PrimeCare Physiotherapy

A Baker’s cyst is a fluid-filled sac that develops on the back of the knee due to an excess of the synovial fluid that lubricates the interior of the knee. This type of cyst is named after William Morrant Baker, the 19th-century physician who was the first to describe the condition. It is also called a popliteal cyst, referring to the area behind the knee.

Synovial fluid not only lubricates all the body’s joints; it reduces friction there. A tear in the knee’s cartilage or inflammation from arthritis can result in an overproduction of the fluid. The build-up of this excess fluid becomes a Baker’s cyst. It may also be caused by poor leg biomechanics.

A small Baker’s cyst may not produce symptoms, but a larger cyst may be accompanied by pain and swelling and can restrict the degree to which the knee can bend. The symptoms vary, but they can include:

A Baker’s cyst may be located below the skin, so it may not be visible to the eye. In diagnosing it, your physician should employ range of motion testing, palpation and observation of swelling patterns. They should also ask you about your medical history to determine whether you have had any recent knee trauma or suffer from any arthritic conditions. An MRI or ultrasound may be required, especially because the symptoms are similar to those of other knee problems.

Often, a Baker’s cyst will resolve on its own over time, given rest and treatment of symptoms. However, your physician may prescribe a course of anti-inflammatory medication (orally), a cortisone injection, aspiration of the fluid by utilizing a needle, and/or surgical removal.

Physiotherapy can assist you in regaining your mobility and maintaining your fitness so that the cyst doesn’t recur. A registered physiotherapist may use acupuncture or dry needling to aid your healing and will work with you to restore your range of motion and strengthen the quadriceps and hip abductor muscles, areas where weakness often contributes to poor biomechanics.

Initially, if you suspect a Baker’s cyst, you can follow the RICE protocol: rest, ice, compression and elevation. Remember, rest may prompt the cyst to heal on its own. When you ice the cyst, never put the ice directly onto bare skin; wrap it in a towel for protection or use a bag of frozen peas. Ice your cyst for no more than 20 minutes each hour.

You may want to wrap the knee, since compression is known to decrease swelling. Before you consult with your doctor or physiotherapist, you can use an ACE bandage or a pair of thigh-high (NOT knee-high) compression socks.

Once you are certain you have a Baker’s cyst, ongoing compression may help you heal. The best knee wrap for your cyst combines compression, ice and stability. Compression is an excellent method of lessening the swelling and allowing the fluid to reabsorb. Ice is a great way to reduce the pain caused by the cyst and can prevent the need for medication. Stability is important if the cyst was caused by damage to the joint or degenerative changes.

Here are three types of knee wraps that are worth considering:

Remember: while you are suffering from a Baker’s cyst, listen to your physiotherapist’s advice regarding exercise, and IF IT HURTS, DON’T DO IT!

Tendons are the tissue fibres that connect the ends of our muscles to our bones. The Achilles tendon connects the major calf muscles – the gastrocnemius and the soleus – to the back of the heel. It helps us lift our heels off the floor and to push off when we run or jump. The tendon is named for Achilles, the man of ancient Greek legend whose mother held him by the heel to dip him into the River Styx to give him invulnerability – everywhere but the heel, which became his downfall in battle.

Achilles Tendonitis occurs when the tendon becomes swollen and painful and is caused by repetitive or intense strain. It is considered an overuse injury. Runners suddenly increase their workloads are subject to it, as are people who participate in sports only on weekends. Runners may also experience Achilles Tendonitis when they run too fast; tackle too many hills or those that are too steep; pronate as their feet strike the ground; or don’t take appropriate breaks between runs.

There are two types of Achilles Tendonitis: reactive and degenerative. Reactive Achilles Tendonitis is usually a response to a sudden increase in training load. A sufferer usually feels pain when beginning a run, but it will ease off as the run progresses, only to reappear afterward. On a scale of intensity, with 10 the worst pain, pain from this type of Achilles Tendonitis is usually a 3/10.

