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Prevention is key.

In a recent CBC article titled, “Wait times for hip and knee replacement grow in Canada”, Dr. Gollish (orthopedic surgeon at Sunnybrook Health Sciences Centre) states the increased demand for these replacements comes from the demographic shift in the Canadian population, to patients over 65 years of age. The article states that “Across the country, 76 per cent of patients received a hip replacement in 2017 within the recommended six-month wait time, down from 81 per cent in 2015. For knee replacements, 69 per cent of patients had the procedure within the benchmark in 2017, compared to 82 per cent in 2015.”

Photo from “Wait times for hip and knee replacement grow in Canada” CBC News.

Wait times for hip and knee replacement are an issue in the Canadian Health System, and likely wait times will continue to lengthen unless the federal government invests some money into increasing the number of surgeries preformed. Or… what if we took a preventative stand point? What if physiotherapists worked with patients to maintain joint integrity, stability, and muscle strength, to perhaps allowing joints to maintain their integrity for longer, and a decreased need for a replacement. What if a preventive strategy could lessen the wait times for a reactive surgery? I am not saying physiotherapy can replace a joint replacement, as there are many circumstances where the only option for decreased pain, increased mobility, and function is a replacement. But why can’t physiotherapy be used to bridge the gap, have less people waiting in pain, and take some of the pressure of our health care system?

OHIP physiotherapy services were drastically cut in 2012, meaning the majority of physiotherapy services are obtained in the private sector. Educating patients about how physiotherapy can prevent degeneration, and promote functionality, could lead to more healthy patients, and a reduced load on the public system.

Stay tuned for our next blog, where we will discuss how exactly physiotherapy can help prevent joint degeneration, prepare you for a joint replacement, and help with rehabilitating patients post surgery.

To read the full article on CBC, click here.

-Charlotte Anderson
Physiotherapist, ALPHA Health Services

 

Meet Olivia Skrastins, Registered Physiotherapist.

Olivia graduated from the University of Toronto with her Masters in Physical Therapy in 2017. Olivia is passionate about orthopaedic manual therapy and is committed to continuing her education in this area. She has completed a basic sports taping course, a soft tissue release course and has received her Level 1 Manual Therapy certification from the Orthopaedic Division of the Canadian Physiotherapy Association. She is interested in sports rehabilitation and enjoys working with a diverse population. Olivia is excited to have the opportunity to help patients reach their goals and maintain an active and healthy lifestyle.

Why did you become a physiotherapist?

I have always enjoyed fitness, interacting with others and being creative. Physiotherapy allows me to incorporate all those interests and use them to help others achieve their goals. As physiotherapists, we have the opportunity to help people with their mobility, which is necessary for every day life!

What did you learn about physiotherapy as you were going through school that you didn’t know before?

I learned that physiotherapy is both an art and a science. Treatment can be approached in many creative ways but there is an underlying anatomical and physiological basis for everything we do. I also learned that you never stop learning! What conditions do you like to treat?

I like to treat a variety of musculoskeletal conditions. However, I do particularly enjoy treating patellar femoral pain, which is often influenced by muscle imbalances and by our alignment during every day activities and exercise.

What is your ‘rehab philosophy’?

My rehab philosophy is quality first! I think it’s important to focus on quality of movement and education, which can lead to injury prevention.

To book with Olivia, click here.

Low Back Pain – Rest, Drugs or Surgery are Not Always the Answer!

If you have been browsing the news headlines or scrolling through your facebook feed in the last day like I have been, you may have noticed several articles criticizing current treatment for low back pain. Major news outlets, such as Global news (click here to see the article) and NBC news (click here to see the article), highlighted results of a recently published study in the Lancet Medical Journal. This paper outlines how our current strategy of bed rest, prescription medications, scans or surgery are not helpful in treating low back pain and associated disability for majority of people.

So, what is something that can help?
Movement! Exercise! Being Active!

