Menopause and Frozen Shoulder: How the Two Might be Connected, and How Acupuncture and Cupping Can Treat Both

/in , /by

Frozen Shoulder: A Symptom of Menopause?

Frozen Shoulder (FS), or adhesive capsulitis, is a condition that causes pain, stiffness, and limited mobility in the shoulder joint. It can be a result of a combination of hormonal changes, injury, and prolonged shoulder immobilization, leading the connective tissues surrounding the shoulder to become thickened and inflamed. This can lead to scar tissue formation and further restriction of movement.

FS primarily affects adults, especially those between 40 and 60 years old, and it occurs more often in women than men. This has led researchers to believe there may be a hormonal link at play. The Traditional Chinese Medicine (TCM) term for “frozen shoulder” translates into English as “shoulder at the age of 50 years”.

Frozen shoulder typically progresses through three stages:

  1. The freezing stage: marked by increasing pain and reduced mobility.
  2. The frozen stage: where stiffness is most severe.
  3. The thawing stage: during which movement gradually improves.

Frozen shoulder can develop over months and may last up to two years if untreated.

Benefits of Acupuncture and Cupping for Frozen Shoulder

In TCM, there is an understanding that different people can have the same symptoms, but have different underlying conditions that are causing pain and other symptoms. The specific presentation of symptoms can help an acupuncturist determine the underlying root causes of the condition and treat them accordingly.

Acupuncture and cupping aims to restore your body’s energy balance, known as Qi, which flows through meridians or pathways. When Qi is blocked or unbalanced, you may experience pain and dysfunction, like in the case of FS.

Acupuncture and cupping helps to treat FS by stimulating the body’s natural healing processes by needling into specific acupuncture points. The benefits include:

  • Increased Blood Flow: improving circulation around the shoulder joint, ensuring that oxygen and nutrient-rich blood reaches the affected tissues. This increased blood flow promotes healing, reduces stiffness, and accelerates recovery. Improved circulation can also reduce swelling.
  • Reduced Inflammation: Reduction in inflammation decreases pressure on surrounding tissues, easing pain and allowing for greater mobility.
  • Relaxation of Tight Muscles: Relaxation of muscles reduces the tension contributing to pain and stiffness while promoting a more balanced flow of energy throughout the body. Improved energy flow can enhance the body’s overall healing process. By relaxing muscles and increasing joint lubrication, acupuncture promotes a greater range of motion.
  • Promotes Holistic Healing: Acupuncture not only targets physical symptoms but also supports overall well-being by addressing stress, anxiety, and fatigue associated with chronic pain.
  • Cupping: Involves placing specialized glass cups on the skin to create suction. This vacuum effect lifts the skin and underlying fascia, increasing circulation and loosening tight tissue. For FS, cupping is typically applied around the joint and shoulder blade.

The number of sessions required varies, but most people see noticeable improvements after 4 to 6 sessions. For chronic or severe cases, a longer course of 8 to 12 treatments may be needed. 

In some cases, individuals with complex conditions may require maintenance sessions beyond the initial course of treatment. These ongoing treatments help sustain progress, prevent symptom recurrence, and further enhance shoulder flexibility and function.

The ability to customize the treatment plan ensures that each patient receives care tailored to their unique needs, maximizing the benefits of acupuncture.

The Menopause and Frozen Shoulder “Double Hit”

There is no current evidence that directly links menopause and frozen shoulder. But it’s likely that changing hormones during menopause can put folks at risk.

Menopause is the stage of life in which people who have periods no longer have one. This occurs due to declining levels of the hormones estrogen and progesterone. Estrogen is also good for the joints, as it protects the cartilage, stimulates bone growth, and helps regulate inflammation. Low levels of estrogen cause many of the symptoms of menopause, like hot flashes and insomnia.

For many, the onset of FS during perimenopause or menopause feels like a double burden. Not only are they dealing with menopausal symptoms, but the sudden, sharp pain and reduced mobility in their shoulders make day-to-day activities even harder.

Acupuncture is exceptional at both treating hormone imbalances and reducing pain. Other symptoms of menopause that acupuncture can help with, include:

  • Night sweats
  • Mood changes
  • Anxiety
  • Fatigue
  • Low back pain

Early intervention through acupuncture and physiotherapy can help maintain shoulder function and prevent the condition from progressing.