Degenerative Achilles Tendonitis or late disrepair is usually the result of ongoing overtraining and is generally seen in older runners. It results in changes to the tendon’s tissue – you may notice it thickening — and its ability to tolerate load. Without treatment, the tendon may be subject to rupture.

Be aware that the reactive type of Achilles Tendonitis may progress over time to degenerative tendonitis.

As long as your Achilles Tendonitis remains in the reactive stage with pain that is a manageable 3 out of 10 and the symptoms subside a day after running, it is okay to continue your training, adapting based on the pain. However, if the pain becomes more severe and takes longer to subside, heed these warning signs. They are signals that your Achilles Tendonitis is moving from reactive to degenerative. Take a two week break from running and consult a licensed physiotherapist. It is probably time to focus on rehabilitation of your tendon, rather than on accumulating miles.

Once your physiotherapist tells you that you are ready to return to running, you’ll need to do so gradually. Overloading your tendon is what landed you in this situation in the first place, so increase your workload bit by bit.

If you do have reactive Achilles Tendonitis, you can generally keep running by adjusting your training plan. Rather than running daily or five times a week, alternate your running days with low-impact cross training – exercises such as cycling, swimming or rowing. These exercises will keep you fit without putting pressure on your tendon.

When running with Achilles Tendonitis, be sure to start your workout sessions with at least 10 minutes of dynamic stretching to prepare warm up your tendon. Start by walking slowly and progressively increase the pace. You’ll help prevent pain once you begin to run.

As you plan your workouts, be conscious of the load your tendon is bearing and add to it gradually. Hill workouts and speed sessions may be detrimental if you aren’t careful, so reduce them or consider eliminating them until you heal.

As mentioned earlier, cross training is an ideal way to keep in shape and prepare your body for running. In addition to cycling, swimming or rowing, there are options such as Aquafit and exercises that strengthen your tendons, such as heel raises and plyometrics. Exercises for your hip muscles are also beneficial.

Finally, consider switching shoes. If your shoes have a heel stack of less than 10 millimetres, get a new pair (see below). If a new pair isn’t affordable, consider heel lifts to remove some of the pressure on your tendon.

If you are suffering from Achilles Tendonitis, wearing the correct running shoe can help you manage it by reducing pain, increasing your capacity for running and assisting in overall rehabilitation. When shopping for shoes, select one with a deep heel cup, a rigid midsole and a stack drop of 10 millimetres (mm) or more. The deep heel cup helps to control your subtalar joint; when combined with a rigid midsole, it helps control pronation and relieve your tendon pain.

The heel stack refers to the running shoe’s difference in height between the back and front of the shoe. Research indicates that a raised heel helps relieve Achilles Tendonitis pain.

If you have any concerns or are seeking a more individualized workout plan, don’t hesitate to turn to your physiotherapist for guidance. It’s their job to help keep you moving – safely!

If you are feeling pain at the back of your neck between your shoulder blades and your spine, you may be experiencing rhomboid muscle pain. Before we delve into the pain itself, let’s identify the rhomboid muscles.

Your rhomboid muscles – both major and minor – are located in your upper back where they connect your shoulder blades to your spine. They are part of a group of muscles that form the shoulder girdle which holds your shoulder and shoulder blade stable. Thanks to your rhomboid muscles, you are able to lift and rotate your shoulder blades and pull them back. Rhomboid muscles also help you throw and pull, lift your arm overhead and rotate your torso.

Rhomboid pain is generally not serious and can be treated easily with physiotherapy. It may be caused by postures that round your shoulders forward, such as hours spent sitting in front of a computer, or by poor posture. This tires the muscles and they become tight, forming a rhomboid muscle knot in the back. In addition, you may feel rhomboid pain from sleeping on your side, rowing, pushups, throwing motions, pulling motions, working out with weights and injury.

