Groin injuries are a common injury amongst active people, as well as those unlucky enough to strain the area by falling, tripping, or getting their leg caught on something. It is usually characterized by pain along the inner thigh where the muscles are thought to have been over-stretched. It also has a reputation for being a “difficult” injury to recover from, although this reputation is somewhat undeserved. Sometimes the nature of the injury is incorrectly assumed from the beginning, which can lead to ineffective treatments and prolonged pain. Groin pain following a strain can result from several different injury mechanisms, each of which requires a different management approach.
Groin or inner thigh pain can be a manifestation of a hip joint problem. The hip is a ball and socket joint that is lined with cartilage and surrounded by other supportive soft tissue for protection. Sometimes when the groin is “strained”, the soft tissue can become pinched and cause pain. The resulting pain comes from compression of this tissue by normal hip movements. Usually, though, the hip can be “unlocked” by moving it in the proper direction, which can be found under the supervision of a well-trained physiotherapist, and relief of pain will quickly follow.
Another possibility is that the ligaments and tendons of the groin take the majority of the force rather than the muscles themselves. These tissues have notoriously poor blood supplies and so don’t receive the nutrients and support needed for good quality healing. Therefore, they can remain painful for weeks or even months if the proper intervention is not undertaken. However, they are quite responsive to tension or resistive forces, and with a specific exercise program, they can be remodeled slowly to decrease the pain and regain the strength. This does require discipline, as the changes will occur slowly over a number of weeks, but should ultimately result in recovery.
When a groin strain primarily affects the muscular tissues, which is what most people assume groin injuries to be, healing will usually proceed over a number of weeks, because of the aforementioned good blood supply. As long as the muscles are not over-stressed during this healing period, and movement and strength are gradually regained as the symptoms allow, the recovery will proceed uneventfully.
For all the different injury mechanisms listed above, once full movement and strength of the area have been attained, treatment will focus on recovering a level of function required by the person’s work or athletic activities. For example, a physiotherapist can guide a tennis player to safely progress and return to running, cutting, lateral movements, and lunging, all of which are necessary components of the sport.
In summary, the crux of the matter with groin injuries is to determine what kind of problem it is. To say you have a “groin injury” on its own does not say enough for a healthcare professional to be able to treat it effectively; they have to be able to understand it on a deeper level to direct the appropriate treatment. The physiotherapists at York Rehab possess the assessment skills necessary to diagnose such injuries and help you to recover as efficiently and effectively as possible.
Headaches are a common ailment experienced by many people. Headaches are known to have a number of causes, and the treatments are as varied as the headache symptoms themselves. Many of us accept headaches as unavoidable and are often treated with over-the-counter or prescribed medications. For some people, headaches can be quite debilitating and also resistant to traditional therapies. One possible therapeutic option that is less well-known to the general public is physiotherapy. Headaches that are “mechanical” in nature – emanating from the joints or muscles around the head and neck often affected by movement or positioning – can often be effectively treated with physiotherapy.
Mechanical headaches can come in several forms. The first type of a mechanical headache is a secondary consequence of neck problems. People who have neck pain, stiffness, or loss of movement may have accompanying headaches but may not associate their pain with a neck problem. If the headache symptoms began around the same time as the neck symptoms did, there is a good chance it is mechanical and therefore treatable with physiotherapy. When the neck symptoms are addressed by adopting exercise and postural strategies that your physiotherapist can show you, the headaches tend to fade away. Or, as neck movement improves with physiotherapy treatment, a noticeable reduction in headache intensity is experienced at the same time.
The second category of a mechanical headache is one where there is no or very little neck pain or stiffness, with the head pain being the primary symptom. If this kind of headache varies with seated positioning, such as worsening with prolonged slouched sitting at a desk and improves with more upright posturing, then the pain source is likely mechanical. And there’s an increased likelihood the headache will respond to physiotherapy treatment.
Often, people mistakenly attribute headache symptoms to “stress”. In reality, someone in a stressful situation is less likely to pay attention to their posture and positioning, which can ultimately lead to a headache. Most of the time with these types of headaches there is a key position or movement that if performed repetitively, or held as a stretch can give rapid relief. The responsiveness to treatment varies from person to person.
