The Best Thing You Can Do For Foot Pain

Foot Pain, specifically pain in the heel or arch of the foot is very common. It can be caused by many factors. It can come on gradually or start spontaneously. And while the causes and presentation may vary, the best way to fix it is often the same.

Before we talk about how to best fix this type of foot pain, let's talk about the most common reason this condition occurs.

The foot, while it may look like a simple structure upon first glance, is quite complex. It is made up of several bones, joints, muscles, ligaments and tendons which all work together to give our foot structure and allows us to endure significant forces when we stand, walk and run. 

One of the structures which helps to support the arch of our foot is made up of a tough tendon-like sheet. It is constantly under tension while we are on our feet. When this structure (called the plantar fascia) becomes overtaxed or stressed, it can begin to tear. Now sometimes this goes unnoticed and heals quickly, however, other times the stress that causes the initial tearing continues. If this is the case, the fascia can reach a point where it becomes painful when you try to walk on it, especially first thing in the morning.

Whether the pain starts all at once or gradually gets worse over time, the first thing I always recommend is to check your footwear!! 

The most common culprit for this type of foot pain is poor footwear with little to no arch support. While arch pain can happen to any type of foot, 9 out of 10 times it is someone with a low arch or no arch that doesn't have good shoes or insoles to support the foot.

So instead of waiting for the pain to just subside on it's own, at least take the time to make sure your shoes, sneakers, sandals, etc. aren't constantly re-aggravating the foot!

P.S. - A routine of stretching and strengthening is also going to be extremely important for the full recovery of your foot. Make sure to choose someone qualified who will be able to guide you when choosing proper footwear AND in setting up a personalized program to ease your foot pain.

How Posture Can Affect That Nagging Shoulder Pain

Have you ever hurt your shoulder and thought, "It will heal on it's own if I just give it time."? There are many factors that can affect recovery from a shoulder injury, but the first one I look for EVERY time is posture.

Posture is such a powerful word. It often evokes memories of being told to 'sit up straight!' by parents and teachers. As soon as I mention it during a physiotherapy session, there is an immediate reaction (correction) in their sitting posture.

Most of us know we could do with some improvement in our resting posture, but have you ever really thought about what it may be doing to your body if you don't fix it? 

While people often think of how poor posture may lead to a rounding of the back while seated, it can also have serious implications for the neck and shoulders. 

If you have poor shoulder posture, or rounded shoulders as it is commonly called, several things can happen within the shoulder to cause irritation and changes to the joint.

One of the most common conditions seen with poor shoulder posture is called shoulder impingement. In this condition, the alignment of the joint has changed enough to cause pinching of the tissue as you move your shoulder and upper arm. As the tissue gets pinched again and again, it can become inflamed or swollen and decrease the amount of space even further. Over time this can cause tearing, typically in the rotator cuff tendons, which leads to increased pain and loss of normal range of motion of the shoulder.

Another common issue is that the top of the arm bone (the humerus) can slide forward in the joint and put extra pressure on the front of the shoulder joint. As this soft tissue becomes irritated and inflamed, it can cause swelling in the tendons in the front of your shoulder. You would often experience this as pain in the front of the shoulder joint.

Poor posture can also lead to muscle imbalances in the shoulder. Typically the muscles that make up the back of the shoulder joint become stretched and weakened, while the muscles of the front of shoulder get tighter. This leads to an increase in poor shoulder posture because it feels even more comfortable to stay in this position.

Even if your shoulder injury is due to another cause, like a fall or a car accident for example, your healing time may be much slower if you are starting with rounded shoulders. Because the joint is already at a disadvantage and the tissue around the joint is constantly under stress, it makes it difficult for the injury to heal. Longer healing times and chronic injuries are often the result.

- So what should you do?

- The short answer is sit up straight.

The longer answer is that the shoulder joint is very complex and there are many factors that can affect your chances of injury and length of healing. It is important to keep your shoulders back, but you also need to make sure the muscles surrounding your shoulder are working properly to allow for proper movement as you move your shoulder and lift your arm.

If you are experiencing shoulder pain and think that posture may be causing it to linger or worsen, make sure to have it assessed by your physiotherapist so they can give you an appropriate specialized treatment plan for your particular condition.

Knee Pain - 3 Things You've Been Told To Do That May Be Slowing Your Recovery

Knee pain is another one of those common conditions that many of us have experienced. Because it is so common, we often hear advice from others who have had knee pain about how to manage it.

Here are 3 recommendations I hear frequently in the clinic and why you may need to be cautious about following these words of advice without first having your knee or knees examined. 

Rest it.  

Easily one of the most common pieces of advice someone with just about any injury will hear. And while rest is VERY important at the appropriate time, it can also lead to poor recovery outcomes if you don't move enough.  

Many of the cases of knee pain that come for treatment at our clinic are due to weakness of certain muscles or over-training in other areas. In these cases, it may just be a matter of adjusting exercise routines or modifying movement patterns to get the knees moving properly again. 

Getting the knee assessed will give you a better indication of whether the knee should be rested or not.

Wear more comfortable shoes.  

