Neck Pain

What is Neck Pain?

Neck pain is medically referred to as Cervical spine dysfunction. Neck Pain is a common aliment especially prevalent in office workers, who works out of home or office using desk and computer as work station. Here countless hours are spent sitting in front of a computer screen or looking down at smart phones. As a result of this lifestyle our neck takes increased loads for prolonged periods and neck pain is common.

Seeking treatment with a trusted Physiotherapist, Chiropractor, or Massage therapist, and/or having an Ergonomic assessment is a smart way to treat the pain or prevent it before it happens.

What are the Causes of Neck pain?

Muscle Strain or Soft Tissue Sprain

In this case the muscles, ligaments of joint capsules have been overloaded and as a result have been injured and damaged. This is best treated with gentle stretches and movements that are specific to your injury presentation. It may also be important to learn what postures/positions caused the strain/sprain so that you prevent this condition from recurring in the future.

“Wry Neck” is an Acutely Stiff or Stuck Joint

This often occurs when you wake up with a painful neck and are unable to turn your head in a certain direction. It is most likely caused by a small piece of tissue that naturally surrounds the joint getting stuck in the joint space. It is best treated with manual and manipulative therapy from a Physiotherapist or Chiropractor as well as in conjunction with Massage therapy.

Degenerative Disc Disease of the Cervical Spine

This term is used to describe arthritis or a disc lesion in the neck. This is the wear and tear that develops over time and is a natural part of aging. Think of it like wrinkles on the inside of our bodies. Sometimes this type of pain can be more stubborn but will resolve with treatment and consistent rehabilitation exercises with a particular focus on good posture.

Neck and Shoulder Pain Caused by a Cervical Radiculopathy

This occurs when there is compression on a nerve exiting at your neck which may refer pain down into the arm and hand. The pain down the arm can be described as shooting, burning, tingling and or numb. You can also experience pain and/or stiffness at the neck. Once the pressure on the nerve root is released the symptoms will be reduced. In most cases Physiotherapy and or Chiropractor in conjunct with Massage therapy will resolve the pain. If your therapist recognizes the pain is severe or not decreasing in a normal timeline they will refer to a Sports Medicine Doctor. Here they may provide you with safe and effective medication management and diagnostic imaging. In more rare cases, surgical management may be needed. Be patient with your treatment and do not rush to surgical intervention if it is not necessary. Remember the timeline for this recovery spans from a few weeks to months.

Cervicogenic Headaches

This type of headache is common in office workers. It is caused by the tightness in the upper area of your neck joints and/or muscles of the head and neck. When tight, these joints and muscles refer pain around the head and can feel like headaches. This condition can be treated effectively with Physiotherapy and Chiropractic. It is important that you change your posture, reduce stress and seek proper treatment

How can Physiotherapy, Chiropractic, and Massage Therapy Help your Neck Pain?

A team of healthcare professionals can personalize your treatments to address your specific injury and help you return to your personal lifestyle goals. Each member of the team has its role. Treatments can include controlling pain with therapeutic modalities, acupuncture, IMS/Dry Needling, and shockwave therapy. Improving range of motion with hands on manual therapy or manipulation and soft tissue release. Maintaining motion by working on regular range of motion exercises for the neck. Increasing strength with a stabilization and strengthening program. Education in regards to lifestyle modifications, posture re-education and ergonomic set up are also important. If your neck pain has not resolved in 1-2 weeks from it’s initial onset it is best to be assessed by a health care professional.

How Long Does it Take to Recover from Neck Pain?

Depending on the cause, severity, duration of the pain and your ability to get the proper treatment, recovery can take a few weeks up to months. It is important to understand what is happening and to seek guidance and treatment from a qualified health practitioner as soon as possible. Remember to be patient and consistent with your exercise program. Your trusted health provider will inform you if your symptoms are not progressing as expected and if you should seek out further investigations or surgical management.

Remember that your trusted physiotherapist and/or chiropractor sees these types of conditions regularly and will be the best person to advise you on the best route of management.

What are the Best Exercises to Help with Neck Pain?

A well-rounded program should consist of core, neck and shoulder stabilization strengthening. It should also include daily range of motion and a stretching regime. These exercises should be individualized to your particular needs and goals.

How to Treat Neck Pain at Home?

  • If you have acute pain in your neck, you may first want to try ice especially immediately after an injury event. If the pain has more of a gradual onset or has been lingering for some time then heat might be the better choice. You may also choose to apply both intermittently depending on how they make your symptoms feels.
  • You should also try to improve the positions and postures that can be aggravating your symptoms. Pay close attention to the positions that make you feel worse such as sitting at your computer, sleeping on your stomach, texting on your phone or using your tablet. Try to adjust these problem causing postures.
  • Try gentle range of motion (ROM) exercises. Turn your head to the left and right. Bring your ear down to your shoulder. Bring your chin to your chest and look up towards the ceiling. Keep these movements within your pain free limits. A qualified physiotherapist will be able to guide you on more individualized and specific exercises that will benefit you.

If your neck continues to have pain or feel stiff an assessment and treatment for Physiotherapy, Chiropractic and/or Massage Therapy is highly encouraged. Contact us today!

