Category: Physiotherapy

Written by Jordan Knapman, Physiotherapist 

 

Vestibular therapy, or vertigo treatment by a physiotherapist, is one of those topics that you likely don’t come across unless you or someone you know has been impacted by vertigo or severe dizziness. One of the most common misconceptions about vertigo is that it is something you ‘just need to live with’.

This is not the case at all! As a physiotherapist in Peak Health who is trained in vestibular rehabilitation, I can set that myth straight and say there is lots we can do to help you or your family member. Whether you are facing chronic dizziness, experience intermittent vertigo symptoms, or are unsure if what you have is even classified as dizziness, we are here to help. If you’ve been experiencing dizziness, or know of someone who has, you’ve come to the right place!

What is Vestibular Physiotherapy?

Vestibular Physiotherapy is a type of rehabilitation geared specifically for dizziness and balance. We have three senses that contribute to our balance and equilibrium, one of which is the vestibular system. This is a small organ in the inner ear that detects how fast we move our head position and in what direction. 

Often, when we have a problem with this organ we can have a sensation of spinning, which is referred to as vertigo. Since information coming from the vestibular system is combined with information coming from our vision and foot sensation, a Vestibular Physiotherapist will often look at all 3 systems to determine the best course of action.

Can a Physiotherapist Use Tests to Diagnose My Dizziness?

No matter the cause of dizziness or vertigo, the tests that are needed will often bring on symptoms. Most commonly, the Dix-Hallpike Test is used to test for a common type of dizziness. In this test, the Physiotherapist will lie down a person on the treatment table quickly, while looking for a specific type of eye movement while you wear special goggles with infrared cameras. 

Other tests may include balance with eyes closed on a foam pad, fast head movements, or even holding your breath! Unfortunately, these tests will often bring on similar symptoms to what you’ve been experiencing, as the Physiotherapist will need to determine what is responsible for your issue. This feeling is most often very short-lived and should dissipate quickly.

However, the most important test is your story as some problems cannot be tested for. A skilled Physiotherapist with training in Vestibular Rehab will spend time in careful discussion with you about what your symptoms feel like, how long they last, when they happen, and how they affect you. All of this allows the Physiotherapist to determine the most likely cause of your symptoms and determine the next steps to confirm their thoughts.

Does Vestibular Therapy Get Worse Before It Gets Better?

This is sometimes possible! Certainly, during treatment for one cause of vertigo, called BPPV, it is very common to feel worse both during and immediately after treatment. This subsides quite quickly, and most feel much better soon after. For other, more complicated causes of vertigo, it is possible to feel slightly worse during the first week of home exercises. 

Thankfully, not everyone experiences this and we know that it does not mean things are moving in the wrong direction! Your Physiotherapist would help in making this determination and adapt your treatment plan if necessary.

How Long Does It Take For Vestibular Therapy To Work?

As with any type of rehabilitation, this largely depends on the underlying cause of your symptoms. For the aforementioned BPPV, the most common cause of vertigo symptoms, may resolve in as few as 1-3 treatments. 

For most other vestibular causes rehabilitation may take an average of 6-12 weeks, depending on how long symptoms have been ongoing. Regardless of how long the dizziness has been occurring, Vestibular Physiotherapy can often make a difference (even if it takes a bit longer!).

So… Does Vestibular Therapy Actually Work?

Vestibular Rehabilitation can be very successful! For many vestibular conditions, Clinical Practice Guidelines mention that this therapy “provides a clear and substantial benefit” and has a “strong recommendation” when used appropriately. 

That said, while an improvement in symptoms is expected in the majority of cases, not everyone will achieve a complete resolution of symptoms for every cause of dizziness. Your physiotherapist will help to determine a management strategy in the case of a long-term condition to deem if vestibular therapy is right for you.

Final Words

At Peak, we believe that through a thorough, in-depth assessment we can get you feeling confident with a plan to help you feel your best. Living with dizziness or balance issues should not be your normal, so let us help you feel your best again! Click here to book in for a vestibular assessment today.

 

References

Bhattacharyya N, Gubbels SP, Schwartz SR et al. Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update). Otolaryngol Head Neck Surg. 2017;156:S1-S47.

Hall CD, Herdman SJ, Whitney SL et al. Vestibular Rehabilitation for Peripheral Vestibular Hypofunction: An Updated Clinical Practice Guideline From the Academy of Neurologic Physical Therapy of the American Physical Therapy Association. J Neurol Phys Ther. 2022;46:118-177.

Written by Dr. Claire Wells, Chiropractor

 

Maybe you’re an experienced runner who’s been dealing with the same recurring “niggle” during long runs for years. Or maybe you’re thinking about doing your first 10k but you’re not sure if your body is ready to take on the training. Or maybe you feel great when running, but you want to see if there is anything you could improve on! A gait analysis, or a running assessment, is often a great place to start when you are stuck on an injury that keeps resurfacing, you’ve hit a plateau with your running, or you are new to the sport and you want to get off on the right foot. 

Gait Analysis 101

A running assessment is not simply watching you run! It involves a thorough assessment of your entire body, in addition to a gait analysis performed via video analysis. This is because as practitioners, we know that running is a full-body sport and we can’t ignore deficits or findings in other areas of the body when we are looking at a runner. The basic breakdown of a gait analysis involves 2 primary sections:

1. Screen for Deficits in Range of Motion, Strength, and Stability.

Based on the mechanics and demands of the sport, there are certain requirements of the body. If we don’t meet these requirements, we are more likely to create adaptations that could lead to injury, or make you less efficient when running. You need to have a solid foundation before you add speed and movement into the mix! From the amount of movement in your big toe to the amount of rib expansion you have, we are looking at it all. There is a misconception that you need to be on a track to pick out running abnormalities when really having a patient stand on one leg can tell us a lot about what we may see when we add the running movement into the picture. 

