What to Expect After a Total Knee Replacement

Undergoing a total knee replacement can feel like a daunting process. There’s a lot of uncertainty, and while surgeons provide valuable information, they often don’t have enough time to cover every detail about recovery. Our goal with this blog is to give you a clear understanding of what to expect after the procedure and address common questions about the total knee replacement journey in British Columbia.

What to expect in the hospital:

Depending on the type of surgery, you’ll likely stay in the hospital for a few hours to a couple of days, with most people staying 1–2 days. During this time, the focus will be on helping you manage pain, avoid complications, and get you moving safely so you’re ready to go home. Here’s what to expect:

• Pain Management: The nurses will give you medication to keep your pain under control, either by mouth or through an IV. Don’t hesitate to let them know if you’re uncomfortable before returning home—they want to make sure you’re feeling well enough to rest, move, and start your recovery. Managing pain is an important part of healing and will help you stay active, sleep better, and complete your exercises more easily.

• Monitoring: Your health will be closely watched to catch any signs of infection, blood clots, or other concerns. Compression devices or stockings may be used to improve blood flow and reduce swelling.

• Getting Moving: A physiotherapist will usually visit you within a few hours or by the next day to help you sit up, stand, and take your first steps with support. Moving early is important to avoid complications and get you on the road to recovery.

• Preparation for Home: Before you leave the hospital, you’ll receive clear instructions on how to care for your incision, take your medications, and will be given a pamphlet or booklet with simple exercises to help the initial phase of rehabilitation.

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What to expect the first week: 

The first week after surgery is key to setting a strong foundation for your recovery. While it’s normal to feel discomfort, staying proactive and consistent with your care can make a big difference:

• Pain and Swelling: It’s common to experience swelling and bruising around the knee. To help reduce inflammation, use ice packs or a compression ice machine (like a CryoCuff) and keep your leg elevated whenever possible. Follow the prescription medication from your doctor closely at this time. If your pain becomes unmanageable, it can be challenging to bring it back under control.

• Mobility Aids: You’ll likely need a walker or crutches to move around safely. Gradually increase your walking distance, focusing on good posture and weight-bearing as tolerated.

• Wound Care: Keep the incision site clean and dry, and watch for any signs of infection such as redness, warmth, or unusual discharge.

• Exercise & Physiotherapy: Gentle exercises such as ankle pumps, quadriceps squeezes, and range-of-motion movements are key to improving circulation, reducing swelling, and preventing stiffness in your knee. These exercises are typically outlined in a booklet or pamphlet provided before you leave the hospital—be sure to follow the instructions closely. This is also a good time to call and schedule your physiotherapy appointment, ideally within 1–2 weeks of your surgery date, to ensure a smooth start to your recovery.

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What to expect from physiotherapy:

Physiotherapy plays a crucial role in your recovery after a total knee replacement. Here’s what you can expect:

• Initial Session (1-2 Weeks Post-op): During your first visit with a physiotherapist, your range of motion, strength, gait, and overall progress will be assessed. The physiotherapist will also ask about your pain levels, medications, and daily activities at home. You'll complete a few questionnaires to track your progress over time. Based on this evaluation, your physiotherapist will provide you with initial exercise progressions and education. 

• Follow Up Sessions (Week 0-6): For the first 6 weeks, you'll attend physiotherapy sessions weekly. The focus will be on improving range of motion, reducing swelling, walking, and strengthening key muscle groups. Your goal during this phase is to achieve a knee flexion of 110 degrees and be able to straighten your knee with no more than 3 finger widths of space behind it. You'll begin partial revolutions on a stationary bike and gradually incorporate weight-bearing exercises for your quadriceps, hamstrings, glutes, and calves to enhance strength and mobility.

• Follow Up Sessions (Week 6 -12): After the first 6 weeks, you'll see your physiotherapist every other week. At this stage, the focus remains on improving range of motion, with a goal of achieving 120 degrees of knee flexion and full knee extension. You should be able to use the stationary bike for full revolutions and walk up and down stairs without difficulty. By this time, you can also discuss with your surgeon when it's safe to return to driving.

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How to manage your pain: 

Effective pain management is crucial for a smooth recovery. Here are some strategies to help you manage pain during your rehabilitation:

• Medications: Taking pain medication as prescribed is essential for managing discomfort early on. Once pain becomes unmanageable, it can be much harder to control. Starting with good pain management allows you to get enough rest, sleep well, and successfully complete your physiotherapy exercises in the early stages, which is vital for your recovery.

• Ice and Elevation: To reduce swelling and alleviate discomfort, apply ice packs or use an ice compression machine (like a Cryocuff) for 15-20 minutes every 2-3 hours. Elevating your leg when resting helps promote circulation, further reducing swelling and aiding the healing process.

• Pacing: Be mindful of your daily activities to avoid overexertion. Long periods of standing or walking, such as cleaning or cooking, can hinder your recovery. Instead, break up tasks into short 10-15 minute intervals, ensuring you don’t overdo it and prevent the energy needed for your physiotherapy exercises. This approach helps you balance activity with rest and ensures better pain control.

• Mobility Aids: Use your prescribed mobility aids (crutches, walker, or cane) as directed by your physiotherapist or surgeon. These devices are designed to reduce pressure on your operated leg, preventing discomfort and promoting healing. Avoid putting too much weight on the operated leg to prevent unnecessary strain that could delay your recovery.

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Physical activity going forward: 

Staying active is crucial for your recovery, but balancing activity with adequate rest is key. Here’s what to keep in mind throughout your rehabilitation:

• Early Recovery (0-12 Weeks): Begin with short, frequent walks around your home and neighborhood. As you build strength and confidence, you can gradually increase your walking distance. During this period, it’s important to focus on your prescribed physiotherapy strengthening exercises. These exercises will help lay the foundation for improved strength, flexibility, and range of motion as you continue your recovery.

• Post-Rehabilitation (3-6 Months): At this stage, low-impact exercises like swimming, cycling, and using an elliptical machine are excellent options to stay active without putting excess strain on your new knee. Continuing to incorporate strengthening exercises for your quadriceps, hamstrings, glutes, and calves will be beneficial for maintaining and improving strength and stability.

• Post-Rehabilitation (6 Months and Beyond): If you’re interested in returning to higher-impact activities, such as running, jumping, or contact sports, it’s essential to consult with both your surgeon and physiotherapist. Each person’s situation is unique, and while high-impact exercises can increase wear and tear on the knee replacement, there may be modifications, techniques, and guidance that will help you safely return to the activities you love.

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When can you drive again? 

The ability to drive depends on several factors, including which leg was operated on, your range of motion, and whether you’re still taking pain medications. Most patients can return to driving within 6 weeks post-surgery, but it’s essential to:

• Consult Your Surgeon: Get clearance from your surgeon before getting behind the wheel.

• Practice in Park: Practice pressing and releasing the pedals in a parked car to ensure your reflexes are sharp.

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When can you return to work? 

The timing of your return to work after a knee replacement depends on several factors, including the nature of your job, your recovery progress, and your overall health. Below are some general guidelines to help you plan:

1. Sedentary Work (Office Jobs, Desk Work):
If your job primarily involves sitting and minimal physical activity, you may be able to return to work as early as 2-4 weeks after surgery. However, it's important to ensure you're able to comfortably sit for long periods and manage any swelling or discomfort.

2. Light Duty (Standing, Light Walking):
For jobs that require light standing, walking, or minimal lifting, a return to work may be possible around 4-6 weeks post-surgery, depending on your recovery progress and comfort level.

3. Moderate to Heavy Physical Work (Lifting, Heavy Walking, Kneeling, or Squatting):
If your job involves heavy physical demands, such as lifting, long periods of standing or walking, or frequent squatting or kneeling, you may need to wait 3-6 months before returning to full duties. Your physiotherapist or surgeon can guide you on gradual return-to-work strategies and ensure you're ready for these activities.

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We hope this blog has answered most of your questions about total knee replacement surgery and what to expect. If you still have questions or would like more information, consider booking a pre-operative appointment with one of our physiotherapists. This appointment will provide you with helpful exercises and tools to make your post-surgical recovery smoother and more efficient. To book an appointment, call us at 250-723-5112 or schedule online at www.portalberniphysiotherapy.ca.

Understanding Vestibular Physiotherapy

Vestibular physiotherapy is a specialized form of physical therapy that focuses on addressing issues with the vestibular system—the inner ear and brain structures that help control balance and eye movements. When the vestibular system is affected, people may experience dizziness, vertigo, and unsteadiness, which can significantly impact their life. Vestibular Physiotherapy offers targeted exercises and strategies designed to alleviate these symptoms, helping individuals regain confidence in their movement and balance. 

Who Should Seek Vestibular Physiotherapy?

Anyone experiencing dizziness, vertigo, balance disorders, or unexplained feelings of disorientation should consider seeking Vestibular Physiotherapy. Specialized physiotherapists are trained to diagnose vestibular conditions, though it is recommended to consult a doctor if symptoms come on suddenly or without explanation. If you’ve already been diagnosed with a vestibular condition like BPPV, vestibular neuritis, or Meniere’s disease, you can often directly book an appointment for treatment. In many cases, a referral is not required to start treatment.

What Conditions Benefit from Vestibular Physiotherapy?

Vestibular Physiotherapy can be effective for a variety of balance-related conditions. Some of the most commonly treated conditions include:

1. Benign Paroxysmal Positional Vertigo (BPPV): The most common cause of vertigo, often triggered by changes in head position.

2. Vestibular Neuritis or Labyrinthitis: Inflammation of the vestibular nerve or inner ear structures can lead to sudden, intense dizziness and imbalance.

3. Meniere’s Disease: Characterized by vertigo, hearing loss, tinnitus, and fullness in the ear, Meniere’s disease can disrupt balance and coordination.

4. Concussion and Post-Concussion Syndrome: Head injuries often affect balance, coordination, and vision, making vestibular therapy a critical part of concussion recovery.

5. Persistent Postural-Perceptual Dizziness (PPPD): A chronic dizziness condition that can develop after a vestibular disorder.

What to Expect During a Vestibular Physiotherapy Session

In a vestibular physiotherapy session, a trained vestibular physiotherapist assesses your symptoms, including dizziness triggers, balance, and coordination. Sessions often start with a thorough examination that evaluates your vision, balance, and gait. Based on this assessment, your therapist will design a personalized exercise program, which may include:

• Balance and gait exercises: These exercises improve stability and coordination.

• Vestibular habituation exercises: These help your brain adjust to movements that trigger dizziness, gradually reducing the symptoms over time.

• Vision stability exercises (gaze stabilization): These exercises train your eyes to stay focused while your head is moving, minimizing blurred vision or dizziness.