 

Written By: Yvonne Sui

Oncology Physiotherapy: Our Approach to Your Healing Journey

/in , /by

I’ve been working with people affected by cancer for about 10 years. My first client was going through breast cancer treatment and had been advised to exercise, but pain in her Achilles tendon was holding her back. Supporting her led me to dive deeper into understanding how chemotherapy and other cancer treatments affect tendons and tissues throughout the body. She shared her experience with others in her recovery community, and from there my oncology-focused practice began to grow.

Over the years, I’ve worked most often with people recovering from breast cancer, helping with pain and reduced mobility following surgery or radiation. This commonly affects the shoulder, arm (including cording), neck, upper back, and ribcage.

As a Fellow of the Canadian Academy of Manual and Musculoskeletal Physiotherapy (FCAMPT), I bring advanced training in hands-on techniques to restore mobility and reduce pain. Manual therapy can be very effective, but research — and my clinical experience — consistently shows that exercise is one of the most powerful tools in cancer recovery. Exercise helps manage side effects such as fatigue, mood changes and nausea, and supports return to daily activities, recreation and work. Excitingly, emerging evidence suggests exercise may also improve long-term survival.

I’m now focusing my practice fully on oncology physiotherapy, supporting people with all types of cancer. My approach is calm, empathetic, and collaborative; it is always tailored to your unique needs and goals. Together we’ll develop a treatment plan that may include:

  • Exercise prescription — ranging from breathing and gentle mobility, to strength and conditioning, to progressive return-to-sport or work programs.
  • Education and guidance — to support safe return to activity, optimize recovery and health, and build strategies to manage pain and other symptoms.
  • Manual therapy — when needed, to improve movement, reduce pain, and complement exercise.

Every cancer journey is different, but physiotherapy has so much to offer in helping you recover, regain confidence, and get back to the things that matter most to you.

Written By: Kate Kennedy

Ankle Sprain from Summer Sports? Here’s Everything You Need to Know to Get Back Out There

/in , /by

 

Ankle sprains or “rolling an ankle” is one of the most common injuries and is often underestimated. Whether it happened during sport, a misstep off a curb, or a slip on an uneven surface, how you manage your sprain in the early stages can significantly impact your recovery.

What Is an Ankle Sprain?
An ankle sprain occurs when the ligaments (tough bands of tissue that stabilize your ankle joint) are forced beyond their normal range of motion resulting in a stretch or tear, usually from rolling or twisting the ankle. Ankle sprains primarily affect the outside of the ankle, often including the anterior talofibular ligament (ATFL), the calcaneal fibular ligament (CFL), and in some instances the posterior talofibular ligament (PTFL).

The Three Different Grades of Ankle Sprains:

  • Grade 1 (Mild): Slight stretch with microscopic tearing, minimal swelling and tenderness, no loss of joint stability. Sport is usually resumed within a couple of weeks.
  • Grade 2 (Moderate): Partial ligament tear, more swelling/bruising/and pain, little to no loss of joint stability. Treatment is required (the sooner the better) and it is typically at least 3 to 6 weeks before activity resumes.  A protective brace or taping is often needed to aid recovery.
  • Grade 3 (Severe): Complete tear of ligaments, significant swelling, instability. Full recovery may take several months. There is usually permanent laxity or looseness of the ligaments. A brace should be used to assist with stability, healing, and resumption of full activity.
  • In some cases, often those with higher impact like landing from a jump, an avulsion fracture can occur. This means that a small piece of bone is broken off where the ligament attaches. A physiotherapist or doctor can help rule out if you need x-rays for a potential fracture.

How Physiotherapy Helps:

  • Diagnose and determine the severity/grade of the injury
  • Swelling and pain management in early stages
  • Targeted exercises to restore range of motion, strength, and balance
  • Manual therapy to improve joint mobility
  • Return-to-sport plans and injury prevention education

When Can You Return to Activity?
Every sprain is different, but returning too soon can increases your risk of re-sprain. A physio-guided rehab plan ensures you’re not just pain-free, but functionally ready.

Sprained Your Ankle Recently?
Immediately after injury let P.E.A.C.E. guide your approach:

P-Protection: in the first 1-3 days avoid movements or activities that increase pain.
E-Elevation: elevate the injured leg higher than the heart as often as possible to help reduce swelling.
A-Avoid anti-inflammatories: avoid taking anti-inflammatory medications or icing the injury as it will reduce tissue healing.
C-Compression: use elastic bandage (ex: tensor) or taping to reduce swelling.
E-Education: a guided active approach is helpful for recovery.

