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

Hip Disorders: Osteoarthritis & Bursitis by Brenda Walsh, Physiotherapist

Our hip joints allow us to do an amazing number of things – walk on two legs, pivot, squat, even kick a ball. It is an engineering marvel to combine the stability required to balance the weight of the torso over a structure the size of a golf ball, with the substantial degree of mobility available. The high demands on the hip joints can, however, take their toll over a lifetime.

Osteoarthritis is the most common hip disorder affecting adults. Primary osteoarthritis (OA) has no recognizable cause, while secondary OA is thought to occur due to altered joint mechanics or following joint trauma. Obesity, excessive loading due to occupational or sport demands can contribute to breakdown of articular cartilage. There is likely a genetic component as well. Muscle imbalances around the hip are also predisposing factors, as shearing forces or high compression load will cause abnormal wear and tear. Alignment issues of the low back, pelvis and leg can also contribute to abnormal forces around the joint.

Muscle imbalances occur as a result of weak, tight, or inappropriately recruited muscles. Our neuro-muscular system can develop certain abnormal pathways of firing, creating suboptimal movement, and potential damage to joint structures. If these are retrained before the cartilage damage is severe, it can halt the progression and reduce the symptoms of arthritis.

One of the most important groups of muscles for maintaining optimal compression and centering the ball, (or head) of the femur in its socket are the Gluteal muscles on the lateral side of the hip. Core strength and balance are also very important components of optimal hip health.

A second common diagnosis of hip pain is trochanteric bursitis. The most prominent lateral point on the hip bone is called the greater trochanter. It was commonly thought that the bursa overlying this point was the most common local cause of lateral hip pain. However, in a recent study, using real-time ultrasound, 80% of patients with lateral hip pain did NOT have bursitis. 50% of the 877 patients studied had tendinosus of their gluteal muscles, ie. a degeneration of the deep hip rotators tendon’s collagen in response to overuse, occuring when other stabilizer muscles weaken. It is part of what has been labeled Greater Trochanteric Pain Syndrome (GTPS).

Symptoms of both OA and GTPS can be similar. Pain from OA is usually felt in one or more of the following areas: the groin (most common), over the greater trochanter, or down the front of the thigh and knee. Usually, arthritis pain is reported with or after activity, progressing to pain at night or at rest.

With GTPS, point tenderness is noted at or behind the greater trochanter, typically worse at night, especially when lying on the affected side. Lateral hip pain with repeated stair climbing and squatting is more likely due to GTPS.

Maintaining adequate strength and flexibility of the hip muscles is an important component of treatment and prevention of both hip osteoarthritis and trochanteric pain syndrome. Physiotherapists are trained to assess these disorders. They can prescribe individual exercise where deficits in strength, mobility and balance are noted.

Brenda Walsh is a registered physiotherapist at our Glenmore clinic.

Off Season Prevention of Curling Injuries by Rob Heimbach, Physiotherapist

Attention Curlers!

The curling season has now come to an end, and most of us won’t step onto the ice again until fall. If you spent any part of the past season haunted by joint or muscle pain, this is the perfect time to do something about it. Absolutely every professional athlete knows that the off-season is the time to rebuild strength and recover from injury. Whatever your age and physical activity level, this same principle applies to you.

Curlers are most likely to experience pain in their shoulders, back or knees. This pain is most likely to affect either the delivery phase or the sweeping phase of the game. Sometimes it can take hours or even days after playing for the pain to subside, or it may lead to the use of pain medications. Pain is a big deal because it can stop your muscles from generating power and can affect your enjoyment of the game. Unfortunately, if not properly addressed, this pain can go on for years, getting worse and worse until it eventually leads to retirement from the sport.

Many of the aches and pains that we experience as curlers originate from a common source: muscle imbalance around the legs, back and shoulders. By building strength and flexibility in our muscles, it’s possible to achieve a consistent, balanced delivery and powerful sweeping. For example, a powerful push from the hack uses the strength in your quads while effective sweeping requires strong deltoids and latissimus dorsi. Conversely, weakness in your quads or tightness in the hip flexors will prevent you from getting low enough to be balanced and effective in your delivery.

