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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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Seasonal Back Pain during Golf? Physiotherapy Winnipeg yourPhysio.com

Again? that seasonal back pain is back…and consecutive golf games are impossible, not to mention your regular league match at any of the golf courses in Winnipeg. One likely culprit; your hip flexors! Yeah, those muscles that lift your knee towards your chest are connected to your back, specifically your lower lumbar spine and pelvis.

During the downswing, the obliques and hip flexors are highly activated, creating a crunch-like position as your hips extend and your pelvis tilts (your belt buckle stays level, pointing forwards) while your chest remains over the ball.

The hip flexors are an important part of your core, working to maintain posture, generate power, stabilize the body, and to decelerate the lower body for efficient energy transfer coming into impact.

Maintaining the quality and function of your hip flexors is very important for maintaining posture through the downswing and impact, especially with the longer clubs, where the greater length of the club’s shaft increases the forces that must be absorbed by the body.

Your hip flexors attach from your spine to your legs.  When they are weak, they are not able to withstand the high forces of the longer clubs and are unable to hold your spine angle.  This results in early extension (loss of spine angle) as the hip flexors lengthen under high loads, resulting in a loss of spinal posture before impact.

 

The Foam Roller Hip Flexor Exercise is a great self-massage exercise that will give your hip flexor muscles (in the front of your hips) a deep and effective sports massage, thus improving the health and quality of your muscle tissue and helping you to perform better.  It will also alleviate soreness and make your muscles feel better.

The foam roller is available at most yoga studios or medical supply stores in Winnipeg; you may even get it covered by insurance! The movement over the roller overloads the muscle tissues through compression, causing your nerves to relax, signalling muscle spasms to shut off, pumping blood and and getting your lymphatic system flowing, to help muscle recovery and regeneration.  You’ll work out those knots (muscle adhesions) in your muscles caused either by inactivity, by the repetitive strain of the golf swing, or by walking a tough golf course.  This will enable you to stretch the muscles back out to their original length, making them more pliable and functional.

Be careful! if the back pain is acute, do not attempt this exercise without first talking to yourPhysio; exercises can be modified and tailored to your injury, and reduce your pain.

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Canada’s Growing Demand for Ergonomics in Kitchens…for Aging in Winnipeg Place, for the disabled and the post Surgical

As the first Boomers move into their later 60’s, their growing demand for services, for activity and for health has spurred the demand for ergonomics in kitchen design.

Aging in place is a term used to describe a person living in the residence of their choice, for as long as they are able, as they age. This includes being able to have any services (or other support) they might need over time as their needs change.

To be clear: the act of aging in place takes place during a period of time in an elderly person’s life where they can have the things that they need in their daily life, while maintaining their quality of life.

The reason this distinction is important is because many people think aging in place will fix the problems they have in their lives. The only problems that can be fixed while aging in place are the ones that a person has planned for (i.e. finances, health, personal or health care, etc.).

The kitchen has always been a place for family and socializing. Making changes for aging in place in the kitchen space can greatly increase its usability and the safety of those that live there. With home modification, people will no longer have to spend less time in the kitchen as they age.

In a growing trend observed by the brand Smeg, European consumers are opting for compact appliances to give their kitchens a homogenous look and more efficient arrangement of appliances. Will this trend make it to Canada? to the USA?

One of the most popular trends in kitchen design is the demand for ergonomics with more and more consumers choosing a linear look for the placement of their appliances. Smeg, a leading Italian home appliance manufacturer, has observed this trend with a significant growth in the sales of its compact appliance range.

Smeg is the only brand to offer its appliances in two design styles – the classic stainless steel look and the linear look in stainless steel with glass. Both design styles are made in standard sizes and have matching aesthetics to ensure the kitchen gets a clean and homogenous look.

All standard compact appliances are 600mm wide and 450mm high and designed to be easily installed in a bank at midway level (chest or eye level) or under the bench. Smeg’s current range includes convection ovens with microwave, combination/steam convection ovens, dedicated steam ovens, microwave ovens with grill function and built-in coffee machines.

