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Showing posts from 2018

Patrizio in Germany and Italy!

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InSync Physiotherapy's Patrizio Jacova, physiotherapist, recently returned from his amazing trip in Europe. Check out the photos below:

Pictured above: A view of the city from the Piazzale Michelangelo, where there is one of the replicas of the statue of David. You can see 5 monuments from there in one photo! The Ponte Vecchio, Palazzo Vecchio, Duomo, Bibioteca Nazionale, and Chiesa Santa Croce.

Pictured above: Cinque Terre, specifically in the town Riomaggiore. This was the perfect place to try lots of food, scuba diving, kayaking, and hiking. Patrizio's only regret was that he didn’t spend a full week there!
Pictured above: Patrizio at Keltendorf Steinbach.




Low Back Strain Injuries: Ball Walk Outs

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Start by pulling in your inner core by making your waistline skinnier below the belly button. Then roll out into a plank position on the ball in full control with a flat spine. Lift one leg off of the ball with full control while keeping your hips level with each other. Try to keep you toes pointed to the floor as much as possible and lead with your heal. Do 3 sets of 5 repetitions holding for 5 seconds on each side to start. Then progress to 3 sets of 5-10 repetitions holding for 10 seconds when stronger. Plank walk-outs on a ball is great for strengthening your core in coordination with strengthening your posterior hip and gluteal muscles. This can help with a faster functional recovery and prevent future lower back strain injuries in sports and everyday physical activity.

What is Cuboid Syndrome?

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Ever feel pain or swelling on the side of your foot? These symptoms may be due to a condition called Cuboid Syndrome, also known as cuboid subluxation or lateral plantar neuritis. In addition to pain in the lateral mid-foot, redness and a restricted range of motion in the ankle may be present. This syndrome is typically associated with an inversion sprain of the ankle. This is when the foot is forced inwards causing the cuboid bone to sublux, or partially dislocate. The cuboid bone is located near the mid-point of the outer side of the foot and is one of the seven tarsal bones that make up the arch of the foot. It connects the foot and ankle as well as provides stability to the foot.


The peroneus longus muscle is a muscle that runs along the outer side of the lower leg and attaches to the lateral side of the foot. Repetitive strain of this muscle due to activities such as ballet, jumping, or running, may place tension on the cuboid bone. Commonly found in athletes, Cuboid Syndrome ma…

Low Back Strain Disc Herniations: Hip Flexor Stretch

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Kneel down onto your left knee. Then rotate it about 45 degrees past the midline of your body. To keep your posture nice and tall imagine there’s a string pulling your whole spine upwards from your pelvis, right up your entire back and neck and up to the top of your head. Then engage your inner core muscles tight below your belly button and keep your low back flat. Next, bend the right knee forward and keep your posture nice and tall without leaning backwards. Then reach your left arm up pointing the fingers towards the ceiling nice and high and point your right finger tips to the floor. Hold this stretch for 30 seconds and repeat 3 times for each side. This stretch can help with low back strain due to disc herniations. If you experience pain and continue having problems then consult your Physiotherapist.

Elbow Strain: Median Nerve Mobility Exercise

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Place your hand onto your opposite shoulder to help prevent it from hiking up. Then turn your head to the opposite side and abduct the shoulder to 90 degrees. Together, extend the elbow, wrist and fingers out fully. As you start to feel a pull into the right side, turn your head to look towards the extended side. Repeat this by looking to the opposite side and extending the entire arm, wrist and fingers while turning again towards the extended side. Do it for 60 seconds, 4 sets two times per day. This is a great nerve mobility exercise biasing the median nerve. It’s important to regain full mobility in the nervous system when you are rehabbing from elbow, forearm, hand and finger tendon & muscle strains. Whether you’re an elite, avid to recreational athlete or just use your arms and hands a lot for work or activities of daily living, having the mobility you need in your muscle skeletal system will help optimize your overall function! 

Hamstring Strain: Basic & Progressive Functional Mobility

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When you strain and injure any part of your hamstring muscle, an important part of the rehab process is to ensure that the sciatic nerve associated with it is moving properly. Depending on the severity of the injury, you want to start this basic mobilization technique within the first few weeks. With the basic nerve mobility exercise to increase hamstring functional mobility start sitting down with tall posture. Slowly extend your knee and flex your toes towards you to further mobilize the hamstring. Then return the knee and ankle back to the start position. Repeat this for 60 seconds 4 sets 3 times per day. With the Progressive nerve mobility exercise for the functional hamstring retraining start sitting down with your knees bent and feet flat. Begin to slump your spine so you’re slouching forward and then slowly extend your knee and flex your toes towards you. When it reaches full knee extension and toes towards you with a pulling sensation, straighten up you back to tall posture. T…

Shoulder Pain & Stiffness: Shoulder Muscle Stretch

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If you feel some pain or stiffness in the shoulder, this stretch may help with the sports you play or physical activities that you do. To stretch out the right side, reach your right hand up and down your back keeping your right elbow pointed upwards. Avoid arching the back by keeping your spine in neutral. Pull the right elbow towards midline with your left hand while keeping the right elbow pointed upwards. Hold this for 30 seconds doing 3 sets on each side daily.

