Physiotherapy Archives - Peak Health & Performance

Common Running Injuries and How to Prevent Them

physiotherapy for running injuries calgary south

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:

Physiotherapist Treating A Running Injury

  • 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:

Person On Treadmill

  • 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

Exercise Is Medicine for Osteoarthritis

exercise rehabilitation osteoarthritis calgary south

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.

elderly man lifting weights

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 your physiotherapist 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.

senior man working out


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


  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.

The Myths and Misconceptions About Osteoarthritis

senior man lifting barbell

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.”

senior couple doing sport outdoors

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.”

active senior tennis playerWhat 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. 

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



  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.

Osteoarthritis: A Brief Introduction

physiotherapy treatment for osteoarthritis calgary south

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].

normal knee joint vs osteoarthritis



“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.

doctor showing knee x-ray to patient

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 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! 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


  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.
  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,
  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.

Peak Prenatal Program

pregnant woman holding stomach

Written by Helen Lo, Physiotherapist 

Are you or is someone you know pregnant? If so, we have some exciting news to share!

Introducing… Peak Prenatal, a comprehensive Peak Program designed to empower women to conquer all stages of pregnancy from conception to delivery!

HelenMy name is Helen, and I am a pelvic floor physiotherapist at Peak Health Kids. Over the past several years I have worked with a number of women through pregnancy and a common theme I came across was how little people truly know about this process and how unsupported they feel throughout it.

From this came the idea of Peak Prenatal, a community for educating and preparing parents for what to expect with pregnancy, labour, delivery, and everything in between.

At Peak Prenatal, we understand that pregnancy is a time of great physical and emotional changes. That’s why we offer a comprehensive program designed to empower women to conquer all stages of pregnancy from conception to delivery. 

Our prenatal physiotherapy services and pelvic floor therapy in Calgary are tailored to meet the unique needs of each woman throughout her journey.  

Peak Prenatal will give you an all-access pass to: 

– An initial 60 minute prenatal physiotherapy assessment and a 30 minute prenatal follow-up session to assess your pelvic floor issues, core, address pain, and prepare you for delivery

– A 45 minute re-evaluation after delivery to reassess your pelvic floor and determine a plan for your goals postpartum

– Four group education sessions and a take-home booklet filled with all you need to help you on your pregnancy journey

– Access to a private community forum to share common questions, concerns, tips, milestones, grief, and everything from prenatal to postpartum

– Access to a specialty referral network of massage therapists, chiropractors, trainers, naturopaths

– Access to a private library of YouTube videos demonstrating all the exercises that will be recommended 


Will I need more than an assessment and follow-up before I give birth? 

Potentially! If you struggle with engaging your pelvic floor muscles or would like some extra support managing pain through your pregnancy, you may benefit from additional sessions before delivery. 

But don’t worry, with each assessment, you will have the opportunity to discuss your concerns and your goals with your pelvic floor therapist and come up with a plan that will work for you. 


What will the education sessions include? 

Education sessions will be 1 hour in length and offered in-person at Peak Health Kids in the evening. Each session is led by a pelvic health physiotherapist. 

Session 1: This introduction to pelvic health physiotherapy will include information about the pelvic floor function and anatomy, pelvic muscles, changes that occur during pregnancy, the basics of pelvic floor engagement, normal urinary and bowel frequency, and reviewing common myths associated with pregnancy. 

Session 2: We will cover common pregnancy concerns such as pelvic pain, pelvic floor dysfunction, abdominal separation (rectus diastasis), urinary incontinence, exercise and physical therapy. 

Session 3: We will start to discuss labour and delivery, pelvic floor relaxation, and the perineal massage. 

Session 4 will review all things after delivery such as when to see your pelvic floor therapist, exercise recommendations, bladder and bowel concerns, returning to sexual intercourse, C-section specific considerations, prolapse and pessaries, and what to consider with baby! 


Can I use my health benefits to pay for this? 

Absolutely! You will be able to bill these sessions through physiotherapy or any additional health spending account you have access to. Our team will be happy to help you navigate this. 


