Tag Archives: rehabilitation

Why is your core so important?

By Courtney White, Registered Physiotherapist

Have you ever wondered what makes up your core, why is it important, or how to safely train your core without getting back pain? Keep on reading to find out these answers and more!

Your core is more than just the muscles that you can see. There is a group of muscles below the big six pack muscles that wrap around you like a corset. Their job is to support you during every movement. This inner unit is like a TRANSFER STATION. To get power generated from your legs all the way to your shoulders, it must pass through the inner core. So, if you do not have proper control over your core, that power will not move between your upper and lower body as smoothly as you want it to.

What Makes Up the Inner Core Unit?

The inner core consists of the following: the diaphragm, the pelvic floor, transversus abdominus (TA), and multifidus. Collectively, these 4 structures create a CORE CANISTER.IMG_5235-01Pic for Core

Diaphragm: The diaphragm is our primary breathing muscle and it forms the top of the core canister. The diaphragm is the component that has the primary control over the intraabdominal pressure within the canister. It moves up and down as you breathe which changes the space in the abdomen and as a result, influences the pressure within the core canister.

Pelvic Floor: The pelvic floor is a group of muscles that form the bottom of the canister. It supports the weight of all the internal organs within our abdomen, assists with bowel and bladder control, and helps to control the intrabdominal pressure along with the diaphragm. The pelvic floor is partners with the diaphragm. When the diaphragm moves up and down, so should the pelvic floor.

Transversus Abdominis (TA): This muscle connects the top and bottom of the canister as well as creates the front and sides of the core canister. It runs deeper than the external six pack muscles that you can see. Its role is to support your lower back during movement and transmit forces between your upper and lower body.

Multifidus: This muscle forms the back of the core canister and runs along the spine. Multifidus serves as a primary support for the spine, pelvis, and hips.

[1]Canister

What Are the Functions of the Core Canister? 

  1. To support the back, pelvis, hips, and trunk during movement
  2. To serve as a transfer station for power and energy between the upper and lower body
  3. To assist with bowel and bladder control
  4. To improve performance during physical activity

How Does the Core Canister Work?

To gain a stronger core overall, it is important to learn how to “pressurize” the core canister. Previously, inner core training has focused largely on tensing the walls of the core canister through focused contractions of TA. Learning how to activate the diaphragm and pelvic floor was often missed or brushed over. More recent evidence now suggests that breath is the driving force behind influencing the intrabdominal pressure. Therefore, the diaphragm is the leader behind pressurizing the core.

When you breathe in, your diaphragm contracts and pushes down into the abdominal cavity which increases the intraabdominal pressure. In response to this increased pressure, the pelvic floor relaxes and lengthens to accommodate the abdominal organs translating downward. During your inhale, the pressure in the front part of the core canister is increased as your belly expands. This is counteracted by multifidus in the back as well as TA which work together to try and keep the intraabdominal pressure evenly distributed. When you breathe out, the diaphragm relaxes and rises which decreases the pressure within the core cannister. As a result, the pelvic floor should normally contract and rise.

[2]GifCore blog

How Do We Train the Core Canister? 

Many people focus on crunches, planks, and other large abdominal exercises when training the core but negate breathing. Learning to connect your breath with movements is the key to developing a stronger core. It will allow you to control the intrabdominal pressure within the core canister. Exercises like planks and crunches are not necessarily bad exercises as they can be very effective later if you first learn to optimize the control of your core canister.

The first step is to learn how to engage your diaphragm through diaphragmatic umbrella breathing. Once you have achieved this, it is time to add in the pelvic floor so that you learn how to engage your diaphragm and pelvic floor together as a unit, referred to as piston breathing. You can also learn how to connect and activate TA and multifidus to further optimize your control over the core canister. However, it is important to highlight that the goal here is to learn how to change the size of your core canister by recruiting all these muscles together, rather than focusing solely on how to contract each specific muscle. Once you have learned how to control the pressure within the core canister, it is now time to perform bigger movements that require you to maintain control over the canister while doing a larger activity.

Check out our post on our Facebook and Instagram pages (dated May 21, 2020) for exercises you can try at home to increase your control of the core canister!

What Can Happen If You Do Not Have Control Over Your Core? 

It is not uncommon to have a weak inner core or lack control over your core canister. This can originate from prolonged sitting and slouching which distorts and changes the shape of the core canister (see part B in Figure 3 below). This positioning leads to breathing through the accessory muscles in your neck and chest, decreasing the engagement of your diaphragm. As you can see in the figure below, this puts a lot of strain on the lumbar spine which can lead to pain and injury. Ideally, your core canister should look something like part A in the figure below where the intraabdominal pressure is equally distributed. Without proper control over your inner core, it makes it very difficult for you to be able to hold your body in a good position during exercise and physical activity. This increases your risk for injury.

