Planter Heel Pain – Plantar Fasciitis

What Is PHP?

Plantar heel pain (PHP), commonly known as Plantar Fasciitis, refers to pain beneath the heel that is typically worse with weight-bearing activities. It is commonly characterized by pain on the first few steps in the morning, tenderness on the inside of the heel bone and increased pain walking barefoot on hard surfaces. The plantar fascia is thought to be the main source of this pain.

Why Is Treatment Important?

Planter heel pain affects up to 10% of populations and predominantly affects sedentary middle-aged and older adults. It is estimated to account for 8.0% of all injuries related to running. It is the most common foot condition treated in physiotherapy clinics.

How Do We Treat PHP?

A recent best practice guide¹ suggests treatment for people with PHP should include stretching, taping, and individualized education. Patients may also benefit from shockwave therapy, followed by custom foot orthotics.

How Can Physiotherapy Help?

Your Physiotherapists can diagnose your heel pain as well as identify the risk factors which can trigger plantar heel pain. They can help you through the management of this condition with individualized treatment such as stretching, manual therapy, taping, and modalities (ultrasound, electrical stimulation or shockwave therapy). At Sun City Physiotherapy, we use an evidence based practice to treat your Plantar heel pain and get you back to pain free movement!

¹Morrissey, D., Cotchett, M., J’Bari, A. S., Prior, T., Griffiths, I. B., Rathleff, M. S., … & Barton, C. J. (2021). Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. British Journal of Sports Medicine, 55(19), 1106-1118.

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Shoulder Pain in Throwers

Shoulders

Shoulder Pain in Throwers

Each spring, at the beginning of baseball and softball season, people will develop pain and soreness in the arm and shoulder when throwing, or after throwing. This can linger or worsen as the season goes, potentially zapping their throwing strength and their ability to participate when it could easily be corrected.

Typically, this pain is a result of overuse or strain on the rotator cuff muscles. Throwing is a very demanding task on the shoulder and requires a sturdy foundation of strength within the rotator cuff muscle group and mobility of the entire shoulder. When we go from not throwing through winter (except maybe the odd snowball) to getting out on the field in spring, it can be a very abrupt change, and therefore, overworks these small supporting rotator cuff muscles. These muscles can then become very tense or tight, and the tendons can become painful from being over worked. Combine this with poor or limited range of motion or mobility and it becomes even more challenging to throw comfortably.

Prevention can be addressed by doing some simple exercises to strengthen the rotator cuff so that it can better support the high demands of the throwing motion. Taking care to warm-up properly is vital. The rule of thumb should be, “warm-up to throw, don’t throw to warm-up!”. This will make huge improvement to comfort and performance.

Try these four quick basic warm-up exercises.

Arm circles: starting small at shoulder height moving to large circles
over 30 seconds. Forwards and backwards
AROM IR/ER starting at sides gradually moving up to 90 abd 30 seconds
Banded IR @ 90 Abd 2×15
Banded ER @ 90 Abd 2×15

Through physiotherapy, we can address excessive tightness, and work to improve strength. Manual therapy and IMS, which can help reduce pain and restore the range of movement needed to throw. Modalities can be applied to settle any inflammation which may have developed.

Education is key to better learn how to warm-up properly for throwing. It is equally important to identify which muscles need to be strengthened properly and how to do it. Your Physiotherapist can guide you through the steps.

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Treatment of Urinary Incontinence and Pelvic Pain in Women and Men

Health and Exercise

Treatment of Urinary Incontinence and Pelvic Pain in Women and Men

Specialized physiotherapy for the assessment and treatment of bladder and bowel incontinence, and pelvic pain are becoming more recognized as a first line of defence.

If you think you may be affected, ask yourself the following questions:

Have you experienced incontinence when heading to the bathroom, or when you cough or sneeze?
Do you find yourself straining or in pain when passing a bowel movement?
Have you experienced pain with intercourse?
Do you suffer from lower back or hip pain?
Are you pregnant or post-partum and experiencing leakage?