Next steps 

The prenatal period can be an exciting time but also can be a time filled with a lot of uncertainty. Peak Prenatal is a program designed to help ease your concerns, answer your questions, and provide a community to support you throughout your pregnancy. Book your discovery call today to speak with Helen and learn more about Peak Prenatal.


Pregnancy-Related Pelvic Girdle Pain

woman holding stomach pelvic pain

Written by Helen Lo, Physiotherapist

What is it Related Pelvic Girdle Pain? 

Pregnancy-related pelvic girdle pain is a specific category of pelvic pain that impacts women during pregnancy. 

It is characterized by pain in the lower back, hips, and/or pubic area that can be exacerbated by certain activities such as walking, climbing stairs, or even just standing for long periods of time. PGP can have a significant impact on quality of life.

The cause of this pain is multi-factorial and is often influenced by biopsychosocial factors. This is essentially the fancy name for any pelvic, hip, and/or low back pain during pregnancy!

How Common is This?

It is reported that between 25-65% of women experience pelvic girdle pain during pregnancy! It is most common for this pain to develop during weeks 14-30 of gestation. 

Risk factors for developing PRPGP

There are a  wide range of risk factors for PRPGP, including:

– Previous pregnancy
– Previous history of low back pain
– Increased BMI
– Smoking
– Work dissatisfaction
– Previous trauma
– A lack of belief of improvement

A Change in Perspective

Previously, the messaging delivered was that the hormones released during pregnancy caused widespread relaxation of our ligaments leading to instability of our joints and thus causing pain. 

Research now is showing that the hormones don’t cause widespread instability and instead increase the sensitivity of our tissues causing the sensation of pain. It is important to understand that pain is an experience, differs from person to person, and can occur in the absence of any structural tissue changes. 

How Can Pelvic Floor Physiotherapy Help?

Although common, we don’t want pelvic girdle pain to dictate your pregnancy and slow you down in any way. 

Pelvic floor physiotherapy is an approach to treatment that can target some of the root causes of this pain and help facilitate an action plan to make you feel better.

Pelvic floor physical therapy (PGP) is a specialized form of physical therapy that focuses on the muscles, ligaments, and connective tissues in the pelvic region. 

It can be used to treat a variety of conditions, including urinary and fecal incontinence, pelvic organ prolapse, chronic pelvic pain, sexual dysfunction, and postpartum rehabilitation.

Physiotherapy treatment could include:

1. Manual therapy including joint mobilization and/or soft tissue release both internally and externally
2. Introducing pain free movement
3. Taping for the low back or belly for increased support
4. Support belts

Consider Trying This: 

The Fitsplint 

This product is a great way to help relieve lower back pain, pelvic pain, or bladder pressure. It is lightweight, breathable, and can be used during exercise! You can find the fitsplint at any Peak Health location and a therapist would be more than happy to help fit you for the correct size. 

Don’t Let Pain During Pregnancy Stop You! 

Pain is one of the most common symptoms reported during pregnancy but it doesn’t have to be. With the help of a pelvic floor physiotherapist, you can learn many strategies to help reduce your pain and remain active throughout your pregnancy. Book your discovery call today to learn more about how physiotherapy can help. 


  1. Clinton, S. C., Newell, A., Downey, P. A., & Ferreira, K. (2017). Pelvic girdle pain in the antepartum population: Physical therapy clinical practice guidelines linked to the International Classification of functioning, disability, and health from the section on Women’s health and the orthopaedic section of the American Physical Therapy Association. Journal of Women’s Health Physical Therapy, 41(2), 102–125.

Guidelines for Physical Activity During Pregnancy

pregnant woman walking

Written by Helen Lo, Physiotherapist

For anyone out there wondering if it is safe to exercise during pregnancy, let me be the first to tell you YES, and it’s encouraged! 

Traditionally, medical advice during pregnancy included reducing exertion and avoiding strength training out of fear of causing potential harm to the baby and injury to Mom. 