2. Screen for Deficits in the Essential Qualities for Running.

When you add speed and movement to the basics, this is when we are able to see how you are able to piece it together on the pavement. Gait analysis with slow-motion video allows us to identify what you’re doing well, and what could be better in your running technique. 

We can identify potential injury risk factors, or reasons why you might be experiencing pain as well as break down biomechanical factors and compensations that are snowballing into less than favorable results. Having a proper gait analysis performed by a trained physiotherapist or chiropractor will give you the confidence to know the practitioner is assessing you head to toe, finding anything that may be contributing to your presentation.

Gait Analysis, Running, and Tapping Into Your FULL Potential

Your chiro or physio can also triage your needs based on your goals and obstacles. We are excellent at diagnoses, manual therapy and exercise prescription, but you may have more specific needs that would be more effectively addressed by different professionals or additional resources. We can help point you in the right direction depending on what we find during your gait analysis. For example, you may need or want:

• A strength and conditioning specialist
• Run Coaching
• A dietician or nutritionist
• Sport psychology
• Lab testing with an exercise physiologist in Calgary
• Massage therapy
• A visit to your medical doctor for blood work
• Diagnostic imaging
• Resources such as book recommendations 

Who Should Get a Gait Analysis?

Running assessments are for anyone who runs!  Whether you are brand new to running, are wanting to get into new distances for racing, or have been running at a high level for most of your life, you will get something out of it. Here are some examples of when a running assessment might be especially valuable:

• You Are New to Running or Want To Get Into It.

This is sometimes the best time for a gait analysis, as we can stop bad habits before they arise, and get you on a tailored strengthening program to best support running injury prevention. 

• You Have a History of Running Injuries or Any Overuse Injury.

The biggest risk factor for an injury is a prior injury. If our brain asks our body to do a task, it’s going to find a way to do it. When we have an injury or pain, our body will adapt so it can still achieve the movement goal while reducing the threat to the compromised area. Often we maintain these adaptations long-term, and this can set us up for new issues. Getting assessed can help to see if you’ve created compensations for your movement deficiencies. 

• You Have a Current Injury That Is Causing You Pain or Preventing You From Running As Often, Far, or Intense As You Want To.

Let’s figure out why! The location of your pain is often NOT the location of the problem. This is especially true when pain has a gradual onset or if you seem to get the same pain that comes and goes repeatedly over a long period of time.

• You Are Looking To Improve Performance.

Because the things we check in a running assessment are factors that contribute to running economy and tissue health, identifying deficiencies (and of course, then working to improve them!) can positively impact your performance in training and racing.    

What Does a Running Assessment Look Like?

This will vary based on the clinic you go to and the practitioner that you see, not to mention the individual being assessed. But the essential components of a running assessment include the following:

1. Mobility and Strength Assessment

• Ranges of motion of the spine, shoulders, and lower extremities 
• Strength of the core and lower extremities
• Stability testing of the core and single leg   
• Breathings mechanics 
• Movement pattern competency 

2. Gait Analysis on the Treadmill

• Slow motion and real-time video analysis of your run from multiple angles 
• Real-time practitioner-led cueing for trial-and-error type corrections and recommendations based on findings  

3. A Summary of Findings

• At the end of your assessment, you will receive a plan of care outlining all of the findings, patterns, and relevant information as we often go over A LOT in these sessions! 
• This summary of findings will also include outcome measures to monitor and progress throughout your treatment plan and running journey 

4. An Action Plan for the next steps. This might include:

• Recommendations for manual therapy, if you are experiencing pain or lacking range of motion.
• An exercise prescription to resolve any deficits identified in the assessment. 
• An individualized warm-up and/or cool-down protocol. 
• A timeline for when to follow up for treatment and/or new exercises.
• A referral to an additional service provider, if needed. 

Final thoughts

These appointments are also great to just connect with a practitioner who understands your sport and can relate to what you’re doing. It’s helpful to have a professional in your corner who not only shares your enthusiasm for running but also has your back when it comes to supporting your goals. 

Our Running Assessment practitioners at Peak have combined experience in track, road running, and trail running, and we can’t wait to help you! Whether you are a novice runner, a long-distance runner, a track athlete, or someone who is curious if you could ever become a ‘runner’, we have someone who is ready to help you. To book your running assessment today, click HERE.

Written by Gina Rolf, Physiotherapist

 

As a peak health physiotherapist who works with kids, I am frequently asked about two common conditions in babies: torticollis and plagiocephaly. While they may sound like tongue twisters, these conditions can have significant impacts on a child’s development. In this blog post, we will explore these conditions, including their causes, effects, and treatments.

What Is The Difference Between Torticollis and Plagiocephaly?

First, let’s define what these terms mean. Torticollis is a condition in which an infant’s neck is tilted to one side, resulting in difficulty turning the head in the opposite direction. Plagiocephaly, on the other hand, is a condition in which an infant’s head becomes flattened on one side, due to various factors such as a preference for sleeping or turning to that side.

Is Torticollis Associated With Plagiocephaly?

So, are these two conditions related? The answer is yes. In fact, torticollis is a common cause of plagiocephaly. When an infant’s neck is constantly tilted to one side, the weight of their head can cause flattening on that side, leading to plagiocephaly.

