Spinal Decompression Therapy for Neck Pain in Toronto

Spinal Decompression by the Registered Physiotherapists at Ace Physiotherapy in Toronto Treatment of Disc Herniation and Pinched Nerve in the Neck

http://www.acephysio.ca/physiotherapy/spinal-decompression-therapy-for-neck-pain-in-toronto

Frozen Shoulder Knowledge Sheet

Frozen Shoulder

 Frozen shoulder is the classical stiffness and pain in the shoulder girdle that greatly restricts motion and movement across this ball and socket joint. Seen in 2% of general population and with a slightly higher incidence in women, frozen shoulder or Adhesive Capsulitis is more common in middle aged populations with peak occurrence in individuals between 40 to 60 years of age.

What is frozen shoulder?

The shoulder joint is a classic ball and socket joint that enables 3-dimensional movement of upper limb. The movement of upper limb is supported by ligaments that hold the articulating surfaces of the bones to ensure free movement; however, when the shoulder joint becomes inflamed, pain and stiffness results making movement across the shoulder joint difficult.

Sign and symptoms of Frozen Shoulder:

Frozen shoulder is classically the result of capsulitis or inflammation of joint capsule. Following symptoms are characteristic: -          Pain in the shoulder that varies in severity and character, from dull and aching to sharp and stabbing that prevents individuals normal shoulder activity -          Restricted range of motion or shoulder movement -          Stiffness A classic frozen shoulder starts with the pain that limits the movement across the shoulder joint. Decreased activity leads to stiffness of ligaments and tissues supporting the shoulder joint, further limiting the movement and range of motion.

How does Frozen Shoulder develop?

In majority of the cases, no specific cause can be ascertained to frozen shoulder; however, the following risk factors greatly increase the risk: -          Previous history of shoulder surgery or shoulder injury that involves a ligament or joint capsule can lead to adhesive capsulitis due to prolonged inactivity or immobility across the shoulder joint. -          Cervical disc herniation is also a recognized risk factor that manifests itself as frozen shoulder in early cases. -          Long standing, uncontrolled Diabetes Mellitus is another established risk factor that impairs the inflammatory response in the shoulder region after a trivial injury. About 10 to 20% of all diabetics develop Adhesive capsulitis at some point of their life. -          Hyperthyroidism as it is known to affect ligaments and muscle spindles. Same is true with hypothyroidism. -          Open heart surgery and neurological diseases like Parkinson’s disease are also known factors Any of the above risk factors increase the risk of irritation or injury to shoulder capsule. Since the shoulder capsule has an extremely rich nerve supply, pain is out of proportion to the degree of tissue damage that limits the mobility of shoulder joint. Prolonged immobility and hypo-activity leads to stiffness and thickening of shoulder capsule that further aggravates pain if any movement is attempted. The patho-physiology of frozen shoulder can be divided into 3 stages: -          Freezing that involves limitation of shoulder activity due to the gradual increase and severity of pain. This stage can last from up to 6 weeks to about 9 months depending on the management -          Frozen stage that lasts for about 3 to 6 months; mild improvement in pain symptoms but stiffness may interfere with the mobility and full range of motion. -          Thawing stage in which the range of motion gradually improves with an absolute return by almost 6 months to as long as 2 years. Ace Physio's Registered Physiotherapists are experts at providing Physiotherapy treatments for Frozen Shoulder.

Rotator Cuff Tendonitis

What is Rotator Cuff Tendonitis?   

Rotator Cuff tendonitis, as the name suggests is a condition in which the tendons of upper limb muscles get inflamed or injured as a result of poorly regulated movements across shoulder joint. The strength and free range of motion, characteristic of shoulder joints is mediated by tough tendons and ligaments that hold the bones in place while providing support during movement; however, sometime excessive activity can damage the micro fibers of tendons leading to inflammatory and degenerative changes.

Rotator Cuff Injury Signs and Symptoms:

Following sign and symptoms are suggestive of rotator cuff tendonitis:

• Moderate to severe pain in the shoulder region that aggravates while performing certain activities that involve stretching of arm (for example in over-head arm movements, pushing or pulling heavy objects and even while sleeping on the affected side of the body).
• Weakness of shoulder/arm movements and limitation of range of motion of shoulder joint
• Often those with rotator cuff injuries will assume a characteristic body posture to make sure the shoulder remains inactive or immobile
• The severity and intensity of pain greatly increases when any activity is attempted involving shoulder joint like combing hair (over head movement combined with external rotation of the shoulder), undoing a bra strap (internal rotation of the shoulder) or lifting weight.
• Pain between shoulder blades may occur due to improper scapular movements, strain of the attached musculature to the scapula, thoracic spine posture, or nerve injury.

How does Rotator Cuff Tendonitis develop?

Shoulder joint is supported by major muscles that connect Humerus to the shoulder blade (Scapula) and collar bone (clavicle).

