Squats are a great exercise for anybody looking to improve performance and prevent injury. When done properly, squats can actually help with pain and weakness in the lower extremity. However, if done wrong, squats could cause injury or pain.

The traditional way of doing squats over-loads our knees, thereby irritating the patella (knee cap).  Squats should be done utilizing the hips.

Keeping the knees directly under the chest and hinging at the hip unloads the knee joint and forces those gluteal butt muscles to work. The gluteals are strong stabilizers of the lower back and legs. When active, forces are less through the knees.  Essentially, you want to squat as if you are about to sit down on a low chair.

The model below shows the ideal way of doing a squat:

Some points to remember:

- Always keep your back in a straight neutral position. Do this by bending at your hip/butt and not through your lower back

- Keep your knees directly over your ankles.  Do not let your knees go over the feet as you squat.  This keeps your body weight above your back and butt forcing those muscles to work.

- Keep your knees at the same width throughout the squat. Do not let them deviate inwards. If deviated, this angulation can cause excessive force through the inside part of your knee joint.

- Do not let your heels rise.  Keeping your feet flat assures stability and that your body does not translate forward.

- Keep shoulders and chest back, avoiding slouching through the upper body.

- When rising from the squat, maintain the same form. Thrust your pelvis forward as you come up, using your hips to rise. Do not let your shoulders and chest come forward.  Use your gluteals to rise, instead of over-loading the quadriceps muscles, which pull on the kneecap.

Squats should be incorporated into every training program, from runners to office workers. Squats can be varied by progressing to one leg, standing on uneven surfaces, adding twists and adding weights.  Always speak with a physiotherapist prior to implementing squats into your program, especially if you are experiencing any symptoms.

Re-Build Yourself.

 

Raj is co-owner and physiotherapist at Foundation Physiotherapy. He has an interest in fitness and regularly incorporates squats and other strength exercises into his clients’ programs.

A little over a year ago, Raj and myself had an idea and a desire to build a physiotherapy clinic that matched our ideals and passion for providing our clients with the best care possible.

One year ago today, we officially opened the doors to Foundation Physiotherapy. We want to take this opportunity to thank all of our clients, friends, and family who have helped us grow over the past year.  So as a thank you – to you our clients and friends- we are giving a free 30-minute massage therapy gift certificate with every custom orthotics purchase until the end of the year.  Use up your benefits before the year ends. Call us today to take advantage of the offer! 

We have big plans for the next year! We have a great team beside us and we look forward to helping you all meet your fitness and health goals and to re-build yourselves!

Last week, we talked about getting in to see your physiotherapist as soon as you experience back pain. This week, we’ll talk about the variety of ways physiotherapy can help.  A recent article in the Journal of Orthopedic and Sports Physical Therapy described the ways to treat back pain based on the best research evidence.

LOW BACK PAIN IS SO COMMON THAT 8 OF 10 PEOPLE EXPERIENCE IT AT SOME TIME IN THEIR LIVES. Although the pain in your back may feel severe to you, most low back pain is not due to a serious problem. Physiotherapists should be able to assess, diagnose and intervene without the use of diagnostic imaging.

Back pain manifests itself in many ways. Localized pain is felt in the lower back (above your tailbone) and buttocks. Radiating pain occurs when there is pain in the back as well as down the leg or foot. This can also occur in the form of numbness and/or tingling and is usually the result of nerves being irritated. Sometimes, symptoms can occur in the leg, without actually being felt in the back. This is called referred pain. More often than not, back pain results from lifestyle factors, such as sitting too much, being in poor physical condition, and bending and lifting improperly.

You can experience one or all of these presentations with back pain.

As discussed last week, early treatment is the key to decreasing your pain and getting back to full activity. Treatment that focuses on exercise, mechanics and posture improves symptoms quickly and reduces your chance for recurrence. A physical therapist will tailor treatment to your specific problem, based on a thorough examination and the probable causes of your low back pain.