Does Physical Therapy Help Torticollis and Plagiocephaly?

The answer to this one is also yes! Physical therapy is often recommended as the first line of treatment for both torticollis and plagiocephaly. 

In the case of torticollis, physical therapy can help to stretch and strengthen the muscles in the neck, allowing for a better range of motion and improved head control. During an appointment, your physiotherapist will review the specific stretches prescribed for your child, as well as ensure all developmental milestones are being met and not being adversely influenced by the torticollis.  

For plagiocephaly, physical therapy can help to improve the baby’s overall alignment, reduce the asymmetry in the head shape, and promote the use of both sides of the body. In some cases, treating in conjunction with a remolding orthosis (more commonly known as a helmet) may be recommended to help direct the growth of your baby’s head. If this is the case, your pediatric physiotherapist will help facilitate this process with other clinics in the city. 

At What Age Is Plagiocephaly Permanent?

It’s important to note that physical therapy is not a one-size-fits-all solution. Each baby’s treatment plan will be tailored to their specific needs, based on the severity of their condition and their age. The good news is that plagiocephaly is not usually permanent, especially if it is caught early and treated appropriately. In fact, most cases of plagiocephaly will resolve with a combination of physical therapy and repositioning techniques before the baby turns one year old.

What Happens If Torticollis is Left Untreated?

Unfortunately, untreated torticollis can lead to a host of other problems, including delayed motor development, difficulty with visual tracking, and even facial asymmetry. That’s why it’s so important to seek treatment as soon as possible if you suspect your child has torticollis.

What Happens If You Don’t Correct Plagiocephaly?

While plagiocephaly is not usually permanent, leaving it untreated can lead to long-term problems, such as facial asymmetry, jaw misalignment, and even developmental delays. Again, seeking treatment as soon as possible is key to ensuring the best possible outcomes for your child.

Key Takeaways

In conclusion, while torticollis and plagiocephaly can be concerning for parents, it is rarely permanent. With the right treatment, such as the stretches and exercises learned during physical therapy, most infants and young children can overcome these conditions and go on to develop normally with an improved quality of life.

So, if you suspect your child has torticollis or plagiocephaly, don’t hesitate to reach out to me or anyone from our team at Peak Health Kids. Together, we can help your child achieve their full potential! Click HERE to learn more. 

Written by Chiropractor Dr. Nathan Boone

 

Maybe you remember what happened: a twist, a step, a fall. Maybe you don’t! Either way, the discomfort in your knee has morphed from a nuisance into an unrelenting and gnawing pain, present during even the simplest day-to-day tasks.

Knee pain, unfortunately, appears to be a universal consequence of having knees (of which most of us have two!). In fact, a recent review reported that nearly 25% of adults are likely to report an episode of non-traumatic knee pain in a given year. 

Infuriatingly, many episodes of knee pain appear to have no specific source, and patients report symptoms of generalized or “moving” pain in the front of their knee that may be aggravated during activities such as squatting, sitting, running, or climbing stairs. 

Persistent pain that interferes with activities you love can be a physically and mentally draining experience, leaving you with questions like: What is causing it? How long will it be here? And most importantly: What can I do about it?

PFPS: Patellofemoral Pain Syndrome 

In the absence of a clear mechanical or structural issue, health care professionals often provide an intentionally vague diagnosis of Patellofemoral Pain Syndrome (PFPS), sometimes referred to as Runners Knee. PFPS describes this nonspecific experience of pain in the area in front of the knee that can range from annoying to debilitating and may prevent or impair participation in activities from running to working out, to just sitting and watching a movie. 

For those experiencing PFPS, there is good news and bad news. The good news is that it can be dealt with. Remember that many people develop knee pain, but most don’t currently have it – this is a testament to its ability to improve! The bad news is that for many people, PFPS is a persistent and recurrent issue that may take time to deal with. 

Due to the vague nature of PFPS, we lack a clear picture of all the factors that may be involved; however recent research has dramatically improved our understanding of the condition, what causes it, and how we can manage it!

What Causes Knee Pain?

The most common question patients ask is: why does my knee hurt? Unfortunately, the answer to this question is a bit foggy – but researchers have some good ideas. The leading theory suggests that the pain stems from irritation of the cartilage on the underside of the patella (kneecap). 

Abnormal, excessive, or repetitive stresses may lead to softening or deterioration of the top layer of this cartilage exposing the more sensitive surfaces beneath. Although our bodies typically thrive under stress, these persistent forces on the patella don’t allow for the necessary recovery time needed to get stronger, leading to a degeneration process that ultimately results in pain. 

Am I At Risk for PFPS or Knee Pain?

“My sister runs every day and doesn’t get knee pain, why does MY knee hurt?” Although these answers are highly individualistic, and you should consult your health care professional regarding your specific situation, there does appear to be some consistent observations amongst PFPS sufferers. 

Consistently, those who have, or develop, PFPS demonstrate abnormal biomechanics during lower limb activities as well as deficits in lower limb strength. In other words: they move differently. As the knee joint is a simple hinge connecting the ankle to the hip, it is at the mercy of what goes on above and below it. Poor control and strength of the hip and knee, especially during single-leg activities (like climbing stairs), place the knee in a disadvantaged position which may result in those increased patella forces mentioned earlier! 

