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Tennis Elbow more common in those who do not play racquet sports…Downtown Winnipeg computer users get Laser or ShockWave therapy today!

Q: My doctor says my elbow pain is due to tennis elbow. But I don’t play tennis. Could you explain how this has come about and what I can do about it?

A: “Tennis elbow” is a common term for a condition doctors call lateral epicondylitis. It’s caused by inflammation of the tendon that connects the extensor muscles of the wrist to the outside of the elbow.

Probably fewer than 10 percent of people get this by playing tennis. The usual causes are recreational activities such as gardening, job-related lifting, using a screwdriver or wrist overuse.

The medial epicondyle can also get inflamed. In this condition, called medial epicondylitis, the affected tendons connect the flexor muscles of the wrist to the inside of the elbow. It’s commonly called “golfer’s elbow” or “pitchers elbow.” Tightening and twisting the wrist from activities such as golfing or throwing a baseball can cause it.

Most people with medial or lateral epicondylitis feel pain when their doctor applies direct pressure to the inflamed area. He or she might ask you to push your wrist against resistance, which could also cause pain. You might also feel pain with handshaking, lifting a briefcase or heavy pot or similar activities.

The treatment is similar for both conditions.

LLLT Low Level Laser Therapy is widely used for any inflammatory condition. Given the minimal depth to the affected bone-tendon area, there is little to impede the efficacy of laser treatment.

trigg-back

rSWT Radial ShockWave Therapy was developed little over 10 years ago by the Swiss company that treats kidney and gallstones. It is the latest treatment for those myofascial trigger points; those areas of chronic, nagging pain, whether it be from overuse or poor postural habits, we all have them.

rSWT neck

You could wear a wrist splint or forearm brace to prevent overuse of the muscles of the forearm.

You can also try a non-steroidal anti-inflammatory drug (NSAID such as ibuprofen or aspirin) and ice packs to help relieve symptoms. Your doctor may recommend physical therapy, especially if you need to return to a job or activity that caused the problem.

Sometimes doctors recommend one or two steroid shots over the affected epicondyle. But there is some risk of tissue loss around the elbow with repeated shots.

The symptoms of “tennis” or “golfer’s” elbow normally get better within a few months with conservative therapy. Once the symptoms disappear, you should begin gradual stretching and strengthening of the tendon and muscle attachments. We will develop an exercise program for you specific to your chosen activity or sport mechanics.

We will also look at your biomechanics. How you move, and perform your work is called ergonomics. Even the simplest changes can have great affects on chronic pain.

Call or email today, I can probably assess your elbow the next business day.

204-9438411 or yrphysio@gmail.com

 

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Redeem this iPhone Pass in Passbook or Google Wallet for next day physiotherapy service in Winnipeg

yourPhysio Pass

Walking via the indoor walkway, through Winnipeg Square, under the Portage & Main Concourse, into TD Centre (201 Portage), keep going through the Exchange District Parkade, up to ground level Albert Street…and you’ve stayed warm, indoors to my door!

Download this iPhone Pass to your Passbook app or to Google Wallet;

please bring it to your first, assessment appointment and

maintain it in your app for 2015;

we’ll make it yourPhysio ‘health spending account’… for next day service options, direct billing, guaranteed appointment times, lunch hour appointments and there is no waiting room.

you can even ‘air drop’ it to friends to share your experience and service at Concourse Physiotherapy, always much appreciated.

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Glucosamine, Chondroitin supplements for Joint Pain in Downtown Winnipeg

If you work in Downtown Winnipeg, you experience the ‘hardness’ of your daily commute. It is a ‘concrete jungle’, and the impact on your feet, knees, hips and back can be felt on a daily basis.

We all know someone who takes ‘vitamins’, or some kind of ‘supplement’ with the latest health benefit.

I get asked almost everyday about ‘glucosamine supplements’ for arthritis, joint pain, etc. Those ‘horse pills almost choked me’ exclaimed one patient, ‘how much do I need to take to even notice a difference in my knee pain?’, ‘where can I get those pills that supposedly help my joints?…are common questions in Downtown Winnipeg.

In a 2010 British Medical Journal, one of the most reputable of all scientific journals; an article published this conclusion:

“Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.”

So is it fair to conclude that it’s not worth taking glucosamine, and/or chondroitin supplements?

Maybe.

May I present the evidence to people to let them make an informed decision. I have seen patients describe dramatic reductions in pain after taking G&C. If the supplement helps your symptoms it may be worth continuing it, especially if stopping taking it causes an increase in pain. I’ve also seen many report no change and complain about the ongoing cost. 1 or 2 have reported occasional side effects, although these supplements are generally considered fairly safe to take.

Other studies have shown more promising results, with Bruyere et al. (2008) concluding G&C may reduce the need for total joint replacement. It’s worth noting however, that in terms of quality of evidence, a systematic review of multiple research papers is usually considered better evidence than an isolated study. A recent analysis by Lee et al 2010 did show that G&C may slow progression of osteoarthritis (as measured by X-ray change) although it required taking it daily over 2-3 years.

But Sawitzke et al. 2010 found “no clinically important difference in pain or function” when compared to placebo. The Cochrane Review (2009) – Glucosamine Therapy for Treating Osteoarthritis had somewhat mixed results but concluded it may reduce pain and improve function.

Prices of G&C vary a great deal. Most clients speak of Costco having ‘bulk’ prices, while Walmart still has the edge on discount pricing for ‘reasonable amounts’. But physicians I have questioned here in Winnipeg, some at our best sportsmedicine centres, still recommend greater than 1600 mgs per day, over greater than an initial 6 week period to judge the supps usage.