The good news is if you seek out a physiotherapist immediately after getting back pain, treatment is extremely effective. The longer symptoms linger, the harder it becomes to treat.  Staying active is important, and bed rest should be avoided.  Based on your examination, the best treatment options for low back pain are:

1) Manual therapy (hands-on mobilization of the joints in your back). Physiotherapists skilled in manual therapy use precise hands-on techniques to relieve stiffness and improve movement of the joints and muscles of your spine.

2) Movement exercises that restore motion and decrease radiating or referred pain. Most physiotherapists prescribe these exercises, using a protocol called the McKenzie method.

If your pain is chronic, do not fear; physiotherapy can still help! Along with the first two options, chronic low back pain is best managed with

3) Progressive strengthening exercises that focuses on core stability and endurance.

You’re probably wondering whether you should bother doing any of these and why not just wait it out? Unfortunately, waiting it out will reduce symptoms, but may not actually fix the reason you got back pain in the first place. That is why it is always important to be assessed by a physiotherapist before attempting to manage back pain yourself. A detailed assessment noting the type of pain, how it occurred, what makes it better and what makes it worse will allow the physiotherapist to prescribe the right treatment option for you.

Re-Build Yourself.

 

Raj is co-owner and physiotherapist at Foundation Physiotherapy. He is currently credentialing through the McKenzie method, a recognized program worldwide in assessing and treating low back pain.

What do you do when you get back pain? Do you wait it out? Sit for hours at a walk in clinic? Wait a few days, then see your family doctor? Take pain medications?

The above scenarios are typical reactions when someone experiences back pain.  However, a recent study published in the journal SPINE (Fritz et. Al, 2012) revealed that the sooner you start physiotherapy, the less time you will spend with back pain AND the lower the cost for both yourself and the health care system.

A typical timeline looks like the following:

Back Pain > wait it out (1 week) > no change > book an appointment with your doctor (2-3 days) > get an x-ray (2-3 days) > x-ray does not reveal anything significant & doctor prescribes medication (2-3 weeks) > still no real changes, doctor refers to physio (2-3 days) = 3-5 weeks.

In the above scenario, it may take over a month before seeing a physiotherapist . The result is wasted health care dollars in physician visits, medications and imaging. More importantly, it has wasted your time and likely resulted in time  off work and decreased participation in your active lifestyle due to pain.

Delaying a trip to the physio office can allow symptoms to develop into a chronic problem.  Your body will begin to compensate for the back pain, potentially causing secondary issues. In the case that medication does “work”, it is usually masking the symptoms, and not addressing the underlying CAUSE of your back pain.

People often ask if they need an x-ray before starting physiotherapy.  The short answer is no. Despite what is revealed on an x-ray, a physiotherapist can assess and intervene properly. Only in very rare circumstances, such as a fracture, would a physiotherapist need to intervene differently. Fractures of the spine are extremely uncommon, and usually occur through severe trauma.

In most circumstances, XRays are not necessary when treating back pain. Physiotherapy can help despite the findings on the XRay. Save health care dollars and time by seeing a physio directly.

Here’s a better scenario:

Back Pain > book an appointment with your doctor (2-3 days) > doctor refers medication AND physiotherapy (2-3 days) = 1 week

This scenario takes about one week before seeing a physiotherapist.  If your physician has not referred to you a physiotherapist, don’t be afraid to ask.

Here’s the best case scenario:

In Ontario, you can access a physio directly without having seen a doctor. Physiotherapists are primary health care practitioners, which means we can assess, diagnose and treat independently. Most physio clinics should be able to get you in for an assessment within a few days.

Visiting a physiotherapist immediately can reduce the symptoms of back pain and get you moving quicker.

Without downplaying the importance of our physician friends, visiting a physiotherapist directly when back pain begins is a more efficient use of your time. A physio conducts a detailed and specified physical assessment so he/she can understand the true cause of your pain and therefore, intervene properly.   Most of the time, back pain is resolved through manual therapy techniques, movement exercises and core strengthening, areas of expertise your physiotherapist can provide you.

