Physiotherapy Toronto Blog 

Everyone gets headaches now and then. Our Toronto physiotherapists treat a wide variety of aches and pains that involve the musculo-skeletal system, but the common garden variety of headache isn’t usually on their radar. Occasional headaches are nothing to worry about. When they become a daily – or nearly daily – reality that interferes with other areas of your life, then headaches require serious treatment.

Physiotherapy for headaches is a relatively recent innovation that has developed over the last decade or two, and can show remarkable improvement for some patients who haven’t responded to other types of therapy. The key lies in determining what is causing the pain, and whether physical therapy can alleviate the problem.

What Type Of Headache Is It?
Headaches are among the most common of all health related issues anywhere, and the International Headache Society lists over 300 types. According to WHO (World Health Organization,) in developed countries, about half of men, and a third of all women, suffer from tension-type headaches.

At one time, it was thought that abnormalities in the blood vessels, and therefore the blood flow, in and around the brain were to blame for migraines and some other types of headaches. More recently, however, the consensus seems to be leaning towards dysfunctions of the cervical spine instead for some cases, known as cervicogenic headaches. That’s where physiotherapy can come into the loop.

• The cervical spine consists of seven vertebral segments from the base of the neck into the skull.
• Though relatively small in size, the neck structures around the spine are intricate and complex, consisting of the spine, muscle, ligaments, tendons, and nerves that need to be both strong and flexible.
• Possible causes include stuff or swollen joints in the neck, inflamed nerves, tightness and/or scarring of the soft tissues.

With the level of complexity, it’s not surprising that many people experience issues related to the cervical spine. Physiotherapy is most useful in cases of chronic and fairly benign – i.e. not severe – headaches. A research study published in 2004 found that regular (non-specialized) physiotherapy treatments helped reduce the frequency of chronic tension headaches. 

Symptoms are typically consistent.

• A cervicogenic headache originates in the cervical spine, but the pain typically radiates to the back of and top of the head.
• Pain and stiffness may become worse as you move your head or neck, and if you stay in the same position for extended periods of time.
• Other symptoms can include tenderness of the muscles and joints, reduced range of motion and mobility of the head and neck, weakness, and even a lightheaded feelings.

What Your Toronto Physiotherapist Can Do

Once other causes have been ruled out, and a cervicogenic headache has been diagnosed, your physiotherapist can begin to determine what is causing the pain.

• Manipulations and exercises can help alleviate the pain;
• Background information can help point out where lifestyle issues are causing mechanical dysfunctions, such as poor posture while sitting at a desk for many hours;
• Treatment will be customized to your specific condition, with the goal of alleviating pain and improving range of motion, if applicable.

If you are experiencing chronic headaches, don’t hesitate to contact one of our Toronto physiotherapists to discuss whether treatment might be right for you. You can call one of our Toronto physiotherapy, chiropractic, and sports medicine clinics today for a consultation.

Walking workouts are very popular with clients in our Toronto physiotherapy and sports medicine clinics for many good reasons. They are a great way to ease into an active lifestyle if you’ve been leading a sedentary life, and a good way to ease back into one after injury or surgery. For many people with arthritis and other conditions affecting the skeleton, muscles or other soft tissues, the low impact aerobic activity is one of the best options for staying fit.

For walking to become a workout, you need an athletic approach. It can also be something you do for fun, but walking yourself fit means having some discipline and getting the basics right. Here are five principles to keep in mind.

1. Mix it up – but be consistent.  This sounds like a contradiction, but it makes sense. When it comes to any fitness routine, consistent effort is the key to success over time. You can develop routines based around walking workouts at 20, 45, and 60 minutes. Within those time frames, you’ll want to include a warm up, rev up to an intense level, and then cool down.
   
   
2. Max it out. Within your fitness level, make the intense portion of your workout as challenging as you can for at least 2 minutes. That can mean anything from a slow stroll at the low end to a power walk where you can no longer speak – nearly as strenuous as a sprint.

• Begin with a warm up, then ramp up the speed at two minute increments until you hit your peak.
• Roll back a level, then hit your peak again. Now, ramp back down in two minute increments.
• For longer routines, increase the amount of time at each level, and add more intervals at the peak level.
• You can also add two to three minute weight routines to your workout, using hand weights no more than 10 percent of your body weight.
• Remember that you’ll burn 25 percent more calories for every 0.5mph increase in your speed.
• Faster also increases your heart rate, boosting your aerobic gains.
  
  3. Equipment matters. Walking doesn’t involve nearly as much equipment as many sports or fitness routines, but there are some essential components, and you can’t cheap out – quality definitely matters. You can increase and decrease your speed effectively in ill-fitting gear. Your Toronto physiotherapist or chiropractor is available for any advice related to your walking and other sports equipment.

