Physiotherapy Toronto Blog

PRP Injections - Are they for you?

By ADMIN on May 16, 2016

PRP Injections – Are they for you?

Toronto Physiotherapy PRP Injections

You may have heard PRP mentioned by your favourite sports celebrities or via locker room chatter at the gym. And now you're wondering - just what is PRP and is it right for you?

PRP stands for “platelet rich plasma” and it's use has been growing throughout North America as a treatment of choice for many orthopedic injuries and conditions. Professional athletes, among others, have used PRP and claim it allowed them to return to competitive form more quickly after a sports injury. PRP injections may be offered as part of our Toronto physiotherapy and sports medicine services.

Over the years, the anecdotal evidence has been mounting, accompanied by dozens of international clinical studies that back up PRP's effectiveness in aiding the healing process for a variety of injuries that are often hard to treat. Tendons and ligaments naturally receive little blood supply, which is why they are notoriously difficult to heal. Tendons and ligaments are injured when they are over stressed, either by chronic repetitive movements or by a sudden injury. Previously, this type of injury or condition was treated with pain medications, physical therapy and surgery if warranted.

Internationally, many studies have found that PRP does provide significant benefits, including:

 - Pain relief;
 - Improved joint function and range of movement;
 - Postponing the need for knee replacement or other orthopedic surgery.

In one study that compared PRP to other treatments, the benefits were still observed six months later.

PRP has been observed to be of particular use for specific conditions such as osteoarthritis of the knee, and in certain groups of patients, such as among younger, active patients with injuries to cartilage - the reason why it's become the celebrity sports star's treatment of choice. It is one of the most popular treatments for relevant conditions at our Toronto physiotherapy and sports medicine clinics.

How Does PRP Work?

The largest component of our blood is a liquid called plasma. In that plasma, you'll find the red and white blood cells and tiny platelets that, together, give it the red colour and consistency we're familiar with.

Platelets are much smaller than red or white blood cells. They are used in the clotting process and they also contain proteins called growth factors. As the name implies, growth factors play a key role in the regeneration of tissues and the healing process as a whole. PRP works on the principle of accelerating that healing process by increasing the percentage of platelets in the blood.

 - First, blood is taken from you, the patient;
 - Then, the platelets are separated out from the other blood cells;
 - They undergo a process called centrifugation that increases their concentration;
 - The platelets are recombined with the rest of the blood and then reintroduced into your body.

While the process itself is not yet entirely understood, it is believed – and the anecdotal evidence backs it up – that PRP speeds up the healing process, so it can be used to prevent worsening of a condition or in conjunction with surgery. It has been found to be effective in treating a variety of conditions, including:

  • Tennis elbow
  • Chronic Achilles tendinitis
  • Jumper's knee (inflammation of the patellar tendon)
  • Acute injury to ligaments and muscles
  • Pulled hamstring
  • Knee sprains
  • Plantar fasciitis
  • Torn rotator cuff and other shoulder injuries
  • ACL and other tears to knee ligaments
  • Arthritis – reduces pain
  • Bone fractures and other injuries
  • Chronic tendon injuries

It can also be used to help speed up recovery after surgery and is often used at our clinic as part of our Toronto sports medicine suite of services.

PRP – and Physiotherapy

The growth factor and enzymes that are injected into the affected area of your body with PRP take some time as they help to stimulate your body's own healing processes. At first, you may actually experience mild side effects such as pain or irritation at the injection site. That may persist for several days. Your treating medical practitioner may recommend that you use a brace or take other precautions during the first week or so after your PRP injection.

PRP injections are the first step in a multi-stage rehab process. After the injections, physical therapy helps to improve strength and conditioning along with teaching you how to protect the area from further injury.

Even if you are still able to function and you may not think that any real treatment is necessary, continued use of an injured tendon or ligament will simply lead to further injury and degeneration over time. An untreated injury is tomorrow's degenerative condition and PRP has proven to be an effective tool that can help in furthering rehab and recovery.