“The best cure for most people? Exercise. Regular movement is the best way to help with the vast majority of cases of low back pain, according to Doug Gross, a co-author of the study and a professor of physical therapy at the University of Alberta.” …. “Exercise-wise, what’s most important is finding a program that you can stick to, said Gross.” (Global News Article)

“Studies show what works best to treat lower back pain: physical therapy, psychological counseling, stretching, massage and other non-invasive treatments. Rest rarely helps: all patients should be urged to stay active.” (NBC news Article)

It is exciting to see more attention and research being given to the importance of movement and regular exercise. This is something I really believe to be true, as do all of us at ALPHA Health Services. A physiotherapist can help you with prescribing the RIGHT movement and exercise to help you decrease and prevent lower back pain.

By Jennifer Harvey
Registered Physiotherapist 

 

 

MIGRAINES- MANUAL LYMPHATIC DRAINAGE CAN HELP!

If you have ever suffered the pain of a headache and especially a migraine, you know that it can be completely debilitating. Migraines can affect cognitive function, cause vision impairments, and reduce your overall ability conduct your regular daily activities. Many people seek treatment from their doctors and end up seeing specialists to try and get control over the pain they are frequently experiencing.

As a last ditch effort to avoid taking more medication, many people are seeking alternative forms of therapy to help combat their headaches & migraines. Even those people who have found the right form of medication to help with the pain, they seek therapies that can help to reduce the overall frequency and duration of each headache/migraine.

Did you know that Lymphatic Drainage can help?

Manual Lymph Drainage (MLD) performed by a certified MLD therapist, is a very light rhythmic massage technique that promotes the movement of lymphatic fluid through the body to its proper areas of drainage.   This type of massage is very different from the regular deep tissue Swedish massage. The light, sequential, repetitive movements provide an analgesic effect and has shown to significantly reduce pain. Massage can have the same effect but Manual Lymph Drainage can go that one step further to reduce pain. Individuals who have migraines, there is some research that suggests there is a hyperexcitability of the sympathetic nervous system (your flight or flight response) due to dysfunctioning neurotransmitters which can cause pain. MLD helps to suppress the sympathetic nervous system, ultimately reducing the pain signals being sent.

What should you expect for your treatment?

Most patients find this type of treatment very relaxing and quite often, patients will fall asleep. During the treatment, your therapist would treat any or all of the following areas: neck, head, face, ears and the roof of your mouth (the hard & soft palate). Many patients report feeling their head feels lighter post treatment. Rebound migraines can happen however, patients report that post treatment, migraines are less intense and/or are not as frequent.

Your therapist will discuss treatment plans with you based on the servierty and symptoms but it’s usually recommended to come 1-2 times per week for an hour for the first 2-4 weeks. It’s always good to keep a diary of your migraines to keep track of the intensity and frequency. This is a great way to easily monitor the effectiveness of the treatment.

If you have any questions about Manual Lymph Drainage, feel free to contact Karen Kingsley, RMT & CDT Therapist kkingsley@alphahealthservices.ca. 

 

By Karen Kingsley, Registered Massage Therapist and CDT Therapist

 

References:

https://link.springer.com/article/10.1007/s10072-016-2645-3

https://www.ncbi.nlm.nih.gov/pubmed/2672665

www.migraineclinic.ca

 

Is a physiotherapist a mobility specialist?

In a recent study, which examined the market profile of physiotherapists in Canada, the term mobility specialist was used to describe the role of a physiotherapist within a complex Canadian health care system. It was an interesting term to use, and one that has yet to be expanded on within our health system. However, it did get me thinking as to how a physiotherapist is trained, the effect a physiotherapist can have on mobility, and how to bridge the gap in knowledge, and educate Canadians as to what a “mobility specialist” really is.