[3]DNS-Scissor

Now that you have learned more about what the core is and why it is important, if you have any questions or are interested in setting up an appointment with one of our Physiotherapists, contact us today! We will be happy to help you achieve your goals by developing an individualized treatment plan. 

BodyTech Physiotherapy

Text References

Diane Lee & Associates: core training vs. strengthening (internet). South Surrey: D G Lee Physical Therapist Corp; (cited 2020 May 22). Available from: https://dianeleephysio.com/education/core-training-vs-strengthening/

Key J. ‘The core’: understanding it, and retraining its dysfunction. Journal of bodywork and movement therapies. 2013 Oct 1;17(4):541-59.

Pronatal Fitness: the first move to teach your clients (internet). 2018 July 18. (cited 2020 May 22). Available from: https://pronatalfitness.com/2018/07/18/360-breathing/

Image References 

[1] The role of the diaphragm. Digital Image. Chiroup.com. Nov 2016. [Accessed on 2020 May 22]. Available from: https://chiroup.com/the-role-of-the-diaphragm/. 

[2] Breathing variations. Digital Image. S. McLaughlin. Aug 2019. [Accessed on 2020 May 22]. Available from: https://www.alignforhealth.com/self-care-for-pain/category/core%20stabilization 

[3] The “pop can” core. Digital Image. J Smeaton. Apr 2019. [Accessed 2020 May 22]. Available from: https://www.depthtraining.ca/the-pop-can-core/.

Is Virtual Physiotherapy for you?

knee painBodyTech 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

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Vestibular Rehabilitation

By Jackie Render, PT

Balance.jpg

Vestibular Rehab is used to treat dizziness, vertigo, as well as feelings of being off-balance and unstable, blurred vision, or generally feeling “off.” A vestibular assessment at BodyTech Physiotherapy involves a detailed history, a central nervous system screen (examination of reflexes, cranial nerves, cerebellar tests), vestibular function testing, and balance testing.

What is the vestibular system?

The vestibular system is a sensory organ that lies inside your skull and connects your brain with your inner ear on each side. The vestibular system contains organs that sense gravity as well as organs that sense acceleration (turning, bending, spinning etc.). The brain uses the information from both vestibular organs to determine how the head is moving in space, for postural responses, to stabilize vision, and for balance. It shares close connections with your hearing organs and some conditions may also affect your hearing in addition to the vestibular system.

What are the symptoms of a vestibular problem?

Dizziness from the vestibular system often presents as vertigo – the illusion of movement. A person with vertigo will often feel as if the room is spinning or they are spinning within the room. Other people may describe dizziness or the room shifting or tilting. You do not need to feel dizzy to have a vestibular problem. Many people with vestibular problems will feel off-balance and unstable, or report blurred vision or generally feeling “off.”

What causes dizziness?

dizziness.jpgDizziness can come from many areas. It can be caused by medications, blood pressure changes, the brain, the neck, or from the vestibular system. Approximately 20-30% of the population experiences dizziness in their lifetime, and vestibular disorders account for a large proportion of dizziness. 

Why does it happen?

People experience vertigo due to a change in nerve signals from one or both of the vestibular organs. This change in nerve signals results in a mismatch of signals from one ear compared with the other and change can be a result of many factors.

Some common causes of Vestibular problems are:

  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Vestibular Neuritis or Labyrinthitis
  • Unilateral or Bilateral Vestibular Hypofunction
  • Meniere’s Disease
  • Vestibular Migraine

Vestibular problems can also be caused by structural changes to the inner ear such as structural defects, autoimmune conditions, blast injuries, as well as aging. Concussions may result in vestibular disorders either through injury to the vestibular system itself, or to the connections it has inside the brain.

It is estimated that over 35% of adults in the United States have a vestibular dysfunction that requires medical attention.

What is vestibular rehabilitation? How can it help?

Vestibular rehabilitation is a proven combination of progressive movements or exercises aimed to address the person’s areas of dysfunction. This is achieved by retraining the brain to maximize recovery or central nervous system compensation. Vestibular treatment is highly individualized and will vary depending on the condition, the presentation, and the individual’s goals.

Exercises for vestibular rehab fall into the following categories or themes:

  1. Gaze stability – working on the ability to keep your eyes focused with head movements
  2. Habituation – exercises to help make aggravating movements more tolerable
  3. Balance – either sitting, standing or while walking depending on the individual’s abilities, to help maximize postural responses
  4. Maneuvers for BPPV – a series of specific movements to help relocate crystals that may become loose in the inner ear; home exercises may also be required to settle symptoms

As the individual progresses these exercises are often combined together to increase the challenge. A combination of eye, head and body movements, mental activity, or functional tasks may also be added to help make the vestibular responses more automatic.