Appliances play a major role in a person’s ability to use and work in the kitchen safely and efficiently. Appliances that do not incorporate universal design, or that are placed improperly, can inhibit this. Select appliances that display information clearly, have convenient functions and are easy to use. Many appliance makers are incorporating universal design principles in their designs, which allow consumers to get a variety of more functional appliances. You should also consider investing in energy saving appliances, which will help you save money. Currently, the most popular placement of any appliance or storage cabinet is at the midway level since it ensures easy and safe access to a range of appliances without the need to bend or stoop.

As in lifting or reaching mechanics, the placement of load or where you interact with that load is of key importance.

Beware of your biomechanics. Know your Ergonomics.

Know yourPhysio Winnipeg!

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Consider your back, shoulders, hips when buying your next mattress Winnipeg…some tips from yourPhysio

Many people complain of back pain soon after they get out of the bed. Whether it be a combination of tight muscles, stiff joints or general aches, this is a common complaint at any age in Winnipeg.
Although, many fail to sense the link between the back pain and the bedding that they use, research has shown the influence the bedding can have on causing as well as relieving the stress from a persons back. When we go in search for bedding, we can see lot of varieties which are made in many different ways. Adding to this variety is our personal preference. The mattress should also match the framework of the bed. With all these considerations, the value we give to our health is probably low down in the list or not in the list at all.
The link between the bedding and back pain is associated with the malalignment of our body structures away from its natural alignment. When the spine is kept straight, which is the optimal shape to minimize stress towards the lower back, we can see that the ear, shoulder tip and the hip joint are in a straight line. Even when a person sleeps, this would be the optimal positioning for better stress distribution. In overly soft mattresses as well as in old mattresses, we can see certain body parts sinking more into the mattress than other parts of the body. This will upset the alignment and would either direct more stress towards the back or would not facilitate already stressed back muscles as well as the spine. Therefore, in order to avoid such back pains linked to your bedding, you can do the following:
1. If appropriate, the old rule was to place a piece of plywood to make the mattress more firm
2. Do shopping and choose a mattress which is soft as well as firm; many of the new ‘pillow-tops does this for you
3. Can sleep on the floor or on a firm surface with a soft covering to relieve pressure to the bony points.
4. Make use of a water or air filled mattress which could sooth the existing pain as well as relieve the stress in the whole body.
5. Do gentle exercises or stretching before getting out of the bed. Contact yourPhysio for appropriate exercise plans
6. Do not place extra pillows under your head, some may used behind the back, between or under your legs.
7. Position your bed at a adequate level to ease the work related to getting out of the bed.
When considering the link between bedding and the back pain, simple measures would go a long way in relieving this chronic problem. Therefore, the money that you spend for a perfect mattress would definitely be worthwhile when considering the suffering, the loss of productivity as well as the time you spend on your bed.

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Post-Operation? Surgery? into Rehab yet Winnipeg? need yourPhysio asap…

Joints just say no. Muscles grow weak.

 

We all know the body’s ability to do the mind’s bidding often falters later in life. But the effects of age on function can be especially unforgiving when you’re hospitalized. Knee replacements, hip replacement, arthritis, rotator cuff, spinal fusions, laminectomies, osteotomies…all common surgical procedures happening in Winnipeg everyday.

 

Lying in a hospital bed day after day can quickly undermine one’s mobility. Even though most of the hospital data comes from the USA; our nurses, doctors, hospital staff are experiencing the same trends in healthcare as the Boomers come into their 60s.

 

Hospitals get it. Care plans are developed for patients that prescribe exercise when appropriate. Doctors put in orders for physical therapists to help patients walk and otherwise preserve their mobility.

 

Nurses and assistants often are expected to help patients move, even if it’s just from bed to chair for their dinner.

 

But that doesn’t mean it always happens. When hospital units become swamped with particularly sick patients, preserving mobility can easily slip down the priority list, hospital administrators say.

 

“There’s the ideal world, and then the practical world,” said Liz Ericson-Macke, a nurse, social worker and case-management supervisor with the Franklin County Senior Options Program.