New research1,2 has proved the complete opposite; showing that there are actually a wide range of benefits to exercising during pregnancy including:

1. Improved aerobic and muscular fitness
2. Promotion of appropriate maternal weight gain
3. Facilitating labour
4. Preventing gestational glucose intolerance
5. Preventing pregnancy-induced hypertension

In fact, not exercising during pregnancy has been associated with risk of:

1. Loss of muscular and cardiovascular fitness
2. Excessive maternal weight gain
3. Increased risk of gestational diabetes
4. Increased risk of pregnancy-induced hypertension
5. Pelvic floor dysfunction
6. Varicose veins
7. Deep vein thrombosis
8. Higher incidences of low back pain
9. Poor psychological adjustment to the physical changes of pregnancy

Guidelines for Physical Activity During Pregnancy 

1. All women that are deemed medically safe to exercise should be physically active throughout pregnancy.
2. Physical activity should be accumulated over a minimum of 3 days per week, however it’s encouraged to be active everyday.
3. Incorporate a variety of aerobic exercise, resistance training, and yoga or gentle stretching for maximum benefit.
4. Pelvic floor muscle training on a daily basis to reduce the risk of urinary incontinence.

The Goal of Exercise During Pregnancy 

Keep in mind, the goal with exercise during pregnancy is to maintain your current level of physical health. Avoid trying to reach peak fitness or train for an athletic competition. If you have never exercised before, a great place to start is 30 minutes of walking daily. 

Below you will find some recommended exercises for pregnancy. The parameters are generalized, and should only be used as a guide. If you are uncertain about how these exercises may work for you, please call to chat with our physiotherapist and we can get you on the right track! 

Please speak with your doctor to obtain medical clearance before participating in any physical activity. 

Try These 3 Exercises to Get Moving 

Squat with a Ball 

Starting position: Place the physio ball against the wall and stand with your back supported by the ball. 

Execution: Squat down moving with the ball, return to standing position. 

Parameters: Sets: 1-2 sets, Reps: 10-12



Starting position: Start in a crawling position on your hands and knees, ensure hips and shoulders are at 90°. 

Execution: At the same time, lift one arm straight out front and lift the opposite leg straight back, return to the starting position and repeat with the opposite arm and leg. 

Parameters: Sets: 1-2 sets, Reps: 6-8 per side


Leg lifts

Starting position: Sidelying. 

Execution: Lift the top leg up towards the ceiling, hold for 2-3 seconds, lower leg back down.

Parameters: Sets: 1-2 sets, Reps: 8-10 per side

Next Steps 

Exercise during pregnancy is safe, recommended, and with the help of a pelvic floor physiotherapist, can ensure maintenance of your current fitness level and overall health. 

Book your discovery call today to see how pelvic health physiotherapy can support you throughout your pregnancy!


  1. Barakat, R., Refoyo, I., Coteron, J., & Franco, E. (2019). Exercise during pregnancy has a preventative effect on excessive maternal weight gain and gestational diabetes. A randomized controlled trial. Brazilian journal of physical therapy, 23(2), 148-155.
  2. Vargas-Terrones, M., Nagpal, T. S., & Barakat, R. (2019). Impact of exercise during pregnancy on gestational weight gain and birth weight: an overview. Brazilian journal of physical therapy, 23(2), 164-169.
  3. Clinton, S. C., Newell, A., Downey, P. A., & Ferreira, K. (2017). Pelvic girdle pain in the antepartum population: physical therapy clinical practice guidelines linked to the international classification of functioning, disability, and health from the Section on Women’s Health and the Orthopaedic Section of the American Physical Therapy Association. Journal of Women’s Health Physical Therapy, 41(2), 102-125.

Pelvic Floor Physiotherapy: What Is It and Who Can It Help?

pregnant woman sitting

Written by Helen Lo, Physiotherapist


Contrary to popular belief, good pelvic floor health is a lot more than “just doing kegels”. Sometimes, it is even the opposite and there is a large focus on pelvic floor relaxation. 

What is Pelvic Floor Physiotherapy?

Pelvic floor physiotherapy is a specialized area of physiotherapy that requires additional training to assess the strength, tone, and function of the pelvic floor through internal and external examinations. 