How To Manage Your Knee Pain

So, what does this mean and what can be done? Any time you experience continued pain or discomfort, visiting your local chiropractor or physiotherapist is always a good idea to get an accurate diagnosis of your knee pain to ensure you are implementing the correct management strategies. Other potential causes of knee pain must first be ruled out before we can call it PFPS! Your professional should work with you to identify the activities that aggravate or relieve your pain, as well as determine any potentially predisposing strength or movement impairments. 

Although our understanding of the development of PFPS is sometimes cloudy, the evidence supporting exercise as a treatment tool is crystal clear.

Strengthening programs targeting the muscles of both the thigh (quadriceps) AND the hip (glutes) appear to have the largest benefit for PFPS patients in the short and long term. 

Because weakness and poor movement control are culprits in the development and progression of PFPS, the strategic application of strengthening activities should come as no surprise. Ensuring you have an exercise plan that is right for you is the first step. 

Although exercise is the most effective single method of managing PFPS, manual therapy techniques including soft tissue massage, joint mobilizations, taping, and even orthotics may be included in treatment plans to help relieve pain and improve function in the short term. 

How Long Does it Take to Make Knee Pain Go Away?

Timelines for managing PFPS can range from weeks to months. Many factors may play a role in the duration of PFPS, including duration of symptoms, strength levels, types of activities, genetics, and prior injuries to name a few. Developing frustration with slow progress and persistent symptoms is common, so demonstrating patience is key when beginning the journey of managing your knee pain. 

As our understanding of PFPS improves, so will our management techniques. For now, one thing is clear: early intervention of relative rest, exercise, and targeted manual treatments are the best tools we have; but a healthy dose of optimism goes a long way as well. 

Final Thoughts

If you are experiencing knee pain and are in search of what direction you should go, book your discovery call today to find out what next steps may be appropriate for you. Our team is always just a phone call away to get you on the right path! 

Peak Health & Performance can help you recover from a wide range of common conditions including:

• Impaired range of motion
• Chronic injuries
• Motor vehicle accident injuries
• Neck pain
• Knee injuries
• Joint pain
• Shoulder pain
• Rotator cuff issues

Written by Melissa Penman, Physiotherapist

 

If you are a parent, teacher, early childhood educator, or anyone who works closely with children, you may be familiar with the term motor milestones. My goal today is to break down these milestones to help you familiarize yourself with what to keep an eye on, and when it may be time to integrate pediatric physiotherapy into your child’s life!

What Are the Fundamental Motor Skills?

The fundamental motor skills are locomotor skills, postural skills, and object interaction skills. Locomotion skills involve movement and include walking, running, jumping, and skipping. Postural skills involve both stationary balance such as sitting and standing posture and moving balance such as climbing stairs or stepping over obstacles. 

Object interaction skills involve movements with an object such as throwing, catching, and kicking a ball, carrying something while walking, and doing the monkey bars.

What Are the Six Motor Milestones of a Child?

1. Crawling
2. Walking and Running
3. Walking Up and Down Stairs
4. Jumping
5. Skipping and Galloping
6. Throwing and Catching

What Are the Physical Motor Development Milestones?

Here are some physical motor development milestones to watch for as your child grows. You will notice there is always a wide range as it is very normal for children to have some variance in these skill development timelines!

0-3 months

• Bringing both hands to the mouth
• Rotating head left to right
• Lifting head when on tummy

3-6 months

• Bringing feet to the mouth
• Pushing through palms with straight arms when on tummy
• Rolling

6-9 months

• Sitting independently
• Rolling tummy to back and back to tummy
• Pushes up on hands and knees from tummy

9-12 months

• Pulling to stand on objects
• Crawling on hands and knees
• Standing independently for a few seconds

12-18 months

• Walking independently

2 years

• Kicking a ball
• Rolling or tossing a ball
• Goes upstairs with help

5 years

• Mature running pattern
• Balance on one leg for 10 seconds
• Goes up and down stairs while alternating feet

How Do You Teach Pediatric Milestones?

Paediatric physiotherapists can help teach pediatric milestones through play including obstacle courses, positioning strategies and targeted skill practice with a focus on making things fun while building strength and endurance. It’s not just about learning the movement, it’s about symmetry and the quality of the movement as well! 

A pediatric physiotherapist can help to make sure that your child can hop evenly on both feet, crawl on both hands and knees, and can walk up and down the stairs alternating their legs, and many other skills that are important for participation in everyday life activities.

What Are the Three Principles of Motor Learning?

The 3 principles of motor learning are acquisition, retention, and transfer. To best explain these, we’ll use the example of learning how to jump.

• Acquisition is learning a new skill. For jumping, this could look like breaking the movement down into its different pieces like bending and straightening the knees, swinging the arms for momentum, clearing the ground, and landing safely. It could mean physically assisting the movement or using tools and structures like a trampoline to help learn the movement.
• Retention is the ability to remember the skill. The key to retention is repetition. Once a child has acquired the skill, repetition of the movement helps build those motor patterns. To use our example, retention would mean that your child is jumping by bending and straightening their knees, using appropriate arm swinging for momentum, and clearing the ground consistently.
• Transfer is the ability to apply the skill to activities at school, home, and in the community like skipping rope, jumping into a swimming pool, or jumping over a puddle.

Final Thoughts

When it comes to motor milestones in children, keep in mind that it is normal to see variability from child to child! If you are wondering if your child is on the right track, if you have questions about motor milestones in children, or want some help facilitating the development of these skills, book in today for a discovery call with myself HERE.

