Physiotherapy Archives - Peak Health & Performance

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.  

References:

  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). https://doi.org/10.1186/s13013-017-0145-8
  2. American Association of Neurological Surgeons (n.d.). Scoliosis. https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Scoliosis#:~:text=Scoliosis%20affects%202%2D3%20percent,occurring%20equally%20among%20both%20genders. 
  3. UK Scoliosis Clinic (n.d.). What is Scoliosis?. https://scoliosisclinic.co.uk/what-is-scoliosis/

How Often Should You Have Physiotherapy?

How Often Should You Have Physiotherapy

By: Blair Milne, Physiotherapist

How Often Should You Have Physiotherapy

 

When you’re a patient in physiotherapy, the sessions are generally set up to be once-a-week appointments for a certain amount of time. During those appointments, your physiotherapist will dig into whatever issues you’re dealing with that day, whether it’s pain in your knee or weakness in your hip. And then you go home again and have another appointment the following week.

Once you leave your initial period of physiotherapy though, things get trickier. How often should you have physiotherapy from this point onward? Is there an ideal frequency?

To answer this question (and many others like it) we reached out to some experts on the topic: physiotherapists! Here’s what they had to say about how often you should have therapy after finishing your initial sessions:

How often should you have physiotherapy?

This will actually depend on two things: the injury or ailment you’re working on and your physiotherapist’s recommendations. Why the injury? Well, different injuries require different amounts of therapy. A bad sprain, for example, will more likely require longer appointments than a torn rotator cuff.

Why the physiotherapist’s recommendation? Let’s say you have a torn rotator cuff. Your therapist will likely prescribe intensive, longer-term care. However, if you’re back to normal activities after a few weeks, then a few times a month might be sufficient.  Once you’ve had an initial assessment, your physical therapist will recommend a treatment plan that matches your physical activity and health condition.

After an injury or episode of pain.

If you’ve just had a spell of pain or an injury that caused you to see a physiotherapist, the best course of action is to continue to have physiotherapy services. This is the perfect time to get some long-term care. You want to keep the therapy going to make sure any lingering issues are treated and that you’re strengthening and stabilizing your injured areas. Most likely, your physiotherapist will want you to come in as often as you can so that you can make the most of the sessions. (If you’re in some sort of work-related pain, though, you’ll want to check with your employer to see if you can take the time to go to therapy. It’s up to your company to decide how much time off is fair.)

To prevent re-injury and strengthen your body.

If you’re just trying to maintain your current health, you probably won’t have to go to therapy as often. You might just want to go once every couple of months to make sure all systems are go. If you recently had surgery or you’ve been recovering from a knee injury or crunched-up shoulder, though, you’ll want to keep up your physiotherapy. Injury prevention is the goal here. Your body is weak and unstable after an injury, and you’ll want to go and have your physiotherapist help it get back to normal strength. You can also have your physiotherapist put you on a “preventative” maintenance plan so that you can go less often but still keep the risk of injury low.

To address chronic pain and muscle weakness.

If you have chronic pain or weakness in your muscles, you’ll want to go to physiotherapy as often as you can. The therapy sessions can help prevent the pain from becoming worse, and the physiotherapist can help you do exercises in your day-to-day life that might help alleviate pain. You’ll also probably want to see a pain management doctor so that you can get some medications that can help manage your pain. And, if you have weakness in your muscles, you’ll want to go to physiotherapy as often as they recommend you go. Your physiotherapist can help you strengthen your muscles by prescribing exercises you can do at home, and they can teach you how to move your body in a way that helps put your muscles in the right place.

Bottom line: It’s up to you!

Really, the frequency of your visits is up to you and your experienced physiotherapist. You can go as often or as infrequently as you want (within reason). You don’t want to go so often that it feels like a chore, but you also don’t want to go too infrequently and fall behind on your treatment. It’s entirely up to you and your physiotherapist to figure out how often you should be going.  Call Peak Health & Performance and get started on your physio treatment plan today.