Don’t wait for it to “just get better.” Book an assessment today and let’s get you back on your feet!

Written By: Danielle Carter

 

References:
Dubois B, Esculier J. Soft-tissue injuries simply need PEACE and LOVE. British Journal of Sports Medicine 2020;54:72-73.
Hubbard TJ, Hicks-Little CA. Ankle ligament healing after an acute ankle sprain: an evidence-based approach. J Athl Train. 2008 Sep-Oct;43(5):523-9.
Martin RL, Davenport TE, Fraser JJ, Sawdon-Bea J, Carcia CR, Carroll LA, Kivlan BR, Carreira D. Ankle Stability and Movement Coordination Impairments: Lateral Ankle Ligament Sprains Revision 2021. J Orthop Sports Phys Ther. 2021
Apr;51(4):CPG1-CPG80.

 

Move Better and Hit Harder on the Court: An Exercise Program to Prepare You for Tennis Season

/in , /by

Summer is right around the corner, and with the French Open concluded and Wimbledon here, I am sure we are all rushing out the door to lace up those tennis shoes.

Players like Alcaraz and Coco have certainly shown us why working on our physical strength can make such a big impact on the court.

Whether you are looking to compete in local tournaments or get together for a casual doubles match with your friends, here are 5 exercises for the lower body, upper body and core that I would consider!

Lower body 

  1. Squats: Great for building lower body strength, do these if you don’t want to have knee pain. 
  2. 3-way lunges (forward/side/back): With tennis being such a dynamic sport, there is a strong requirement to be able to lunge in all directions. 
  3. Single-leg hinges: Great for strength, balance and stability while targeting your glutes, hamstrings and core. These are all the important muscles for movements such as sprinting. Do this exercise if you don’t want to lose points from drop shots.
  4. Monster walks: Great for lateral movement on the baseline during groundstrokes or when you do your split stance at the net to get that volley winner. 
  5. Calf raises- double leg or single leg: Important for explosive movements such as jumping, running and quick directional changes. Do these and your Achilles will thank you. 

Upper body 

  1. ½ kneeling single-arm dumbbell shoulder press: Enhance your core stability and power: more aces, more free points. You’re welcome.
  2. Supine dumbbell pec flies: Whether you like to hit the ball flat or with top spin, strong pectoral muscles will help with the power of your groundstrokes and serve.
  3. Pull-ups or lat pulldowns: Strengthen your back and improve your posture so you don’t use the sun as another excuse for missing that easy overhead smash.
  4. Rows: Strong scaps, healthy shoulder, enough said.
  5. Forearm stretch and strengthening: Do these unless you like tennis elbows? 

Core

  1. Bird dogs: Improve core stability, balance and coordination. Lower back pain? No thanks 
  2. Side planks: Improve your rotational power and stability. KEY to generating power in your forehand and backhand. 
  3. Forearm plank: Upper back, shoulder and core stability. This is your 3 in 1, talk about efficiency. 
  4. Palloff press in split stance: Core stability to unleash your forehand and backhand.
  5. Dead Bugs: Coordination and core stability, never wiff a ball again! 

Check out this video to see examples of each exercise:

All jokes aside, these are not the only exercises to help your tennis game. But these foundational movements will certainly help with injury prevention, so you can keep playing the game you love!

Written By: Victor Choy

Step into Summer: How Clinical Pilates Can Help You Hit the Trails Stronger

/in , , /by

 

With the days getting warmer and summer adventures calling, many of us are itching to lace up our boots and hit the trails. Hiking is a fantastic way to enjoy nature, build cardiovascular fitness, and reset mentally. But before you dive into steep climbs and uneven terrain, it’s important to make sure your body is ready for the challenge, especially if you’ve been dealing with stiffness, aches, or old injuries. If you’re feeling a little out of step after a busy spring, you’re not alone.

Whether you’re easing into day hikes or training for a multi-day trek, working with a physiotherapist trained in Clinical Pilates can help you move more efficiently, manage lingering discomfort, and reduce your risk of injury. Most importantly, it can help you feel stronger and more confident on the trails.

Why Prepare Your Body For Hiking?