REFERENCES:

Newell, K. M. (2020). What are Fundamental Motor Skills and What is Fundamental About Them?, Journal of Motor Learning and Development, 8(2), 280-314. Retrieved Mar 20, 2023, from https://doi.org/10.1123/jmld.2020-0013

Kinactive Kids https://www.physio-pedia.com/Motor_Learning_-_Back_to_the_Basics

Written by Dr. Claire Wells, Chiropractor

 

Are you having pain during or after running? Whether you’ve been racing for years or just bought your first pair of running shoes, none of us are immune to pain and injury. Here are answers to some common questions you may be experiencing.

What Is the Most Common Running Injury?

Knee pain is the most common complaint, with hip pain coming in second. Common injuries include patellofemoral pain syndrome, iliotibial band syndrome, Achilles tendinopathy, medial tibial stress syndrome, tibialis posterior tendinopathy, plantar fasciopathy, and calf and hamstring muscle strains. Certain types of tissue are more prone to injury depending on variables like distance and speed, the total volume of training, and experience level in the sport.

What Causes Running Injuries?

It is usually impossible to pinpoint one specific factor that is to blame when you get injured. Here are some things to keep in mind based on the research in this area:

• The NUMBER ONE risk factor for future injuries is a previous injury. This is why it is important to fully rehabilitate all injuries, no matter how severe. Being pain-free does not mean that the tissue is fully healed or that strength and function are restored.
• Training errors can also play a huge role. 80% of running injuries are overuse injuries. Training volume (frequency, duration, and distance) and training intensity (how hard you’re working) are often poorly managed.
• Shoe type does not predictably contribute to injury risk.
• Gait biomechanics can play a role. Every run requires thousands to tens of thousands of steps, so the way you move with each step matters. Believe it or not, running is a skill!
• Many non-sport factors play a role in how ready your body is to handle the stress of training, and in how sensitive your body is to pain. These include sleep, nutrition, hydration, mental health, emotional state, overall physical health, and life stressors.

How Do You Tell If A Running Injury Is Serious?

Here are some indications that you should get assessed:

• Pain exceeds 3/10 (with 10/10 representing the worst pain you can imagine)
• You notice swelling, redness, or another visible change in the pain location.
• There was a sudden onset of pain with a clear mechanism of injury (ex: you rolled your ankle, or you felt/heard a “pop” when your knee twisted, etc.)
• It used to hurt only at the start of runs, but now it hurts the whole time, worsens during your run, or starts to linger after you stop.
• It does not improve with a few days off training.
• You have tried stretching, foam rolling, medication, ice/heat, etc. and it’s persisting or worsening.
• You have tingling, pins and needles, numbness, sharp shooting pain, and/or electric-like pain.

How Long Does a Running Injury Take to Heal?

It depends on things like the extent and duration of the injury, the type of tissue that is injured, and whether you are appropriately modifying what you’re doing. Here are some general timelines for tissue healing in an otherwise healthy body:

• Muscle: 2 weeks to 12 months (depending on severity)
• Tendon: 2 weeks to 12+ months (depending on severity)
• Bone: 6-12 weeks
• Ligament: 2 weeks to 12 months (depending on severity)
• Cartilage: 9+ months

It is important to keep in mind that these are timelines for tissue healing, not for return to sport at full capacity. Returning to running needs to be gradual and progressive but may take place before the tissue is completely healed.

What Is the Fastest Way To Heal a Running Injury?

Most injuries can be managed by modifying the variables of your training program and doing specific rehabilitative exercises. However, the specifics drastically vary based on the injury and the individual. For example, some injuries require total rest from weight-bearing on the injured leg, while some require heavy loading of the painful tissue, so it’s important to get assessed by a professional. 

Often, we can help manage symptoms with manual therapy (such as soft tissue treatment and joint mobilizations) and therapeutic modalities (such as acupuncture or dry needling, and shockwave therapy) to help get you back running as soon as possible.

Is Walking Good For Running Injuries?

Walking may be appropriate depending on the injury and whether walking recreates the pain that you have when you run. The problem with walking is that it doesn’t replicate the exercise intensity of running, so cross-training may be better if you want to maintain fitness. This could include cycling, cross-country skiing, or using an elliptical – whatever you have access to that doesn’t aggravate your pain. 

Again, it depends a lot on the injury you have, so it’s best to consult with your Chiropractor or physiotherapist. Once you are cleared to return to running, using walking in a run-walk progression is a helpful strategy that is supported by research.

When Can I Start Running Again After an Injury?

There are different approaches to this, but a good general rule would be that you need to be pain-free with walking and cross-training for 2+ weeks first and be able to perform basic single-leg strength and plyometric exercises with proper form and no pain. Some examples include:

• 30 seconds of single-leg squats at a rate that mimics your running cadence
• 20+ reps of single-leg calf raises
• 1 minute of double-leg hops; equal distance on both sides for a single-leg triple-hop test

The best thing to do would be to get assessed by a chiropractor or physiotherapist who can test for symmetrical and sufficient ranges of motion, balance, and strength. And be sure to follow a structured, gradual, and symptom-monitored return to running program when you do get back to it!

How Do Physiotherapists and Chiropractors Help Treat Running Injuries?

Both can help by assessing your injury, testing for movement dysfunction and strength imbalances, identifying training factors that may have contributed to your injury, and guiding you through the recovery process. They can make a plan to get you better based on your injury – including education, training modifications, specific exercises, and hands-on treatment.

At Peak Health And Performance, we offer a wide range of treatment options including Physiotherapy, Massage Therapy, Chiropractic Care and Concussion Care to address a variety of conditions and help improve your quality of life. Book your appointment today!

