Management of Osteoarthritis

What is Osteoarthritis (OA)?

Osteoarthritis is the most common form of arthritis and occurs when the protective cartilage that provides cushion and support at the ends of bones gradually wears down. This is a degenerative disease that can worsen over time, often resulting in chronic pain affecting your day-to-day activities. Eventually if the cartilage wears down completely, the bones in the joint will rub directly on each other exacerbating the symptoms.

Common Symptoms of OA

1. Pain and Tenderness
2. Joint Stiffness
3. Muscle Weakness and Loss of Flexibility
4. Grating Sensation
5. Bone Spurs- not a symptom but a sign
6. Swelling

Most Common Risk Factors

1. Old Age
   • Articular surfaces on the end of bones can wear down over time due to the natural aging process that occurs to muscles, joints, and bones.
2. Obesity
   • Excess weight puts more stress on the joints (commonly occurs to weight bearing joints such as the hip and knee).
3. Repeated Stress on the Joint
   • Over time this will cause the articular surfaces to wear down.
4. Joint Injuries
   • A break or tear can lead to the development of OA over time.
5. Genetics and Certain Metabolic Diseases
   • People with a family history of OA are at a greater risk.

Treatment for OA

An effective approach is seeking physiotherapy treatment at earlier stages, accompanied with an exercise program specific to you. You may feel some discomfort during exercising, but this feeling is normal and should calm down. If it is unbearable then do not continue with the exercise. Of course with any exercise, there are always risks associated, therefore consult your doctor prior to beginning any new exercise program.

                Exercise has many benefits for ALL people including improved health, fitness, and mood. Many people believe that exercising with OA could harm your joints and cause more pain, but research shows that people can and should exercise when they have OA. It is considered the most effective, non-drug treatment for reducing pain and improving movement in those with OA.

Recommended Types of Exercise

So now we know that exercise can ease symptoms of arthritis, but what is best for you? Well that varies from person to person so here are a few main categories of exercises to include in your program:

1. Flexibility

                This category includes exercises that will help to improve or maintain the range of motion of the affected joint(s). By relieving stiffness in the joint and increasing the ability for the joint to move through its full range, you will decrease the risk of further damage, improve the function of the limb and joint, and decrease overall pain. There are two main categories of stretching to consider:

• Dynamic Stretching: these are movement-based stretches that involve multiple joints. They should be performed prior to activity to prepare the body.
• Static Stretching: these are stretches that take the muscle to its end range before holding that position for a minimum of 30 seconds. These stretches should be performed after activity when the muscle is already warmed up.

2. Strengthening

                These exercises work to build stronger muscles to help support and protect the joints. This allows for offloading of the affected joint which has the potential to relieve many symptoms. It is recommended to engage in strengthening exercises 2-3 days/week. Examples of strengthening exercises include lifting a limb against gravity, using free weights or elastic bands, or weight machines requiring you to push or pull against resistance.

3. Aerobic / Endurance

                These exercises help with overall fitness and improve your cardiovascular health. They typically involve the use of large muscle groups in the body in a repetitive and rhythmic manner. Canada’s guidelines for adults are to achieve 150 minutes of moderate- to vigorous-intensity aerobic physical activity per week. This intensity typically involves you to breathe a little harder and sweat but not be out of breath. Activities falling under this category include walking, biking, dancing, or even everyday activities such as mowing the lawn or shoveling as long as you are achieving a moderate- to vigorous-intensity.

4. Balance

                This is a fourth, less recognized category that is very important to consider in your exercise plan. These exercises will target smaller groups of muscles to decrease your risk of falling and can help improve your ability to do other exercises. Balance exercises include anything with a smaller or unstable base of support such as performing activities on a foam pad or single legged exercises.

Summary

                Arthritis doesn’t have to keep you from living your life and participating in your everyday activities. Exercise and arthritis should coexist! Research has shown that people with osteoarthritis who exercise regularly have less pain, more energy, improved sleep and a better day-to-day function. Work with your Physiotherapist to create an exercise program that is right for you and kick start your road to a healthier life!

Is Virtual Physiotherapy for you?

BodyTech Physiotherapy is offering virtual physiotherapy appointments with our most experienced therapists. All you need is a phone, tablet or computer. It is as simple as clicking a secure link to connect with us in a video chat.

What to expect?

Your first appointment with us will be an assessment. The Registered Physiotherapist will ask questions to complete a history and gain a complete understanding of your injury in order to provide a diagnosis.

You will be asked to do a series of movements to allow the therapist to examine your range of motion and strength, as well as be able observe how you move and perform certain tasks. You may be asked to demonstrate walking, stairs, sitting, standing or any movement pattern specific to your injury.

Treatment

Based on the findings from your assessment, the therapist will be able to cue and correct your movement patterns. You will also be given specific exercises to help in your recovery. Your therapist may give you some self-directed treatment techniques, or teach another person how to assist you with these techniques.