Cervicogenic Headache

What are Cervicogenic Headaches?

Cervicogenic HeadachesCervicogenic headaches are headaches that stem from the neck. The pain is perceived in the head but the dysfunction is originating in the neck. Typically, these headaches originate in the upper three vertebrae of the neck (vertebrae are the bones of the spine). Certain movements or sustained postures can cause strain or compression to the joints, muscles, ligaments, discs and/or nerves of the neck. This in turn, can refer pain to the head in the form of a headache.

The reason that upper neck dysfunction refers to the head and face causing headache is because there is a merger of the upper neck spinal nerves (C1, C2, C3) with the trigeminal nerve (which controls the sensation of head, forehead, jaw line, back of eyes and ears). This cross-communication between these nerves is what leads to cervicogenic headache.

What Causes Cervicogenic Headaches?

Cervicogenic headache is caused by any activity or event that puts excessive stress/load on the upper neck. This can occur with one specific event (such as whiplash or blunt trauma) or may build up gradually with sustained poor postures (at the computer or while doing housework for example) .

What are the Signs and Symptoms of Cervicogenic Headache?

The headache itself can feel like a constant dull ache, typically on one side of the head and face but if there is significant injury affecting both sides of the neck, then the headache can occur on both sides. Also, the headache can be accompanied by neck pain or neck stiffness. It usually comes on during the provocative activity or after the activity and even sometimes the next morning following the provocative event.

What Are Some Exercises That Can Help Cervicogenic Headache?

Since posture of the entire spine and specifically the upper neck is a leading contributing factor for developing cervicogenic headache, the goals of exercise will be to improve posture. Keep in mind that an individualized approach to exercise will be more effective in treating cervicogenic headache when compared to a general program. A qualified physiotherapist will be able to assess you and will develop the best exercises for your specific posture and your lifestyle goals.

Here is a list of generalized exercises that may be helpful for this condition. Exercises should not exacerbate symptoms and should be conducted in pain free ranges of motion.

Posture Based Exercises

  • Gentle Chin Tucks while elongating the back of the neck
  • Shoulder Blade Pinching while lengthening and lifting through the spine

Neck Stabilization Exercises

  • Deep Neck Flexor Activation while keeping the spine in neutral
  • Gradually stacking the neck bone by bone into upright alignment (from a flexed position)

Muscle Release/Stretching

  • Myofascial release with two balls at juncture between the head and top of the neck
  • Upper Trapezius stretching
  • Flexion of the neck to stretch all the long muscles on the back of the neck
  • Sternocleidomastoid stretching
  • Scalenes stretching
  • Levator scapulae stretching
  • Pectoralis stretching

Upper Back Stabilization Exercises

  • Lifting spine to neutral from a flexed position over an exercise ball

Functional Exercises

  • Whole body exercises that improve core and postural musculature (such as squats, shoulder press, push up, pull up, deadlift etc)

Physiotherapy for Cervicogenic Headache

It is advisable to visit a trusted physiotherapist at the onset of your symptoms. Your physiotherapist will conduct a thorough assessment and develop an individualized treatment plan. A multi-modal approach to care is the most effective. Your treatment plan may consist of the following strategies and techniques:

  • Hands on Manual Therapies: to mobilize the joints of the neck, upper back, shoulders or other areas of the body that may be contributing to your symptoms
  • Acupuncture: to stimulate the nervous system, release tight bands of muscle and stimulate a physiological response that will activate the bodies’ natural healing process.
  • Shockwave Therapy: to release chronic muscle tightness, tension, tight muscular bends known as knots.
  • IMS / Dry Needling: to release tight bands of muscle and re-set the nerve impulse to the associated muscles
  • Prescriptive Exercise: individualized exercises that will address muscle imbalances and postural dysfunctions.
  • Soft Tissue Release: stretching and manipulation of soft tissues and muscles that may be contributing to your symptoms
  • Posture Re-Education and Activity Modifications: to prevent further aggravation and make you more mindful about your posture.

Can Cervicogenic Headache Be Cured?

Yes, of course! The most efficient route would be to see a physiotherapist who can help develop a personalized program that will target your specific issues. Most simple cases will resolve within 1-2 weeks but more complex cases will take weeks to months for full resolution of symptoms. This will all depend on the cause, severity, duration of the pain, your ability to get the proper treatment and your ability to modify any aggravating activities/demands. The key is to stay consistent with your prescriptive exercises and make any necessary lifestyle changes to prevent this condition from recurring (such as adjusting your work station and limiting phone/tablet browsing for instance).

If your headache or neck continues to have pain or feel stiff an assessment and treatment for Physiotherapy, Chiropractic and/or Massage Therapy is highly encouraged. Contact us today!

What is Whiplash?

Whiplash is an injury resulting from rapid acceleration-deceleration force to the head, neck and or spine. It occurs commonly a result of a car accident, fall or sport injury. A sudden force from any direction causes your very mobile neck attached to a heavy head to move beyond its natural range of motion. This causes overstretching and/or compression of the tissues resulting in micro traumas to the tissue not detectable by X-ray imaging.

What are the Symptoms of Whiplash?