Some of the common conditions we can help with include:

• Sports injuries
• Musculoskeletal injuries
• Neck pain
• Shoulder pain

Written by Kate Thompson, Physiotherapist 

 

Many diagnoses and conditions are prescribed medication to help manage it. Diabetes is treated with insulin or high cholesterol with some variety of statin medication. For OA, one of the best-known treatment options is exercise, when dosed correctly and specific to you.

How Exercise Can Help Manage Your Osteoarthritis Symptoms

Ongoing research suggests that exercise can promote change both directly, at the joint, and indirectly, by improving your overall function and movement quality [1]. Osteoarthritis commonly involves the breakdown of the joint, inflammation, and decreased cell metabolism or turnover.

Studies show that exercise may have a protective effect on the joint by stimulating a process called ‘autophagy’, which recycles old and/or damaged cells into newer, healthier ones! [1] This is an amazing process that the body goes through that essentially goes out with the old, and in with the new.

Exercise can promote positive change indirectly as well, by improving stability and function by increasing muscle strength and helping you move in a way that distributes the load of your body more efficiently. One of the most well-known research programs studying the effect of exercise on individuals living with hip and knee osteoarthritis is called Good Life with osteoArthritis in Denmark (GLA:D). 

This consists of 2 weeks of education and 6 weeks of neuromuscular training led by a physiotherapist. In one GLA:D study with nearly 10,000 participants, pain intensity and quality of life improved significantly following the completion of the program! Furthermore, participants who completed the program reported they took fewer painkillers and took fewer sick days [2].

Introducing Peak Arthritis: A Physiotherapy Program for Osteoarthritis

The Peak Osteoarthritis Intervention Program is an 8-week exercise program that is based on GLA:D research and combines education and neuromuscular training to help individuals living with OA manage their symptoms and continue to participate in the activities they enjoy.

Participants will be assessed by a physiotherapist and be provided with a plan specific to them, and be guided through an 8-week exercise program at 2x 1-hr sessions/week. Sessions are structured as circuit training, where participants learn the fundamentals of strength training in a way that is of special benefit to Osteoarthritic joints. 

You start by learning the fundamentals of how to hinge, squat and lunge and then we progressively load these movements, based on your ability levels. You will have 1:1 sessions with a physiotherapist throughout your program, and have access to group exercise facilities to perform your exercises.

What Are the Goals of the Program?

The ultimate goal of the program is to help you be able to do more of the things you love in life. We want to help you feel fulfilled and happy. Whether that is being able to feel like you can go up and down the stairs without clinging on to a railing, being able to walk 3 blocks instead of 1, getting back into an exercise routine, playing tennis, getting back into golf, whatever your WHY is! Let our Peak Health physio know what your goals are at the beginning of the program and you can set realistic expectations together for what you hope to achieve from the program.

 

Short-term goals for how to help you achieve your longer-term goal are as follows:

• Get stronger
• Move smarter
• Gain confidence (In the way you move, in your ability to complete daily tasks, in your knowledge about what OA is and how it affects your body)

How Do I Know if I Would Be a Good Fit for the Program?

There is no specific age requirement for participation in this program! We welcome beginner to experienced exercisers and most levels of OA patients (mild OA to severe OA). Regardless of your experience with exercise, we will adapt the program to your unique ability level. 

You may not be a good fit for the program if you are unable to stand or walk independently without a higher-level gait aid such as a walker. If you would like more information to know if you would be a good fit for the program, please call the clinic at 403-287-7325 and you can request that the lead physiotherapist for the program call you with more information.

We can’t WAIT to see how exercise rehabilitation can help you move better!

Book a discovery call with our physiotherapist Kate today HERE.

At Peak Health And Performance, we offer a wide range of treatment options including massage therapy and concussion care to address a variety of conditions and help improve your quality of life. Some of the common conditions we can help with include:

• Poor posture
• Connective tissue issues
• Knee injuries and Knee pain
• Joint pain relief
• Impaired range of motion

References:

1. Kong H, Wang XQ, Zhang XA. Exercise for Osteoarthritis: A Literature Review of Pathology and Mechanism. Front Aging Neurosci. 2022 May 3;14:854026. doi: 10.3389/fnagi.2022.854026. PMID: 35592699; PMCID: PMC9110817.
2. Skou ST, Roos EM. Good Life with osteoArthritis in Denmark (GLA:D™): evidence-based education and supervised neuromuscular exercise delivered by certified physiotherapists nationwide. BMC Musculoskelet Disord. 2017 Feb 7;18(1):72. doi: 10.1186/s12891-017-1439-y. PMID: 28173795; PMCID: PMC5297181.

Written by Kate Thompson, Physiotherapist

 

What Are Some Common Myths About Osteoarthritis?

Although a very common diagnosis, there seem to be many misconceptions about what Osteoarthritis is or what may affect it. Let’s dive into some of these together! 

Myth #1: I Heard That Running Gives You OA

 “I enjoy running for exercise. I don’t think I have Osteoarthritis, but I have heard that continuing to run long distances can put me at risk for developing Osteoarthritis.”

What the research says: Research has shown that both non-runners and runners exposed to high-volume training loads (>92 km/week) have higher rates of Osteoarthritis than recreational runners [1]. Therefore, due to the numerous other health benefits of running, it is not sound advice to tell recreational runners to stop running [1,2].

It is important to consider that these studies do not account for other risk factors of Osteoarthritis, such as age, previous trauma and obesity, which may have had an effect on the results of these studies. 