The pelvic floor muscles collectively form a bowl at the base of your pelvis. These muscles work together to support your organs, control continence, provide stability for your low back and pelvis, move fluid through the pelvic girdle, and increase blood flow to the organs that control erection and orgasm. 

Key Terms

Stress Urinary Incontinence: Uncontrolled urine leakage when you cough, sneeze, or jump

Overactive Bladder: The feeling of a frequent urge to empty your bladder

Pelvic Organ Prolapse: The feeling of heaviness or pressure in the vagina due to 1 or more organs dropping down as the muscles and tissues in the pelvic region are no longer able to support them


Dyspareunia: Pain with intercourse either before, during, or after

Rectus Diastasis: An observable bulge through the abdomen due to the separation of the “6-pack” abdominal muscles that can commonly occur during during pregnancy or postpartum.

Would You Need Pelvic Floor Physio?

1. Do you struggle with uncontrolled leakage of urine or stool (incontinence)?
2. Are you constantly feeling the urge to pee (urgency)?
3. Do you feel a heaviness or pressure in your pelvic region?
4. Do you experience pelvic pain, low back, hip pain, or painful intercourse (dyspareunia)?
5. Have you received a diagnosis or experienced symptoms of endometriosis?
6. Did your abdominals separate (rectus diastasis) during or after pregnancy?
7. Do you experience pain when passing stool or infrequent bowel movements (constipation)?
8. Does your child wet the bed?
9. Prenatal care
10. Postpartum care

If you answered yes to any of these questions, or if you fall into the pre or post natal window, you are a perfect candidate for pelvic floor physiotherapy! Although many of these symptoms are very common in the general population, it does not mean it’s normal or that you have to settle for these symptoms. Pelvic floor physio can help! 

Who Should See a Pelvic Floor PhysiotherapistSo…Who Should See a Pelvic Floor Physiotherapist? 

The short answer is anyone! A Pelvic Floor Physiotherapist can help whether you are pregnant with your first child, a competitive olympic weightlifter experiencing leakage with each lift, a child that is missing sleepovers due to wetting the bed, or someone experiencing pain with intercourse. 

What to Expect at Your First Appointment:

During your first visit, expect a comprehensive 60 minute 1-on1 assessment between you and your therapist. Your pelvic floor therapist will start by taking the time to listen to your concerns, medical history, and goals of treatment. Following this, you will be taken through the hands-on portion of the assessment which could include an external and internal examination (if deemed appropriate and agreed upon by you). 

Although an internal examination (vaginal or rectal) is considered the “gold standard” to assess the pelvic floor, your therapist will meet you at your comfort level and walk you through each stage of the assessment. Don’t worry if you choose not to have an internal examination, there is still plenty of valuable information that can be gained from an external assessment! There are even times when an internal exam is not recommended such as when working with kids. 

At the end of the first appointment, your therapist will review their findings and provide you with a detailed plan of action tailored to you and your goals.


What does an internal pelvic exam entail?

An internal exam consists of a digital exam conducted either vaginally or rectally.

Is it safe to see a pelvic floor physiotherapist while pregnant?

Yes, we actually recommend all women come in for an assessment after their 1st trimester. This helps us to obtain a baseline of strength and can help guide you through a comfortable pregnancy. If your doctor or midwife has advised you against sexual intercourse, we will proceed without conducting an internal examination. 

Can I still come to my appointment if I am on my period?

Yes! If, however, you are uncomfortable with coming in during this time, you can reschedule your appointment. 

How soon after delivery should I come to pelvic floor physiotherapy?

6 weeks after delivery. We usually recommend coming in for an internal exam following your 6 week check-up with your doctor or midwife. However, if you are experiencing significant pain, bowel concerns, and/or bladder or urinary dysfunction, feel free to come in sooner. 

Don’t Let Your Pelvic Floor Limit You!

Many people may tell you your pelvic floor symptoms are normal but they are not! Your pelvic floor physiotherapist is here to prove to you that although leaking urine and prolapse may be common pelvic floor concerns, there is hope and it can get better with professional help. Click below to book an appointment and take back control of your pelvic floor!