Personally, I have recommended our local Winnipeg stores, like Guerrilla Jacks and Sunrise Health; as there is still nothing like more opinions and education about your health.

So the question you need to ask yourself is, am I willing to spend that much on a treatment that might help or may make no difference to my pain or the progression of arthritis?

Words of caution: If you are planning to take supplements to treat arthritis or other conditions discuss this with your GP or Pharmacist.

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Core training not just for your abs, improve your sitting posture, prevent back pain by Physiotherapy Winnipeg

We’ve all heard physios, chiros, docs and fitness experts claim that core training is important for overall fitness and health. Health clubs offer core training exercise groups and physiotherapists recommend it for those recovering from spinal injury. Your core is the collection of muscles that stabilize the spine, this includes the hips, pelvis, abdominals, lower back, mid-back, and neck regions of the body. These muscles are extremely important in all sports, so why do so many ‘office athletes’ that basically sit for a living overlook core training?

The reason most people skimp on this vital part of their workout is because the benefits are simply overlooked.

Benefits of core training:

It’s important to note that performing a few crunches is not proper core training. As a matter of fact, I recommend that these be avoided for much of a lower back stabilization program. We simply just do not need any more ‘flexion’ in our daily routine; you sit most of your day!

Since your core involves many different muscles groups, a variety of exercises are needed to ensure you work them all; some exercises to explore include, but are not limited to, lunges, bridges, planks, and crunches. Every patient learns how to properly stretch their hip flexors, the ‘culprit’ muscle that usually guards when the ligaments are sprained in the lower back.

Pilates and Yoga classes are also excellent for strengthening your core muscles while also improving balance and posture. Check out Pilates Manitoba as they are offering 50% off their introductory classes for first-time participants.
When your core is strong, your whole body works better. Core training isn’t just for athletes, it’s for anyone who would like to have their body working at its greatest potential. For anyone just starting an exercise program, be sure to talk to yourPhysio first.

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Winnipeg, have you heard? Sitting is bad for you…solutions by Physiotherapy Winnipeg, yourPhysio.com

Winnipeg, by now you know you probably know that sitting down all day is terrible for you. As computer hardware and software accelerate the ‘web 3.0’, we can do more than ever before from a sitting position. Ergonomics is no longer a foreign word, and our ‘core’ exercises need to be performed everyday!

Who needs scientists to tell you that sitting for even one hour causes the production of fat-burning enzymes to decline a whopping 90%, or that more than four hours of desk time each day raises your risk of a heart attack by more than 100%?

You can feel exactly how crappy sitting all day makes you feel at the end of each workday; though you may be shocked to learn that being a regular gym-goer doesn’t protect you from the harmful effects of all that sitting. Standing up more is scientifically proven to have huge health benefits, but in our digital world it’s not as simple as it sounds. Here’s how to make the switch to an upright workday.

Try the latest DIY option, I have had so many patients describe their attempts at raising their work surface by box, crate, home-made devices, etc. I’m sure you could find the latest ‘how-to-video’ on YouTube to get an idea as to how to produce something for your workstation. Ergonomic clients of yourPhysio.com have purchased electronic and hydraulic ‘sit-stand’ workstations to allow their employees the postural variety that may be necessary for back pain, hip strains or knee sprains. These rehabs require movement throughout the day, and consistent changes in posture is a great place to start.

Invest in an ‘anti-fatigue’ mat, change your shoes every 6-8 months or try an over-the-counter orthotic to replace those worn insoles. You may require a doctor’s note to have orthotics covered by your insurance plan, but it is an employment benefit; so benefit!

Tweak your ergonomics, hire an ergonomic consultant for an hour and learn the proper way, not only how to sit, but how to perform your job so that it will not cause pain. Ask questions about posture, exercise and equipment available to make any task easier and less painful.

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your Ergonomics, line of sight and that nagging neck-shoulder-upper back pain, by Physiotherapy Winnipeg

Whether it be at work, rest or play; a candy bar cannot make that pain go away…but your ergonomics at the workstation, at home or doing any activity can make a significant difference to your health.

We can often find those simple modifications, those easy answers to perform a task easier, and safer. The problem is that many of us do not take the time to change our habits, make changes and implement them consistently at our busiest work areas…the kitchen, in this case. The ‘pant hangar’ keeps the recipe near eye level, there is no awkward posture to maintain and the cabinet can even be accessed quite easily, well done!

 

This concept always applies to those that must ‘sit for a living’, the ‘desk jockeys’ of the finance, legal, grain and media industries here in Downtown Winnipeg. Like a ‘whiplash’, those muscle aches can proliferate throughout the upper back and neck.

 

Such that, you must remember to adjust your computer monitor height; use some yellow pages or photocopy paper bundles. Some recent ergonomic assessments have resulted in 8-10 inches of monitor height changes to accommodate the individual’s line of sight. Your eye level should be equal to that of the curser start position, in the most frequently used software program. This position allows the eye to adjust to a variability of 2-3 inches of text/toolbar and decreases or eliminates the chronic forward head posture.

Let your human resource department or health & safety manager know that I am available for any size group education, assessments and ergonomic design.

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Sitting a ‘disease in Winnipeg? Just a necessary evil of our computer driven ergonomics Downtown

Really…too many media driven articles on sitting as a disease”…since 1991, it’s been a necessary evil of our increasingly computer driven ergonomics at work, rest and play; the desktop, the laptop, the smartphone, the tablet, next?

But then why are exercise plans so quick to add the situp? or bench press? or knee extension? All of these place our biomechanics, our posture into greater flexion! Beware, add more extension exercises now! add those planks!

Give yourself more reasons to stand…even every 12 minutes is ideal. If you cannot figure it out, give me a call…your ergonomics may be your disease…and you are not retiring anytime soon.