Myth #2: Running Will Worsen My OA.

 “I have Osteoarthritis and have been told that I should stop running, as it will make my Osteoarthritis worse.”

What the research says: There have been a variety of studies that have found that running does not appear to accelerate the progression of existing knee OA in runners >50 years of age [1]. There have however been some small-scale studies that have suggested that individuals with OA who run may require increased recovery time from running [1]. 

Therefore, it is recommended that if an individual has OA, enjoys running, and is managing their symptoms well, they should continue to run as long as they monitor running frequency to ensure adequate recovery time between bouts [1]. For example, if you run 3 days/week, I would recommend spreading the runs out throughout the week instead of running 3 days consecutively.

Myth #3: I Have OA so I Can’t Do Anything Fun Anymore.

 “I have been diagnosed with Osteoarthritis and have been told to stick to ‘low-impact’ activities. I want to continue to play hockey for as long as I can but I am nervous that it will make my OA worse.”

What the research says: There have been multiple studies to suggest that long-term participation in high-impact activities are not associated with the development of OA [2,3]. That being said, these studies are limited, as it is challenging to control for other risk factors of Osteoarthritis. Thus, it may be more productive to make these decisions based on your current symptoms. 

For example, if you experience a mild increase in pain while playing hockey, however, the pain returns to your baseline by the next day, it is likely safe for you to continue playing. On the contrary, if playing hockey increases your pain significantly after playing and takes 2-3 days to return to baseline levels, I would recommend discontinuing until you have a thorough assessment from a physiotherapist in Calgary. 

The physiotherapist will be able to tell you if playing hockey is a realistic goal, and if it is, they can help you make activity modifications and provide you with exercises to help you return to hockey with fewer symptoms! If it is not a realistic goal for you, they will help you find other ways to stay active in a way that fits with your lifestyle and your goals. 

Myth #4: I Have OA in My Back so I Can’t Twist.

“I have Osteoarthritis in my spine. I was told I should avoid bending forward or twisting.”

What the research says: What you do with your spine is not as important as how you do it. Your spine is made to twist and bend, however, over time some of these movements can become stiff and painful. 

Gentle mobility exercises and performing movements that load your spine such as squats, hinges, pushes and pulls can make your spine more resilient and allow you to complete your daily activities with less irritation and risk of injury.

Myth #5: There Is a One Size Fits All Plan for OA

“I heard that there is one specific exercise program that you can do that will help you manage Osteoarthritis symptoms.”

What the research says: Exercise is a leading treatment approach for Osteoarthritis, however, there is no ‘one size fits all’ formula to exercising with Osteoarthritis [4]. A great place to start is learning how to squat, hinge, lunge, push and pull with good technique, as these are movements that occur naturally throughout the day as you complete daily activities. 

For example, you have to squat to sit on a chair, lunge to get up the stairs, and hinge to unload your dishwasher. Factors such as the weight you lift, distance you move, and sets/reps you complete should vary based on your symptoms and fitness level.

In summary, every individual is unique and your presentation requires a specific exercise and management plan designed for you. Contact Peak today to see if you would be a good candidate for a physiotherapy assessment and personalized exercise rehabilitation plan to help manage your OA. Click HERE to book your discovery call today. 

At Peak Health And Performance, we offer a wide range of treatment options including massage therapy and concussion care to address a variety of conditions and help improve your quality of life. Some of the common conditions we can help with include:

• Poor posture
• Connective tissue issues
• Knee injuries and Knee pain
• Joint pain relief
• Impaired range of motion

 

References:

1. Alexander JLN, Willy RW, Culvenor AG, et al. Infographic. Running Myth: recreational running causes knee osteoarthritis. British Journal of Sports Medicine 2022;56:357-358.
2. Horga LM, Henckel J, Fotiadou A, et al 3.0 T MRI findings of 104 hips of asymptomatic adults: from non-runners to ultra-distance runners. BMJ Open Sport & Exercise Medicine 2021;7:e000997. doi: 10.1136/bmjsem-2020-000997
3. Chang AH, Lee J, Chmiel JS, Almagor O, Song J, Sharma L. Association of Long-term Strenuous Physical Activity and Extensive Sitting With Incident Radiographic Knee Osteoarthritis. JAMA Netw Open. 2020;3(5):e204049. doi:10.1001/jamanetworkopen.2020.4049
4. Kong H, Wang XQ, Zhang XA. Exercise for Osteoarthritis: A Literature Review of Pathology and Mechanism. Front Aging Neurosci. 2022 May 3;14:854026. doi: 10.3389/fnagi.2022.854026. PMID: 35592699; PMCID: PMC9110817.

Written by Kate Thompson, Physiotherapist 

So You’ve Been Told You Have Osteoarthritis. You’ve Landed on The Right Page…

What Is Osteoarthritis?

Osteoarthritis (OA) is a disease that commonly affects joints of the body such as the hip and knee, shoulders and hands [1], and is a lot more common than people think. If we zoom into what is going on at the joint, it helps paint a picture of what is actually going on when an individual develops OA.

A joint is where two bones come together, and serve the function of absorbing and distributing mechanical load in your body [1]. A healthy joint should have cartilage covering the surface of the bones, enough space between the bones so they do not rub against each other, as well as ligaments and muscles surrounding them to support them and keep them stable.

OA results in changes to the cartilage, bone and joint space, and can also affect the surrounding ligaments, tendons and muscles [1]. As a result, the structure and function of the joint change which can result in symptoms such as pain, stiffness and instability [1].

