Physiotherapy Toronto Blog

Hamilton Physiotherapy

This summer get out there and SWIM. Not only is it refreshing on hot summer days, it also has many health benefits that working out on land can’t offer.


Water is denser than air so every time you move in the water your body is working against resistance. This is similar to using weights only the waves make movements more variable. This variability is the stimulus that tells your body to engage its core muscles to maintain your posture so you can stay afloat. By constantly challenging your core with every movement you make, your body will improve its stability.

Swimming also uses virtually every muscle in the body, so it makes it easy to tone. If you are kicking for example, you are using your abdominals, glutes, hamstrings and all the muscles in your back to stay afloat and propel yourself forward. When you use your arms (ex. pulling in front crawl) you work the pecs, lats and rotator cuff. The faster you swim the more resistance you encounter and the harder your muscles work, therefore the more calories you burn. Swimming at a moderate pace burns around 500 calories per hour!!


The density of water also increases your buoyancy when swimming, which makes you feel like you are much lighter than you actually are. Feeling like you have less body weight translates to less impact on your joints, as you avoid the normal ground reaction forces encountered with running, jumping or sports like soccer and basketball. This makes swimming a good alternative for people with arthritis and low back pain.  


When performing strokes like front crawl, back crawl or breaststroke your muscles reach their limits of range of motion as you extend your limbs. By continuously reaching the end of a muscle’s available range of motion, the muscle will accommodate to this needed range and stretching occurs. This repetition also helps improve muscle endurance, which in turn improves muscle strength.


Swimming is one of the best means of challenging the cardiovascular system. It improves the strength of the heart and its ability to quickly and efficiently pump blood throughout the body. This efficiency will increase your resting metabolic rate, lower blood pressure, improve cholesterol levels, and improve tissue oxygenation. Being in water also improves lung function because air intake is limited, both in frequency and volume. Because of this, you learn how to effectively breathe with your movement, increasing lung capacity and oxygen intake with each breath.

Article provided by Registered Physiotherapist, Samantha Costabile.  Appointments with Samantha can be made at the Athlete's Care Hamilton location.

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No matter what level of sport you or your children are involved in, you have likely known someone who has sustained a serious knee injury. Anterior Cruciate Ligament (ACL) injuries are probably at the top of the list for the most discussed. It is universally known as a season-ending injury, and is sure to draw some sympathetic looks from teammates. In the United States, approximately 120 000 people per year sustain an ACL injury. The numbers per year are increasing, and are higher in females when same-sport comparisons are made1. With the soccer season starting up, this seemed like the perfect time for a discussion.

To understand the impact of an ACL injury, it is important to know what the ACL is. It is a ligament that runs between the tibia and femur. It is considered to be a primary stabilizer against forward movement of the tibia on the femur, but also helps to resist valgus forces (see below), limit rotation and facilitate normal joint mechanics. Although it plays a big role in the above, there are also other structures that help out, which explains why some people can still operate in a semi-normal fashion despite an ACL injury.

Knee Injury
A. Anterior view of the knee, ACL highlighted in red

So how do these injuries happen? Often they are non-contact injuries2. Examples include sudden deceleration from a sprint, forceful rotation, landing from a jump, valgus positioning and knee hyperextension (although this is debated). Depending on the sport, they can also be contact injuries. Signs and symptoms of an ACL injury include hearing a “pop”, a quick onset of swelling, difficulty weight-bearing, and feeling unstable1.

ACL Injury

B.  Example of a valgus knee injury, which happens when the knee collapses toward the other knee

Luckily, it is possible to predict if you are at risk for this type of injury. Below is a list of risk factors for ACL injury supported by research3,4. It should be noted that a great deal if this research focuses on the female athlete.

  • Being female: Due to anatomical and hormonal differences.  
  • Increased joint laxity
  • Excessive hamstring laxity: This allows more forward translation of the tibia and stresses the ACL.
  • Insufficient ratio of hamstring to quadricep strength: If quads overpower the hamstrings, the tibia is pulled forward.  
  • Poor lower extremity control: Difficulty controlling knee position during dynamic movements.
  • Impaired proprioception: This means poor joint position sense, or difficulty determining what position the knee is in.  
  • Being overweight
  • Excessive forefoot pronation: While pronation (foot flattening) is a necessary movement for walking and running, if it occurs excessively or too quickly, it can increase the risk of ACL injury.

Hamilton Physiotherapy

Despite the long list of risk factors, prevention is possible, and strategies aimed at this are effective. Early physiotherapy intervention can help to identify and generate solutions for individual risk factors. Neuromuscular training programs are a great way to protect against these injuries5,6. In simple terms, this means performing strengthening, coordination, balance and other types of exercises to improve strength or relevant muscles and simulate situations in which an athlete may become injured. These programs have actually demonstrated measurable changes in movement patterns5,6 and have been shown to reduce ACL injury rates by approximately 50%7. A great example of this is found in the FIFA 11+ warm-up, which when utilized in elite collegiate soccer programs, helped to reduced overall injury risk by more than 40%8. An easy google search will bring up photos and videos of the exercises.