Hiking challenges more than just your lungs. Long climbs, rocky terrain, descents, and carrying a pack can put stress on your knees, hips, ankles, and back. Many hikers experience lower back discomfort, or fatigue in the stabilizing muscles that support posture and movement. Taking the time to prepare your body before you ramp up mileage or elevation can help prevent common injuries like knee pain and ankle sprains. It also means you’ll move more confidently and enjoy your hikes without nagging discomfort.

How Clinical Pilates Can Help You Move Better on the Trails

Every hiker has a unique body and movement history, which means their needs and challenges on the trail are equally unique. Whether you’re recovering from an injury or feeling stiff after months at a desk, a tailored approach is key. Clinical Pilates offers a personalized way to address your specific biomechanics and goals.

Working with a physiotherapist trained in Clinical Pilates means you’re receiving guidance based on thorough assessment and clinical reasoning. Physiotherapists are trained to identify joint restrictions, movement inefficiencies, and muscle imbalances that could limit performance or lead to injury. With this understanding, they will design a program focused on improving strength, mobility, and control where you need it most.

Some key areas that Clinical Pilates might target include:

  • Strengthening your hips, knees and ankles to tackle hills and uneven terrain
  • Enhancing core control for hiking endurance
  • Improving balance and proprioception to reduce the risk of slips and falls
  • Restoring mobility and movement efficiency to help you stay light on your feet
  • Addressing old injuries that still affect loading patterns, confidence, or stability

The goal is to help you move with greater ease and control, focusing on the areas that will support you most on the trail, so that you can hike longer, stronger, and with more confidence!

Get Trail-Ready This Summer!

Whether you’re managing old injuries or simply want to feel stronger and more stable, now is the perfect time to get your body trail-ready. Clinical Pilates can help you hike longer, with less discomfort and more ease. By focusing on your body’s unique needs, you’ll be better prepared to enjoy everything the season has to offer – one step at a time.

Written By: Alexia Lee

Core Strengthening: Beyond the Six-Pack

/in , /by

Core Strengthening: Beyond the Six-Pack

Everyone has heard of their core, but do we really know what it is? Most people associate their core with having a six-pack of abs. But did you know that the core extends far beyond the abdominal muscles you can see? A strong core is essential not just for aesthetics but for overall function, injury prevention, and optimal performance in daily life and sport.

What Exactly Is the Core If Not Chiseled Abs?
The core is a complex system of muscles that work together to provide stability, balance, and power. These muscles are located in your pelvis, hips, lower back, and abdomen. They can be further broken down into two categories: deep “stabilizers” and superficial “movers”. One of the movers is the Rectus Abdominis, the “six-pack” muscle that helps with forward flexion of the trunk. Although these muscles are important, today’s focus is on the “deep stabilizers”, also known as the “deep core muscles”.

The Deep Core Consists Of:
1. Diaphragm— yes, your breathing muscle! Breathing plays a huge role in stabilizing the core.
2. Pelvic Floor — These muscles support the pelvic organs and contribute to core stability.
3. Transverse Abdominis (TVA) — A deep abdominal muscle that acts like a corset, providing core stability.
4. Multifidus— Small but mighty muscles along the spine that assist with stability.

Why Should We Care About Deep Core Strength?
You may be wondering, why focus on the deep core if it won’t give you a six-pack? The deep core plays a crucial role in treating pain, preventing injury, increasing performance, and making everyday function easier.

Low Back Pain and the Importance of the Deep Core
Trunk strength and endurance tend to decrease in patients with low back pain. In chronic cases—where pain persists for more than three months—the timing of deep core muscle activation can be affected. If these muscles are not turning on or firing at the right time, it can lead to instability and prolonged discomfort. Strengthening the deep core helps retrain these muscles, providing better spinal support and reducing pain. A strong core also distributes forces evenly, reducing strain on the spine and joints.

Injury Prevention
A weak core can lead to poor movement mechanics, increasing the risk of injury in both daily activities and sports. A stable core reduces the likelihood of lower back pain and other injuries by keeping the spine supported.

Performance Improvement
Athletes rely on core strength for power, balance, and efficiency in movement. Whether you are running, lifting, cycling, or playing sports, a strong core enhances performance by improving movement control and force transfer.

Everyday Function
From bending down to pick up something to tying your shoes to carrying groceries or sitting at a desk, your core is engaged in almost every movement you make. A stable core helps maintain good posture, reducing strain and fatigue throughout the day.