With the right physiotherapy intervention, symptoms of back pain can be often be resolved within two weeks. Your physio can also show you how to prevent future episodes through postural and strengthening exercises. As the research suggests, the longer you wait, both the cost and the time to full recovery increase.

So the next time you or someone you know experiences low back pain, don’t wait; visit your physiotherapist immediately!

Re-Build Yourself.

Raj is co-owner and physiotherapist at Foundation Physiotherapy. He is currently credentialing through the McKenzie method, a recognized program worldwide in assessing and treating low back pain.

With the very mild winter we’ve had, there are a lot more runners on the streets of Toronto than normal for this time of year. Runners are gearing up for spring races trying to set new times, hit new distances, or maybe just finishing the race. The blog is a short summary of a talk I did last week at the Running Room in Toronto.

Strength training is an often overlooked piece of the puzzle for most runners. And that’s exactly why it’s important to talk about. Adding some strength training into your routine can make you a more efficient, faster, stronger runner.

So the first thing to do is address the elephant in the room. If you’re reading this, you are probably a runner.

And if you’re a runner you probably hate strength training, or do as little as possible. And that’s ok. You’re running 3-4 times a week- who has time for more training right? But you want to hit those lofty race time goals right? and you don’t want to end up with chronic injuries? Well let’s talk about biomechanics..

Running is a dynamic activity which requires a stable base of support. That base of support is your core. If it cannot support the stress you put on your body while running, then say hello to knee, hip and low back injuries… and goodbye to that pretty personal best you planned on setting this summer.

To simplify you want to work at 3 muscle groups:

1.gluteus maximus and hamstrings to help hill and tempo runs

2.gluteus medius and minimus to improve single leg stance phase of running

3.core and postural muscles to improve posture and make you more efficient

That last point is key… you want to be more efficient!! That means less effort, faster runs, and better recovery.  Oh and it lower your chance of injury from the repetitive stress of running. So do your research, look up some exercises, or see your physiotherapist and speak with them about your training program.

If you’re an NBA fan, you’ve probably noticed a trend in this year’s short and condensed season…

Andrea Bargnani – injured

Derrick Rose – injured

Too many NBA stars are spending this season on the injured list.

Now I don’t know what the players were doing for conditioning in their off-season, but my guess is a lot of these guys weren’t ready for the season because of the ‘lock-out’ and the really short training camp.

A study in the Journal of Orthopaedic & Sport Physical Therapy looked at core muscles of Elite Aussie Footballers in the pre-season and then looked at who ended up with hip, thigh, or groin injuries during the season. What did they find?? Footballers with small multifidus muscle were more likely to get injured over the course of the season. What is the multifidus? It’s one of the important muscles in you inner core. 

Think of it this way…your body is a machine. If you have a weak link the machine is going to break down somewhere. Your inner core stabilizes your lumbar spine and pelvis. It is the engine of the machine. If it’s broken down, or not working properly,  you can bet that at some point, other parts of the machine will start to break down as well.

What does that mean to you as an athlete? You’re already active and want to start fixing that core? It is always best to get assessed by a physiotherapist so that he/she can isolate your issue and fix it quicker. But since we are already talking core and you’re already reading, here is one of my favorite exercises for activating the entire core muscle complex:

Everyone hates it…because it works. A couple of pointers: lie down on your stomach; elbows flat and toes pushing into the ground; squeeze your stomach and lift up so that you look like a plank of wood. Make sure you keep your knees straight, your buttocks tucked in, and try to pull your shoulder blades together. Now hold it as long as you can, without dipping your lower back or hips.  Try this for three repetitions. And try to hold the position longer each time you try it.

So when you’re preparing for your next beer league season or resuming your recreational Ultimate Frisbee career, visit your physio to help PREVENT injury. You’ll be happy you did!

 

 

Re-Build Yourself

Matt is the co-owner and physiotherapist at Foundation Physiotherapy.

A new study published in the Annals of Internal Medicine shows that physiotherapy is more effective in relieving your neck pain than pain medication and gets you faster results than chiropractic treatment!