If you answered yes to any of these questions, the pelvic floor muscles, fascia and nerves may be contributing to your symptoms, and assessment by a pelvic floor physiotherapist is recommended.

Pelvic floor physiotherapy goes beyond the well-known Kegel, and should be assessed and treated similarly to any other muscular injury or imbalance. The goal is to optimize the coordination, strength, and flexibility of the pelvic floor muscles. Through the use of a ‘rib to knees assessment approach’ your pelvic floor physiotherapist will explain the important relationship between your diaphragm, core, and pelvic floor. Any imbalances, previous trauma, or de-conditioning can lead to symptoms such as rib pain, core weakness, back/hip pelvic pain or incontinence. Your pelvic floor physiotherapist will then work to address these symptoms, and create a manageable and empowering treatment plan to help you regain control and function around what can often feel like an isolating and embarrassing problem for many.

Who would benefit from a Pelvic Health Assessment? Those experiencing:

Stress incontinence: leakage with coughing, sneezing, jumping, running;
Urge incontinence: leakage or loss of control without being able to delay voiding;
A mix of the above incontinences;
Women during pregnancy and post-partum;
Post Prostatectomy, and:
Nocturia – waking multiple times throughout the night to void

What should you expect at a Pelvic Health Appointment?

Assessment of posture, movement mechanics, core and pelvic floor muscle activation;
Option for internal assessment of pelvic floor musculature;
Exercises specific for your pelvic floor muscle tone and function;
Education on symptom management, and;
Self-management techniques to confidently perform exercises at home

If you have questions or concerns around your pelvic floor, or are currently pregnant or post partum, book an assessment with our Pelvic Health Physiotherapist, Paige Marzinzik at our Downtown or Lower Mission Clinic.

– by Paige Marzinzik, Physiotherapist, Pelvic Health Therapist

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What Is Scoliosis?

Health and Exercise, Physio Articles

What Is Scoliosis?

What is scoliosis?

Scoliosis is a deformity of the spine, usually diagnosed in adolescents; often without a known cause.

What is Scheuermann’s Kyphosis?

It is a (hyper)kyphosis; a spinal deformity that leads to a more rounded appearance of one’s upper back (sometimes referred to as a “roundback” or “hunchback”)

What does this look like; and what does that mean for me or my child?

It means that you may have noticed some differences in the appearance of your child or yourself as compared to peers: uneven hips, waist, and/or shoulders, a “sticking out” spot on the ribs and/or back, a shoulder blade that doesn’t match the other side. You or your child may also experience increasing symptoms as the condition progresses, such as pain, breathing difficulty, osteoarthritis, mental health problems, and decreased health-related quality of life.

What is Schroth?

Schroth exercises are an evidence-supported, set of physiotherapeutic scoliosis specific exercises (PSSE). They are aimed at preventing the progression of the spinal curve, or to optimize post surgical results. Studies have shown that Schroth is effective for decreasing pain, improving quality of life, increasing back muscle endurance and range of motion, and improving self-image.

Does timing matter?

Early detection and care planning are very important. The options for, and effectiveness of treating a scoliosis or kyphosis vary with stages of skeletal maturity. If you suspect you, your child or teen has scoliosis or kyphosis, it is important to get it screened by a professional such as a doctor or physiotherapist.

What should I expect when signing up for Schroth therapy?

Assessment of your posture/curve and movement
Education about your scoliosis/kyphosis
Specific Exercises, positions and postures to practice at home
Monitoring your scoliosis/kyphosis

Scoliosis and Kyphosis management is a team approach which includes your family doctor (observation, monitoring, and care coordination), physiotherapist (physiotherapeutic scoliosis specific exercises), orthotist (bracing), and surgeon (surgery).

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Making Sense of ‘Persistent’ Pain

Chronic Pain

Making Sense of ‘Persistent’ Pain

It seems self evident that pain is caused by tissue damage and is therefore resolved by tissue healing. But what about when the initial injury should have resolved long ago and yet our pain continues into many months and possibly even years? This is known as ‘persistent’ or ‘chronic’ pain and in order to understand how it can develop we need to explore where pain really comes from.

