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What the heck is “Tunnel of Guyon Syndrome”?
“Tunnel of Guyon Syndrome” is a neurological condition whereby the Ulnar nerve is compressed or damaged at the palmar aspect of the wrist and hand. This compression (or damage) occurs as the Ulnar nerve passes through a tunnel in the wrist called “Guyon’s Canal”. Guyon’s Canal is formed by 2 bones of the hand, the pisiform and hamate bones, and a corresponding ligament that connects both bones. The Ulnar nerve, after passing through the canal, will innervate the pinky finger and ½ of the ring finger including muscles in the area. When the Ulnar nerve is compressed or damaged, the patient may experience pain, pins and needles, numbness, tingling, a burning sensation as well as hand and/or finger weakness.
The causes of Tunnel of Guyon Syndrome are varied but are typically a result of repetitive or acute trauma to the area of Guyon’s Canal. For example, individuals who cycle for extended periods (particularly over uneven or bumpy terrain) can develop Tunnel of Guyon Syndrome by gripping the handrails of a bicycle. However, other causes can include tumour, ganglion cysts, osteoarthritis or fracture of the hamate (eg. can occur during baseball batting or a golfer striking the ground with a club as opposed to contacting a golf ball).
Diagnosis is usually made from a detailed history and physical examination by a trained healthcare professional. A Nerve Conduction Velocity (NCV) test may be ordered to further examine how the Ulnar nerve on the affected side is working. A Chiropractor and Physiotherapist can perform conservative therapy to the affected hand/wrist and provide injury prevention recommendations as well as appropriate rehab exercises and activities.
If you think you may be suffering from Tunnel of Guyon Syndrome, contact our head office to book your assessment today!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.
“Snapping Hip Syndrome” is a term that most athletes and avid sport enthusiasts have heard, but what does it mean?
Snapping Hip Syndrome occurs when tight muscles and/or tendons located in the area of the hip roll over a bony prominence as you move your leg. As a result, a sufferer can feel a “snapping” sensation in the area of the hip and possibly hear an audible “pop” sound. Typically, Snapping Hip Syndrome is painless and not damaging to the involved tissue but it can be annoying. However, if left untreated, over time in some cases, bursitis can develop in the area of the hip as a result of Snapping Hip Syndrome.
As mentioned above, Snapping Hip Syndrome is most commonly associated with tight muscles and tendons located in the area of the hip. As such, those who play sports or perform activities with repeated hip flexion are vulnerable to its development. The good news is that Snapping Hip Syndrome can often be treated conservatively by a Chiropractor, Physiotherapist, Registered Massage Therapist and Fascial Stretch Therapist, all of whom are available at our clinics. All of these healthcare professionals can assess and treat the tight muscles and/or ligaments involved and can all also provide stretches and exercises to remedy the situation.
If you think you may be suffering from Snapping Hip Syndrome, contact our head office today at 416-385-0110 or book your appointment on-line!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.
Bones can bruise?!?
A “bone bruise” (a.k.a. “bone contusion”) is a relatively common injury, particularly in athletes. In order to explain how a bone can bruise, let’s talk about some anatomy first. “Periosteum” is a membranous tissue that surrounds bones, excluding the articular (i.e. “joint”) surfaces. You can think of periosteum as a type of bone “skin”. In the event of a trauma to a bone, for example, a force received while participating in a contact sport, the periosteum can be injured. This injury would result in the development of a “bone bruise”.
Bone bruises are not overt fractures of a bone but nonetheless, they can be quite painful. A diagnosis can generally be made through a detailed history and physical examination, not necessitating the use of special imaging or tests such as x-ray, CT and MRI scans. Conservative treatment from manual therapists such as from Chiropractors, Physiotherapists, Registered Massage Therapists and Fascial Stretch Therapists can help reduce pain, provide range of motion support and dispense the appropriate rehabilitation for proper recovery.
If you believe you may be suffering from a bone bruise, contact our office or book online in order to secure your next appointment today!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.
What is the Achilles tendon?
At all Sports Specialist Rehab Centre locations, our staff frequently diagnose and treat Achilles tendon injuries. While injury to the Achilles tendon may be quite common, with questioning, even though our patients may be aware of where the Achilles tendon is located, few are aware or understand what the Achilles tendon is.
A tendon is connective tissue that attaches a muscle or group of muscles to a bone. When a muscle contracts, the tendon pulls on the bone it attaches to and subsequently moves the bone resulting in joint motion.