You may feel rhomboid pain after carrying heavy bags or backpacks. In addition, if you have problems with your shoulder joints due to arthritis or myositis, it may affect the surrounding muscles.

You generally feel rhomboid pain under the neck between the spine and shoulder blades. It may be referred to as shoulder blade pain. You may also feel it at the backs of the shoulders or in the mid-upper back. Additional symptoms can include:

If you are feeling rhomboid pain, begin by treating it as you would any other muscle injury – with RICE, or rest, ice, elevation and compression. Avoid activities that use these muscles; ice the area several times a day for 15 to 20 minutes; wrap the area with a compression bandage; and when lying down or sleeping, keep your chest and shoulders elevated with pillows. You can also use topical pain relievers, such as Voltaren, or essential oils to reduce pain.

After a few days of icing the area, you can apply heat with a warm compress or a heating pad for 15 to 20 minutes at a time; you may wish to alternate heat and ice.

If you’ve taken these steps and haven’t found relief, it’s time to see a physiotherapist. They can recommend a course of exercise that will help the injured area heal. These exercises may include stretching your chest to reduce the strain being placed on the muscles and those that strengthen your upper back.

You can also try a self massage: Take a tennis ball and place it between your upper back and the wall. Lean into it until you find the sore spot; then, gently make small circles with the ball. You can also lie on the floor and roll your shoulders over a foam roller to loosen and massage the muscles. Your physiotherapist will suggest other exercises targeted to your injury, depending on its severity.

It will take a bit of time to recover from rhomboid muscle pain, depending on how severely you have strained the muscles. Mild strains generally heal within three weeks, while more severe strains may take several months to heal.

Once your rhomboid pain is going, going, gone, keep it at bay by using a number of preventive measures:

Once you’re back to your old self, you can also consider working with your physiotherapist on an exercise program to ensure that you avoid imbalances in your body.

If you are diagnosed with a soleus muscle strain (a tear), you may wonder, “What is the soleus muscle?” You’re not alone. The soleus, one of the muscles that makes up the calf muscles, is not as well known as its partner, the gastrocnemius muscles that shape our calf. Soleus muscle pain can be felt as deep soreness or tightness when you press on your Achilles tendon, walk on your tiptoes, or pull your toes toward your shin.

The name soleus is derived from solea, the Latin word for sandal, appropriate given the muscle’s placement. The soleus muscle is hidden beneath your two-heads of gastrocnemius muscle in your lower leg. It starts at the tibia and fibula bones and combines with the gastrocnemius at the heel to form the Achilles tendon. It is a broad, flat, powerful muscle that is important to maintaining posture and balance; it prevents you from falling forward at the ankle when you are standing and also helps control pronation, or the tendency of your foot to land on its outer edge, rather than plant itself squarely on the ground.

The soleus works with the gastrocnemius to enable plantar flexion, or the ability to point the toes downward; it is largely in charge of plantar flexion when you stand on your toes. It is also known as the soleal pump because it, with assistance from other muscles, pumps deoxygenated blood back from your legs to your heart.

The soleus muscle comprises mostly slow twitch muscle fibres and it is relatively resistant to fatigue, making it valuable in endurance activities such as distance running and walking. However, it is also occasionally involved in explosive movements, so it comes into play in sports such as basketball and tennis.

The soleus muscle, along with the other calf muscles, bears a heavy load when you run or walk; it supports a load that is between five and seven times your bodyweight. That’s a lot of pressure! If the soleus muscle fibres aren’t strong enough for the task at hand, it can cause muscle fatigue and tightness in the calf area. In fact, the soleus is one of the most common causes of pain in the calf area.

The soleus muscle is also subject to strain (i.e., tearing). This is generally due to a sudden overload to the muscle, such as a sprint or stepping off a curb, or to repetitive overuse. When there is an acute overload, you will feel soleus muscle pain when walking but may still be able to continue with the activity.