You will have a chance to ask questions and clarify your abilities and restrictions. Your therapist will educate you about your condition and provide suggestions on how to modify your activities if needed.

Still not sure if virtual physio is right for you? Schedule a free 10 min phone consult with one of our therapists.

Call 519-954-6000 or email: info@bodytechphysio.ca

Cupping Therapy

By Tim Penner, Registered Massage Therapist

Cupping therapy is a technique using cups applied to the skin to treat an array of illnesses. Used for centuries, its popularity continues to grow as people seek alternative and natural methods for treatment. Cupping stimulates healing by pulling blood to the region being treated. It promotes new blood flow to the area and removes stagnant blood which causes an anti-inflammatory effect by encouraging the body to release white blood cells, platelets, fibroblasts and other healing substances. Cupping is an effective technique to stretch fascia and muscles by helping to separate the different layers of tissue through the use of suction.

Cupping therapy uses cups, made of soft silicone and hard plastic, to suction soft tissue.  It is this vacuum effect, or negative pressure that provides a therapeutic result when applied to the skin. Many types of cupping therapy have been developed over the years. At BodyTech Physiotherapy our massage therapist uses 2 different types of cupping techniques: massage cupping and dry cupping. Massage cupping is usually done in a massage therapy treatment in which the cups are applied to the skin and moved around. Dry cupping is slightly different as the cups are applied to the skin and the affected body part is moved around to create a stretching effect.

Is cupping for me?                          

Massage or dry cupping can be used for many different conditions. The effects on the body include helping decrease stress, encourage relaxation and improve circulation. It can also be used to decrease swelling in certain areas and can help improve respiration when applied to the ribs and chest.  When it is used in conjuntion with massage and in specific areas, it helps reduce tension in muscles, and fascial tissue restrictions. The combination of massage and cupping leads to improved range of motion and posture. It can reduce tone in the muscles, help to improve flexibility and aid in reducing fascial adhesions left behind by old injuries. Cupping can help with many conditions such as low back pain, fibromyalgia, whiplash and tendonitis.

Some conditions that can be treated with cupping

• Tendonitis
• Fibromyalgia
• Frozen shoulder
• Low back pain
• Whiplash
• Tension headaches
• Carpal tunnel syndrome
• Plantar fasciitis
• Sprain/strain
• Golfer/tennis elbow
• IT band friction syndrome

               

Low back pain                                      Iliotibial Band Friction Syndrome

Along with the conditions listed above, cupping also can be beneficial to the people suffering from the effects of Parkinson’s and Multiple Sclerosis, as well as using it to aid in rehabilitation after a major injury or surgery.

The most common side effect of cupping therapy is the bruised appearance that you see after the treatment is completed. The discolouration of the skin is only on the surface of the skin and does not generally cause pain after the massage. The bruised appearance can last for a few days or even up to a week. If significant bruising occurs your therapist will promptly remove the cups and discuss the effects with you.

Overall, cupping therapy can be beneficial to almost everyone. Just like massage, every treatment is specific and individualized to each client and their needs.

The Sitting Solution

By Carla Cranbury, PT

Let’s face it, we sit a lot. Between working, commuting, and watching television, the Canada Health Measures Survey found that most Canadian adults spend 9 hours and 48 minutes of their waking time being sedentary. Most of us know that physical activity is good for us, but did you know that just sitting less (regardless of exercise) can also be beneficial in the long term?

A study published in 2009 followed more than 17 000 Canadians for 12 years. Over the twelve years they compared the participants’ daily sitting time and leisure time physical activity with mortality rates of various causes. What they found was that the amount of daily sitting time was positively associated with mortality rates from all causes, except cancer. Basically the more people sit, the higher the risk of mortality. This even includes people who are physically active, showing that high amounts of sitting time cannot be compensated for with exercise, even if it exceeds the current minimum physical activity recommendations.

Other studies have echoed similar findings. A seven year study reported that people who spend less than half their time sitting have a lower risk of mortality than those who spend more than half their day sitting. Another six year study reported that women who spend 16+ hours sitting per day have an elevated risk for cardiovascular disease compared with women who sit for less than 4 hours a day.

These studies are not to say that physical activity is not important – it still is, and it is still beneficial for your health. Physical activity also contributes to decreased time spent sitting.  What these studies are saying is the physiology associated with excessive sitting is different than the physiological benefits of exercise, and therefore excessive sitting cannot be compensated for with periods of exercise.

So now that you know, what can you do?

