Victoria Physio News
- Brought to you by Therapeutic Edge

Arthritis Pain?

POSTED: January 16, 2013

Consult a Physiotherapist if you are experiencing pain, joint stiffness and decreased mobility due to arthritis. Physiotherapy has an excellent long-standing history of effectively treating the symptoms of arthritis.

A Canadian study of patients with Rheumatoid Arthritis showed that those who followed a home-based physiotherapy program improved with the treatment and were able to maintain the results one year later. Other research findings have shown that low-intensity exercise over a 24-week period can provide pain relief and improvement in functional status.

There is strong evidence that therapeutic exercise is an effective means to achieve pain relief, improve strength, reduce swollen joints and improve function which means less sick leave and a better quality of life.

Therapeutic exercise plays an important role in managing the symptoms of other forms of arthritis as well, such as Osteoarthritis.

Therapeutic exercise, whether prescribed for specific joint problems or a general exercise program, results in reduced pain, improvement in physical activity, aerobic capacity and energy levels.

Carrying excess weight puts individuals at risk of developing osteoarthritis, particularly in the weight-bearing hip and knee joints. A recent report from the Canadian Institute for Health Information (CIHI) demonstrates a correlation between being obese and the incidence of knee and hip replacement surgeries.

Physiotherapy begins with a medical history and physical assessment that includes an analysis of function and gait. The treatment is then tailored to the individual’s symptoms, needs and lifestyle.

Using exercise, education and a variety of therapeutic modalities as needed, physiotherapists work with their clients to help them:
• Regain muscle balance and flexibility
• Improve circulation and endurance
• Improve strength and stability
• Improve poor posture; and
• Maintain or increase mobility

Physiotherapists make a contribution across the health care continuum. They help people of all ages gain and maintain optimal physical function and an active lifestyle. With their applied knowledge and understanding of the human body in action, physiotherapists are able to help their patients increase mobility, have less pain, build strength and improve balance and cardiovascular function.

Physiotherapists not only treat injuries, they also provide education on how to prevent the onset of pain and/or injury that can limit activity. For more information, visit the Arthritis Society’s web site at


POSTED: December 5, 2012

Learning How To Decrease Pain AND Improve Your Function

1. Ask your physiotherapist to provide you with
education about pain science and pain management

2. Practice relaxation, breathing exercises and body awareness exercises every day. Work with your physiotherapist to bring these techniques into your exercises and daily activities.

3. Understand that pain does not have to limit you from participating in your usual daily activities – relaxation, breath control and letting go of muscle tension may provide less need to modify activities with the guidance of your physiotherapist.

4. Pace yourself. Work with your physiotherapist to learn how to set goals for work, hobbies and social activities that will not flare up your pain, and that will allow you to recover.

5. Do your best to be patient and persistent.
Recovery from chronic pain requires ongoing practice.

6. Do the things that bring you joy, on purpose, even if they are difficult. Your nervous system has powerful “anti-pain” mechanisms that only turn on when you smile, laugh, have fun and do things that are personally meaningful.

7. Work with your physiotherapist to find an exercise program that is right for you. Exercise produces the biological changes that promote allow your body to recover.

Exercise daily for short periods at a pace that is comfortable for you. Make small increases frequently.

8. Talk to you physician about developing a plan and setting goals to taper off your pain medication - if the pills do not allow you to move better and have less pain.

9. Encourage your family and friends to support healthy behaviours related to recovery (gradually resuming your usual activities of daily living, eating properly, getting enough sleep, exercising at a safe level).

10. Be open with your physiotherapist. Ask questions related to improving your function.

11. Remain confident that you will attain your goals of less pain, greater mobility and improved quality of life, over time.


POSTED: November 7, 2012

Make no bones about it – osteoporosis prevention must start at an early age

Physiotherapists advise that skipping, dancing and other fun strength and balance activities can help battle the onset of osteoporosis, the “paediatric disease with geriatric consequences”, as Osteoporosis Canada so aptly describes it.

Osteoporosis currently affects 1.4 million Canadians. This disease is characterized by low bone mass and deterioration of bone tissue causing bones to become more fragile and resulting in a higher risk of fractures. As the incidence of osteoporosis grows, it is anticipated that the next 35 years will see a threefold increase in the number of hip fractures alone, not to mention an increase in other fractures such as the spine and wrist, also common in people with osteoporosis.

Increasing age, sedentary lifestyle and poor nutrition are important risk factors for osteoporosis. Research shows that those who focus on their bone health when they are young can significantly decrease their risk of osteoporosis later in life. A crucial element in preventing osteoporosis in later years is to adopt good exercise habits early on that include plenty of weight bearing activities to increase bone strength. Meena Sran, PhD, (and past PABC President) a physiotherapist and osteoporosis researcher says simple activities like skipping, running, jumping, and dancing are good examples of ‘fun’ bone building activities. “These activities can help both kids and adults build and maintain their bone density throughout life”.