This type of strain is most common in sports with sudden acceleration and changes in direction, such as sprinting. It is especially prevalent when someone in a stationary position puts on a sudden burst of speed, as in basketball or football.

When the injury is due to repetitive overuse, the pain will build gradually over time, especially if the muscle is tight. Once it reaches that threshold, the more you continue the activity, the more it hurts. This is an injury common to runners.

When you strain your soleus, you have essentially pulled the muscle beyond the limit of its elasticity, stretching it too far and tearing some of the muscle fibres. The pain may be intense and the area may be tender to the touch, accompanied by bruising and swelling. Walking may be difficult.

You should begin treatment for your soleus as soon as you feel pain. Initially, you should implement the RICE method: Rest, Ice, Compression and Elevation.

Rest is essential to allowing the injury begin to heal. Depending on its severity, the injury will need rest for two to three days up to as much as two to three weeks.

Apply ice to the injured area for 10-to-15-minute periods at a time, three or four times daily. Don’t put ice directly on bare skin; wrap it first. When not applying ice, wrap the area with a compression bandage, although take it off at night. It will help reduce any swelling and provide support so you don’t injure the soleus further. With regard to elevation, this is most important during the first few days after injury, since keeping your calf raised above the level of your heart draws excess fluid away from your calf.

Next, consult with a registered physiotherapist for a complete evaluation of the injury and the most effective treatment regimen. He/she may suggest that you wear heel pads to keep the heel raised and decrease tension on the muscle. They may also suggest crutches or a rigid boot; it will depend on the severity of the injury.

Your physiotherapist will also suggest a course of exercise to strengthen the muscles so they can heal without being overloaded. They may also prescribe resistance exercises to help the muscle fibres align properly and balance exercises, since a soleus tear can leave you a bit unbalanced.

You can strengthen your soleus muscle as a means of preventing injury. The best options are seated single-leg and double-leg calf raises done with knees bent. You point your toes downward while your knees are bent, preferably at a 90-degree angle. (If you don’t bend your knees, the exercise will target the gastrocnemius muscle instead.)

You can also do standing heel raises by bending your knees about 30 degrees, lifting your heels off the floor and lowering them back down without turning the foot outward.

Treat your soleus muscle with care; it is a vital piece of your anatomy, whether you are a runner or simply aim to get from one place to another!

If you’ve been experiencing chronic pain or tight muscles, intramuscular stimulation might offer relief. First, however, you might want to know a bit more about this technique, used by specially trained physiotherapists.

Intramuscular stimulation is actually a made-in-Canada solution to muscle tightness or pain. It was invented in the 1970s by Dr. Chan Gunn, a physician working for the BC Worker’s Compensation Board. Gunn was trained in Western medicine, but he was also adept at acupuncture, an ancient Chinese practice. He drew from both approaches to pain in creating IMS. It is based on the theory that much chronic pain results from the nerves overstimulating the muscles. IMS works to reset these nervous impulses as a way of reducing pain by using acupuncture needles to stimulate the affected muscles.

IMS releases or lengthens affected muscles so that they relax. Your IMS-certified practitioner will assess you to determine which, if any, muscles can be helped by this approach. They then sterilize the affected area and insert very fine needles – the same type of needles used for acupuncture – into a muscle and manipulate the depth and direction to stimulate healing. (The inserted needle targets a compressed nerve root.)

The needle causes the muscle to twitch or cramp in response, triggering a spinal cord reaction; once that occurs, the needle is removed. (If the muscle is functioning normally, it won’t twitch or cramp.) The muscle can then relax and begin to function normally. Dry needling, as it is called, also creates a tiny wound in the muscle that promotes blood flow to the area and stimulates healing by producing a healthy inflammatory response that removes toxins from the area.

Intramuscular Stimulation provides two major types of positive results: increased movement and significant pain reduction. As you progress through your treatment regimen, the tight bands of muscle will loosen and allow for increased joint mobility. In addition, as the muscle loosens, there will be less pressure and compression on your joints, nerves and ligaments, so your pain should subside.