Rotator cuff Tendonitis is the result of any movement or activity that involves excessive stretching or straining of muscle fibers or tendons of upper limb. Some recognized risk factors are:

• Overuse or abuse of shoulder muscles that may damage the tendons and leads to inflammatory changes.
• Falling on an out-stretched hand
• Lifting heavy objects and placing them in shelves at certain height.
• Advancing age that leads to wear and tear changes in the main structural protein of shoulder joint, i.e. Collagen and leads to degenerative changes in the shoulder joint
• Any condition that increases the deposition of Calcium in the joint space or minor sports injuries that over-time leads to the formation of spurs. Calcium crystals and bony spurs further enhance the rate of degenerative changes in the rotator cuff tendons.  This is referred to as Calcific Tendonitis of the Rotator Cuff.
• Frequent and repetitive overhead movements of arm especially in some sports like throwing base-ball or other sports like swimming.
• Occupations like painters or Carpenters and weight lifters also prone their shoulder joint to repetitive stress and unnecessary strains that leads to bruising and tearing of tendons.

Some people develop muscle or tendon weakness with age or with some medical conditions like steroid use and some blood disorders, in all such cases the risk greatly increases that can be minimized by performing some muscle stabilization and strengthening exercises. 

The Physiotherapists at Ace Physio are experts at providing customized rotator cuff strengthening and stretching programs to assist in the recovery of function and the decrease of pain in the rotator cuff.

Ace Physio also offers Shockwave Therapy which can be excellent for assisting in the recovery of calcific tendonitis, rotator cuff tendonopathy, or partial tears of the rotator cuff.

To Book an Appointment at the Best Physiotherapy in Toronto call 416-900-6653 or book online at www.AcePhysio.ca

Ace Physio »Ace Physio is Toronto’s newest state of the art physiotherapy and sports injury clinic. Whether you’ve been suffering from a sports-related injury, motor vehicle accident injuries, workplace related i...

Ace Physio »
Ace Physio is Toronto’s newest state of the art physiotherapy and sports injury clinic. Whether you’ve been suffering from a sports-related injury, motor vehicle accident injuries, workplace related i...

Ace Physio Physiotherapy & Sports Injury Clinic

INVITATION TO THE ALL-NEW ‘ACE PHYSIO’
Physiotherapy and Sports Injury Clinic located in Downtown Toronto

To our valued patients,

Allow me the pleasure of inviting you to the grand opening of our new Toronto office, still located at 2 Carlton St., but now in suite #601.  These new premises will be the offices from which we will serve and assist you in all your health care needs.

We are expanding our hours, and adding new experts to our health care team.

Our  inhouse Chiropodist will be performing Chiropody services including:

·         Custom Orthotics with Highly Accurate 3-Dimensional Laser Casting

·         Shockwave Therapy of Foot/Ankle Conditions

·         Gait/Running Biomechanical Screening

·         Arthritic Foot Complaints

If you or someone you know suffers from a foot or ankle condition, this is an excellent opportunity to attend treatment with a highly skilled, and highly qualified Chiropodist.  Please call the office at (416) 900-6653 or book online at www.AcePhysio.com to schedule an appointment with Vincent Ku (Chiropodist).

We are also pleased to announce that two of the most highly sought after and skilled physiotherapists in the city have joined our team.  Lauren Kelly D. and Lauren A. bring a wealth of experience treating both sporting and overuse injuries.  Their fresh approach to physiotherapy, and expertise allows them to offer the most comprehensive treatment experience possible for their clients.  Our schedule has also been revamped for added availability, making your treatments more convenient than ever!

At Ace Physio we are pioneering modern patient health, by taking technology that was once only available to professional athletes and the very wealthy, and making it available, and affordable, to the general public and recreational athletes alike.

Try one of our innovative therapies today, and feel the difference!  
Call our office today at (416) 900-6653
or book directly online by visiting www.AcePhysio.com

Best regards,
Brad Saltz (Owner and Registered Physiotherapist @ Ace Physio)

The Latest Research on Achilles Tendon Treatments

Reference: Alfredson H, et al Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. Am J Sports Med. 1998 May-Jun;26(3):360-6.

On July 19, 2011 I was reading the “Running” section in the Canadian National Post when I came across an article about achilles tendonitis by Dr. Tim Rindlisbacher (The article can be accessed here http://www.nationalpost.com/life/running/Greek+hero+about+Achilles+tendonitis/5127299/story.html). Dr. Rindlisbacher essentially treats achilles tendonitis by recommending rest, and performing platelet-rich plasma (PRP) injections. Unfortunately while rest will obviously help, it is very hard to tell my athlete patients to stop their favourite sports for any prolonged period of time, and PRP injections are not only very expensive but to Dr. Rindlisbacher’s own admission in the article, they have not proven to work any better than placebo. In my opinion as a physiotherapist that treats a significant number of achilles tendonitis patients this kind of advice from a doctor is either intentionally misleading to the public for his own financial gain, or simply ignorant to the well validated studies on treatments that have proven effective for achilles tendonitis.At the top of the page I have referenced a study which was published in the highly reputable ‘American Journal of Sports Medicine’ by Dr. Alfredson that demonstrated that eccentric calf muscle training in recreational athletes who had the diagnosis of chronic Achilles tendinosis not responsive to past conservative treatments (i.e. rest, NSAIDs, changes of shoes or orthoses).

