How to Prevent Tennis Elbows

Tennis elbow or golfers elbow doesn't have to be from playing tennis or golf. They are terms used for tendonitis of the elbow. Athletes or office workers can all suffer from them. To prevent the onset of these conditions, contrary to some common sense, you need to work out your shoulder, neck and elbow together to eliminate the root causes of these conditions, not just stretch and strengthen your elbow and wrist.

There are two reasons why this is the case. First, all nerves controlling muscles in the arms are from the neck. You will need to maintain a good posture and neck flexibility to ensure no pinching to the nerves, so that the muscles will function at the optimal level. Secondly, your shoulder is the base for you to move your arm. Without a strong and stable shoulder, you will have to put extra stress on your forearm and elbow to be able to perform at the same level. After a while, pain and injuries will start as a result. So when you experience any elbow pain and discomfort, you should also check your posture and shoulder strength and flexibility in addition to stretching your elbows.

In a clinical setting,  most cases we see, there are most likely to be some issues with the neck and shoulders. While you get treatment for your elbow pain, if the other problems are not solved, the results would be sub-optimal.

Physiotherapy Treatment for Neck Pain

Many people suffer from acute or chronic neck or shoulder pain. As more and more people work in front of a computer all day, the cases are only increasing.

To help reduce or eliminate the pain, first thing you need to do is to check your posture and the set up of your work station. Most importantly, make sure your head is Not poking forward while you work. Gently pull your head back, straighten your neck by tucking the chin in. Adjust the height of the chair so that your elbows are supported on the armrests and feet flat on the floor with knees bent at 90 degrees. Adjust the monitor so that your eyes don't need to look up while you sit up straight. The placement of the keyboard should be such that you can type without reaching forward. Every half hour or so, try to sit up, straighten your neck and gently pull your shoulder blades together and hold for 30 seconds. Move your neck side to side very gently with your chin tucked in for a few times afterward as well. If you can keep up with the above, the mild symptoms would improve quickly.

For people with more severe problems, coming to see a physiotherapist would be your best start on the way to recovery. On the first visit, you will get a comprehensive assessment including medical history and physical examination to find out the cause of the pain and other problems. Depending on the findings from the assessment and your tolerance, treatment options will include manual mobilization, massages, stretches, ultra sound, electrical stimulation, acupuncture, intramuscular stimulation and many others. A set of exercises to help you regain your mobility, reduce pain and regain function will also be gradually introduced. On every follow up visit, a brief assessment will be done before treatment to ensure the correct treatment plan has been carried out and your objective and subjective signs and symptoms are improving.

With the coordinated efforts from our therapists and you, we will ensure your return to your happy and active life style. 


Combine Physiotherapy and Acupunture for Best Results in Rehabilitation

Best medical practice in patient care would combine scientifically proven methods and traditional healing arts to achieve the best outcome for the clients. When applying this principle to rehabilitation, a combination of best physiotherapy practice and traditional Chinese medicine/ acupuncture would have the best outcomes in reducing pain, restore mobility and function, and maintain a pain free and active life style.

A physiotherapist is an expert in assessing musculoskeletal and neurological dysfunctions by using most up to date anatomical and physiological knowledge and tools. They will most likely find out the source of the pain and dysfunction. With skills in manual therapy, massages, modalities, and exercise prescription, a good physiotherapist will quickly restore most anatomical and physiological dysfunctions. But at the same time, the cause of the pain and suffering might not be eliminated when you consider the client as a whole. It would involve considerations of the life style, body composition, efficiency of body energy system, and most importantly, emotions. A registered traditional Chinese medicine practitioner/acupuncturist have the required knowledge and skills to balance body's energy system and analyzing emotional/ life style variations.

At iBalance Physiotherapy, award winning physiotherapist and experienced acupuncturist work side by side in helping you achieve the best and lasting results in return you back to your active life.

Fall Prevention and Mobility Aids

The population size of people over 75 is rapidly increasing. While more people are enjoying good health, physical abilities will inevitably decrease due to degeneration, disuse, and diseases.  As the mobility declines, fear of falls is eventually in everybody's mind. To maintain a safe mobility, while it is important to exercises to keep up leg strength and balance, it is equally important to use appropriate walking aids to help prevent falls.