The solution to this problem must include building strength and lengthening tight muscles. Since this takes time to do, it can be difficult to achieve during the curling season. A proper, targeted stretching and strengthening program, provided by your Physical Therapist, during the off season will make you a better shot maker while at the same time eliminate distracting aches and pains. By consulting with your Physical Therapist early in the off season, you’ll be giving yourself the best chance to return to the ice in the fall as a stronger and more comfortable athlete.

Rob Heimbach is a registered physiotherapist and associate at Sun City Physiotherapy’s Glenmore location. He can be contacted at glenmore@suncityphysiotherapy.com.

Injury Prevention in Curling by Rob Heimbach, Physiotherapist

If you’re a regular league curler, whether recreational or competitive, then you’re surely familiar with the aches, pains and injuries that go hand-in-hand with the sport. Joints and muscles at the knees, back and shoulders are most vulnerable to injury. The good news is that by taking the following three preventative steps, you can minimize your chances of injury and maximize your enjoyment of curling this season!

Number one on my list is proper equipment. I can guarantee that if you curl long enough you’re going to fall once or twice. Over 90% of curling injuries result from a slip and fall. If you’re on the ice with any regularity, it’s worth ditching the runners in favour of a proper gripper and slider. Beginner curlers and young curlers in particular should also consider wearing a helmet when starting out. Scary fact: when you fall, your head is the body part that’s most likely to hit the ice first!

Number two is a proper warm up. But wait, there’s a twist. You need to actually get WARM. You need to increase your heart rate and body temperature! If you think that I’m stating the obvious, just look around at all of the curlers casually chatting or gently stretching before going on the ice. These activities will only warm you up if you’re doing them on a hot beach or in a hot yoga studio. Start by running on the spot, high-knees, butt-kicks, or doing jumping jacks. Follow that up with some curling-specific stretches including the legs and trunk, and you’ll be ready to hit the ice.

My third and final tip is this: get a qualified coach to take a look at your mechanics. I remember the first time that I saw my delivery and sweeping on camera, I was shocked at how awkward I looked! I’m not saying that you’re in the same boat; you might be perfect. But you may not look as good as you think you do. If you aren’t already getting regular coaching, an instructor can provide you with some insight into your technique. Improving your delivery and sweeping by optimizing the way that you load your joints and muscles will improve your performance and prevent overuse injuries. You’ll play better, and feel better doing it!

Keep these three points in mind and with any luck you’ll make it through the curling season with little to no time missed due to injury! If you do happen to run into any issues along the way, keep in mind that a visit to a physiotherapist can help you to get back on track. Happy curling in 2016!

For more information on curling injuries, prevention and exercise, join us for a free informational talk on Tuesday, January 26th at 6:30 at Sun City’s Glenmore location. Call 250-762-6313 to reserve your seat.

Rob Heimbach is a registered physiotherapist and associate at Sun City Physiotherapy’s Glenmore clinic. He can be contacted at 250-762-6313 or email glenmore@suncityphysiotherapy.com

Exercise after Pregnancy by Brenda Walsh, Physiotherapist

There are a few things a woman should take into consideration when resuming exercise after pregnancy: Pelvic floor strength and her abdominal muscles. Restoration and strengthening of the Pelvic Floor muscles is very important and should begin in the early days and continue weeks after delivery. Whether her delivery was vaginal or C-section, special attention needs to be paid to the post-partum woman’s abdominal wall. A widening of the gap between the two bands of the Rectus Abdominus muscle, known as Diastasis Recti, may not resolve spontaneously after pregnancy.

Pregnancy and childbirth puts a woman’s body through one of her life’s most strenuous events. Laxity in the ligaments, an increase abdominal girth, an exaggerated forward tilt of the pelvis can alter the center of gravity, affecting dynamic stability of the spine and pelvis. Combined with the load of carrying a new baby and breastfeeding, these added stresses to the spine can lead to postural fatigue and discomfort. Physiotherapists are experts at analyzing posture and alignment and can prescribe postural exercises and advice on body mechanics.