• Canalith repositioning maneuvers (for BPPV): If you have BPPV, specific maneuvers can be performed to help move the displaced crystals in your inner ear back into place, effectively relieving vertigo.

Consistency and follow-up are essential for optimal results, and your therapist will adjust your program as you progress. Depending on the origin of our diagnosis, most people find significant relief from their symptoms after a few sessions, but some may need ongoing therapy depending on the severity of their condition.

Book Your Vestibular Physiotherapy Session

If you’re experiencing symptoms of dizziness, vertigo, or balance issues and think vestibular therapy may help, Port Alberni Physiotherapy is here to support you. Our vestibular therapist, Natasha Prokop, specializes in assessing and treating a wide range of vestibular conditions. You can book an appointment online at www.portalberniphysiotherapy.ca or call us at 250-723-5112.

Physio-Approved Gifts: Health and Wellness on a Budget

Looking for a thoughtful, health-focused gift this holiday season that won’t break the bank? We’ve got you covered! In this blog, we’re sharing a list of our favourite health and wellness items that are practical, budget-friendly, and high-quality—plus, they’re guaranteed to get plenty of use. Best of all, these products are physio-approved, so you know they are coming from a reliable source. We’ve included links to our top picks for easy shopping, but if you’re eyeing something else that didn’t make the list, feel free to ask us at your next appointment. We’re always excited to talk about anything that keeps people healthy and moving!

Foam Roller: 

Foam rollers are excellent tools for muscle recovery and relieving tension, perfect for home use and in between physiotherapy or RMT sessions. When selecting a foam roller as a gift, look for one with a smooth surface, unless a specific texture is asked for. Choose a roller made of high-density, quality foam for durability. Also, consider the size—rollers come in various lengths. Think about where and how it’ll be used: will it travel to sports events or mainly stay at home? A compact 12-18 inch roller is ideal for travel, while a 26-36 inch roller offers the most versatility for home use. 

Most Versatile on a budget: Amazon Basic Foam Roller

Best for Travel: GRID 13 Inches 

Best All Around:​​ GRID 26 Inches 

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Resistance Bands: 

Resistance bands make a fantastic gift for the home workout lover or the family member who's always on the go. They’re lightweight and versatile, easy to pack for travel, and take up minimal space at home. With options in different materials, lengths, and shapes (long vs. circular), it can be tricky to choose the right one. For a simple, practical gift, we recommend a high-quality fabric looped band, which can easily add intensity to bodyweight exercises. Look for a durable fabric band with silicone strips to prevent slipping. For a great stocking stuffer, a bundle of varying resistance levels in elastic loop bands is a thoughtful, versatile choice.

Best for Lower Body: Polygon Fabric Resistance Bands (thick) or Peach Bands (thin)

Best Stocking Stuffer: Gritin Resistance Bands 

Most Versatile: Arena Strength Bands

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Yoga Mat: 

If you’re buying a yoga mat as a gift, keep a few key features in mind. First, consider thickness—a mat that’s around 5mm or thicker provides extra cushioning, ideal for joint support during floor exercises. Next, look at the material. High-quality, eco-friendly options like natural rubber or TPE are durable and often offer better grip than standard PVC. Speaking of grip, a textured, non-slip surface is essential to prevent sliding, ensuring safety for poses and exercises. Lastly, think about size and portability. For those on the go, a lightweight, standard-sized mat with a carrying strap is ideal. For someone who primarily exercises at home, a thicker mat with extra cushioning is the crème de la crème.

Best Quality on a Budget: Gaiam Yoga Mat

Best All Around: Jade Yoga Mat

Most Versatile (Double Sided): Lululemon “The Mat” 5mm

Best Travel Mat: Jade Travel Mat 

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Fitness App Subscription:

A fitness app subscription makes a fantastic gift! Popular platforms like the Peloton App , Nike Training Club, and Alo Moves offer a wide range of online classes guided by expert instructors. On days when motivation is low, having pre-made workouts ready to go can be a game-changer. These apps let users filter workouts by length (20, 30, or 45 minutes, etc.), equipment (like body weight or dumbbells), and even music style—making it easy and enjoyable to jump right in. Peloton and Nike Training Club are among our favourites for their user-friendly design, well-instructed workouts, and fantastic features. A one-year subscription could be the perfect way to keep your loved one moving all year round.

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Athletic Socks: 

We get it… socks as a holiday gift may seem a little lame. But for a fitness fanatic, high-quality athletic socks are actually a fantastic gift! They’re one of those items people rarely buy for themselves, which makes them a thoughtful, practical choice. If your family member enjoys Barre or Pilates, look for specialty grip socks to help them move easily in class—it’s a small touch that shows you notice their hobbies and want to support them. For the runner or gym goer in your life, breathable socks with extra cushioning are a winner, providing comfort and support. 

Socks for the Millenials: Lululemon Power Stride Socks 

Best Crew Socks: Gym Shark Crew Socks

Best Pilates / Barre Sock: Happy Full Foot Sock

If you're searching for local holiday gifts, feel free to give us a call (250-723-5112) or check out our social media platforms (Instagram and Facebook) for more ideas. We have a variety of items in stock, including Biofreeze, TENS machines, water bottles, Pilates and yoga equipment, and sports tape—perfect for stocking stuffers or last-minute gift ideas.

Desk Ergonomics and Postural Pain

Postural back and neck pain is a common condition often seen in physiotherapy clinics. As more people work from home without having education on proper office ergonomics, musculoskeletal issues such as back pain, neck strains, and carpal tunnel syndrome are becoming more prevalent. The two main contributing factors to neck and back pain in office workers are poor desk ergonomics and lack of postural strength and mobility. Physiotherapists are trained to address both issues through ergonomic assessments and can provide guidance on suitable exercises for work and home.

In this blog, we will discuss desk ergonomic suggestions to promote good posture and prevent pain, as well as suitable desk exercises to reduce muscle pain at your desk.

Ergonomic Suggestions:

Below you'll find some tips for improving your desk ergonomics. Remember, everyone's needs are different, so it's best to get a personalized assessment from a local physiotherapist, your workplace occupational therapist, or health and safety coordinator. If that's not possible, or if you just want some simple suggestions to get you started, take a look at our tips below.

Desk and Chair Height

In any ergonomic assessment, we start with the desk and chair position. These are the most important and will make the biggest impact on your comfort level. Here are our suggestions:

1. Seated Desk Height: Your desk should be at a height where your forearms are parallel to the floor when typing. Typically, this means the desk should be around 29-30 inches from the floor, but it can vary based on individual height.

2. Standing Desk Height: If you use a standing desk, the height of the desk should be just below your elbow. Your elbows should be able to sit at 90 degrees when typing. Typically, this is around 38-46” inches.

3. Chair Height: Adjust your chair so that your feet are flat on the floor and your knees are at a 90-degree angle. Your thighs should be parallel to the floor, and your feet should rest comfortably on the ground. If you can’t achieve this with your current office setup, using a footrest can be helpful. 

4. Chair Lumbar Support: Ensure your chair has good lumbar support to maintain the natural curve of your lower back. You can use a lumbar roll or a small cushion if your chair lacks built-in support.

5. Backrest: The backrest should support the natural curve of your spine. It should be reclined slightly, at an angle of 100 to 110 degrees, to encourage an open hip angle and reduce pressure on your lower back.

Monitor Position

Monitor position can significantly impact your neck, shoulders, and wrists. If you experience neck pain at work, check your monitor's height and position.

1. Monitor Height: The top of your monitor should be at or slightly below eye level. This position prevents you from tilting your head up or down, which can strain your neck. If needed, use a monitor stand or a stack of books to elevate your screen.

2. Monitor Distance: Place the monitor about an arm's length away from you. This distance helps reduce eye strain and allows you to view the entire screen without excessive head movement.

3. Laptops: Try using a laptop stand and a separate keyboard if your main computer is a laptop. This will help position your neck and head correctly and allow your wrists to be in a more ergonomic position. 

4. Dual Monitors: If you use dual monitors determine which one is for primary use or if you use both equally, that will help with the setup. If you have a primary monitor it should be set up directly in front of you and the distance and position suggested above. The secondary monitor should be placed next to the primary monitor, at the same height and distance. It should be angled slightly towards you to minimize head and neck movement. If you use both monitors equally, place them side by side and angle them inward slightly to form a slight curve. The point where the monitors meet should be directly in front of you, ensuring minimal head movement.

Keyboard and Mouse Placement

Your keyboard and mouse position has an impact on your wrist, hands and believe it or not - your shoulders. Good ergonomic placement can prevent wrist strains, carpal tunnel, and even upper back pain and tension headaches. 

1. Keyboard: Your keyboard should be directly in front of you, with your wrists straight and your hands at or slightly below elbow level. A negative tilt keyboard tray can help maintain a neutral wrist position.

2. Mouse: Position your mouse close to your keyboard to avoid overreaching. If you use a mouse frequently, it is recommended to try an ergonomic mouse since it provides a more natural position and can prevent wrist and thumb strains. 

3. Keyboard and Mouse Supports: You can also try a gel keyboard or mouse pad with wrist support to allow for a more neutral and relaxed wrist position.

Additional Tips

1. Document Holder: If you frequently refer to documents, use a document holder placed at the same height and distance as your monitor to avoid repetitive neck movements.

2. Lighting: Ensure your workspace is well-lit to prevent eye strain. Position your monitor to reduce glare from windows or overhead lights.

Desk Posture and Exercises: 

As physiotherapists, we commonly get asked “What is "good" desk posture?”. Well, the truth is your best posture is always your next posture. Humans are meant to move; we are not meant to be stuck in one position for long periods. Holding a stiff upright posture can feel just as bad as being slumped over a computer desk if maintained for too long. 

So why do we all think that a slumped posture is a "bad" posture? Well, it's because most of us spend way too much time in that position. We work for 8 hours at a computer, drive home slumped over our steering wheels, and then sit on a sofa peering down at our phones. It's not that it is a bad position; we just spend too much time in it. And what happens if we spend too much time in one position? You guessed it... pain. 

The solution to solving postural pain is intuitive - to prevent postural pain, try your best to incorporate more movement into your weekly routine. This can include a balanced functional strengthening routine, mobility exercises, or even stretches at your desk. Just by moving your body more frequently, you should notice your neck, back, and shoulder pain start to alleviate. Movement is key to fixing postural pain! 

We have gone ahead and selected exercises that are easy to incorporate at your desk, at home, or at the office to get you started at building strength and moving more. 

• Seated Cat Cow: This exercise is great for moving your full spine through flexion and extension. It is simple to do at a desk and doesn’t require equipment. You can start with the following amount: 1-2 x 10 reps 

• Scapular Squeezes: This exercise targets your rhomboid muscles and thoracic spine. It moves your spine into extension helping you get out of a slumped position and strengthens the muscles between your shoulder blades. Try 2 x 10 reps to start. 

