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Read informative articles written by our registered therapists to help you better understand your injuries and ailments, and to have a deeper understanding of why and how we treat your conditions.

Full recovery after an ankle sprain by Krista Smith, Physiotherapist.

It was a crisp autumn day when Sue decided to go for a hike. All of a sudden she caught her foot on the unstable ground and rolled her ankle. Her ankle was sore, swollen, tender to the touch and she felt unstable while walking on it. Eventually, after a couple weeks of rest, ice, elevation and gentle movement she was again able to resume most of her usual activities of daily living. She thought she would rest over the winter and be ready to get back to hiking in the spring.

Fast forward to spring. The snow is melting, the birds are chirping and Sue is getting ready to once again get back to hiking and soccer. This time though, she observes some odd changes. Sue notices that her ankle still feels weak and she is worried about slipping when she goes out for her long hikes. She decides not to play soccer in the spring out the fear that running on the field with opponents may result in rolling her ankle again. She even feels unstable while standing on one foot and very stiff in her ankle when having to kneel or squat.

Sue is a classic example of someone who has recovered well from the acute symptoms of an ankle sprain but has not done the proper rehabilitation to recover fully from the injury. Ongoing symptoms of stiffness, weakness and poor balance are common. If someone has been limping or using crutches for a period of time after the initial injury, general weakness in that leg is also quite common. Due to the residual ankle weakness and reduced balance, there may be an increased risk of rolling the ankle again with return to sports and activities.

A physiotherapist can help get you on track for a full recovery. During an initial assessment, a physiotherapist will ask you questions about your specific injury and assess your mobility, strength and balance.  Based on the findings of the assessment and your specific goals, your physiotherapist can come up with a personalized home exercise program for you. Manual therapy, which involves hands on techniques, is also used to treat stiffness and reduced range of motion. Following a physiotherapy treatment program most people are able to safely and confidently return to their regular sports and activities.

Krista Smith is a Registered Physiotherapist and associate at Sun City Physiotherapy’s downtown, St Paul Street location. 

A recipe for jaw pain by Nick Black, Physiotherapist

The fact of the matter is jaw pain can be down right miserable. Talking and eating are two of our most important functions in daily life and the jaw plays a large role in both. If wrapping your teeth around a big juicy Okanagan apple has lost its sweet satisfying crunch and been replaced by pain, then seek some help.
Many structures in and around the jaw can contribute to pain. The teeth and their attachment to the jaw and skull are obvious contributors that your dentist is well equipped in managing. Infection or dysfunction within the ears, sinuses, salivary glands or lymph nodes are problems best addressed by your family doctor. However, other structures such as the jaw joint (temporomandibular joint) and associated ligaments and tendons are common contributors to jaw pain that are often left untreated. Dysfunction in the neck can also refer pain and/or dysfunction to the jaw. Another, often overlooked contributor to jaw pain, is the effects of our mental health. It is well documented that stress, anxiety, exhaustion or depression will not only effect our head and neck postures but also how the nervous system reacts to messages sent from dysfunctional tissues, such as those in and around the jaw. A sensitized nervous system can increase one’s experience of pain.
Pain is complex but treatment doesn’t have to be. An assessment by your family doctor, dentist or physiotherapist with special interest in temporomandibular dysfunction will ensure you are referred to the correct health professional for managing your problem. If the problem relates to dysfunction of the jaw joint, the first step is to address any habits outside of normal jaw function, such as teeth grinding, pen chewing or jaw clenching. A restriction in joint mobility is common, affecting your mouths ability to fully open, in which case, the sleeve (capsule) of the joint is susceptible to strain and inflammation. Clicks and pops are very common but are rarely related to the cause of your pain.
Try this – gently place your finger tips about 3cm above your temples, then clench your teeth on and off. You will feel the temporalis muscle tightening under your fingers. Now gently place your fingers 5cm directly below your temples on the sides of your jaw and clench your teeth. You will feel the masseter muscles tightening. You have just located two of the most important muscles for eating. Both the temporalis and masseter muscles and their tendons are common contributors to jaw pain that respond well to hands-on soft tissue treatment techniques. In addition, many people can relate to how these muscles might be clenched a bit tighter in times of stress and anxiety, thereby contributing to the muscles overload.
The important message is that many structures, behaviours and feelings contribute to the experience of jaw pain and effective management is best achieved through identifying all factors involved.
Nick Black is a registered Physiotherapist with an interest in temporomandibular dysfunction at Sun City Physiotherapy Winfield. He can be contacted at the new Winfield location by phone: 250-766-2544 or email:winfield@suncityphysiotherapy.com