Who Can Benefit from Core Strengthening?
The short answer: everyone! Whether you’re an office worker who sits for long hours, a weekend warrior hitting the trails, or a high-performance athlete, a well-conditioned core is essential for movement efficiency and long-term health.

How to Strengthen Your Deep Core
Effective core training involves more than just crunches. A well-rounded program should include stabilizing exercises, anti-rotation, and anti-extension movements. Some examples include:

1. Dead Bugs:

  • Start by lying down on your back on an exercise mat.
  • Lift both legs up into a table top position (knees and hips bent at 90 degrees).
  • Raise your arms so they are both pointing straight towards the ceiling.
  • Maintaining a neutral spine, extend your right leg forwards whilst simultaneously raising your left arm overhead in a controlled manner.
  • Return your arm and leg to the starting position, then switch to repeat the movement on the opposite side.

2. Heel Slides:

  • Start by lying down on your back with both knees bent.
  • Slowly slide one heel out by straightening the knee.
  • Slide your heel back to its starting position with and repeat the movement on the opposite side
  • For an added challenge, do the same exercise starting in a bridge position:

3. Bird Dogs:

  • Start on your hands and knees, with your hands under your shoulders and your knees under your hips.
  • Reach one leg up and out so it’s in line with your back, and reach the opposite arm straight out in front.
  • The arm and leg travel out together, then back to the starting position.
  • Switch sides.

4. Diaphragmatic breathing (breathing deep into your belly):

  • Lie on your back on a flat surface or in bed, with your knees bent.
  • Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe.
  • Breathe in slowly through your nose so that your stomach moves out, causing your hand to rise. The hand on your chest should remain as still as possible.
  • Tighten your stomach muscles, so that your stomach moves in, causing your hand to lower as you exhale through pursed lips

5. Pallof Presses:

  • Set up the cable machine or resistance band so that it sits at chest height.
  • Stand sideways to the machine or band and grip the attachment with both hands at chest height, then take a few steps out to the side and backwards so that the band or cable is providing resistance.
  • With a neutral spine, extend both arms to press the cable or band forwards until the arms are fully extended.
  • Revert the movement by slowly bringing the pulley back towards your chest.

How Do I Know If I Am Activating My Deep Core?
If you’re unsure whether you’re activating your deep core correctly, a physiotherapist can help assess your technique and guide you through proper engagement. With expert guidance, you can gradually build core stability and progress your exercises to help prevent injury and improve movement efficiency.

Written by: Evelina Michniak

Strength Matters: How Diabetes and Muscle Loss Are Linked

/in , /by

Diabetes, especially type 2 diabetes (T2DM), is a widespread health challenge that affects millions of people around the world. It’s not just about blood sugar levels; it can also lead to a concerning condition called sarcopenia, which is the gradual loss of muscle mass and strength as we age. Let’s explore the connection between diabetes and sarcopenia, why it matters, and what you can do to keep your muscles and health strong.

The Diabetes-Sarcopenia Connection

Sarcopenia isn’t just an unfortunate part of aging; it can also make managing diabetes more difficult. Here’s how it works: T2DM can speed up muscle loss, and weakened muscles can lead to poorer blood sugar control. This creates a vicious cycle where less muscle mass can lead to  less physical activity, which in turn can worsen diabetes management.

Research shows that older adults with T2DM experience muscle loss more rapidly than those without the condition.

Why Muscle Matters

Muscles play a crucial role in how our bodies use glucose, the sugar that fuels us. Healthy muscles help absorb glucose from the blood, which is especially important for people with diabetes. Unfortunately, when muscle function declines, so does the body’s ability to manage blood sugar, leading to higher levels of insulin resistance.

Key Factors Contributing to Sarcopenia

Several factors can contribute to the development of sarcopenia, particularly in people with diabetes:

  1. Aging: Muscle loss typically begins around age 30 and can increase significantly by age 80, especially in those with T2DM.
  2. Energy Intake: As we age, our calorie intake and requirements decrease leading to increased fat accumulation and further muscle loss.
  3. Physical Activity: A sedentary lifestyle greatly contributes to muscle decline. Regular exercise is essential, especially for those with diabetes, to help maintain muscle mass and improve insulin sensitivity.
  4. Diet: Nutritional factors, like vitamin D and protein intake, are vital for muscle health. Vitamin D is essential for proper metabolic function and muscle health, and inadequate protein can accelerate muscle loss.
  5. Hormonal Changes: Hormones such as estrogen and testosterone play important roles in maintaining muscle mass. Changes in these hormone levels can negatively impact muscle health.
  6. Smoking: Smoking can lead to decreased muscle strength and further metabolic issues, making it harder to manage diabetes.