How a Proper Bike Fit Can Make Your Pain Disappear

bike fit pain calgary south

By: Mark Van Thournout

bike fit pain calgary south


Peak Health & Performance is excited to offer BIKE FITTING at our Marda Loop location! Getting a custom bike fit is a great way to help you achieve your cycling goals, whether that’s increased performance, decreased pain, or just enjoying riding more! All of our bike fits are done by our physiotherapist who has a thorough understanding of how your body moves and will work with you on an individualized physical assessment and fit process to address your goals and any roadblocks you are experiencing.

What Can a Bike Fit Help With?

Knee Pain

The occurrence of knee pain in the general population is estimated to be 25% over the course of one’s life – in cyclists, this rises to 50% (Bini, 2011). These injuries tend to be “overuse” injuries – pedaling at 90 rpm for an hour results in 5,400 pedal strokes. Your lower limb alignment is important to consider due to the repetitive nature of cycling. There are three main bike fit interventions that are recommended for alleviating knee pain: saddle height, cleat adjustments, and cadence modifications.

Custom Bike Fit

Low Back Pain

As cycling shoe technology has evolved, low back pain overtook knee pain as the most prevalent issue that cyclists or triathletes complain about (Pruitt, 2001). Managing low back pain in cyclists is all about changing how much forward bending that is needed. This can be done by controlling how far away the handlebars are, altering the height of the handlebars, or considering the overall position of the rider on the bike.

Cycling culture plays a role here as well; much of the pro peloton will ride with their stems as low as possible which is referred to as “slamming the stem”. Lowering the handlebars increases how far you need to bend forward to reach the handlebars. Ignoring the current trend in favour of a higher set stem can help to reduce back pain (Pruitt, 2001).

Hand Numbness/Tingling

Nerve issues in cyclists are quite common and fortunately, there are some easy fixes to reduce the occurrence of nerve-related problems. Increased pressure on your carpal tunnel (typically with straight handlebars) or the pinky-side of your hand (typically with road handlebars) can cause complaints of hand numbness or tingling, particularly on longer rides. Hand numbness is best tackled by addressing saddle tilt, handlebar tilt, and the use of cycling gloves.

What to Expect From a Bike Fit?

1. It’s all about you! Our bike fits are done with you at the center of it all. We’ll start with some detailed questions about your riding history, cycling goals, current fitness, and any pain that you have while riding. These answers will help inform the changes that we make to your bike together. There’s no sense in making someone look like a Tour de France rider when they just want to be comfortable biking around Fish Creek; a good bike fit should be focused around your goals, not someone else’s.

2. Lots of hopping on and off the bike! We’ll make each change one by one, and let you evaluate how each change feels. We’ll also mark the original position and any changes that are made, so that you can always return to previous positions if things change. We can also try out new pieces and parts – we’ve got all the equipment here, all you need to bring is your bike and any parts that you’d like to try out.

3. Forget the formulas. Many online bike fitting guides are very specific about their advice – your knee must bend 30 degrees at the bottom of your pedal stroke, your elbows must be bent 15 degrees, your seat height should be set to exactly 98% of the length of your leg. These can be helpful guidelines to start with, but everyone’s body is different and these types of recommendations are not guarantees for tackling pain on the bike. A professional bike fit with a physiotherapist can help dispel some of these myths and leave you with a tailored fit, based on your exact body type, flexibility, and cycling experience.

How Are We Different?

image6Many bike shops around the city offer bike fitting, each with their own beliefs and method to fitting. Some lean heavily on technology, others take a more manual approach. Our bike fits are done exclusively by physiotherapists with additional training in bike fitting. This means that in addition to a bike fit, you’re getting the attention of an expert in movement systems, flexibility, strength, and injury prevention and rehabilitation. We’re experts in bodies and movement, and not beholden to industry trends or quick fixes.

Some issues are best served with a two-pronged approach: both physiotherapy and bike fitting. For example, a bike fit can address numb or tingling fingers during a ride, but may not consider that the root cause of that numbness is actually a neck issue rather than a wrist/hand problem.

