Blog | Sports Specialist Rehab Centre

Jun 17 0

Race Preparation!

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Summer is finally here! Living in Toronto in the summer means there are tons of opportunities to get your run on!

Here are some tips to help get your body ready for your next run and some tips to help your body recover post-race so you’re ready to go for the next one!

PREPARATION
PRACTICE
It’s hard for your body to go directly from couch potato to marathon runner overnight, so you want to make sure you’ve practiced and trained to get ready for your race. There are some great apps out there that can help you get from couch to 5km in just a few short weeks and clubs or programs like the Running Room which can help you improve your time and motivate you to push the length of your run. Give them a try and make sure you reach at least 80% of your race distance prior to race day so you know you can do it.
HYDRATE
Your body needs to be well hydrated and ready to go for your next race. Drinking too much water the day of the race could leave you with cramps, feeling bloated and uncomfortable. It’s recommended by the American College of Sports to “eat a nutritionally balanced diet and drink adequate fluid during the 24-hour period before an event”. They also recommend drinking 500mL of fluid 2 hours prior to exercise to maintain good hydrate and allow for proper excretion prior to the run. This will help to keep you from getting dehydrated on those hot summer days.
SLEEP + REST
If you want to feel great on your race day, make sure you give yourself adequate rest and sleep in the days prior to your race. Give yourself a break from training for 2 days prior to race day so give your body time to rest up. Make sure you’re getting a good night’s sleep – try for at least 6-8 hours for the two nights prior to your race.

RECOVERY
COOL DOWN
I’ve said it before and I’ll say it again, MOTION IS LOTION. Our bodies will have a bit of a rough time going straight from intense activity to complete rest. The best way to recover post-race is to make sure you have a good cool down. Start with a light jog and taper it down to a slow walk. Make sure you also include some dynamic stretching afterwards to give your muscles the best chance of recovery!
HYDRATE AGAIN
Depending on the length of your race, you may want to start rehydrating in regular intervals during the race to maintain fluids that might be lost during exercise. Again, depending on the length and intensity of exercise, electrolytes might need to be replenished along with any fluids lost during the period of exercise
WARM BATH
I have previously written an article on Delayed Onset Muscle Soreness, aka DOMS. One great tip to help alleviate some of that pain post-run is taking a warm bath to help with pain relief and get your blood flow going to promote tissue healing and repair.

Author: Dr. Allie Dennis

RESOURCES
Convertino VA , Armstrong LE , Coyle EF , Mack GW , Sawka MN , Senay LC Jr , Sherman WM . American College of Sports Medicine position stand. Exercise and fluid replacement. Medicine and Science in Sports and Exercise. 1996; 28(1): i-vii.

Shirreffs SM, Armstrong LE, Cheuvront SN. Fluid and electrolyte needs for preparation and recovery from training and competition. Journal of Sports Sciences. 2004; 22(1): 57-63.

Jun 10 0

Hurt versus Harm

Posted by ssrcadmin

One question I hear from many of our patients at The Sports Specialist Rehab Centre is “Should physical activity be painful?”. Generally, the answer is “No”.

Physical activity can be loosely defined as a voluntary activity performed by an individual for a specific purpose that leads to movement and force generated from the body. This can include exercise, sports or rehab. The forces generated during physical activity can place stress upon the muscle tissue, joints and supportive tissue. As such, it is common and sometimes expected that during physical activity, there can be some discomfort (i.e. “hurt”). For example, if I am playing tennis, I would expect some minimal discomfort in my wrist, elbow and possibly shoulder. That said, this “hurt” does not necessarily translate to damage of body tissue. However, if a physical activity is ever painful (i.e. “harm”) while being performed, generally, that is not a good sign. This may indicate that you are damaging tissue as opposed to just engaging it. As such, should a physical activity ever become painful, please stop the activity immediately! The age old adage of “no pain, no gain” is not a fruitful one. The pain generated while performing an activity could represent significant trauma to an area and could have long term and far reaching implications.

Everyone’s definition of pain is completely subjective. So you, the individual, become the best judge at deciding when an activity becomes harmful, and not just a bit hurtful. If you should have any questions or questions regarding when an activity is hurtful versus. harmful, please don’t hesitate to contact one of our therapists who would be more than happy to explain!

Be active but be safe!