Kegel exercises are an important part of pre-natal health. The Pelvic Floor muscles (PFM) lie at the base of the pelvis, and run from behind the pubic bone to the tailbone. Differentiate a PFM contraction from the buttock muscles. To avoid increasing intra-abdominal pressure, don’t hold your breath and push. Instead, think of pulling the two side walls of the vagina toward midline, and lift up inside. Hold this contraction for 10 seconds, without holding your breath.
Immediately after a vaginal delivery, many women find it hard to feel a contraction in their pelvic floor muscles. It works much easier if “muscle memory” exists from previous practice.
If you’re having difficulty with this, an internal examination by a women’s health physiotherapist can determine the extent of the problem. Other concerns, such as uncomfortable scarring after an episiotomy, can also be addressed.

We have 3 layers of abdominal muscles. 100% of women have some degree of Diastasis Recti, or abdominal separation in their third trimester of pregnancy. At 8 weeks post-partum, if the gap is marked (greater than 2 fingers width), if untreated it will likely still be a problem after a year. Diastasis Recti can aggravate low back problems and result in a midline “doming” of the abdomen under load. The underlying cause is an abnormal increase in intra-abdominal pressure during exertion, not the pregnancy itself.

If you suspect you have a Diastasis, try to avoid activities that strain on the abdominal wall. This would include sit-ups, especially over a large ball, heavy lifting, yoga postures that include back bends, Pilates “100’s”. This is until you have learned to contract the inner Transversus Abdominus (TrA) muscle to support the wall.

Two thirds of women with Diastasis Recti have some level of Pelvic floor dysfunction. The Pelvic Floor muscles and TrA work synergistically to support the pelvic organs, especially during exertion. Good tone in these muscles helps to prevent and treat prolapse and stress incontinence, which can show up in mid-life.

Brenda Walsh is a registered physiotherapist and associate at Sun City’s Glenmore location. She can be contacted at glenmore@suncityphysiotherapy.com

Vertigo & Dizziness by Robina Palmer, Physiotherapist

‘Vestibular Rehabilitation’ is an area of focus in my physiotherapy practise – I am often asked what exactly that means. The vestibular system (involving your inner ear) is responsible for sense of movement, body orientation and balance. The vestibular system (along with our eyes, muscles, and joints) send constant feedback to our brain about our body’s movement and orientation.

Dysfunctions, disorders, trauma or viruses that affect the inner ear can be a potential cause of vertigo, dizziness, decreased balance, tinnitus (ringing in the ears) or a change in hearing. As a vestibular therapist I can assess the potential causes of the mentioned symptoms and provide treatment to help decrease dizziness, vertigo and improve balance.

Dizziness is the umbrella term that refers to a sensation of abnormal, unwanted, movement – a feeling of unsteadiness, lightheaded or feeling ‘off’. Vertigo is a more specific term and implies that there is a rotational component to your dizziness – either the room is spinning around you or you are spinning in the room. Both vertigo and dizziness are symptoms, not a diagnosis, so part of my job is to figure out the possible cause and provide treatment.

One of the most common conditions within the inner ear that I treat is a condition called BPPV – benign paroxysmal positional vertigo. BPPV is caused by a crystal that is free floating within the inner ear. The signs and symptoms are pretty easy to recognize (vertigo brought on when lying flat, rolling in bed, looking up to the ceiling or bending forward). Treatment for BPPV is also quite effective.

It is also important to recognize that not all causes of vertigo or dizziness are associated with problems in the inner ear. Cardiovascular (heart) disorders, thyroid conditions, anxiety, migraines, neck disorders/injuries and neurological conditions are all potential causes.