• Banded W’s: If you need something a little harder, Banded W’s work on the postural muscles between the shoulder blades, mid-back and neck with a bit of resistance. You can start with 2-3 x 10 reps 

• Neck Stretch:  This exercise focuses on elongating and stretching the muscles in your neck, specifically your scalene muscles. Your scalene muscles can become exceptionally tight from a slumped forward posture, and stressful breathing. Try 3 x 10 second holds on each side to get started. 

• Figure 4 Stretch: The Figure 4 stretch targets your glute and piriformis muscles. These can become tight if you are seated for long periods of time. It is a simple exercise to incorporate at your desk, no equipment required. Try 3 x 10 second holds on each side

• Hip Hinge: This exercise helps move your hips through a full-range flexion and extension. It also strengthens your glutes and extends your thoracic spine. It is a great exercise for people who sit most of the day.  Start with 1-2 x 10 reps during your work day.

• Lateral Lunge: This exercise is a great hip opener, taking your hips through a big range of motion. Lateral lunges focus on hip abduction, which is not a common position for desk workers. It’s a nice stretch. Try 3 x 10 repetitions alternating left and right. 

Setting up your office desk correctly is crucial for preventing postural pain and ensuring long-term comfort and productivity. An ergonomic workspace can significantly reduce the risk of developing musculoskeletal issues such as back pain, neck strain, and carpal tunnel syndrome. 

If you’ve read through this blog and are struggling to get your desk ergonomics right, have more specific questions, or need more individualized exercises, reach out to your local physiotherapist. At Port Alberni Physiotherapy, we offer in-person Ergonomic Assessments at your place of work or home office. You can call us at 250-723-5112 to book an appointment. 

A Small Blurb on The Benefits of Women's Health Physiotherapy

When we think about physiotherapy, the first thing that often comes to mind is sports injuries, chronic back pain, or post-surgery rehabilitation. But did you know that physiotherapy plays a crucial role in women’s health too? Women’s health physiotherapy is a specialized field that addresses a wide range of issues unique to women, from pregnancy-related discomforts, like abdominal separation, coccyx pain, and pelvic girdle pain to pelvic floor disorders, like urgency incontinence and prolapse. A lot of these conditions are VERY common and are not something you need to struggle with. Symptoms can be reduced if managed properly and addressed in a timely manner by a women's health-specific physiotherapist. Let’s dive into how these women’s health services can be beneficial.

Pregnancy and Postpartum Care

Pregnancy is a beautiful experience, but it can also be physically demanding. Your body undergoes tremendous changes, which can lead to discomfort, pain, and sometimes more serious issues like pelvic girdle pain or incontinence. Women’s health physiotherapy offers tailored assessments, exercises, and treatments that help manage these challenges, making your pregnancy journey smoother.

During postpartum recovery, physiotherapy can be invaluable. It helps in restoring core strength, improving posture, and addressing any issues that may have arisen during pregnancy or childbirth, such as diastasis recti (abdominal separation), pelvic floor dysfunction, incontinence, back pain, or pelvic girdle pain. With the right guidance, you can regain your strength and confidence as you navigate the early stages of motherhood.

Pelvic Floor Health

The pelvic floor is a group of muscles that support the bladder, uterus, and bowel. Strong pelvic floor muscles are essential for bladder and bowel control, sexual function, and overall core stability. Unfortunately, many women experience pelvic floor dysfunction due to childbirth, aging, or other factors. This can lead to issues like incontinence, pelvic organ prolapse, or chronic pelvic pain.

Women’s health physiotherapists are trained to assess and treat pelvic floor disorders. Through a combination of exercises, manual therapy, and education, they can help you strengthen and control these muscles and improve your quality of life. Whether you’re dealing with minor discomfort or a more severe condition, physiotherapy can make a significant difference.

Supporting Women in Every Stage of Life

Women’s health physiotherapy isn’t just for pregnancy and postpartum care; it’s beneficial throughout every stage of life. For young women, it can address menstrual pain or help with sports-related injuries. For those going through menopause, physiotherapy can help manage symptoms like pelvic floor weakness or osteoporosis-related issues.

As women age, maintaining mobility, strength, and balance becomes increasingly important. Physiotherapy can help prevent falls, manage arthritis, and keep you active and independent for as long as possible. Women’s health physiotherapists are physiotherapists with a specialty. Most have experience with orthopedic conditions and they have the benefit of addressing a multitude of issues and combining treatments.

Tailored Care Just for You

One of the most significant benefits of women’s health physiotherapy is the personalized care it offers. Your physiotherapist will take the time to understand your specific needs and goals, creating a treatment plan that’s uniquely yours. This individualized approach ensures that you receive the care and support you need, whether you’re recovering from surgery, managing a chronic condition, or simply looking to improve your overall health.

Women’s health physiotherapy is more than just a treatment—it’s a pathway to better a better quality of life, and a smoother entry and recovery from pregnancy. By addressing the unique health challenges that women face, this specialized care can help you stay strong, active, and confident. If you’re experiencing any issues that you think might benefit from physiotherapy, consider booking an appointment with a women’s health physiotherapist. At Port Alberni Physiotherapy & Wellness, Lauren Siddall has special training in women’s health services, as well as orthopedic conditions, and clinical pilates. To book an appointment visit us at portalberniphysiotherapy.janeapp.com

Understanding Osteoarthritis and How to Manage

Have you started noticing stiff and painful knees or hips? Are you experiencing swelling in your knee(s) after activity or running errands? Are you struggling to get out of bed due to joint pain and stiffness? Does your knee pain limit your ability to be physically active or restrict your job demands? These are all initial signs of osteoarthritis. As physiotherapists, we get a lot of people asking questions about osteoarthritis (OA), with over 20% of Canadians struggling with some sort of arthritic condition. In this blog we are going to break down the condition step by step and give you tips on how to manage it effectively. 

What is Osteoarthritis?

Osteoarthritis, commonly referred to as OA, is the breakdown of joint cartilage (the tough material that covers bone), and changes to the underlying bone and surrounding joint structures.

The features of OA include:

• Loss of articular cartilage with narrowing joint space

• increased density and cysts of the underlying bone

• stiffening of the joint capsule

• degeneration of the meniscus, often with meniscus tears

• osteophyte formations

The picture below shows the differences between a healthy knee joint and a knee joint with OA.

How does Osteoarthritis develop? 

OA develops when the degradation of articular cartilage super-seeds the synthesis of healthy articular cartilage. Meaning, that cartilage covering your joint surface is disappearing faster than it is being reproduced.

We won't bore you with the underlying metabolic process that causes these changes but know that a lot of research has been done to show how this occurs. If you want to learn more about the science you can click here to read more. 

Factors that cause cartilage degradation include:

• Too much mechanical stimuli or use (i.e a previous trauma to the joint, too much use of the joint due to work or sport, joint mal-alignment or poor biomechanics, muscle weakness, and increased body weight)

• Too little mechanical stimuli (i.e not enough use - living a sedentary lifestyle)

• Inflammation mediators (body weight and genetics)

Basically, a joint must be used a healthy amount with good alignment to build and maintain healthy cartilage… think of Goldilocks, not too much, not too little, but just right. 

What are the main risk factors for developing Osteoarthritis?

We often receive the question "What did I do to cause the osteoarthritis?" In some cases, there is nothing you could have done differently. Some people are more predisposed to developing osteoarthritis than others. Genetics, gender, and age play a significant role and are factors that cannot be changed. Below, we have categorized the risk factors for osteoarthritis into two groups: non-modifiable (things you can't or couldn't have changed) and modifiable (things that can or could be changed).

Non-Modifiable Risk Factors for OA

• Age: Being over 40 years of age

• Gender: Being Female 

• Genetics: Having a family history of OA

Modifiable Risk Factors for OA 

• Being Overweight

• Having a prior joint injury

• Having a hard physical occupation

• Overuse of joints in spare time (i.e choosing a sport or hobby that is hard on your joints). 

What can I do to prevent Osteoarthritis? 

A consistent strength and cardiovascular routine can reduce the risk of developing OA. Canadian Physical Activity Guidelines recommend for the ages of 18-64 an accumulation of 150 minutes of moderate-vigorous physical activity per week and two strength training sessions using major muscle groups per week. If you are over 65,  the recommendation is the same as above, with the addition of physical activities that challenge balance. 

Strength training can help prevent osteoarthritis by building stronger muscles around a joint, providing better joint support and stability, reducing the load and stress on the joint, maintaining proper alignment, and reducing the risk of joint damage. Additionally, it can aid in weight management by building muscle mass and increasing your metabolic rate. Regular strength training also promotes the flow of synovial fluid, which nourishes the joint cartilage and keeps it healthy. This fluid also helps lubricate the joint, reducing friction and wear.

Cardiovascular activity is also important for joint health. Regular gentle cardio like running, swimming, and biking help to control your weight, keep your joints moving in a healthy way, can increase muscle strength, and help with circulation. 

Overall, movement in the right amount with proper joint alignment is a key factor in reducing the risk of osteoarthritis. 

How do I manage a diagnosis of Osteoarthritis?

here are various approaches to managing osteoarthritis, and the chosen pathway is usually based on the patient's prior treatments and the severity of the condition.

The first stage of OA treatment involves education, evidence-based exercises, and weight management. Education focuses on the development, signs and symptoms, management strategies, and treatment options for osteoarthritis. This helps patients understand the physiology of OA, what causes flare-ups, and what options are available to them. Education also empowers patient, helping them advocate for themselves and make informed decisions about their treatment. In addition to education, it is recommended to start an evidence-based exercise program targeting the muscles surrounding the affected joint, as well as implementing weight management strategies (such as nutrition plans).

If a patient is not showing signs of improvement in the first stage of treatment, pharmacological interventions are introduced. This would include pain medication, possible steroid injections, or weight management medications. In tandem, some patients will select to try an offloading brace (for knee OA) which can be prescribed by your physiotherapist or doctor and requires a custom fitting. Custom braces can be expensive but are typically covered by extended healthcare plans. 

If a patient has tried education, evidence-based exercises, weight management, pain medication, possible injections and bracing and not managing well (i.e having difficulties at work, unable to perform daily tasks, or describing a lower quality of life), then joint replacement surgery becomes a viable option. In Canada, surgery is a final treatment option as it is the most invasive choice. Joint replacement surgery comes with risks like all surgical interventions and if this can be avoided with other conservative methods it is advised. Joint replacements typically only last 15-20 years, before needing a revision. Therefore, if a joint replacement is completed on a patient in their 40’s they may need two or three revisions in their lifetime. This is why a surgeon or doctor may ask a patient to wait until they are older before surgery is suitable.

Because of the complexity and frequency of osteoarthritis resources have been created to support patients on their journey with the condition. One of the best resources available is GLA:D Canada, there are online tutorials and education available, as well as in-person exercises and education programs around the country.