Dr. Paolo De Ciantis

Jun 03 0

6 Steps to A Healthier Day

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6 Simple Steps to A Healthier Day:

Sit Less
We’ve all heard that sitting is the new smoking. Try to combat this by taking sitting breaks. Set yourself an alarm: each hour stand up and take a short walk, whether it’s to the bathroom, the water fountain or just a lap around your desk, your body will thank you
Move more
Even little things like taking the stairs instead of an elevator, parking your car farther away, or taking a walk around the block are beneficial for your health. Every thing counts!
Drink more water
Considering our body is made up of approximately 70% water, it’s a pretty important part of our diet. Try substituting at least one pop or sugary drink each day with water. Try carrying a container of water around with you every day so you’ll have easier access at all times.
Eat more fruits + vegetables
Start with substituting one food per day with something fresh. If your usual afternoon snack is something processed, try switching it with an apple or carrots and hummus. Another tip is to portion out your dinner plate so 50% of the contents are vegetables and the rest is split between protein and carbohydrates,
Sleep
Set a bedtime for yourself and stick to it. Allow for 6-8 hours of sleep every night. Even better, try to turn off all screens at least 30 minutes before sleeping so your body can get itself ready without that extra stimulation. Sleeping is so important for both your mind and body.
Be proactive with your pain
Combat your pain before it gets chronic. At the first sign of pain, go see your chiropractor, physiotherapist, athletic therapist, massage therapist or medical doctor. They will be able to give you treatment and active care to work on at home. The goal is to get rid of the pain quickly and teach you ways to manage things on your own. The longer pain has settled in, often, the longer it takes to go away. Don’t procrastinate seeing someone!

Jun 13 Comments Off

COVID-19 Policy

Posted by ssrcadmin

To our valued patients, we have updated our COVID-19 policies and procedures in order to reflect the current change of the COVID-19 pandemic in Ontario and current government and regulatory college guidelines and recommendations.

We kindly ask that any patients who may be experiencing COVID-19 symptoms or who may live with someone who is experiencing symptoms or is confirmed to have COVID-19 to inform our administration staff and to reschedule your upcoming appointment.

Our staff will continue to self monitor for COVID-19 symptoms prior to attending our clinics for in person treatments.

Furthermore, as per current government and regulatory college recommendations, our treatment staff is no longer required to wear protective face masks for in person treatments. As such, should you prefer treatment from a staff member who will wear a protective mask during in person treatments, please inform our administration staff at booking or prior to attending your appointment.

For those experiencing COVID-19 symptoms, please contact the following:

Public Health Ontario: 1-877-604-4567

Telehealth Ontario: 1-866-797-0000

May 26 0

Heat vs. Ice!

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I get this question too many times a day to even count. So, I thought I would spend some time laying out why I might recommend heat for one person and ice for another.

Both heat and ice are helpful tools in pain management. Although there are many theories as to why they work, the research is incomplete and there is still much that is unknown. One main theory for icing, for example, is that the reduction in temperature reduces the conductive ability of your nerve to relay information back and forth, therefore not allowing the ‘alarm signal’ of pain to be expressed as quickly. It is also understood to be helpful for inflammation as blood flow to the area is decreased. Heat, on the other hand, promotes blood flow to the area, which is helpful for healing. Heat activates certain neurotransmitters which blocks the ability for our body to perceive pain.

WHEN TO USE ICE
You have an acute injury (e.g. ankle sprain), within the first 48 hours
Inflammatory conditions (e.g. rheumatoid arthritis, ankylosing spondylitis)
Red, hot, swollen tissue

WHEN TO USE HEAT
Acute low back or neck pain
Chronic pain
Muscle stiffness

HOW TO USE ICE
Make sure the ice is covered or wrapped in a wet cloth, and not against your bare skin to protect from frostbite (I’ve done this before. It’s not fun – I promise!)
Use the 20:20:20 rule – 20 minutes on, 20 minutes off, 20 minutes on. This can be repeated several times a day

HOW TO USE HEAT
If you have sensory issues, be careful not to burn your skin
Heat can be applied much longer than ice and there’s really no guideline – just make sure you are awake and aware of the sensations you are feeling so as not to become injured

Having said all that, each person and each body is different; what works for one person might not work for someone else. So, if you love ice and find it’s super helpful for your chronic pain – GO FOR IT!

As with everything, there are precautions and contraindications to all forms of therapy. Make sure you speak with a regulated health care professional to make sure that ice and/or heat is safe for you before using it.

Author: Dr. Allie Dennis

RESOURCES:
Algafly AA, George KP. The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. British Journal of Sports Medicine. 2007;41(6):365-369. doi:10.1136/bjsm.2006.031237.
Nadler SF, Weingand K, Kruse RJ. The Physiologic Basis and Clinical Applications of Cryotherapy and Thermotherapy for the Pain Practitioner. Pain Physician. 2004;7:395-9.
Malanga GA, Yan N, Stark J. Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate Medicine. 2015; Early Online: 1-9.

May 19 0

Do I Have a Slipped Disc?