 

 

“If you have knee osteoarthritis, you may feel unsteady when putting all of your weight through one leg while going down the stairs. This is because the muscles, ligaments, and joint structure are not able to support and disperse the weight of your body as it normally should.”

 

Who Is at Risk of Developing OA?

Known risk factors for developing OA include [1]:

• Aging
• Obesity
• Genetics
• Previous trauma/injury to the area
• Gender (females have a higher incidence than males)
• Hormones and metabolic disease

It is important to note, however, that OA is not inevitable if you have one of these risk factors! For example, although aging increases your risk of developing OA, not everyone who ages develops OA [1].

My Doctor Diagnosed Me With Osteoarthritis, but I Have Never Had an X-Ray. Do I Need One To Confirm the Diagnosis?

This is a tricky subject. In the past, it was common practice for health practitioners to refer patients for X-rays to guide the diagnosis of musculoskeletal conditions. Newer research, however, has identified that there may not always be a strong correlation between imaging findings and patient symptoms [2,3]. 

For example, if you took 100 people off the street and took an X-ray of their knees, some people without any knee pain at all may have X-rays that indicate OA, and some people with severe, debilitating knee pain may have X-ray results showing a healthy joint. In addition, if you are an older adult, it is common for there to be structural abnormalities found on your imaging that simply have developed over time and are not related to your symptoms at all [2].

Therefore, recent recommendations advise that OA should be diagnosed based on your symptoms, instead of through X-ray.

For example, if your symptoms follow a typical presentation of OA, such as joint pain, stiffness in the morning lasting <30 mins, crepitus with movement and weakness/instability, it is acceptable to be diagnosed without a referral for an X-ray [2,3]. 

Your doctor may request an X-ray if you have an atypical presentation and/or if there is suspicion of a different diagnosis2. Examples of an atypical presentation may include severe local inflammation, redness around the joint and rapid, progressive pain that is unrelated to use [2].

How Do I Know When I Need Surgery?

A better question might be, “How do I know if I need surgery?”. It’s important to consider that not everyone diagnosed with OA requires a joint replacement! It is recommended that patients diagnosed with OA try conservative management for a significant period of time to manage their symptoms, improve function and delay further changes to the joint structure [4]. 

The Osteoarthritis Research Society International suggests that NSAIDs (non-steroidal anti-inflammatory drugs) and exercise have the highest level of evidence for improving knee and hip OA symptoms [4]. If you have spent a significant amount of time trying conservative methods and still are unable to manage your pain, and your pain is considerably impacting your quality of life, it may be time to have a conversation with your doctor about other options.

Although there is significant evidence demonstrating that joint replacement surgery can improve symptoms, function and quality of life, surgical candidates are often under-educated about the risks of surgery and what the recovery process might look like [5]. For example, it can take months of physiotherapy to restore your mobility and strength following surgery. 

Furthermore, you may still experience pain in the months following surgery as you progress through rehab to optimize your new joint function. In addition, there is a risk that you may not regain a full range of motion following surgery [5]. 

It is important to remember that everyone has a unique anatomy, fitness level, stress level, and life experiences going into surgery and all of these factors will play a role in your recovery. If you are currently waiting for surgery, it is important to consult with a Peak Health physiotherapist on how you can best prepare for the surgery to optimize your outcomes after the operation.

To learn more about Osteoarthritis, check out our other blogs on the topic or reach out to me directly at [email protected]! I would be more than happy to answer any questions you may have on how physiotherapy and exercise rehabilitation can help you manage your OA diagnosis.

To book a free discovery call with me, click here.

At Peak Health And Performance, we offer a wide range of treatment options including massage therapy to address a variety of conditions and help you get back to your daily activities pain-free. Some of the common conditions we can help with include:

• Poor posture
• Connective tissue issues
• Knee injuries
• Joint pain relief

References:

1. He Y, Li Z, Alexander PG, Ocasio-Nieves BD, Yocum L, Lin H, Tuan RS. Pathogenesis of Osteoarthritis: Risk Factors, Regulatory Pathways in Chondrocytes, and Experimental Models. Biology. 2020; 9(8):194. https://doi.org/10.3390/biology9080194
2. Xia Wang, Win Min Oo, James M Linklater, What is the role of imaging in the clinical diagnosis of osteoarthritis and disease management?, Rheumatology, Volume 57, Issue suppl_4, May 2018, Pages iv51–iv60, https://doi.org/10.1093/rheumatology/kex501
3. Wood G, Neilson J, Cottrell E, Hoole S P. Osteoarthritis in people over 16: diagnosis and management—updated summary of NICE guidance BMJ 2023; 380 :p24 doi:10.1136/bmj.p24
4. Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, Kraus VB, Lohmander LS, Abbott JH, Bhandari M, Blanco FJ, Espinosa R, Haugen IK, Lin J, Mandl LA, Moilanen E, Nakamura N, Snyder-Mackler L, Trojian T, Underwood M, McAlindon TE. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019 Nov;27(11):1578-1589. doi: 10.1016/j.joca.2019.06.011. Epub 2019 Jul 3. PMID: 31278997.
5. Beswick AD, Wylde V, Gooberman-Hill R, Blom A, Dieppe P. What proportion of patients report long-term pain after total hip or knee replacement for osteoarthritis? A systematic review of prospective studies in unselected patients. BMJ Open. 2012 Feb 22;2(1):e000435. doi: 10.1136/bmjopen-2011-000435. PMID: 22357571; PMCID: PMC3289991.