Physiotherapy Toronto Blog 

Put the Thaw on Frozen Shoulder

By Athlete's Care on July 03, 2020

Registered Physiotherapist, Rebecca Chambers, has taken scientific data as well as her own personal experience to provide tips, tricks and exercise programs to help guide your recovery and minimize shoulder pain.

Frozen Shoulder Physiotherapist

What is Frozen Shoulder?

3 Things are Necessary for a Diagnosis of Frozen Shoulder:

  1. Persistent and Pervasive Pain: Pain is constant, worsens at night and with movement, and present for more than 3 weeks.
  2. Severe Limit in External Rotation: External rotation is limited by at least 50% or is less than 30 degrees
  3. Moderate Limit in at least 2 Other Directions: Abduction and Flexion are easiest to assess. 

Who Gets Frozen Shoulder?

  • Frozen Shoulder can either be Primary or Secondary
  • Primary Frozen Shoulder is idiopathic or of unknown origin
  • Secondary Frozen Shoulder comes as a result of another injury such as a fracture, surgery or a rotator cuff tear
  • Frozen Shoulder is more common in women aged 40-65
  • Frozen Shoulder is more common and can be more severe in individuals with diabetes or thyroid issues

Frozen Shoulder is Divided into 4 Stages

Once you have determined you have frozen shoulder, it is important to know one’s current stage in this condition in order to decide the best course of treatment.  You can then access information, tips and exercises that are geared toward that stage. Movement can optimise how quickly you move through these stages. Be smart, but keep moving!

For more information visit frozenshoudlerphysio.ca


Book an appointment with Rebecca, either in-person or virutally, and she will help you determine what stage you're in, provide recommendations to help thaw your frozen shoulder and get you moving again.

Click here to request your appointment. 

 

 

 

Can exercise help prevent illness from COVID-19?

By Athlete's Care on July 03, 2020

Exercise can help boost your immunity, lower inflammation and may help prevent serious complications from COVID-19 if you catch it.

https://luminohealth.sunlife.ca/DHSLab_ArticleController?url1=ka03m0000013WUfAAM&src=article&Language=en_US

By Anna Sharratt, Lumino Health

Toronto Physiotherapy


If you’ve been looking for motivation to get exercise more, new research may help. An early studyon COVID-19 suggests that exercise may help prevent serious complications from the virus.

Scientific studies have found conditions that put you at higher risk of serious illness from COVID-19. According to the Centres for Disease Control, they are:

  • High blood pressure
  • Cardiovascular Disease
  • Diabetes
  • Obesity
  • Chronic lung disease
  • Liver Disease
  • Age – the older you are, the higher your riskMany of these conditions can lead to more inflammation in the body. And because COVID-19 causes inflammation, a situation called a cytokine storm can develop. That’s when the body’s immune system overreacts. This can lead to your own immune system attacking healthy organs.

How exercise can help

Exercise, even 20 minutes a day, reduces inflammation in the body. It also reduces oxidative stress, part of the body’s natural aging process, which leads to tissue damage. Studies have found those with liver diseaseheart disease and obesity who exercised regularly saw their inflammation levels drop.

Exercise also improves immunity, improving the body’s ability to ward off infection.

Dr. Paul Oh, the medical director of the Cardiovascular Prevention and Rehabilitation program at University Health Network’s Toronto Rehabilitation Institute, says exercise could help your body recover from COVID-19. But we don’t know for sure yet.

"Moderate intensity exercise has been shown to boost your immune function and improve the body's response to viral infections. It is possible then, that exercise could improve your body's immune response to COVID-19, but this is yet to be studied."

The recent study showed evidence that exercise could help with one specific complication of COVID-19. It’s called Acute Respiratory Distress Syndrome (ARDS). This complication of COVID-19 affects between 3% and 17% of all patients. ARDS happens when fluid builds up in your lungs’ tiny air sacs. This reduces the amount of oxygen in your blood.

Through regular bouts of exercise, people can:


These can all set them up to be in better shape if they contract COVID-19.

The best way to exercise

Before you get off the couch, you need to come up with an exercise plan. That’s because failing to stretch and prepare your body for a workout can lead to injuries.

You can’t stay active if you’re injured, says physiotherapist Daniel Yoon, the clinic director of Athlete’s Care in Toronto. “If they can’t move, they can’t develop cardiovascular health,” he says.

Yoon says that over the past several months, many people have become very sedentary due to stay-at-home orders. That makes the fascia — connective tissue in the body tight. Many are developing posture issues from sitting on soft surfaces. “They’re losing their ability to move,” he says. Plus, they’re developing debilitating neck and back pain.

Yoon says that before launching into an aggressive workout regime, it’s best to fix what’s ailing you. Correct your posture by setting up a more ergonomic work station. Build corrective exercises into your day and warm up extensively before any exercise.