For triathletes, a bike fit can help optimize your aero position, while adding physiotherapy to the mix would address core and back strength to help keep you in that position. Adding physiotherapy to your bike fit adds an additional layer of problem solving to get you back outside and on track for your cycling goals.

Sneaky Signs You Might Need a Bike Fit

Hand position

When you’re out on a long ride, take a look down at where your hands are sitting on your handlebars. Are they snuggled up against the brake hood? Or are they slightly back, leaving a space between your hand and the hood? There are a few problems with that – your bike is going to handle differently, if you hit any bumps in the road, your hands are going to slide forward, and most importantly, it’s hard to reach your brakes from this position.

The easiest fix for this is to fit you with a shorter stem, bringing your handlebars closer to your body and shortening the distance that you need to reach. That way, you can sit in your typical comfortable position, but just a little bit safer on the road.

Custom Bike Fit - Righ and Wrong Hand Position

Chainstay Wear

Take a look at your chainstays on either side, and watch for signs of rubbing. This is a sign that your shoes are allowing too much heel-in, or external rotation at the hip, in physiospeak. It may not be every pedal stroke, but you might notice yourself bumping against the chainstay with your heel as you pull back on your pedal. There are a few tools in the toolbox to fix this.

One is to go the physio route, and get you better at controlling your hip motion and prevent you from clipping the chainstay – this is usually corrected with glute and thigh exercises. There are also changes to your shoe setup that could solve this – either rotating your cleats on your shoes to prevent that heel-in position, or fitting new cleats that allow less float (how much your heel can move side-to-side).

Chainstay Wear

Time in Aero Position

This is specifically for triathletes – pay attention to how long you can maintain your aero position for. Aero is of utmost importance in triathlon, especially in long distance racing.

One culprit behind not being able to hold an aero position is where your bar pads are oriented. Your elbows should be stacked roughly underneath your shoulders. If your elbows are forward from your shoulders, it takes much more core strength to hold that position. Try this at home to simulate the difference – get into a classic plank position, and have your elbows right underneath your shoulders. Now try shifting your elbows forward from your shoulders.

The fix for this can also come from physio, bike fitting, or both. In physio, we would look at core strength and back extensor endurance. The bike fit solution might be to move your bar pads closer to your body, stacking your elbows underneath your shoulders and getting you closer to that classic plank position. Either way, both fixes would help you stay in your aero position for longer and make the most of your watts!

If you experience any of these three issues, a bike fit would be a great solution to help address these and further optimize your position on the bike!

Time in Aero Position - Wrong and Right

Next Steps

The ultimate goal of bike fitting is to get you excited about riding your bike – whether that’s indoor or outdoors, for comfort or for power, or getting set up on a brand new bike! A good bike fit should be tailored to your individual needs and experience, and we’re excited to offer exactly that at Peak. Click here to book your individualized bike fit with our physiotherapist today.


  • References
    Bini, R. R. & Hume, P. A. (2013). Effects of workload and pedalling cadence on knee forces in competitive cyclists. Sports Biomechanics, 12(2), 93-107.
  • Bini, R. R., Hume, P. A., & Croft, J. L. (2011). Effects of bicycle saddle height on knee injury risk and cycling performance. Sports Med, 41(6), 463-476
  • Ericson, M. & Nisell, R. (1897). Patellofemoral joint forces during ergometric cycling.Physical Therapy, 67(9), 1365-1369.
  • Case, C. & Connor, T. (2016 – present). Velo News Fast Talk [Audio podcast].
  • Pruitt, A. L. & Matheny, F. (2001). Andy Pruitt’s medical guide for cyclists. RBR Publishing Company.

Scoliosis: What You Need to Know

Have you noticed that one shoulder sits higher than the other? Do you find you tend to always lean to one side? Or maybe you’ve noticed that your waist looks fuller on one side, and that your clothes fit a bit funny. You may have something called scoliosis, which is an abnormal curvature of the spine. It can lead to back pain, hip pain, difficulty breathing, poorly fitting clothes, and in some cases, nerve impingement and nerve pain. Read on to learn more. 

