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Showing posts from 2018

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…

Low Back Pain: Gluteus Medius Pressure Point Ball Release

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Place the release ball on the Gluteus Medius muscle located just below the superior aspect of the pelvic bone called the Iliac crest. Then roll on to the ball and bring your forearm to the ground. Go back and forth with partial weight and then to progress it with full weight on the release ball. Roll it out for up to 3 minutes before stretching. Following up with the Hip Rotation stretches after doing this ball release technique can help with your lower back pain. If you have any pain you are not sure about while doing this exercise, consult your Physio before continuing.

Rotator Cuff Strain: Big Ball Reach Outs

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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. It’s very important to retrain your core strength in conjunction with the rehab of your rotator cuff strain to have a more successful recovery! This is a great functional exercise to help you get back into many sports such as rock climbing, Ultimate Frisbee, Volley Ball, Basketball or Swimming.

7 Easy Exercises with a Towel

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Home exercising can be just as effective as going to the gym by using household items such as a medium-sized towel. Check out the exercises below for a full body work-out:

1) Plank Walks:  In a plank position with a towel under both feet and maintaining a neutral spine, walk forwards by placing one hand in front of the other for 10 to 20 steps.

2) Neck Rotation:  Find where the hairline ends to locate a noticeable "bump" on the back of your neck. This is the spinous process for your 2nd cervical vertebrae. Place the edge of an unrolled towel on this spot, then cross your hands over, making sure the top hand is on the same side as the direction of rotation (e.g. right arm will pull towel downwards towards the middle of the chest if you are turning LEFT). Complete a pain-free rotation 3 times in each direction per day.

3) Knee Tucks:  Start in a plank position with a towel under both feet and keep a neutral spine, then engage the lower abs below the belly button to pull the kn…

Ankle Sprain: Strengthening Stabilizer Muscles

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It’s generally good to get your ankle moving after you’ve sprained it. How much time you wait depends on whether how bad you sprained it with the amount of swelling you have, whether you can weight bear on it or if there’s a fracture involved . If you’re unsure, consult your local Physiotherapist before doing this exercise. This exercise works the Peroneal muscles that help to stabilize the ankle. Start by wrapping a resistance band around the forefoot with the lower legs supported by either a rolled up towel or folded Yoga Mat so that the heels are up from the floor. Place a small squishy ball between the knees and maintain a squeeze on the ball throughout the exercise. This helps you isolate the movement focus towards the ankles and prevents the hip and thighs from being involved. To strengthen the left lateral ankle, keep the right ankle stiff to stabilize. keep the ankle plantar flexed, so toes pointed down, and move the foot outwards lead by the little toe. Do 3 sets of 10 to 15 …

Sacro Iliac Joint Pain: Wall Squat Core Activation

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This exercise can help with Sacro Iliac joint pain that can be caused by hyper mobility or instability due to strained ligaments from repetitive strain or acute trauma. 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…

5 Strengthening Exercises for Dancers

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Overuse injuries are commonly found in dancers due to their intense training regimes. Nearly 60 to 90% of dancers experience an injury or multiple injuries during their careers (Steinberg, Siev-Ner, Peleg, et al., 2013). These injuries include chrondromalacia patella ("runner's knee"), Achilles tendinopathy, and metatarsal (foot) fractures. Some major causes of injury may be due to anatomic structure, genetics, training regime, improper technique, floor surfaces, age, body mass index, muscle imbalance, nutrition, and menstrual function (Steinberg et al., 2013).



Dance typically includes being on the toes and forefoot in a extreme plantar flexion position, known as "en pointe." Individuals with poor balance and landing techniques will experience higher ground reaction forces which may subsequently strain the back, knees, and ankles. Incorrect form in many non-professional dancers entail a valgus knee position (knees caved inwards) and hip adduction. Conversely, …

Low Back Pain: Gluteus Medius Strengthening vs Wall

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This simple exercise works the gluteus medius muscle of your hip if it’s really weak! 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. This is a close-chain exercise to strengthen the Gluteus Medius Muscle which can dynamically stabilize your hip and pelvis and help decrease low back pain when doing weight bearing activities like running, any running sports or even walking and hiking.