If you have been diagnosed with osteoarthritis or would like to learn more about the condition, reach out to your local physiotherapist. Physiotherapists can guide you through each stage of the process, assist with an evidence-based exercise program, discuss or prescribe bracing options, and provide you with education on the condition. 

At Port Alberni Physiotherapy, we have physiotherapists with special post-graduate certifications in osteoarthritis management who would be happy to help you. To book an appointment, please visit our website www.portalberniphysiotherapy.ca or call us at 250-723-5112.

5 Best Places to Paddle Board Around Port Alberni

Port Alberni has some amazing local paddleboarding spots to explore. Paddleboarding has become more popular over the past few years, which has inspired us to highlight the areas around the Alberni Valley. We are extremely fortunate to live close to Strathcona Park and have lake and ocean access offering a simple way to stay active close to our community. If you are looking for a new summer activity or just new inspiration we have sussed out the best spots to get started. 

Sproat Lake

 This is an easy suggestion, but definitely one of the best. We are incredibly lucky to have such an amazing lake on our doorstep with public access. You can easily take an inflatable or fiberglass board to Sproat Lake Provincial Park. Parking is relatively easy, just make sure you get there early on a weekend as the parking lot can fill up fast. There is a small trail leading to the lake access that wraps around to the east giving you more spots to launch.  

Taylor Arm Park is also an easy place to launch. We recommend using an inflatable paddleboard since there is a small trail under an overpass you will need to walk under. This park tends to be less busy and offers beautiful quiet views of the lake. 

Fossil Park has slightly more secluded public access to Sproat Lake. There is a beautiful old-growth forest trail leading to the lake. The trail takes about 30 minutes to walk making it more suitable for an inflatable paddle board. Once you get there, there is a beautiful pebble beach and flat grassy area to pump up. 

Canal Beach 

Photo Courtesy of Canal Beach Facebook Page

This previous plywood mill site has been revitalized into a public green space and has access for non motorized water sports, making a great place to paddle board on the Alberni Inlet. This area is on the ocean so be careful of a small tide and possible currents. Click here for more information about the park. 

Loon Lake 

Photo Courtesy of Mosaic Forestry Management

Loon Lake is situated 10 km east of Port Alberni and can be accessed by the public through the Mosaic Campground sites. Recently, Mosaic Forestry Corp. constructed a public dock, making it easier to reach the lake. There is a small gravel road that you will need to drive down, so it's important to have a good vehicle with proper tires. Both inflatable and fiberglass boards would be suitable.

Nahmint Lake 

Photo Courtesy of Vancouver Island Off Road & 4x4

There are two possible access points to Nahmint Lake:  Nahmint Lake Recreational Site and Blackies Beach. To reach both points, you will need to drive down active logging roads. The roads are well maintained, but we recommend having adequate clearance and good tires. Once you are at the lake, you will see gorgeous mountain views, a gravel beach, a quiet environment and away from the hustle and bustle of Sproat Lake. If you are looking for an enjoyable quiet paddle with some privacy, Nahmint Lake is the perfect spot for you. 

Doran Lake 

Doran Lake is located 40 km west of Port Alberni on your way to Ucluelet and Tofino. After turning off Highway 4, you will drive for about 20 minutes down a logging road that tends to be less maintained the further you go. To access this spot, you'll need an AWD or 4x4 vehicle. Since it is only accessible by car, both fiberglass and inflatable paddleboards are suitable for use. Upon reaching the lake, you will find clear water and ultimate privacy, as it's rarely accessed other than by anglers and the occasional local. Most of the lake is rocky, which can make launching a bit tricky, but you'll be able to find a suitable spot if you take a walk around.

Let us know if you've tried out any of these recommended spots by snapping a pic and tagging @portalberniphysiotherapy on Facebook or Instagram. We would love to be a part of your stand-up paddle-boarding adventure!

How to Wear Your Hiking Backpack

As hiking season approaches, many people are gearing up to spend more time outdoors to stay active. With the increase in heavy backpack usage, we've noticed an uptick in the number of individuals visiting our clinic with complaints of back, neck, and shoulder pain after long hikes. Properly wearing your backpack is crucial for reducing muscle tension and pain during your treks. Below, you'll find our tips and tricks on how to wear your backpack correctly, pack it to distribute the load appropriately, and some additional tips on using hiking poles for added fun. So, sit back or buckle up and have a read...

How to Wear Your Hiking Backpack

Wearing your hiking backpack correctly can make a huge difference in preventing shoulder, neck, and back pain. Before we delve into this, it's crucial to have a properly sized backpack. If you hike frequently, it's worth investing in a backpack with a suspension system to ease the load on your shoulders and provide better breathability. There are also male and female versions of backpacks, with the primary difference being the width of the frame. Female backpacks are generally more narrow, offering a snugger fit across the chest and shoulders. Hiking backpacks are typically sized once you reach the 40-50L range and above. It's best to have someone measure you to ensure you purchase the correct size. The main issue with having the wrong size is that the frame may be too long, preventing you from being able to look up, and the hip belt may be in the wrong place, making it more difficult to carry weight around your hips.

Once you have the correct size backpack, you are ready for the next stage… how to wear it properly.

Step 1: Locate the top of your hips, place the hip belt firmly around your waist and cinch tight.

You can find the correct spot by placing your hands on the tops of your hips or natural waistline, this is also called the iliac crest. It would be the same place you would carry a child or a laundry basket.

Step 2: Lean forward and pull the side straps tight. You want to feel cinched in but comfortable at this step. Your lower body should be holding most of the backpack‘s weight at this stage. 

Step 3: Adjust the top straps for balance. This step is a personal preference. You can lengthen or shorten your top straps based on how you want your backpack to feel. You should be able to easily fit your 1-2 fingers between your upper straps and your shoulders. 

With the correct backpack size and fit, your hips and lower body should be supporting most of the backpack’s weight. This will reduce stress and strain on your neck, back, and shoulders, making it more comfortable for both long and short treks

How to Pack Your Hiking Backpack

Packing your backpack correctly is a crucial step in making your hiking experience more comfortable. Having your heavy and light items in the appropriate place can alter your pack’s weight distribution changing the way the backpack feels. 

Step 1: Light Non-Essential items on the bottom.

You want to pack light non-essential items first so they sit at the bottom of your bag. This would include things like: 

• Sleep bags

• Towels

• Air mattress

• Camping pillow

Placing soft items on the bottom of your backpack also gives your backpack a cushion when you take it off. The soft items will protect more expensive things like your stove, gas canisters, food etc. 

Step 2: Heavy items in the middle

Heavy items get packed second so they are in the middle of the pack. This brings the heavy items closest to your center of gravity, making them easier to carry. Heavy items would include

• Food

• Clothes

• Camelbak (Extra Water)

• Stove

• Gas 

Step 3: Lighter Easy to Grab Essentials on the top.

The top of your backpack should be packed with essential items that you need quick access to, but that are not too heavy. Things like:

• Sunscreen

• Light snacks

• Toiletries

• First Aid Kit

• Rain Jacket

Organizing your backpack with light non-essential items near the bottom, heavy items in the middle, and light essential items at the top allows your back to be properly balanced. This positioning aligns your pack with your center of gravity, providing greater stability and making your back, neck, and shoulders more comfortable during hiking.

How to Use Hiking Poles

Hiking poles are a great way to reduce stress and strain on your muscles and joints. They give another point of contact while hiking, which can make you more stable going up and down hills. To use hiking poles, you want to lengthen the poles so that your elbows are just under 90 degrees while holding onto the handles.

When hiking steep uphill terrain you can shorten the poles slightly to make them easier to use. When hiking steep downhill terrain you will want to lengthen your poles to make it easier to contact the ground and give you support.

We hope this information helps and you have an amazing hiking season ahead. As always, if you have specific questions or want to be shown how to do this in person, book an appointment at our clinic, Port Alberni Physiotherapy & Wellness.

Exploring the Rotator Cuff

Have you ever heard the term rotator cuff, but wondered what it is? Maybe you’ve had a rotator cuff injury but were never shown shoulder anatomy, and were left feeling confused. Well, we are here to break it down and make it simple. By understanding shoulder anatomy, you can better understand why your physiotherapist gives you those funky exercises, why your shoulder may be painful in certain places, or why particular movements may make your pain worse.

The rotator cuff is a common sight for shoulder injuries and pain but many patients struggle to understand its anatomy. The rotator cuff is made up of four muscle groups (sometimes 5 depending on who you ask) with the acronym S.I.T.S -  referencing the first letter of each muscle - Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis. Some practitioners will also include the Long Head of the Biceps in this grouping as well. 

Let’s dive a little deeper into each muscle group…

Supraspinatus Muscle: This is the most superior muscle of the rotator cuff, sitting on the top portion of the scapula (shoulder blade) in a gully called the supraspinatus fossa. The tendon runs through a narrow space in the shoulder complex and attaches to the humerus (arm bone). Because of this muscle's orientation, it commonly gets compressed or squashed due to poor shoulder posture or biomechanics.

Its main action is to lift the arm out to the side, or abduction, for the first 10-15 degrees. It also assists the deltoid in abduction between 15-90 degrees. 

Infraspinatus Muscle: Sits on the back of the shoulder blade and attaches to the outer side of the head of the humerus. 

Its main action is to rotate the shoulder outwards (external rotation) and helps with extending the arm back..

Teres Minor: This muscle sits very close to the infraspinatus on the back of the shoulder blade but is much smaller, and also attaches to the outside of the head of the humerus. 

Similar to the infraspinatus, its main action is to externally rotate the shoulder and assist with extension of the arm. 

Subscapularis: This is the largest and strongest muscle of the rotator cuff. It sits on the front of the shoulder blade, between the shoulder blade and the ribcage, and attaches to the front of the humerus. 

Its main action is to rotate the shoulder inward (internal rotation)

Understanding the four main muscles of the rotator cuff, their orientation, and the actions they are responsible for can help you comprehend why certain positions or movements may cause pain. 

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The Role of the Rotator Cuff

The rotator cuff is responsible for creating stability of the shoulder while assisting with movement. The four muscle groups form a “cuff” around the shoulder to aid in its stability, hence the term rotator cuff. The anatomy of the shoulder joint is inherently unstable, with a large humeral head making contact with the shallow surface of the scapula. In practical terms, think of a golf ball sitting on a golf tee, this seems unstable right? A small force could cause instability to the golf ball or cause it to fall off altogether. This rings true for the shoulder as well. The rotator cuff keeps the “golf ball on the tee” increasing the stability of the joint. 