This is not to suggest that all headaches are mechanical. There are many headaches that will not respond to physiotherapy treatment. If your headache is constant and doesn’t vary with positioning or movement, it is less likely to be mechanical. Determining whether positioning and/or specific movements are the root cause is something a well-trained physiotherapist can help you with. Two or three appointments would usually be a sufficient amount of time for a therapist to determine whether your pain is mechanical. If you decide to see a physiotherapist for your headache and it’s determined that the pain is not mechanical in nature, you will be referred back to your doctor.
If you have a persistent headache that is not responding to medication, put down that pill bottle and pick up the phone to make an appointment with a physiotherapist. A visit to a registered physio will get you a comprehensive assessment to see if your headache has mechanical features – a McKenzie trained physiotherapist can help with this. If the cause it mechanical, they will be able to show you how to self-manage it and what to do to prevent it from coming back which can be a wonderful option that excludes the need for pills. It is surprising how rapidly this approach can work, even with headaches that have previously persisted for months or years. Explore your options; a physiotherapist may be able to offer you quick relief allowing you to return to living your life – hopefully, full of activity.
A common injury for people involved in sports such as soccer, tennis, squash, or running is an ankle sprain. Many athletes and weekend warriors alike have experienced this injury, often multiple times, and may rely on using a brace for support to prevent re-injury or be forced to cut back on their participation due to recurring injury. It is possible to minimize the recurrence rate of this injury by seeing a qualified physiotherapist who can assess for and address the following limitations that are common in people with repetitive ankle injuries.
Some people who have had a long history of ankle injury have range of motion limitations. What can happen is the ankle swells following the sprain, and it gradually recovers, but the scar tissue that forms to rebuild the injured tissue does not get adequately stretched. This is how a stiff ankle can develop, and playing sports with this movement loss can lead to another injury quickly. A physiotherapist can identify these limitations and prescribe the proper stretches to recover as much mobility as possible.
Secondly, following the recovery from an acute (within 6 weeks of injury) ankle sprain there might not be any residual pain, but often there is a lingering weakness. Because the ankle feels free of pain the athlete is compelled to return to their sport, neglecting the strength deficits that are present. Depending on the sport, this might manifest as decreased endurance, overall strength, or explosive power such as in jumping sports. This can be remedied by regularly performing the appropriate exercises specific to your sport, exercises which can be determined by a physiotherapist.
A hidden impairment that an athlete may not notice after an ankle injury is decreased proprioception. This refers to the “position sense” of your joints and ligaments, similar in a way to other senses such as vision and smell. There are sensors embedded in these tissues that give the body feedback about where it is in physical space, and we rely on this sense to maintain good balance and stability during weight-bearing activity. After an ankle sprain, we often lose some of this sense, but it can be readily retrained much like muscle strength can. Specific balance exercises can be done to regain this sense, with progressions to sport-specific activity.
Building on that last point, before returning to your activity is considered, an athlete should be able to perform the necessary tasks involved in the activity. For example, a soccer player should be able to sprint, change directions quickly, kick, and dribble a ball. Often the speed at which these activities can be done following an ankle injury is much less than in normal conditions. Agility exercises and plyometrics, which are a type of exercise involving explosive movements such as jumps and sprints, are essential here. Regaining these skills is crucial to minimize the risk of long-term ankle injury recurrences.
To summarize, if you have had trouble with repetitive ankle injuries, you should consider seeing a physiotherapist who will assess to see if any impairments discussed above are present and design the optimal program for you to address them. Frequently the solution to the problem is relatively simple; it just takes some diligence to stick with the program to see results. Instead of worrying about your ankle every time you return to activity, wouldn’t it be nice to pivot, jump, sprint or whatever you do with confidence? You can make that a reality following an individualized physiotherapy regimen to help with your recovery, so you can get you back in the game as quickly and safely as possible.
If you’ve ever had joint pain, this situation may be familiar to you: every family member, friend, and coworker has the time-honoured “magic solution” to get you better. Whether it’s heat, medication, meditation, or dousing yourself in honey, everyone has a suggestion. One you may have heard about is doing “McKenzie exercises” to recover. What are these exercises? Are they effective? How does it work?
Also known as Mechanical Diagnosis & Therapy (MDT), the McKenzie Method is a comprehensive assessment system for orthopedic conditions such as back pain or shoulder pain, and is more than just a series of exercises. It allows the assessor to reliably classify you into different subgroups so that the right treatment can be applied. Practitioners need to understand you and your condition before they can hope to begin any treatment. It’s just like taking your car into the mechanic when something is malfunctioning – a good mechanic will take the time to ask you what the problem is (what are the symptoms?), and then will run tests to determine the source of the problem (does it hurt if you move that way?). You can’t expect the repairs to be made immediately – careful diagnosis is required first.