 

“Sometimes just getting people up and walking them may not happen as much as we would like it to.”

 

Michele Weber acknowledges that. While working on her doctorate, the clinical nurse specialist at Ohio State University’s Wexner Medical Center evaluated how well nurses stuck to the mobility guideline for intensive- and critical-care patients.

 

It took persuading, but physicians bought into the guideline that took effect in 2009. They issued a blanket order giving registered nurses greater power to decide when exercise and physical therapy were appropriate during stays in the ICU, which average 5.5 days. A physician’s order is still required for physical therapy, however.

 

In late 2010 and early 2011, Weber examined the care provided to 207 patients — 41 percent of whom were older than 60 — to see whether the guideline was being followed.

 

“We were following protocol 30 to 40 percent of the time,” she said.

 

There were several barriers to improving compliance, including factors beyond the nurses’ control. Some patients refused to exercise. Many hospital rooms are small, with constrained layouts that didn’t lend themselves to the right kind of chair.

 

In some cases, nurses didn’t have the right supportive devices — walkers, canes, gait belts — close at hand. Some equipment didn’t have battery backup so that IVs could remain hooked up to patients when they were up and about.

 

And inadequate staffing levels sometimes hurt compliance.

 

Today, audits show compliance is better, typically between 50 and 60 percent, Weber said. The hospital added the mobility guideline to the orientation process for new critical-care nurses, provided better equipment and balanced staffing.

 

Mount Carmel Health System declined to share similar compliance data. A spokesman for OhioHealth said the hospital system doesn’t have such data.

 

Efforts to get patients moving might seem at odds with another hospital priority: fall prevention. But Weber said there were no adverse outcomes during the OSU research project.

 

The benefits of getting a patient moving early have become more widely recognized, said Dr. Larry Swanner, vice president of medical affairs at Mount Carmel West.

 

“In the past several years, we have increased our focus on physical therapy,” he said.

 

For patients who have had hips or knees replaced, early exercise leads to quicker recovery times. For surgical patients, walking encourages deep breaths and coughing, which reduces the risk of pneumonia.

 

Meanwhile, patients who have undergone abdominal surgery might find that walking stimulates the return of their intestinal function.

 

If a physician orders physical therapy in the morning, it should take place that same day, Swanner said. If it’s ordered late in the afternoon, it should happen the next morning.

 

OhioHealth has been assessing many protocols, including for mobility, through a process-improvement group focused on geriatrics, said Michele Stokes, director of senior health services at the Gerlach Center for Senior Health.

 

“We really have a lot of opportunity across the system to be aware and do more for our elderly patients,” she said.

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Whether you sit at a computer, shovel snow, lift sandbags or play hockey in Winnipeg, your back pain is probably the result of tight hip flexors

yourPhysio anatomy lesson first; your hip flexors are the dominant muscle in the ‘knee to chest’ action. Anatomically known as your; Iliacus, Psoas Major and Minor, and your Quadratus Lumborum, these muscles are attached to your hip, to your lower back and your pelvis. Consequently, when overused or tight they can reconfigure your lumbar spine, throw out your hip and back, affect your sacro-iliac joint, and change your biomechanics thoroughly.

Even though stretching is essential for all muscle work, it can actually be damaging if not done properly. When you stretch without warming up your muscles, it increases your likelihood of injury, as you are trying to stretch a cold muscle. So before you stretch, make sure you warm up; walk in place, cross-train, and increase the blood flow into your muscles so you can prevent an injury. As a physiotherapist, I do commonly advise patients to hold a stretch for 20-30 seconds, but why? The reason is because our muscles have a protective reflex to avoid over extension or contraction. When you are stretching your muscle, the muscle spindles, which are the components that produce contraction, activate a reflexive pathway which causes them to shorten in order to compensate for the stretch (called the myotatic reflex). This is what causes your leg to kick out when you tap your knee.

