Assessments

Our strong orthopaedic skill set and experience enables us to provide a comprehensive assessment in order to treat the condition, rather than just symptoms management.

Our well trained, experienced, licensed practitioners help are patients return to ‘peak performance’. ‘Peak performance’ is very individualized and can mean anything from walking to running a marathon, or even taking off a shirt to throwing a discus. Our highly skilled staff has gained expertise from post-graduate courses in the following areas which you will see from the physiotherapy services offered below.

Conditions We Treat

We are analyst gurus. We listen to your symptoms, do a thorough examination and then act on what we have found. Sometimes a pain in the foot leads us to a low back problem and sometimes a pain in the arm leads us to the neck. Wherever we go, rest assured, we are getting to the source of the problem. These are some common problems that we see, click on the problem and find out more:

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Everyone has experienced back pain at some stage of their life – perhaps it has lasted just a day, but some of the bad bouts have resulted in bed rest for some time. And everyone knows the best person to get you better. The problem is that everyone is different and needs to be treated as such. We need to find out what is causing the problem. We will watch you walk, bend over, or watch any movement that seems to be bringing on the pain. We will test any muscle or soft tissue that may be causing the problem as well as individual spinal segments that may be contributory. Then we may stretch out, mobilize, tape, acupuncture or use any other technique up our sleeve to come up with the solution. I’m sure you have all heard about ‘core stability’. It is such an overused statement, yet it is so underused. It is well proved that if you switch on your stability muscles and get them on automatic pilot, the chances of your back pain returning become slim to nil. Pilates is now the buzzword and the buzztherapy for teaching these muscles to work. We offer 1 on 1 work with a Pilates instructor should this be a good option, if those muscles are buried too deep in the memory bank!
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Shoulder problems are either of the acute injury sort or the long standing ‘won’t go away’ sort. The acute sudden onset shoulder pain is usually caused by a traumatic injury, whether it be from a sport, a fall on the outstretched hand (called a FOOSH) or a repetitive action. These injuries are really painful with loss of movement and decrease in strength. The long standing problems are more the norm that we see – the ones that bother us in bed or reaching in the cupboard or fridge to pick something up. As a rule of thumb, if it’s your shoulder that hurts, then it is most likely your shoulder at fault. But if it’s the back of your shoulder or down your arm or up into your neck, then there is probably a neck/spinal component involved as well. It’s important to come up with the right analysis of the problem. Often poor posture is involved which causes muscle imbalances, stability problems and ultimately a shoulder/arm that moves improperly. We re-educate these muscles to improve posture and regain normal movement. Mobilization work around the spine works well and believe it or not, in these cases we rarely even touch the shoulder. If it’s a problem at work, then an ergonomic assessment may be necessary so that this problem does not reappear.
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Everyone knows about a pain in the neck. There are also a lot of accompanying symptoms such as headaches, ringing in the ears, arm and hand pain &/or pins and needles. A lot of the time there can be a precipitating event such as a slip and fall or whiplash, but sometimes it can be a nagging pain that has been there for some time. Manual therapy as well as acupuncture and IMS can be very helpful in controlling the pain as well as improving your sitting posture with specific exercises. Proper pillow(s) are also an important way of alleviating neck problems.
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1 in 4 of us will feel knee pain at some point in our lives. It can be a result of an accident or post surgical from a ACL reconstruction or meniscal tear. Or the knee can be the victim of what happens either above or below it. The knee cap is the bone that moves the most in the body and it moves according to the forces that guide it. Therefore a thorough examination of the entire lower quadrant can be very useful in determining the cause of the knee pain. A large number of runners present to us with more unusual knee symptomology that must be thoroughly assessed. Manual therapy as well as a host of other tools will help resolve your knee pain depending on the cause of your problem.
Foot Pain
Ankles and feet are the key to balance and mobility. If poor feedback is going back to the brain about where we are in space, then we are more prone to falling…not good in our cold slippery climate at times. A good diagnosis is important to understand why you are getting the pain, particularly if it is not simply a result of a roll over on your ankle. It is important to maximize feedback from our feet and we have a lot of tools to help maximize this. It is important to check our whole body alignment, Achilles tightness, neural flexibility and gait analysis. And we can’t forget to check out footwear – that can really help or hinder our walking pattern.
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Achy backs, sore shoulders, fuzzy hands, pain down the arm, headaches – these are all symptoms of problems that must be analyzed from an entire upper quadrant assessment. Certain postures such as computers, reading papers, driving, carrying groceries probably exacerbate the symptoms. Other related symptoms that usually present in the clinic may be tennis or golfers elbow, carpal tunnel, dequervains syndrome. We need to look centrally at the stability from the neck and shoulders. If there is control here, then you are less likely to overuse your arms and hands. There is local treatment to be done to help control the immediate pain and inflammation, but ultimately, work will need to be done to help stabilize and get better postural control. This may take longer than you expect especially if the problem has been there for awhile, because neural tissue is more irritable and sensitive than other tissues. The work station may have to be assessed as it can relate to your pain and pathology. And we don’t want to see this pain return. This can be arranged through your physiotherapist.