For more information on PRP injections and our physiotherapy Toronto services please call one of our clinics in the Toronto area – including Hamilton – or visit our website today.

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High Protein Banana Bread

By ADMIN on April 29, 2016

Try this easy recipe for delicious high protein banana bread

Toronto Dietitian


  • 1 scoop Chocolate Protein Powder
  • 2 scoops Vanilla Protein Powder
  • 1 cup Whole Wheat flour
  • 2 tsps Baking Soda
  • 1 tsp Ground Cinnamon
  • 5 Ripe Bananas
  • 2 Whole Eggs and 2 Egg Whites
  • 4 tbsps Greek Yogurt
  • 2 tsps Vanilla Extract
  • ¼ cup Brown Sugar
  • 1 cup Rolled Oats
  • ½ cup Flax Seed Flour
  • 2/3 cup Chocolate Chips (Optional)


  1. Preheat oven to 350oF/ 176oC
  2. Combine all dry ingredients, except Chocolate if you choose to use it, in a stand mixer
  3. Add all wet ingredients to the dry ingredients and mix until thoroughly combined
  4. Add Chocolate Chips if desired
  5. Pour mix into a greased baking pan/ bread pan and put in oven for 30-40 minutes, or until a toothpick comes out clea
  6. Remove from oven and from baking pan/ bread pan and let cool before enjoying!

Provided by Athlete's Care Registered Dietitian and Sports Dietitian Ben Sit.  Appointments with an Athlete's Care Registered Dietitians can be made at our Yonge & SheppardYonge & Eglinton and King & Yonge locations

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Simple & Effective Yoga Runner's Stretches

By ADMIN on April 29, 2016

These simple and effective yoga runner's stretches can be performed after a run or incoporated into your daily stretching routine.

Stretches provided by Registered Massage Therapist Larysa Krawec. Appointments with Larysa can be made at our Athlete's Care Oakville and Athlete's Care Mississauga locations.

1. 'Thread the Needle' - Piriformis Stretch

Massage Therapy Toronto

2.  Hip Flexor Stretch

Mississauga Massage Therapy

3.  Hamstring Stretch

Toronto Registered Massage Therapy

4.  'Supine Twist' - Glute Stretch

Registered Massage Therapist


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Concussions - Why risk it?

By ADMIN on February 29, 2016

Article by Dr. Pamela MacDonald, Chiropractor, Medical Acupuncture and Functional Integrated Therapy Provider 

Toronto Chiropractors Concussion ManagementIn recent years, increasing incidence and associated consequences of sports-related concussion have been at the forefront of the media and public health concern. Although many professional athletes have access to prompt diagnosis and proper management following a concussion, the same programs have not been historically available for younger, amateur athletes.This has resulted in a need for better diagnosis and management, and pre-season baseline testing for all athletes.

The purpose of a baseline test is to measure every area of brain function, which could become affected following a concussion. This way, if a concussion occurs (or is suspected), we can compare their post-injury state to their baseline parameters in order to make an accurate diagnosis as well as guide a safe recovery and return-to-play. As you may know, secondary concussions prior to full recovery can cause permanent injury.  Without access to healthy baseline parameters, clinicians have no way of determining when the brain has fully recovered.

A concussion is a neurologic injury that causes a temporary disturbance in brain cells, as a result of extreme acceleration or deceleration of the brain within the skull.This can be caused by a direct blow to the head or by indirect “impulsive” forces that are transmitted to the head. A concussion results in a number of pathophysiologic consequences including metabolic disturbance and changes in cerebral blood flow and perfusion. Symptoms can range from headache, nausea, vomiting, dizziness and confusion to neck pain, fatigue, irritability, sadness and cognitive difficulties. While 85-90% of concussions will resolve symptomatically in 7-10 days, numerous studies have shown that symptom resolution is a poor indicator of full brain recovery. This is why an objective comparison of post-injury scores to pre-season baseline scores is so imperative.

