What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition which impacts the median nerve at the level of the wrist joint.  The median nerve is one of the three main nerve supplies to the hand.

carpal-tunnel

Carpal tunnel syndrome refers to compression of this nerve which can result in:

1) pain
2) tingling and/or numbness (usually of the thumb, index, and middle fingers)
3) weakness
4) decreased and/or loss of fine motor function of the hand

Treatment scenarios for this condition can include the following:


1) night splinting
2) physical therapy
3) cortisone injections
4) in severe cases, surgical release of the carpal tunnel

Treatment “tips” to minimize carpal tunnel include the following:

1) Avoid prolonged repetitive tasks which include the wrist, digits, or both
2) Avoid extremes of wrist range of motion – either wrist extension (backward motion) or wrist flexion (forward motion)
3) Rest periods of just a few seconds for the hands can go a long way to the prevention and/or minimization of carpal tunnel syndrome

For more information or to be assessed to see if you have carpal tunnel syndrome, please contact our Grange location and book an appointment with Gail Hamilton.  Gail has over 40 years of experience and specializes in treating hands.

What to do if you’ve been in a car accident?

With all the rain we’ve been getting this winter, the roads have been quite slick and if you’ve been involved in a motor vehicle accident (MVA) we’re here to help.  Here is a step by step guide to help you through this stressful time.

 

  1. If you were seriously injured, have either paramedics at the scene or a friend/family member take you to Emergency to be assessed. Such injuries would include if you suspect a broken bone or dislocation, have lacerations which require stitches, or lost consciousness at the scene and have signs of a concussion:

  – dizziness

  – blurred or double vision

  – headache

  – nausea or vomiting

  – drowsiness

  – problems focusing or with memory

 

  1. If there is more than $2000 worth of damage you will need to go to a police station and fill out a police report

 

  1. Regardless of who is at fault, contact your motor vehicle insurance company. They will start up a claim and put you in contact with an adjuster who will handle your claim. They will also send you a form(which they call an AB-1 form) to fill out and send back to them. You can find this form on our website under “Forms” if you’d like to get started on filling it out.  Insurance companies typically want this form returned to them within 10 business days.

 

  1. If you’re injured and require treatment, depending on the injury your treatments could be directly covered by your motor vehicle insurance company. You can contact our clinic to make an appointment to be assessed by a physical therapist, who can then advise you if treatments will be covered and also refer you to massage therapy if warranted. You do not need to see a physician to be referred to physical therapy, however, you may want to see one if you require any medication or time off from work.  Please note, it can take up to 2 weeks for injuries to fully present themselves.

 

  1. Ice versus heat? Typically we recommend ice for the first 2 days to settle your inflammation, then switching to heat.  A towel placed around a frozen bag of peas is a convenient way to apply ice on any area.  Make sure you have good sensation on the area you are applying ice or heat so that you will be able to tell if it gets too cold or too hot.  Usually 15 minutes of application is enough and can be repeated every 1-2 hours as needed.

Osteoarthritis – Joint Disease

With the return of colder weather, those with arthritis are suffering. Osteoarthritis is the most common joint disease and it is possible to have arthritis in any synovial joint; however the typical areas affected are the hips, knees, hands, low back and neck.

knee-osteoarthritis

Knee Osteoarthritis – source: canadadrugstop.com

Osteoarthritis occurs when the cartilage in a joint begins wearing down; this results in pain, swelling and stiffness. Sometimes the wear and tear can continue until the cartilage is gone, resulting in “bone-on-bone”. At that stage, osteoarthritis is very painful and many people opt for a joint replacement or other surgical intervention.

Before surgery becomes desirable there are many other options for treatment. You can and should consult with your physician to discuss options for pain management. 

Physical therapists can help too! Your Physical Therapist can make a plan to help manage the pain, and provide you with an exercise program to manage the swelling and stiffness. Your therapist can also assist you with options such as custom bracing. 

Unfortunately there is no cure for osteoarthritis but with proper management you can continue to lead an active and healthy lifestyle!

 

Alissa Hemsley is a physical therapist at our Callingwood location. To schedule an appointment to be assessed or if you have further questions on this condition, please feel free to contact the clinic.

 

Do you suffer from headaches or migraines?

Did you know that physical therapy, acupuncture, and massage therapy can all help treat headaches or migraines?