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In short, the answer is NO – our discs don’t ‘slip’.

I often get this type of question from patients with back pain and neck pain so I wanted to take some time and explain what our intervertebral discs are, whether or not they ‘slip’ and why they may sometimes contribute to pain in our back or legs.

⦁ What is an intervertebral disc?

Our spine is made up of 33 vertebrae and the majority of them are separated by intervertebral discs. These discs are made up of two components – the outer annulus fibrosis which is composed of strong connective tissue and the inner nucleus pulposis which is a softer, gel-like material. The disc allows for increased motion in our spine and helps connect each segment together.

⦁ Do discs slip?

Nope! The connective tissue attaching those discs to our vertebrae is very strong and much too stable to cause any slippage. Some things that might occur to the discs over time includes dessication (aka dehydration), bulging, herniations, and other forms of degeneration. These are all very common and the majority of adults will have findings of these things in their spine, regardless of whether or not they are experiencing pain. In fact, it has been studied quite often that degenerative findings in the intervertebral discs have little to no correlation with pain.

⦁ Can discs cause pain?

Sometimes. The most likely reason a disc will cause pain is a disc herniation. Over time, with repetitive stresses on our back the outer annulus fibrosis can begin to tear. If it tears enough, some of the inner, gel-like nucleus pulposis can herniate out of the disc and can irritate the nerve root sitting nearby. The pain can be a result of mechanical compression or chemical irritation to the nerve, or both. This can lead to symptoms along the entire course of the nerve. For example, disc herniations in your lumbar spine, or low back, may cause symptoms down your legs.

So what does this mean for the patient with back and/or leg pain?

Majority of cases of back and leg pain due to disc herniations are self-limiting and will get better on their own. Conservative care (e.g. chiropractic, physiotherapy, massage therapy) can often help you get there faster. There are very few cases where disc herniations can lead to a medical emergency – if you are unable to urinate and/or unable to control your bowel movements, go to the emergency room. Additionally, if you have rapidly worsening neurological symptoms (e.g. weakness, loss of sensation), this also needs to be checked out urgently and more invasive approaches to care may be necessary.

Dr. Allie Dennis

**This is not intended to be a replacement for medical advice. If you are suffering from any of these symptoms, please see your healthcare provider for appropriate management**

May 12 0

Garden Safely This Spring!

Posted by ssrcadmin

Spring is here! Time to get those gardens flourishing. Gardening can be very hard work with lots of kneeling, bending, twisting, lifting and carrying. It’s important to ensure we keep our bodies and spines healthy and moving well during this increase in physical activity.

The Ontario Chiropractic Association has an excellent acronym to help us remember how to stay healthy while we’re gardening!

HEALTHY BACKS

H – Have the right tools for the task at hand.

E – Ensure you drink plenty of fluids.

A – Alternative between light and heavy jobs.

L – Lift correctly.

T – Take frequent breaks.

H – Heavy loads should be shared.

Y – Your feet should be protected with thick soled supportive shoes.

B – Before you start, warm-up your muscles.

A – Avoid muscle strain, learn the right techniques.

C – Change positions frequently.

K – Kneel to plant and weed.

S – Spinal check-ups can help keep your back healthy.

If you do injure yourself while gardening, or have questions about specific techniques (lifting, bending, etc…) please go see a regulated health professional for a proper assessment, treatment and advice specific to your body. Enjoy the sun! Looking forward to seeing those May Flowers!

Author: Dr. Allie Dennis

Source: http://www.chiropractic.on.ca/wp-content/uploads/Tips-for-a-Healthy-Back-in-the-Garden-Apr17-v2.pdf

May 05 0

What is Fascia?

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Many of you may have heard of the term “fascia” before. Over the last few years, “Fascial Stretch Therapists” (F.S.T) have gained popularity in the fitness and Kinesiology fields. In fact, your Registered Massage Therapist (R.M.T) may have already thrown around the term myofascial release or even suggested incorporating fascial techniques into your hands-on sessions. It’s possible you might have even suffered from a common condition called plantar fasciitis. So, the question remains, what is fascia?

To best explain fascia, try picturing a form of netting, webbing, a sort of glue or bandage. It’s actually a dense sheet, or band, of irregular connective tissue that lines the body wall and limbs, supporting and surrounding muscle groups that perform similar functions. It is strong yet mobile. Picture a spiderweb, intricately interwoven silk threads; this intricate interwoven network runs throughout our entire bodies acting like a web, holding us together.

The appearance of fascia throughout the body can differ greatly, ranging from quite thick, mimicking muscles such as the fascia making up the plantar fascia of the foot; it can also be quite thin and broad such as the thoracolumbar fascia of the lower back. Important to note is that when fascia is tight and inflexible it can pull on other structures within the body, causing tension, pain and decreased range of motion.