Weight training is another activity that can help people improve their bone density. “Weight training is particularly important the older we get,” says Dr. Sran. “Most fractures from osteoporosis occur as the result of a fall, so it is important to work on maintaining and improving our strength and balance. ”If you have special concerns such as back pain or knee pain, it’s best to get an assessment from a physiotherapist who can develop a personalized exercise program tailored to your health needs”.

Weight bearing and strength training exercises have an important role to play in osteoporosis prevention and management, by increasing bone mass at a young age and maintaining bone density and preventing falls in later years. Physiotherapists, with their comprehensive knowledge of how the body moves, are playing an integral role in the prevention and treatment of osteoporosis. Whether you want a life long exercise plan to prevent osteoporosis, or already have the disease and need advice on maintaining function and reducing your risk of falls, consult a physiotherapist who can help you achieve your bone health goals.

Back Pain

POSTED: September 12, 2012

Almost everyone experiences some type of back pain during the course of their lives. More than 70% of back problems begin during routine daily activities. Accidents and other forms of trauma account for only 30% of back problems.

Back pain can be due simply to a lack of exercise or a result of poor posture or body mechanics.

Poor posture or twisting movements during such routine activities as gardening, housework, picking up a child, reaching for an object or even coughing can cause acute back pain: pain that can last for hours, days or even years if ignored. The pain can be felt in the back or may be “referred pain” that is felt in the low abdomen, groin, leg or foot. Specific sensations can include pins and needles, numbness or a burning feeling. These should not be left untreated.

Normally, pain resulting from muscle or ligament strains will fix itself in the first 24 to 48 hours. If the pain does not subside after 24 hours, is happening regularly, is severe, or is getting worse, you should see your Physiotherapist.

The physiotherapist’s focus is to treat the problem quickly, reduce pain and return you to normal activity as soon as possible.

Since so many factors can be the cause of back pain, physiotherapists offer a range of comprehensive treatment programs designed specifically for your individual case, including hands-on treatment such as:
- exercise prescriptions to strengthen and condition the back and stomach muscles that support the spine
- mobilization involving small movements
of one or more joints in the spine
- manipulation which improves spine mechanics
- physical modalities which can include the use of heat, ice, or various types of electrical stimulation
- posture correction
- advice and education to prevent future back pain, as well as back protection strategies.

Your body will go through 3 stages of healing after every injury, and your Physiotherapist will help you through each stage.

1. Inflammation – Pain and swelling need to be controlled. Physiotherapists recommend: ice, activity reduction, ultrasound or electro-therapy to help with inflammation control and pain management.
2. Repair – scar tissue formation occurs, which is how your body mends; at this stage your Physiotherapist will prescribe therapeutic exercise for range of motion or stretching.
3. Remodeling – your body is rebuilding healthy tissue; your Physiotherapist will guide you through a strengthening or conditioning program.

Regular aerobic exercise, such as walking, swimming will help prevent injury and provide the condition a healthy back needs. A Physiotherapist will help you maintain your strength and fitness to minimize injuries and prevent re-injury.

Clinical research shows that early treatment of back pain prevents chronic back pain, and sufferers can return to work and other activity, enhancing their quality of life and general well being.

Travel Tips

POSTED: July 30, 2012

Physiotherapists recommend these posture tips:
- If the hollow in your back is not supported, try a lumbar roll or rolled up T-shirt;
- Keep shoulders in line with trunk and upper back to allow for even loading through the spine;
- Hips and knees should be as close to a 90 degree angle as possible to maintain good spinal alignment.
- Depending on transportation policy, a backpack or other piece of carry-on luggage can act as a footrest to bring legs and knees to a comfortable height; preferably at 90 degrees.
- Position the arm rest so your elbows are bent to 90 degrees. If your arm rest is too low, use a small pillow under your forearm.
- Shift your weight frequently to reduce prolonged pressure points when sitting, including moving hips and knees.
- Keep headrest centered in the back of your head. Adjust the chair to an upright position so that your seat is at the back of the chair.
- If you’re driving, change the angle of the steering wheel at rest stops as a way to change your sitting position.

Physiotherapists recommend doing one exercise from each of the following groups before, during and after the journey, to maintain good general circulation, and decrease stiffness by moving the joints. Slowly stretch until a gentle tension is felt in the muscle (this should not be painful). Take relaxed breaths and do each exercise slowly, repeating twice on both sides.

Head and neck:
- Head Turn – turn head over right shoulder and back to centre;
- Head Tilt – bring ear towards shoulder without turning head or lifting shoulder;
- Neck Bend – tuck in chin and slowly bring towards chest. Slowly return to start position;
- Neck Extension – raise chin to ceiling and look up as far as you can. Slowly return to start position;

- Shoulder Stretch – link fingers together and push up with palms facing upwards;
- Shoulders Back – squeeze shoulder blades together. Expand rib cage with each breath;
- Shoulders Forward – cross arms across chest and hold back of shoulders with hands. Hug shoulders forward so that a stretch is felt between shoulder blades;
- Shoulder Rolls – Shrug shoulders. Make circles with one shoulder, then the other. Touch shoulder blades together and relax. Repeat three or four times.