How to Improve Flexibility with a Yoga Block

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Flexibility is the ability to move a joint through its complete range of motion and is important in carrying out daily activities and in athletic performance. Maintaining flexibility of all joints produce efficient movement and reduces risk of injury. It can be improved in all age groups by regularly engaging in exercises targeting different joints. Joint capsule stiffness, muscle viscosity, ligament and tendon compliance all affect flexibility. Therefore, adequate warm-up and proper stretching is essential in optimizing joint range of motion. Chronic conditions such as lower back pain may arise if an individual has poor lower back and hip flexibility, in conjunction with weak abdominal muscles.

Flexibility exercises are most effective through warm-up exercises or passively through moist heat packs or hot baths to increase the muscle temperature. An effective warm-up is typically 5 to 10 minutes long, but may be longer for older adults or individuals with health conditions. Watch the…

Low Back Pain - Gluteus Medius Strengthening

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Do you have lower Back Pain? You may have weakness in your glute med muscle! This exercise is great for strengthening that and help support your low back. Begin by lying on your left side to strengthen your left Gluteus medius “Butt” muscles. Keep your right hip stacked on top of your left and place your right hand on your right hip. Then bring your right foot on the ground in front of your left knee and bend the left knee to 90 degrees. Bring your left foot up, while maintaining the ninety degree bend in your knee. Hold this for 10 seconds; Do 3 sets of 10 repetitions.

Sacro Iliac Joint Pain: Gluteus Medius vs Ball

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This is a great functional 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. Lean your inside hip onto the exercise ball against the wall. 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.

Sacro Iliac Joint Pain: Gluteus Medius vs Wall

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This simple exercise works the gluteus medius muscle of your hip if it’s really weak! 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. This is a close-chain exercise for the Gluteus Medius Muscle and helps to prevent your hip from flaring out and stabilizes your sacro iliac joint when do weight bearing activities like running , any running sports or even walking and hiking.

How to Reduce Interscapular Pain

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Persistent pain between the shoulder pains, or interscapular pain, may arise from a number of varying causes. The scapula is the bone that connects the humerus (upper arm bone) with the clavicle (collar bone) on either side of the body. The intrinsic muscles of the scapula include the subscapularis, teres minor, supraspinatus, and infraspinatus, all of which make up the rotator cuff. The major muscles surrounding the scapula that make up the interscapular region include the rhomboids, trapezius, and levator scapulae.
The rhomboids are two quadrate-shaped muscles that originate from the lower cervical vertebrae and upper thoracic vertebrae and attach to the medial border of the scapula. The rhomboids work to retract and rotate the scapula downwards. The trapezius muscle extend from the occipital bone of the skull to the lower thoracic vertebrae and attach to the scapular spine. Its action is to elevate and rotate the scapula upwards. Likewise, the levator scapulae run from the upper c…

Rotator Cuff Strain

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This exercise is great for rehabbing from a rotator cuff strain or shoulder impingement strain. Wrap a mild resistive elastic band half way down the mid back, and then cross it over at the front and securely wrap both ends onto each hand. Turn facing a wall and place your pinky finger and edge of hand firmly against it. Keep your posture tall and inner core engaged while pushing your hands against the wall up to the ceiling in “V” formation and externally rotate the hands out, holding it at the top for a good long second. Then slowly bring it back down. Repeat this 10 to 15 repetitions for 3 sets. By keeping your inner core engaged and your posture tight, this exercise is great for rebuilding the shoulder strength you need in any overhead reaching sports, especially rock climbing, volleyball, and basket ball. You should not have any pain when doing this exercise. If you do experience pain please consult your local Physiotherapist before continuing.

Shoulder Impingement Pain and Rotator Cuff Strain

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This exercise is great for strengthening the rotator cuff in conjunction with the rest of the shoulder complex muscles after recovering from an impingement or rotator cuff strain. Loop a closed elastic band with mild resistance around your arms above your wrists. Kneeling on the ground, keep your spine in neutral posture with your inner core muscles engaged. Imagine there is clock face numbered 9 to 3 O’clock on the ground in front of you. Begin by reaching the right hand to 12 O’clock and then back to the start position. Proceed to continue to 1 O’clock, 2 O’clock, 3 O’clock and then backwards up to 12 O’clock again. Then do the same with your left hand to 12 O’Clock until you reach 9 O’clock and reverse back to 12 O’clock again. That’s 1 complete repetition. Do 5 repetitions for 3 sets. This exercise should not produce any pain. If it does please consult your local Physiotherapist before continuing. 

Which is Better for an Injury: Ice or Heat?