Taking Action: Managing Sarcopenia and Diabetes

Fortunately, there are effective strategies to tackle sarcopenia alongside diabetes. Here are some key approaches:

  1. Dietary Management
  • Focus on a balanced diet rich in protein (aim for 1.0 to 1.5 grams per kilogram of body weight) to help maintain muscle mass.
  • Incorporate foods with anti-inflammatory properties, like those high in omega-3 fatty acids, to support overall health.
  1. Physical Exercise
  • Engage in Progressive Resistance Training (PRT), which is essential for building and maintaining muscle. Aim for at least 150 minutes of moderate aerobic activity each week, combined with 2-3 sessions of strength training.
  • Regular exercise can significantly improve muscle mass and enhance blood sugar control.
  1. Professional Support
  • Physiotherapists can create personalized exercise programs to improve mobility and strength. A physiotherapist will ensure the exercises prescribed are both effective and safe and address any mobility or injury concerns.
  • Kinesiologists focus on developing fitness plans that emphasize resistance training to counteract muscle loss. Kinesiologists are experts in guiding you through proper exercise technique and will help in injury prevention.
  • Dietitians help create meal plans that ensure you’re getting the right nutrients to support muscle and overall health.
  • General Practitioners monitor diabetes progression and manage any necessary medications.
  • Psychologists can assist with mental well-being and motivation to stick to health plans.
  1. Collaborative Care Approach

Working with a team of healthcare professionals ensures all aspects of your health are addressed, from physical fitness to nutritional needs. This holistic approach can empower you to take control of your health and improve your quality of life.

Conclusion

Managing diabetes and preventing sarcopenia is crucial for maintaining health as we age. By focusing on nutrition, regular exercise, and seeking support from healthcare professionals, you can enhance your muscle strength and overall well-being.

If you’re looking for guidance on managing your diabetes or muscle health, don’t hesitate to reach out to us at Treloar Physiotherapy Clinic. Our team is here to support you on your health journey!

Written by Jordan Yum

Fall into Balance: Transform Your Routines with Clinical Pilates!

/in , /by

September marks the shift from summer to fall. Coinciding with the seasonal change is a tendency to ‘fall’ back into the more regular routines of school, work, sport and exercise.

Come October these new routines tend to be settling into place.

Whether it is the return to the familiar or commencement of the new, it is not uncommon for some aches and pains to accompany these now regular activities.

All activities consist of ‘patterns’ of repetitive postures and movements. The significance on how these influence our complaints often go unnoticed until they impact us negatively. Even then it may not be obvious.

Many of our repetitive postural and movement patterns tend to overload certain areas of the body while at the same time underutilize other regions. This naturally leads to something called an imbalance of function which often plays a significant role in both our inactive and active lifestyle-related complaints.

Correcting these faulty patterns can reduce the risk of chronic overuse type injuries, as well as reduce the risk of acute ones.

This is where Clinical Pilates can be very beneficial. The emphasis on the quality of movement versus the amount of resistance or load is ideal to re-train or reinforce desired patterns.

Some benefits of addressing imbalances and improving our patterns include:

  • improvement of pain/ discomfort
  • injury prevention
  • enhanced performance

We are all humans doing modern human things on a daily basis, many of which include combined bodily movements requiring various direction, speed and control. As a result of ongoing repetition, our body continues to repeat these same movements, thus leading to patterns of imbalance with associated bodily correction (compensation).

But we are also all unique individuals with different presentations and needs. There is no ‘one size fits all’ approach to any type of physical training or rehabilitation, including Clinical Pilates.

An assessment with a Clinical Pilates Physiotherapist can help identify and guide your specific needs, which is especially important if you are managing any discomfort or injury. Some areas they can help you with include:

1. Postural/Movement Analysis

A Clinical Pilates therapist can analyze your lower body mechanics using the reformer to identify issues like overactive hip flexors or weak glutes contributing to knee pain. Targeted Pilates exercises on and off the reformer can strengthen these areas and improve alignment for better function.

