Tag Archives: neck pain

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!

BodyTech Physiotherapy

Physiotherapy for Temporomandibular Joint Disorder

Temporomandibular joint disorders (TMD) is a broad term that encompasses various disorders of the temporomandibular joint (TMJ). If you experience jaw pain with chewing, jaw clicking/popping, facial pain, or frequent headaches, you might have a TMD. Physiotherapists can diagnose and treat TMD.

Temporomandibular Joint (TMJ) Anatomy and Function

The TMJ is composed of two articulating bones: the temporal bone (part of the skull) and the condyle of the mandible (jaw bone). There is an articular disc located between the two bones. The disc is firm but flexible, and its purpose is to reduce friction and cushion the repetitive force between the two bones during chewing, talking, and any other joint movement.

During jaw opening, the condyle of the mandible and the articular disc normally slide forward in unison. The muscles surrounding the joint are responsible for moving the mandible and the disc in sync. If the condyle and the disc are out of sync with each other, this is called disc displacement and is characterized by pain and clicking sounds when opening the mouth.

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Symptoms

Symptoms of TMD can include the following:

  • Jaw pain when opening the mouth wide or chewing
  • Locking of the jaw
  • Limited range of motion, or unable to fully open the mouth
  • Painful clicking or popping when opening or closing the mouth
  • Tooth wear and tear from grinding or clenching the jaw
  • Facial pain
  • Headaches
  • Ringing in the ears

Causes of TMD

Often, there is no single cause of TMD. There is usually a combination of factors which predispose a person to TMD.

Poor posture of the neck, head, and shoulders contributes to muscular tension and strain. Poor posture may cause muscle imbalance and changes in muscle length in the neck and shoulders. These muscles pull on the jaw and can alter the resting position of the mandible in the joint, resulting in increased stress on the TMJ and disc. After prolonged time, the joints in the neck and back may become stiff and cause associated symptoms such as neck pain, limited range of motion, and headaches.

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In addition, jaw clenching or teeth grinding may contribute to the development of TMD. When the jaw is clenched, the muscles are under increased tension and may pull the disc out of position. It normally happens while the person is asleep, so they are unaware they are doing it. Clenching or grinding can also result from being under stress (e.g., at home or at work) for a prolonged period of time.

Finally, trauma or injury to the TMJ (such as a broken jaw) may predispose a person to TMD.

Treatment for TMD

Physiotherapists assess and treat TMD using non-surgical and drug-free techniques. The physiotherapists at BodyTech Physiotherapy will evaluate your condition to determine the underlying factors contributing to your pain. They will prescribe an individualized exercise and stretching program based on your unique needs. Our physiotherapists are also trained to correct biomechanical changes of the TMJ and neck using manual therapy.

Other options for treatment include:

  • Relaxation procedures
  • Acupuncture
  • Dietary modification to relieve jaw pain during chewing
  • Dental orthotics or mouthguards worn at night. These help to prevent teeth grinding and jaw clenching
  • Pain relief and anti-inflammatory medications
  • Medications to relax the muscles of the jaw
  • Surgery, in rare cases

Temporomandibular joint disorder is a complex and multifaceted condition. With all the factors that can contribute to TMD it is important to visit a physiotherapist for a detailed assessment to ensure treatment is individualized to your specific issues.  If you experience jaw pain and headaches, consider seeking help from a physiotherapist.

BodyTech PhysiotherapyBodyTech Physiotherapy 519-954-6000

The Importance of Posture

Posture types

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.