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Ever wondered whether to use ice or heat for your sore muscles, your healing fracture, or any injury? Both ice and heat have been commonly used to treat an array of injuries, but when to use either one is critical in preventing further damage and promoting faster recovery.


Acute irritation or inflammation of a muscle, ligament, or tendon is typically treated with ice. The cold application reduces inflammation and numbs the pain, especially when the superficial tissues are red, hot, and swollen. The inflammatory response associated with damage to tissues is a defence mechanism in the human body that lasts for the first several days to protect against infection. The response involves immediate changes to blood flow, increased permeability of blood vessels, and flow of white blood cells to the affected site.

ICE APPLICATIONIce can be used for gout flare-ups, headaches, sprains, and strains. It is crucial to apply ice to the site of injury during the first 48 hours post-injury to minimize…

Vancouver Physiotherapist: Sharing her Why, Nadine Stunzi

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So Nadine, tell us…What do you like most about being a Physiotherapist?” What I love most about being a Physiotherapist is that I feel like we actually have an amazing capacity to create a lot of impact in the health care system. We get a fair amount of time with patients at a high frequency, coupling that with our vast clinical knowledge in our commitment to life long learning, I really feel and have noticed in patient outcomes that we can create a lot of meaningful change in patients’ lives… not just in terms in their functional well being but also in terms of their emotional well being as well. “Great.. And why did you become a physiotherapist?” Why?! I think why is a beautiful question that’s really important to ask behind a lot of what we do. You should be ground in that. Three and a half years of my life I spent being a personal trainer and I loved it! I loved working with the powerful tools of exercise and creating change and I loved the relationships that I built, but I wanted…

Shoulder Impingement Pain

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Ok! So today we’re going to do some “Kettle Bell Rotates”, and this is really great for the rotator cuff in conjunction with strengthening the scapular muscles. And so what we’re going to start off with… Iyad’s got a kettle bell; And so the reason why a kettle bell is actually better is because with a dumbbell the weight is kind of on the side and with a kettle bell the weight is actually going straight down right through the forearm. So we’re going to start off basically holding a… so this is a 10 pounder here so it’s a little more as you get stronger in your rotator cuff. If you’re a little bit weaker at first start off with a 5 pounder, but with a 10 pounder it gets a little bit heavier. So what Iyad’s going to do is bring his arm into a 90 degree angle and keep the shoulder at a 90 degree angle and you can see that the weight is going down straight through the forearm here right down. And so he’s going to do a rotation going outwards all the way and inwards all the way and he’s go…

Shoulder Impingement Pain Advanced Strengthening For A Weak Shoulder

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Hi my name is Iyad, I’m a Physiotherapist here at INSYNC PHYSIOTHERAPY. Today I’m going to show you an exercise that is particularly useful for any upper extremity rehabilitation or warm up. Some people in sports like Ultimate Frisbee, Rock Climbing, especially baseball or cricket where you involve a lot of throwing, this will be very very useful for it. Now the best thing about this is that you progress it on your own and you can modify it according to your needs. So all you need is a ball. The ball can have weight to it. That would probably help you by adding a strength component to this thing. Or if you’re not even injured and you just want a good warm up for the shoulder it can actually work really well for that. So the whole premise of this is that you are throwing the ball and catching it before it lands using a lot of the muscles of the shoulder blade and the rotator cuff to do so. So if you’re recovering from a strain and this is suitable for you and your stage of rehab then t…

INSYNC PHYSIO's Jenn Lam in Thailand!

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Insync Physiotherapy's Jenn Lam, RMT, recently returned from amazing trip to Thailand! Check out the photos below:

Pictured above: Here is Jenn feeding an elephant at the Elephant Sanctuary where she also got to walk and bathe the rescued animals from the riding facilities in Bangkok
 Pictured above: Temple Wat Arun along the Chaopraya River in Bangkok
Pictured above: Famous Taiwanese shampoo massage where the hair stylists got to put Jenn's hair into funny styles!
Pictured above: Beach in Rawai, Phuket

Lower Back Treatment: 1-Legged Squat

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Starting with tall posture, engage your core muscles below the belly button by drawing the lower abs inwards toward the spine. Avoid arching the low back. With arms in a ready position do a one-legged squat with your body weight distributed equally over the foot. Don’t go any lower than a ninety degree bend in the knees, keeping your knees in alignment with your second toe and over your heel as much as possible. Hold for a good long second and then straighten back up with your butt muscles to the start. Do three sets of 10 repetitions daily. The one-legged squat is a great exercise that’s effective in strengthening the quad and posterior hip muscles with the core and balance and proprioception to help further strengthen the lower back. The key is to keep your inner core low back stabilizing muscles engaged by making yourself skinnier at the waistline while you keep breathing. This will help you build increasingly higher level of low back core strength with your thighs and legs. 