Do I Need a Physio or Chiropractor For Sciatica?

Do I need a physio or chiropractor for Sciatica

By: Dr. Claire Wells, Chiropractor

Do I need a physio or chiropractor for Sciatica

 

A sharp pain begins in your lower back, shoots down one of your legs and makes it impossible to walk normally.

If this has happened to you or someone you know, it’s likely that you have sciatica—the medical term for a condition in which nerve roots in the spine are compressed. A typical case of sciatica will last for about two to six weeks if left untreated. Getting the right treatment early can speed up the recovery time by helping you avoid secondary complications such as muscle spasms and atrophy, weakness, and numbness. These professionals are trained to diagnose and treat problems with a patient’s nervous system, including the sciatic nerve and lumbar spine. Each profession has its own set of skills, but they both work to get you on the road to recovery fast. Here’s what you need to know before choosing between physiotherapy or chiropractic care:

What is the difference between a physiotherapist and a chiropractor?

Physiotherapists and chiropractors have similar backgrounds and training, so they both know how to deal with chronic pain disorders. They will both use physical examinations to diagnose disorders and pain signals.  Their education, though, varies depending on the country they are in. In the United States, both professions require a minimum of a master’s degree. In Europe, only chiropractors need a master’s degree, while physiotherapists require a doctorate. If you see a chiropractor for sciatica, you can rest assured that he or she has the necessary training to treat it—as well as other neuromusculoskeletal disorders such as spinal stenosis, hip pain or joint pain.

Physiotherapists are trained to treat a wide range of conditions, including those related to the nervous system. They can help you recover from sciatica, but they may also work with you to prevent it. Chiropractors, on the other hand, are trained to treat the causes of a sciatica-like pain, but not the symptoms. A chiropractor might prescribe chiropractic treatment such as exercises to strengthen your core and lower back muscles, or recommend that you exercise in a pool (to avoid overusing your leg muscles).

How do physiotherapists treat sciatica?

Physiotherapists can help you recover from sciatica pain by administering treatments to help relieve the symptoms you are experiencing. Depending on your specific pain, they might use ice packs to reduce swelling, heat packs to relax your muscles, or electrotherapy to reduce the pain in your nerves. They can also teach you how to exercise your core and lower back muscles, which can help you prevent a recurrence of sciatica. Physiotherapists can also work with you to modify your daily activities if you are experiencing a lot of discomfort when you are on your feet. Physiotherapists can also work with you to improve your posture and make sure that your workstation is ergonomically friendly. Improving your posture can help prevent a recurrence of sciatica by taking pressure off your lower back and core muscles. If you already have sciatica, good posture can reduce the pain.

How do chiropractors treat sciatica?

Chiropractors will examine your spine and lower limbs to find the cause of your sciatica. Once they’ve identified the source of your pain, they’ll use spinal manipulation to adjust the problematic joint to remove the pressure on your nerve roots and provide pain relief. Your chiropractor might also recommend a set of exercises to strengthen your core and lower back muscles, to prevent future episodes of sciatica. Depending on the severity of your symptoms, your chiropractor might prescribe an anti-inflammatory medication or muscle relaxants as part of your pain treatment.

Should you see a physiotherapist or chiropractor for sciatica?

Physiotherapists and chiropractors have many things in common, but they also have some key differences. Both use manual therapy as their approach to treatment, but depending on your specific needs and circumstances, you might benefit more from seeing one profession over the other.

For example, if your sciatica is mild and you are looking for ways to relieve the pain and improve range of motion, you should see a physiotherapist. If you have a moderate case of sciatica and want to speed up your recovery, you might want to see a physiotherapist first and then see a chiropractor.

Which profession should you see first?