The World Health Organization recommends all adults:

  • do at least 150 minutes of moderate-intensity physical activity throughout the week.
  • For more health benefits, adults can increase their moderate-intensity physical activity to 300 minutes per week.
  • Do muscle-strengthening activities involving major muscle groups 2 or more days a week


Lower-impact exercise such as walking or hiking can be a good first start, Yoon says. Try to add some weight-bearing exercises such planks or squats too. Once your fitness improves, you can start to jog or engage in a higher-intensity workout.

If you need help with pain, injuries or putting together an exercise routine, speak with a physiotherapist.

 

WELCOME BACK!

By Athlete's Care on June 04, 2020

As we open our doors again for care in the clinic, we are excited to be able to see you again in person! We have been preparing for your visit and want you to know that your health and safety are paramount during these unprecedented times.In anticipation of your visit to one of our clinics, we have created this educational sheet so you can be prepared for your session while reducing any risks associated with a medical visit. The measures detailed below will allow you to safely work with your doctor or therapist in person, even if physical distancing measures cannot be met. While we are trying to implement the greatest risk mitigation measures, we respect that the evidence is changing on a regular basis and our practices will have to adapt as we learn more and more. We also respect that any physical contact is not free of risk but these protocols should be followed for the safety of yourself, your family and our staff.

 

ACTIVE AND PASSIVE SCREENING

A COVID-19 Health Screening Questionnaire will be sent to you prior to your appointment. Please ensure that you fill this out within 2 hours of all in-person visits. If you have answered YES to any of the screening questions, please contact the clinic and speak to an administrator before entering. You will also see signage throughout the clinics regarding safety measures in place in the facility, such as the use of personal protective equipment (PPE), physical distancing, and hand-sanitizing.

 

FILLING OUT FORMS

Any additional forms that require completion will be sent to you in advance of your appointment and we ask that you kindly submit them back to us prior to your appointment. If not possible, we ask that you bring a completed physical copy to your appointment. ARRIVAL AT CLINICWe are asking clients to arrive at least 5 minutes before your session. We are also requesting that you wear a reusable mask while attending your appointment. If you do not have one, a mask will be provided to you at a cost of $2.00

 

WAITING AREA

When you arrive at the clinic, please use the hand sanitizer provided to clean your hands. We have removed most of the seating from the waiting room and ask that you stand while you wait to be assigned to your practitioner’s designated room. We have marked areas in our waiting room where you can stand safely while maintaining a safe distance from others. If you do need to use one of the chairs in the waiting room please do so. We will ensure the surfaces of the chair are cleaned after every use. We have taken measures to schedule your appointments in a staggered fashion to help maintain physical distancing, and limit the number of people in the waiting areas.

 

TREATMENT SPACE/EXAM ROOMS

When our front desk staff has assigned you to the exam room or treatment space, please go immediately to the room. The door should be open. We ask you not to open the door as to minimize contact with door handles. Please sit on the chair or on the bed. If you need to change your clothes please tell your therapist and they will close the door or draw the curtain, and leave the room. Please place your clothes on the chair rather than the hook.

 

DURING YOUR CONSULTATION/TREATMENT

Before the session begins, your doctor or therapist will provide you with another opportunity to sanitize your hands. Your doctor or therapist will be wearing a medical grade mask and may or may not have protective eye wear in the form of safety glasses or a face shield. If during your session a manual treatment was provided that required body-to-body contact, your therapist may instruct you to change your clothing after the appointment and to wash them with detergent before you wear them again. This should not be necessary if the therapist only uses his/her hands or arms during the session as each therapist is maintaining a stringent hand hygiene protocol, but we respect that you may have your own risk mitigation strategy and encourage to do what you feel most comfortable doing,

 

APPOINTMENT TIMES

We are required to maintain a very stringent adherence to your appointment and treatment times with the doctor or therapist as we will require time to clean all surfaces in the room between patients and it is imperative that we minimize the waiting time for patients in the waiting area.

 

WASHROOM USE

We kindly ask that you limit the use of the clinic’s washroom as to minimize additional points of contact. We encourage you to use the facilities before you leave your workplace or home. However if there is a need, a washroom will be available. If you do use the washroom, please notify the front desk so they can wipe surfaces after use.

 

AFTER YOUR CONSULTATION/TREATMENT

When your session is completed the therapist or doctor will open the door for you and you may make your way to the front desk to make payment and to schedule follow up sessions. Your therapist may also be the one to schedule your follow up appointments in order to minimize people congregating at the front desk. Your doctor or therapist may also suggest booking some sessions in person and some sessions via virtual care or video consultation. We also ask that you block book multiple therapy appointments in advance. Our therapist availability is now significantly reduced so this will allow you to book the days and times that you prefer, and will help to maintain physical distancing at the front desk. All invoices will be emailed to you to minimize the exchange of paper. When you arrive home or to your office, please wash your hands. If you used a reusable mask please wash with soap and water. If you have a medical grade disposable mask please discard and wash your hands again.