Sometimes people realize that their footwear is causing their knee pain. When they wear their old sneakers or boots, their knee pain really acts up. Many patients have come in with very soft soled shoes or 'rocker bottoms' (shoes that don't allow your foot to rest flat on the ground) saying they were told to get something with more cushion for their foot. 

While each case needs to be evaluated individually, most often your foot actually needs more support, not less. The soft sole can temporarily relieve symptoms by decreasing the impact on your joints as you walk. Without stability however, the joints often become overtaxed and irritated as they try to compensate.

Wear a pull-on fabric knee support.

These knee supports are very popular and are often the first thing people suggest as a fix when you first experience knee pain. While they CAN help to reduce swelling in the knee and the feeling of compression can make the knee feel better temporarily, a pull-on sleeve doesn't help to fix the root causes of knee pain. Actually, a small brace like this may give you a false sense of support and lead to further injury if you rely on it for stability.

As with most pain or stiffness, it's important to have the knee assessed in order to figure out the root cause of your knee pain. Wearing a knee brace that you picked up from a store or a friend may actually slow down your recovery if it wasn't recommended after proper hands-on assessment.

You may notice a bit of a theme in this post. While any or all of these suggestions may be helpful at the appropriate time, it is ESSENTIAL to have your knee assessed.

With proper assessment, you will know what is wrong and, together with your physiotherapist, you can determine a treatment plan and even discuss which of the suggestions might be helpful.

Neck and Shoulder Pain - Why Sitting Isn't Doing You Any Favours

Sometimes it seems like that nagging neck or shoulder pain comes out of nowhere! And when you try to treat it with some heat, or painkillers, or cooling creams, etc., nothing seems to work. You get that slight improvement for an hour or two...maybe a day. Next thing you know...BAM! the pain is back again.

Most people that present with this type of injury are baffled by the pain because they "didn't do anything strenuous to hurt it lately".

The crazy part is, it might not be any one thing that sets off the injury. In fact, it's much more common to see an injury that's the accumulation of all the little things we do on a daily basis that add up to one big, bad, sore neck or shoulders.

One of the main culprits I see almost daily is actually your sitting posture. The way you set yourself up at your desk, in your car, on the couch...all can play a role in how much stress is being put on the neck and shoulders throughout your day.  

Take a look at your posture right now, for example:

• How are you sitting in your chair?
• Do you have good support?
• Are you leaning forward?
• Are you hunched over a laptop, tablet or phone?

All of these things can affect your neck and shoulders and lead to pain and stiffness over days, months, years of sitting in poor postures.

So what should you do about that nagging neck or shoulder pain? You may not have to look much further than changing your sitting position and correcting posture. 

If you are sitting for long periods of time during your day, here's 4 things to keep in mind to help reduce stress on the neck and shoulders:

1) Mare sure you are sitting at the back of your chair and not perched on the edge.

Often times when we are focusing on our work, we tend to move out toward the front of our chairs. This means you have to lean forward, which causes more stress on the neck and shoulders.

2) Adjust your chair (and lumbar support if you have it) so you have good support for your low back?

Supporting your lower back typically leads to better posture for your upper back, neck and shoulders.

3) Sit closer to your desk and make sure your back is resting against the back rest of your chair. 

If you are leaning forward, just like when you perch on the edge of your chair, you increase neck and shoulder workload...not to mention low back strain too!

4) When possible, mare sure your shoulders, back and arms are supported.

This is most easily accomplished with a high back chair with adjustable arms, back and seat. This way the chair can be set up for YOU, instead of you trying to get comfortable in one that isn't suited suited to you.

One last thought...

Are you usually hunched over a laptop, tablet or phone and you're not at a desk on seated in a good chair?...Try to remember: head up, shoulders back! 

That is really a topic for a whole other blog post, but I had to at least mention it before I sign off. 

Remember, try out these tips to get you started if you are having neck and shoulder pain. You may be surprised how much it helps! 

Back Pain And Why You Should Ignore Friendly Advice

Okay, that might be a bit harsh... 

Don't ignore everyone completely when they talk to you about back pain. Just make sure you keep a few things in mind when getting that well-meaning advice.

First, let's set up the scenario...you may have gone through a similar situation. You start to have back pain or maybe you've been dealing with it for a while. When asked why you're looking a bit bent over today, you mention to a friend that your back has been getting pretty bad lately and it's starting to affect your everyday life. 

Suddenly, you see them light up. They look like a kid in class with their hand shot straight up in the air and a giant grin on their face because they know all the answers. 

The reply usually goes something like this: "I've had that before! I know just what you should do!"  

This is where you insert advice 'X'...

Now, X can be anything from stretching and strengthening to getting painkillers and surgery....I've heard it all. Not that there isn't a time and a place for these options (and many more), the issue here is that the advice is based on THEIR experience. And despite what they may think, back pain comes in many shapes and forms. 

Just for a few quick examples of different structures that can be affected...you can have strained muscles of the low back, herniated discs, degenerated discs, nerve pinching or irritation...or even combinations of these conditions. Within these broad structure categories are several sub-categories and variations. 

Now I'm honestly not writing this to scare you away. The point is that your back pain is not necessarily the same as your friend or family member's back pain.

