Monday, March 31, 2014

Pes Anserine Bursitis, or "My knee hurts!"

Knee and back pain are kinda like a really good steak: everyone has experienced it, or at least knows someone who has. The types with flashy names like "runner's knee" (patellofemoral pain) or "lumbago" (lower back pain) get all sorts of attention, but what about poor old "hurt goose's foot"?! An awkward way of describing for anserine bursitis, it doesn't really tell you what's going with your knee, does it? Not to worry, that's what we're here for.

Because it often pops up right alongside other knee problems (MCL tear anyone?), this injury is often overlooked. The "goose's foot" refers to the pes anserinus, the conjoined leg tendons that connect to your tibia, just below your knee cap, on the inner side of your lower leg. They're most there to flex the knee, but also stabilize it side-to-side.

Guess it's not surprising then that pes anserine injuries are found most commonly in young individuals playing sports with lots of side-to-side movement. Risk is also increased in people with tight hamstrings, who overpronate when running, or who are obese. Pain normally creeps in when going from sitting to standing or climbing up stairs, but walking along a flat surface feels just fine. Especially when the injury is due to some feat of athletics, the pain can occur when stretching the hamstrings or reproduced with some stretches by your physiotherapist.

Not a young buck but still struggling with knee pain you think might fit that description? Pes anserine bursitis also occurs in older patients with articular cartilage damage. It often coincides with osteoarthritis of the knee, increasing the severity of pain and functional limitations.

So, hurty knees, what are you going to do? No matter the knee pain, it's important to have it diagnosed, since there are SO many different things that could be going on. If it is pes anserine bursitis the first thing you'll likely be prescribed is rest. Anti-inflammatory medications will help with swelling and pain, but won't fix the problem. Physiotherapy is what you'll need to correct the biomechanics that lead to your injury, and ultrasound or electrical stimulation will also help reduce inflammation.  Take action now and count your lucky stars: the need for surgical intervention is rare for this injury!

Wednesday, March 19, 2014

Thumbs...down. Skier's thumb is no fun.

Winter just. won't. end. Good! That means you're all still skiing, and today's post is still relevant. 

Kidding! Of course this post is relevant, it's about an injury commonly know as skier's thumb, but it doesn't actually discriminate. We're referring to a tear of the ulnar collateral ligament in the thumb after an extreme force pulls the thumb away from the palm of the hand. That extreme force could be you hurtling down a mountainside with a ski-pole in hand, bailing, and falling while holding onto the aforementioned pole. Or you could've been rock climbing, or you might've caught a ball funny, or were playing a ridiculously violent game of rock-paper-scissors. Doesn't matter how it went down, we're going to talk about your sore thumb.

About that thumb, it's sore, yeah? Feels weak when you pinch or pick things up? See a bit of bruising around the joint? Run your other hand along it and maybe feel a little bump? Take a deep breath, and don't panic. Our physiotherapists know just what to do.

If it's a minor tear and you get in right away, you'll probably be right as rain after a few physiotherapy sessions. You may need to immobilize your thumb with sports tape when doing activities, and your physiotherapist can give you some guidance. If your injury is more serious, you may need to immobilize the thumb with a "thumb spica" cast for a few weeks. Immobilization is important to let the ligament heal, and then treatment to help get your strength and range of motion back can begin.

Think you've got a case of skier's thumb? Give any of our clinics a call to see a physiotherapist. Otherwise, thumbs up for a few more days of skiing!

Friday, February 28, 2014

Old or recurring injuries? Stop 'em now!

If you've been injured in the past or exercise regularly, and haven't fixed the aches, pains, or sore spots that keep nagging at you, we hear you. Whether you've just tweaked a little something that keeps aching or have an injury that keeps on coming back for more, it's time to get them straightened out so you can be in tip top shape come the sunshine!

Injuries happen, and an ache or pain that dissipates in a few days is usually nothing to worry about. If it's lasting for weeks or months, or happens to reoccur, that's a sign that something isn't quite right, so it's time to stop ignoring it! Even if the pain is mild, don't try to be macho - pain can cause your body to alter it's mechanics which leads to unnecessary stress on joints, ligaments, muscles and tendons.

These pains are likely due to overuse or a small injury to a tendon or muscle. While taking something like ibuprofen can make you feel right as rain, it doesn't take care of the problem. Exercising through the masked pain and swelling can leads to chronic inflammation, causing weakness, tissue breakdown, more pain, more swelling and BAM! You're got yourself a nagging injury.