Common mobility aids include crutches, canes, walkers, and wheelchairs. Let's take a look at the advantages and disadvantages using each of them.

Canes provide the least support for people with a mobility impairment. But they are small, light and very easy to carry. They should be used when the person is only slightly unstable and has good upper extremity strength and coordination, i.e., people who have some minor pain and weakness of one foot/ leg. They should be used only for short distance walking, but they are great for people to go up and down stairs where they can hold onto the railing on one side and the cane the other side.

Crutches are for people who are unable to bear full weight on one leg but have very good arm strength. A pair of crutches can help you precisely control how much weight you put on one foot: none at all, slight, or half. The use of them requires more strength and coordination for most seniors with physical disabilities.

Walkers will provide the most support for people who are still able to walk but are unsteady, weak and dizzy. Different types of walkers with a different combination of stability, mobility and weight suite people with varying conditions. But overall, they are heavier and bigger than other types of walking aids.

People will have to consider using wheelchairs when they have frequent falls even with a walker. The most difficult barrier for people to start using a walking aid is a psychological one. They often tell you they feel embarrassed for using them or they sometimes think their permanent impairment is only temporary. Lots of persuasion and  some professional help would be required to keep our seniors safe.  

Injury Prevention and Management

Ice or Heat after an Injury

It depends on the severity and location of the injury.

Usually,  for an acute muscle and joint sprain or strain, ice is applied immediately after the injury, especially if you see swelling, bleeding, and feel a constant throbbing pain. Ice with compression at where it is hurting will help control swelling, decrease inflammation and pain during the first 2 days. This is very helpful in injuries such as a sprained ankle, a pulled muscle and contusions. The important thing to remember is to use ice NO more than 10-15 minutes at a time, and NOT more often than every hour. This way you can avoid any adverse effect of using ice.

Two days after the injury, once the pain is subsiding, swelling is controlled, you need to start using heat to help improve circulation, decrease pain and speed up the healing process. Heat should be used for 15-20 minutes at a time,  2-3 times a day.

With relative rest, gradually return to a normal activities will happen in around 2 weeks for most minor injuries. After 7-10 days if the pain is not subsiding, it is time to seek medical attention and treatment. If you are engaged in competitive sports and would like to maintain your training level and make sure you can go back to your sports, consultation and treatment from your physiotherapist would be advisable right after the injury.

The above is a general guideline. In some instances, we need to assess the specific conditions. For most headaches, ice over the base of the skull at back of the neck and sometimes over the forehead will help better than heat, no matter how long you have had the problem. For neck and back strains, if the pain is not severe, more of a tight sensation in nature, you can use heat right from the beginning. If you are still not sure, call us at 613-979-8633 for a free consultation.


Rest or Exercise after Injuries

The answer is always Relative Rest.

For a minor sprain or strain, the first 2 days only gentle range of motion exercises are allowed, meaning you should be moving the injured body parts within a relatively pain free range. Resistance exercises are not recommended at this time. There is not going to be complete pain free at this acute stage. But if the movement is not increase your discomfort  level more than 10-15% over baseline, you should be moving it. And also continue training on things not involving the injured body part, so that your return to regular training will happen as fast as possible post injury. Once your pain level goes down and range of motion returns to normal, gradual resistance training should be introduced as soon as possible to assist the healing process. 

If there is a more severe injury, such a fracture, torn ligament or tendon, the injured body part might be immobilized by a cast or splint, you still need to move the joint below and above where it hurt. This is not only useful in reducing swelling, pain and stiffness while you are in the cast, but very important in regaining all normal function of the involved side of the body once you are allowed to move again.


Self management of Arthritis and Other Degenerative Conditions

Most of the times when we talk about arthritis, we are talking about osteoarthritis or rheumatoid arthritis. They are both inflammatory conditions and cycles from active and inactive stages.  Osteoarthritis is a degenerative condition which will happen once people age and wear and tear happen to their joints. Rheumatoid arthritis is an autoimmune disease where the soft tissue around the joints become inflamed, causing the joint to be swollen and painful. Osteoarthritis mostly happens to individual joints which bear most body weight or have most movement. Rheumatoid arthritis happens more likely symmetrically on both sides of the body to the same joints.