The Achilles tendon is the tissue formed from the union of tendons from the gastrocnemius and soleus muscles. These muscles primarily make up the “calf” muscle (located in the back part of the lower leg just below the knee). The Achilles forms just above half way down the back part of the lower leg and attaches to the calcaneus (i.e. “heel bone”). As such, with contraction of the gastrocnemius and soleus muscles, the Achilles can drive the foot into a toe pointed down (i.e. “plantar flexion”) motion. In about 7%-20% of the population, individuals can have an “accessory” or additional muscle called the plantaris muscle. While the tendon of the plantaris muscle binds to the calcaneus as well, it may or may not be part of the Achilles tendon proper in these individuals.
If you have any questions regarding the Achilles tendon or believe that you may have injured it, please contact our head office today or book on-line in order to secure your assessment from one of our amazing staff!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.
Any Space, Anytime Exercises
With the onset of the COVID-19 global pandemic, most fitness centres across the country have been forced to temporarily shut down. These include yoga studios as well as specialized training centres for professional athletes. As such, many of us have turned to training and working out at home and outside, with the goal to achieve the same level of fitness success as prior to COVID-19. This, however, may increase the risk of injury due to a lack of supervision and unfamiliarity with the use of new space.
Exercising at Home
Here are some things to consider:
Footwear: Make sure your choice of footwear is tailored to the type of exercise you’re performing in order to prevent slips and falls. You should either be wearing shoes or be barefoot if you’re using a mat.
Space: Make sure the space around you is clear of objects you can trip on, such as toys.
Props: Use proper household items to substitute for weights and dumbbells.
Stools and benches: If using a stool or bench for support during your workout, make sure that it is stable and has a wide base of support.
Exercising outside
No equipment, no problem. As not everyone has access to a home gym or gym equipment, there are many household items that you can use to substitute for kettle bells, weights and dumbbells to get an effective workout.
Mobility drills
While exercising safely is important, it’s equally crucial to perform a few stretches before and after a workout. A great way to build a comprehensive exercise regime is to incorporate mobility drills that can help manage pain and reduce the risk of injury. Here are two examples of excellent mobility drills:
Drill #1: Active hip flexor mobility
Begin in a split kneeling stance with the legs bent to roughly 90 degrees. Staying tall, squeeze your glute muscles and lean forward until you feel a stretch on the front of your hip. Move in and out of the stretch repeatedly. To increase the challenge of the stretch, you can bend the back leg and hold it with your hand. This is a great exercise for improving hip mobility and may even help those with back pain.
Drill #2: Active shoulder mobility
Lie on your back on the ground or foam roller. Using a band or towel in your hands, pull it apart to create a light tension. While maintaining tension, slowly bring your arms overhead until you feel a stretch in your shoulders or chest, neck and back. This is a terrific drill for improving upper body mobility and reducing shoulder and neck tension.
Enjoy your workouts!
Author: Dr. Marco De Ciantis, D.C.
Your running shoes should protect your feet from the stress of running, while permitting you to achieve your maximum potential. Selecting the right shoe for your foot can be confusing without the proper knowledge.
What’s Best for Your Low or High Arched Feet?
If you have low arches, called “pronators”, you’ll need a shoe that provides stability. However, if you have high arches, called “supinators”, you’ll need a shoe with good cushioning. Check your arches to determine the most appropriate shoes for your feet.
When you’re shopping for your next pair of running shoes, choose a store (in person or on-line) with knowledgeable staff with a wide variety of available shoes. Don’t hesitate to consider a range of brands and styles of shoes, what works may surprise you. There are three main features you need to consider when selecting the best running shoe for
your needs: shape, construction, and midsole.
To find out a shoe’s shape, look at its sole. Draw a straight line from the middle of the heel to the top of the shoe. If you have low arches (“pronators”), this line should pass through the middle of your toes, making it a straight-shaped shoe, with the added stability you need. If however you have high arches (“supinators”), this line should pass through the outer half of your toes, making it a curve-shaped shoe, your most comfortable fit.
Take out the insole and look at what type of stitching is used on the bottom. If you have low arches (“pronators”), board construction shoes, which have no stitching on the bottom, are built specifically for you. If you have a mild low (“pronators”) or mild high arch (“supinators”), combination shoes, which have stitching that begins halfway, are the best construction for you. If you have high arches (“supinators”), slip-constructed shoes, which have stitching running the entire length of the shoe provide you with the flexibility you need.
The midsole determines most of a running shoe’s cushioning and stability. If you have low arches (“pronators”), dual-density midsoles will give you shock absorption, as well
as some stability. If you have high arches (“supinators”), single density midsoles offer the good cushioning you need but without the extra stability you don’t need.