- Body Twist – turn body and head to look over right shoulder. Reach left hand across the body to hold on to top right edge of chair. Repeat on opposite side;
? Back Arch – arch back until pelvis tilts forward. Try to breath normally;

- Back Slump – slump forwards and bring shoulders towards knees as far as comfortable. Keep stomach relaxed. Pelvis should tilt backwards;
- Body Stretch – find suitable location and stand with feet shoulder-width apart and as tall as you can. Push hips forward without losing balance and reach arms straight above head, linking fingers with palms facing upwards.

Foot and ankle
- Sitting Calf Stretch – keep left heel on floor, lift toes and the front of the foot as far off the floor as possible. Repeat on opposite side;
- Foot Pumping – pump each foot several times, as if working a car accelerator, to bring back circulation to feet and ankles.
- Heel Lifts – lean forward and rest elbows on knees. Keeping full weight on elbows, lift heels off the floor as far as you can, keeping balls of feet in contact with floor. Gently lower down and repeat several times;
- Ankle Circles – lift left foot off floor and pull upwards and at the same time roll foot inwards. Then push the foot downwards and roll it outwards. Repeat 20 times on each side.

For all seated stretches and exercises, sit tall in the seat with your ear, shoulder and hip roughly in line with each other, and feet slightly apart.

Arms should be resting comfortably with your hands in your lap.

Exercises should be performed on both sides of the body.

It is especially important to remember to exercise if using a laptop computer or doing other work while traveling.

Many people become so engrossed that they fail to take a break for hours at a time and end up with pain and stiffness in the neck or hands upon reaching their destination.

Ankle Sprains

POSTED: June 18, 2012

Ankle sprains are a common but painful injury that can happen in sports like running, soccer, basketball or volleyball, or simply by stepping unexpectedly onto an uneven surface.

The ankle joint is made up of three bones - the tibia, the fibula and the talus. The talus is held between the other two bones primarily by

These ligaments are like thick elastic bands and they give the ankle stability. The muscles that move the ankle come from below the knee and are attached to bones in the foot by their tendons, which pass over the ankle joint.

When an ankle is sprained, the ligament has either been over stretched, partially torn or completely torn. Ankle sprains are classified as Grade Type I (mild), Grade Type II (medium), and Grade Type III (severe).

Most ankle sprains cause injury to the ligaments on the outside of the ankle. Initial treatment for all sprains is rest, ice, compression and elevation as soon as possible and for 72 hours after injury.

The RICE method helps promote healing, decreases pain, and reduces swelling around the ankle joint.Mild sprains may only require an elastic bandage for compression, while the more severe sprains require a splint or a cast.

Similarly, the severity of the injury will determine whether crutches are required and for how long. Most ankle sprains heal in three to eight weeks, but when the injury is more severe it will take longer to regain ankle stability.

Physiotherapy treatment can start very early after an injury. Rehabilitation techniques will help reduce the time that your ankle is painful and ankle movement is restricted so that you can get back to work and activity more quickly.

Early treatment will reduce the swelling and pain, making it easier to walk. Even one treatment and appropriate advice can make a significant

Stretching is an important part of the healing process. It helps:
" Regain full movement,
" Increase circulation that aids the healing process;
" Maintain muscle strength; and
" Maintain soft tissue flexibility.

Stretches for the ankle concentrate primarily on the gastrocnemius and soleus muscles (calf) and the hamstrings (back of thigh), but include other muscle groups in the leg such as the quadriceps (front of thigh).

Stretching should always be done in the 'pain free range' to get the most benefit. As you gain range, you will be able to stretch further.

The severity of the sprain will determine when you begin moving the joint. It is important to allow adequate healing time to regain the stability the ligaments provide.

Avoid damaging the ankle further by doing too much too soon, whether it is exercise, standing or walking.

Exercise programs for the injured ankle should progress gradually from range of motion and muscle strengthening in the pain free range to more demanding activities like exercises done while standing.

The strengthening program should include exercises for the muscles that work with the damaged ligament(s) to give the joint additional support.

When the sprain has healed enough to tolerate it, exercises done on a wobble board or on a mini-trampoline will help retrain balance.

When recovering from an injury, it is important to take into consideration the effect of the entire day's activities on the injured joint. If you have been doing a lot of walking on a given day, it may be wiser to do non-weight bearing aerobic work for the leg such as swimming, pool running or stationary bike, as cardiovascular fitness is required no matter what sport caused the injury.

Plan your activities so you can build rest into your day. Make sure your rehabilitation program includes exercises that will help you regain your overall conditioning as well as those that are specific for the ankle.