So what do you do? The first step is to apply heat before exercising, and use RICE (Rest Ice Compression Elevation) after training to help control the pain and swelling. It will help you control the symptoms best without having to slow down too much, but again, it's not going to fix the problem. It's time to see the physio, be evaluated and figure out what the issue is so you can say buh-bye to that pain-in-the-whatever.

Instead of quitting exercise because something hurts, your physiotherapist will set you up with a personalized treatment plan, including exercise options that won't aggravate your injury. The plan will also include advice on how to modify your training techniques so you can keep doing the activities you want, but pain free.

Once your physiotherapist helps make that pain a distant memory,  be sure to start ramping up your normal activity slowly. Again, most of these sorts of injuries are due to over training, so getting back at it too hard or too fast will land you right back in injury land!

Sunday, February 9, 2014

Don't get shut out: preventing groin strain

With the Winter Olympics now in full swing, almost everyone in the country is thinking about one thing: HOCKEY! We know offsides and icing are common in hockey, but unfortunately so are groin strains.Whether you are a back yard rink rat or a 2018 hopeful here are some tips to keep you on the ice and off the injury reserve:

WARM UP: this is most often on the injury prevention list because it is SO important! Make sure to warm up completely, including dynamic or movement stretches. If you aren't sure what that means, ask next time you're in and your physiotherapist would be happy to explain these to you.

STRETCH THIGHS DAILY: stretch both the inner thigh and outer thigh muscles daily. While tight groin muscles can lead up to a strain, you should also stretch your hamstrings to keep your muscles balanced.

REGULAR MASSAGE & MANUAL THERAPY: regular massages from a massage therapist and regular manual therapy from your physiotherapist helps to keep your muscles flexible. They also help to break down old scar tissue and help with trigger points that could lead to injuries later on.

PRACTICE SPORT-SPECIFIC DRILLS: sudden changes of motion during play can cause groin strains, but practising the movements helps your muscles adapt and become stronger while doing them. Based on the sport your play, and the condition you are in, our physiotherapists can assign exercises specific to your needs. 

WORK ON CORE STABILITY: a strong core is a stable base for the movements you'll be doing no matter the sport, and can reduce the chance of straining your adductor.

IMPROVE YOUR PROPRIOCEPTION: proprioception is your body's ability to know what part of it is doing without looking at that part. That seems a bit confusing, but it's how you can walk up stairs without looking at your feet, or put food in your mouth without a mirror. That seems like the sort of thing you might not be able to improve, but it's based on balance, coordination and agility. Balance and sport-specific movement work improve your proprioception, improve your stability and all that helps to avoid injury.

STRENGTHEN THIGH & HIP MUSCLES: strengthening the muscles involved in the movement responsible for an injury increases your stability in that area. It is important for preventing injury, but especially for preventing a reoccurrence if you've already been injured. Your physiotherapist can determine where your muscle imbalances are, and assign exercises specific to your needs.

REST: make sure you rest! Over training leads to fatigue, which most definitely increases your risk of injury. Use it as your excuse to watch some of the games! Go Canada!

Monday, January 20, 2014

Don't get snowed in! How to Shovel Snow and Prevent Snow Removal Injuries

With all the snow we had this past weekend (and all that's surely still to come), many of you are probably best friends with your shovel. If you're lucky enough to have teenagers to do it for you, pass this on to some of your less fortunate friends. Those of us who are stuck  shovelling, huffing, and anticipating a hot cuppa afterwards often think of snow removal as just another of the joys winter brings, but in all seriousness, it can actually be dangerous! Every winter people are injured while shovelling or using a snow blower, so heed these tips to make sure you aren't one of them:

Look out: watch out for icy patches or uneven ground, since a fall could be worse than just having to shovel a bit of snow. Make sure to keep scarves and hats from blocking your vision, you need to watch where your shovel or blower is going too.

Warm-up: warm up with some light exercise inside for 10 minutes before you go exercise by moving snow outside. Once you're back inside warm up again with a nice hot drink.

Pace yourself: just like any other exercise, be sure to take breaks when you need them, and don't get dehydrated. You don't feel as thirsty when it's cold, but you need to stay hydrated all the same. If you've gone at it too hard and experience chest pain, shortness of breath of other signs that  indicate a heart attack be sure to stop immediately and call 9-1-1.

Pace your blower: snowblowers can help make quick work out of clearing a driveway, but if used improperly could leave you with a back injury. They are designed to move at a particular speed, so don't be trying to force your blower to go faster - it's already doing the work for you!