Generally, depending on the duration of the pain, the tight or painful muscle will require a series of IMS treatments before the pain disappears or lessens to a great degree.

IMS is generally considered to be unpleasant, but not painful – especially given the results. Each needle is only inserted for a few seconds, but as the muscle is stimulated into relaxation, there may be a bit of discomfort before the pain dissipates. Pain relief may happen quickly or it may take a few days. In addition, patients generally have increased movement and muscle function as a result. The IMS-trained physiotherapist carefully identifies the points for needle insertion so that the affected muscles can react.

Afterward, you may experience some bruising and soreness in the area. Your physiotherapist may recommend that you avoid vigorous exercise or stress to your body so the treatment can take effect. Drinking a lot of water and applying heat to the area will flush the body and assist in healing.

Acupuncture and IMS both use the same needles and dry needling technique, but they are very different therapies.

Acupuncture is an ancient Chinese medicine technique that focuses on using needles to stimulate the body’s meridians of energy, specifically those related to a certain organ or muscle. A series of needles is inserted around a particular point and may be left there for 10 to 20 minutes to effect change.

IMS, a technique that is only about 50 years old, blends Western medicine with traditional Eastern medicine to impact chronic pain and muscle dysfunction. It is based on Western medicine’s understanding of the human body’s physiology and anatomy.

Acupuncture is relaxing, but IMS can often be intense. However, both strive to help the patient feel better.

While you may think of splints as devices used to immobilize injured body parts, it’s a term that has another connotation in the medical world, one with which many runners are all too familiar. Shin splints is a term used to describe pain in the lower leg; it refers to the inflammation of one of the muscles that runs along the tibia or shin bone, the tibialis posterior. The tibialis posterior runs along the inside rear of the tibia bone. Posterior shin splints are the most common cause of painful shin bones.

Your tibialis posterior muscle controls a portion of the foot’s arch when it is doing weight-bearing exercise. It helps to produce the motion that allows your foot to lift off the ground when you are running or walking, necessary to keeping the foot and ankle stable; this is called supination. The tibialis posterior muscle also helps to apply the brakes to the flattening of the arch when you are in motion.

However, you should talk to a registered physiotherapist or a physician before proceeding with specific treatment options. A physiotherapist will base the treatment on the severity of the injury.

With stage one shin splints, your pain disappears during warm up exercise, so you may be allowed to continue exercising unless the injury worsens. A stage two injury means the pain may reappear at the end of a workout, so your physiotherapist may recommend modified workouts while you are treated.

If shin pain worsens during a workout, this means that it’s time to suspend activity before the tibia suffers stress fractures. This is a stage three injury. If you have pain and discomfort all the time, your injury has progressed to stage four and it’s time to stop all activity. You may need crutches or an air cast to take pressure off the area while it heals.

It’s important to address shin splints even though the recovery isn’t quick; it usually takes at least two months. However, depending on the severity of the injury, you may be able to continue with modified exercise.

As with most injuries, it’s useful to start with the RICE method of treatment: rest, ice, compression and elevation. Apply ice every two to four hours for 20 to 30 minutes. Avoid anti-inflammatory drugs for the first 48 to 72 hours. See your physiotherapist as soon as possible to obtain a diagnosis so that you can begin to rehabilitate your injury. Initially, your physiotherapist may do some supportive taping to help support the injured soft tissue and offer your tibia some stress reduction.

Next, your physiotherapist will work with you to help you regain your full range of motion without pain. This often involves remoulding scar tissue so it doesn’t tear easily in the future by lengthening and orienting it through stretching, massage and targeted exercises. Your physiotherapist will also evaluate your gait to determine what corrections need to be made so that you can prevent a recurrence of your shin splints. You may need to wear corrective orthotics to give your foot some assistance.