Why should I have treatment?

Dizziness and imbalance can have a significant influence on quality of life. They can make you feel anxious and isolated. You may feel fearful of falling or of movement bringing on symptoms. Individuals with vestibular dysfunction are often reluctant to turn their head when they are standing or moving. Those with BPPV may be fearful of looking up or lying down because of fear of symptoms. Over time this can lead to neck and upper body pain. If you feel your dizziness or imbalance makes you more cautious with movement, or interferes with your daily life you should consider a vestibular assessment. A vestibular therapist can provide you with information about your condition and appropriate treatment options to help restore your quality of life.

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Injury Prevention and Physiotherapy

By Cassandra Kroner, PT

best-chicago-group-step-class.jpgIt is a common misconception that you only need to see a physiotherapist if you have an injury or pain. Physiotherapists have a wide range of skills, and recognizing the risk for future injury is one of them. Injury prevention is applicable to all individuals, regardless of their activity level, from the office worker to the athlete, and especially for those with previous injuries that could reoccur.

Repetitive Strain Factors

  • Occupation
  • Training errors
  • Age
  • Excessive or repetitive loads
  • Inappropriate footwear
  • Structural abnormalities
  • Muscle control
  • Core stability
  • Joint alignment
  • Muscle strength and flexibility imbalances
  • Previous injury
  • Posture

In general there are two types of injuries – traumatic and repetitive strain. Traumatic injuries are easier to understand, as they are the result of a singular event that causes damage. On the other hand, repetitive strain injuries occur when stressors that normally do not cause harm are repeated to the point of causing micro trauma that builds over time until the tissue becomes inflamed and injured. These injuries tend to begin subtly, and gradually increase in severity. Combined with the multi-factorial list of possible contributing factors, repetitive strain injuries can be challenging to diagnose and treat. However, in most cases repetitive strain injuries can be avoided with a good injury prevention and maintenance program.

A Common Factor: Muscle Imbalance

When an individual is involved in one specific sport or has a repetitive aspect to their job, the muscles are put under a great deal of strain to repeatedly perform the same movements. Sedentary jobs involving prolonged postures can have similar effects with certain muscles constantly working for long periods. Over time, muscle imbalances develop as the muscles that are being used the most continue to get strong while the reciprocating muscles become lengthened and weak. These muscle imbalances can cause movement restrictions that affect performance and increase stress on the body. Increased stress on muscles, joints and ligaments eventually leads to a repetitive strain injury.

15250-a-young-woman-stretching-outdoors-before-exercising-pv-630x390.jpgThe First Steps Toward Injury Prevention

Getting started on the road to injury prevention is as simple as booking an appointment with a physiotherapist. If you are unsure how injury prevention could apply to you or if you could be at risk for injury, speaking with a physiotherapist can help clarify your needs and goals. The same expert assessment skills physiotherapists use to diagnose injury will be used to proactively assess for risk factors that could lead to future injury. Your lifestyle, the demands of your job, and the specific sports or activities you participate in will be considered, along with the assessment findings, to develop an individualized treatment plan. This plan could involve manual therapy to correct joint restrictions or muscle length imbalance, strength and flexibility exercises, correction of movement patterns, and education.

By addressing several predisposing factors to injury, the body is optimally prepared to handle the demands of the workplace or sport. This can translate to decreased frequency and severity of future injuries, with the added benefit of a shortened recovery time in the event an injury does occur. Don’t wait for an injury to strike to take charge of your health!

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CanineTech Laser Therapy for Dogs

Laser_TreatmentLaser Phototherapy, Low Level Laser Therapy or cold laser is phototherapy involving the application of monochromatic and coherent light to injuries and lesions to stimulate the healing process. It is used to increase the speed, quality and tensile strength of tissue repair, decrease inflammation and decrease pain. Laser can treat many common disorders, acute or chronic, or can be used for acupuncture point stimulation. It can be used to treat muscle, tendon, ligament, connective tissue, bone and skin tissue.

Laser can be used in rehabilitation for large and small animals, and for both performance and companion animals. It is used for treatment of animal athletes due to the shorter recovery and thus decreased time away from sport. It can even be used on competition days for performance animals.

Laser is effective in treating: sprains and strains, wounds and abrasions, haematomas, ligament and tendon injuries, bowed tendon, acute and chronic inflammation, joint injuries, myofascial trigger points, pain points, deep-tissue and superficial acupuncture points, acute and chronic pain, non-union and small-bone fractures, mucous membranes, and post-surgical wounds.