Knee Reflex

There are two main types of stretching: dynamic and static. Static stretching is what we just talked about, which is a stretching routine that includes holding 30 second stretches for specific muscles. When using static stretching before a sport that requires you to use specific muscles to initiate specific movements, it is hard to relate static stretches to dynamic activity. This is where dynamic stretching comes in. Dynamic stretching is designed to mimic the actions and movements you are expected to perform during a specific sport. For example, this would include kicking around a soccer ball in warm-up before a soccer game, so your body can get accustomed to activating the required muscles. That way, your muscles can make the necessary preparations to prevent injury, as playing a sport requires many specific dynamic and explosive movements.

Starting blocks

For your hip flexors, I teach a ‘dynamic lunge’; such that your hip flexors, quadriceps and pelvic muscles are used within the stretch. If you add Kegel exercises to this movement, the pelvic floor muscles are activated more and a greater effort can be applied to this core stretch. Remember those pre-natal classes guys? A patient was recently surprised to know that guys can do Kegels too! Guys are equipped with those same pelvic floor muscles and ladies should appreciate these efforts, as do the men!
Overall, stretching is very beneficial for movements involved in a regular day, and those involved in heavy labor, repetitive activity and sports. Therefore, it should be a priority for everyone to incorporate some sort of stretching into their daily routine (after warming up of course!), in order to maintain optimal functionality.  Flexibility is a highly underappreciated component of muscular strength and function, but key to good performance at work, home and recreation.

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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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How people choose a Physio, a Doctor, a Chiro, in Winnipeg…for back pain, for health advice, for whiplash

Thanks again to my fellow members at the Winnipeg Executives Association, for the positive feedback and referrals following my 2012 Business Profile presentation; How do you choose your Healthcare Providers? Based on the US pre-election survey by INC magazine…

In reverse order of importance, the top five were:

#5 a great Receptionist.

Oooops, if you have been to my clinical location in the formerly TD Centre, at Portage & Main, you would know that I have been a ‘sole proprietor’ since 1991. Clients know that when they call for an appointment or have any kind of question, that they are going to speak directly with me, the Physiotherapist. Whether it be by phone, text, email or video-chat; I do not hesitate to educate you on the spot and answer the greatest concern in real-time!

#4 your Insurance Coverage.

In Manitoba, you do not need a doctor’s referral to see a Physiotherapist. But, you may need one to be covered by your particular insurance coverage. Manitoba Health only covers physiotherapy treatment if obtained in hospital, and WCB, and MPI, only cover a specific number of treatment sessions. So, beware of your coverage and be proactive in your rehab!

I DO direct bill to most insurance plans, if they do allow this to occur as some plans prefer that the client do it by mail or online, such as Sun Life or ManuLife. Healthcare Spending Accounts are becoming more of the norm with ‘flex’ benefit plans. These accounts are excellent ways to be proactive in your health plan by applying these funds to ergonomic assessment or exercise programs.

Like some other providers, I typically do NOT charge for ‘tray fees’, ‘chart maintenance’, exercise tubing or even for Doctor’s notes.

#3 convenient Parking.

Well…again, we are located in Downtown Winnipeg’s most secure parking complex; the Exchange District Parkade, off Albert Street at #35…my entry is at ground level, directly across from Winnipeg’s best kept secret, parking meters inside a parkade entrance.

#2 convenient Office Hours.

For the approximate 60,000 people working within a 5 minute walk of Portage & Main, the most requested appointment time is between 10am and 2pm, with a normal treatment day from 845am to 530pm in the clinical location.

My research begins at the home office, and ergonomic assessments take me onsite to clients’ work places; from garbage trucks to police cruisers, from bus depots to gold mines, from military helicopters to postal distribution centres, from bank tellers to executive offices, from lumber plants to product warehouses, from grocery clerks to sports professionals, from grain elevators to your cottage kitchen…I’ve worked the day and night shifts, and experienced a huge variety of task conditions.

#1 my Location.

Do you know anyone that works within walking distance of Portage & Main?

Do you know anyone who works in an office connected through the Winnipeg ‘W’ walkway system?

Do you know anyone with a schedule that demands a guaranteed appointment time? …there is no waiting room

I invite you to refer them to our services, for healthcare that may not always be what they expected or even be the best in town, but I will always move them in a direction to make it right for them. Thanks.