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Showing posts from 2018

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 …

Ankle Injuries & Ankle Sprains: Gluteus Muscle Retraining

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This exercise is great for retraining your Gluteus Medius after an ankle injury. After you sprain your ankle, the muscles all the way up into the hip on the affected side can be affected. 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 hip 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 to stabilize yourself a little more. Next, 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 daily. 

Ankle Injuries & Ankle Sprains: 1 Legged Squat

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The one-legged squat is an excellent exercise after injuring your ankle from a ligament sprain. It works your quad, posterior hip, core muscles and your balance and proprioception to help with your functional recovery. 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 ten repetitions daily.

Ankle Injuries: Strengthening After A Sprain

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This exercise is great for strengthening your injured ankle and retraining important muscle activation patterns on the injured side. Use a resistance band tied to a stable anchor and wrap it around the unaffected leg. With the affected ankle, stand either in front of the band or inside while keeping your posture tall and inner core engaged. Hike the foot with the band wrapped around the leg up off of the ground and slowly push the leg out to the side and then slowly return it back to the middle while keeping the foot off of the ground the entire time. Resist the movement with the standing leg by squeezing the butt muscles. Repeat this 10 times for 3 sets daily.

Strain vs Sprain? How To Recover Optimally

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Acute sprains and strains may impede performance and delay return to a sport. Proper management, treatment, and prevention is essential to recovering effectively. An athlete must first understand the definition and recognize the differences between a "sprain" and a "strain." A sprain is defined as a violent overstretching of one or more ligaments in a joint. A sprain can result in pain, tenderness, swelling or bruising at the joint. A strain is defined as a stress or direct injury to the muscle or tendon. A strain may also cause pain when moving or stretching the injured muscle, but can also cause muscle spasms.

Grades of Strain: 1) Grade I - Mild Strain: slightly pulled muscle with no muscle or tendon tears and no loss of strength and low levels of pain
2) Grade II - Moderate Strain: partial tearing of the muscle or tendon at the bone attachment with reduced strength, moderate pain levels
3) Grade III - Severe Strain: complete rupture of muscle-tendon-bone attachm…

Ankle Sprains - 4 Point Star Balance

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This exercise retrains your balance, strength and proprioception and will help you regain functional mobility faster after an ankle sprain. Start by putting your weight on the side of the affected ankle and hike the opposite foot up off of the ground. Remember to keep your inner core tight below the belly button. Then with the foot that’s off of the ground touch the first point in front of the ground, then to the side and then behind you, and then cross over to the other side of the body. Repeat the 4 points of contact (front, left side, back and right side) for 30 seconds 4 sets 4 times per day. As you get stronger increase it to 60 seconds 4 sets 4 times per day. If you have a fracture as a result of your injury or you are unsure if this is the right exercise for you to do, consult your physiotherapist before starting this exercise.

Ankle Sprains: 2-Legged Squats

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The two legged squat is a basic strengthening exercise that’s very effective in strengthening your ankle immediately after an acute ankle sprain for the first couple of weeks as long as you can fully weight bear on that ankle and foot and that there is no fracture from your sprain. Sometimes the ligaments can be torn and pull off a piece of the bone where it attaches and this is called an avulsion fracture. Scans such as X-rays will not necessarily show that there is a fracture if the ankle injury /sprain was recent. There are certain tests that your physiotherapist can do before getting an X-ray to determine that there is a greater likelihood of a fracture. So if you are unsure, I would suggest consulting your Physiotherapist before starting this exercise. Starting with tall posture, engage your core below the belly button by drawing the inner core muscles towards the spine making your waistline skinnier. Maintain normal breathing without arching the low back. With arms in a ready po…

Back, Sacro-Iliac-Joint Pain & Dysfunction: Core Stability Foam Roller

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Lying with your low back flat on the foam roller pull your inner abdominal muscles downward. Imagine you are making yourself skinnier at your waistline and breath into your diaphragm. Slowly lift one bent knee up towards the chest, followed by the other knee while keeping your core engaged, low back flat and breathing into your diaphragm. Then slowly lower one leg down at a time. Repeat this for 3 to 5 minutes 4 times daily on the foam roller to strengthen your core stability muscles for your lower back, pelvis / sacroiliac joints and hips. To progress and increase the difficulty of this exercise, start with both knees and both arms straight up in the air while lying flat on the foam roller. Reach one arm up above your head towards the ground and lower your opposite leg with a bent knee back down to the floor while keeping your core engaged, back nice and flat and breathing into your diaphragm. Return the arm and knee back to the start position and do this for the other arm and leg. R…