What Is Scoliosis(1,3)

Scoliosis is a 3D deformation of the spine, which leads to visible changes in the appearance of the torso, and internal structural changes in the intervertebral discs in the back. If left untreated, this eventually leads to irreversible changes in the structure of the bones in the back as well. Depending on the severity of the scoliosis, it may or may not be painful until later adulthood. Typically, most of the structural changes occur during adolescence before the bones are finished growing. Once skeletal maturity is reached – when there can be no more change in bone structure – the curve will remain at that shape. However, later on in adulthood, we can start to experience age-related changes to the bone that can lead to worsening of this curve as time, and age, goes on. 

Progression of Scoliosis(1,3)

In adolescence or early stages, scoliosis can be painless, and can often be missed if it is mild. If left untreated and allowed to progress, scoliosis can cause an aching back pain, which typically feels like the muscles on one side of the back are constantly tight. As the scoliosis progresses, you can begin to develop breathing challenges, as the ribcage will be more compressed on one side of the body, making it difficult to take in a full breath. Sometimes, the bottom-most rib can even touch the top of the hip bone on one side which can lead to sharp, acute pain. Over time, the intervertebral discs can become wedged-shaped which can cause nerve complications such as numbness and tingling, nerve pain, and nerve root compression.

What Causes Scoliosis?(1)

80-90% of scoliosis cases are idiopathic – which means there is no known cause. Adolescent Idiopathic Scoliosis is the most common type of scoliosis, affecting adolescents aged 9-17, and typically affects girls more than boys. The remaining 10-20% of scoliosis causes are due to congenital abnormalities (from birth), neuropathic or neuro-muscular conditions, or other systemic diseases. 

Because of this sequelae, early detection and treatment is essential to maintaining a quality of life that is not dictated by the scoliosis!

How Can I Check if I Have Scoliosis?(1)

Perform this quick checklist to see if you may have scoliosis:

    • Is one shoulder or shoulder blade higher than the other? 
    • Is one arm farther away from the body?
    • Does your body look tilted to one side?
    • Are your hips uneven in height or twisted?
    • Is one leg shorter than the other?
    • Do you find it hard to take a full deep breath?
    • When exercising, do some moves feel easier on one side of the body? 
    • Do you have consistent achy pain on one side of the upper or lower back only?
    • Is there a hump on one side of your back when you bend forward?
    • Do your lower ribs stick out in front on one side of your body? 
    • Does one foot turn in/out more than the other?

If you answer yes to one or more of these questions, you would benefit from a physiotherapy assessment to determine whether you have scoliosis.

A physiotherapist will also be able to help figure out whether your scoliosis is functional or structural.

If you have functional scoliosis, you may answer yes to some of the screening questions above and appear to have a curvature, however on x-ray, the spine remains straight. That is because functional scoliosis is due to muscle imbalances and postural habits, rather than the structure of the spine itself.  For this reason, this type of scoliosis responds very well to orthopaedic physiotherapy treatments.

Structural scoliosis involves visible changes to the vertebrae on x-ray, and the shape of the spine is physically deformed. Physiotherapy treatments are also very beneficial for structural scoliosis, however depending on the severity, you may also require bracing and/or surgery.  

Treatment of Scoliosis

1. Physiotherapy (1,3)

Traditional Orthopaedic Physiotherapy treatment typically consists of core stabilization exercises combined with appropriate back strengthening. The goal is to stretch the tight muscles on the inside of the curve, and strengthen the elongated muscles of the outside of the curve, while also working on the deep core unit to provide overall stability to the whole body. An exercise program will be developed based on your symptoms, and will aim to address areas of pain and stiffness that you are experiencing. 

Schroth Therapy is a specific exercise-based approach to treating scoliosis and other postural dysfunctions. The exercises combine postural corrections with breathing mechanics to work towards curve correction. The overall aim of Schroth therapy is to improve motor control of the body and essentially ‘re-learning’ where straight is. When the scoliosis is detected early, and rapid intervention with Schroth is implemented, correction of the abnormal spine curvatures towards a more normal postural alignment is possible. 