First, here is an overview of the more common types of headaches:

Tension headaches:

this is the most common type of headache and is usually felt as mild, steady, dull pain on both sides of the head

Migraine headaches:

a recurring headache that is often moderate to severe in pain, and is often felt as a pounding or throbbing pain to usually just one side of the head. It can be accompanied by nausea, vomiting, and/or sensitivities to light and sound

Cluster headaches:

the least common, it is usually the most severe and is felt as a stabbing pain behind one eye

The key to treatment is to figure out the cause of your headache. With tension headaches, physical therapy, acupuncture, and massage therapy are all effective ways to release tight and spastic muscles causing your headache. Physical therapists can also assess if a specific joint in your neck may be causing the muscle tension, thereby leading to the headache.

Migraines are believed to be caused by altered circulation to your head. In traditional Oriental medicine, the thought is there is a blockage in your energy flow, or your Qi (pronounced “chi”), in your head and neck. Acupuncture and specifically Shiatsu (or “finger pressure”) massage can help address these blockages and naturally restore your body’s energy flow to effectively treat your migraines.

For more information, please contact one of our clinics to see if one of these treatments can be beneficial to you. Cindy Bacchus, a registered massage therapist at our Grange location, is also specifically trained in Shiatsu therapy to help treat headaches and migraines.

Repetitive Ankle Sprains

Are you fairly active? Do you suffer from repetitive ankle sprains? Well let’s discuss about ankles this time!

The ankle is a complex joint that is able to move in many directions but it is also expected to take your body weight (and more if you are jumping or running). This makes it necessary for the ankle to be supported by many active structures like muscles and tendons and also passive structures like ligaments.  When you injure the muscles/tendons in the ankle, it is referred to as a strain, and when you injure the ligaments (which are more common) it is referred to as a sprain.

The following picture gives a brief idea about the anatomy of ligaments that are often involved in most ankle injuries. In the majority of situations, the ligaments injured are the ones that support the outside of the ankle, primarily the anterior talofibular ligament and middle calcaneofibular ligament.

 ankle-diagram

Our body can, as in most situations, heal an injured structure with scar tissue so long as the injury is not too severe, but if not managed properly there could be some degree of leftover:

  • Weakness in the joint
  • Decreased movement in the joint
  • Decreased proprioception

Of the above three the first two are self-explanatory and if left unrestored can lead to repetitive ankle sprains. Let’s discuss about proprioception a bit here. 

To put it simply: proprioception is the ability to perceive the relative position of a joint in any given situation. This awareness leads to better muscle activation, thereby leading to improved active protection of the joint.

If left untrained, the decreased proprioception and hence the decreased position sense in the joint makes an individual more prone for a repeated injury. Proprioception can be restored by doing proper…

  • Balance training and
  • Impact training

These exercises are to be initiated once adequate healing has occurred in the ankle and may have to be continued for several weeks depending on the severity of the original injury.

So physical therapy will help not only with improving your muscle strength and restoring your ankle mobility, but also with providing you proper proprioceptive retraining to help prevent another injury in the future.

Sudharshan Sundararajan is a physical therapist at our Grange location and with over a dozen years of experience behind him, he has successfully treated numerous ankle injuries in the past.  Please contact one of our clinics if you’ve suffered an ankle injury and would like to have your ankle assessed!

What is IMS?

IMS (Intramuscular Stimulation)

IMS is a needling technique that treats pain of a

neuropathic origin – when the nerves stop communicating properly with the

surrounding muscle or tissue following injury. The nerve becomes hypersensitive,

circulation to the area is reduced, and muscle shortens and contracts. Fine needles

(typically acupuncture needles) are inserted into the contracted muscle, initiating

a reflex that in turn relaxes the muscle. The tiny injury caused by the needle also

tells the body to kick off the healing process to the area, and restores the normal

communicating function of the nerve.

 

IMS uses an in depth assessment which looks for the signs of neuropathic pain.

This includes sensory changes (e.g. tenderness to the area), autonomic changes

(e.g. goosebumps, perspiration, excess fluid), trophic changes (e.g. hair loss), and

muscle/motor changes (e.g. pain from pulling on joints and tendons).

 

Traditional Chinese Medicine (TCM) Acupuncture vs. IMS

TCM acupuncture uses specifically patterned meridians, or energy pathways

throughout the body to help promote natural healing and reduce pain. Typically

physiotherapists use acupuncture as a modality and adjunct to other treatment

techniques and are not trained in all aspects of TCM acupuncture. The use of

needles follows the specific meridians, as opposed to IMS, which uses physical signs.

 

While it’s true that IMS can be a more uncomfortable practice than acupuncture,

IMS is designed to stimulate and trigger a reaction in a contracted muscle. For

clients who have experienced chronic pain or limited relief using conventional

physiotherapy methods of treatment, the deep aching, or “twitching” experienced

can be welcome as this can produce more instant relief and results not experienced

IMS can be used to treat a wide variety of conditions. Your physiotherapist will be

able to determine if IMS is an appropriate treatment technique for you.

