One of the most common forms of pain, shoulder pain, isn’t only an annoyance but it can have a huge detrimental effect on your quality of life. PRI in Toronto, Ontario has doctors well versed in tackling all forms of shoulder pain. See Dr. Bob Grossman, or Dr. Vlad Levitin for the pain relief you need today to improve your life tomorrow

What are the different forms of shoulder pain?

The primary sources of shoulder pain are:

Bursitis: Inflammation of the bursae, small fluid sacs that act as cushions between bones

Tendonitis: Acute or chronic inflammation of the shoulder tendon

Tendon and muscle tears: Damage to soft tissue that can go from acute to a chronic condition

Dislocation: Can stretch or loosen muscles and tendons creating shoulder instability

Impingement: When movement of the shoulder impinges on the tendons and bursa

Arthritis: Osteoarthritis, or wear and tear arthritis causing chronic pain with age

Fracture: Broken bones usually due to sports impacts or auto collisions

What are the causes of shoulder pain?

The primary causes of shoulder pain are:

Impact injuries: Most often sports related, or motor vehicle accident related

Age related wear and tear

Stress or inflammation of the joint and surrounding muscles and tendons

Repetitive motion injuries

You should never dismiss shoulder pain that occurs without physical trauma as normal. Other causes of shoulder pain include avascular necrosis, bone tissue deterioration due to low blood supply and a brachial plexus injury, a case of a stress or tear in the nerves that communicate between the spine and shoulder area.

What treatments does PRI offer for shoulder pain?

At PRI, we specialize in a variety of techniques aimed at alleviating nagging pains and increasing mobility to aching shoulders. After correctly identifying the source of the pain, they employ extensive mobility stretches and exercises aimed to release tension to the area and increase blood flow. If the issue stems from subluxations (spinal misalignment), a full spine and body approach will be taken over an isolation treatment. It is important to remember to practice proper technique with and without doctor supervision. Physical health is after all a full time endeavor. Taking home these exercises and executing them regularly will lead to a stronger and more resilient shoulder.

To find out how we can help you, please contact us at:

Tel:      (416) 477-1101

E-mail: reception@priclinic.com

Web:   www.priclinic.com

Aquatic therapy (or water therapy) uses the natural buoyancy of water to facilitate exercise without the compressive loading forces present with routine land-based physical therapy programs.

What Is Aquatic Physical Therapy?

For patients who are in pain and are weakened due to an injury or disability, aquatic therapy offers the perfect solution to begin treatment. Water therapy sessions are conducted in PRI physiotherapy pool. The natural buoyancy of water reduces stress on the body and helps patients exercise easier with less pain. Plus, the natural pressure of water in therapy pools reduces joint and soft-tissue swelling and provides enough resistance to strengthen muscle.

PRI’S Aquatic Therapy Drives Results

Fully-equipped, state-of-the-art outpatient orthopedic facilities

Highly trained, licensed clinicians

Virtually all insurances accepted

Patients do not need to know how to swim

Aquatic therapy helps improve certain medical conditions

These conditions include:

If you have been affected by these chronic debilitating conditions, please see a specialist at the PRI clinic. This multi-disciplinary team is specifically trained to properly introduce your body to aquatic therapy, which will allow your body to achieve a remarkable improvement in your lifestyle. To book a consultation, please call or follow these links.

Tel:      (416) 477-1101

E-mail: reception@priclinic.com

Web:   www.priclinic.com

We look forward to helping you out!

More than 30% of North Americans have some form of acute or chronic pain. Among older adults, the prevalence of chronic pain is more than 40%.  Given the prevalence of chronic pain and its often disabling effects, it is not surprising that opioid analgesics are now the most commonly prescribed class of medications in the United States.  In 2014 alone, U.S. retail pharmacies dispensed 245 million prescriptions for opioid pain relievers. Of these prescriptions, 65% were for short-term therapy (<3 weeks), but 3 to 4% of the adult population (9.6 million to 11.5 million persons) were prescribed longer-term opioid therapy. Although opioid analgesics rapidly relieve many types of acute pain and improve function, the benefits of opioids when prescribed for chronic pain are much more questionable.

However, two major facts can no longer be questioned. First, opioid analgesics are widely diverted and improperly used, and the widespread use of the drugs has resulted in a national epidemic of opioid overdose deaths and addictions. More than a third (37%) of the 44,000 drug-overdose deaths that were reported in 2013 (the most recent year for which estimates are available) were attributable to pharmaceutical opioids; heroin accounted for an additional 19%. At the same time, there has been a parallel increase in the rate of opioid addiction, affecting approximately 2.5 million adults in 2014. Second, the major source of diverted opioids is physician prescriptions. For these reasons, physicians and medical associations have begun questioning prescribing practices for opioids, particularly as they relate to the management of chronic pain. Moreover, many physicians admit that they are not confident about how to prescribe opioids safely, how to detect abuse or emerging addiction, or even how to discuss these issues with their patients.

The good news for chronic pain sufferers is that there is care available. Conservative care, including chiropractic, can help to alleviate acute and chronic symptoms as well as correct underlying mechanical dysfunctions and recommend exercises to keep the body moving. One such program for chronic pain management was developed by Dr. Carlo Ammendolia, DC, PhD, at the University of Toronto and Mount Sinai Hospital. Dr. Ammendolia’s evidence-based boot camp program helps spinal stenosis patients by providing strategies for self-management, decreasing pain and increasing function through guided exercise and manual therapy. Patients who have attended the boot camp report increased mobility, reduced pain and a greater quality of life.