Lower Back Treatment: 2-legged Squat

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Starting with tall posture, engage your core below the belly button by drawing the inner core muscles toward the spine without arching the low back. With arms in a ready position do a two legged squat with your body weight distributed equally over both feet. Stay in Spine neutral. Don’t go any lower than a ninety degree bend in the knees, keeping your knees in alignment with your second toe and over your heels as much as possible. Hold for a good long second and then straighten back up with your butt muscles to the start. Do three sets of ten repetitions daily. The two legged squat is a great exercise for strengthening the quad and posterior hip muscles with the core to help strengthen the lower back. The key is to keep your inner core low back stabilizing muscles engaged by making yourself skinnier at the waistline while you keep breathing. This will help you build more low back core strength with your thighs and legs.

How to Prevent Elbow Injuries in Young Throwers

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Recent research has shown that nearly 40% of 7 to 18 year old baseball players endure elbow and shoulder pain during their baseball season. Nearly half of these injured players report their ongoing participation despite having pain. A recent epidemiological study of ulnar collateral ligament (UCL) injuries in athletes 17 to 20 years old reported the number of UCL reconstructions has increased dramatically for this age group. Early education and detection of elbow injuries in throwing sports may help reduce the number of overuse injuries from developing.

Symptoms "Little league elbow," or known as medial epicondyle apophysitis, is most commonly found in young throwers. Sports such as baseball, softball, tennis, or golf, can result in this overuse injury to the growth plate on the inside of the elbow. Repeated stress to the growth plates may cause inflammation and lead to pain or swelling. Serious injury may even result in separation of the growth plate from the rest of the bo…

Shoulder Impingement Pain: Rotator Cuff Eccentric Strengthening

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Shoulder Impingement pain can be caused by muscle imbalances in the Shoulder Complex. Weak and shortened external rotator cuff muscles can be one of the contributing factors to this problem. When the Rotator cuff is strong and activates properly, it dynamically stabilizes the shoulder joint and allows for proper biomechanics to occur. To strengthen the external rotator cuff muscles position your elbow by your side, shoulders relaxed and your posture in spine neutral. Holding on to a resistance band use your other hand to help it out to the end range of external rotation. The opposite hand is doing all the work pushing the band outward that is being held by your other hand. Then let the hand holding the band slowly return to the start position. This is called Eccentric Strengthening because you’re strengthening the rotator cuff with a lengthening movement of the muscles. Repeat this for 10 repetitions, doing 3 sets daily.

Shoulder Pain: Posterior Deltoid and Capsule Stretch

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Shoulder pain can be caused by many things going on with the shoulder complex. One of the things that can cause shoulder pain is an impingement problem of the rotator cuff due to a tight posterior deltoid muscle or posterior shoulder capsule. To stretch this out find the angle that it is most tight in the back side. Then, lean your shoulder blade firmly against a wall to stabilize the shoulder blade to isolate the stretch. It’s important to place your shoulder blade firmly against the wall to stabilize it. Otherwise, the stretch will be more into your rhomboid muscles on the inside of the shoulder blade. Gently pull the arm across the body and hold this stretch for 30 seconds. Repeat this for 3 sets.

INSYNC PHYSIO's Michelle Robichaud in Northern Europe

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Insync Physiotherapy's Michelle Robichaud, RMT, recently returned from her amazing trip to Northern Europe and back in time for the 2018 BMO Vancouver Marathon where she completed an 8-km run! Congrats Michelle!


Check out the photos below of Michelle in Iceland, Scotland, and Denmark:




Back Pain Treatment - Core strength with Hip Extension

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This exercise can help treat weakness from acute or chronic back pain. On your hands and knees in 4-point position, engage your inner core by pulling the Transverse Abdominal muscles below the belly button inwards towards your spine while keeping your low back flat. Extend the thigh with a bent knee and make sure the pelvis stays level. Hold it for a few seconds and then bring it back down. Repeat this for 10 repetitions for 3 sets on each side. Your ability to engage your inner core muscles and isolate hip extension without extending and arching the lower back is the key to doing this exercise successfully. If you have any increase in pain or unsure about how to do this exercise, consult your local physiotherapist before hand.