2. Exercise/Training Strategies

For runners dealing with knee pain, a Clinical Pilates therapist can evaluate running mechanics on the reformer to identify contributing factors. Specific Pilates exercises can be integrated to strengthen supporting muscles and enhance running performance.

3. Ergonomics/Workstation Set-Up

If you’re experiencing neck and back discomfort from prolonged computer use, a Clinical Pilates therapist can assess your posture and recommend adjustments to your workstation. Utilizing the reformer, they can prescribe Pilates exercises that strengthen postural muscles and improve overall alignment, reducing strain.

In summary, creating positive changes to our day-to-day routines are beneficial. As our ability to move becomes more natural and free of any restrictions and any faulty compensatory patterns, the better we continue to live a pain-free life while engaging in all our daily activities.

Written by Jonathan Poon

The Basics of BPPV: Positional Vertigo

/in , , /by

Summer is here and that brings more outside time and fair weather. Activities like gardening and yard work are frequent, and sports like golf, tennis and swimming encourage us to spend time outside enjoying all that Vancouver has to offer. But have you ever found yourself moving into a position where you are bending over, looking high up or tilting your head to one side and suddenly the outside world appears to be moving?  It can be a very unsettling feeling, even if it doesn’t last long.

 

Vertigo is the sensation of the outside world spinning.  It is a symptom, but not a diagnosis.  The incidence is quite common, as much as 1 in 15 adults will have an episode of vertigo in their life, according to an Ear Nose and Throat Doctor teaching at Columbia University.  One of the causes of vertigo that we see at Treloar Physiotherapy is a condition called Benign Positional Paroxysmal Vertigo (BPPV).  It is important to note that BPPV is not the only cause of vertigo, but it is the most common.  Here is some basic information about BPPV:

What is it?

  • BPPV is a problem that occurs in the vestibular system that causes a sensation of spinning for short periods of time when the head is moved into certain positions.
  • The crystals that are located in sacs within the inner ear break free, moving into one of the semi-circular canals of the inner ear.
  • When your head moves, the crystals float through the canal and continue to move even after you stop moving. This creates a temporary spinning sensation (vertigo) that comes on with specific head movements.

What causes it?

  • In most cases, we do not know what causes the crystals to break free and move into the semi-circular canals.
  • Very few cases occur because of a physical blow to the head (ie something that ‘knocks’ the crystals loose).

What movements trigger the vertigo symptoms?

  • Big movements that involve bending over and looking down – emptying the dishwasher, weeding the garden, bending low to pick up something under the bed, tying shoes, putting the golf ball on the tee (!).
  • Looking up at something high – getting ready to prune the tree, changing a light bulb (we don’t do this as often anymore thanks to LEDs!), a high tennis serve toss, looking up/leaning head back while washing your hair.
  • Changes of position – moving from lying down to sitting up or vice versa (ie in/out of bed, getting up/down off an exercise mat) or turning your head/rolling to one side while lying down.

How long does the vertigo last?

  • With BPPV, the vertigo sensation itself typically lasts less than 1 minute, and not more than 2 minutes (it can often feel much longer in the moment!). The symptoms will recur as the head and body move into the provoking positions.
  • There can also be a sensation of imbalance while moving/walking or mild nausea when someone is suffering with BPPV and this can occur more frequently.

How do you treat BPPV?

  • BPPV can be treated very effectively with a re-positioning maneuver – essentially using gravity and the position of your head to move the crystals out of the affected canal and back to their normal resting position. When this happens, and the crystals are ‘back in their home’ the vertigo symptoms go away.

Many people use the internet to look up home treatment for BPPV and often read about the ‘Epley Technique’.  This is the most commonly performed re-positioning maneuver for BPPV; but it does not treat all types of BPPV.  The Epley is only effective for one type of BPPV. The key to effective treatment involves: figuring out which ear has the problem (it is usually only one ear), determining what canal the crystals are stuck in, and effectively applying the correct treatment technique.  If the wrong technique is used, or done incorrectly you will not likely cause damage, but you can make yourself feel pretty rotten and it will not solve the problem.

 

A physiotherapist who has studied vestibular rehabilitation will take you through an assessment that will involve the following:

  • A thorough history of your symptoms and current challenges.
  • A safety screen to rule out more serious causes of vertigo.
  • A physical assessment to determine if BPPV is the cause of the vertigo and how to best treat it.