Factors that can affect fascia:
⦁ Repetitive movement
⦁ Sedentary lifestyle (little to no daily movement)
⦁ Trauma including surgery or injury (ex. post C-section)
⦁ Postural imbalances
⦁ Inflammation
⦁ Pathology

The benefits of regular body work, or preventative maintenance as I like to describe to patients, is so important in maintaining the health of your muscles, tissues and fascia. Keeping these integral tissues in consideration for your fitness and overall health, and getting manual work done, the fascia will become more pliable, your range of motion will increase, you will begin to experience a decrease in pain and discomfort and it will eventually increase the flow of the lymphatic fluid. This can lead to decreased inflammation and swelling.

Regardless if you are feeling specific discomfort in a particular bodily area, preventative work can be performed. Each individual responds differently to each modality (ex. myofascial release, trigger point therapy, cupping, active release therapy, acupuncture and so on). Whether you see a Chiropractor, Physiotherapist, Acupuncturist, Registered Massage Therapist or Fascial Stretch Therapist, listen to your body!

At your next appointment ask your practitioner about fascial work or try a session with a Fascial Stretch Therapist – I’m sure you will not be disappointed!

Author: Lesley Andress R.M.T

Apr 28 0

The DOMS

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Why does my body hurt after a workout?
You know that feeling a day or two after a really tough or new workout? The one where everything just hurts? Well that pain has a name! You might be suffering from something called DOMS (aka Delayed Onset Muscle Soreness).

What is DOMS?
DOMS is muscle pain that typically begins approximately 12-24 hours after a particularly difficult or new workout. The pain tends to peak between 24-72 hours after the offending exercise routine and can sometimes last up to 1 week!

Why does DOMS happen?
For many years it was believed that a build-up of lactic acid was the cause of this post-workout pain; however, more recently this has been proven untrue. Although there is still some controversy and unknown variables surrounding the exact mechanism of DOMS, the current general consensus is that it is related to the healing of microtears or microscopic damage to your muscle tissues that occur during eccentric contractions. Eccentric contractions are what happen when your muscle is both contracting and lengthening at the same time (for example, when bringing your arm back down in a slow controlled manner during a bicep curl, you are eccentrically contracting your bicep – keeping that contraction while bringing the muscle into a position of length).

How do I make it feel better?
Again, for this, the evidence is conflicting. Mostly, just giving your body some time to heal will help you out. This isn’t to say you should go sit on the couch and wait it out! Out of all of the poor evidence on treatment for DOMS, exercise has been found as one of the most effective methods (MOTION IS LOTION!). Instead of another gruelling workout right off the bat, try some lighter movements like a light jog, some light yoga and stretching for a few days before getting back into it. Things like ice or an Epsom salt bath might help speed things along as well but the evidence is poor on these. Make sure you are always hydrating!

Can I prevent DOMS?
While DOMS may not be entirely prevented unless you just don’t move ever (in that case, you’ll likely end up with worse problems than just some good ol’ DOMS), there are some ways to reduce the severity. When you’re starting a new exercise, make sure you progress slowly into it to give your muscles time to react to their new demands. Some evidence shows a proper warm-up and cool down might also be beneficial in prevention.

What if it isn’t DOMS?
If the pain occurs DURING the workout, if the pain persists beyond 1 week, or it is preventing you from doing your activities of daily living, then it might be something else. Make sure to seek care if things aren’t progressing the way you think they should. Of course, you always need to trust your own body and seek care if something doesn’t feel right.

Author: Dr. Allie Dennis

Resources:
Cheung K, Hume PA, Maxwell L. Delayed Onset Muscle Soreness: Treatment Strategies and Performance Factors. Sports Med. 2003; 33 (2): 145-164.
American College of Sports Medicine: https://www.acsm.org/docs/brochures/delayed-onset-muscle-soreness-(doms).pdf

Apr 21 0

Dr. Paolo’s Morning Shake

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I love to begin each day with a hard workout session! Following that session, I need a high energy, hearty and protein filled shake in order to get may day going! Here is what I found works best for me, try it out if you like:

1. 710 mL (about a pint and a half) of cold water.

2. 1 large banana (or 1 cup of frozen unsweetened mixed berries)

3. 1 tsp of ground unsweetened cocoa pods

4. 1 tsp of ground turmeric

5. 2 cups of ground rolled unsweetened oats

6. 1 tsp of ground cinnamon

7. 2 tbsp of ground flax seed

8. 1 avocado

9. 1/2 scoop of whey protein isolate (I prefer chocolate or vanilla flavoured)

Enjoy!