Brachial Plexus Injuries (BPI)

brachial plexus physiotherapy in torontobrachial plexus treatment toronto
Brachial plexus injuries usually occur from a traumatic birth or from a devastating injuries anywhere along one’s lifespan. We have been using various techniques including EMG and biofeedback and acupuncture to help patients regain the best possible function and the results have been dramatic.
Cerebral Palsy (CP)
cerebral palsy physiotherapy in TorontoCerebral Palsy is a result of early brain injury that leads to motor impairments as one grows and functions in daily life. With the remarkable guidance and education from Dr. Karen Pape, we are using innovative techniques and strategies to overcome adaptive movement behaviours.

This is with the help of the power of neuroplasticity that Dr. Norman Doidge discovered and that Dr. Karen Pape has taken to another level. In her 2016 book, ‘The Boy Who Could Run and Not Walk’, she describes her findings as well as her techniques that have changed people’s lives. We have seen remarkable results, but not without a lot of work from the therapist as well as the patient.

Our Services

physiotherapy services imageThis is a clinical approach utilizing skilled hands-on techniques, including but not limited to mobilizations/ manipulations to diagnose and treat soft tissue and joint structures to modulate pain, increase range of motion, reduce or eliminate soft tissue inflammation, improve tissue extensibility and improve function.

physiotherapy services imageAcupuncture is an ancient form of Chinese medicine involving the insertion of solid filiform acupuncture needles into the skin at specific points on the body to achieve a therapeutic effect. No drug is injected. The needles alone create the beneficial effects of acupuncture. Acupuncture needles are very fine, flexible and rounded but sharp at the tip. They are ‘atraumatic’, meaning that they do not have a cutting edge like a hypodermic needle, which slices through tissue. Their design allows acupuncture needles to slide smoothly through tissues and makes them unlikely to cause bleeding or damage to underlying structures. Acupuncture points (also referred to as ‘acupoints’) are places on the skin that have a lower resistance to the passage of electricity than the surrounding skin and are part of a network of points that were mapped centuries ago by the Chinese. In general, the goal of acupuncture is to restore balance or homeostasis.
physiotherapy services imageIMS is a total system for the diagnosis and treatment of myofascial pain syndromes (chronic pain conditions that occur in the musculoskeletal system when there is no obvious injury or inflammation). IMS involves using a dry needling technique to affected areas/muscles of the body that may precipitate pain and dysfunction. IMS is very effective for releasing shortened muscles from underlying neuropathy, that otherwise can cause a mechanical pull on various parts of the body resulting in conditions such as chronic tendonitis, joint/disc compression and degeneration, nerve entrapment, etc. The goal of treatment is to release muscle shortening, which presses on and irritates the nerve. IMS thereby in effect, treats the underlying neuropathic condition that is the source of the problem not just the symptom. A detailed assessment by a practitioner trained in IMS will determine whether you are an appropriate candidate that would benefit from this technique.
services_04This is a process of examining key ergonomic risk factors including tasks, work behaviors, environment & equipment usage that may contribute to pain and RSI injuries.

physiotherapy services imageART is a soft tissue movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves to restore normal pain free movement around a joint(s). It works very well with old sprains or chronic problems that have not been resolved with other therapy techniques. It is largely successful in many cases of orthopedic conditions including carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems and tennis elbow. It is done with hands on approach and a gliding motion as the treated part is moved either actively or passively.
physiotherapy services imageGraston Technique involves using specifically designed stainless steel instruments that glide along a patient’s muscle, tendons or ligaments and act like a ‘scar tissue’ stethoscope. When a restriction or adhesion has been encountered, the instrument can then be used to ‘break up’ this abnormal tissue and restore flexibility and health into the tissue. So, it is helpful in not only the diagnosis but also the treatment of soft tissue dysfunction or pathology. Clinical experience has shown efficacy in the management of a large number of musculoskeletal disorders.
Manual lymph drainage is a type of gentle massage which is intended to encourage the natural drainage of the lymph, which carries waste products away from the tissues back toward the heart.
physiotherapy services imageMassage therapy consists primarily of hands-on manipulation of the soft tissues of the body, specifically, the muscles, connective tissue, tendons, ligaments and joints for the purpose of optimizing health. There are many types of massage that act on the muscular, nervous and circulatory system to create a therapeutic effect.
Physical dysfunction and pain and the effects of stress can also be relieved or prevented through the use of Massage Therapy.

physiotherapy services imageThese are direct and active manual techniques directed at improving musculoskeletal function. it engages a restrictive barrier of the muscle and requires the patient’s participation for maximal effect.