Complete Concussion Management Inc. (CCMI)
was developed from the necessity to provide high-risk athletes with evidence-based concussion management strategies.  The baseline testing protocol was developed through years of research to establish the most comprehensive testing battery to assess both acute injuries and the readiness to return to high-risk sporting activities. Baseline testing involves testing athletes prior to starting their sporting season to assess numerous physical and cognitive systems that can be affected by a concussion. The true value of having baseline test results is on the back-end, when making return-to-play decisions.  Having access to sound test results as compared to an individual’s healthy state scores provides clinicians with a set of objective data that can be utilized to make better informed, and therefore safer, return-to-play decisions.

CCMI offers the most comprehensive baseline assessment available, including 9 different tests of cognitive, physical and functional abilities.The CCMI baseline test protocol consists of the following test areas:

  • Memory
  • Concentration
  • Visual Processing/Visual Movements
  • Reaction Time
  • Balance and Proprioception
  • Motor Strength
  • Neurocognitive Testing (ImPACT)

Toronto Chiropractors

CCMI baseline testing takes roughly 30 minutes per individual and is covered under secondary health insurance benefits for either physiotherapy or chiropractic (depending on who administers the test).  Full team testing can be completed within 1 to 2 hours and can be done either in the certified clinic location or off site at a team training/practice facility.  All patient data is stored on an electronic health records system that is accessible by all 160+ clinic locations across Canada. Parents, athletes & concussed patients can also download the CCMI Concussion Tracker App to locate the nearest CCMI clinic, view baseline test results, and receive rehab exercises prescribed by your CCMI clinician.

No single concussion test is adequate to be used in isolation for either diagnosis or return-to-play decision-making.  The CCMI protocol conducts the most extensive concussion baseline testing available. Clearance of any athlete is not granted until there is a complete return to baseline of all pre-season measures following the passing of all step-wise return-to-learn and return-to-play stages including a 2-step process of physical exertion testing.


The CCMI program is available through several Athlete's Care locations across Toronto and the GTA including Athlete’s Care at the Beach

CCMI certified clinicians, Dr. Pamela MacDonald and Dr. Christina Voldner, are available for team and individual baseline testing as well as post-injury assessment and treatment.

For more information or to visit a CCMI certified clinic near you, please visit:


  1. Giza CC, Hovda DA. The New Neurometabolic Cascade of Concussion. Neurosurgery. 2014;75:S24–S33.
  2. Signoretti S, Lazzarino G, Tavazzi B, Vagnozzi R. The Pathophysiology of Concussion. PM&R. 2011;3(10):S359–68.
  3. Vagnozzi R, Tavazzi B, Signoretti S, Amorini AM, Belli A, Cimatti M, et al. Temporal window of metabolic brain vulnerability to concussions. Neurosurgery. 2007;61(2):379–89.
  4. Vagnozzi R, Signoretti S, Tavazzi B, Cimatti M, Amorini AM, Donzelli S, et al. Hypothesis of the Postconcussive Vulnerable Brain: Experimental Evidence of Its Metabolic Occurrence. Neurosurgery. 2005;57(1):164–71.
  5. Vagnozzi R, Signoretti S, Cristofori L, Alessandrini F, Floris R, Isgro E, et al. Assessment of metabolic brain damage and recovery following mild traumatic brain injury: a multicentre, proton magnetic resonance spectroscopic study in concussed patients. Brain. 2010;133(11):3232–42.
  6. Signoretti S, Vagnozzi R, Tavazzi B, Lazzarino G. Biochemical and neurochemical sequelae following mild traumatic brain injury- summary of experimental data and clinical implications. Neurosurg Focus. 2010;29(5):1–12.
  7. Vartiainen MV, Holm A, Lukander J, Lukander K, Koskinen S, Bornstein R, et al. A novel approach to sports concussion assessment: Computerized multilimb reaction times and balance control testing. J Clin ExpNeuropsychol. 2015;1–15.
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Reasons Why Athletes Should Take Advantage of Deep Tissue Massages

If you’ve ever run a marathon, or even watched one on TV, you’ve likely noticed numerous runners receiving massages during or after the race. In fact, you’ve probably wondered what are the benefits of receiving such instantaneous treatment for muscle stiffness, cramps or prolonged physical exertion?

