*not affiliated with any specialty college


  Contact : 416-385-0110

Blog

Breathing is Important!

How important is breathing?

The short answer is…. VERY!

I know this sounds like a silly question and silly answer – of course breathing is important, without oxygen our bodies wouldn’t survive. But I’m here to explain why breathing is not only vital to living, but is important for pain management and musculoskeletal health.

The first important piece of information is to know and understand what the diaphragm is. The diaphragm is our main breathing muscle. It sits at the bottom of our rib cage and when our brain tells us to breath in, it gets the diaphragm to contract, pulling it downwards and leading to decreased pressure in our chest cavity. This change in pressure allows air from the outside to flow into our lungs with ease. When we breath out, the diaphragm relaxes, pushing the air back out of the lungs.


https://media1.britannica.com/eb-media/36/92936-004-8881E781.jpg

I assess breathing in almost every patient I have, especially those with low back and neck pain.

In patients with low back pain, there is often a large focus on core stability and core strengthening. What you may not realize, your diaphragm is really the top part of that ‘core’ that we talk about so much. By focusing on your diaphragm while breathing and allowing it to work optimally, you are training your core. There is evidence showing faulty breathing patterns in a significant number of patients with low back pain, compared to their pain free counterparts.


http://ibphysio.com.au/wp-content/uploads/2015/04/core-muscles.jpg

In patients with neck pain, there tends to be a lot of ‘chest breathers’. Instead of using their diaphragm to control breathing, these patients often use their accessory breathing muscles in the neck that really only need to be activated when we’re exercising very hard and need to have hard, rapid breathing. So again, by focusing on your diaphragm while breathing and allowing it to work optimally, you are allowing those accessory breathing muscles in the neck to have a break so they can stop taking on another muscle’s job.


http://www.physio-pedia.com/images/e/e7/949_937_muscles-of-respiration.jpg

Finally, breathing plays an important role in pain management. When we are in pain, our sympathetic nervous system turns on (i.e. fight or flight response). This tells our brain that something bad is going on and every sensation becomes amplified. When our sympathetic nervous system is amped up, we tend to use shallow, rapid breaths; this is not the most efficient way to oxygenate our tissues. By taking some time to focus on diaphragmatic breathing, and taking slow, deep breaths, we are actually able to ‘trick’ our brain and tell it that everything is okay, by turning on our parasympathetic nervous system instead (i.e. rest and digest response). This allows for a decrease in sensitivity to painful stimuli which really just means that our brain will tell us we have less pain than we did before.


https://s-media-cache-ak0.pinimg.com/736x/42/fb/98/42fb981f07b10cbb16164c8be93600d5.jpg

So in summary, BREATHE! It will help you in more ways than you even knew.


Author: Dr. Allie Dennis

Resources:
Roussel N, Nijs J, Truijen S, Vervecken L, Mottram S, Stassijns G. Altered breathing patterns during lumbopelvic motor control tests in chronic low back pain: a case-control study. European Spine Journal. 2009; 18: 1066-1073
Chaitow L. Breathing pattern disorders, motor control, and low back pain. Journal of Osteopathic Medicine. 2004; 7(1): 34-41.
Cagnie B, Danneels L, Cools A, Dickx N, Cambier D. The influence of breathing type, expiration and cervical posture on the performance of cranio-cervical flexion test in healthy subjects. Manual Therapy. 2008; 13(3): 232-238.
Jerath R, Edry JW, Barnes VA, Ferath V. Physiology of long pranayamic breathing: Neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Medical Hypotheses. 2006; 67(3): 566-71.

Read More

Injury With Spring Cleaning

Spring has sprung! Currently, with all the available time at home, I know lots of people will be doing that deep spring cleaning. With any activity that you haven’t done in a while, it’s important to make sure you’re keeping excellent form and using spine-sparing techniques in an attempt to avoid injury. Here are some tips to keep you feeling good while you’re busy cleaning out that garage and vacuuming in places you forgot existed!