Restoring strength to your muscles is also critical, so your physiotherapist will help you create a realistic exercise plan that will restore weakened calf, shin, quadriceps, gluteal and other lower limb muscles to their appropriate strength. Once you’ve reached this point, it’s time to return to your usual activities – but you’ll want to work with your physiotherapist to create a workable re-entry plan.

So, if you’re feeling pain in the area near your tibia, don’t hesitate to have it diagnosed. As they say, shin up – or do I mean chin up?!

The phrase “Pain in the Butt” is a slang reference to someone who is annoying, but it derives from a real medical problem: a pulled or torn muscle in the buttocks that can, indeed, be painful.

One of the major causes of buttocks pain is a strain – a tear to one of the gluteal muscles. This type of injury is often called a pulled butt muscle. A strain happens when the load placed on the muscle exceeds its normal boundaries. It can result when there is too much force or repetitive force during the muscle’s contraction. They are most likely to occur during exercise, especially sports that involve running or jumping.

A strain, or tear, to a gluteal muscle, may result in sudden pain after a fall or an exercise session. Chronic wear and tear can also lead to a strain in the glutes. Your muscles may experience fatigue if you aren’t properly conditioned to handle a specific exercise or motion or a strain may result if you don’t warm up adequately before exercise. In addition, poor technique can lead to gluteus strains.

Your buttocks are medically referred to as your gluteus and each buttock comprises three separate muscles: gluteus maximums, gluteus medius and gluteus minimus – along with fat. These muscles run diagonally from the pelvic rim toward the femur, or thigh bone. They exist in layers with the gluteus minimus being the smallest and deepest; the gluteus medius in the middle and the gluteus maximus the most superficial. The three muscles work together to stabilize the pelvis and allow for hip motion by contracting or shortening.

If the injury results from trauma, you may feel a sharp, sudden pain when it occurs. However, it will be most noticeable when you undertake activities that rely on the use of the affected gluteal muscle. Depending on the severity of the tear, your symptoms may include:

If you experience gluteal pain and can pinpoint the time of an injury, be cautious for the first 48 to 72 hours. Rest is important. You may also want to ice the affected area using a bag of frozen peas or crushed ice wrapped in a damp towel. Apply the ice for 15 to 20 minutes each hour or two.

Until you receive treatment, it is important to proceed cautiously so the injury doesn’t worsen; avoid the temptation to stretch and exercise through the pain. This means avoiding certain motions and activities, such as sitting cross-legged or with your thigh crossed over; sitting in a deep chair; climbing stairs; and, of course, running or cycling.

You will also want to contact a licensed physiotherapist to assess your injury. A physiotherapist will stress and stretch your soft tissues, exploring the muscle strength, lengths, range of motion, flexibility and stability to determine the extent of the strain. They may ask for a diagnostic ultrasound, since this test shows soft tissues and tendons.

Your physiotherapist will start rehabilitation with movements involving the specific muscle before moving on to resisted movements, followed by activities that involve the muscle, such as climbing stairs. Then, you can transition to running and jumping activities. Exercises will focus on strength and range of motion.

It is important to treat a gluteal strain or pulled butt muscle, because if it doesn’t heal properly, it can recur and become a chronic problem. Generally, for a moderate tear, you can expect healing to take place within six to eight weeks. If the strain is a recurring one, it will take longer.

Take heart! With determination and treatment, you will no longer be the butt of jokes about your gluteal strain.

There are multiple reasons why many people don’t get enough sleep at night. One of the main reasons is physical discomfort, which can be due to inadequate neck support or a room temperature that’s too warm or too cold. Often, the cause of lack of sleep due to physical discomfort is shoulder pain.

There are several conditions that can cause shoulder pain during and after sleeping. One common cause is an injury to the rotator cuff. The rotator cuff is a group of muscles and tendons that are attached to the bones of the shoulder joint. These muscles and tendons allow you to move your shoulder while at the same time keeping it stable. An injury to the rotator cuff can be caused by tendonitis, strains, or partial or complete tears.