If you work at a desk most of the day, sitting can be hard to avoid. Some options are:

• Ask your work if they can accommodate an ergonomically sound standing desk
• Take frequent breaks from sitting to walk around
• Go for a walk on your lunch break
• Walk to your co-workers desk to talk to them instead of sending an email
• Park at the back of the parking lot to get a few extra steps
• Take the stairs!
• Take frequent standing breaks throughout the day
• Discover new ways to be active during your leisure time – ditch the TV and get outside

It’s the small changes to your daily routine that can add up and make a big difference. The best time to start is today!

References

Katzmarzyk, Peter T. et al. “Sitting Time And Mortality From All Causes, Cardiovascular Disease, And Cancer”. Medicine & Science in Sports & Exercise 41.5 (2009): 998-1005. Web.

“Directly Measured Physical Activity Of Adults, 2012 And 2013”. Statcan.gc.ca. N.p., 2017. Web.

Manson, J.E., P. Greenland, and A.Z. LaCroix. “Walking Compared With Vigorous Exercise For The Prevention Of Cardiovascular Events In Women”. ACC Current Journal Review 12.1 (2003): 29. Web.

Weller, Iris and Paul Corey. “The Impact Of Excluding Non-Leisure Energy Expenditure On The Relation Between Physical Activity And Mortality In Women”. Epidemiology 9.6 (1998): 632-635. Web.

Snow Shoveling Safety

If you are like us, you have probably spent a good chunk of time clearing off your car, driveway, and sidewalks these past few weeks. If you are not used to this kind of strenuous activity, you also might have felt tired and sore once you were finished. At BodyTech Physiotherapy we have already seen an influx of people with low back pain due to shoveling snow. As a result of this, we have compiled a list of safety tips to keep you moving injury-free until spring rolls around.

1. Consider hiring snow removal services if you have lower back issues or heart problems, including a previous heart attack, a known cardiac disease, high blood pressure, and/or high cholesterol.
   • Snow shoveling can be as strenuous on your body as lifting weights – a sudden increase in physical activity levels, especially without proper form, can predispose you to injury.
   • Studies have shown that exercise using your arms (like shoveling) significantly increases blood pressure levels compared to leg exercise (like walking), putting you at a higher risk of a heart attack.
2. Use the proper tools
   • Sturdy, non-slip winter boots and salting are essential to prevent slips and falls.
   • An ergonomic shovel can help reduce excessive amounts of forward bending, which could otherwise put a lot of strain on your lower back.
3. Use proper form
   • Stand with your legs hip width apart
   • Hold the shovel close to your body
   • Space your hands apart to increase leverage
   • Bend from your knees, not your back
   • Engage your core/tighten your stomach while lifting
   • Avoid twisting while lifting
   • Walk to dump your snow instead of throwing it
   • Pushing is easier than lifting
4. Warm up
   • Cold, stiff muscles are more prone to injury. Get your body warmed up and ready to go by marching on the spot, doing some small squats, and rotating your upper body from side to side.
5. Shovel early and often
   • Freshly fallen snow is lighter and fluffier than snow that has been sitting for a few hours, which makes moving it much less stressful on your body.
6. Slow and steady wins the race
   • Though it may be tempting to power through and get your shoveling done as fast as possible, work at a slow and steady rate while focusing on proper form to decrease your risk of injury.
   • If there is a large amount of snow, work in layers of 2-3 inches instead of trying to lift it all at once.
7. Take breaks and hydrate!
   • We recommend shoveling for 15 minutes followed by a 15 minute break
   • Remember to drink water or other non-alcoholic beverages during your break – shoveling is hard work!

Massage Therapy for Injury Prevention

When muscles become tight and sore, seeking out the help of a Registered Massage Therapist (RMT) is always a smart idea. But, why wait until things get bad before working with a RMT? Massage therapy is not only effective in relieving existing pain and discomfort, but it is also an important step in preventing symptoms from occurring in the first place.  Using massage therapy to help you address issues such as muscle imbalances, posture, repetitive strain injuries and stress can prevent future injuries and pain from affecting your daily life.

Massage therapy can be used to help maintain good posture by addressing shortened, tight or sore muscles. Good postural muscle balance is important because an imbalance in the muscles surrounding a joint can cause discomfort and thus lead to injury. Posture is affected by the way you hold your body when sitting, standing, or moving. Improper posture over time leads to changes in muscle length. Possible consequences of poor posture include neck, shoulder, and back pain, or headaches and jaw pain from increased stress on muscles, joints, tendons and ligaments. Muscles will become shortened and tight from being in a slouched position, and the muscles on the other side of the joints will become lengthened and weak from constantly being stretched. When this kind of muscular dysfunction occurs, joints and ligaments are not receiving the support they need from the surrounding muscles. Without this stability, the joints and ligaments become more vulnerable to injury. The resulting muscle imbalance limits range of motion, changing the way the body moves, which will affect work or sport performance. Regular massage therapy can be used to restore neutral posture and decrease muscle tension.