TAKE BREAKS
Our bodies aren’t made to go from 0 to 100 with no preparation. Many of us tend to be less active in the winter and then want to immediately jump back into our previous level of activity. It’s important that you know your body’s limits and even start out on the cautious side. Every 30 minutes, stop, stretch, take a rest, drink some water and make sure your body is ready to continue the task before moving on.

KEEP A NEUTRAL SPINE
Cleaning that bathtub? It’s important to make sure we maintain the natural curve we have in our low back when bending/reaching over. The longer you stay in a flexed position through your lumbar spine, the more susceptible your back is to pain and discomfort.

LIFT WELL
Cleaning out those old boxes from the garage? Make sure you only lift what you can handle. As above, maintain that neutral spine. Bend from your knees and hips, not your back. Keep the load close to your body to have the centre of gravity stay as close to you as possible.

GET DIRECTLY BEHIND THAT MOP OR VACUUM
It’s easy to want to do some crazy twists and turns getting into those nooks and crannies with your mop or vacuum but in order to keep your back, neck and shoulders feeling good and comfortable, being directly behind the cleaning tool is the best. Keep your hips forward and square and position yourself in a slight lunge to keep your back from aching!

If you have any other questions about keeping your body safe and comfortable during spring cleaning, you can contact Dr. Allie Dennis at the Sports Specialist Rehab Centre!


Author: Dr. Allie Dennis

Read More

Body Saving Tips for Sitting at a Computer All Day

Are you a desk worker like the majority of people in our modern society? Does your back or neck get sore when you’ve been stuck in your chair all day typing away? During these unprecedented times, are you spending increasing amounts of time at your desk in front of a screen? These tips are for you! Let’s get you feeling more comfortable so you’re happier at that desk.

⦁ The top of your computer screen should be at forehead level and the top of the words at eye level. This keeps your head in a straight and upright position without extra strain on your spine.
⦁ If you use a phone a lot at work, headsets are the best way to prevent neck and shoulder irritation. Cradling the phone in your neck repetitively will start to create soreness and pain.
⦁ Your keyboard should be roughly at elbow height, assuming your shoulders are down and elbows are sitting at 90 degrees. Make sure your wrists aren’t sitting in too much extension. As in the photo above, it can help to have a wrist pad to bring the wrists into a little bit of flexion.
⦁ Your feet should be flat on the ground. If they are unable to reach and be flat after adjusting your chair to the height of your desk and computer, you can put a foot rest underneath to help you out.
⦁ Your new favourite number is 90! We want your joints to be resting comfortably in a 90-degree position – ankles, knees, hips and elbows should all be at roughly 90 degrees while you are sitting.
⦁ Ideally, you will be sitting all the way to the back of the chair and have some sort of support to maintain the natural curve we all have in our lumbar spine. It is great if your upper back can be resting against the chair as well.

As important as the above tips are, the most important tip is to MOVE! MOTION IS LOTION. The above position should be your ‘reset’ position but ideally we aren’t staying in any one position for more than 10 minutes at a time. Go ahead and slouch, cross your legs, lean to one side – as long as you stay there for under 10 minutes these so-called ‘bad’ positions don’t bother me. If you can, get up once an hour and walk around the office, grab a cup of water, go to the bathroom, just get out of that seat.

Author: Dr. Allie Dennis

**Please note that this is for educational purposes only and not intended as specific medical advice. If you have any questions or concerns make sure to consult one of our knowledgeable health practitioners at the Sports Specialist Rehab Centre.

Read More
Virtual Appointment

Virtual Appointments now available!

Virtual Appointment
Book your virtual appointment today!

 

We would like to announce that as of today, patients can book virtual appointments online with their Chiropractor, Fascial Stretch Therapist and Physiotherapist!  Virtual appointments with your therapist can be used to guide home self-care management of pain, lifestyle recommendations, anxiety relief and rehabilitation activities. The virtual appointment option is particularly useful for certain members of the population who are at greater risk to COVID-19. Keep yourself motivated and on track while at home by booking your virtual appointment today. 

 

Read More

Clinic Operational Changes in Relation to the COVID-19 Pandemic

Due to the ongoing COVID-19 pandemic, we at the Sports Specialist Rehab Centre have modified staffing and operational hours in order to address the issue. We may be available to address acute and/or emergency cases. Please contact our office at 416-385-0110 for any questions or concerns.