The rotator cuff is also involved in almost every movement of the upper limb, providing the “fine-tuning” of the shoulder. When you throw a baseball the rotator cuff is working, when you carry your groceries the rotator cuff is working, when you type at your desk… guess what, the rotator cuff is working. A healthy rotator cuff means you can type for 8 hours during a workday pain-free, while also heading to a tennis match and producing big forceful swings with confidence. It’s important to have a balance of strength and flexibility in these muscle groups to maintain good function of the entire shoulder complex.

It is well documented that if the balance of strength and flexibility is unequal in the rotator cuff, this then leads to dysfunction, pain, and impaired capabilities. 

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Common Rotator Cuff Injuries

Rotator cuff injuries can occur at any age. In the younger population, we typically see rotator cuff injuries from a trauma (like a fall) or from overuse with overhead activities (i.e. volleyball, baseball, and swimming). In the older population, rotator cuff injuries are typically due to impingement, and muscle degeneration, which can lead to calcification and tears. Poor biomechanics of the shoulder, like having rounded shoulders at your desk, can prematurely affect the quality of the rotator cuff muscles and tendons due to constant pressure and friction, making it more likely to develop pain, inflammation and tears.

The most common rotator cuff injuries are: 

• Rotator Cuff Tendonitis (acute inflammation of the tendon)

• Rotator Cuff Tendinopathy (chronic inflammation and disorganization of the tendon)

• Rotator Cuff Tears (small or large tear(s) of the muscles or tendons)

• Impingement Syndrome (biomechanical dysfunction of the shoulder complex resulting in abnormal wear and tear) 

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Common Symptoms of Rotator Cuff Injuries 

The most common symptoms of a rotator cuff injury are:

• Pain on the front or side of the shoulder, often radiating down the arm

• Painful range of motion, most commonly above shoulder height or when lifting the arm through abduction, external and internal rotation.

• Muscle Weakness, most commonly in abduction and external rotation. 

• Functional Impairments - unable to push or pull without pain, lift overhead, or hand behind the back 

It is worth noting that not all rotator cuff injuries are marked with pain or loss of function. Some people may have a significant tear on a scan but no loss in function or reported pain. 

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With all of this additional information about the rotator cuff, we hope you have a better understanding of the anatomy of the shoulder. Understanding the “why” behind your rehabilitation or the causes of your pain can be a powerful tool in your recovery. 

If you have more questions reach out to your local physiotherapist. If you live locally in Port Alberni, reach out to one of us at www.portalberniphysiotherapy.ca or call us at 250-723-5112.

Goal Setting with Your Healthcare Practitioner

Goal setting is an important part of working with any healthcare practitioner. From your initial appointment to discharge, goals are established to guide treatment and track progress. 

When booking an appointment with a physiotherapist, strength and conditioning coach, massage therapist, or acupuncturist, it’s wise to think about what you want to get out of the appointment for a positive experience and to achieve best outcomes. 

Goal setting can be challenging and intimidating when asked on the spot during an appointment. To prepare yourself, here are some questions you may want to think of beforehand:

• What is my injury restricting me from doing?

• If I felt 100%, what type of activities would I like to do? 

• Can improvements be made in my performance of my chosen sport?

• What steps do I need to take from where I am now to where I want to be? 

• What things may prevent me from achieving my goals (ex. Work schedule, child care)?

We often think of goals on a timeline, both short term and long term. We can break down goal setting into two forms, progressive goals which are the small short-term steps to completing your long-term or outcome goals. Progressive goals help to keep your motivation and treatment on track. They are small more tangible achievements that ensure you are progressing towards your ultimate outcome. 

In a healthcare setting, progressive goals may look like completing your exercises three times a week, when the outcome goal is to run 5km without knee pain. Here is another example of appropriate goal setting. The progressive goal may be achieving full knee extension after an ACL surgery, when the outcome goal is to return to varsity volleyball. The fun really starts when your progressive goals start to improve your function, performance, and quality of life, ultimately leading to the success of your outcome goal. 

Goal setting is important to ensure motivation during your recovery and rehabilitation. Big goals don’t happen overnight. It’s the small achievements and commitment overtime. We are all guilty for expecting instant gratification, but when it comes to the human body and rehab there is no substitute for time. Unfortunately, healing just takes time, and your commitment to the cause and resilience through small setbacks is important. 

If you haven’t already, at your next healthcare appointment set goals with your practitioner. Rehab can feel like a full time job, so make sure you have a clear vision both you and your provider believe in. When you’ve answered the “WHY” behind the reason for your rehab, it’s much easier to stay on course. 

Understanding Shin Splints: Causes and Recovery

As Marathon season approaches, many people are excited to begin their long-distance training. However, one of the most common concerns among runners is how to prevent shin splints. Shin splints are a common injury that can occur during long-distance running. Unfortunately, many people are unaware of what shin splints are, how they develop, how to treat them, and most importantly, how to prevent them. In this blog, we will discuss the two different types of shin splints, what causes them anatomically, effective treatment options, and how to prevent them if you plan to start a running program. We aim to help you stay healthy and keep you moving. 

First, let's start with the two types of shin splints: anterior or posterior. The difference between them is the location of pain, which is caused by the specific muscle group affected. 

Anterior Shin Splints: 

Anterior Shin Splints tend to be more common and involve pain along the front (anterior) part of the shinbone, typically on the outer edge.

Anterior shin splints affect the muscles at the front of the lower leg, primarily the tibialis anterior muscle. This muscle is responsible for dorsiflexion of the foot (bringing the toes upward) and is heavily involved in activities like walking, running, and jumping.

Posterior Shin Splints: 

Posterior shin splints involve pain along the inner (posterior) part of the shinbone, closer to the calf muscles.

Posterior shin splints primarily affect the muscles and connective tissues at the back of the lower leg, including the posterior tibialis muscle and the flexor hallucis longus muscle. These muscles play a role in controlling the movement of the foot and stabilizing the arch.

Now that we know the two different types, what actually causes shin splints? 

Shin splints are caused by repetitive stress on the shinbone and the tissues that attach muscles to the bone. For instance, during long-distance running, the muscles on the front and back of the shin bone contract every time your foot hits the ground. This can lead to irritation or inflammation where the muscles of the shin connect to the bone. The irritation and inflammation cause sharp pain during physical activity and impact, and sometimes a dull ache after exercise. The area of pain is usually a couple of inches and can be sore to touch. However, it typically improves with rest and doesn't usually show signs of swelling.

If you do notice any swelling or if rest doesn’t improve your symptoms, it is important to speak to your GP or physiotherapist. Sometimes, shin splints can be mistaken for a stress fracture and requires different treatment.

So what are the major contributing factors causing Shin Splints? 

• Overuse or Overtraining: Rapidly increasing the intensity, duration, or frequency of exercise, particularly high-impact activities like running, can strain the muscles, tendons, and bone tissue in the lower leg.

• Biomechanical Issues: Flat feet, improper footwear, or irregularities in running or walking gait can lead to uneven distribution of stress along the shinbone, increasing the likelihood of shin splints.

• Muscular Imbalances: Weakness or tightness in certain muscles, particularly the calf muscles and those surrounding the shinbone, can disrupt proper biomechanics and contribute to shin splints.

• Hard Surfaces: Exercising on hard surfaces, such as concrete or pavement, can exacerbate impact-related stress on the lower legs.

How Do I Prevent Shin Splints? 

Strength Training: If you're someone who runs long distances, it's important to start a strength training program that includes ankle and calf strengthening exercises. This is your first line of defense, as building strength will make you more resilient and better able to handle stress and strain without getting injured.  For injury-specific exercises, we recommend speaking with your local physiotherapist as exercises can vary depending the type and severity of your shin splints.

Soft Surfaces: Mix things up by running on softer surfaces such as trails instead of just on concrete or pavement. Trails provide more cushioning and put less stress on the lower leg muscles. You can also try using a treadmill, although for longer distances this isn’t always everyone's favourite. 

Good Footwear: Invest in good footwear that provides proper arch support, especially if you're prone to shin splints. Visit a local running store to get fitted for shoes that are best suited for you. 

Insoles: Consider using insoles if you have flat feet and have experienced shin splints in the past. Insoles can support the arch of your foot and reduce the load on the muscles in the posterior shin, lowering your risk of developing shin splints.

Running Assessment: Consider getting a running assessment to check your technique. Most physiotherapy clinics offer assessments where they record you running on a treadmill and review the components of your gait and any biomechanical factors that may be contributing to your shin splints. This typically results in a treatment plan and exercises to address the underlying issues.

What happens if I already have shin splints? How Should I treat them? 

Recovery from shin splints requires patience and usually a multifaceted approach:

• Rest: This is the most important but everyone’s least favourite option. You must reduce the volume and load on the lower leg muscles to allow them to recover. This may be reducing your running distances to a more manageable level or temporarily halting impact activity to reduce pain. Your physiotherapist will help explore options with you to decide what path will work best for you and your training. 

• Ice Therapy: Applying ice packs to the affected area can help alleviate inflammation and pain. Aim for 15-20 minutes of ice therapy several times a day.

• Strength Training: progressive strength training for your calves, the muscles of the anterior shin, arches of your feet and outer hip are beneficial while you “rest”, they can help increase resiliency of the injured muscle groups so return to activity doesn’t result in another flare up.  For injury-specific exercises, we recommend speaking with your local physiotherapist as exercises can vary depending on the type and severity of your shin splints.

• Gradual Return to Activity: Once the pain subsides, gradually reintroduce activity, paying attention to proper form, footwear, and surface. A Return to Run Program is always a smart choice, there are great ones all over the internet and your physiotherapist should be able to guide you. Slow progressions are key! 

If you or someone you know is struggling with shin splints, or have had shin splints in the past and want more prevention tips, book an appointment with one of our physiotherapists. You can book online at www.portalberniphysiotherapy.ca or call us at 250-723-5112. 

The Physical and Mental Benefits of Therapeutic Massage

Massage was once only available at high-end spas or considered a luxury. However, it is now included in many employee health benefits packages, widely available, and an important tool for promoting mental and physical health.

If you haven't had a massage before, it involves techniques such as pressing, kneading, and manipulating the skin, muscles, tendons, and ligaments of the body. The pressure used during a massage can range from light strokes to deep pressure. 

Massage is increasingly being offered as part of a standard treatment routine for injury rehabilitation, injury prevention, pain management, and is beneficial for a wide range of medical conditions. It is worth considering as part of your health routine if you haven't tried it yet.

One big misconception about massage is that it is only for indulgence and relaxation. While this may be true in some situations, massage is much more than that. Many massage therapists and body workers have a range of knowledge in strength training, home-care strategies, flexibility, and mobility exercise prescription, among other unique areas of interest.

In this blog, we will discuss the many benefits of massage.

Mental Benefits of Massage

Stress Reduction:

Massage is a powerful remedy for stress, as it promotes the release of endorphins - our body's natural stress-fighters. The gentle kneading and rhythmic strokes performed by skilled therapists work at easing tense muscles, leaving you with a sense of relaxation.