There are a number of things you can do to protect the injured ankle while it is healing and to minimize the risk of re-injury.

" Wear high-top running shoes or a brace in your running shoes. These braces protect the ankle joint by blocking ankle movement in the direction of the sprain;

" A physiotherapist can tape your ankle if this is required;

" Gradually build your level of activity and sport to regain your pre-injury level of conditioning;

" Expect some discomfort as you progress in your rehabilitation but learn to recognize your body's limits. Your ankle should not be sore and swollen for an extended period of time after exercise;

" Avoid activities on slippery or uneven surfaces and in areas with poor lighting; and

" Always warm up before exercise and include a cool down after every session.

A physiotherapist will conduct a thorough assessment of your injured ankle and plan a rehabilitation program tailored to your level of activity that will help reduce swelling and pain, and promote healing and recovery.

The program will include exercises that are important to improve the strength of the calf and ankle muscles. It may also include modalities such as ultrasound or interferential and education on how to prevent sprains in the future.


POSTED: May 17, 2012

A game of golf is a healthy activity to help gain and maintain flexibility and range of motion. It is a physical activity that includes walking, lifting and repetitive arm movements, providing the benefits of cardiovascular and strengthening exercise programs.

However, returning to action after being on hiatus for several months puts enthusiasts at high risk of injury. The golf swing is a complex, explosive and physically stressful movement that requires the full rotational capacity of 127 joints and the dynamic activation and co-ordination of 400 pairs of muscles.

To avoid injury, Physiotherapists recommend:

" Walking 20-30 minutes a day, three to four times a week; during the golf season

" Begin practicing your grip on the club;

" Practice your back swing. Keep the club at waist level and slowly increase to a full swing;

" Start with one of the shorter clubs and work up to the longer, heavier irons.

" Stretch as a warm-up, as a break during repetitive movements and as a cool-down after your golf game. It helps you to move easily, keeps muscles flexible and relaxed, joints mobile, and relieves tension and strain.

" Gear - such as your golf shoes, clubs and golf bag - are meant to ease the work, not cause additional strain.

" Carry your golf bag over both shoulders and walk upright. If you have a one-strap system, alternate sides;

" Push rather than pull a wheeled golf cart;

" Hold clubs in a loose, comfortable grip to reduce strain in your hand and forearm;

" When standing for long periods, stand tall and occasionally shift your weight from one foot to the other, or rest one foot on your golf bag or cart.

Reduce strain by fitting the clubs to the golfer,
not the golfer to the clubs - Physiotherapists recommend that golfers choose their golf equipment to match their skill level and body type.

Plantar Fasciitis

POSTED: April 11, 2012

Plantar fasciitis is a painful inflammation of the plantar fascia – a thick, fibrous band of connective tissue in the sole of the foot that supports the arch of the foot. It runs from the ball of the foot to the heel, stretching to its limit when the foot is on
the ground and supporting your full body weight.

When placed under excessive stress, the plantar fascia stretches too far and tears, resulting in inflammation. The effects of the stress can build up gradually or be the result of a sudden occurrence.

The most common causes of plantar fasciitis include:
- Flat feet;
- High arches;
- Sudden increase in activity;
- Increased weight gain, either from obesity or
pregnancy; and
- Poorly fitting footwear.

The pain is commonly felt on the bottom of the foot, where the fascia attaches to the heel.
It is most severe in the mornings when getting out of bed because the fascia is in a shortened position at rest, and when you stand up, the sudden stretch and load of your body weight pulls on the attachment.

Symptoms of plantar fasciitis vary from mild to severe. They can linger for months at a time, with pain increasing and decreasing in an unpredictable pattern. Often, discomfort may nearly disappear for several weeks, only to re-emerge full-blown after a single workout or change in activity. The pain may even temporarily ‘fade’ as you walk.

Plantar fasciitis is a common injury runners experience and along with the causes listed above, it can be triggered by a sudden
increase in your training schedule, or by switching running surfaces – especially from a softer surface to a harder one.

While plantar fasciitis can be treated, it does not resolve quickly. It pays to review each of the factors and try to prevent its onset.

STRETCH – before, during (if needed) and after activity. Tight calf and/or hamstring muscles (back of thigh) limit range of motion and put extra strain on the plantar fascia. Stretching as a warm up and as a cool down will help you move easily, keep
muscles flexible and relaxed, joints mobile and relieve tension and strain.

A physiotherapist can assess your injury and provide appropriate stretching and strengthening exercises that will promote an earlier return to your activity, as well as advice on how to prevent recurrence of injury.

MOVE – For mild cases of plantar fasciitis it may be enough to stretch more frequently, build more rests into your routine, and ensure you have good footwear.

More severe cases may benefit from a heel cup or orthotics. In its most severe form, going barefoot is a poor idea – even in the house. Avoid worn-out shoes and try running on soft surfaces. You don’t have to stop exercising however consider switching to a non-weight bearing sport like swimming or cycling. When you do try running again, begin at a much lower level of intensity and a shorter distance, then you can build up gradually.