Torticollis by Jennifer Olynyk, Physiotherapist

Have you or someone you know just welcomed a new addition to the family? If so, this article may be for you! Since the promotion of “Back to Sleep” as well as babies having to spend time in the NICU or PICU due to numerous conditions, head shape issues have been increasing. Torticollis can also be caused by trauma during birth, awkward positioning in the uterus and other conditions.
When a baby is born, the bones that make up their skull are soft and gradually overtime they begin to fuse. If during this time there is more pressure put on one side than the other, the baby’s head may start to flatten more on one side. This is called “Plagiocephaly.”. Sometimes the flattening can be severe and facial features can begin to shift as well. The most notable being a shift of the ear and forehead and an asymmetry between the baby’s cheeks and jawline. If a baby spends most of the time on their back or had to spend time in the NICU/PICU, there may be equal flattening on both sides resulting in “Braciocephaly.”
Often the first time this is brought to the family’s attention is at their 3 month check-up or vaccinations. If this has happened to you, don’t fret and stay off the internet!! Most of the time this condition results from a tightness or imbalance of strength between the babies neck muscles called the sternocleidomastoid or SCM for short. If this muscle is the culprit then the condition can also be referred to as Congenital Torticollis. Torticollis can have many different causes, some worse than others, but 80% are due to muscular issues from the SCM.
The condition is most apparent around 2-3 months or older. At this time babies are getting stronger and exploring their environment more. If you notice your baby tends to look one direction more than the other, especially when they are on their back, this may be an indication of torticollis. Often the first indication is the flattening at the back of the head.
Torticollis can be easily treated without any manipulations or medications. With gentle stretches and strengthening exercises, the baby’s neck muscles can even out and this will help with their head shape as well. It is best to see your physiotherapist before 6 months of age. This is due to the skull bones becoming increasingly fused as well as the creeping, crawling and rolling when babies begin to explore their environment.
If your healthcare provider or someone you know has brought this condition to your attention, don’t worry. Come see your physiotherapist for an assessment and treatment plan that works for you and your little one.
Jennifer Olynyk is a registered physiotherapist and associate at Sun City Physiotherapy’s downtown St. Paul Street clinic location.

Fall Prevention by Krista Smith, Physiotherapist

While many people consider seeing a physiotherapist to help with their recovery after an injury or surgery, few consider scheduling a physiotherapy appointment for injury prevention. When it comes to fall prevention, we observe and assess functional movements including your walking pattern, balance and lower extremity strength. A personalized program including education and home exercises can then be designed based on the information we gather from the assessment to help improve your strength, balance and walking pattern.

To avoid tripping while walking, it is important to develop a safe walking pattern. The swing through leg should be lifted high enough to properly clear the ground. A shuffle pattern can result in catching the toe and tripping. Also, since a large portion of walking is spent standing on one foot while the other leg is swinging through, we want to assess balance and stability on the stance leg. If unsteadiness is noted while standing on one foot, a walking aid such as a cane or walker can be beneficial to add stability and support. A physiotherapist can adjust a walking aid and provide instructions and a demonstration. A physiotherapist can also teach safe and effective exercises to help improve walking pattern and endurance for those who feel weak or unsteady while walking.

It is very important to stay active and keep moving. Daily physical activity is essential to maintain aerobic endurance, lower extremity strength and balance. It is never too late to start an exercise program. It is best to think of exercise as a slow gradual progression rather than an all or none activity. It is important that you find an activity that is enjoyable to you to stay motivated and keep active. This may include walking, hiking, cycling, swimming, tennis or golfing. In addition to aerobic activity, a physiotherapist can design an appropriate home exercise program to help improve endurance, balance, coordination and strength.

Krista Smith is a Registered Physiotherapist at the Sun City Physiotherapy downtown location.