To fully understand and properly treat your very individual circumstances, you need to be assessed by a licensed physiotherapist. A diagnosis of your condition will be given, along with a customized treatment plan and schedule.

The point is...while that friendly advice is well-meaning, you might want to talk to your local physiotherapist first.

7 Excuses We Tell Ourselves When Putting Off Treating Pain/Stiffness ... And What To Do NOW!

We all make excuses...we all have reasons for putting things off, especially when it comes to doing something new. As a physiotherapist, I've heard many possible reason why people wait SO long to take action and seek treatment for their injuries. Let me tell you right now, once you make the decision to do something about it, you'll be wondering why you waited so long!

So, just in case you fall into any of these categories....here's a list of the top 7 excuses I hear on a regular basis as to why you aren't coming to physiotherapy for the help you need. 

1. "I don't have the time" 

Life is busy...I'll give you that. With work, kids, grand kids, sports, the gym, community events...the list goes on and on...there's never enough hours in the day. Even retirees, who are supposed to be living the life of relaxation, are finding it hard to squeeze everything in. My answer is always the same and it comes in the form of the following questions: What is your injury or issue stopping you from doing? Is there anything on the list of 'busy things' that is being affected by pain, stiffness or weakness? If so, is it worth making some time to correct the problem? If the answer is YES (and it usually is), it's time to take action!

2. "It will get better on it's own"  

We are all hopeful that this one comes true. The problem is that often the pain or stiffness doesn't go away and even gets worse! Injuries can become chronic and harder to treat. They can also cause injury to other areas of the body as you compensate for stiff or sore joints and muscles. My advice is to save some grief and get yourself assessed early. This can really speed up recovery times!

3. "I don't want to commit when I'm not sure it will help" 

If you haven't been to physiotherapy before or you didn't have a great experience in the past, you may be wondering if it's worth going for an assessment in the first place. Our solution to this issue is our free info session. In these sessions you will learn your initial diagnosis and a typical treatment plan that would be used. This gives you the chance to make an informed decision before committing to treatment. Space is limited for these sessions so check with us right away if you'd like to learn how we can help.

4. "I have to get a referral from my doctor"

Getting a referral can seem like a daunting task. You have to make an appointment with your GP, wait for this appointment, hope they give you the referral you asked for, book a PT appointment, then FINALLY see a physiotherapist. Well here's some great news!!! You don't need a referral to see a physiotherapist! While some insurers may require it, typically you are covered for physiotherapy even without a referral from you doctor.

5. "It's going to hurt too much"

I won't lie...sometimes it can be uncomfortable during a physiotherapy session. That being said, each exercise or movement is chosen to maximize your ability to move with less pain and stiffness by the end of your treatment plan. While some things may cause discomfort, you should always be able to talk to your physiotherapist and come up with a treatment plan that is best suited and tolerable to you.

6. "I don't really know who to ask about my injury"

Often people are just unsure who to turn to about a specific injury. There are many options available to you, and that can make it confusing when you are trying to make a decision. While you can always consult your doctor, I strongly recommend talking to your physiotherapist when dealing with pain, stiffness and mobility issues. Physiotherapists are highly trained and skilled at treating most injuries to the body, including those involving: muscles, ligaments and tendons, joints, bones and nerves.

7. "It's just old age"

Many people today attribute their aches and pains to the natural aging process. While it's true that we may be more susceptible to wear and tear as we age, many of the issues I see on a daily basis are caused by poor movement patterns and muscle imbalances that can be corrected with a combination of proper stretching, strengthening and hands on therapy. . Talk to a trained physiotherapist to see how you can combat the aches, pains and stiffness that are often attributed to 'old age'.

So if you've been using one of these excuses for putting off dealing with that nagging injury...don't let it hold you back any longer from getting out, being active, and doing the things you love! Take action right now! You'll be happy you did.

Exercise For Proximal Hamstring Tendinopathy

For many runners with this type of injury, the first thing they want to know is "When can I get back to running?" Discussing the importance of gradual loading is crucial in educating your patient. Understanding how to get back to running by following proper loading principles will lead to better compliance during the rehab process and better outcomes.

Check out these resources for management of proximal hamstring tendinopathy.

http://www.running-physio.com/phtvids/

"Text Neck" is Real!

"Text Neck is Real"

The link above is a great post that was shared by a colleague of mine at Gaudet Rehabilitation and Sport Performance. Some food for thought...

"Happy Thanksgiving to all. Leave the technology aside and spend time with your loved ones. "Text neck" is real. More and more kids aged 12-15 are coming through the clinic with postural changes on par with a 70 year old who has worked their entire life. Yesterday, an assessment and xrays showed moderate to advanced arthritis at the cervical/thoracic spines for one of my clients, age...17. Health care professionals can help, but unless behaviour change takes place, those restrictions will set back in whether it's manipulated/mobilized/or exercised. Bring back the days of playing outside. The cuts/scrapes on the legs and arms are far less restricting long term."

Early physical therapy for low back pain reduces costs, resources

This recent article shows a direct link between early PT intervention and the reduction of costs and resource utilization by our healthcare system.