It is possible that those of you reading this will have one or more of these risk factors. However, some may be more obvious than others. For best results, consult a physiotherapist for advice on injury prevention.

Article provided by Registered Physiotherapist, Nick Peters.  Nick believes in an eclectic approach to treatment, with an emphasis on manual therapy, dry needling and functional and sport-specific exercise. Appointments with Nick can be made at the Athlete's Care Hamilton location.



1. Epidemiology and Diagnosis of Anterior Cruciate Ligament Injuries. Clinics in Sports Medicine (2017).
2.Collegiate ACL Injury Rates Across 15 Sports: National Collegiate Athletic Association Injury Surveillance System Data Update (2004-2005 Through 2012-2013). Clinical Journal of Sports Medicine (2016). 
3. Anterior Cruciate Ligament Injuries in Female Athletes-Part 1: Mechanisms and Risk Factors. American Journal of Sports Medicine (2006).
4. High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: Is PFP itself a predictor for subsequent ACL injury? British Journal of Sports Medicine (2015).
5. Effects of evidence-based prevention training on neuromuscular and biomechanical risk factors for ACL injury in adolescent female athletes: a randomised controlled trial. British Journal of Sports Medicine (2015).
6. Comparative Adaptations of Lower Limb Biomechanics During Unilateral and Bilateral Landings After Different Neuromuscular-Based ACL Injury Prevention Protocols. Journal of Strength and Conditioning Research (2014).
7. Interventions Designed to Prevent Anterior Cruciate Ligament Injuries in Adolescents and Adults: A Systematic Review and Meta-analysis. American Journal of Sports Medicine (2012).

8. Efficacy of the FIFA 11+ Injury Prevention Program in the Collegiate Male Soccer Player. American Journal of Sports Medicine (2015).

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Toronto Sports Dieititan


  • 3/4 cup unsweetened shredded coconut
  • 6 medjool dates, pitted
  • 3/4 cup walnuts (or any nut you have)
  • 1 cup grated carrots
  • 1/4 cup hemp hearts
  • 1/4 cup honey or agave syrup
  • 1 tsp pure vanilla extract
  • 1 tsp ground cinnamon

Yield:15-20 bites       Prep time:15 min      Total time:15 min

Gluten Free • Dairy Free • Paleo


  1. Reserve 1/4 cup shredded coconut in a shallow dish for rolling.
  2. Place remaining ingredients in a food processor and blend.
  3. Form mixture into 1-inch (2.5 cm) balls and roll in reserved shredded coconut, coating balls completely. Transfer to a baking sheet and refrigerate for 2 hours.
  4. Keep chilled, or freeze in an airtight container. Enjoy 1 or 2 as a snack or dessert. 

**Recipe adapted from Joyous Health -

Toronto DietitianRecipe provided by Athlete's Care Registered Dieititian, Kerry Miller.  Kerry takes a personalized approach to creating plans that best suit her client’s lifestyle. She makes sure that her recommendations are not only nutritious, but delicious too! Let her take the guess work out of nutrition for you by translating science into practical strategies for improved health and performance.  Appointments with Kerry can be made at our Athlete's Care - Liberty Village location.

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Hamilton Physiotherapy

It's that time of year again... spring is in the air, birds are chirping and fair weather runners like myself start to strap on their running shoes again! Whether you are delving into training for your next race, or just running for your personal goals, here are some tips to help you avoid injury.

1. Slow and steady wins the race. Progress slowly.  Do not increase any element of your training too quickly. 10% per week is a good amount of distance to increase per week. Give yourself an extra week or two in your training schedule... you may need it for recovery.

2. Do more runs, not less. You are better off to do four runs of 20 min runs in a week instead of two 40 minute runs.

3. Only change one element per week. Do not add hills AND intervals in the same week.

4. If you feel an injury coming on, take a step back. Go back to the amount of running you were doing before the injury started and stay there for a week or two. If the injury doesn't go away, it might be time to seek professional help.

5. Stretch and strengthen. A good base before your running season of glut, hamstring, hip flexor and core strength will go a long way and maintaining that strength throughout  the season will really help keep you injury free (and running better!). Anyone who runs needs to incorporate some stretching into your program too.  

6. Keep a healthy weight. Of all the factors associated with running injuries overtraining and a higher body mass seem to have the highest correlation with injury. On the flip side, a low BMI has also been associated with an increase in stress fractures and spinal injuries in women. Stress the HEALTHY in healthy weight!!

Rebecca is a 4 time half marathoner and a Registered Physiotherapist with specialist training in running injuries.  Appointments with Rebecca can be made at our Athlete's Care Hamilton location.

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Happy Family Day

By ADMIN on February 17, 2017

Happy Family Day from your Athlete's Care Family

Athlete's Care Sports Medicine Centres will be closed on Monday February 20th.


Toronto Physiotherapy


Toronto Sports Medicine






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