Tissue damage is not actually what causes us to feel pain per se, rather, it is our nervous system’s RESPONSE to PERCEIVED DAMAGE or even just the perception of POTENTIAL damage that leads to this. This mechanism can be described in terms of inputs and outputs.

An input is where the body picks up signs of potential tissue damage via ‘nociceptive’ nerves, which detect things such as increases in tissue pressure, shearing or tearing forces, extremes of hot or cold and so forth. This information is then sent to the central nervous system (CNS) for consideration.

If the CNS perceives these signals as a threat to your well-being, it will effect an output response by modifying or activating the function of a number of bodily systems. One good example is the sympathetic nervous system, which helps to bring about the body’s stress response commonly know as ‘fight or flight’. These output responses can lead to symptoms such as:

• Muscle spasms/aches/tightness/weakness,
• Changes in your posture
• Increased rate of breathing• Increased pain and sensitivity to pain
• Increased heart muscle tone,
• Increased arousal, alertness and attention.

These responses are generally necessary to aid our recovery, but there are times when they can become excessive and counterproductive. For example, if tissue damage is allowed to go on for prolonged periods, it can lead the CNS to accelerate its response causing it to react to things that would not normally be painful. Also, because responses are based on the CNS’s PERCEIVED level of injury or threat, a person’s beliefs, past experiences and emotional state (anxiety/low mood) can be enough to lead the body to mount a pain response even in the absence of any actual tissue damage.

A counterproductive or prolonged response like this can also lead to:

• Slow healing of cuts and recovery from illness
• Difficulty in concentration and memory
• Changes in sleep patterns
• Fatigue
• Altered libido
• Digestive problems
• Widespread and spontaneous pain
• Increased muscle activity

In these situations, conventional treatments alone are not always enough and a deeper knowledge of how to bring back true balance is essential. Holistic physiotherapy treatment will help you to move away from a persistent, painful and domineering ‘fight or flight’ state by boosting areas such as your immune and parasympathetic nervous
systems (areas all too often ignored!).

Some examples of things that can help include:

• Relaxation and breathing exercises
• Having a good understanding of your condition
• Graded fitness training and exercises
• Doing away with unhelpful and damaging beliefs and worries
• Developing a healthy sleep pattern

Further articles to come! If you’re struggling in the meantime, contact us today to start your journey of understanding and lasting recovery.

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Planter Heel Pain – Plantar Fasciitis

Sun City Physiotherapy Locations

Phone: 250-861-8056

Phone: 250-762-6313

Phone: 250-766-2544

Phone: 778-699-2006

Shoulder Pain in Throwers

Sun City Physiotherapy Locations

Phone: 250-861-8056

Phone: 250-762-6313

Phone: 250-766-2544

Phone: 778-699-2006

Treatment of Urinary Incontinence and Pelvic Pain in Women and Men

Who would benefit from a Pelvic Health Assessment? Those experiencing:

What should you expect at a Pelvic Health Appointment?

Sun City Physiotherapy Locations

Phone: 250-861-8056

Phone: 250-762-6313

Phone: 250-766-2544

Phone: 778-699-2006

What Is Scoliosis?

What is scoliosis?

What is Scheuermann’s Kyphosis?

What does this look like; and what does that mean for me or my child?

What is Schroth?

Does timing matter?

What should I expect when signing up for Schroth therapy?

Sun City Physiotherapy Locations

Phone: 250-861-8056

Phone: 250-762-6313

Phone: 250-766-2544

Phone: 778-699-2006

Making Sense of ‘Persistent’ Pain

Sun City Physiotherapy Locations

Phone: 250-861-8056

Phone: 250-762-6313

Phone: 250-766-2544

Phone: 778-699-2006

Sun City Physiotherapy Locations

Phone: 250-861-8056

Phone: 250-762-6313

Phone: 250-766-2544

Phone: 778-699-2006