The role of a physiotherapist involves working in health, mobility, and rehabilitation. Physiotherapists are trained to understand soft tissue dysfunction, to rehabilitate patients with physical or neurological injury/disease, and to keep the Canadian population moving. However, the rehabilitation and mobility market in Canada is a complex system, with patients interacting with regulated and unregulated health professionals to be physically active or mobile in order to complete activities of daily living, participate in exercise or sport, improve quality of life, or achieve functional independence. The concept of rehabilitation and mobility is vast because of the many suppliers of goods and services that sit in multiple market spaces, straddling the line of publicly funded health providers, private sector business, regulated and unregulated health professionals, and the many areas of practice of those offering physical and virtual goods and services. So, let’s be clear on what a physiotherapist does, and how seeing a physiotherapist as a mobility specialist can drastically change your health, function, and quality of life.

To become a physiotherapist, you must obtain a Masters in Science degree in Physical Therapy. Registered Physiotherapists are required to hold a practicing license in order to practice in Canada. A physiotherapist is able to and is trained to assess, manage, diagnoses, and treat injury/disease/chronic pain/anatomical abnormality/illness that effects a patients mobility. Mobility includes, but is not limited to- walking, running, driving, eating, movement, dancing, cooking, personal hygiene and parenting. Lack of mobility or pain with mobility affects ones activities of daily living, quality of life, and independence. A physiotherapist uses their education in anatomy, physiology, exercise training principles, neurological anatomy, and psychology to assess, diagnosis, treat and manage any and all conditions which may effect ones mobility. A physiotherapist can help patients get back to what they need, want, and love to do, by addressing the body symptoms, muscle impairments, joint issues, and optimizing functional movements. A physiotherapist is highly trained in anatomy and soft tissue, and is equipped to be the provider to get YOU moving again after any physical ailment.

So, if you are injured, experiencing decreased mobility or pain with movement, if you have a disability, or chronic pain, if you have muscle imbalance, poor joint alignment, are you want to prevent degeneration of your joints and muscles… a physiotherapist can help you!

 

-Charlotte Anderson, Registered Physiotherapist, PhD Candidate

Urge incontinence is a sudden and strong urge to urinate resulting in varying degrees of involuntary loss of urine. Also called “overactive bladder” or OAB, this condition can happen anytime, anywhere, and to anyone. The unpredictability of OAB leads to feelings of anxiousness, embarrassment, and negatively impacts one’s quality of life. The fear of being unable to stop oneself from emptying their bladder when out in public can result in isolation and avoidance of social situations. Sometimes it feels like you are at war with your own body! Pelvic floor physiotherapy can help. With a diagnosis of OAB, there are many physical and behavioural impairments that contribute to this condition. They can be addressed and resolved.

Your bladder is a muscle. It has a complex neural communication system between the brain and the pelvic floor muscles that surround it. There is both an involuntary (reflexive) and voluntary communication system that tells the bladder when to relax, expand, and store more urine or when to contract and empty. With OAB, these signals are not coordinated properly and may be upregulated, or overactive. Once the message starts, the cascade of messages are amplified and augmented through behavioural responses such as anxiety or stress associated with rushing/finding a toilet. The bladder receives all of these messages to “SQUEEZE!!!” and the pelvic floor musculature does not have the strength, coordination, or proper messaging to inhibit the bladder’s contractions.  There is a disconnect between the brain (which controls the muscles), and the muscles (which produce the action). Both have to be addressed to adequately solve an OAB.

Treatment for urge incontinence includes the completion of a bladder and bowel diary (over the course of 2-3 days). This journal provides important information and identifies patterns regarding dietary habits, hydration, activities and behaviours that may be triggering or contributing to this condition. Bladder and bowel diaries may be completed multiple times throughout the course of treatment as it is able to track improvement and progression over time. With this information, we talk about behavioural changes that can be implemented regarding dietary adjustments. Many foods are known to irritate the sensitive bladder lining and can contribute to bladder overactivity. Persistent constipation takes up space within the pelvis and the distended rectum pushes on the bladder. When the bladder has less space to expand, this can throw the neural signals to the bladder out of whack as well. If constipation is identified, we will discuss ways to resolve this through diet, toileting postures and optimal strategies for emptying. If appropriate, you may be expected to adhere to toileting every day at the same time to establish a routine and pattern for the bladder. Behavioural training is an imperative aspect of recovery and includes education on effective urge delay strategies that will help inhibit or downregulate the overactive system of signals that feed into the strong bladder contractions.