Several symptoms can result depending on the extent of damage and severity of the injury. The most common reported symptoms are:

  • Pain and stiffness of the neck
  • Headache
  • Dizzines
  • Shoulder Pain

Other less common symptoms include numbness and tingling in the arms of hands, visual or auditory disturbances, jaw pain, anxiety, depression and even trouble speaking or swallowing.

Treatment of Whiplash by Physiotherapists, Chiropractors and Massage Therapists

Generally, those who have been in a motor vehicle accident or experienced significant trauma should be taken to the hospital or see their family doctor soon after for medical examination and possible an X-Ray to rule out any serious injury.

Our Physiotherapists, Chiropractors and Massage therapists are highly trained and experienced in the treatment of whiplash. It is well researched that early intervention leads to optimal outcomes. Interventions and treatment strategies can include education, individualized exercises, manual therapy, modalities and acupuncture or dry needling. It is important that you find a reputable clinic that offers these services working together to personalize your program and maximize your recovery.

Best Exercises to Help with Whiplash?

Before starting exercises to help with your whiplash, it is important that you seek an assessment with a Physiotherapist and or Chiropractor to ensure your exercise program and treatment is matched to your level of injury and stage of healing. In the first few days after having whiplash it is important that you pay attention to your symptoms. Try to return to your daily activities early but balance it with rest using pain as your guide. Start with gentle neck range of motion (ROM) exercises in a pain free range.

  • Turn your head left to right
  • Bring your ears to your shoulder
  • Bring your chin towards your chest
  • Look up towards the ceiling in a controlled fashion

Once the ROM exercises are tolerated and have been incorporated for a few days then you may try isometric neck strengthening exercises using pain as your guide. If you are feeling pain during the exercise scale it back.

As your pain settles your exercise program should progress to match with more advanced neck stabilization, strengthening, core training and even Clinical Pilates if recommended by your physiotherapist.

What to Avoid After a Whiplash Injury?

It is well documented that stabilization ie. Use of a neck collar or too much rest early on is detrimental to progress. In severe cases, it may need to occur for 2-3 days but should be supplemented with daily exercises. In most cases AVOID too much rest. Your tissue requires stress of some force to stimulate the natural healing processes. Your will need to listen closely to your body and balance the right amount of rest with activity. In the initial stages avoid quick movements, or large painful motions with your neck.

How Can You Treat Whiplash at Home?

Whiplash is a complex injury and is best treated by professionals. That being said in the first 2-3 days ice and anti-inflammatory medication can be helpful with the balance of rest and movement.

As symptoms improve you can apply heat to the strained muscles and start a gentle exercise program. Exercises should be added gradually and should start from easiest and most basic movements.

  • ROM Exercises
  • Gentle Isometric Exercises
  • Neck Stabilization Exercises
  • Should and Upper Back Strengthening
  • Full Body Functional Movements

If you have not experienced relief in 2 weeks it is best to consult with a medical professional be it a Physiotherapist, Chiropractor and/or massage therapist.

How Long Does it Take to Recover from Whiplash?

Recovery time is dependent on many factors. These include the type of tissue injured and the amount of damage, the ability for you to modify your lifestyle and the type of tasks/sport you want to return to.

Normal soft tissue healing time is 6 to 8 weeks (if the inflammation was managed appropriately early on in the process) and this does not include the time it takes to build up endurance, stability, strength and motor control patterns For this reason, seeking early treatment is highly recommended.

If you think you have whiplash, contact us today and we will get you on the road to recovery.

TMJ Disorders

  • Do you have pain in your jaw?
  • Do you have pain or clicking with chewing?
  • Have you asked your dentist about your jaw pain with little success to date?

What is the Temporomandibular Joint?

The Temporomandibular Joint (TMJ) is the jaw joint found just in front of your ear. When something goes wrong with your TMJ it’s called Temporomandibular Dysfunction (TMD). TMD issues can be caused by:

  • Imbalances of the muscles of your head, neck and jaw
  • Issues within the joint itself called an internal derangement of the joint
  • A combination of 1 and 2

What are the Symptoms of Temporomandibular Joint Dysfunction?

With TMD you can often hear clicking when you open or close your mouth, which can be associated with pain and stiffness as well. Cases of TMD that are caused by muscle imbalances often lead to a tense feeling around your jaw, head or neck. Other symptoms of TMD include:

  • A click with jaw opening
  • A click with jaw closing
  • Pain with opening your mouth wide
  • Pain with clenching your teeth
  • Tension and tightness around your jaw joint, sides of your face or temple area

What can a Chiropractor and/or Physiotherapist do for your Jaw Pain?

Therapy provided by a Chiropractor or Physiotherapist may be helpful for TMD that is caused by muscles, joints or both. Your chiropractor or physiotherapist can perform manual techniques along your upper neck and inside your mouth that release tight muscles. In addition, they can educate you on what is happening, why it’s occurring and what lifestyle modifications that you can make. They will guide you on how to strengthen your jaw and help you determine which activities to avoid for a speedy recovery.

Other treatments techniques employed by your physio or chiro may include acupuncture, dry needling and an individualized exercise program.

What are the Best Exercises to Help with Jaw Pain?