• Your shoes are your friend, and they’ll either make your walk easier and more productive, or be a hindrance if not worse.
• Look for flexible soles and plenty of cushioning.
• They should be lightweight.
• Stiff heel counters prevent side to side movement.
• Choose lightweight materials for your walking gear – there are many high tech fabrics that will heat/cool you, and wick away any perspiration from your skin.
• Dress in comfortable layers.
  
  4. Stay hydrated. This should go without saying, but even if you’re still at the lower end of the scale, and you may not feel like you are sweating much or losing a lot of fluids, you still need to hydrate.

• Water is still a good option, and better that questionable energy drinks that get their boost from caffeine and sugar.
• Some studies actually suggest that drinking more water – up to 17 ounces – will increase your metabolic rate, and therefore the amount of weight you should lose.
• A study in Brazil found that green tea might have some helpful correlation to faster recovery rates for athletes.
• Both green tea and coconut water have sufficient sodium to help replenish electrolytes.
  
  5. Adjust for the weather – but keep going.  Be realistic about our Canadian climate, but don’t let it keep you from getting the workout your body needs.

• Have a waterproof outer layer and footwear that is appropriate for each season;
• Adapt your walking time for the seasons – that means earlier in the morning in the summer to avoid heat, and later in the afternoon in winter to take advantage of the day’s highest temperatures;
• The extremes are the exceptions – days with a high pollution count, during a blizzard, or if you suffer from seasonal allergies, you’ll want to explore indoor walking options in your area;
• Have a Plan B route in mind in case your first choice is flooded, too icy, or otherwise undesirable.

Pro Tip: Use a pedometer and/or heart rate monitor to be sure you’re within your advisable rates. A personal coach can help you set your goals.

Above all, make walking a habit and not something that you’re adding on to your day. It should be an integral part of your daily routine.

Even if you feel healthy and don’t seem to have any issues, we advise that you get the advice of your healthcare professional about your fitness goals, especially if there are pre-existing issues, or previous injuries or surgeries. Our Toronto physiotherapists, chiropractors, and other sports medicine specialists are available for advice and consultation. Call us or drop by one of our Toronto physiotherapy clinics today to make an appointment.

• Carbs! Eating simple carbohydrates beforehand is a good way to replenish those glycogen stores when you start your workout. Simple carbs are also digested fast and gives a quick boost of energy. Examples: a fruit, granola bar, greek yogurt, and dried fruits.
  
  
• If you are doing weight training during your workout, you should also consider eating a bit of protein before your workout. Examples: greek yogurt, nuts, milk, and a hardboiled egg.
  
  
• Try to eat a snack at least 30 minutes before your workout. You do not want to be too full when you're exercising because it may lead to discomfort. 
  
  
• Stay hydrated before, during, and after your workout. 
  
  
• After your workout, refuel with crabs and protein. Try complex carbohydrates like quinoa, brown rice, and whole grain bread. You can pair those up with foods rich in protein such as chicken, egg, tofu, beans, and fish. If you can't have a meal right away, make sure you have a snack at least 20 minutes after your workout. This can be a small protein shake, greek yogurt, toast with peanut butter and banana, or chocolate milk.
  
  
• Note that if you're an athlete, your protein needs may be increased!
  
  You can talk to a dietitian for more personalized nutrition recommendations regarding protein needs. Find out more about the Nutritional Counselling programs available at Athlete's Care.

• Pack and bring your food! Make sure you plan ahead before your go grocery shopping so that you’ll be able to choose healthy products. Make your meals ahead of time and pack them in containers so you don’t have to rush to make it before you leave for work.

• Share your healthy meals with your coworkers to encourage healthy eating in the environment.

• Research nearby food places that sell healthy meals when you feel like buying food for your lunch break. This can give you the opportunity to walk around and move more if you’re mostly sitting at your work.

• Drink plenty of water. Bring a portable water bottle to work so you can refill it throughout the day.

• Be mindful of your caffeine intake.  If you need energy, try consuming healthy snacks like fruits, vegetables, or nuts as alternatives to more cups of caffeinated beverages.

• Have a light lunch (for example: salad with a side of protein) and snack throughout the day.

• Get up and move during your lunch break to catch some sun and take a stroll outside.

• Take breaks when needed. Stretch, move your body, and refresh yourself in order to take the strain away from your lower back, neck, and eyes due to long periods of sitting and staring at the computer screen.

• Try to reduce the consumption of sugary snacks and drinks at work. Eating them will not keep you alert throughout the day. Consume complex carbohydrates instead.

Nutrition tip provided by Registered Dietitian and Sports Dietitian, Ben Sit.   Contact Athlete's Care at Yonge & Sheppard to book an appointment with Ben or click the here to find a Registered Dietitian near you!