We will all get through this, together.

Stay safe and healthy.

Read More

COVID-19 Update Contacts and Stress Management

Here at Sports Specialist Rehab Centre, we are not only committed to your physical health but also your mental and social well-being.  The ongoing COVID-19 pandemic represents a new territory that we are all navigating together and as such, the SSRC team will be keeping you up-to-speed with the latest developments in disease prevention, treatment options and self-management care.  Thus, below you will find techniques to cope with stress produced as a result of the COVID-19 pandemic. 

For those with suspected COVID-19 symptoms or those with related concerns, please use the online assessment tool found at Ontario’s COVID-19 info page or contact Telehealth Ontario at 1-866-797-0000. 

Please visit Ontario’s COVID-19 info page for the latest information regarding the pandemic: https://www.ontario.ca/page/2019-novel-coronavirus

 

Read More

Congratulations Dr. Marco for winning the Up and Coming Award!

In October 2019, Dr. Marco was awarded the Up and Coming Award from the Ontario Tech University.  This award was granted based on his professional and humanitarian work since graduating with his Master’s in Health Science at Ontario Tech University in 2017.  Please visit the Ontario Tech University Alumni page (https://alumni.ontariotechu.ca/alumni-association/alumni-association-awards/recipients/index.php) to read more about the award recipients. 

Read More

At Home Therapeutic Exercises: Just Start Walking!

Walking – it’s the simplest thing you can do to get a workout in.

Even 15 minutes a day can start you on the path to an activity habit, keep in mind that movement is improvement!  Walking is the easiest choice when the weather is agreeable but don’t let a little rain or light snow keep you indoors.

When to Walk

It’s easier to get into the habit of exercising if you choose a specific time daily.  If you are a morning person, the best time for you to exercise might be before you go to work or after the kids are off to school.

Not a morning person?  A walk during your lunch break will work up an appetite and aid digestion.

Alternatively, if the evening is the best time for you, schedule your walk after dinner and when evening chores are done.

The important thing is to decide on the best time for you and try not to allow other events to get in the way.


Here are some tips to get the most from walking:

1. Dress properly

In mild weather, wear several light layers so that you can remove a layer as your body warms up from the activity.

If it’s a chilly day, bring gloves and a hat.  You want to be comfortable and enjoy your walk.

2. Wear supportive shoes

Thin-soled, untied or loose-fitting shoes may result in a twisted ankle or sore arches – not the benefit you are looking for!

Wear footwear that is appropriate for the weather.  Your walk will not be enjoyable with cold or wet feet.

3. Bring a bottle of water

It’s surprising how quickly you may become thirsty, even during a short walk. 

4. Walk at a comfortable, brisk pace

The quicker the walk, the greater the benefits. 

A companion is a good idea.  Ask your partner, a friend or one of your children to come along with you.

5. Keep moving

Get your arms moving while you walk.  Swing them gently front to back.  As an added bonus, it will limber up your shoulder joints and muscles.

View your walk as an enjoyable break during the day – a time when there are no chores to do or deadlines to meet.  Breathe deeply.  Look up at the sky, the trees and the rooftops.  Smile.  Life gets better when you fit in a walk!


If you’re experiencing pain, consult a health care professional to assess your specific needs and identify a course of action that’s right for you.  Canadian chiropractors are committed to helping Canadian’s get more physically active.  A chiropractor can evaluate your strength and flexibility, and screen for anything that may limit your physical activities. Ask your chiropractor for an evaluation!

Read More

Frozen Shoulder

What do you mean my shoulder is frozen?

Adhesive capsulitis, often referred to as ‘Frozen Shoulder’, is a condition in which the capsule surrounding the shoulder joint becomes inflamed and movement is significantly reduced. The key sign in frozen shoulder is that both active and passive ranges of motion are equally limited.

Unfortunately, right now, researches aren’t entirely sure why this condition occurs in people. It is understood to be a self-limited condition, with most people recovering within a 2- to 3-year period. However, some studies have shown that there can be residual effects up to 10 years later in 20-50% of people afflicted. It has been found to be more prevalent in middle aged adults. Increased prevalence has also been found in people with diabetes, thyroid conditions, previous shoulder injuries and those who have had previous surgical procedures.