Rocobado’s 6×6

TMJThis series of exercises was designed by Mariano Rocabado, a Chilean Physiotherapist, and international expert on TMJ treatment. There are six exercises, to be performed six times a day and repeated six times each, hence the name 6×6.

To perform:

  • Place the tip of your tongue behind your teeth with your jaw gently closed. Take six breaths. Then using your tongue perform a clucking noise from this positon 6x
  • Place your tongue of the roof of your mouth (ideal tongue position), just behind your front teeth. Then open and close your mouth slowly 6x.
  • Perform the same movement as above but place your fingers underneath your chin to add resistance on opening 6x, repeat with fingers on the front of chin with closing 6x and then applying resistance on both sides 6x without letting your jaw move off midline.
  • Sit up tall, bring your head back over neck (retraction), support your head with your hands and nod your chin slowly up and down in a small range of movement 6x.
  • Tuck your chin down slightly and hold for 6 seconds with good tongue position 6x
  • Sit up straight and squeeze your shoulder blades together 6x.

What Should be Avoided if you have Jaw Pain?

  • Chewing heavy meats, nuts, raw carrots etc.
  • Taking big bites into burgers, apples etc.
  • Do not chew gum or bite your nails
  • Avoid intentionally clicking your jaw or clenching your teeth
  • Limit your speaking if it is an aggravating factor
  • Slouching or poor posture at your desk.

How can you Treat your Jaw Pain at Home?

  • Wear a mouth guard at night if prescribed by a dentist
  • When yawning, support the bottom jaw
  • Keep teeth apart when resting
  • Rest tongue on the roof of the mouth behind the front teeth as much as possible
  • Keep mouth closed to promote nasal breathing
  • Buy a lumbar support roll and have your workstation ergonomics assessed

How Long Does it Take to Recover from Temporomandibular Dysfunction?

If you are experiencing jaw pain and take active steps towards recovery such as modifying your lifestyle, actively performing exercises and seeking professional treatment when necessary, you should have relief in a two-month time frame.

Every injury is slightly different and most often than not there will be contributing factors from lower down in the kinetic chain, ie. Spine or pelvis. Treatment may have to address the full body for a speedy recovery and future prevention.

To book your appointment with one of our highly trained physiotherapist or chiropractor give us call  today. Be sure to mention that you are suffering from TMD so that you may be booked with a practitioner that specializes in TMJ care and support.

Cervical Postural Syndrome

What is Cervical Postural Syndrome?

The cervical spine refers to the top part of the spine or what you would think of as your neck.

Cervical postural syndrome then simply refers to a condition where one adopts poor posture of the neck which often occurs in combination with poor posture of the shoulders, upper back and middle back.

Although poor posture can look different on different people, typically cervical postural syndrome is associated with forward head posture where the head and neck lie in front of the trunk. Forward head posture often goes hand in hand with a protruding chin, rounded shoulders and increased curvature in the upper back.

When you are in an optimal posture the load of your head and the force of upper body movements are evenly dispersed through your spine and the muscles of the head, neck and shoulders. You can only imagine that sustaining positions of poor posture can lead to muscle imbalances and place excessive load on specific soft tissues, joints and bones of the head, neck and upper back. Over time, this can lead to tissue damage and signals of pain to alert the body of this dysfunction.

What are Risk Factors for Postural Syndrome?

Individuals who spend a lot of time in one specific position or posture are at the highest risk of developing cervical postural syndromes. It can become tiring to stay in one position for a long period of time and when our muscles get tired, they adopt other positions that are not always ideal. We tend to fall into positions where the bones and joints are left to bear the forces imposed instead of the muscles. These positions are not ideal and lead to postural syndromes.

Those who are particularly at risk include individuals who spend a great deal of time focussing on something in front of them or below their line of vision such as people that sit in front of a computer, spend hours reading, studying or driving. This also includes individuals who spend hours browsing on their tablets and/or smartphones. In addition, every day activities that require both arms to be working in front of the body, such as cooking, cleaning and gardening to name a few, can also be particularly taxing on our posture.

In sport, the same principals apply. Athletes are at risk of developing postural syndromes if their sport requires them to maintain a position for a prolonged period of time. Cyclists are a specific population that fall in this category.

What Causes Cervical Postural Syndrome?

This question ties into the last. Cervical postural syndrome is caused by poor postures that are sustained for long periods of time. Over time, the body adapts to bad posture. There can be changes in length of some of our muscle groups, activation of some muscles becomes inhibited while other muscle groups can become more dominant ultimately causing muscle imbalances. This can also lead to changes in boney alignment and added strain on structures such as the joint, tendons, discs etc. Our body tissues can only take so much. You may not feel any discomfort at first when you adopt poor postures but eventually, when you have exceeded the tissue capacity for strain, pain will develop.

What are the Symptoms of Postural Syndrome?

Symptoms can vary between individuals. The most common complaint is a dull ache or burning pain in the neck, mid to upper back and/or along the tops of the shoulders. Occasionally, individuals may complain of headaches.

Generally speaking, the symptoms are provoked when individuals are in the faulty posture and tend to improve once they correct their posture or change positions.

Treatment for Postural Syndrome?

