal as well as clinical experience with the different stages of cancer. She works towards creating improved quality of life for her clients through education, exercise, acupuncture and manual lymph drainage techniques. She believes in implementing a variety of modalities and current knowledge to personalize client care.

    Juliette has a specific interest in the relief of pain and restoration of mobility in scoliosis. She has worked with clients following extensive reconstruction surgery as well as non-operative conditions. She has studied with Dr. Rudolph Weiss of Germany (Katerina Schroth’s grandson) and received a certification in his Scoliologic method. She has a developed an approach to the application of massage therapy in scoliosis which has been published by her professional alumni newsletter. SutherlandChan_FingerPrint

    Juliette implements knowledge and clinical techniques from a variety of post-graduate courses such as: techniques for post-operative breast cancer, joint mobilizations, Structural Integration for structural alignment (Nisa), Scoliologic method, myofascial techniques, muscle energy techniques (METs), positional release, acupuncture and craniosacral techniques. She utilizes and incorporates several different treatment modalities to develop an individualized approach for each client based on their assessment.

    Association Memberships

    Juliette is registered with the College of Massage therapist of Ontario. She is a member of the Canadian Massage Therapy Association and the Canadian Academy of Medical Acupuncture

    Temporomandibular Joint Dysfunction (TMJ)

    TMJ  – Temporomandibular Joint Dysfunction

    Determining the best program to relieve pain in the jaw begins with an assessment of your jaw joints, facial muscles, neck, posture and work habits. Our Registered Physiotherapists and Registered Massage Therapists work closely with your treatment team of dental professionals to find solutions to your jaw pain. In addition to direct treatment a home program of self-treatment strategies is often provided.  

    Who will benefit? You may benefit from therapy if you have any of the following symptoms:

    ·         pain with opening and closing your mouth

    ·         pain when chewing/talking

    ·         clicking, popping sounds

    ·         limited range of motion of the jaw

    Treatment approaches may include:

    ·         Soft tissue release (massage therapy)

    ·         Joint mobilizations

    ·         Acupuncture

    ·         Craniosacral therapy

    ·         Home exercises

    ·         Correcting posture

    ·         Coordinating treatment with your dental professional

     

    Service provided by: Juliette Woodruff RMT

    More information: https://orthophysio.com/?s=TMJ  https://orthophysio.com/latest-news/massage-therapy/jaw-discomfort-tmj/

     

    Do I have TMJ?

     

    If you’ve ever experienced jaw pain, you may have been told, “You have TMJ!”. But do you really have that? The short answer is Yes! In fact, you and everyone you know has TMJ.

     

    TMJ is the short form for temporomandibular joint. As it is in the name, that’s just the name of a joint in your body, to be more specific, the jaw joint. Therefore, as long as you have jaw joints, you have TMJ.

    Pathology in this joint is generally referred to as Temporomandibular dysfunction (or TMD for short). Like anything else in life, this joint is all about balance! There are a lot of tiny muscles around your jaw and face that are responsible for opening and closing your mouth, one of the most important functions of the human body. You need this joint for functions like eating and speaking.

    What are the symptoms of TMJ dysfunction?

    If you experience any of the following symptoms, you might be dealing with TMD:

    • Pain around the jaw
    • Clicking of the joint (associated with pain)
    • Limited range of motion of the jaw (not able to fully open the mouth)
    • Morning headaches
    • Ear pain
    • Neck pain and stiffness (especially around the base of the skull)
    • Pain with chewing and/or talking
    • Pain that increases with stress

    Why does my jaw click?

    Your jaw clicks when the fine balance around the joint is compromised. There is a disc in the middle of your jaw joint which is responsible for smooth movements of the bones of the joint. This disc can be pushed out of the place due to a variety of reasons (like excessive muscle tension), which can lead to clicking around the joint. Pain and stiffness can be due to many factors such as excessive muscle tension, degenerative changes, tissue irritation, or joints that move too much or too little. 

    What can I do to control my TMJ pain?

    There are a number of self-management techniques that can help with this pain. The goal of these techniques is to reduce the tension around the joint and give it some rest. Some suggestions that you might find helpful are:

    • Avoid end range movements (e.g. taking big bites)
    • Try a softer diet for a period of time
    • Avoid habitual chewing (e.g. gum)
    • Pay attention to your posture
    • Wear your mouth guard at night (if you have one prescribed by your dentist)
    • Avoid intentional clicking of the jaw
    • consider anti-inflammatory pain medications (talk to your doctor or pharmacist if this is appropriate for you)

    Who should I see for TMJ pain?