Back, Sacro-Iliac-Joint Pain & Dysfunction: Core Stability Strengthen (With Progression)

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Start off with one hand below your belly button and pull your inner abdominal muscles downward. Imagine you are making yourself skinnier at your waistline. Put your other hand by your low back to make sure you keep it nice and flat. Slowly lift one bent knee up towards the chest, followed by the other knee while keeping your core engaged, low back flat and breathing into your diaphragm. Then slowly lower one leg down at a time. Repeat this for 3 to 5 minutes as a basic core stability strength exercise 4 times daily. To progress and increase the difficulty of this exercise, start with both knees and both arms straight up in the air. Reach one arm up above your head towards the ground and lower your opposite leg straight down to the floor while keeping your core engaged, back nice and flat and breathing into your diaphragm. Return the arm and knee back to the start position and do this for the other arm and leg. Repeat this alternating pattern with the arm and opposite leg for 3 to 5 mi…

Mid and Low Back Stiffness: External Oblique Stretch

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This exercise is to stretch out the external oblique muscles. Start by placing the arm of the side to be stretched out to the side on the ground. You can hold a weight or dumbbell in your hand to anchor yourself down. Then bring both knees up to your chest and twist them down to the opposite side. Use your other hand to hold your knees down. Hold the stretch for 30 seconds for 3 sets for both sides. If you are experiencing any acute or sharp pain consult your Physiotherapist before trying this exercise. 

Overuse Knee Pain: IT-Band / Lateral Quad Stretch

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Start by lying on your good side with the tight Iliotibial Band or “IT-Band” facing up. Keep your inner core muscles below the belly button engaged while keeping your low back flat. Then, bring the bottom knee towards your chest and with your left hand, reach down and back for your other leg above the ankle. Pull the heel back towards the bum while keeping the core engaged and the low back flat. Keeping the top knee and ankle parallel and level with the floor, lift your bottom heel onto the top part of your knee. Next, guide your lower leg down toward the floor with your heel while keeping the top leg, knee and ankle parallel and level to the floor. As the top leg is lowered down, have the top knee and thigh pointed downwards so it’s in alignment with your whole spine. Hold this stretch for 30 seconds and repeat 3 sets 2 times daily. This “IT-Band” stretch is particularly helpful if it’s caused by tightness by an overly tight lateral quadriceps muscle. This type of overuse knee pain c…

Hip, Low Back, Sacro-Iliac Joint Pain or Stiffness: 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 hip, low back or sacroiliac joint pain and dysfunction. If you experience pain and continue having problems then consult your Physiotherapist.

Neck, First Rib Pain & Stiffness: Anterior Scalene Muscle Stretch

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With Chronic neck stiffness, you may actually have a stiff first rib due to a tight anterior scalene muscle. This can be caused by old trauma, stress or bad posture from sitting. Start by placing the inside part of the hand below the thumb firmly above your collar bone and over the first rib. Then take a big breath in, keep your chin tucked, look upwards slightly and tilt your ear away from the shoulder. Don’t forget to exhale and just keep breathing in and out normally while holding this stretch for 30 seconds. Repeat it 3 times for each side twice per day.

Neck Pain & Stiffness - Sternocleidomastoid Muscle Stretch

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With Chronic neck pain, you can quite often have tightness in your sternocleidomastoid muscle due to sitting or doing activities with less than ideal posture. Start by placing the inside part of the hand below the thumb firmly on your collar bone called your clavicle and your Manubrium (the part just inside to the collar bone. Then keeping your chin tucked in, look upwards, tilt your ear away from the shoulder and turn your head toward that left side while maintaining your gaze upwards. Hold this beautiful stretch for 30 seconds and repeat it 3 times for each side twice per day.

Responding to a Cervical Spinal Cord Injury

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A catastrophic cervical spinal cord injury occurs with structural distortion of the cervical spinal column due to actual or potential damage to the spinal cord. Damage above the C5 vertebrae in the spinal column results in the greatest risk of immediate sudden death for an athlete. Above this level, damage may impair the spinal cord’s ability to transmit respiratory or circulatory control from the brain. Effective acute care is critical in preventing permanent dysfunction or death in an athlete as a biochemical cascade of events can occur during the initial 24 to 72 hours post-injury.


Any of the following symptoms warrants the initiation of a spinal cord injury management protocol:

- unconsciousness or altered level of consciousness

- bilateral neurologic complaints

- significant midline spine pain

- obvious spinal column deformity

Treatment: When treating a cervical spinal injury, stabilize the spine in a neutral position immediately. Avoid applying traction to the cervical spine to creat…