 

Lindsay Walker is a physical therapist at our Callingwood location and is certified in IMS needling. Please contact our Callingwood clinic if you would like to book an appointment with her to find out if IMS is for you.

 

Do you have heel or arch pain?

Plantar Fasciitis

With the warmer weather (finally!) many of you are getting back into running and walking outdoors.  So this month’s topic discusses a common cause for heel and arch pain – plantar fasciitis, which is inflammation of the thick ligamentous tissue which starts at the heel of the foot and fans out to the base of the toes.

 

heal pain or plantar fasciitis

 

Symptoms:

–          Dull pain to the heel of your foot and into the arch

–          Pain is worse and often sharp after sleep or rest and subsides after walking a few minutes

–          Pain may increase with a full day of being on your feet

–          Symptoms usually start in one foot and can move to the other due to limping/compensating

Causes:

–          Poor/improper footwear

–          Increased standing, walking, or activity level

–          Walking/standing on hard surfaces

–          Running hills or on soft terrain (sand)

–          Genetics: pronated feet or a high rigid arch

–          Heel spurs

–          Increased age or weight

The good news is that plantar fasciitis is completely treatable and curable.

We will help settle the inflammation, release active triggers in your muscles and plantar fascia, assess and treat for any joint stiffness, as well as recommend proper footwear for your feet.  We also carry a wide range of Superfeet insoles that can fit into your regular footwear to provide heel and arch support.

These insoles are an affordable and effective option as most people do not require custom orthotics for proper support.

If you have any questions or would like to book an appointment, please contact one of our clinics today!

Janice Bealer, a runner herself, works at our Grange location and has a keen interest in treating injuries related to running. Acupuncture and dry needling are often included in the treatment plan as well. Feel free to contact her if you would like any further information.

Did you get diagnosed with “lumbar spinal stenosis”?

Lumbar spinal stenosis (LSS) is a condition in which there is a narrowing of the pathways that nerves and blood vessels pass through within the lower aspect of the spine.

This leads to back/leg pain in clients and significant disability (most commonly in a reduced ability to walk). Spinal stenosis is the most common diagnosis for spinal surgery in adults over 60 years of age.

Physical therapists are able to diagnose spinal stenosis based on signs and symptoms from a thorough verbal history, a physical examination, and a detailed investigation of tests like X-rays and MRIs.

Prior to the option of surgery becoming available, most patients are recommended for physical therapy. Research done by our group saw approximately 60% of patients with LSS in Canada are referred for physical therapy.

Our team had the opportunity to conduct a detailed review of the current state of research evidence on LSS, a process known as a systematic review. In our study, we found that exercise therapy is more effective for LSS than not exercising for back and leg pain.

Physical therapy was also found to be just as effective for improving walking distance in the long-term (2 years later) as surgery. Prescription of lumbar braces were also effective in improving walking distance. The advantage of seeing physical therapy is that we can tailor exercises to your symptoms and make sure that you are exercising safely and effectively.

Prescribing a lumbar brace is also very important through us as you want a proper, tailored fit specifically to your condition. There are many products available and getting the best one for your back is vital. While typically long-term pain outcomes are in the favor of surgery, improving quality of life and disability with physical therapy is just as effective and can be a good option for those attempting to avoid surgery.

Research is still ongoing but current evidence shows physical therapy has a large role to play in helping LSS.

Joey Mo is one of our physical therapists at our Callingwood location. Staying up-to-date on the current state of research is an important aspect of being a physical therapist so that we can best help our clients. You can read Joey’s paper titled Physical Therapy Interventions for Degenerative Lumbar Spinal Stenosis: A Systematic Review published in the prestigious journal Physical Therapy: Journal of the American Physical Therapy Association and Royal Dutch Society for Physical Therapy. If you are experiencing back pain or difficulties walking, or if you would like to speak to our physical therapists more on LSS, give our clinics a call to see if we can help you on your road to recovery.

Staff changes

We have had a number of changes to our clinics to report.  At our Callingwood location, Sarah Roskin is now off on maternity leave.  We wish her the best as she prepares for the arrival of her baby girl.  Sadly Rebecca DesRoches is no longer at our clinic, as she has moved to beautiful BC.  Jenna Truelove has also changed clinics to be closer to home. With that, we welcome the arrival of Audrey Nunweiler to the physical therapy team.  At our Grange location, we welcome Marie-Pier Picard to the physical therapy team.  She is excited to explore her opportunities here, having recently moved from Ontario this summer.