Low Level Lasers are handheld devices that are about the size of a flashlight. The laser is placed directly over the injured area for 20-180 seconds. Depending on the size of the injured area, the laser may have to be applied 2-6 times in one treatment to cover the injured area. During the treatment time, the non-thermal photons of light emitted from the laser pass through the layers of the skin penetrating to depths of 3-4cm depending on the wavelength used. Low Level Lasers have a photochemical effect similar to photosynthesis in plants. The light is absorbed by the cells and interacts with light sensitive areas, which increases intracellular metabolism and converts usable energy into normalizing damaged or injured tissue, reducing pain, inflammation and swelling, and decreasing healing time. The laser increases blood flow to the area increasing oxygenation and bringing cells to aid in the healing process. The increased blood flow also helps clear inflammatory cells, fluids and debris from the area.

The frequency of treatment is based on the type and stage of the injury or the condition being treated and how often the animal can attend treatment. Usually during the acute phase of healing the treatment is more often, but during the chronic and rehabilitation phases the treatment frequency is decreased.

There are only a couple of considerations of safety with laser treatment. Lasers are potentially harmful to the eye, but it is highly unlikely especially with the use of safety glasses. Also, there is a potential for discomfort or a minor burn at the site of treatment when used on dark-skinned or dark-haired animals. This is avoided with a change in the duty cycle of the probe to 50% reducing the average power of the light beam and minimizing the risk of minor burns or discomfort.

Laser is safe and non-invasive, offering quick relief from inflammation and pain, as well increase healing for both acute and chronic injuries for your competitive or companion animals.

Canine Rehabilitation at CanineTech Rehab

IMG_1834Has your dog had an accident or trauma that is limiting movement or causing pain? Has your dog had recent surgery? Could the function or performance of your dog be improved? Does your dog perform in competitive activities requiring strength and endurance? Have you noticed your dog is sore when you pet or brush him/her? Has your dog developed weakness? Is your dog getting older and has age related changes? If you have answered yes to any of these questions, then your dog would benefit from canine rehabilitation.

CanineTech Rehab is a division of BodyTech Physiotherapy. It is a referring practice for veterinary clinics providing physical rehabilitation services for canines offered to you by an animal rehab trained, registered physiotherapist. Dogs suffer from similar injuries as their owners and thus are being offered expert treatment for conditions causing pain and dysfunction.

What is Canine Rehabilition? It is physiotherapy assessment and treatment techniques applied to the canine patient. Physiotherapy helps to restore, maintain and maximize strength, function, movement and overall well-being through examination, evaluation, diagnosis and physical intervention.

Our animal rehab trained physiotherapist has over 10 years of experience as a human physiotherapist.  She has undergone extensive, advanced level post-graduate training to enhance her physiotherapy education, assessment and treatment skills. She has completed the introduction and advanced courses for canine rehabilitation and is working towards her Diploma in Canine Rehabilitation.

Canine rehabilitation has been growing in popularity and recognition with a variety of individuals providing these services to the public. The Animal Rehab Dvision (ARD) of the Canadian Physiotherapy Association (CPA) has been advocating for registered physiotherapists to be the professionals of choice to provide animal rehabilitation. Physiotherapists are specifically trained in hands on techniques such as mobilizations that can help to reduce pain and improve mobility.  They have in-depth knowledge of how the joints and muscles work, thus being able to prescribe the appropriate exercises and treatment plan.

What is manual therapy? It is physiotherapy in which a physiotherapist uses their hands to mobilize (specific technique to improve movement) the joints to reduce stiffness, relieve pain, increase movement and restore function. These techniques also include treating the soft tissue to improve length and strength, as well as a specific exercise program developed for your dog’s individual needs. Manual therapy is important post-surgical, post-fracture, post-immobilization or for arthritic joints, allowing the dog to regain pre-injury mobility and function.

At CanineTech Rehab our approach to canine rehab follows the same principles we apply to human physiotherapy at BodyTech Physiotherapy.  The assessment of your dog will focus on identifying the underlying cause and contributing factors to their injury or condition. This approach will enable us to treat your dog in the most effective way. Appropriate exercises, manual therapy and modalities will be combined to improve the course of your dog’s recovery. Ongoing communication and cooperation with you and your veterinarian will ensure the best care possible.

Our mission at CanineTech Rehab is to improve the quality of rehabilitative care for our human companions, our dogs. We provide high quality, advanced manual therapy care for your dog using the knowledge and skills of a certified Canine Rehab therapist.

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