Robina Palmer is a registered physiotherapist and partner at Sun City Physiotherapy. She can be contacted at the downtown St. Paul Street location or email her at rpalmer@suncityphysiotherapy.com

BODY ROLLING: A NEW WAY TO ENHANCE FLEXIBILITY AND WELL BEING by Brenda Walsh, Physiotherapist

How often do you get a tight area in your back that you’d love to get rid of? Or a tense band in your buttock or hamstring that has plagued you for weeks?
Have you noticed that your shoulders round forward, and you’re tight across the back of your shoulders?
The nagging tight spots we feel can be the result of restricted mobility or adhesions in fascia, the elastic web of connective tissue that surrounds and connects muscles.

There is a technique to improve flexibility that is easy, inexpensive and works extremely well in conjunction with stretching to improve myofascial mobility. It’s called Body Rolling, and it’s a powerful self-treatment tool using a firm 5” diameter ball. It is similar to using foam rollers, which are popular in gyms. Because of its size and compressibility, it is useful in areas other tools can’t reach.

Body Rolling techniques combine the relaxing effects of massage with the toning effects of exercise. Working with your own body weight, the exercises ease movement by loosening the muscles and their surrounding fascia, with the benefits of a deep self-massage. It can take as little as 10 minutes to work a specific area, and you can do it at your convenience. Working an entire region or chain of muscles gives the best results, since fascia is connected in long tracts that can span more than one joint.

The techniques of Body Rolling can: free adhesions in the connective tissue sheath that wraps around muscles and lies between muscle fibres; help muscles lengthen; improve muscle flexibility and tone thereby improving range of motion and shock absorption in the joints; improve circulation; and assist in correction of faulty posture

People with an active lifestyle often come in to see a physiotherapist with unexplained pain in a muscle, tendon or joint. Physiotherapists look at posture, movement and perform selective tissue tension testing to determine the problem. As a physiotherapist, I use many tools, such as manual therapy, exercise and soft tissue releases to improve freedom of movement.

With exercise that is highly repetitive in nature such as running, cycling, rowing, racquet sports, fascia surrounding the working muscles tends to be loaded in one direction and can subsequently shorten. Movement patterns and normal posture can be altered, which can lead to injury and pain. Learning to use Body Rolling, and stretching along planes of movement, rather than spot-treating tight areas can free things up most effectively.

People working at a desk job every day tend to develop shortening in certain muscle groups– typically the pectoral muscles, the hip flexors, and the hamstring muscles. Over time, this can result in adaptive shortening. The price tag of a desk job can be poor posture, aches and pains at the end of the workday. Activity breaks and Body Rolling can help.

Brenda Walsh is a physiotherapist at Sun City Physiotherapy. She can be contacted at the Glenmore clinic or email glenmore@suncityphysiotherapy.com

TMJ Dysfunction Series II by Vince Cunanan, Physiotherapist

Argh! You woke up with another headache, and your teeth hurt from clenching yesterday at work, as you just met another stressful deadline. As you massage your temples and face, which actually feels relieving, your significant other tells you about your loud teeth grinding last night. As you look in the mirror while brushing your teeth, you are always intrigued by how your jaw “wiggles” side to side when you open your mouth. It’s done that for years but hasn’t created any other problems to your jaw function. Sound familiar? You are presenting with Myofascial Pain Dysfunction (MPD) of the Temporomandibular Joint, the TMJ.

The TMJ is the ball and socket joint that connects the Mandible (jaw bone) and the Temporal bone (one of the bones of your skull). It’s the small joint located in front of your ear. There is a cartilage cushion in between the ball and socket, referred to as the Disc. The disc is supported by special Ligaments, which keep the disc in place. Movement problems of the disc can be responsible for creating many symptoms in the TMJ, such as clicking, crepitations, locking, muscle spasm, and pain. There are several muscles which support and control movements of the TMJ. Symptoms can often be related to these muscles. These include temporal pain, headaches, muscle spams, tinnitus and ear pain, and even teeth pain.

TMJ Disorder/Dysfunction, or TMJD/TMD, is seen more commonly in women than men. There is a 3:1 incidence in females to males, and can include one or both jaw joints. In most instances, the dysfunction is a result of an imbalance or change in the normal function of the bones, ligaments, muscles, disc, or nerve components of the TMJ complex.