 

Often treatment can be done in the same session.  Assessment and treatment for BPPV does involve reproducing the symptoms of vertigo – but it’s worth it when the vertigo is gone.  Don’t let vertigo get in the way of enjoying the activities that you enjoy, especially in the summer season!

Call one of our clinics or book online (www.treloarphysio.com) to make an appointment with one of our physiotherapists trained in vestibular rehabilitation.

Written by Stacy Benmore (Physiotherapist, Treloar Physiotherapy Kerrisdale). 

Dance Pain-Free: Physiotherapy Tips to Conquer Snapping Hip Syndrome

/in , , /by

What is Dance Physiotherapy?

Dance Physiotherapy combines manual therapy & clinical pilates techniques to help artistic athletes – dancers, gymnasts, skaters (and more!) reach their goals. Dance physio is ideal for artistic athletes of any level who are recovering from injury, preparing for pointe work, looking to prevent injury, improve mobility or overall performance.

Dance physiotherapy can help with a variety of conditions including:

  • Knee injuries – for example jumper’s knee & bursitis
  • Back injuries – including spondylolisthesis
  • Foot injuries – for example plantar fasciitis, bunions and achilles tendinopathy
  • Hip pain & injuries – including snapping hip syndrome
  • Chronic or acute ankle sprains
  • Overuse injuries
  • Joint Hypermobility

In this blog post we will be discussing snapping hip syndrome which unfortunately, is very common in dancers, particularly when extending the leg or coming into a grand battement.

What is the snapping or clicking sound? One of the most common sounds is a deep “clunk” when extending the leg. The most likely cause of this is spinal instability and/or over-recruitment and chronic thickening of your psoas muscle (your hip flexor) 

How do I get rid of the noise/ snapping sensation? By working on mobility, stability and then gradually loading the hip. Below are some great exercises to start with!

1. Aikido or “Frog” Mobilization

Come into Aikido or frog stretch position – knees wide on the mat, bottoms of the feet together, arms or forearms resting on the mat. 

Rest in this position for 10-15 seconds, allowing for a gentle stretch in the inner thighs and opening of the front of the hip. 

From here, bring your pelvis into a forward tilt (think about rotating the top of your hip bones towards the mat), and hold for a further 10-15 seconds. Engage your deep core in this position to get an even deeper stretch through the front of the hip! 

Alternate between these positions 4-5 times.

Note: There should not be any discomfort or pain in the hips during this mobilization. If you are feeling any pinching or discomfort decrease how far apart your knees are or consult your physiotherapist before continuing. 

One of the common contributors to snapping hip syndrome is when the outer, or lateral glute muscles have increased tension in them – this can occur when glute med grips to maintain turnout in standing – rather than the deep external rotators. 

 

  2. External Rotation in Table Top

Equipment needed: pillow or small ball 

Lie on the mat, back flat and deep core engaged. Slowly bring both legs up to tabletop position (knees bent at 90 degrees) with the small pillow or ball between your thighs. 

Maintaining inner thigh activation by squeezing the pillow or ball, slowly extend one knee in parallel. Then, from the deep hip socket, externally rotate your extended leg (coming into turn-out). Hold for 2-3 seconds and then come back to parallel and then back to your tabletop position. Continue to maintain the squeeze of the pillow/ball during this entire process. 

Repeat this up to 10 times on each side.

Tip: to ensure the core & deep external rotators are working, check that hip flexors are relaxed throughout this entire exercise.

 

3. Plié Variation targeting deep external rotators

Begin standing tall, in first position. Start with a demi plié and then, maintaining your turn-out (external rotation), slide one leg along the floor (in fondu – one side continues to be in plié, the other knee extends). The foot on the extended leg should come onto the ground. Then, while maintaining your weight over your standing leg (in plié), bend your extended leg while you slide it back to first position. 

During this movement you should be able to feel your inner thighs (extended leg) and deep external rotators (standing leg).

Tip: Place one hand over the outer glutes on your standing leg – these muscles shouldn’t be gripping or over-activating as the turnout should be coming from your deep external rotators.

Note: This exercise can be completed in centre or standing at the bar (or at a counter at home!)

 

Thanks for reading! Consult your physiotherapist if you experience pain or are interested in a personalized targeted program to address your specific goals!

 

Written by Talia Berson (Physiotherapist, Clinic Pilates Instructor).