Massage Therapy in TorontoWell, runners and many athletes alike, can reduce pain, and increase flexibility by receiving treatment on the spot. But in order to boost overall recovery time, a deep tissue massage is often recommended ideally a few days after any extreme physical action because it can target key problem areas before they become seriously troublesome.

During a deep tissue massage, the therapist applies acupressure, trigger-point work (focused on all those tiny muscle knots) and “deep transverse friction” where scar tissue is broken by back and forth movement over muscle.

Deep tissue massages aren’t like other massages where you will walk out relaxed, and smelling like a beautiful array of fragrant oils. Due to the nature of this treatment, you will likely leave feeling more pain than usual, however the long-term benefits cannot be disputed.

Here’s why athletes, especially marathoners, should schedule a deep tissue massage:

Reduced pain and recovery time

In a study published by the journal Science Translational Medicine, 11 men were exercised to exhaustion and given 10 minute leg massages immediately afterwards. Following an analysis of the recorded muscle biopsies prior, during and after the workout, scientists discovered that the massage prompted the production of mitochondria, an energy cell that builds muscle, boosts recovery time and suppresses pain.

Improved flexibility and injury prevention

Athletes who receive regular deep tissue massages notice an increase in their range of motion because their therapist is actively breaking down all the tightness around the muscles.

Intense training or exercise can lead to a build up of scar tissue, and the development of many adhesions where the muscle, fascia, and other tissues clump together causing stiffness, and subsequent vulnerability to injury. During a deep tissue massage, your muscle fibers are stretched and scar tissue is broken down which promotes flexibility and agility.

Increased circulation

Massages are a healthy part of any detox, and due to the intense nature of the deep tissue massage, blood circulation is increased which enables the muscle to expel toxins and absorb fresh blood and oxygen.

Oxygenation means the muscles are suppler, and athletes are also able to breathe deeper during exercises or sports. On a psychological level, better breathing enables a calmer state of mind, and helps relieve stress or anxiety.

Better sleep patterns

Numerous studies have found that massage therapy induces better sleep and actually helps maintain consistent sleeping patterns. Of course, we all know that sleep is a crucial part of the recovery process for any athlete, but muscle pain and tension can sometimes prevent this and become bothersome in the long term.

A deep tissue massage will reduce tension, induce relaxation, and enable athletes to achieve greater sleep that can make him or her recover faster and perform better.

When should you schedule a deep tissue massage?

Since you will likely walk away from your deep tissue massage feeling a bit battered and bruised (don’t worry, it’s for the best), we recommend scheduling an appointment after a workout or run, preferably with an easy workout or run planned for the next day. This helps out with recovery, and enables you to derive benefits from harder physical activity 24 hours later.

If you have just run a marathon, it’s best to wait at least three to five days before booking an appointment because such an intense activity will cause inflammation, and it’s better to let your body heal a bit beforehand. Once you have dealt with the most acute symptoms of your post-marathon pain, then it’s time to schedule a massage and flush out further damage.

Our team of experienced Toronto massage therapists has treated professional athletes, Olympic athletes, performing artists along with everyday aches and pains including posture related injuries.  Our massage therapy team has also been instrumental in the development of specialized injury prevention programs.

Massage therapy treatments can be booked for 30, 45 or 60-minute sessions and we have 16 convenient locations to serve you.  Book your massage therapy appointment and see the difference it will make for you.

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