Taking time for yourself, be it 30, 60, or 90 minutes, can help you destress and improve your mental and physical health. Whether you spend this time in silence or casual conversation, just setting aside this time can be a significant stress reducer.

Improved Sleep Quality:

Sleep can be improved by massage as it helps induce relaxation, leading to deeper and more restful sleep. This can be particularly helpful for those who struggle with insomnia or irregular sleep patterns. Massage has been found to increase the levels of serotonin, which is a neurotransmitter associated with feelings of relaxation. In addition to this, massage can also reduce the levels of the stress hormone cortisol. These hormonal changes can create a better physiological environment that is more conducive to sleep.

Decreased Anxiety:

Massage can have a balancing effect on the autonomic nervous system. By promoting both the parasympathetic (rest and digest) and sympathetic (fight or flight) branches, massage helps the body maintain equilibrium, reducing the overall stress response and reducing anxiety. Studies have suggested that massage can lead to a reduction in cortisol levels, which are associated with stress. Lowering cortisol levels contributes to a more relaxed state and a reduction in anxiety.

Physical Benefits of Massage

Muscle Tension Relief:

A massage therapist or body worker directly manipulates muscles and soft tissues to help release knots, tightness, and adhesions, which allows the muscles to relax. As the therapist works on specific areas of tension, the muscle fibers are encouraged to lengthen, and the nervous system responds by signalling the muscles to let go of their contracted state. The overall result is a reduction in muscle tension.

Enhanced Circulation & Recovery:

During a massage, the gentle pressure applied to your body helps to stimulate blood flow, which in turn improves the delivery of oxygen and nutrients to different parts of the body. This improved circulation can help promote healing and recovery by delivering nutrients to your muscles and tissues more efficiently than before.

Pain Relief:

According to the Gate Control Theory of pain, non-painful input (such as the sensation of massage) can block the transmission of pain signals to the brain. The tactile stimulation from massage may help override or modulate pain signals, reducing the perception of pain.

Enhanced mental and physical relaxation is a benefit of massage (as seen above) which helps reduce pain. Massage also stimulates the release of endorphins, which are the body's natural painkillers. These neurotransmitters can create a sense of well-being and act as analgesics, diminishing the perception of pain.

Improved Flexibility:

Massage improves muscle flexibility by relieving tension, tightness, and restrictions in the muscles and tissues. Massage techniques like targeted pressure, passive stretching, and myofascial release help muscles relax and promote a wider range of motion. Massage releases trigger points, prevents adhesion formation, and addresses muscular imbalances, improving muscle function and flexibility. It alleviates stiffness and prevents future restrictions, promoting greater freedom of movement and enhancing physical well-being.

Massageis an excellent way to relax and recover from physical and mental stress. It's not a luxury but a vital health tool that helps with injury prevention, the healing process, and overall well-being.

If you are looking for a therapeutic massage experience book with our Body Worker, Taylor Christensen, online or by calling our clinic at 250-723-5112. 

Glutes 101: Where They Are and How to Use Them

Today, we dive into the often underestimated and overlooked powerhouse of the body—the glute muscles. Yes, those muscles that are the real MVPs in shaping and supporting our bottoms. 

How many times have you heard a fitness instructor or physiotherapist say “use your glutes” or “you know what your problem is… you just don’t use your glutes”. But when does someone actually show you where your glutes are, how to activate them, and what they do? 

Sometimes we forget that the simplest knowledge can be the most powerful, so today we are breaking it down. Grab your water bottle, put on your favourite workout playlist, and let's talk glutes!

Location, Location, Location: Where Are Your Glutes?

First things first, where exactly are these glutes we're talking about? Well, they're the group of muscles in your buttocks, made up of three individual muscles: the gluteus maximus, gluteus medius, and gluteus minimus. 

Gluteus Maximus: The Powerhouse of Extension

This is the biggest of the three glute muscles and also the most powerful. It is the one that sits right on the surface and can give you the J.Lo definition. Beyond having a cute peach it is also the prime mover in hip extension. Meaning when you lift your leg back behind you, your gluteus maximus is the main driver of that movement. It is important in so many daily movements, but recently with a rise in desk jobs, a lot of us don’t use this main muscle as often as we should, causing it to atrophy (or shrink). 

Gluteus Medius: The Underrated Middle Sister

Gluteus medius never receives the attention it should. It is the prime mover of hip abduction (lifting your leg to the side) and a big contributor to hip extension and rotation, as well as hip stability. A weak gluteus medius or poor activation can lead to a host of issues like back pain, IT Band syndrome, and poor hip and knee mechanics when running, walking, and squatting. When someone has a weak gluteus medius we often see a hip tilt on a single leg called a Trendelenburg sign.

This little gal needs to be worked often and in most physiotherapist opinions everyone should have an isolated hip abduction exercise in their physical fitness routine. You want to keep the gluteus medius strong and healthy. 

Gluteus Minimus: The Happy Helper

Gluteus Minimus is the smallest of the glute group, and its primary job is to help with hip stability and hip abduction. Single-leg exercises tend to target this muscle group the most and it is happy to tag along when working out the two bigger muscles in its group. 

Getting to Know Your Glutes: What Do They Do?

We touched on this a little bit above, but in a more general sense the glutes are more than just a cushy seat for your favourite chair—they're involved in a range of movements, from standing up straight, to walking, running, and even maintaining balance. Strong glutes help support your lower back, improve posture, and maintain proper hip and knee mechanics. In short, they're the unsung heroes of your body!

Activating the Power: How to Use Your Glutes

It’s time to put those glutes to work! The key to activating your glutes is to focus on engaging them during exercises, creating a stronger mind-body connection. If you aren’t used to using your glutes you may have to consciously think about it at the start. Try squeezing your glutes in a chair just to locate them first and then transfer that standing or at the top of a squat. These simple actions can help strengthen and tone these muscles over time and help create a strong connection. 

Glute Exercises to Get Started: 

Now, the fun part—let's explore some exercises that will fire up the glutes:

• Squats:

• Stand with your feet shoulder-width apart.

• Lower your body as if you're sitting back into a chair, keeping your chest up and knees behind your toes.

• Squeeze your glutes as you return to the starting position.

Reverse Lunges:

• Take a step backwards with one foot, lowering your body until both knees are bent at a 90-degree angle.

• Push off the back foot, engaging your glutes, and return to the starting position.

• Repeat on the other leg.

• Glute Bridges:

• Lie on your back with your knees bent and feet flat on the floor.

• Lift your hips toward the ceiling, squeezing your glutes at the top.

• Lower your hips back down and repeat.

Monster Walks:

• Start a band around the arches of your feet or ankles.

• Take small steps in a lateral direction, keeping tension on the band

• Try 10 steps to the left and 10 steps to the right.

• Resisted Hip Abduction

• Stand on a single leg with a band around your ankles

• Lift your non-standing leg out to the side, inline with your standing leg

• Lower the leg back to the starting position and repeat

• Single Leg Deadlifts

• Standing on a single leg, hinge forward at your hip

• Lift the back leg at the same rate as you tilt forward

• Return to an upright position by squeezing your glutes 

Keep the sets and reps of all exercises simple, begin with 3 sets x 10 reps (on each side - if the exercise is on a single leg), and progress to 12-15 reps once you are able.

Incorporate some or all of these exercises into your routine, and your glutes will thank you later. Remember, consistency is key, so make sure to gradually increase intensity and challenge yourself as you progress.

If you want something more individualized or would like someone to show you technique and walk you through the paces, book an appointment with one of our clinicians. You can do this by phone at 250-723-5112, or online at https://www.portalberniphysiotherapy.ca

Unraveling the Knot: Understanding, Exercising, and Preventing Tension Headache

Tension headaches are like uninvited guests who show up at the most inconvenient times, wrapping our heads in a vice-like grip. These headaches, often characterized by a dull, persistent pain, are a common affliction in our stress-laden lives. In this blog post, we'll delve into the causes of tension headaches, explore exercises that can provide relief, and discuss proactive measures to prevent these unwelcome visitors.

Understanding the Culprits: What Causes Tension Headaches?

Tension headaches are often the result of muscle contractions in the head and neck regions, typically triggered by stress, anxiety, or poor posture. Prolonged periods of staring at screens, inadequate sleep, and dehydration can also contribute to the onset of tension headaches. Understanding these triggers is the first step in effectively managing and preventing these headaches.

Exercise Treatment

Exercise can be a powerful tool in alleviating tension headaches. Engaging in activities that promote relaxation and release muscle tension is key. Here are a few exercises that may help:

1. Neck Stretches: Gently tilt your head to one side, bringing your ear toward your shoulder until you feel a stretch on the opposite side of your neck. Hold for 15-30 seconds, then switch sides. Repeat as needed throughout the day.

2. Shoulder Rolls: Sit or stand with your shoulders relaxed. Slowly roll your shoulders forward in a circular motion for 10-15 seconds, then reverse the direction. This simple exercise can help release tension in the shoulders and upper back.

3. Massage ball: If you get good relief from massage work, you may benefit from a massage ball to continue these techniques at home. A massage ball relieves tension by placing pressure on a muscle allowing it to relax. This is particularly useful in the sub-occiptal muscles at the base of the skull. Below is a great video showing you how to use a massage ball correctly for tension headaches.

4. Yoga: Yoga emphasizes gentle, flowing movements that can help relax muscles and reduce stress. Incorporating these practices into your routine may contribute to headache prevention. Below is a great Youtube video so you can get started at home.

Preventing Tension Headaches

Prevention is often the best medicine. Here are some lifestyle adjustments to help prevent tension headaches:

Manage Stress: Identify stressors in your life and develop healthy coping mechanisms, such as mindfulness, meditation, or engaging in hobbies. The Headspace App is a great place to start mindfulness meditation if you haven’t used it already. This app walks you through a variety of mindfulness practices to help relieve stress and cope with the anxieties of everyday life.

Maintain Proper Posture: Be mindful of your posture, especially when sitting for extended periods. Keep your spine straight, shoulders relaxed, and take breaks to stretch and move. We advise our clients to use a phone timer or download a posture app that reminds you to check your posture. Ideally you take breaks every 30-60 minutes to move around. This can include coffee breaks, switching from a seated to standing position (with a sit to stand desk), or doing physiotherapy stretches or strengthening exercises.

Desk Ergonomics: To ensure that your desk set up is not contributing to your tension headaches , it's important to check your ergonomics. At Port Alberni Physiotherapy, our physiotherapists can conduct on-site Ergonomic Assessments to identify any issues and suggest solutions. Alternatively, you can schedule an appointment to discuss potential changes that can be made to improve your workplace ergonomics. There are also many resources online to do an ergonomic scan at home and make quick fixes.