Diana in Europe!

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Diana, who works front desk at both the Burnaby and Cambie InSync Physio clinics, recently returned from her trip to Europe! Diana and her dragon boat team, Dragon Zone Premier, had the opportunity to compete at the 2018 Club Crew World Championships in Szeged, Hungary as one of the five Premier teams representing Canada. Her team placed 6th overall in the world with 48.803s in the 200m Mixed Premier Standard Boat Grand Final, 5th overall in the world in 500m Mixed Premier Standard Boat Grand Final, and 4th overall in the world in the 2km Premier Mixed Standard Boat Final. 

Following her competition, Diana got to see the beautiful emerald waters of Plitvice National Park, hidden blue caves near the island of Hvar, and the historical city walls of Dubrovnik, Croatia. 



Diana also got to explore the ruins of Pompeii as well as the Roman Forum and Colosseum in Rome, Italy.



One of her highlights was seeing the rows of colourful houses on the island of Burano and watching a talented glassma…

Shoulder Impingement Pain: Rotator Cuff Muscle Stretch

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To stretch out the right rotator cuff muscle, place a non-stretchy strap with your left hand over your head and behind your back. Reach the right hand behind your back to grab the strap. Reach as far up as you can towards your limit but avoid tilting your shoulder forward. Stabilize the front of your right shoulder by placing it against a corner or a door frame and step the left foot forward. Hold tightly with your right hand and pull the strap upwards with your left. Hold this stretch for 30 seconds and repeat for 3 sets. Doing this stretch daily can help increase the mobility of your stiff shoulder if you’re experiencing shoulder impingement pain due to a tight overuse Supraspinatus Rotator Cuff muscle. It’s also great to do as a warm down stretch when it’s abnormally tight and stiff. If you have pain or if you’re unsure about how to do the exercise, please consult with your local Physiotherapist before continuing. 

Elbow Pain: Forearm Extensor Stretches

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This stretch will help ease the tight lateral forearms. This condition is commonly called “Tennis Elbow”. Start with the elbow in a bent position. With a closed fist, fully flex the wrist and rotate it outwards with assistance from the other hand. Then straighten out the elbow and hold for 30 seconds and repeat for 3 sets. Lateral elbow pain can be caused by overly tight forearm extensor muscles from sports or repetitive strain activities such tennis, racket sports, rock climbing and prolonged computer desk work. If you have pain or unsure about doing this exercise, consult your local physiotherapist before continuing.

How to Safely Exercise When Pregnant

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Remaining active during a pregnancy may help reduce some discomforts and help prepare the body for delivery. Acute exercise generally increases oxygen uptake, heart rate, stroke volume, cardiac output, and lung volume during pregnancy. Remember to complete the "PARmed-X for Pregnancy" health screening prior to participation in a prenatal fitness class or other exercise. Medical clearance should be obtained prior to exercise for women who were sedentary prior to pregnancy or have a medical condition.

Benefits:reduced backachesreduced constipation and bloatingmay help prevent gestational diabetesimproved weight managementincrease in energyimproved moodimproved posturebetter sleep patternsdevelopment of muscle tonepromotes strength and endurancebetter coping with labour
Contraindications to Exercise:Absolute Contraindications: hemodynamically significant heart diseaserestrictive lung diseaseincompetent cervix/cerciagemultiple gestation at risk for premature labourpersistent seco…

Elbow Pain: Forearm Flexor Stretches

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This is stretch will help ease the tight forearms! Start with the elbow in a bent position. With the opposite hand, fully extend the wrist and fingers. Then straighten out the elbow and hold this for 30 seconds and repeat 3 sets. The overuse tendinopathies that occur in the medial elbow can be caused by overly tight forearm flexors. This is very common in rock climbers or golfers. If you have pain or unsure about doing the exercise, consult your local physiotherapist before continuing.