ADD IT UP – Add up all of your symptoms. If there is tenderness on the inside bottom of your heel, especially when you first wake up in the morning, you may have plantar fasciitis.


POSTED: March 19, 2012

For an injury free ride Physiotherapists recommend:

FRAME SIZE - Stand over your bicycle's top tube (between the saddle and the handlebar). The general rule-of-thumb for road biking is to have roughly one inch of clearance between your buttocks and the frame. For mountain biking on trails, you should have two to six inches depending on the terrain and the slope on which you are riding so that you are compact and can put your feet down quickly.

SADDLE POSITION AND HEIGHT –The saddle should be level for endurance and recreational riding. If you are sliding forward from a forward-tilting saddle, your arms and back will be taking too much weight. If the seat is tilted backwards, you may place undue strain on your low back and may experience discomfort or pain in the saddle area.

Saddle height should be set so your legs are not quite fully extended at the bottom of each pedal stroke. The straight leg should have a slight bend in the knee, roughly 30-degrees. If you have to shift your seat with each stroke, your saddle is too high and needs to be lowered. A bicycle seat too low will create stress on your knees; and too high will increase stress on your lower spine.

HANDLEBAR POSITION –The handlebar position can make a difference to the comfort of your back and upper body while riding. Handlebars that are too low or too far forward force you to stretch and bend down too far, placing undue stress on your back and neck. Higher handlebars will have you put more

weight through the saddle. Generally, taller riders should have lower handlebars in relation to the height of the saddle. Also ensure you have the correct distance between the seat and handlebars. If it is inadequate, your neck muscles may become strained.

SHOE/CLEAT ALIGNMENT – If you ride your bike with clipless pedals, the position of the cleats on your cycling shoes determines the comfort of your feet, ankles, knees, hips and back. Misaligned cleats can put stress through all joints from your foot to your low back with every pedal stroke. Your feet should point straight ahead when clipped into the pedals and you should have a little bit of ‘float’ or sideways movement between the pedal and the cleat to allow your joints to follow a natural pedal stroke. The rule-of-thumb is to continue adjusting the cleats until you feel no torsional, or twisting, stress in your leg as you pedal.

If you are injured from cycling consult your physiotherapist


POSTED: February 14, 2012

Running is an activity that many enjoy and can be extremely beneficial to one’s health. A 30 to 40 minute run, three or four times a week can help to maintain flexibility, increase mobility and build strength and endurance.

Proper posture and body mechanics will help lessen the strain on your body.

Physiotherapists recommend:

- Stretch before and after your run. Concentrate on stretching the calf, hamstring, quadriceps, iliotibial band, groin, buttocks, outside of the knee and back. With each exercise, hold the stretch for at least 15 seconds, until you feel tension but not pain, and do not bounce.

- Before starting your run, relax and take a deep breath. This allows the lungs to move into an efficient position and the hips to pull forward, for an easier run. After exhaling, try to maintain your chest in this alignment.

-Look straight ahead and run in a straight line. Swing your arms naturally.

-Good running posture will allow your feet to run almost automatically, with a quick, gentle push. The push off should always be forward and not upwards.

-A smooth stride will reduce effort and therefore increase efficiency. Increasing the frequency of your stride and keeping the feet lower to the ground will allow your muscles to stay relaxed.

- Increases in mileage and speed should be by 10%. An unrelenting increase in mileage from one week to the next will ultimately result in injury.

- Pace for interspersing of hard days and easy days and also hard and easy weeks.

- One or two days a week, at least, should be devoted to rest or non-running activities.

Because of the repetitive nature and impact running has on your body, runners tend to be more susceptible to injuries.

- Avoid running on hard surfaces. Dirt paths are better than asphalt and asphalt is better than concrete. Grassy areas may look inviting but they may hide holes, rocks, and other potential hazards;

- Rotate your activities (running, cycling, swimming, etc.) to reduce strain and keep it interesting;

- Don’t overdo it – proper rest is essential; listen to your body and watch for recurring or persist

Shoveling Snow

POSTED: January 26, 2012


Back injuries and pulled muscles are among the most common health threats from using poor technique when shoveling snow. While most people recognize that shovelling snow is very hard work, that can put severe stress on your heart, fewer people recognize the stress and strain that it places on the low back.

Take time to stretch and prepare your body for activity with a simple warm up of marching on the spot and a few shoulder circles to help tackle the snow.