2. Bracing (1,2,3)

Depending on the severity of your curve on x-ray, an orthopaedic surgeon who specializes in scoliosis may recommend a full body brace. Sometimes, this can result in a slight straightening of the curve, however this is not the primary goal. The brace is typically worn until skeletal maturity has been achieved, and works to prevent further progression of the scoliosis curves. They are typically prescribed to be worn full time (up to 23 hours per day), and work to provide counter-pressure on the outside of the curves while offloading the fatigued muscles on the inside of the curves.

3. Surgery (2)

If or when scoliosis progresses, it can begin to cause compression of the spinal cord. If it does not respond to more conservative treatments (physiotherapy, exercise and bracing), surgery may be required. The surgery would aim to stop curve progression, reduce the deformity, and maintain/regain balance through the trunk. Surgery typically involves spinal fusion where the bones of the spine are fused with hardware to secure the spine in a straightened position. There are also some newer approaches to scoliosis correction surgery that do not involve fusion, but rather are based on pressure/counter-pressure systems, pulleys, and tethers to gradually straighten the spine.

5 FAQ’s about Scoliosis

1. I have scoliosis, will I have to have spinal surgery?

No! The need for surgery is based on the severity of the curve(s), how much it is impacting your daily life, and how you have responded to non-surgical treatment approaches. Having scoliosis does not necessarily mean you have to have surgery.

2. Will my scoliosis just keep getting worse?

Not necessarily. Once skeletal maturity has been reached, the structural component (the bones visible on x-ray) will not worsen until later adulthood, and even then it is not inevitable. It can appear to worsen due to muscle imbalances, depending on habitual postures, exercise habits, workplace ergonomics, etc. This is where a physiotherapy exercise based approach can be VERY helpful!   

3. I was told to just “wait and see” what my scoliosis does before treating it. How long should I wait before seeking treatment for my scoliosis?

The ‘wait and see’ approach is an outdated approach to scoliosis management that we now know is not the way to go.  The faster you get treatment, the better your chances are of stopping or slowing the curve progression, and avoid worsening symptoms. 

4. Does swimming help manage my scoliosis?

Unfortunately, no. Although swimming is a great exercise for overall health and wellness, it can actually accelerate the progression of the curve, as it encourages the flattening of the thoracic spine. Historically, it was recommended as the “best” exercise for patients with scoliosis, as being in the water eliminates the force of gravity. Originally, it was thought that gravity played a role in scoliosis curve progression. However, we now know that this is untrue and have since advanced our treatment protocols for the condition such as the Schroth method outlined above. This is not to say that people with scoliosis should not swim recreationally, however competitive levels or very frequent participation should be avoided.

5. Does scoliosis only affect females?

Although more common in girls, boys can and do get scoliosis as well. Research shows there is a slightly higher prevalence of scoliosis in gymnasts and ballerinas/dancers, which are historically more female-dominant sports. This is more due to the overuse of one side of the body, or putting the body into positions that promote a flatter spine, rather than having more females in the sports. 

What Next?

If you suspect you might have scoliosis, or you have already been diagnosed with scoliosis, check in with a physiotherapist for a spine assessment! Even if you currently don’t have any pain, the sooner you start treatment, the better chance you’ll have to stop the curve progression, avoid more serious symptoms, and potentially decrease the severity of the curve. The physiotherapist will be able to assess whether you have functional or structural scoliosis, however, requesting full spine x-rays from your doctor would also be beneficial to get a good look at the true shape of the spine. If you would like to pursue Schroth therapy, an x-ray prior to the assessment is mandatory, as the physiotherapist will need to examine the x-ray images before you attend.  


  1. Negrini, S., Donzelli, S., Aulisa, A.G. et al. 2016 SOSORT guidelines: orthopaedic and rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis 13, 3 (2018).
  2. American Association of Neurological Surgeons (n.d.). Scoliosis.,occurring%20equally%20among%20both%20genders. 
  3. UK Scoliosis Clinic (n.d.). What is Scoliosis?.

Peak is a safe, welcoming, and inclusive place. Be yourself, we like it that way.