Ankle Sprain: Wall Squat Core Activation

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This exercise can help with the retraining of the core stability, hip, leg and ankle muscles after an acute ankle ligament sprain. If you experience pain or you’re unsure about this exercise please consult your local Physiotherapist before continuing. Wrap a closed loop resistance band around the thighs just above the knees. Then position yourself so that your low back is fully leaning up against the big ball on the wall. Keep your posture nice and tall but don’t arch your low back when leaning upright against the big ball. Next, engage you inner core stabilizers by contracting your pelvic floor muscles and pulling your transverse abdominal muscles below your belly button inwards, hugging your spine. Remember to keep breathing. Leaning your weight on the ball slide downwards doing a wall squat while you maintain static isometric pressure against the resistance bands. Keep your knees over your ankles and in alignment with your second toes. Hold the wall squat for 10 seconds. Repeat thi…

How to Program: Linear vs. Non-Linear Periodization?

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Designing a work-out program for yourself? There are many different ways to create the ideal program that suit your fitness levels and fitness goals.

PERIODIZATION Periodization entails systematic planning of various aspects of a training program through progressive cycling during specific periods. The goal of periodization is to optimize fitness levels while reducing the risk of injury. There are different components to the basic structure of a periodization cycle.
CYCLES  A macrocycle is a complete training period that may be 1, 2, or 4 years in duration. A mesocycle is a period or multiple periods within a macrocycle aimed to develop a single training block. The mesocycle may consist of a preparatory period, a competitive period, and a transition or rest period. A microcycle is a structural unit that makes up a mesocycle. It details weekly plans for progressive overloads specific to the goals of the mesocycle. For example, four 4-week microcycles will equate to a 16-week training p…

Low Back Pain: Core Stability Strengthening

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Keep your posture tall and your inner core engaged by pulling the muscles below the belly button inwards toward the spine. Wrap a resistance band around your upper back. With your belly on the the ball stay on your hands and feet. Secure the band on the floor with your opposite hand. Reach your index finger forward, with the thumb up towards the wall on a slight angle out, then come back down. Repeat this 10 times for 3 sets on each side. To progress the functional core strength, reach your index finger forward while extending your opposite leg and heel back at the same time. Keep the hips and pelvis level. Repeat this 10 times for 3 sets on each side. This core strengthening exercise can help your low back get stronger after injuring it. If you have pain or unsure about the exercise please consult your local physiotherapist before continuing.

How to Avoid High-Altitude Illnesses

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Altitude training involves spending several weeks at a higher altitude (preferably over 2000 m or 8000 ft above sea level) to adapt the body physiologically. At elevations greater than 1200 m or 3950 ft, there is a decrease in atmospheric pressure which reduces the partial pressure of oxygen in inspired air. This causes decreased arterial oxygen levels and leads to increased ventilation and cardiac output, along with an elevation in heart rate. Performance will decrease for individuals that have not acclimatized to the change in pressure and are consequently exposed to a risk of high-altitude illnesses.

AcclimatizationAcclimatization is the process of adapting to the decrease in oxygen concentration at a specific altitude. With acclimatization, there will be an increase in heart rate, blood pressure, bicarbonate excretion, respiratory frequency and volume along with a reduction in plasma volume. To compensate for the decreased arterial oxygen levels, erythropoietin (EPO), a hormone in …

Shoulder Pain: Biceps Stretch

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Place the thumb side of your hand facing forward firmly against a door frame or corner at the level of your hips. Keep the elbow bent to start. Then straighten the elbow and hold for 30 seconds doing 3 sets. Assisting the rotator cuff, the long head of the biceps muscle attaches onto the front aspect of the shoulder. It can sometimes be stiff causing anterior shoulder pain. This muscle can be tight in sports such as rock climbing, Volleyball, paddling or weight lifting.

Hand & Finger Tendon Strains: Tendon Glides

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When it comes to particular sports like rock climbing or other activities dependent on finger tendon strength, It’s particularly important to restore their maximal gliding capability. This tendon gliding mobility exercise does just that! Begin by extending the hand and fingers as much as possible. Then bring the fingers into a closed hook position by crimping the fingers down (keeping the knuckles aligned with the wrist). Then make a closed fist by rolling the fingers down. And then finally move into a flat fist with the fingers reaching down. Perform the movement in a slow and rhythmic sequence by moving through a full range of motion and keeping the wrist in neutral. Do this for 3 sets of 10 repetitions 3 times per day is excellent for rock climbers, volleyball players and any other activities that require intense finger strength and mobility.

How to Prepare for a Competition Abroad

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Preparing for a competition in another country takes weeks in advance to properly adapt the body to new environmental conditions. There are a number of aspects to consider when travelling abroad such as the climate, elevation, pollution, accommodations, food, water, vaccinations, and emergency plans.