Tips to help get a handle on safe shovelling:

  1. Choose a shovel that’s right for you – A shovel with an appropriate length handle is correct when you can slightly bend your knees, bend forward 10 degrees or less, and hold the shovel comfortably in your hands at the start of the shovel stroke. A plastic shovel blade is lighter than a metal one, putting less strain on your spine; and sometimes, a smaller blade is better than a larger one. This avoids the risk of trying to pick up a pile of snow that is too heavy for your body to carry. Ergonomic shovels with a bent shaft require less bending and your heart doesn’t need to work as hard;                              

  2. When you grip the shovel, make sure your hands are at least 12 inches apart. This will increase your leverage and reduce strain on your body. Always keep one hand close to the base of the shovel to balance weight of the lift and lessen the lower back strain;

  3. Lift the snow properly – Squat with your legs apart, knees bent and back straight. Lift with your legs. Do not bend at the waist. Scoop small amounts of snow into the shovel and walk to where you want to dump it. Holding a shovel of snow with your arms outstretched puts too much weight on your spine.

  4. Spray your shovel with a lubricant or silicon spray so the snow does not cling;

  5. Step in the direction in which you are throwing the snow – This will help prevent the low back from twisting and “next-day back fatigue” experienced by many shovellers;

  6. Tackle heavy snow in two stages – Begin by skimming off the snow from the top and then remove the bottom layer. Avoid overloading the shovel. You are working too hard if you cannot say a long sentence in one breath. If this is the case, take a short rest or decrease the intensity of effort slightly;

  7. Take frequent breaks when shoveling – Stand up straight and walk around periodically to extend the low back.  Do standing extension exercises by placing your hands on the back of your hips and bend backwards slightly for several seconds. Because you bend forward so much when shovelling, you need to reverse this by straightening up and bending backwards slightly;

  8. Wear proper footwear with good tread to help avoid slipping or falling;

Shovelling snow is a rigorous physical activity.  If you don’t exercise regularly or if you have a medical condition consult a Physiotherapist.

Brought to you by PABC Physio Tips

Seniors Fall Prevention

POSTED: January 4, 2012

Physiotherapists tips for reducing the risk of falling:

  • Plant both feet securely on the ground before getting out of the car;

  • Wear a good pair of lace-up walking shoes that will support your feet and provide necessary cushioning for your joints; this will make walking safer and more comfortable. Avoid high heels, slippers, and open-toed sandals, which can cause you to trip; 

  • Make sure the tips on canes and crutches are large and spiked for icy conditions;

  • Sit rather than stand while dressing;

  • Before you get up out of a chair or up from bed, wait 10 seconds before rising to your feet to prevent dizziness;

  • Install handrails and grab-bars in the bathrooms and stairways;

  • Concentrate on what you’re doing while you’re doing it, and move at a speed that feels comfortable;

  • Avoid taking unnecessary balance risks like standing on furniture. Instead, use a sturdy stepladder.

  • Avoid hyper extending the neck. Extending the neck backwards can cut off circulation to the brain, causing a black-out or even stroke.

  • Be mindful around pets. Feet can get caught in leashes, dogs can knock you down or you can trip over the sleeping or wandering pet;

  • Slow down. Be conscious of risky situations and hazardous areas;

  • Be physically active every day to improve posture, muscle strength and balance. Enroll in Tai Chi or an exercise program to improve flexibility;

The risk of falling in older adults can be reduced dramatically when specific exercises, activities and interventions are prescribed by a physiotherapist. A targeted physiotherapy treatment program can help maintain or regain strength, flexibility and endurance in a way that still feels safe and secure.

For example, a physiotherapist will assess a senior’s physical status and provide appropriate recommendations or treatment. As part of the assessment, the physiotherapist will review medical history and determine general physical condition, strength, flexibility, balance and gait (the way each person walks). After determining the primary limitation, a program of exercises and activities will be prescribed that focus on that area but with an overall goal of improving physical function and mobility.

Healthy New Year

POSTED: December 31, 2011

All of the staff at Therapeutic Edge Physiotherapy, Victoria BC wish you a happy and 'healthy' New Year.

All the best in 2012!

Safe Skiing And Snowboarding

POSTED: November 25, 2011

Winter enthusiasts look forward to this time of year when there’s an abundance of winter activities to enjoy, like skiing and snowboarding.

Before heading out to the slopes, you need to remember that winter activities often pose a higher risk of injury if time isn’t taken in advance for proper body conditioning.

Physiotherapists see an increase in “impact” injuries in winter. They recommend good conditioning program prior to hitting the slopes. Workouts to stretch and strengthen thighs, hamstrings, buttock muscles and abdominal muscles can also help.

The “ABC’s of Winter Conditioning”
A is for Alignment – People spend a lot of time in seated or contorted postures, which can affect postural alignment. This may limit the body’s ability to achieve and maintain peak capacity and may lead to pain or injury.

A Physiotherapist can tailor a program of stretching and strengthening exercises to promote optimal postural alignment.

B is for Balance – Balance is a fundamental component of any sport, especially skiing. If you have a sedentary lifestyle, you may need to “train” your balance reactions for sport related activity. Most gym’s have balance equipment available. Use them to improve balance and ultimately enjoyment on the slopes.