Cervical postural syndrome is best managed by improving postural imbalances through an individualized corrective exercise program, manual therapies, ergonomic adjustments, and lifestyle changes. A skilled physiotherapist or chiropractor can work with you to develop an individualized treatment program that will be targeted to your specific needs.

Full recovery can take anywhere from 4 weeks to 3 months. Keep in mind that you will need to make changes in muscle flexibility, strength and endurance which takes time and commitment to a regular exercise program. To speed up your recovery and prevent future re-aggravation, you will need to make adjustments to your posture and modify any activities that provoke your symptoms.

Exercises for Postural Syndrome?

Here is a list of generalized exercises that can help with postural syndrome. Keep in mind that everyone’s muscle imbalances and postural dysfunction is different and there is no one size fits all approach to treat this condition. You can try these exercises as long as they help your symptoms but if you continue to experience pain or discomfort, we recommend visiting a trusted physiotherapist or chiropractor.

  • Gentle chin tucks while elongating the spine
  • Gentle shoulder blade pinching and releasing
  • Pectoralis Stretching
  • Cat and Camel Mobilization of Spine on all 4s
  • Mobilization of Upper Back on Foam Roller
  • Ts, Ws and Ys over a Swiss Ball
  • Snow Angel on the Wall
  • Wall Push Up
  • Wall Slides for Serratus Anterior
  • Bird Dog

Your physiotherapist or chiropractor can advise you on the specifics including sets, reps and duration for holding these exercises based on your symptoms and the stage of healing you are in.

Postural Supports that can Help with Cervical Postural Syndrome?

There are numerous postural supports available on the market and it can be intimidating trying to decide which one will be beneficial for you.

The key to finding a helpful posture support is finding something that will help YOU maintain a neutral spine. A support that works for someone else may not work for you so be wary about taking recommendations from friends and colleagues. It is always best to try the support first hand and see how it affects your posture-whether it improves it or not.

Also, be cautious of over correction. You don’t want a posture support to push you too far past your optimal position because that can also cause strain and discomfort. You also may not have the mobility in your spine to accommodate such a big change and as such will be forced to compensate elsewhere in the body.

Also keep in mind that a posture support doesn’t have to always keep you in perfect posture but it can also serve as a reminder to correct your posture on your own.

Below we have listed a few postural supports that we recommend to our clients. A trusted physiotherapist and/or chiropractor can help you choose the supports that are right for you.

  • Lumbar Roll (D shape)
  • Lumbar Roll (5” round)
  • Posture Medic posture brace
  • Postural taping
  • Fully adjustable Ergonomic Chair

Life is unpredictable and you cannot always rely on these posture supports so be sure to implement a corrective exercise routine so that you can make positive changes to your posture that will be lasting. Contact us if you require any assistance.

Cervical Degenerative Disc Disease

What is Degenerative Disc Disease?

The neck is comprised of vertebrae (spinal bones) and in between each spinal bone is a cushioning disc. Degenerative disc disease (DDD) refers to process of natural wear and tear of these intervertebral discs. DDD is a common condition in the neck that has the potential to lead to neck pain, neck stiffness and radiating arm pain when nerve irritation exists. It is important to note that the existence of DDD does not always result in symptoms. Many individuals who present with DDD on MRI are actually asymptomatic.

General Anatomy of the Disc and the Natural Progression of Change

Each disc has an tough, fibrotic outer portion called the annulus fibrosis and a more gel like, fluid inner portion called the nucleus pulposes. The nucleus pulposes is what contributes to the shock absorbing function of the disc. Before the age of 20, the water content in the disc is very high. After 20 years of age, as a result of the aging process, water content diminishes. As the disc loses water content and “dries out” it becomes susceptible to cracks and tears. The disc does not have a direct blood supply and instead receives it blood supply and nutrients through diffusion from the end plates (found at the attachment of the adjacent vertebra). As such, the healing capacity of the disc is decreased and even when healing does occur, the disc is weaker and is susceptible to damage more easily in the future.

What Causes Degenerative Disc Disease of the Cervical Spine?

Genetics is thought to play a role however, a traumatic neck injury or postural dysfunction has the ability to instigate or speed up the wear and tear process.

Wear and tear will tend to develop more rapidly in areas of the spine that are subject to increased load, pressure and strain.

With age, degeneration of the discs is to be expected. DDD is like wrinkles in our spine.

What Can Be Done for Degenerative Disc Disease in the Neck?

If you experience symptoms relating to DDD then there are many conservative options to management that have proven to be effective.

  • Posture Re-Education-To improve alignment of the spine and decrease strain on the discs.
  • Corrective Exercise-To improve muscle imbalances and posture as well as improving activation of the musculature that stabilizes and supports the spine.
  • Manual and Manipulative Therapies-Hands on therapies to improve mobility of the intervertebral joints and soft tissue surroundings to improve joint and muscle function.
  • Lifestyle Modification and Ergonomic Corrections-To decrease the strain that can be placed on the neck and discs of the neck to prevent injury and aggravation.
  • Shockwave Therapy – to release chronic muscle tightness, tension, tight muscular bends known as knots.
  • Acupuncture and IMS/Dry Needling – To decrease pain, improve nerve and local muscle function, and reduce compression of the joint due to taut bands of muscles.