    There is no one healthcare profession who is dedicated just to the treatment of TMJ pain. If you are experiencing these symptoms, you should consider discussing it with your dentist, TMJ trained physical therapist/massage therapist or your physician.

    How can physiotherapy help my TMJ pain?

    Your therapist assesses your jaw joints, muscles that can affect the balance around the joints, your posture and your neck. Yes, your neck! In certain cases, your neck and posture can lead to pain around the jaw.

    Depending on the findings of the assessment, your therapist may consider any of the following treatment options:

     

    If you are dealing with a jaw pain/stiffness that is not improving with self-management techniques, and/or you have seen your dentist or doctor but still have discomfort around your jaw, you may benefit from physiotherapy treatment.

    Contact us if you are interested in learning more about the treatment of TMD or would like to book a treatment for your TMJ pain/stiffness.  Speak with Milad Bazaz-Jazayeri, Registered Physical Therapist –  mbazaz@orthophysio.com – to learn more about the treatment that fits your needs best.

     

    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.

    Treat Yourself – The art of self-massage to relieve neck and back tension

    Treat Yourself – Learn the art of self-massage to relieve neck and back tension –

    Juliette Woodruff Registered Massage Therapist

    June 14, 2017, 12:15-1 pm

    You can’t always see your registered massage therapist when the knots in your neck give you headaches or the muscle tension builds in your back.  Self-treatment with rollers, lacrosse balls and other trigger point techniques can give you immediate relief – or make you worse.

    Provided by Juliette Woodruff, Registered Massage Therapist, this 40 minute workshop will introduce you to techniques you can use to immediately reduce muscle tension and instruct you in the best applications to avoid injuries.

    Format:  Participant workshop

    Maximum number: Limited to 10 participants

    Juliette Woodruff, Registered Massage Therapist and Certified Acupuncturist

    jwoodruff@orthophysio.com

    Juliette joined The Orthopaedic Therapy Clinic Team in 2004. A graduate of the Sutherland-Chan College of Massage Therapy she has completed advanced studies in manual lymph drainage and she is currently pursuing certification in breast cancer treatment and myofascial release therapy. In 2012 she received her certification in acupuncture from McMaster University.

    Stress is an Opportunity for Growth when Approached the Right Way

    Stress is a fact of life. Sometimes it gets so bad we see ourselves as unfortunate, even as lost souls. But with the right understanding and resources, we can regain strength and actually grow from stressful situations. We can use stress to find our limits and boundaries—to challenge us and empower ourselves to heal.

    Being stressed out is an opportunity for growth when you approach it the right way

    Stress

    Stress approached truthfully and intelligently can bring evolution on the highest level. I like to think of stress as an acronym, STRESS, which stands for:

    • Strain
    • Thoughts
    • Rest
    • Energy
    • Support
    • Strategy

    It’s an easy way to remember the different elements that make up this force that has such great impact on our lives. A clear and strong understanding of how stress is seen intelligently can only bring an opportunity for greater confidence in healing with it.

    Strain

    The combination of physiological, emotional, and energetic dysfunction is the first “S” in STRESS.

    • Physiological: Chronic stress produces too much of the stress hormone, cortisol, which triggers a cascade of unhealthy changes in the body. Functional systems, such as digestion, hormone, immune, and cognition, are affected by chronically high cortisol levels and eventually become dysfunctional.
    • Emotional: When the physiological systems are not functioning well, negative emotions come up more frequently. Anxiety, depression, and nervousness are examples of chronic-stress related emotions. How we see life (with the glass half full or half empty) will affect our emotional reactions to stress, too.
    • Energetic: We exist on many different levels, energetically being one of them. (Read more about this in the Energy section further down.) When we’re healthy, our energy body is in synch with our physical body. When this dynamic is unbalanced we lose energy. A helpful analogy is to think of yourself as a computer with trillions of programs running, and how viruses in your system will slow it down or cause malfunctions.
    • Thoughts:  We are what we think about; high-vibration positive thoughts are healthier than low-vibration negative thoughts.Our thoughts affect our physical reality because we manifest what we think about, both consciously and unconsciously. From language to buildings to politics to technology to hamburgers—everything began as a thought.