Such interventions are also valuable for other Musculo-Skeletal (MSK) pain sufferers. A 2012 U.S. study has revealed that patients receiving chiropractic treatment combined with exercise for chronic neck pain were twice as likely to become pain-free than those receiving medication.

The study followed 272 neck-pain patients for 12 weeks. The patients were randomly assigned to one of three groups: 91 to the spinal manipulation therapy group, 90 to the medication group and 91 to the home exercise group.

The results of the study are encouraging for chronic pain sufferers who prefer not to take medication to manage their pain:

32% of those receiving only chiropractic care became pain-free

30% of those exercising became pain-free

13% of those treated with medication for chronic pain became pain-free

Chiropractic care as part of the healthcare team can play an important role in the assessment and management of chronic pain related to MSK conditions. More and more studies are providing evidence of effective relief of chronic pain through chiropractic treatment.

For more info on how to take control of your health, and tackle chronic pain in a smart way, please reach out to:

Phone: (416) 477-1101

E-mail: reception@priclinic.com

Web:   www.priclinic.com

Dorsiflexion is the action of raising the foot upwards towards the shin. It means the flexion of the foot in the dorsal, or upward, direction.

People use dorsiflexion when they walk. During the middle stages of weight bearing and just before pushing off the ground, the foot will reach its end range of dorsiflexion.

If there are problems with dorsiflexion, then the body will compensate naturally, which in turn can cause issues elsewhere.

For a movement to be considered dorsiflexion, the foot should be raised upward between 10 and 30 degrees.

Dorsiflexion uses the muscles in the front part (anterior) of the foot.

The tendons of the muscles that pass through the front of the foot and into the ankle joint include:

tibialis anterior

extensor hallucis longus

extensor digitorum longus

These tendons are located on the front of the leg and are supplied by the deep peroneal nerve. Damage to this nerve can stop a person from being able to raise their foot.

Plantar flexion is the opposite of dorsiflexion and involves moving the foot in a downward direction, toward the ground.

Plantar flexion occurs when the foot is moved downward between 20 and 50 degrees.

The muscles whose tendons cause plantar flexion are located on the back (posterior) and inside of the leg, and pass into the back of the foot via the ankle joint. These include:

tibialis posterior

flexor digitorum longus

gastrocnemius

soleus

Possible injuries

Whenever a person is standing upright, their foot is the only part of their body in contact with the ground.

This means that any interaction between the foot and the ground goes through the ankle and then the rest of the body in a kinetic chain.

As a result, problems in the foot and ankle can affect every other part of the body. Often, it is the knees that are affected first, then the hips and back, and eventually the shoulders and neck.

If someone cannot raise their foot upward or the movement is limited, then they may have poor dorsiflexion.

Causes

The possible causes of poor dorsiflexion include:

Ankle joint restriction: This is when the ankle joint itself is restricted. This can result from scar tissue in the joint or a tight joint capsule. A joint capsule is connective tissue filled with fluid that serves as a type of natural ‘hinge’ in the body.

Flexibility deficit: Dorsiflexion problems can occur when the muscles in the calf, known as the Gastroc/Soleus complex, are tight and cause restriction.

Genetics: Poor dorsiflexion can be linked to a person’s genetics.

Ankle injury: If a sprain has not healed properly, a person may limit their movement to avoid pain. Doing this consistently will tighten the joint capsule and cause scar tissue, which limits dorsiflexion.

Other injuries: Damage to the lower body, and even the hip and back, can make a person modify the way they walk and affect their dorsiflexion.

Any dorsiflexion problems that occur can carry on up the body and cause injuries from the knee all the way to the shoulder. This domino effect can work in both directions.

Depending on the cause of limited ankle dorsiflexion, there are different exercises to help improve it.

Tight calves

A limited dorsiflexion caused by tight calves can be improved by stretching the calves. Helpful stretches include:

Gastrocnemius stretch: Keep the back leg straight with front knee forward until feeling a stretch. Hold for 20 seconds.

Soleus muscle stretch: Lean against a wall with the leg that needs stretching at the back. Bend the knee with heel on the ground until feeling a stretch. Hold for 20 seconds.

Stretching on a step: Place foot on a step and then lower heel down to the ground until a stretch is felt and hold for 20 seconds.

Joint restriction

Dorsiflexion problems caused by joint restriction can be reduced using exercises, including:

Squats and lunges: One of the easiest ways to improve dorsiflexion.

Training barefoot: Shoes can be restrictive, so if a person trains barefoot the ankle will dorsiflex naturally.

It is important to stretch properly as the wrong technique can make the exercise useless or could cause more problems.

Unless there is permanent damage to the ankle due to trauma, restriction and muscle tightness causing dorsiflexion problems can be improved over time through specific exercises.

Injuries

With any injury, it is important to ensure adequate recovery and rehabilitation time. Rushing back to activities too early can cause further problems.

Ankles are load bearing, so it is important to give them rest by minimizing walking and prolonged standing after an injury.

To find out how we can help you, please contact us at:

Tel:      (416) 477-1101

E-mail: reception@priclinic.com

Web:   www.priclinic.com