 

Frozen shoulder is typically broken down into 3 phases:

PHASE I – FREEZING/PAINFUL

This phase typically last 3-9 months and is described as an acute synovitis (aka inflammation of the capsule) of the shoulder joint. The condition is often missed at this point because people think that it is just a typical shoulder concern that they can handle themselves. It’s not until the reduction in range of motion and pain continues to progress do they tend to seek care. This phase tends to be the most painful and can be quite debilitating. If caught at this phase, literature suggests that intra-articular steroid injections plus manual and active therapy are most helpful in reducing pain and limiting the amount of range of motion lost. In this phase, it is best to stay within a relatively pain-free range of motion so as not to increase the inflammation in the joint; this is not to say range of motion exercises are not necessary but avoiding significantly aggravating movements is an important aspect of this phase of treatment.

PHASE II – FROZEN

This phase may last between 4 and 12 months. External rotation tends to be the most limited range of motion in this phase; flexion and internal rotation tend to be the next few ranges that are limited due to adhesive capsulitis. In the frozen stage, there isn’t necessarily a worsening of symptoms but the range of motion stays limited and eventually the patient will be pain-free at the end of their range. In this phase, evidence recommends more aggressive manual therapies, joint mobilizations and other modalities (e.g. acupuncture, TENS) to improve range of motion and decrease pain.

PHASE III – THAWING

This phase can last anywhere from 12 to 42 months. This is the phase where the patient’s range of motion starts to return back to normal. Literature suggests some people will have some residual stiffness and limitations 5-10 years after diagnosis of the condition.

Conservative care is the first line of treatment. Should symptoms persist and no changes made over the course of 6 months to 1 year, other more aggressive interventions might be considered by your medical doctor. Some examples are manipulation under anesthesia and/or surgical release of the capsule. This form of intervention is rare as most cases resolve on their own and resolve quicker with conservative therapies.

Author: Dr. Allie Dennis

Resource:

Manske RC, Prohaska D. Diagnosis and management of adhesive capsulitis. Current Reviews in Musculoskeletal Medicine. 2008;1(3-4):180-189. doi:10.1007/s12178-008-9031-6.

Burbank K, Stevenson J, Czarnecki G, Dorfman J. Chronic Shoulder Pain: Part II. Treatment. Am Fam Physician. 2008;77(4):493-497.

DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 – .Record No. 113935, Adhesive capsulitis of shoulder; [updated 2015 Mar 27; cited 2015 Jun 16]. Available from http://web.a.ebscohost.com/dynamed/detail?vid=3&sid=9807b87f-2e5c-4a75-9521-c3a82edf9a28%40sessionmgr4001&hid=4209&bdata=JnNpdGU9ZHluYW1lZC1saXZlJnNjb3BlPXNpdGU%3d#db=dme&AN=113935. Registration and login required.

Read More

If You Love to Drink Coffee or Tea, You May Need to Hydrate!

Most of us live in a hustle and bustle environment which can involve long hours with minimal breaks. In order to get through these days, a vast majority of us enjoy caffeinated beverages such as coffee or tea.

I personally enjoy no less then 3 or more cups of coffee or espressos daily! However, as many of us who enjoy coffee or tea will attest to, all that consumption can result in a full bladder and increased frequency of unrination. As a result, we tend to lose more water in the process, becoming progressively dehydrated. Now, off hand, that may not be very alarming, but a loss of too much water can lead to down stream affects such as muscle soreness or muscle cramping. For those who enjoy sports or physical exercise, this is anagolous to the muscle soreness or muscle cramping that can occur with excessive sweating without hydrating during physical activity. In order to minimize the likelihood of coffee or tea muscle induced soreness or cramping, I generally recommend to patients that with every caffeinated beverage you enjoy daily, consume an extra glass of water after you finish the caffeinated beverage. This can help minimize the water loss!

Enjoy your coffee and tea and get through your day! Just be mindful to hydrate a little more.

Read More