Not only is there a behavioural component to treating urge incontinence, pelvic floor physiotherapy identifies what muscles and soft tissue (internal and external) may be contributing to OAB symptoms. It is quite common for those with urge incontinence to have abnormal tension and tightness within the abdominals, adductors, and even hip flexor muscles (to name just a few).

The pelvic floor muscles communicate intimately with the bladder. Therefore, we can tap into optimizing this communication system by identifying issues with pelvic floor strength, flexibility, and coordination. By addressing muscle imbalance, tone, and incorrect activation, you are addressing the factors contributing to an OAB.

Treatment then focuses on increasing the flexibility/mobility of the external and internal musculature through hands on manual therapy as well as providing a guided home exercise program for maintaining the flexibility gains made during treatment.

Bladder training and treatment for urge incontinence involves a lot of commitment and persistence. With continued guidance and support from a pelvic health physiotherapist, client’s are able to regain control of their bladder again and feel much more confident in social environments.

If you find you are frequently worried and anxious about finding the closest bathroom, or you leak urine when you are on the way to the toilet, stop letting your bladder control you and book an appointment with Leeanna Maher, Registered Pelvic Health Physiotherapist today!

 

Leeanna Maher
Registered Pelvic Floor Physiotherapist

New Year, New Babies, New Milestones
Physiotherapy for Babies and Infants

 

 

 

Parenthood is amazing but it comes with much stress and many challenges. When it comes to motor development, parents often look to their other children, nieces, nephews and friends’ kids for comparison. Sometimes this is a recipe for disaster as it can often breed unnecessary anxiety and stress. Here is a guideline as to when most kids achieve certain milestones:

0-6 months:

  • Moving hands to mouth and kicking both feet while on their back
  • Lifting head and chest up while on their belly
  • Rolling from back to tummy and tummy to back
  • Sitting with assistance
  • Crawling on belly in a circle

6-12 months:

  • Sitting independently
  • Crawling forwards and backwards
  • Standing with assistance
  • Pulling to stand on furniture
  • Standing independently
  • Walking along furniture

12-24 months:

  • Walking independently
  • Going up and down stairs with support
  • Running

Unless your child has an underlying medical condition, most infant and toddlers will reach their age-appropriate motor milestones by the age of 2. So the idea that ‘the sooner, the better’ is not necessarily true. It is important that infants practice every motor skill as it is important for their current function and prepares them for future movements. For instance, I often hear something along the lines of: “My child walked when she/he was 10 months!! She/he never had to crawl”. Yes, it is great that they can walk but it is also important for children to crawl. Crawling helps infants build the necessary strength for transitioning from one position to another. So when it comes to your baby’s motor development, have patience and play, play, and play again. If you need some extra guidance, visit a physiotherapist.

 

Winta Desta
Registered Physiotherapist, Paediatric Physiotherapist
To book with Winta, click here

February is coming… the shortest month of the year but it always feels the longest. It’s cold, dark and it feels like you haven’t seen the warm sun in years.   All you feel like doing is hibernating in your house with a fuzzy blanket and Netflix. It’s the “February Blues” and we want winter to be over!

Ok, so there’s no question that February is my least favourite month (Sorry Dad, I know it’s your birthday month). How can we make it through this miserable time of year? Focus on self care! What is self care? Well, it’s taking time out of our crazy schedules to focus on things that reduce your stress, improve your wellbeing or quite simply, make you happy.