Tips For Healthy Cycling. By Nick Black, Physiotherapist

Cycling orchard lined roads, touring between vineyards, cruising the Kettle valley railway, flowing down trails at Smith creek, or eagerly awaiting completion of the Okanagan rail trail – cycling offers something for everyone in the beautiful Okanagan.
After an injury or surgery, my patients commonly ask “do you think I’m ready to get back on my bike?”. More often than not, the answer is “yes”. The bicycle is such a fantastic tool for rehabilitation and exercise, producing low impact forces on the body, while promoting lower limb range of motion and strength. However, whether your goal is rehabilitation, fitness, competing in the next triathlon, or just plain enjoyment, you should be aware of some common aches and pains that can stem from time on your bike.
Necks, backs and knees are the most common areas of complaint from cyclists. Sure, cycling is low impact but it can also require long periods of time in sustained postures. When a muscle is in a prolonged contraction its blood flow is limited, its pH level drops becoming more acidic, at which time the muscle will begin to fatigue and complain. Experiencing muscle fatigue and mild pain is a normal process of getting stronger, however only when balanced with adequate recovery time! Prolonged load beyond your tissues tolerance and inadequate recovery time are the primary reasons for injuries on the bike.
If you’re new to cycling or getting back on the bike after a long hiatus, I would encourage you to adhere to the following three principles. 1) Get your bike properly fitted to you. A well fitted bike creates an efficient posture, significantly reducing unwanted loading on your neck, back and knees. Your local bike store can guide you in this process. 2) Start low and build slow. Gradually increasing the load on your bodies tissues and allowing recovery after a ride will allow your tissues to adapt, becoming more tolerant to prolonged postures on the bike. 3) Develop your core strength. The concept of ‘core strength’ is an over promoted concept but when it comes to cycling, having strong gluts and lower back muscles will help to maintain an efficient posture for producing power through the legs and minimizing strain on your back in the process. Consider consulting a physiotherapist or exercise professional for a few core strengthening exercises that can be performed off the bike two to three times a week.
The benefits of cycling far outweigh any of the potential aches and pains mentioned above. Train smartly by adhering to the above principles and continue to experience the joys of cycling in the Okanagan. Maybe I’ll see you at this years Apple triathlon?
Nick Black is a registered Physiotherapist at Sun City Physiotherapy Winfield. He can be contacted at the new Winfield location by phone: 250-766-2544 or email:winfield@suncityphysiotherapy.com

Shoulder Health. By Jordan Ruder, Physiotherapist

Get Your Head Around Your Shoulders this Summer!

With summer fast approaching, many of us are jumping back into one or more of our favourite fair weather activities, be it golfing with an orchard view, volleyball on the sandy beach, swimming in the crystal clear Okanagan lakes, playing tennis with friends or a little extra gardening for all of you green thumbs! Whatever the summer activity of choice, we all hope this warm weather finds us ready to tackle the ‘fun in the sun’ at full steam without having to worry about those pesky aches and pains that often set in over the winter.

One aspect that many summer activities have in common is that you will undoubtedly require a pair of healthy shoulders to fully enjoy them. As a practising physiotherapist treating patients with various conditions and injuries for almost a decade, I must say that shoulder pathology and dysfunction are some of the most common conditions walking in and out of our clinics on a daily basis.

When you dissect this shoulder issue further, there are a few key things that make the shoulder one of the most biomechanically impressive but also one of the most vulnerable regions to injury in our body.

First of all, the shoulder is the most mobile joint in the human body. The ‘ball and socket’ anatomy of the shoulder allow for movement that we see in no other body region. Whether it be flexing the shoulder 180 degrees overhead to smash a beach volleyball or fully externally rotating your shoulder during your golf swing follow-through, the shoulder girdle demonstrates phenomenal flexibility.

This fantastic mobility in the shoulder girdle however comes with a price. In order for this flexibility to be functional when teeing off with your driver on 18 or lifting heavy pot of flowers up on your deck, the shoulder requires a significant amount of dynamic stability. This dynamic stability is accomplished by work of a few important muscles that surround the very flexible shoulder joint…most notably, the rotator cuff as well as other scapular stabilizing muscles.