A qualified physiotherapist or chiropractor can assist you with a conservative management plan that is individualized to your specific needs and targets your goals. If you require further medical management, your physiotherapist or chiropractor will refer you to a specialist who will be able to help you evaluate other treatment options. It’s always best to exhaust all conservative options first as the outcomes are excellent and the majority of people with symptoms of DDD will respond positively.

Can You Cure Degenerative Disc Disease?

DDD occurs as part of the natural aging process. As such, there is nothing abnormal about the process. The process of aging is not a disease and in our opinion, the terminology referring to this condition as a “disease” is an inaccurate representation.

The good news is that conservative management is generally very successful at reducing the symptoms associated with DDD. The symptoms of DDD often flare up when there is undue strain, load or pressure affecting the specific discs or aspect of the neck. These symptoms will typically settle and/or your discs will adapt to accommodate the load within weeks or months so that the symptoms are once again under control. Treatment received from a trusted physiotherapist or chiropractor can help expedite the recovery/adaptation and can give you the required tools to prevent future occurrences.

How Can You Stop Degenerative Disc Disease?

You cannot stop DDD for the same reasons as discussed above. However, you can slow the advancement of DDD if you follow some of the suggestions below:

  • Ensure you have a healthy, well balanced diet
  • Do not smoke
  • Ensure that you are getting enough water in your diet
  • Work on your posture
  • Avoid unnecessary and excessive compressive load through your spine (aggressive weight lifting and/or activities that your musculoskeletal system is not conditioned to)
  • Lead an active lifestyle
  • Get the right treatment if you injure your neck, back or shoulders

Exercises for Degenerative Disc Disease?

A well-rounded program should consist of neck range of motion, neck and shoulder stabilization and strength as well as postural re-education geared at the muscles of the neck, back and shoulders. Ideally, these exercises should be individualized to your particular needs and goals through physiotherapy or chiropractic care.

If you are symptomatic, exercises should be gentle and should stay within your pain free limits. General exercises to choose during this phase include:

  • Gentle chin tucks (while lengthening the spine)
  • Deep neck flexor activation
  • Gentle range of motion (ROM) exercises of the neck, shoulder girdle and thoracic spine
  • Gentle stretching of the neck, upper back and shoulder musculature
  • Scapular stabilization exercises

If you are non-symptomatic and you have mastered some of the basic exercises above then you can move on to more advanced exercises:

  • Progression of neck stabilization and deep neck flexors
  • Progression of scapular stabilization
  • Upper back strengthening
  • Rotator cuff strengthening
  • Full body functional movements that target the core and spinal alignment such as planks, push ups, pull ups, shoulder press etc.

Contact us today if you would like one of our trusted physiotherapists or chiropractors to advise you on sets, reps and holding times for the above exercises. They can also ensure you have correct form and are not compensating due to weakness. Your program will be individualized based on your examination findings and will deliver the best results.

Cervical Stenosis

The spinal canal is a circular opening that transcends the length of the spine and contains the spinal cord and existing nerve roots. The term spinal stenosis refers to the narrowing of this canal and/or the space a nerve root exits the spine. Stenosis can occur along any portion of the spine. Cervical spinal stenosis is a narrowing of spinal canal specifically in the neck region. This narrowing can be caused by physiological changes such as enlargement in the joints or soft tissues such as the disc. Significant narrowing can result in compression of the nerve roots and/or the spinal cord and affect the function of the nervous system. This may cause variety of symptoms including pain and tingling into the upper extremities and/or all four limbs.

What Causes Cervical Stenosis?

Some of the most common causes of cervical stenosis include:

  • Postural or Spinal Dysfunction: repetitive prolonged positions can lead to stiffness in certain areas of the spine. This creates areas in the spine that do not move well and areas that compensate by moving too much. This can contribute to stenosis and eventually lead to arthritis.
  • Arthritis: Everyone experiences some degeneration with age. Arthritic changes in the spine can result in bone spurs (outgrowth of bone), disc bulges, swollen ligaments, and enlarged joints of the spine, which can all cause spinal stenosis.
  • Herniated discs: Leaking of the inner material from the disc can cause compression or irritation of the nerve roots or spinal cord.
  • Trauma: Traumatic injury to the neck can sometimes cause fractures or inflammation severe enough to compress the nerve roots or spinal cord.
  • Tumor: Cancer growths can encroach on the nerves and the spinal cord.

What are the Signs and Symptoms of Cervical Stenosis?

People with a cervical nerve compression may not recognize any symptoms in the early stages. However, overtime, symptoms could become more noticeable and they may include:

  • Neck pain: Neck can be stiff and sore with reduced ranges of motion. Sometimes audible grinding sounds may be evident with neck movement.
  • Nerve pain: Sharp, shooting, burning, and/or numbness and pain down the arm(s) and/or leg(s) may be evident especially with bending the neck down or up.
  • Weakness or numbness: Hand weakness and/or numbness in the arm could get bad enough to affect grip. These symptoms could also be experienced in other parts of the body, such as the both arms or legs.
  • Reduced motor skills: The person might encounter difficulty with fine motor movements such as hand writing, buttoning a shirt, opening a door, turning a key, typing, etc.