If you are suffering from a mild case of sciatica, visit a physiotherapist first. He or she will help you to identify the cause of your pain, which will help you avoid it in the future. You can then visit a chiropractor for treatment, if necessary. If you have a more serious case of sciatica, it’s best to visit a doctor first. Your doctor can administer a diagnostic test, prescribe medication (if necessary), and recommend exercises that you can do at home. Once your pain has subsided, you can visit a physiotherapist or chiropractor for advice on how to prevent a recurrence of sciatica in the future. Depending on the severity of your symptoms, you might want to visit both professions.

Bottom line

Physiotherapists and chiropractors are both trained professionals who can help you recover from sciatica. Depending on the severity of your symptoms, you might want to see one or both professions for treatment. Peak Health and Performance has caring, professional physiotherapists that can relieve your sciatica symptoms.  Give us a call today to learn how we can best help you!

9 Conditions That Physiotherapy Can Treat

What conditions can physiotherapy treat

By: Blair Milne, Physiotherapist

What conditions can physiotherapy treat

You might think of physiotherapy as something reserved for people with broken bones or other serious injuries, but it’s so much more than that. From sprained ankles to frozen shoulders—there are many common conditions that a physiotherapist can help you recover from that will improve your quality of life.

A physiotherapist is a muscular specialist who helps treat people with different types of injuries or conditions on a daily basis. Their role is to assist patients in relieving pain and regaining strength and mobility after an injury or surgery, while also identifying risk factors for future injuries and helping to prevent them from happening again.

This article outlines 9 common conditions that can be treated by physiotherapy:

1. Sprained Ankles

Sprains are overuse injuries that can happen to anyone, at any time. They occur when the soft tissue that connects your bones to your muscles (ligaments) is overstretched, which leads to a tear. This can cause swelling and severe pain, which can make walking or running very difficult—if not impossible. Depending on the severity of the sprain, you can usually recover in a few days to a few weeks.

A physiotherapist can help to speed up your recovery by providing you with targeted exercises or stretches for your specific injury. Exercises are a great way to help strengthen your joint and surrounding muscles, making it easier to lift and push your foot off the ground when you walk. Sprained ankles can also be treated with a variety of different taping techniques that can help support your joint and keep it in proper alignment.

2. Frozen Shoulder

A frozen shoulder is also known as adhesive capsulitis. It causes your shoulder joint to stiffen, which leads to pain and limited range of motion. Frozen shoulder is more common in individuals over 40 and women who have had children.

A physiotherapist can help you manage your symptoms and regain range of motion by stretching out your tight muscles and providing you with exercises to help improve your strength and joint mobility. They may also use heat therapy, cold therapy, or ultrasound to help speed up the healing process. A physiotherapist can also assist you with a shoulder massage technique called joint mobilization, which helps increase the range of motion in your shoulder, while also reducing pain and stiffness. If your shoulder is frozen, it’s important to see a physiotherapist as soon as possible.

3. Scoliosis

Scoliosis is a curvature of the spine that causes a side-to-side imbalance in your spine. It is a common childhood condition, but can also develop later in life.

A physiotherapist can help you manage your symptoms and improve your posture with a special exercise called a “posture correction exercise”. This exercise can help reduce your scoliosis symptoms, improve your posture, and help you feel more comfortable while sitting and standing. If you have scoliosis, it’s important to see a physiotherapist to determine if you need to wear a back brace. A physiotherapist can assist you in choosing the right type of back brace for your condition. They can also help you fit and wear your back brace properly.

4. Knee Pain

Knee pain is a common complaint that often comes from overusing your joints, which can happen if you are a runner or someone who does a lot of heavy lifting. This can cause your knee joint to be overworked and lead to inflammation of the knee.

A physiotherapist can help you manage the pain and reduce inflammation with ice, heat, and other treatments. They can also help you with a number of different exercises, such as squats and lunges, to help strengthen and stretch your knee joint. If you have knee pain, a physiotherapist can help you determine if you have a torn meniscus or a knee ligament tear, which requires a different treatment plan. They can also test your knee joint mobility using a variety of different tests, such as the leg length test, to determine if you have knee joint restrictions.