C is for Core Training –Skiers and boarders need a strong core or torso as an “anchor” for the legs. These are the muscle groups that work together to stabilize the trunk. Exercises that have a rotational component and work the core areas in three dimensions are best.

While many sports such as cycling, or weight training are one-dimensional, life and sports, like skiing, are 3-D so you must train for them.

D is for Deceleration Control – Skiing and boarding are all about controlling the gravitational pull on frozen water. A typical ski turn usually lasts 2-3 seconds. Skiers must be able to control their deceleration speed to slow the forces of gravity and finish their run safely.

Exercises that work the quadriceps in a slow controlled manner such as step ups, split squats and lunges are excellent ways to train
for this. They mimic the forces of skiing and allow you to improve strength in a hip-extended position - the functional position for all sports.

Using Your Laptop

POSTED: October 26, 2011

Physiotherapists offer advice to prevent injury from mobile technology. We now work anywhere, using wireless technology like laptops and Physiotherapists are seeing more and more clients suffering from pain that results from working directly at their laptops.

The long periods people spend working without taking breaks, sitting with their heads bent forward and shoulders hunched often triggers pain from the serious effects of the neck and shoulders to the wrists and hands.

Musculoskeletal disorders are one of the most common causes of severe long-term pain and physical disability, and are considered one of the biggest health problems facing mobile workers today. Statistics show that an increasing number of laptop users experience ongoing aches and pains. Many of these injuries can be prevented with improved work habits and posture.

Physiotherapists are concerned with the increase of repetitive strain injuries (RSI) and other soft tissue injuries as people spend more and more time slouching over their laptop. Many individuals discount the discomfort that they feel until they are experiencing full blown symptoms of RSI by then the problem is much more difficult to resolve.
Many of these injuries can be prevented with improved work habits and posture.

Physiotherapists have the knowledge and skills to advise on modifications to the work environment as well as giving guidance on improving work habits and postures. Specific strengthening and stretching exercises, combined with aerobic conditioning, may be part of the prescription to prevent recurrence of RSI.
Prevention and early intervention are the preferred approaches to managing RSI. Simple changes such as adding an external keyboard or mouse, and raising the monitor screen, will allow you to adopt a healthier working posture.

Laptops defy the ergonomic principle of allowing for optimal posture for musculoskeletal health, and laptop users who spend hours on end typing text will have likely suffered the consequential sore shoulders and tight neck.

For example, if you’re working with elbows at the recommended 90-degree angle, the laptop’s screen position will require that you bend your neck forward to view it, which puts excessive loading through the joint of your neck. But if you raise the laptop to eye level, then you are typing an awkward angle that can put strain through wrists and elbow joints. While extended computer usage of any kind can be hard on your body, prolonged laptop use can be especially hard on the user.

Physiotherapists recommend using key commands and shortcuts whenever possible, buying laptops equipped with adjustable height screens, and using an external keyboard when typing for extended periods.

- Make frequent postural changes and take breaks;
- Remove unnecessary supplies from carrying case such as drivers, batteries, and cables;
- Select a carrying case with wheels or backpack style.
- If these options do not work for you try periodically alternate carrying on the left and right shoulders or hands;
- Use a docking station, external keyboard, and pointing device whenever possible;
- Be creative – try using items around you to optimize your setup. For example, use your portable computer on top of the carrying case to raise the monitor to eye level or use a three-ring notebook to incline/decline to a better angle. This is especially effective when using an external keyboard;
- Alternate from your lap to a desk every 30 minutes.

Raking Leaves

POSTED: September 30, 2011

While raking can be a good way to enjoy moderate exercise, too much twisting, reaching, bending, lifting and carrying bags of leaves can place excessive loading on the spine, resulting in back strain or more serious injuries.

Before starting, Physiotherapists recommend:
Warm-up exercises for the larger muscle groups such as the shoulders, back and the legs before (and after) all yard work.
Well-fitting shoes with good soles will prevent slipping and give your back better support.

Hold the rake handle close to your body to help maintain good posture while raking. Keep one hand near the top for better leverage and use your arms and legs more than your spine. Ergonomic rakes, sold in garden centres across the country, have bent or side handles or handles that are padded for less strain on the hands and wrists. This design ensures that the elbows are bent slightly and also encourages good posture;
Change sides frequently and avoid twisting from the waist. When raking, the tendency is to plant the feet in a fixed position and rake in several directions from that position. Instead, place one foot ahead of the other which allows you to shift forward and backward easily as you rake;
Take frequent breaks and/or change to a different activity.

When bagging leaves, lift manageable loads. Keep your back straight and use your legs to do the lifting. If you have to stoop, face the pile of leaves and don’t twist as you lift;
Don’t try to overreach to get those last few leaves;
When lifting the bag of leaves, tense your stomach muscles to give your back additional support and keep the bag close to the body.