    We created words to articulate our thoughts and give form to our ideas. But often we don’t pay attention to the power of words. We use them indiscriminately, carelessly, angrily. Yet choosing our thoughts and words carefully, with wisdom, results in better outcomes. Positive words have a higher vibration than negative words—their energetic signature has better qualities. High vibrations are associated with positive feelings such as love, forgiveness, compassion and peace. In contrast, low vibrations are associated with harmful feelings such as hatred, fear, greed and depression.

    In his book The Secret Life of Water, Masaru Emoto’s experiments with water molecules and crystallization patterns prove that the quality of thoughts and words (high vs. low vibration) influence the quality of water. In Breaking the Habit of Being Yourself, Dr. Joe Dispenza writes about the brain’s neuroplasticity and the power of words to create change—positive or negative.

    • High vibrational words: Love, Happiness, Compassion, Peace, Opportunities, Respect
    • Low vibrational words: Hate, Depression, Judgement, War, Problems, Dishonour

    Rest:

    Strong sleep and restorative time outs are important for healing from stress. Our bodies have opportunity to heal when we sleep. This is when your functional systems and energetic systems regenerate and reboot.

    Good sleep quality relies on a few factors:

    • intelligent duration ( 8-10 hours for most people )
    • a dark room to prevent disruption of your circadian biological clock
    • cool temperature
    • quiet setting
    • a comfortable, supportive bed.

    Certain hormonal and physiological dysfunctions from chronic stress can disrupt sleeping patterns—seeking support from a qualified health practitioner may help. (For a well-researched, informative book on the importance of smart sleeping, pick up Lights Out by T.S Wiley with Bent Formby.)  Restorative time outs include going for walks in the park, sitting outside in the sun, deep breathing, and hugging. All these activities have been shown to reduce cortisol levels—read Cracking the Metabolic Code by Dr. James B. LaValle for more insight.

    Energy:

    We are vibrational beings composed of many different energetic systems, including meridians, acupuncture points, chakras, and etheric fields. Vibrational Medicine by Dr. Gerber is one of the most respected and well-researched books on energy medicine. Unbalanced, stressed energy systems can affect physical biological systems (particularly the hormonal systems) and create disease.

    One of the techniques I use in my practice is tapping.  It is a simple, effective way to reset and rebalance our energy systems. It’s part of a method called the Emotional Freedom Technique (EFT), which helps people deal with stress and unhealthy emotions. For more in-depth opportunities to experience energy medicine, seek out healing practitioners who use the tools I have found have found most helpful in my practice such as Reiki or Qigong. Acupuncture can also help to balance energy. These skills can introduce you to new and exciting healing methods to reduce stress.

    Support:

    We are all here to do two things in this world: learn and help each other out. I tell this to my patients all the time. I’m also fond of signing off my emails with “Unity and Healing”. Why? Because stress is humanity’s common denominator—we all experience it, no matter what our lives look like. With such a strong connection pulling us together, it’s natural to unite for support and healing. Friends, family, health practitioners, and support groups are all potentially blessed opportunities to heal and grow from stress.

    Strategies for Stress:

    We all need a well formulated and executed plan to evolve from stress. (We don’t just need it—we deserve it!) You are the only one who can control YOUR life and to be successful, strategy is pivotal.

    Five Minute Living: An intelligent strategy includes having the right support (see the second-last “S” of STRESS, above), and the “Five Minute Living” concept: anyone can find five minutes a few times per day to regain a healthy state of being and happiness. Five minutes of deep breathing, stretches, tapping or other energetic practices, walking, positive affirmations, peaceful quiet sitting, hydration, supportive eating and supplements, and hugging a loved one is time well spent on powerful approaches to dealing with stress.

    My patients who come to me for help managing stress may get a Reiki treatment or Qigong session. Or maybe they’ll get some bodywork to release tension. But they will also get coaching to help them adopt the practices I’ve mentioned here as part of STRESS—like exercise, better sleep habits, nutrition, positive affirmations—so they can find balance in their daily lives and learn to handle stress like a master.

    If you are experiencing stress and would like to learn how to manage it or would like to learn whether Reiki, Qigong and energy balancing can help you, please contact Dr. Adonis Makris, DC at 416-925-4687 or email at Amakris@orthophysio.com