For our shoulders to remain healthy and function at the high levels required for our summer fun, this balance between flexibility and stability must be maintained.
Some common conditions and injuries that we as physiotherapists assess and treat where shoulder flexibility and stability become compromised include; Shoulder Impingement, Tendinitis/Tendinopathy, Bursitis, Rotator Cuff Tears, Shoulder Dislocations/Separations, Frozen Shoulder, and Scapulothoracic Dysfunction.

If your summer involves getting or staying active and you want your shoulders to be ready for the action, book a consultation and some treatment with your physiotherapist to ensure your shoulders are ready to shoulder the load!

Jordan Ruder is a Registered Physiotherapist and Associate at the Downtown location of Sun City Physiotherapy. He is a member of the Canadian Physiotherapy Association and is also a Fellow of the Canadian Academy of Manipulative Physical Therapists (FCAMPT). He can be contacted by phone at (250) 861-8056 or by email at downtown@suncityphysiotherapy.com.

DeQuervain’s Syndrome and Physiotherapy. By Krista Smith, Physiotherapist

Physiotherapy Can Help with DeQuervain’s Syndrome

Do you experience pain in your wrist near the base of your thumb? Did it come on gradually? Is it sore when you move your thumb or wrist? Does it hurt to grip, write, garden, hold a cup of coffee, cut vegetables or pick up a baby? If so, you may have a condition known as de Quervain’s syndrome.

DeQuervain’s syndrome involves the abductor pollicis longus tendon and extensor pollicis brevis tendon. These tendons connect muscles in your forearm to bones in your thumb. To help reduce excessive friction, these tendons travel in a tendon sheath. When a high load is placed on these tendons, such as a repetitive movement of the thumb or wrist, it can result in a thickening of the tendons and the sheath. Initially, symptoms are usually only present with certain aggravating activities, but if this injury continues to worsen you may experience pain at rest, swelling and tenderness at the base of your thumb and wrist.

Rest is the first step to treating de Quervain’s syndrome. This is often difficult when we use our wrist and thumb dexterity for so many daily activities. For this reason, it is not uncommon to see people who have had this condition for weeks to months at a time, with no significant change in symptoms. As a general rule, try to avoid any positions or movements that cause pain. A protective splint may provide some benefit in the initial stages of healing to help immobilize the wrist and thumb.

Physiotherapy can help treat this injury using a combination of education, modalities, manual therapy, soft tissue techniques and a progressive home exercise program. Since the tendons and sheath are often aggravated by repetitive movement or prolonged positions of the thumb and wrist, it also may be necessary to address your home or work ergonomics. When possible, modify to a neutral thumb and wrist position and take frequent breaks from your activity.

De Quervain’s syndrome usually begins with a gradual onset of symptoms, often when a new movement or activity is introduced that places increased demands on the tissue. An example is a mother with the new task of repetitively picking up a newborn baby. Physiotherapy can be quite helpful in the management of this condition. If you experience pain at the base of your thumb as the result of a trauma, such as a fall on an outstretched hand, it is advisable that you follow up with your doctor to determine if further investigations, such as an x-ray, are required prior to starting physiotherapy.

Krista Smith is a registered physiotherapist at the Sun City Physiotherapy downtown clinic. She can be contacted at downtown@suncityphysiotherapy.com

Bike techniques to race fast and remain injury-free. By Sun City Physiotherapy

Cycling is considered a low impact activity but some cyclists do experience pain the the back, knees, feet, saddle region, neck, wrists and hands.

The Physiotherapy Association of British Columbia (PABC) recently outlined some simple steps, call the Physio-4, that cyclists can use to reduce their chances for injury, prevent pain, and cycle more effectively.

The Physio-4 for Cycling:

Select a bike that fits. An ill-fitting bike causes pain. A bike that fits – frame size, pedal alignment, handlebar position and saddle height – promotes good posture. Your physiotherapist can provide tips on correct bike fit and can correct poor mechanics before pain and injury develop.

Choose cycling if you have osteoarthritis in your hips, knees or feet. The non-impact, rhythmic motion helps reduce joint pain and stiffness and keeps your muscles strong. Your physiotherapist can prescribe a cycling program and help you choose the right bike.

The aerobic benefits of cycling help to manage high blood pressure and reduce the risk of heart disease. Cycling builds stamina. Your physiotherapist can help determine the right level of aerobic exercise and develop a program to meet your goals.