MPD can be due to various causes of increased muscle tension and spasm. In some instances, MPD can be a physical manifestation of psychological stress. Often, there is no disorder of the joint itself. There is often a history of facial pain and temporal headaches, secondary to Nocturnal (night time) jaw clenching and Bruxism (teeth grinding). Dental issues may have influenced symptoms over time. This might have lead to the use of a nighttime splint. There may also be ear pain, fullness, or tinnitus. Erratic movement patterns of the jaw during opening and closing are related to lack of neuromuscular control, which requires re-education through physical therapy.

The TMJ specific muscles involved in MPD are the Temporalis and Masseter. The temporalis is a fan-shaped muscle that fills the temporal space, and inserts onto the mandible. Its function is to raise the mandible to close your jaw. The masseter is a thick and strong muscle attached at your cheekbone and runs to the angle of the mandible. Its function is to also raise the mandible to close your jaw. Try this: clench your teeth several times and press your fingers firmly on your temples; now on your cheeks. Did you feel tenderness? Aching? Maybe even a sensation like a toothache? WHAT IS THE SIGNIFICANCE? These muscles become subjected to fatigue and overuse with prolonged and persistent clenching and bruxism, which leads to MPD symptoms. It’s like these muscles are running a marathon without rest, everyday!

Proper assessment, diagnosis, and successful treatment rely on a skilled physical therapy practitioner, with expertise in TMJ management. Treatment of MPD is focused on desensitizing muscles through hands-on mobilization, restoration of normal functional movement pattern through exercise, and providing education regarding prognosis and self applied maintenance. Treatment may also include other muscle re-education techniques such as Intramuscular Stimulation (IMS). We look at other mechanical influences such as neck disorder and posture, to assist in maximizing treatment management. At times, we often work with your oral practitioner (dentist, orthodontist, oral surgeon), and other practitioners who deal with behavioural modification, to optimize results.

Vince Cunanan is a TMJ Specialist and registered physiotherapist and associate at Sun City Physiotherapy Downtown Kelowna. He can be contacted at downtown@suncityphysiotherapy.com.

Iliotibial Band Syndrome by Sun City Physiotherapy

Running is a popular activity that can help maintain or improve your cardiovascular fitness and in some cases help you lose weight. There are many different reasons to run but often there is a goal set that may include 5Km, 10Km, half marathon, or full marathon.
When training for longer runs including 10km, half and full marathons it is important to remember that the training schedule should take place over long periods of time to allow your muscles and joints to accommodate for the increased strain that will be placed on them during the long run. As a physiotherapist, I treat many runners with all sorts of injuries. Some of the most common injuries include plantar fasciitis, achilles tendonitis, muscle strains, and Iliotibial band friction syndrome (IT band syndrome).
IT band syndrome is a repetitive stress injury that occurs when the iliotibial band glides over the lateral femoral condyle on the outside part of the knee. The iliotibial band is the thick band that runs from the outside of the hip down to the outside of the knee. It is a common injury for long distance runners (20-40 miles/week) but is not limited to only long distance runners. Running on various terrains can increase the risk of developing this condition. Up and down hills, graded slopes, and cambered roads have all been shown to increase the risk. This syndrome may also be found in other athletes or weekend warriors such as cyclists, weight lifters, and participants in jumping sports.
With IT band syndrome there is rarely a history of trauma. Patients will often complain of knee pain that may be difficult to localize and usually increases with repetitive motions like running. The symptoms usually get worse with changes in training surfaces, increasing mileage, or training on crowned roads.
Studies have found that long distance runners with IT band syndrome have weaker hip abductor and glut muscles on the involved leg compared to the uninvolved leg. The hip abductor muscles are located on the outside part of the hip and help prevent the leg from moving towards the centre of the body. It is also noted that fatigued runners are more prone to having their hip adduct (move towards the centre) and internally rotate (leg turns inwards) which causes more friction on the iliotibial band and therefore the symptoms get worse.
The management of IT band syndrome usually includes: 1) activity modification (usually decreasing mileage). 2) New running shoes. Shoes should be replaced about every 500km. 3) Heat or ice. 4) Stretching the IT band. 5) Strengthening the hip abductors and glut muscles.
If you are interested in pursuing long distance running you should: 1) follow a certified training schedule. 2) Make sure the shoes you are wearing are the right shoes for you. 3) Increase your mileage slowly to allow your body to accommodate for the increased strain. 4) Hit the gym – muscle weakness can cause problems down the road. 5) Go in for an assessment with a health care professional if you start to experience aches and pains that aren’t going away.