Stay Hydrated: Dehydration can contribute to tension headaches, so make sure to drink an adequate amount of water throughout the day.

Prioritize Sleep: Establish a consistent sleep routine and aim for 7-9 hours of quality sleep each night.

To live a tension headache-free life, it is essential to understand the causes of tension headaches, practice appropriate exercises, and take preventive measures. By making minor lifestyle modifications and integrating relaxation methods into our daily routine, you can relieve the knots of tension headaches. If you need more assistance we strongly recommend consulting a healthcare professional for a thorough assessment and personalized treatment plan, you can do this through our website www.portalbneriphysiotherapy.com or by calling 250-723-5112.

The PEACE Method - The New Approach to Injury Management

After an injury, we often resort to the RICE or PRICE method, which involves resting, icing, compressing, and elevating the injured area. However, recent evidence-based updates suggest that avoiding anti-inflammatory medication is crucial during the first few weeks of healing. The acronym PEACE is now being used in injury management, and here is what it’s telling us:

Protection: The protection aspect of the PEACE method emphasizes the importance of protecting the injured area without completely immobilizing it. This may involve using braces or splints, which provide stability without restricting all movement.

Elevation: Similar to the RICE method, elevating the injured area can help reduce swelling and improve blood flow.

Avoid Anti-Inflammatory Agents: Unlike RICE, the PEACE method advises against the use of anti-inflammatory medications during the initial stages of injury, as inflammation is considered part of the natural healing process. Using anti-inflammatories may interfere with the body's ability to repair itself.

Compression: The PEACE method recommends a modified approach to compression. Instead of tight compression that might restrict blood flow, gentle compression may be used to provide some support without inhibiting the body's healing mechanisms.

Education: Educating the individual about the nature of their injury, potential recovery timelines, and the importance of active management is an essential aspect of the PEACE method.

Even though injury management techniques are constantly changing as new research is being conducted, it is important to put the newest methods into practice. At this point in the medical literature, if you use the PEACE method you are giving yourself the best chance at a full and healthy recovery.

Watch this video on the PEACE Method to learn more:

Understanding Whiplash: Causes and Effective Treatment

Whiplash, or Whiplash Associated Disorders (WAD) is a common injury treated by healthcare professionals. We commonly see these injuries in a clinical setting after a car accident, falls, or sports injuries, but many people are unaware of what causes whiplash or how to effectively treat it. In this blog will answer the common questions surrounding whiplash and suggest effective exercises that you can start at home. 

What is Whiplash?

Whiplash refers to an injury of the neck from a rapid acceleration and deceleration movement. This generally happens when the neck and head move forwards and backwards quickly and unexpectedly with a high amount of force. This forceful and rapid motion can strain or damage the soft tissues in the neck, primarily the muscles, tendons, and ligaments. Although in rare cases nerve damage, fractures, and dislocations can occur. 

When treating whiplash, your healthcare practitioner will typically assign a grade to the injury related to the severity of symptoms. Here are the four different grades of whiplash:

Grade 1: Complaint of neck pain, stiffness, and tenderness only. No physical signs are present.

Grade 2: Complaint of neck pain and stiffness, along with musculoskeletal signs. Musculoskeletal signs include a noticeable decrease in neck range of motion and point tenderness.

Grade 3: Complaint of neck pain and stiffness, along with neurological signs. Neurological signs include sensory deficits, weakness, and a loss or decrease in reflexes.

Grade 4: Complaint of neck pain and stiffness, along with a fracture or dislocation.

Most whiplash injuries are a result of a soft tissue injury and are classified as a Grade I or II. These types of whiplash injuries can be successfully treated by rest, education, and physiotherapy.

Grade III and IV whiplash injuries are possible, but much more rare and require different intervention. If you are experiencing changes in neurological signs or suspect you may have a fracture due to a whiplash injury please speak with your GP or visit an emergency department right away.

Causes of Whiplash: 

The primary cause of whiplash is any sudden, forceful movement that hyperextends and hyperflexes the neck. Common scenarios include:

• Car Accidents: Rear-end collisions are a notorious trigger for whiplash. The abrupt deceleration of the vehicle can jolt the neck forward and backward.

• Sports Injuries: Contact sports, especially those with a high risk of collisions or tackles, can lead to whiplash. It's crucial for athletes to use protective gear and proper technique.

• Falls: A sudden slip or fall can result in whiplash, especially if the head and neck snap backward upon impact.

• Amusement Park Rides: The rapid and unpredictable movements on certain amusement park rides can subject riders to forces that may cause whiplash.

• Cycling Accidents: Falling off a bike, performing a quick sudden stop at high speed, or a collision with a vehicle can cause whiplash. 

How Long Does Whiplash Last? 

The duration of whiplash can vary significantly from person to person, depending on several factors, including the severity of the injury, the individual's overall health, and the effectiveness of treatment. In general, whiplash symptoms can last anywhere from a few days to several weeks or even months. Here's a rough timeline of how whiplash symptoms may progress:

• Acute Phase (0-72 hours): In the immediate aftermath of the injury, you may experience pain, stiffness, and swelling in the neck and surrounding areas. Symptoms are typically at their worst during this phase.

• Subacute Phase (3 days to 3 months): Most people start to see improvement in their symptoms within the first few weeks, but it's not uncommon for some symptoms, like stiffness and occasional pain, to persist for several months.

• Chronic Phase (3 months and beyond): If whiplash symptoms continue beyond three months, they are considered chronic. Chronic whiplash can be more challenging to treat, but with the right interventions, many individuals still experience improvement over time.

It's essential to note that seeking early and appropriate treatment can significantly influence the duration and severity of whiplash symptoms. Physiotherapy, massage, and even acupuncture are valuable treatment options that can help speed up recovery and reduce the risk of chronic symptoms.

It's also important to follow your healthcare provider's recommendations, adhere to your prescribed treatment plan, and actively participate in any exercises or therapies recommended for your recovery. If your whiplash symptoms persist or worsen, it's crucial to consult a healthcare professional for further evaluation and adjustments to your treatment plan. Each person's experience with whiplash is unique, so the duration of symptoms can vary widely.

Treatment for Whiplash

Common treatments for whiplash aim to alleviate pain, reduce inflammation, improve neck mobility, and promote overall recovery. The specific treatment plan may vary depending on the severity of the injury and individual needs. 

It is important to keep your body moving and generally active after a whiplash injury. Doing gentle exercise and returning to work as soon as you feel able typically helps recovery. You do not need to wait until you are 100% better to return to a somewhat normal routine.

Going for a gentle walk or completing your household chores is an easy way to incorporate movement at the start of your recovery.

It is important to start gentle range of motion exercises as early as possible. This will help decrease joint stiffness. This may be uncomfortable at first, but will improve with time and practice. It is helpful to push into a bit of pain to start as this will improve your range of motion and get you back to your normal self.

Pain should not be avoided in the early stages as long as it is mild. You won’t cause more or prolonged damage by doing gentle exercises during the early phases of recovery. Pain in this case, is a reminder that you’ve had an injury that you need to be gentle.

Here is a list of common treatments to aid in whiplash recovery:

• Rest: Initially, resting the neck and applying ice or heat can help alleviate pain. This is recommended for the first 72 hours when pain is typically at its worst. 

• Physical Therapy: This is a cornerstone of whiplash treatment. Physiotherapists can create a customized exercise program to improve neck strength and flexibility.

• Manual Therapy: Hands-on techniques like massage and joint mobilization can help alleviate muscle tension and improve mobility.

• Heat Therapy: Heat can promote blood flow and relax tense muscles, easing discomfort.

• Pain Medication: In some cases, over-the-counter or prescription pain relievers may be recommended to manage pain and inflammation.

• Education: Patients are educated on proper posture, ergonomics, and exercises to prevent future injuries.

Exercises for Whiplash

These exercises are meant for the early stage of whiplash and are simple but effective. They are meant to improve your range of motion and build foundational muscle strength so you can progress to harder exercises with your physiotherapist. You can complete these exercises 2-3 x day for the first 10 days to 2 weeks after injury.

It is important to note that once these exercises become too easy, it is important to have exercise progressions. Exercise progressions help build muscle strength to its original baseline level prior to injury and will prevent re-injury once you return to your normal routine.

• Neck Range of Motion 

  You want to complete all 6 ranges of motion to the best of your ability. Slight pain and discomfort is okay. On a pain scale you don’t want to go above a 4/10.

  You may find extension and rotation particularly difficult - go slow and be gentle.

  Complete 2 sets x 10 repetitions of each range of motion, taking breaks as necessary.

• Isometric Neck Strengthening 

  Complete all ranges of motion on each side only pushing as hard as you can tolerate

  Complete 3-5 reps x 5- 10 second holds in each position

  Make sure your neck stays in a neutral position when applying pressure

In summary, whiplash is a neck injury resulting from rapid and forceful movement, often caused by car accidents, sports injuries, falls, or other abrupt incidents. While it can be painful and uncomfortable, there are effective treatments available, with rehabilitation playing a crucial role in the recovery process.

If you or someone you know has experienced whiplash, we strongly recommend consulting a healthcare professional for a thorough assessment and personalized treatment plan, you can do this through our website www.portalbneriphysiotherapy.com or by calling 250-723-5112.

The Healing Power of Clinical Pilates in Rehabilitation

Clinical Pilates is known to have many benefits when recovering from injury or improving chronic pain. The combination of controlled movements, mindful breathing, and focused exercises on muscular strength and alignment can improve a patient’s body awareness and overall mind-body connection. Whether you're seeking post-injury rehabilitation, pain management, or a path to lifelong wellness, Clinical Pilates offers a gentle, yet powerful approach. 

Read along to discover the many benefits of Clinical Pilates and whether or not it is right for you.

The Core of Rehabilitation

Rehabilitation is all about restoring movement, strength, and function to those who've experienced injuries or health conditions. As clinicians, we understand the significance of personalized, well-rounded treatments that cater to each individual's unique needs. Enter Clinical Pilates – a method that aligns seamlessly with this philosophy.

The Power of Controlled Movements

At the heart of Clinical Pilates lies a focus on controlled movements that engage the body's core muscles. These gentle yet precise movements aid in retraining muscle activation patterns, enhancing stability, and improving overall body awareness. For someone navigating their way through rehabilitation, these controlled movements can be transformative.

Tailored to Your Needs

One of the most remarkable aspects of Clinical Pilates is its adaptability. Whether you're recovering from a sports injury, surgery, or managing chronic pain, a skilled practitioner can customize the exercises to suit your specific condition. This tailored and individualized approach not only accelerates your recovery but also helps prevent further injuries by addressing underlying weaknesses.