Rare but severe cases of cervical stenosis, can compress the spinal cord and more severe symptoms can appear which include:

  • Changes in walking: Legs may feel heavy and slow to react which may cause difficulty with balance and walking
  • Changes in sensation and the control of all 4 limbs
  • Incontinence: May develop difficulty controlling bowel and/or bladder.
  • Paralaysis: May completely lose function and sensation of any body parts below the level of the spinal cord impingement.

If these symptoms are present it is important to seek emergency medical care from a doctor at your nearest hospital emergency room.

How Can my Chiropractor and/or Physiotherapist Help?

The chiropractors and/or physiotherapists are able to catch early signs and symptoms of potential cervical stenosis through detailed history taking and physical examination. If stenosis is suspected, therapists may recommend getting a referral for an X-ray of the neck spine to determine the exact cause of the symptoms. Meanwhile, if the symptoms are minimal the therapists can perform variety of treatment techniques such as acupuncture, electrical modalities, soft tissue release, and exercise rehab to manage the symptoms.

How Long Does it Take to Recover from Cervical Stenosis?

Cervical stenosis recovery time is largely dependent on the severity and the cause of the stenosis. The majority of people experiencing nerve root compression pain (numbness, tingling, weakness, shooting pain) will get better in a month but low-grade symptoms will persist for a few months.

What are Safe Home Exercises I can do for Cervical Stenosis?

Cervical stenosis is a condition that should be properly diagnosed and examined by a professional to determine the exact types of exercises required. The earlier you start with the best rehabilitation exercises for you the faster your recovery and better pain management is achieved.

Some of your rehabilitation exercises may include.

  • Nerve gliding or flossing exercises
  • Deep Neck Flexor strengthening
  • Scapular (shoulder blade) Stabilization Exercises
  • Stretch for Pectoralis muscles
  • Neck stretches including Upper Trapezius & Scalene Stretch

Due to the nature of nerve pain associated with this condition it is important to seek care from your trusted medical professional before starting a rehabilitation program. This is to ensure your program is safe for your individual needs. To book an assessment with our highly trained physiotherapist or chiropractor please  call us Today!


What is a Concussion?

A Concussion, or mild traumatic brain injury is among the most commonly occurring sport, motor vehicle, and recreation injuries. A concussion is caused by a hit to the head or to the body resulting in a reversible disruption of normal brain function.

What are Symptoms of Concussion?

Concussion injuries cause symptoms including headaches, dizziness, nausea, irritability, fatigue, light & noise sensitivity, cognitive challenges including memory, focus, and concentration, and mood changes. Following concussion, people experience a range of functional issues that disrupt their regular lives. Common issues include exercise intolerance, balance problems, intolerance to head/eye movements and visual problems.

Concussion symptoms are treatable and resolve through treatment with an experienced health professional with specialized training in concussion including physiotherapists, chiropractors and physicians.

How Long Does it Take to Recover from a Concussion?

Full recovery often occurs in approximately 4-12 weeks after injury, however many people experience persistent symptoms that require physiotherapy or other interventions to resolve. In fact, these persistent symptoms requiring treatment is called Post-Concussion Syndrome (PCS) and can persist long after the concussion has occurred.

After an initial 24- 48 hours of rest following injury, it is safe and recommended to resume a gradual reintroduction of activities. In fact, long periods of rest may prolong your symptoms and slow your recovery. Active rehabilitation and gradual reintroduction of your activities is important to guide your recovery.

For acute concussion (within 7-30 days of injury): Your physiotherapist will guide you through the return to play protocol that includes 6 stages to help you return to your sport safely and quickly. Athletes will be progressively challenged with balance, motor control, vision and cognitive activities specific to their sport to restore function and build confidence in returning to high performance.

For post-concussion syndrome, treatment will be based on the assessment findings and tailored towards your specific problems.

What is involved in a Physiotherapy-Based Concussion Assessment?

A concussion is often complex and results in physical, emotional and cognitive symptoms. The areas of function most commonly affected include:

  • Visual System, our eyes
  • Vestibular System, our inner ear that impacts balance
  • Autonomic Nervous System, heart rate, blood pressure, breathing etc.
  • Neck and spine, which can be the cause of headaches, dizziness and pain

A comprehensive concussion assessment screens these systems through testing of eye movements, balance, exercise tolerance and a cervical spine exam.

The findings of the assessment will be discussed with you along with the individualized management plan for your goals & lifestyle. Your physiotherapist may also recommend involving other members of the clinic team to discuss reasons for follow up with your doctor.

What are the Best Exercises to Help with Neck Pain?

A well-rounded program should consist of core, neck and shoulder stabilization strengthening. It should also include daily range of motion and a stretching regime. These exercises should be individualized to your particular needs and goals.

What is the Treatment for a Concussion?

Treatment with an experienced Physiotherapist or Chiropractor helps you recover faster from concussion symptoms so that you can return to your sport, work and get back to your pre-injury lifestyle.