Stretch and strengthen off your bike to improve on-bike performance. Your physiotherapist can create a program to treat muscles that are prone to tightness as well as help you strengthen areas such as your core to dramatically improve your cycling efficiency.

It’s also important to remember to always wearing a helmet and fluorescent clothing by day and reflective clothing at night. After dark and in the rain, cyclists should ensure they have lights that work – white for the front and red for the back. Cyclists should also be vigilant about what’s on the road and be on the lookout for car doors being opened by motorists.

Running techniques to race fast and remain injury-free. Sun City Physiotherapy

This is the time of year where you are starting to ramp up your training for triathlons and running races. It has been shown that as many as 80% of runners sustain a running-related injury in a given year. So what are the reasons for so many running injuries? And how can they be avoided? 

Training schedule, running technique, and tissue strength/tolerance are three major determinants as to whether or not you will be sidelined with an injury this season. 

Here are more detailed explanations of the three common causes for injury:

Too much too soon. An overly ambition training schedule is a classic mistake. It is believed that as much as 80% of running injuries occur because of training errors. An easy to follow guideline is the 10% rule: avoid increasing your running mileage more than 10% from the previous week. 

Poor or inefficient running technique. A potential cause for injury is technique, or rather, a poor technique. It can result in too much impact too quickly (vertical loading rate) as you land. A high vertical loading rate can be caused by any of all of the following: heel striking with your foot too far in front of your hips (over-striding), a lack of bend in your knee or hip during landing, a lack of strength in core/hip musculature to help absorb impact. Instead, gradual increased training in a flatter/minimalist shoe (to reduce heel striking), increasing step cadence to approximately 180 steps per minute, and aiming to land softer or ‘quieter’ are all ways of reducing tissue overload.  
Core and hip muscle weakness. It has been shown that a lack of gluteal muscle strength can lead to increased stress on the knee and foot, resulting in a greater chance of tissue breakdown. Taking part in a consistent individualized strengthening program throughout the year can be a key component to avoiding injury. 

Remember, don’t wait until minor aches and pains turn into significant injury. Every runner is different, so book an appointment with Sun City Physiotherapy to determine how best to avoid injury this season.  Call 250-861-8056 to book your appointment today.

Swim techniques to race fast and remain injury-free. Sun City Physiotherapy

Swimming has a relatively low risk of sport related injury, yet, swimmers often complain of shoulder pain. This can be caused by muscle overuse and incorrect technique. By making stroke adjustments, you can not only minimize pain and prevent injury, but also improve performance.

The Physiotherapy Association of British Columbia (PABC) recently outlined some simple steps, call the Physio-4, that swimmers can use to reduce their chances for injury, prevent pain, and swim more effectively.

The Physio-4 for swimming:

Be mindful of body rotation. Never swim with a “flat body” as this limits the rotation of the shoulder along the axis of the spine. Develop a symmetrical way to rotate your body for an efficient breathing pattern and this will greatly reduce the risk of shoulder injuries.  

Enter the water with a flat hand. A hand directed outwards when entering the water leads to unhealthy internal rotation.  This is one of the most common causes of acute pain in the shoulder as it overuses the muscles.  It is best to enter the water with a flat hand, fingertips first. 

Maintain good posture. The saying “shoulders back, chest forward” applies both in and out of the water. Hunched or rounded shoulders can lead to a wide arm recovery that causes shoulder injuries and “cross-overs” in your stroke. Strengthening the muscles at the back of the shoulder and stretching those at the front will help prevent injury, and help you to swim faster.

Incorporate bilateral breathing into your swim workout. Breathing only on one side will develop the muscles on that side more than the other.  This can eventually lead to shoulder problems.  By breathing on both sides with every workout you can prevent this from happening.

Aside from these injury-prevention techniques, there are important things to remember when swimming outdoors. Never dive head first into water unless the depth is known. When swimming in lakes or oceans be aware of any natural hazards such as tides and rapids, never swim alone, and always let someone know where you are training. And always be mindful of boaters – because they may not always be looking for you.

If you are injured or in pain during or after swimming, or require an exercise program to help avoid or overcome shoulder injury, Sun City Physiotherapy can help. Call 250-861-8056 to book your appointment today.