Keep your back straight while lifting with the legs;
Don’t pile too many leaves into one bag, especially if they are wet. It will be heavy and awkward to lift;
When finished for the day, take a few moments to cool down by doing the same exercises performed prior to raking.

Back To School : Choosing The Right Backpack

POSTED: September 12, 2011

Choosing a Backpack for Back to School

It’s time to head back to school and everyone is busy buying pencils, geometry sets and what seems like the 15th pocket sized dictionary in the last 10 years. (Where do they all go anyway? ) We here at Therapeutic Edge Physiotherapy in Victoria would like to share another Edge Tip with you regarding that ever so essential back to school item: The Backpack.

Backpacks are the workhorse of the student population. They get dragged around, sat on, used as goal posts and carried back and forth every day. Over the course of the year, the bottom can become a never emptied, rummage around till you find it layer that may serve only to add weight, not functionality.

Here are a few simple guidelines to think about when choosing a backpack.

-not oversized to carry more!
-pack should sit evenly in the middle of the back (no sag towards the "rear")

-find a lightweight backpack that won't contribute to the overall weight significantly when loaded.
-a loaded backpack should not weight more than 10-15% of your child's body weight

Padded Back and Straps
-to help reduce pressure on the chest/shoulders and prevents items from digging to your child's back

Backpack Tips:
Loading your Backpack: Teach your child to load heavier items (text books) closer to the back keeping the load closer to their centre of gravity. This prevents strain on the back and improves efficiency of core tummy muscles.

Posture: STAND TALL! with your head and neck in line with your shoulders, keep tummy muscles engaged and use both shoulder straps to help evenly distribute the weight of the pack.

Things to Watch Out For:
- Red marks on the shoulders
- Tingling in arms and hands
- Pain in low back

**Encourage your child to tell you if they have aches and pains. Physiotherapists can help your child before it becomes a more serious injury and to teach then how to engage tummy and back muscles for proper posture.

Victoria Physiotherapy Tips – Getting The Most Out Of Gardening – Part 2

POSTED: August 9, 2011

August in Victoria is a bountiful pleasure in our garden city. There is nothing like fresh produce from the garden. Not only does a garden provide fresh fruits and vegetables but thirty minutes of yard work, planting or raking gives great general health benefits such as preserving flexibility, increasing mobility and building strength and endurance. However, many people overdo it in the garden. This week we continue to share the advice of the Physiotherapy Association of BC with more physiotherapy tips for the garden.

5. Raking or hoeing – keep your tools close to your body and your back straight to reduce strain. Use your arms and avoid twisting your trunk. Use long-handled tools suited to your height.

6. Weeding or planting – do not bend from the waist. Squat or kneel on a kneeling pad or use tools with long handle.

7. Digging or shovelling – insert the head of the shovel vertically into the ground and step on the blade. Lift small amounts at a time and bend at the knees, using your legs not your back to lift the load. Avoid twisting. Use a wheelbarrow to move big or heavy loads.

8. Lifting or carrying – know your limits and lift properly: bend your knees, not your back. Keep the load close to your body. Don’t lift items that are too heavy for you to handle – get help! Use a wagon or wheelbarrow to transport supplies and / or to move or carry heavy items.

9. Pruning or trimming – get as close to your work as possible. Don’t stretch beyond your reach or past your stable footing. Rehearse the movement as a stretch first to test your ability and positioning.

10. Remember to take a moment to site back and enjoy your hard work.

Victoria Physiotherapy Tips – Getting The Most Out Of Gardening

POSTED: July 18, 2011

Summer is upon us and so are those weeds. In this post we will share some tips from the Physiotherapy Association of BC on best practices while in the garden. These tips are recommended to provide you with all of the joy and health benefits of gardening without the aches and strains associated from over doing it.

To be injury free season, Physiotherapists recommend:

1. Begin with a warm up – Start with easy raking, or go for a five-minute walk to warm up your muscles. Follow this with stretching all major muscle groups to help prevent injury. Give your back, neck, hands and fingers some extra time when stretching.

2. Be aware of your posture and body mechanics – Move your feet instead of twisting at your waist when sweeping, raking, mulching or potting. If you can’t avoid twisting, tighten your stomach muscles in order to protect your back.

Use your legs rather than your back when lifting or unloading heavy bags or pots. Bend your knees, keep your back straight, and hold the object close to your body to prevent unnecessary strain on your back.

3. Use ergonomically correct tools – Buy tools with long handles to help with weeding. Build or buy a potting bench that is high enough to prevent unnecessary bending. Sit on the ground to trowel without bending over. When kneeling use a knee pad to avoid putting too much pressure on your knees.

4. Pace Yourself – Don’t try to do everything all at once. Take breaks throughout your work and do some gentle stretching to keep limber. Vary tasks to make sure different muscles get used and one particular muscle group is not overworked. Repeated actions that use a specific muscle or muscle group can cause pain or injury.

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