A Chiropractor can also assess your gait, as well as the mobility of the joints in your feet, legs,pelvis and spine to help you avoid developing running-related problems. To ensure your body is moving properly, consider visiting a Chiropractor!
Author: Dr. Marco De Ciantis, D.C.
“Compartment Syndrome” (CS) is a relatively common muscular injury, particularly in professional and recreational athletes. CS occurs when pressure builds within an injured muscle inside a specific compartment. A “compartment” (of a limb) refers to a conglomerate of muscle, nerve tissue and blood supply that are encased within a tough tissue called “fascia”. Following a traumatic or repetitive injury to a muscle, swelling or bleeding can occur. This swelling and/or bleeding can in turn lead to a rapid increase in pressure within a compartment, cutting off oxygenated blood flow and endangering the safety of the tissue within the compartment. This is due to the fact that the fascia comprising the compartment walls does not stretch much. If left unchecked, there is the potential of permanent damage of the muscle, vascular and nerve supply in the affected compartment. CS most notably results in extreme pain and possibly compromised function of the affected muscle and associated joint(s).
CS is classified as either “acute” or “chronic”. Acute CS is considered a medical emergency and surgery is often required in order to prevent the possibility of permanent damage. Acute CS is usually the result of a direct and significant trauma to a limb. Chronic CS on the other hand is the result of a repetitive motion or activity (eg. kicking) that can result in injury to a muscle. Chronic CS can be managed conservatively and is not considered a medical emergency. For both Acute and Chronic CS, aside from pain, the affected area may look swollen/expanded or discoloured, be painful to the touch (self or other) and be accompanied by altered sensation (such as pins and needles or numbness).
If you feel that you may be suffering from CS, please contact our office today to book an assessment with one of our amazing treatment staff!
Author: Dr. Paolo De Ciantis, BSc.(Hons.), M.Sc., D.C.
Squatting is a fundamental biomechanical motion and, as such, we all end up performing squats daily. This manifests during daily actions such as sit-to-stand (and vice versa) transitions from a chair, couch or even a toilet! That said, some of us challenge the squat motion during specific exercise activity. This can be accomplished in many ways by performing, for example, goblet squats or using a squat rack with an olympic bar. Since squatting is such a fundamental daily activity, let’s go over some squatting basics by discussing the joints primarily involved in squatting!
The 3 joints primarily involved in the squat motion, from bottom to top, are the ankles, knees and hip joints. A problem with any of these joints (or combination thereof) can dramatically alter the biomechanics of your squat. Even a slight change could place an individual at risk for serious injury. For example, limited motion at the ankle joints could result in over flexion of the lumbar spine during the doward motion of a squat. In this scenario, given that a person is using an olympic bar on their back during the squat, this could result in the bar rolling dangerously close to the head. I’ve personally witnessed this in a gym and a weighted olympic bar almost rolling over someone’s head!
In order to address the ankle, knees and hips prior to squatting exercises or even for day-to-day activity, you want to get them moving! I recommend self mobilization/ballistic warm-up activities. These recommendations generally involve 3-4 sets of 10 of the following:
-ankles: clockwise and counterclockwise circles as well as up/down motions
-knees: bend and straighten
-hips: in and out’s and flexion and extensions
If you intend to perform squatting exercise activity, after warming up the aforementioned joints, I then recommend performing 3-4 sets of 10 of an unweighted squat motion. The idea is to warm up the joints then get the body ready for a weighted activity by performing the unweighted biomechanical motion of the activity you are about to perform.
Given that there is no existing issue with the knees, hips, ankles or low back/pelvis, your squats should operate smoothly. However, if you should have questions regarding your squats, how to properly perform them or even concerns about the health of the joints involved in squatting, do not hesitate to contact your healthcare provider today for a thorough assessment!
Happy squatting!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.
It’s finally winter! That means many of us will be participating in fun winter activities outdoors like skating. That said, in order to minimize the likelihood of injury, it is important to perform a few basic warm up activities specifically geared for skating prior to lacing up those blades!
-ankles: up/down and clockwise/counterclockwise rotations (perform while sitting)
-knees: bend and straighten (perform while standing)
-hips: move the legs forward-back and in-out motion (perform while standing)
EXTRA TIP: Wear comfortable clothing that will allow for the body to move easily in an unrestricted fashion while skating.
If you have specific concerns regarding skating or need further guidance, do not hesitate to contact your healthcare provider today for advice and recommendations. Safe skating!
Author: Dr. Paolo De Ciantis, B.Sc.(Hons.), M.Sc., D.C.