Other than seeing medical help from your doctors and specialists, there are a few things you can do yourself to manage the condition and achieve a better quality of life.

First, pain control. The level of pain is the worst when the disease is in active inflammatory stage. You will need to take your medication to control the inflammation and pain. Do relative rest and stop some your routine exercises to avoid aggravating the condition. Use ice for osteoarthritis. Use heat for rheumatoid arthritis.  Range of motion exercises should continue within pain free range: move the involved joints 10-20 times, 3-5 times a day to maintain the range and improve circulation. Use a brace or splint for weight bearing joints such as knees to provide necessary support and protection.

When the inflammation is controlled, the pain and swelling will decrease, and the condition enters an inactive stage. Now what you need to do is to gradually increase the load of your exercises to improve the range of motion of the joints and strength of the muscles. If your muscles are stronger, you will have a greater control of the joint motion, thus less risk of injuries.  Generally, you start with Non-weight bearing exercises, such as ankle weights, elastic resistance exercises. Once you are able to do these pain free, you should move on to more demanding exercise types, i.e., swimming, stationary bikes and other exercises which you can load the cardiovascular and musculoskeletal systems without putting too much stress on the joints. Keeping a daily log of your activity types and duration is a great way to monitor how much you can do without irritating the joints.


Correct Sitting Posture

There are so many people working with computers are suffering from neck, shoulder, arm pain and headaches, almost everybody you ask would tell you they have or had these kinds of problems. But do you know some simple postural correction exercises and stretches will help reduce or even eliminate the aches and pains? Let's tell you how.

As a natural tendency, after sitting in front of a computer, most people will slouch with their head poked forward, shoulders shrugged up. This posture will cause the muscles in front of neck and between shoulder blades to be weak and the muscles at the back of neck, top and front of shoulders to be tight. With time, the imbalance will cause strains and inflammation to the muscles, unable to support head and shoulder movement, and thus pain. To help treating this problem, one of the most important steps is to pull yourself out of the improper posture.

First, check if your monitor is at your eye level. Adjust the height of your chair of the monitor so that when you sit up straight, chin gently tucked in, and feet flat on the floor with knees bent slightly more than 90 degrees, the upper one third of the monitor should be at your eye level.  

Secondly, make sure your elbows and forearms are supported on the arm rests while you are typing.

Third, put a small sticker on top of the monitor to remind yourself to do the following: every 1/2 hour, tell yourself to sit up straight, gently tuck your chin in as if doing a double chin, pull your shoulder blades together without shrugging up your shoulders, and hold this for 30 sec or a minute. This small exercise will help reduce tension in the tight muscles , tighten up week ones and help reduce the overall stress to your neck and shoulders , thus reducing pain and stiffness.

Finally, getting up and walking around for a few minutes every hour or so, regular shoulder and upper body endurance and strengthening exercises are all important in helping to maintain a pain free work place.


Proper Body Mechanics for Lifting and Yard Works to prevent back injuries

There are too many people  hurt themselves doing lifting, carrying and other chores at home. The most common complaint is back injuries. Even though the majority of the injuries will resolve in a few days, some are severe enough requiring treatment. The worse, some could become chronic problem. To prevent this from happening, some rules of proper body mechanics must be followed.

First, make sure you assess the load you need to work on. If you suspect you need help with it, ask for help. Lifting and carrying anything over your capability is always a disaster waiting to happen. Once you are certain you are able to handle the load, move as close to the object you are working with as possible. Tighten your abdominal muscles, keep your back straight, bend your knees, hold the object against yourself, use the big muscles in your thighs and hips to lift, instead of using your back muscles.

Secondly, if you are standing on the same spot for an extended period of time working on something, the above applies as well. You need to tighten your abdominal muscles gently, maintain an upright posture, get as close to the work as possible and avoid bending forward to do the job. You also need to take breaks before you feel exhausted to avoid overuse injuries.

To prevent back injuries while doing physical work, stretches to hip flexors, hamstrings, calf muscles and gluts are the most important. You will need to stretch before and after your work to make sure your leg muscles can stay away from pain.