Repetitive strain injuries occur when the same motions are being repeated frequently. Common sites for repetitive strain injuries are in the wrists, elbows, shoulders, and low back. These types of injuries can be avoided by ensuring there is good muscle balance in the areas of the body that are being most frequently used. This will ensure the joints, ligaments, and tendons are being properly protected from injury.

Stress is one of the most common causes of tight and painful muscles seen by massage therapists. When your body is stressed, the natural reaction for your muscles is to tense up. This is the body’s defense mechanism against injury or pain. Stress can be physiological (ie. from chronic painful conditions), or emotional. Prolonged periods of stress and muscle tightness can cause abnormal muscle tension, as well as mental/emotional symptoms such as irregular sleep patterns, anxiety, and mood disorders. Receiving regular massage therapy has been proven to help relax muscles and restore normal muscle tension, as well as improve sleep quality, mood, and relieve anxiety.

Seeking preventative care from your Registered Massage Therapist is vital to maintaining normal range of motion, correcting posture, and reducing stress. Working with your massage therapist on a consistent basis throughout the year will ensure problem areas are identified before they become painful, and therefore prevent further injuries.

BodyTech Physiotherapy 519-954-6000

 

The Importance of Posture

Person A shows good posture, with a straight line going through the ear, tip of the shoulder, slightly behind the hip joint, slightly in front of the knee joint and slightly in front of the lateral malleolus (ankle) in the foot. The rest of the postures shown are incorrect, with different points of the body deviating either too far forward or too far behind the line that would indicate correct posture.

Posture is not typically on our minds until it starts to cause discomfort or injury. Today’s lifestyle regularly involves sitting or standing for prolonged periods of time, which is often sustained at the expense of proper posture. Posture refers to the position of our bodies, which is created by the different joint angles and the muscles that control those joints. Correct posture requires minimum muscular activity to maintain, which in turn minimizes stress placed on the joints. The opposite occurs with incorrect posture; muscles fatigue in attempt to maintain the altered position and joints are placed under increased stress.

There are a variety of factors that can cause or contribute to faulty posture. Correct posture may be difficult to maintain if joints are too stiff or too mobile, muscles are weak, too shortened or lengthened, or imbalanced. Over time incorrect posture will cause joint stiffness, thus causing the muscles to work harder and may result in pain. At this point, self-correction becomes difficult as it is harder to correct through joint stiffness. Joint stiffness will also result in some muscles becoming weak and others overused due to a change in the starting position of the stiff joint. Early identification of these contributing factors could prevent an injury from occurring, or from becoming a chronic problem that is more difficult to treat.

Possible consequences of poor posture include neck, shoulder, and back pain, or headaches and jaw pain from increased stress on muscles, joints, tendons and ligaments. Muscles will become shortened and tight from being in a slouched position, and the muscles on the other side of the joints will become lengthened and weak from constantly being stretched. The resulting muscle imbalance limits range of motion, changing the way the body moves, which will affect work or sport performance.

A detailed posture assessment by a physiotherapist can identify the contributing factors to poor posture, and is a smart idea for anyone wishing to be proactive and prevent future injury. Once these contributing factors are identified there a number of treatment options that will target the causes of the poor posture, prevent further injury, and help to decrease pain. A strengthening program will be designed to target weak muscles, and stretching will loosen tight muscles. This treatment combination works to correct these muscle imbalances, making correct posture easier to maintain while decreasing pain. Strengthening has the additional benefit of stabilizing loose joints, and joint mobilizations can correct stiff joints. Joint mobilization is a specific hands-on technique to improve joint movement, and can help to relieve pain and restore function. A combination of exercise, manual therapy and education will improve your course of recovery and assist with further injury prevention. Education about how to maintain correct posture in daily activities will allow you to remain pain free and prevent further injury.

Why is massage therapy a good idea for everyone?

Many people think of a spa like setting when they think of massage therapy, however, a Registered Massage Therapist can work in many different locations including a physiotherapy clinic.

Massage therapy can be useful in combination with physiotherapy or as a sole treatment option depending on the issue. Even when there are no specific problems, massage therapy is a great option for the prevention of injuries, particularly for those individuals with sedentary jobs.

Massage therapy in combination with physiotherapy is an excellent option for many people. Often an injury involves more than one type of tissue, such as muscle, joint, tendon and/or ligament, and would benefit from a variety of treatments. Massage therapy can help facilitate physiotherapy treatments by addressing other components such as shortened, tight or sore muscles. This allows the physiotherapist to focus on function and mobility, as well as stretching and strengthening exercises.

As an exclusive treatment option massage therapy can help with many conditions either chronic or acute to relax and alleviate sore muscles. In addition, massage can help prevent injuries. For individuals that spend their day at sedentary work stations these positions and postures can predispose you to many aches and pains. Massage therapy can help maintain good postural health and muscle balance.