Tendonitis occurs when muscles in the shoulder are injured or overused, causing inflammation. An inflamed shoulder is painful. The pain can be felt during the day, at night, or both. Tendonitis is caused by keeping the arm in the same position for long periods of time, such as sitting at a computer all day. Another cause is sleeping on your side at night, which can cause your arm to fall asleep. Other causes of tendonitis are sports injuries, poor posture, tears, and aging.

Rotator cuff tears can be caused by a single event or by repeated motion over time that eventually results in a small tear that can grow bigger over time – think of baseball pitchers and their repetitive arm motion. Besides rotator cuff injuries, other conditions that cause shoulder pain are osteoarthritis, bursitis, and shoulder impingement:

In this condition, the cartilage — the material that provides cushioning to the ends of bones — degrades. Degradation of cartilage in the shoulder joint causes shoulder pain over time. Osteoarthritis occurs with age as well as from trauma and injury. Symptoms include a decreased range of motion in the shoulder joint and stiffness and pain with movement. You may also hear clicking or grinding sounds in your shoulder when you move it.

Bursae are fluid-filled sacs that cushion tissues around joints. Shoulder bursitis occurs when the bursae around the shoulder joint become inflamed or irritated. Symptoms include redness and stiffness in the shoulder, local tenderness, and increased pain from movement or pressure.

Shoulder impingement occurs when the tissues that surround the rotator cuff grind or rub against adjacent bones and tissues. This rubbing can eventually lead to bursitis, tendonitis, or bone spurs. This condition is characterized by weakness in the shoulder and pain at the top or outer part of the shoulder.

The duration of your shoulder pain from sleeping depends on your sleeping posture, as well as on your underlying medical conditions. Here are some things you can do to prevent waking up with a sore shoulder:

Applying heat and cold is a natural way to relieve pain in your shoulder after sleep.

• If you have osteoarthritis, apply moist heat to the shoulder joint to ease stiffness and relax muscles.
• For a strained shoulder, first apply ice to reduce inflammation and pain, then apply heat to reduce stiffness.
• If you have tendonitis in your shoulder, apply ice to reduce inflammation and pain.
• If heat and cold don’t relieve your shoulder pain, you can consider taking non-steroidal anti-inflammatory drugs for temporary pain relief, such as acetaminophen, NSAIDs, or Naproxen.

For most people, shoulder pain after sleeping resolves within 48 hours. For some people, however, the pain becomes persistent. If self-help measures don’t work, it’s time to see a physiotherapist.

If your shoulder hurts longer than a few weeks, if you have additional pain or limited movement, and if you regularly wake up at night because of your shoulder pain, it’s time to consult your doctor.

Other signs that indicate a need for medical attention are grinding, snapping, clicking, or popping noises in your shoulder; visible growths or masses in your shoulder; and an inability to perform your regular tasks of daily living.

Usually, the last thing you want to do when you’re in pain is move. It feels much more comfortable to take a painkiller and sit still so the pain seems less. However, sitting still may be the worst thing you can do if you have chronic pain because it causes you to become weaker in the long term. That’s where physiotherapy for pain management comes in.

Physiotherapists specialize in teaching you how to move in ways that are safe, yet functional, so you don’t lose body strength. Physiotherapy is effective for pain due to osteoarthritis, rheumatoid arthritis, fibromyalgia, and neuropathic pain (caused by injured nerves or tissues). Physiotherapy works for pain that affects the knees, neck, head, back, and shoulders. It works for both acute and chronic pain (pain you’ve had for more than 3 months).

Physiotherapists offer a variety of treatments that may include:

Physiotherapists work with patients individually to pinpoint and understand each patient’s pain and what caused it. Before deciding on a treatment plan, a physiotherapist will do a thorough assessment of your pain situation. They will choose a certain therapy or therapies based on the degree and nature of your pain as well as on your physical ability. They will then determine how best to manage your pain.