Here are some simple suggestions to help get you started with your self-care practice

  1. Meditation

This can be something you do at the beginning or end of your day. It doesn’t have to take long but this can be a great way to bring some mindfulness into your daily life. Meditation can reduce stress, increase happiness and can increase concentration and self awareness. Have a look online. There are a ton of apps out there that can help guide you in your meditation practice.

 

  1. Get outside

Spending time outside in nature has shown to decrease stress. I know, it’s cold out there but there are lots of fun winter activities that you can be apart of. You don’t have to go too far to experience nature.   Toronto has a great outdoor trail system where you can actually see some wildlife (I’ve seen both deer and fox on the Lower Don Trail). You forget that you’re actually in the city. Skiing, skating, snowshoeing, and dog sledding are all fun activities that can get you outside and get that body moving during the cold month of February.

 

  1. Go for a massage

Take an hour out of your day and get a massage. I know, I’m an RMT and a bit biased on this, but having a massage is a great way to let go of the stress and tension in our bodies. I don’t know how many people have said while on my table “Wow I didn’t realize how tight I was.” Massage can help to reduce anxiety, improve sleep, reduce pain, and improve immunity.

Remember, Self-care doesn’t have to take up a lot of your time. By just adding some little things that make you smile or allow you to let go of the stresses in your daily life, can provide you with a more balanced lifestyle.

 

Karen Kingsley


Registered Massage Therapist
To learn more about Karen, click here

What is a physiotherapist?

In a recent study, which examined the market profile of physiotherapists in Canada, the term mobility specialist was used to describe the role of a physiotherapist within a complex Canadian health care system. It was an interesting term to use, and one that has yet to be expanded on and further defined within our health system. However, it did get me thinking as to how a physiotherapist is trained, the effect a physiotherapist can have on mobility, how to bridge the gap in knowledge, and educate Canadians as to what a “mobility specialist” really is. If “physiotherapist” and “mobility specialist” are synonymous… we better show a connection!

The role of a physiotherapist involves working in health, mobility, and rehabilitation. Physiotherapists are trained to understand soft tissue dysfunction, to rehabilitate patients with physical or neurological injury/disease, and to keep the Canadian population moving. However, the rehabilitation and mobility market in Canada is a complex system, with patients interacting with regulated and unregulated health professionals to be physically active or mobile in order to complete activities of daily living, participate in exercise or sport, improve quality of life, or achieve functional independence. The concept of rehabilitation and mobility is vast because of the many suppliers of goods and services that sit in multiple market spaces, straddling the line of publicly funded health providers, private sector business, regulated and unregulated health professionals, and the many areas of practice of those offering physical and virtual goods and services. So, let’s be clear on what a physiotherapist does, and how seeing a physiotherapist as a mobility specialist can drastically change your health, function, and quality of life.

To become a physiotherapist, you must obtain a MSc degree in Physical Therapy. To become registered and be in good standing with the College of Physiotherapists, practitioners must obtain a license to practice. A physiotherapist is able to and is trained to assess, manage, diagnoses, and treat injury/disease/chronic pain/anatomical abnormality/illness that effects a patients mobility. Mobility includes, but is not limited to- walking, running, driving, eating, movement, dancing, cooking, personal hygiene and parenting. Lack of mobility or pain with mobility affects ones activities of daily living, quality of life, and independence. A physiotherapist uses their education in anatomy, physiology, exercise training principles, neurological anatomy, and psychology to assess, diagnosis, treat and manage any and all conditions which may effect ones mobility. A physiotherapist can help patients get back to what they need, want, and love to do, by addressing the body symptoms, muscle impairments, joint issues, and optimizing functional movements.

A physiotherapist can get you back on your feet!

And perhaps we have to start thinking of physiotherapy = mobility= functionality… and therefore take the term mobility specialist one step further to…  specialists in returning to function.

-Charlotte Anderson
Registered Physiotherapist

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