Mind-Body Connection

The mind-body connection is an essential component in the rehabilitation process, especially when dealing with chronic pain. Pain is not solely a physical sensation; it's also influenced by psychological factors. Clinical Pilates incorporates mindfulness and controlled breathing techniques that help manage stress and anxiety – both of which can exacerbate pain. By promoting relaxation, positive mental state in combination with body awareness and proper posture, Clinical Pilates helps develop a stronger mind-body connection and effectively reduces pain. 

Gradual Progression

One of the keys to successful rehabilitation is gradual progression. Clinical Pilates excels in this regard by offering a range of exercises that can be modified to accommodate various levels of fitness and recovery. Clinical Pilates provides a structured framework that allows individuals to start at a level that aligns with their current capabilities and gradually advance as their pain tolerance and strength improve. Whether you're just beginning your journey or well on your way to recovery, there's a suitable Pilates routine for you.

Building Long-Lasting Habits

One of the most rewarding aspects of using Clinical Pilates as a form of treatment, is witnessing patients transition from rehabilitation to maintaining an active, healthy lifestyle. Clinical Pilates equips individuals with valuable tools to sustain the progress they've made. The exercises learned during rehabilitation can be seamlessly integrated into daily routines, ensuring that the benefits of Pilates extend far beyond recovery. There is also the chance to transition to group classes, making it more affordable, fun, and social - adding to its longevity. 

Extended Health Care Coverage 

Clinical pilates is often eligible for coverage under extended healthcare plans. Some clinicians are certified to provide Clinical Pilates and can bill within your extended coverage. If you have questions and want to know if you are eligible, you can always contact the clinic for more guidance.  

Incorporating Clinical Pilates into rehabilitation is a decision that can positively impact your journey to recovery. The combination of controlled movements, tailored exercises, and mindfulness can bring about comprehensive healing.

If you want to learn more about clinical pilates or book an appointment, reach out to us at 250-723-5112. You can also book an appointment with one of our clinicians at Port Alberni Physiotherapy, or book a class at our onsite yoga and pilates studio - Yellow Door Studio.

Tennis Elbow: Understanding and Treating the Overuse Injury

Lateral Epicondylitis, or more commonly known as Tennis Elbow, is a common workplace and sport injury, but what actually is it? Tennis Elbow is classified as an overuse injury, which affects the tendons in the forearm, causing pain and discomfort in the outer part of the elbow. In this blog post, we will delve into the causes, symptoms, and treatment options for tennis elbow.

Causes and Symptoms:

Tennis elbow is caused by repetitive stress and strain on the forearm muscles and tendons, often due to repetitive upper limb activities such as computer use, lifting heavy loads , repetitive vibrations, and forceful wrist movements. Surprisingly, you don’t actually have to play tennis to get tennis elbow. Only 5% of people with the condition relate the injury to tennis. More commonly we see the injury in patients with repetitive one-sided movements in their occupation, such as mechanics, carpenters, electricians, gardeners, and office workers.

The primary symptom of tennis elbow is pain and tenderness on the outer side of the elbow, which can radiate down the forearm. The pain may worsen with activities that involve gripping, lifting, or wrist movements. In some cases, individuals may also experience weakness in their grip and difficulty performing everyday tasks.

Clinically, the most common complaint patients have when experiencing tennis elbow is elbow pain when lifting their purse or backpack, lifting a coffee mug, or gripping and using the steering wheel while driving.

Benefits of Physiotherapy Exercises for Tennis Elbow:

Physiotherapy exercises and treatment play a crucial role in managing and alleviating symptoms of tennis elbow. There is a lot of evidence to support gradual loading of the tendons in the elbow and wrist in combination with manual therapy such as elbow mobilizations, massage, and dry needling for clinical and cost effective outcomes. More recently, research has shown that shockwave and prolotherapy may also be effective at treating tennis elbow. If symptoms are resistant to physiotherapy treatment, surgery may be indicated.

In cases where a patient needs to use their upper limb for work purposes or performance and is unable to rest, a tennis elbow brace may also be effective. A tennis elbow brace essentially helps to offload the tendons in the elbow so they are not repetitively strained while the patient continues to complete work tasks or training. The placement of a tennis elbow brace is very important in order for it to be effective. If you are planning on using one, it may be beneficial to speak to your physiotherapist to review proper placement. 

Out of all the different treatment methods, a combination of exercise, stretching, and manual therapy seems to be the most effective. Exercises aim to strengthen the affected muscles and tendons allowing them to respond better to load, decrease inflammation, and promote healing of the injured area. As with any exercise regimen, it is essential to consult with a qualified physiotherapist or healthcare professional to ensure the exercises are appropriate for your specific condition and stage of healing. Here are some entry level and effective exercises to try at home to get started: 

1. Isometric Wrist Extension:

Rest your forearm on a table with your palm facing down.

Press your palm into the table as if trying to lift it off the surface, but keep your wrist still.

Hold this contraction for 10 seconds, then release.

Repeat 10 times on the affected side, complete 2-3 sets as tolerated

2. Eccentric Wrist Extension:

Sit on a chair with your forearm resting on your thigh, palm facing down, and your wrist hanging off the edge.

Hold a lightweight dumbbell or a resistance band in your hand and allow your wrist to drop downwards.

Then, slowly raise your wrist back to a neutral position.

Perform 3 sets of 10-15 repetitions on each side.

3. Pronation and Supination:

Hold a lightweight dumbbell or a soup can in your hand, with your forearm supported on a table.

Start with your palm facing down, then slowly rotate your forearm to bring your palm facing up (supination).

Return to the starting position and repeat the movement in the opposite direction (pronation).

Perform 3 sets of 10-15 repetitions on each side.

5. Wrist Extensor Stretch:

Extend your affected arm straight in front of you, palm facing down.

Use your other hand to gently bend your wrist downwards until you feel a stretch along the top of your forearm.

Hold the stretch for 30-45 seconds, repeating 3 times on each side.

Complete after your strengthening exercises

Tennis elbow might be a common injury, but with proper knowledge and early diagnosis, you can recover relatively quickly. Many factors contribute to the outcome and speed of recovery such as age, occupation, and consistency with exercises; However, the key lies in listening to early warning signs, gradual progression in activity, and seeking professional help when needed.

If you suspect you have tennis elbow or want to improve your technique to prevent it, consult with a qualified physiotherapist by clicking on the BOOK NOW button below. With the right approach, you can enjoy your favourite activities or bounce back to work with good outcomes. 

Benefits of Dry Needling and Intramuscular Stimulation

You may have heard the term Intramuscular Stimulation (IMS) or Dry Needling (DN) when talking about physiotherapy and rehabilitation, but what actually is it and how is it beneficial? This blog will go through the differences between the two needling practices and how they may benefit you. In the end, the hope is you’ll gain more knowledge and decide whether either form of these needling practices are right for you in your recovery journey.

Dry Needling (DN)

Dry Needling (DN) or Trigger Point Dry Needling (TPDN), is the use of a small dry needle that is inserted into a taut band of muscle or trigger point to release tension. 

Trigger points are taut bands of muscle that may occlude blood flow causing a radiation of pain in a distinct pattern. Common areas for trigger points are the postural muscles around the neck and shoulders and your glute and quadriceps muscles. At their worst, you may feel a sharp pain or severe tightness that radiates outward. 

During a Dry Needling treatment the needle may go in and out of the targeted muscle or your practitioner may move it around slightly. The goal is to accurately target a trigger point, causing a muscle “twitch” when the needle is inserted. This response will effectively cause muscle relaxation (lengthening), pain relief, and increase blood flow.

Intra- Muscular Stimulation (IMS)

Intramuscular Stimulation or IMS is a form of intramuscular dry needling focused on relieving chronic pain. This method was developed by Dr. Chan Gunn and is taught at the University of British Columbia. Dr. Gunn worked for the Worker’s Compensation Board of BC. It was here he noticed patients with taut bands of contracted muscle that stayed shortened causing chronic stress on soft tissues, nerves, and joints ultimately leading to hypersensitivity. These areas of hypersensitivity would exist well past the successful healing of an injury causing, what Dr. Gunn referred to as neuropathic pain. 

IMS was developed to target neuropathic pain by addressing the area of discomfort, but also the dysfunction of the nervous system. During IMS treatment, a sterile dry needling is inserted into taut or tender muscles at the site of pain or near the spine where the nerve that is associated with the affected muscle originates. 

Accurate insertion of a dry needle will elicit a muscle “twitch” or a dull ache, while healthy muscle will feel painless. The ache or twitch response leads to three physiological effects; muscle relaxation (lengthening of the muscle), a healing response due to the microtrauma from the needle insertion, and improved nerve signaling due to a generation of an electrical potential.

The Difference Between IMS and Dry Needling

The main difference between IMS and DN is in the approach to treatment. The method of IMS focuses on chronic pain by addressing the area of pain and also the dysfunction of the nervous system, which is why you may have needles inserted in painful muscle as well as the corresponding nerve region of your back. While dry needling, looks more at muscle trigger points and aims to release radiating muscle tension. Is there overlap of these techniques? Very much so, however one may work better for you depending on the cause of your pain.

The Benefits of IMS and Dry Needling

The benefits of these two needling practices are similar in that they:

• Reduce Pain: This can take many forms. In many cases, the deactivation of trigger points alone can reduce pain locally; however, by improving muscle extensibility this can, take pressure off joints to reduce joint pain, or nerves to reduce radicular pain. Additionally, chemical changes within the muscle and associated nerves can block or influence the transmission of pain messages to the brain

• Improve Muscle Extensibility: The deactivation of trigger points is mostly to thank here. By releasing taut bands found within muscle, muscled spasms can be decreased, seeing an increased range of motion. Improved joint mechanics and using the “twitch response” to our advantage can allow for improved recruitment and activation of appropriate muscles.

• Promote Healing: By using a needle., we are creating tiny injuries in a dysfunctional muscle. The body then has an inflammatory response in the area. This is a natural healing process which stimulates healing through collagen and protein formation and can help to restore muscle function.
  
  

• Promote Blood Flow: Trigger points cause tightness in muscles which can occlude blood flow, restricting oxygen delivery. This lack of oxygen can contribute to pain in the affected area. By using DN or IMS to deactivate trigger points in the muscle, we can reduce the barrier to blood flow and improve oxygenation.
  
  

• Provide a Window of Opportunity: Using Dry Needling or IMS is kind of like pressing the RESET button on a muscle and nervous system. It provides a window of change where a muscle can be recruited more effectively and help re-establish movement patterns.

It is important to note, that you don’t want rely on dry needling as a stand alone treatment, but instead pair it with other physiotherapy techniques as well as appropriate home exercises to help reinforce movement patterns and repaired function.

If you are interested in either of these treatments, we have clinicians that are qualified in IMS and Dry Needling and are happy to help! Book an appointment with us online or by phone.