Jet Lag Jet lag is when the body cannot adapt rapidly enough to a time zone change. This results in fatigue, poor sleep and performance. There are a multiple factors affecting jet lag such as the number and direction of time zones crossed, age, individual health, dehydration, stress, alcohol, and excessive food intake. It is estimated to take approximately one day per time zone crossed to re-synchronize the body. It is recommended to spend time outdoors once you arrive at destination to help adjust the sleep/wake schedule. To prevent jet lag, slowly adjust your sleep schedule a few days before travel and maintain adequate levels of hydration and nutrition.
Nutrition Travelling in another …

Sacro Iliac Joint Pain: Advanced Gluteus Medius vs Ball

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This is an advanced ball exercise for the Gluteus Medius Muscle in your hips. It helps to stabilize your sacroiliac joint when walking, hiking, running , and any running sports that involve cutting like soccer, football or ultimate frisbee. Wrap a resistance band around your inside hip.Lean your inside hip onto the exercise ball against the wall and pull with the band towards the outside hip with your hand. With your inner core engaged and your posture tall flex your inside knee up to your chest. Start by driving your outside hip into the ball to bring the inside hip upwards so it’s level with your other hip. Then release and drop your inside hip back down and repeat. Do 10 repetitions for 3 sets. This exercise should not produce any pain. If it does please consult your local Physiotherapist before continuing.

Ankle Sprain: Glute Med Strengthening

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You might have a weak glute med muscle if you’ve sprained your ankle! Start by leaning your forearm into the wall and have your outside hip flared out. With your inner core engaged and your posture tall flex your inside knee up to your chest . Start by squeezing the outside hip in and drive across to the other hip and upwards. Bring the outside hip in line with the knee and foot below. Then release and drop your hip back out and repeat. Do 10 repetitions for 3 sets. A strong glute med muscle can help with better hip and pelvis stability. This can help you fully rehab the injured ankle and facilitate a recovery back to Physical activities and sports. If you have any pain consult your physiotherapist before continuing this exercise.

How to Warm Up For a Bigger Bench Press

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The bench press is one of the key complex exercises to build upper body strength and mass. It involves the pectoralis major, triceps brachii, anterior deltoids, traps, back, and glute muscles. Check out the following blog post on how to properly perform the bench press: https://blog.insyncphysio.com/2017/04/strength-training-for-dragon-boat.html



Warm up prior to any exercise is key as it raises the heart rate and circulation of blood to the muscles to prepare for an increase in activity. Complete the following steps before performing light reps on the bench press to warm up effectively for a bigger bench press:
1) Self-Myofascial Release: Foam rolling decreases tissue density and muscle viscosity, while increasing blood flow into the muscles. Apply moderate pressure to the chest, lats, and tricep muscles. Do not roll over joints. Pause on any tender spots for several seconds. 


2) Dynamic Warmup:a. Side Lying Windmills: Lie down with your back on the floor with one leg extended and the ot…

Low Back Pain: Psoas March

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This exercise is called the Psoas March and it’s really great for increasing your hip flexor strength with your core and also with giving you that explosiveness and really awesome if you have issues with your SI joint and your hip joint. So we’re going to start off by actually having Vivian lying down flat on the mat and she wants to make sure that her low back is nice and flat; So that’s what the hands going to feel for so there’s no arching of the lower back. And you want to have this hands just below the belly button and that’s just going to help you engage that core a little more and you’ll feel a facilitation of that transversus. And you’re going to bring both knees up: So you want to have them up above ninety degrees… So here’s ninety and you want to go a little further. And then you’ll be wrapping a band around your feet and with the band you want to have it around the feet like this with the legs out a little bit with tension and parallel so they’re like train tracks. So you’r…

Quick Recovery for Finger Sprains

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Finger sprains commonly occur in sports and every day activities that involve heavy lifting or repetitive hand motions. Falls or contact sports such as football may even force a finger out of its normal joint position resulting in a dislocation. The force to the finger may cause joints in the finger to hyperextend or move sideways. Sprains of the finger are classified according to the extent of injury or damage.

Classification:1) Grade I - Mild: A first degree sprained finger is present when the ligaments are only stretched but not ruptured. There may be localized swelling, slight pain, and slight reduction in range of motion, but strength remains unaffected. An individual may continue to engage in an activity. Taping of the injured finger may be more effective. Recovery is immediate.

2) Grade II - Moderate: A second degree sprained finger occurs when there is partial ligament tears, a greater reduction in range of motion and some loss of strength with more swelling and pain. The join…