All these patients had Achilles tendon pain not allowing them to run, and all had significantly lower calf muscle strength on the injured side compared with the non-injured side.

After 12-weeks of heavy eccentric training, all the patients were back at their pre-injury levels with full running activity. Their calf muscle strength on the injured side had increased significantly and no longer differed from that of the non-injured side. Meanwhile, none of the patients in the control group improved within the same time period.

So what exactly was the Exercise Program?
At Ace Physio we are experts at teaching medically sound and evidence-based exercises to help promote healing and strengthening of your achilles tendon. Our highly trained physiotherapists have post grad certifications in the ‘Foot and Ankle Complex’ and use a variety of methods including therapeutic taping to allow you to perform these exercises safely, with minimal pain or discomfort, and correctly, so that you achieve maximal results in the shortest possible time frame.

Shockwave Therapy for Achilles Tendonitis
Reference: The American Journal of Sports Medicine – High-Energy Extracorporeal Shock Wave Therapy as a Treatment for Insertional Achilles Tendinopathy by John Patrick Furia, M.D.

Additionally at Ace Physio we utilize Shockwave therapy in our treatment of Chronic Achilles Tendonitis.

Shockwave Therapy is an incredible new therapy for the treatment of tendon injuries that has only recently come to Canada. Shockwave therapy has been highly validated in multiple studies utilizing a double blinded, randomized clinical trial for the treatment of Achilles tendonitis. We have included a direct link to the study in PDF format by clicking on the above link. This study demonstrates the clinical effectiveness of Shockwave therapy for the treatment of Achilles tendonitis.

At Ace Physio we utilize the top of the line Storz MP200 Shockwave therapy machines to provide treatment. Our expert and friendly staff can assess and determine the best course of treatment for you to help you get rid of your achilles tendon pain and discomfort and get back to your sports faster!

Contact Ace Physio today!
Tel: 647-884-5005
http://www.acephysio.com
info@acephysio.com

Carpal Tunnel Syndrome: Acupuncture vs. Splinting

Reference: Kumnerddee W, Kaewtong A. Efficacy of acupuncture versus night splinting for carpal tunnel syndrome: a randomized clinical trial. J Med Assoc Thai. 2010 Dec;93(12):1463-9.Carpal Tunnel Sydrome is chracterized by numbness, tingling, burning or pain in the median nerve of the hand for more than a week or for more than three times in the past six months.

Until recently the first line of conservative treatment for carpal tunnel syndrome from doctors is typically nocturnal/nighttime splinting. Splinting, reduces stress on the peripheral nerve in the wrist, allowing it to heal and avoids awkward wrist positions as a person sleeps. Night splinting has shown in previous studies to give patients significant improvement in their symptoms and decrease in their discomfort.

A new study from Thailand had 61 patients with carpal tunnel syndrome (CTS) randomly assigned to either acupuncture or night splinting groups.
The Acupuncture group received electro-acupuncture twice a week for 5 weeks (10 sessions in total). The night splint group received neutral wrist splint during the night for 5 weeks.

Result: Although both groups improved equally with respect to overall symptoms and function, visual analogue pain scale decreased significantly more in Acupuncture than in the night splint group.

Conclusion: Electro-acupuncture is a highly effective and cost efficient treatment for Carpal Tunnel Syndrome and should be a first line of treatment, well before risky surgeries or cortisone injections.

Carpal Tunnel Treatments @ Ace Physio
At Ace Physio our expert Physiotherapists with Acupuncture certifications are performing electro-acupuncture stimulation using the AcuHealth Professional 900. The Acuhealth Professional 900 is a high end electro-acupuncture unit that offers the pain relief of Acupuncture without needles.

Ace Physio also offers; Shockwave Therapy, Super Pulsed Laser Therapy, Gua Sha, and Traditional needled acupuncture, & night splinting for the treatment of Carpal Tunnel symptoms.

“Ace Physio regularly treats Carpal Tunnel and has helped many past patients reduce their pain and discomfort , and improve their well-being. At Ace Physio we would love to chat with you about your condition and help you recover faster.”
-Brad Saltz (Registered Physiotherapist)

Contact Ace Physio today!
Tel: 647-884-5005
http://www.acephysio.com
info@acephysio.com