Treatment may include the following:

  • Education and management strategies for your symptoms
  • Vision and Balance training
  • Vestibular rehabilitation
  • Guidance on exercise with heart rate parameters to guide exercise intensity for return to activity
  • Cervical spine treatment including manual therapy, strength training and proprioceptive exercises
  • Sport and movement specific coordination and reaction time exercises
  • Return to play management

Treatment goals will be discussed and reviewed often to track the progress you are making towards achieving your goals.

In some cases, it is possible that a comprehensive initial assessment may aggravate symptoms of a concussion. This is normal and typically settles within 24 hours. We recommend that you arrange to have someone with you to ensure your safe transportation home.

Alternatively, starting your initial consult through our virtual care is another great option to get you on the road to recovery if you know the stimulation of travel will aggravate your symptoms.

Contact us today to schedule your concussion treatment session or to receive more information about our concussion treatment services.

What Causes Dizziness?

Your dizziness could be caused by several different factors in combination or isolation. Common causes of dizziness include;

  • The Inner Ear (Vestibular System*)
  • Visual Motion Sensitivity
  • Concussion
  • Upper neck dysfunction such as after a Whiplash injury
  • Low Blood Pressure and your Cardiovascular system
  • Neurological dysfunction
  • Medications
  • Psychogenic (anxiety/depression)
  • And more….

What are the Symptoms of a Vestibular Disorder?

Symptoms of a vestibular disorder include:

  • Dizziness
  • Vertigo (Feeling like the room is spinning)
  • Feeling off balance
  • Keeping your eyes focused when there is lots of motion in your visual field
  • Tinnitus (Ringing in the ear)
  • Nausea
  • Headaches
  • Your eyes can “pulse” when you look in a certain direction

What is the Vestibular System?

The Vestibular System is a sensory information system essential for normal movement and equilibrium. It is made up of three semi-circular canals, located in the inner ear, consisting of fluid and sensors that detect head and body movement. The brain uses this information, and integrates it with vision and body position, to control your balance.

Various conditions can affect the Vestibular System, including aging, infection, concussion or other factors, causing problems with the processing of head and body movement and resulting in functional impairments and associated symptoms, such as dizziness, nausea, blurred vision and the feeling of being off balance.

What is Benign Paroxisimal Positional Vertigo, or BPPV?

BPPV, is a condition of the vestibular system affecting the inner ear and how it detects head movement. It is one of the most common causes of vertigo but often misdiagnosed.

BPPV creates a strong sensation of vertigo (the allusion of movement though none exists) with certain head and body movements that are short lived and sometimes associated with nausea and feeling of being off balance. The great news is that although often highly distressing when it happens, BPPV is treatable and typically resolves with correct diagnosis the appropriate treatment.

Most often BPPV occurs naturally – meaning not due to an injury or specific aggravating factor. Some individuals are more likely to get BPPV including older adults, individuals with migraines, and individuals who have had head injuries.

How Can Physiotherapy Help with Dizziness?

Your physiotherapist will do an assessment to correctly diagnose the cause of your dizziness. They can effectively treat dizziness that is caused by the vestibular system, concussion and upper neck dysfunction. They can also identify other sources and refer back to your doctor for further investigation, helping to direct your care.

If your dizziness is caused by the inner ear, vestibular rehabilitation is an effective way to treat the cause and encourage adaptation and habituation to restore normal function.

Through hands-on treatment, teaching you the proper exercises and educating you on how to modify your lifestyle, your physiotherapist will help you restore your balance, retrain your eye/head and body movement and help you learn to feel safe again when you move.

What is involved in a Dizziness Assessment with a Physiotherapist?

A dizziness assessment with one of our physiotherapists includes the following:

  • Health history and understanding of your symptoms and lifestyle
  • Neurological Scan
  • Biomechanical Neck Assessment
  • Assessment of Vascular system (pulses and blood pressure)
  • Dizziness Special Testing (positional test that may or may not create your dizziness)
  • Balance and Gait Testing

What is Involved with Vestibular Treatment and Rehabilitation?

Your physiotherapist will start with a comprehensive assessment involving a thorough history and physical tests for vertigo, balance, eye/ head control and movement sensitivities. They will also perform a neurological scan and biomechanical assessment of your neck. Based on the assessment findings an individualized treatment program will be recommended for you and may include the following:

  • Education on how the vestibular system works specific to your condition
  • Repositioning Techniques to treat BPPV
  • Eye/Head Stability Exercises to regain clear vision during head movement and decrease dizziness
  • Balance Retraining to improve balance and decrease dizziness or nausea
  • Movement Habituation to decrease symptoms of motion sensitivity and disequilibrium
  • Instruction to general physical activity to build overall strength and fitness

Tips for Success with Vestibular Rehab

Tips for success with vestibular rehabilitation include:

  • What makes you dizzy is actually good for you. When we experience dizziness we often stop moving our head and limiting our movements, however this prolongs and sometimes worsens the problem!
  • The right exercises will make you feel mildly to moderately dizzy, but over time the brain will learn how to process your movement and restore your normal, symptom free, motion.

This is normal and typically settles within 24 hours. We recommend that you arrange to have someone ensure your safe transportation following the session.

Contact us today to schedule your vestibular rehabilitation treatment session or to receive more information about our vestibular treatment services.