Brachial Plexus Injuries (BPI)

Brachial plexus injuries usually occur from a traumatic birth or from a devastating injuries anywhere along one’s lifespan. We have been using various techniques including EMG and biofeedback and acupuncture to help patients regain the best possible function and the results have been dramatic.

brachial plexus physiotherapy in toronto

brachial plexus treatment toronto

 

Cerebral Palsy (CP)

cerebral palsy physiotherapy in TorontoCerebral Palsy is a result of early brain injury that leads to motor impairments as one grows and functions in daily life. With the remarkable guidance and education from Dr. Karen Pape, we are using innovative techniques and strategies to overcome adaptive movement behaviours. This is with the help of the power of neuroplasticity that Dr. Norman Doidge discovered and that Dr. Karen Pape has taken to another level. In her 2016 book, ‘The Boy Who Could Run and Not Walk’, she describes her findings as well as her techniques that have changed people’s lives. We have seen remarkable results, but not without a lot of work from the therapist as well as the patient.

physiotherapy services imageShockwave therapy treats the involved area using pneumatically generated acoustic waves traveling faster than the speed of sound. This bombarding of the affected tissue produces a number of biological responses resulting in scientifically demonstrated neovascularization (new blood vessel growth), which in turn dramatically accelerates the healing process. It has been found to be particularly effective with plantar fasciitis, tennis elbow & shoulder calcific tendonitis.

A course of Radial Shockwave Therapy (RSWT) typically consists of 3-4 visits administered weekly. The painful site is identified and approximately two thousand shockwaves are administered using a hand held applicator in combination with a conductive gel. The process is relatively pain free and can be adjusted for patient comfort.

CranioSacral Therapy (CST) is a gentle, hands-on approach that releases restrictions in the soft tissues that surround the central nervous system. This results in relief of pain and dysfunction.
With a light touch, the CST practitioner uses his or her hands to evaluate the craniosacral system by gently feeling various locations of the body to test for the ease of motion and rhythm of the cerebrospinal fluid pulsing around the brain and spinal cord. Soft-touch techniques are then used to release restrictions in any tissues influencing the craniosacral system.

physiotherapy services imageA specific exercise program will be designed using the principles of overload, specificity & progression such that the individual can perform independently this exercises at home or at the gym in order to increase strength & function.

physiotherapy services imageEach individual has a goal that they are striving to attain with the physiotherapy & massage therapy appointments. We will provide a progression of exercises along with any specific tips; whether its’ use of specific gym equipment or other tips that need to be performed prior to return to their specific activity.

physiotherapy services imageIt is important to make sure the rehabilitation includes return to former activity. In some cases, that means returning to running, golfing, skiing, tennis or any other sport or recreational activity that was causing them concern and inability to play/do to the best of their ability. There are progressions of exercises that need to be worked into their rehabilitation program and they are specific to the sport/recreation. These are exercises/drills that your physiotherapist will be sure to progress you through them so that you can return to your sport/recreation with no problems.
physiotherapy services imageMany different types of tapes can be used in a variety of different techniques to help control movement, either facilitation or inhibition, , swelling &/or pain. Several types of tapes that are used are kinesiotape, dynamic tape, McConnell tape, adhesive white tape, various tensors & splinting materials can be an adjunct.
physiotherapy services imageThese are various machines that Physiotherapists use including ultrasound, interferential, muscle stimulation, transcutaneous electrical nerve stimulation (TENS), and biofeedback that help control pain & inflammation, facilitate muscle contraction/relaxation. The ultrasound uses high frequency sound waves; the other machines use currants of varying shapes and frequencies depending on the purpose.

physiotherapy services imageVarious materials are used to make made-to-measure splints or braces to help aid in musculoskeletal healing. Sometimes, we will recommend a specific off the shelf splint or brace that may also do the trick!

physiotherapy services fms sfmaFMS stands for Functional Movement Screening. It is a tool used to identify limitations or asymmetries in seven fundamental movement patterns that are key to functional movement quality in individuals with no current pain complaint or known musculoskeletal injury.

These movement patterns are designed to provide observable performance of basic locomotor, manipulative and stabilizing movements by placing an individual in extreme positions where weaknesses and imbalances become noticeable if appropriate mobility and motor control is not utilized.

The SFMA stands for Selective Functional Movement Assessment. It is the movement based diagnostic system designed to clinically assess 7 fundamental movement patterns in those with known musculoskeletal pain. The assessment provides an efficient method to systematically find the cause of symptoms, not just the source, by logically breaking down dysfunctional patterns and diagnosing their root cause as either a mobility problem or a stability/motor control problem.