At Foundation Physiotherapy, we use a combination of manual therapy, education, exercise, and postural correction to help our clients get rid of their neck pain and build a healthy foundation to prevent symptoms from recurring.

Now, neck pain occurs for a number of reasons. The best option is to get your neck assessed by a physiotherapist who can isolate your issue and teach you the appropriate exercises to get better faster.

That being said, one reason that many people experience neck pain is due to tight neck muscles. One of the main culprits is your upper trapezius.

From neck pain to headaches, to making it difficult to look over your shoulder while driving, these guys are usually involved.

Here are two quick and easy exercises that can benefit most people in reducing their neck pain or preventing neck pain.

Chin tucks are a simple yet effective tool for treating neck pain. Especially for those of you working on a computer all day!! How simple? Follow the picture. Pull your chin in, hold, relax, repeat 10 times. Done.

For this one, you are going bend your neck towards your opposite shoulder and gently apply a little “pull” your arm as in the picture. This stretch shouldn’t hurt. And please hold the stretch for at least 60 seconds! None of this 10 second stretch stuff anymore!

So the  next time you have neck pain, instead of grabbing the Advil… call your physiotherapist!

Re-Build Yourself!

Matt is the co-owner and physiotherapist at Foundation Physiotherapy.

BIG NEWS! GREAT CHANGES TO HEALTHCARE!  Physiotherapists in Ontario can now “diagnose.”

As of Sept. 1, 2011, Ontarians will be able to ask their physiotherapists directly, receive an expert diagnosis and be prescribed a treatment plan, all without visiting a medical doctor.

What does this mean? Prior to this, physiotherapists were not able to diagnose your condition. Although, we were able to assess your injuries and treat them, we were withheld from communicating an official diagnosis (the identification of the nature and cause of your symptoms). This
responsibility belonged solely to physicians.

After years of lobbying and proving that physiotherapists are experts when it comes to the physical body, the legislation was changed, allowing us to diagnose our clients’ conditions. This means fewer visits to physician offices, saving lots of health care dollars. As physiotherapists conduct detailed assessments of physical conditions, clients’ can be more confident in their diagnoses. They can also expect better prognoses.

But wait, there’s more. Over the coming months, our ability to diagnose will help us with the ability to order X-Rays, ultrasound or lab tests.  We will keep all our clients’ updated regularly about these exciting changes in health care.

Please read this post from the College of Physiotherapists of Ontario for more information.

Re-Build Yourself

Raj Suppiah is the co-owner and physiotherapist at Foundation Physiotherapy.

Foundation Physiotherapy is now accepting new clients.

Our modern facility includes:
- four private physiotherapy consultation rooms
- a massage therapy room
- a multipurpose gym with resistance training and sports retraining equipment
- on-site washroom facilities, including a shower
- treadmill for gait and running assessments

We offer a variety of services and skills to enhance your physical health.  These include:

- physiotherapy
- registered massage therapy
- custom made foot orthotics
- custom made knee bracing
- acupuncture
- personal training
- sport retraining and sports injury management

Foundation Physiotherapy is located on street level at 383 Front Street West at the base of the Concord CityPlace Apex C Towers.

Give us a call or email us today!

Located at Front and Spadina in Cityplace, we are downtown Toronto’s premier sports injury and physiotherapy clinic. Our philosophy is to address the foundation of our clients’ injuries, speed up recovery and instil valuable tools for physical wellness.

Our registered physiotherapists and massage therapists are highly skilled with the most up to date therapeutic options. We offer a multitude of services and products to complement your program. All our sessions are one-on-one with your therapist, without the use of aides or assistants. At Foundation Physiotherapy, we strive to determine the root cause(s) of your injury at your first consultation, so we can quickly set you on the path for renewal.

Please browse through our website for more information about us, our services, our philosophy, our team and what makes us different. Or call us and speak directly with our physiotherapists.

Why wait any longer? Send us an email or call us. Start re-building your foundation today!

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