We recognize that this is a lot of information to digest and the procedures may be quite different from what you have been previously accustomed to. However, following the above guidelines will help to ensure a safe and comfortable environment for all parties in the clinic, which is in everybody’s best interest. Underneath these layers of extra protection, rest assured we are still the same, caring, attentive providers we have always been! We are very much looking forward to reconnecting with you soon!

Biopsychosocial Approach to Treatment

By Athlete's Care on May 22, 2020

As we continue to live in these unprecedented times, we have in a short period of time, learned how to adjust to these new and often, challenging circumstances. Whether we are the parent who is working from home on your couch, while your children complete their assignment, a Retail Salesmen who is currently laid off, or a Nurse who has just gotten off 3 night time shifts and is living in their camper, to protect their family from contracting the virus. We all are experiencing physical, social, and emotional changes. Even as a clinic, we have had to adapt to new models of care. As Therapists, we strive to provide the best for our patients. We have now used social media platforms to reach out to our communities to help provide support and education. In saying this, one change specifically that has truly been for the better, is that we have all adopted more of a biopsychosocial approach in our practice and everyday life.

As customers in the past, and by past, I mean two months ago, you trusted us with your care, and graced us with your presence on a regular basis in our clinics. You were provided not only hands – on treatment, whether is was from clinicians such as a Massage Therapists, Physiotherapist or Chiropractor, but you also had the opportunity to work through your exercise regime around a community of clients, who were also working toward their recovery and fitness goals. I am sure like us, you did not expect this shift towards an online platform of care, where the hands-on component of your treatment, has beenplaced at the side (for now). The interesting thing is, that when we look at the biopsychosocial approach; which is not new to the medical world, as it was conceptualised in 1977 by George Engel, that is suggests that “in order to understand a person’s medical condition, it is not simply the biological factors to consider, but also the psychological and social factors” (Gatchel et al, 2007).

This model has been used for patients with chronic pain to explain the predominant drivers of their pain, whether that is because of social/environmental factors (eg. Work, relationships with family, social environment, living situation), behavioral factors (eg. Physical inactivity, fear of activity due to pain), emotional factors (eg. Trauma, anxiety, stress, avoidance behaviors), cognitive factors (eg. Catastrophizing thoughts, your expectations for treatment or your recovery) or biological/mechanical factors (eg. Physical symptoms (muscular, neural, respiratory, etc)) (Gatchel et al, 2007).

To put this into perspective, when you watch a scary movie, you may begin to breathe a little faster, tighten you muscles or even brace yourselves, your palms may become sweaty, or you may even recall a previous movie or experience that made you feel a similar way. This interconnection of body systems is an unconscious response, which is called the fight or flight response. Our bodies are innately protecting us from fearful or painful experiences. Now take this example and apply it to someone who has experienced multiple ankle sprains in the past. This constant stress on the body; physically, emotionally, socially, and behaviorally, can lead to a major tole on the body. Their perceptions of pain or their recovery may have changed, their ability to cope or communicate their feelings and/or needs mayaffected relationships or even their ability to complete their work or household duties. Their pain experience is unique to them, and through using a biopsychosocial approach, we can use tools to address the primary drivers of their pain.

The use tools such as mindfulness, qi qong, expressive writing, self-affirmations, motivational interviewing, yoga, and pain education can, if warranted, have a drastic effect on your overall quality of life. As I said previously, each of us are unique, in that there is not a “one size fits all” approach to recovery, so connecting with your health care professional, who can help you understand what may be contributing factors to your injury/pain, is the first step! The amazing thing about our clinic, and these unprecedented times, is that more than ever, we are supporting each other.

At Athlete’s Care we pride ourselves on our holistic approach to care, and our wide multidisciplinary team. Therefore, even duringthese socially distanced times, we can help you reach your same recovery and fitness goals; together. We are available even while you are watching your children at home, or in between your shifts. Virtual care is very muscle an accessible option for you to address your needs. We are a widespread, compassionate, and experienced team who is adopting a new approach to your care, and is ready to help you, whenever you are ready!

Written by: Olivia Drodge, Reg. PT.
Registered Pelvic Health Physiotherapist

(1) Gatchel, Robert J., Peng, Yuan Bo, Peters, Madelon, L.; Fuchs, Perry, N.; Turk, Dennis C. 2007 The
biopsychosocial approach to chronic pain: Scientific advances and future directionsfckLR Psychological
Bulletin, Vol 133(4), 581-624