TMJ Dysfunction Series Part I by Vince Cunanan

Did you wake up this morning with acute facial pain and inability to open your mouth? When you think to yesterday, you remember taking a big bite from an apple and experienced a sharp pain in your jaw joint. Today, you can’t really open or fully close your mouth. That unexplained clicking in your jaw that you’ve had for two years has suddenly gone away. Now, there’s just facial tenderness in front of your ear and you’re worried that you can’t eat! If you experience this, you likely have a “locked jaw”, or Acute Disc Displacement. This is one of the common disorders of the Temporomandibular Joint, more known as the TMJ.

The TMJ is the ball and socket joint that connects the Mandible (jaw bone) and the Temporal bone (one of the bones of your skull). It’s the small joint located in front of your ear. There is a cartilage cushion in between the ball and socket, referred to as the Disc. The disc is supported by special Ligaments, which keep the disc in place. Movement problems of the disc can be responsible for creating many symptoms in the TMJ, such as clicking, crepitations, locking, muscle spasm, and pain.

TMJ Disorder/Dysfunction, or TMJD/TMD, is seen more commonly in women than men. There is a 3:1 incidence in females to males, and can include one or both jaw joints. In most instances, the dysfunction is a result of an imbalance or change in the normal function of the bones, ligaments, muscles, disc, or nerve components of the TMJ complex.

Disc Displacement is a mechanical problem that occurs when the disc ends up in the wrong position within the ball and socket. In this case, it is likely that the disc has become displaced due to the wide opening, creating increased stress and strain on the ligaments, resulting in pain around the joint and spasm in the facial muscles. There is also a longstanding history of unexplained clicking in the joint, which may be a pre-disposing factor to this problem. In essence, the disc needs to be properly re-educated to find its’ normal resting position again, and the mechanics restored to the muscles and joint. Specialized physical therapy care would assist in restoration of disc position, to restore movement and function, as well as normalize the pain.

Dysfunction in these tiny joints can have many causes. These can include trauma such as blow to the head, whiplash, falls, sports injuries, arthritis, dental occlusion, dentures, history of joint noises, stress (clenching, grinding), poor habits (posture, physical, oral), and many others. Signs and symptoms may include facial pain, headache, neck pain, ear pain, sudden changes in bite, tooth pain, ringing in the ears, shoulder pain, and facial tingling or numbness.

A physical therapist can help you understand and manage your TMJ dysfunction. Often it is obvious that the TMJ is the cause of symptoms you experience. However, for many people, the symptoms they experience can be widespread, and may not make it so obvious. As mechanics for the human body, physical therapists can properly assess, diagnose, and treat the TMJ and most of the possible influences. We provide a specialized hands-on approach to treatment, education, and exercise program. Treatment may also include other muscle re-education techniques such as Intramuscular Stimulation (IMS). In many instances, we often work with your oral practitioner (dentist, orthodontist, oral surgeon) to ensure the best outcome possible for your TMJ. Treatment can be very effective in a short period of time. A self-applied approach with a little guidance from specialized physical therapy practitioners will help with long-term benefits.

Acute Disc Displacement is only one of several diagnoses of TMJ dysfunction. Keep connected to read about other problems that these tiny joints can give you. Don’t stop eating apples though…

Vince Cunanan is a registered physiotherapist and associate at Sun City Physiotherapy’s Downtown Kelowna and Glenmore clinics. He can be contacted at info@suncityphysiotherapy.com