Pick your weapon wisely: if using a shovel make sure to pick one that is comfortable for your height and strength. Using a shovel that is too heavy, too long, or even too short is not only asking for injury but also makes shovelling less efficient.

Just don't do it: if you have a medical condition or do not exercise regularly, make sure to check in with your doctor before braving all that white stuff. Snow removal places high stress on the heart, and you might be better off hiring someone to remove the snow for you.

How to shovel snow without injury:

  1. Push the snow, instead of lifting it, as much as possible
  2. If you need to lift the snow, lift with your legs by squatting with your back straight; don't bend at the waist
  3. Only scoop small amounts of snow at a time, and remove deep snow in pieces: holding a heavy shovel of snow with your arms outstretched puts strain on your spine
  4. Walk the snow over to where you want it, do not throw it over your shoulder to avoid twisting your back.
That's it! We might not be able to make it fun, but with these tips and snow removal should be easy and injury free. If you've already hurt yourself dealing with snow this winter, be sure to give any of our clinics a call. Our physiotherapists would be happy to assess the injury and help get you back to pain free!

Monday, January 6, 2014

Avoid Winter Injuries

The ski hills are open, the canal is frozen, and you have to wake up 30 minutes earlier to shovel the driveway. Oh, what joy winter brings! All that snow and ice can also bring along injuries, so it's important to take extra care out there.
  • Be careful: yeah, yeah, take care because it's slippery out, we all know that. Most of us don't heed that advice though. When winter strikes you get winter tires and drive more slowly on icy roads. You should take the same care with yourself. Wear shoes with good traction for walking around and keep an extra pair at the office to make sure you're still conforming to dress code. Allow a little extra time for getting around and moving a bit more slowly will help you avoid the embarrassment of slipping when you're out in public, and save you a bruise or two!
  • Warm up: in this weather, the only warming up you want to do is by the fire with hot cocoa after a full day on the slopes. You should also be warming up before you start. Do the first 10 minutes of your skate/ski/snowshoe at a slower pace. Start with a few blue runs before you drift over to the black diamonds.
  • Cool down: when it's cold outside your instinct is to dash into the chalet right after a session. Don't just stand about in the cold, but remember to dial down to a lower intensity before you finish up for the day. It signals to your body that activity time is coming to an end, and the drink you've earned is soon to come.
  • Start slowly: New Years Resolutions and months of non-winter sports can lead to "too much too soon". Where does that get you? Very likely injured. Off-season cross training is the best way to make sure you're ready once the snow base builds, but not everyone has thought that far ahead. If you haven't, start slow. Or come in to see one of our physiotherapists: we can help identify any imbalances or instabilities you might have. Call any of our clinics so we can help you stay injury free now, instead of treating you for the rest of the year!

Friday, November 1, 2013

Plantar fasci-what-is?!

Lower back pain is something we can all imagine, but what does it mean if your plantar is fasciating (no, that's not actually a word)?! Today we're going to talk about plantar fasciitis, a common injury you have likely heard about in passing. Now you'll be able to do more than just steer the conversation towards the weather.

There's a band of connective tissue running along the sole of your foot, known as the plantar fascia.

Normally it just chills out supporting the arch of your foot, but if it gets stretched too far it can tear, causing inflammation. That inflammation leads to pain, and is referred  to as plantar fasciitis.

What causes plantar fasciitis? Good question. Sometimes physiological things like flat feet or high arches, if left to their own devices, can cause it to arise. Or a sudden change in how your feet need to support you, such as an increase in activity or increased weight gain might bring it on. It's a common injury in runners, especially after increasing training volume or switching from running on a soft surface to a harder one.

The pain is typically felt on the bottom of the foot, close to the heel. It might fade and reoccur in an unpredictable pattern, or disappear completely only to return after a single workout. So you've got some tenderness on your heel, how do you know if you've got plantar fasciitis? Ask yourself the following questions:

Does it hurt especially when you wake up in the morning?
Does the pain go into the rest of your heel or the arch of your foot?
Do you notice the pain when you've stood up after sitting/lying down for a long time?
Does the pain occur after/during activity?

If you answered yes to any of the above, you may very well have plantar fasciitis. Icing the site of inflammation, adding more rest into your daily routine or substituting your normal exercise with non-weight bearing activity (such as swimming) are all options to help reduce your pain. While some cases will be helped greatly just by stretching tight leg mucles, while others may need custom orthotics. So feel free to give us a call, and any of our physiotherapists can help diagnose the cause of your specific pain. Then we can recommend the course of action that you need to get moving again, pain free.