5. Exercise Intolerance

Exercise intolerance is a condition that has to do with your heart and lungs. It makes it difficult for your body to get enough oxygen, which can cause you to get out of breath very easily. If you have exercise intolerance, you might find that you get out of breath quickly when climbing stairs or walking up a hill. This can make even the most basic daily activity difficult.

A physiotherapist can help you manage your symptoms and improve your overall fitness by prescribing a physical therapy and fitness program. They can also help you learn how to use an inhaler properly, if you have asthma. A physiotherapist can also help you make sure you are safe when exercising. They can assist you with a fitness assessment to determine which exercises are best for you, or find ways to modify exercises if you are at risk for injury. They can also help you find a safe way to exercise at home, if you have a physical impairment.

6. Chronic Back or Neck Pain

Back and neck pain are common conditions that can be caused by a number of different things, such as poor posture, heavy lifting, or an injury.  Some back and neck pain resolves by itself after a few days or a week, but persistent back or neck pain may make daily living difficult.  Some pain can only be relieved with the help of a physiotherapist.

A physiotherapist can help ease your chronic pain by creating a personalized exercise program designed for your specific condition. They can also help you improve your posture by identifying and correcting any bad habits or muscle imbalances in your upper or lower back. This can help reduce your chronic pain and put you on a path to reclaiming a pain-free life. If you have chronic pain, a physiotherapist can determine your pain levels and assist you with a specific exercise program to help you manage the pain. They can also help you identify any potential injury or cause of your pain, and help you avoid re-injuring yourself. If your pain is chronic, it is important to see a physiotherapist as soon as possible, as waiting too long can make it harder to recover.

7. Sciatica

Sciatica is a painful malady that’s caused when the sciatic nerve is irritated. This vital nerve runs from your lower back, through your hips and down to your legs. It can be caused by a number of different things, such as a herniated disc, degenerative disc disease (DDD), or a spinal stenosis.

A physiotherapist can help you manage your pain and improve your mobility with a combination of targeted stretches and exercises. They can also assist you with heat therapy, cold therapy, and joint mobilizations. If you have sciatica, a physiotherapist can help you determine if you have a herniated disc or DDD, which affects your sciatic nerve, versus a spinal stenosis, which does not. If you have sciatica, it is important to see a physiotherapist as soon as possible, as waiting too long can prolong your recovery period.

8. Carpal Tunnel Syndrome

Carpal Tunnel Syndrome is a common wrist problem that occurs when your carpal tunnel swells, which causes pressure on the nerves in your wrist. This can lead to pain, tingling, and numbness in your hands and wrists.

A physiotherapist can help you manage your pain, improve your strength, and create a safe exercise program, as many people with carpal tunnel syndrome have trouble exercising. They can also help you with a number of different exercises designed specifically to reduce your pain, regain strength, and improve mobility in your wrists and hands. If you have carpal tunnel syndrome, a physiotherapist can help you determine if you need surgery to relieve pressure on your nerves. They can also help you recover from surgery and avoid re-injuring your wrists when you’re done healing.

9. Rotator Cuff Injury

A rotator cuff injury is when one of your shoulder muscles is injured.

A physiotherapist can help you recover from rotator cuff injuries, such as tears, by teaching you how to properly use your shoulder. They can also help you with a number of different exercises designed to improve your strength, range of motion, and help you avoid re-injuring your shoulder. If you have a rotator cuff injury, a physiotherapist can also help you determine if you need surgery to repair the injury, or assist you with managing your pain with other treatments. If you have a rotator cuff injury, it is important to see a physiotherapist as soon as possible, as waiting too long can make it harder to recover.

Wrap Up

Peak Health and Performance is a physiotherapy practice that has successfully treated these conditions and others in the Calgary community for years.  Our caring, professional staff can guide you with an initial assessment that will diagnose the source of your problem and offer a personalized treatment plan designed to help you recover soon.  Call Peak Health & Performance today to learn more about how physiotherapy can help you.

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