The McKenzie Method system was developed by New Zealand physiotherapist Robin McKenzie in the 1950s and 60s. One day he had a patient with back pain radiating down to his foot come in and he told him to go lie down on an unoccupied bed. Little did Robin know, the top half of the bed was at an angle, so the patient laid face-down on the bed with his back in maximum extension (like the cobra position in yoga). At the time the conventional wisdom was this was a terrible position for back pain. However, when Robin asked the patient how he was doing, he remarked that the leg pain had disappeared. This was so contrary to all his teachings that it inspired him to begin experimenting with different postures and movements and making careful observations with his patients. Patterns began to emerge, and he realized that these patterns could apply to all joints of the body.
Today the McKenzie Method is practiced globally by rehabilitation professionals of many backgrounds. Since its humble beginnings in New Zealand, it has been supported by numerous scientific publications around the world. Despite this, it is not a universally adopted system. Because the emphasis is first on understanding the problem at its root, which may take several sessions to achieve, it is at odds with the “treatment first” approach. Too often in rehabilitation the approach is to treat the symptoms with modalities such as heat or electrical stimulation, as opposed to getting an understanding of the cause. Fortunately, when the cause is identified using MDT, treatment can be very effective.
The majority of musculoskeletal problems are mechanical in nature – they are affected by movement. Mechanical problems require mechanical solutions, and often it is simply a matter of finding the right direction and force to move into. For example, a person with knee pain might respond to repeated knee straightening movements and have less pain and improved squatting mechanics as a result. If the right movement is applied regularly and aggravating factors are avoided, then rapid improvement is seen, often in a matter of days. Most people can treat themselves once they know what to do – patient independence is one of the central philosophies of MDT. This saves time and eliminates the need for long courses of treatment with many visits. Additionally, you will be shown how to prevent future episodes from occurring, and how to self-treat if the pain does happen to return.
So, the next time that shoulder starts to ache or your knee starts to lock up, instead of using the old family remedies, try looking up a certified McKenzie practitioner. The solution to your problem may be simpler than you think. York Rehab’s Newmarket Physiotherapy clinic has the most therapists certified in McKenzie treatment in Ontario.
Yoga can be intimidating because there’s a misguided notion that you need an advanced level of strength and flexibility. And although possessing an advanced level of each will make a yoga session easier, a great workout is always achieved because yoga pushes your own limits no matter what your capability. Our Newmarket physiotherapy clinic has a Fitness Studio where we’ve been hosting yoga classes for several years. We think yoga is wonderful for your health, wellness, recovery and spirit. Yoga really is magical. From time to time we host a Chair Yoga session in order to encourage people to come out and experience Yoga – we feel if you try it once, you’ll be hooked.
So why the chair? Here are some benefits of Chair Yoga:
Balance & Support. We want to reduce the intimidation factor in order to get someone to come and experience yoga first hand. The chair adds an element to a person’s confidence knowing that it can be used as a prop to aid with balance and support. Poses that require a one-legged stance are much easier when you have something to hold on to and it allows you to develop competency in the particular position until you are comfortable enough to let go.
Building Strength & Stamina. Many are fooled into thinking that yoga is easy, it’s just a bunch of easy poses while you are sitting or lying down. And while sitting and lying are definitely part of the practice, the deliberate and controlled movement that is required from each pose will often engage muscles not normally used making yoga a great workout. This results in developing greater strength, stamina, flexibility, and balance. And this happens regardless of how good you are at yoga – as long as you challenge YOUR limits you will experience results.
A chair to assist with something like a “spine twist” or a “warrior pose” can safely get you into slightly more challenging poses sooner allowing you to reap the rewards quicker.
Get into Activity Sooner. When recovering from an injury, especially if the injured area is in your lower body, mobility (and confidence) may be limited. A chair provides the support that allows you to begin introducing exercise/activity back into your life. The opportunity to sit while engaging in activity can reduce any discomfort you might feel while standing if you are recovering from an injury.
If you’d like to know when the Fitness Studio at our Newmarket physiotherapy clinic will hold its next chair yoga session give us a call – 289.796.1155.