The advantage of seeing a physiotherapist for pain management is that they are able to spend time with you to ask questions, discuss your pain issues with you, and obtain feedback from you while you do your exercise routine, something that regular doctors may not have time for.

If you do your prescribed exercises three-to-four days each week for 30 minutes a day, your chronic pain will improve because you’ll have:

It’s important to be consistent with your exercise routine. Regular exercise not only helps you to maintain your ability to move and function, it also helps your body to heal itself by increasing endorphins, your body’s natural pain-relieving chemicals.

The more you move, the less pain you’ll have in the long term. This is essential. It is important to understand that, ultimately, you have to do the work if you want to feel better. A physiotherapist can only guide you to a faster and more complete recovery.

With the help of a physiotherapist, you will learn how to exercise safely to accommodate your pain. As a result, you’ll be able to function better on a daily basis.

A physiotherapist is an invaluable member of your healthcare team when it comes to pain management. You may also need a regular physician, in case you need medication to help manage your pain, and a clinical psychologist to help you deal with your pain better on a mental-emotional level.

If you’re in chronic pain, seeing a physiotherapist as a member of your healthcare team will reduce your pain levels and improve your quality of life.

Surgery is not something to take lightly, because it places stress on your entire body: not only on the bones, muscles and soft tissue involved, but also on the heart, the lungs, the circulatory system and other organs.

Problems that may arise following various types of surgery include issues with balance and posture; breathing difficulties; loss of sensation; weakness; reduced lung function; blood clots; and incontinence.

Given the impact, it’s not surprising that your body needs time to recover its strength and stamina, as well as its mobility. In order to give your body the best opportunity to adjust to the demands of surgery and achieve the results you envision, you’ll want to take advantage of post-operative rehab physiotherapy.

A licensed physiotherapist will be able to promote healing, help improve your range of motion in the affected area, prevent the loss of muscle mass and keep scar tissue from forming. Physiotherapy assists you in achieving optimal post-operative physical functioning. In addition, it helps to keep you motivated and reduce the normal post-operative feelings of stress and frustration.

Post-operative physiotherapy is always beneficial, and it is often recommended for surgeries such as:

In fact, research has demonstrated specific benefits of post-operative physiotherapy for a number of procedures:

Your first encounter with post-operative physiotherapy will generally take place in the hospital, where the staff physiotherapists often provide basic rehabilitation at the bedside to:

Once you are discharged, you’ll want to continue your recovery under the care of a licensed physiotherapist. Your licensed physiotherapist will work collaboratively with you to create a rehabilitation program designed to meet your goals and needs. They will conduct a full assessment and take into account the restrictions and timelines specific to the type of surgery you’ve undergone. Post-operative physiotherapy happens in three phases, each with a different focus: early recovery, returning range of motion and restoring function.

The early recovery phase of rehabilitation begins once there is a reduction in post-operative pain and swelling. Initially, they will generally work with you to further alleviate any pain and swelling, suggest gentle exercises to begin restoring muscle function and provide manual therapy to start increasing range of motion.

Once you’re ready, your licensed physiotherapist will move on to help you normalize your body’s range of motion, strength and mechanics. Your program during this phase of physiotherapy will likely include balance and proprioception – the sense of your body’s position in space – exercises, more challenging strengthening exercises, soft tissue treatment for mobility and more aggressive manual therapy that will help restore range of motion.

The final phase of your rehabilitation will focus on restoring independent movement, continuing to build your strength and meeting your personal goals. Each person is different; one may be hoping to be involved in competitive sport, while another may simply want to be able to keep up with energetic young children or grandchildren. Therefore, the exercises during this phase of your program will be targeted toward complex functional goals. Your balance and proprioception exercises will also increase in difficulty and manual therapy will continue to increase your range of motion.

By taking advantage of the services offered by a licensed physiotherapist, you are giving your body the boost it needs to function at its best.