Building a Stronger Core to Prevent Low Back Pain

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Up to 80% of individuals will experience some lower back pain at least once in their lifetime. Lower back pain (LBP) results in high costs and places a burden on society. These costs include diagnostic, treatment, and indirect costs associated with work disability. A number of conditions can lead to low back pain such as infections, tumours, fractures or dislocations of the spine. However, lifting heavy loads is generally thought to be a key predictor of LBP. An important element in prevention of LBP is to correctly stabilize the trunk during lifting by pre-activating the abdominal wall muscles. By doing so, the spine will increase in stiffness to reduce the effect of undesired spinal perturbations. Exercises aimed at bracing the abdominal muscles may reduce the risk of LBP.
There are two ways of stabilizing the abdominal muscles: an abdominal hollow or abdominal brace. An abdominal hollow begins by drawing in the lower abdomen (transversus abdominus) while maintaining relaxation of …

Back Pain, Lower Back Treatment “Building Core Strength”

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Lie on the ground with the stability ball under your heels with your legs straight and your toes pointing up. Engage your inner core muscles below the belly button. Then extend your hips by squeezing your butt and lifting it off the ground. Then bring the ball in towards you by flexing your knees and hold for a second and then straighten your legs back to the start position while keeping your butt up and hips extended. Keep your inner core engaged the entire time. Start by doing 3 sets of 10 repetitions and then progressing it to 3 sets of 15 to 20 repetition 4 times per week. This is great for building core stability to keep your low back strong when you have chronic back pain. If you are experiencing acute low back pain or unsure please consult your Physiotherapist before doing this exercise.

Shoulder Tendinitis & Rotator Cuff Tendinopathy: 4-Point Plank Walk-Out

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Shoulder Tendinitis and Rotator Cuff Tendinopathy can cause a lot of muscle imbalances to occur at the shoulder complex. These imbalances can affect the optimal movement in the shoulder and delay your functional recovery. The four point plank walk out helps retrain important muscle activation patterns for a better functional recovery. Position yourself in plank position with supine neutral. It’s important to make sure your inner core is engaged and that you stay in spine neutral throughout this exercise. Start by walking the hand and foot out to one side,then back to the centre, and then to the other side, and back to the centre again. Put full equal weight each time you place your hand and foot down. Repeat this for 30 seconds 3 sets 2 times daily. If you have any pain or unsure if this is the right exercise for you, consult your local Physiotherapist before doing this exercise.

Shoulder Pain and Rotator Cuff Tear: 4-Point Walk-Out

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A rotator cuff tear can cause a lot of muscle imbalances to occur at the shoulder complex. These imbalances can affect the optimal movement in the shoulder and delay your functional recovery. The four point walk out helps to retrain the muscle activation in the shoulder blade to work together with your rotator cuff muscles for a better functional recovery. Place your hands and knees in a four point position in neutral supine. It’s important to make sure your inner core is engaged and that your spine is in neutral posture throughout this exercise. Start by walking one hand out to one side, then back to the centre, and then to the other side, and back to the centre again. Put full equal weight each time you place your hand down. Repeat this for 30 seconds 3 sets 2 times daily. If you have any pain or unsure if this is the right exercise for you, consult your local Physiotherapist before doing this exercise.

How to Recover from Achilles Tendinopathy

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The Achilles tendon is the thickest tendon in the human body. It attaches the gastrocnemius and soleus muscles (together known as the triceps surae) as well as the plantaris muscle to the calcaneus bone (heel) of the ankle. These muscles combined allow for plantar flexion at the ankle and flexion of the knee.

Tendinopathy of the Achilles tendon refers to a condition that causes pain, swelling, or stiffness at the tendon connecting the muscles to the bone. Commonly found in athletes such as runners, overuse of the tendon, may result in microtrauma or repeated injuries to the Achilles tendon. Wearing improper footwear, having poor training or exercising techniques, making a sudden change to your training program, or exercising on hard surfaces may also cause minor injuries to this tendon. Pain and stiffness may develop gradually and are typically worse in the morning. Pain is generally worse after exercise, but may potentially arise during training. Overtime, symptoms may be so severe …