Ankle Injuries

 

An ankle sprain is a very common injury that can happen to athletes, non-athletes, children and adults.  A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another, and help stabilize joints, preventing excessive movement. 

Most ankle sprains can be managed conservatively.

Initial conservative management of ankle sprains should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).

The P.R.I.C.E. principle helps decrease pain and swelling and can be used during the rehabilitative process as needed.

Additional treatment options include:

• Electrotherapy
• Ultrasound
• Laser therapy
• Taping
• Bracing
• Soft tissue techniques
• Manual mobilization

Rehabilitative strategies should also include:

• Exercises that incorporate active range of motion
• Stretching and strengthening for the ankle joint and lower extremity
• Proprioceptive/balance training to minimize the risk of ankle instability and re-injury.

An untreated ankle sprain may lead to chronic ankle instability.  This may also result in secondary foot, knee, hip, and back problems because of subtle changes in movement patterns. 

If you are having difficulty with ankle pain, our qualified health professionals can determine the cause of your pain and prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.

Contact us:

519-662-4441

www.nhwc.ca

 

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New Hamburg Wellness Centre - Motor Vehicle Accident (MVA) Rehabilitation

FACTS YOU SHOULD KNOW ABOUT TREATMENT FOR YOUR INJURIES:

·    The New Hamburg Wellness Centre offers emergency access to care for individuals who have sustained injuries in a motor vehicle accident (MVA).  You do not have to see a medical doctor to start receiving treatment for a motor vehicle accident injury at our centre. Our centre is capable of immediately initiating your claim and starting rehabilitation and treatment for your injuries.

·       You have the right to choose where you would like to have your treatments done.  You may wish to choose our facility based on familiarity, location, convenience, hours, and the multi-disciplinary services we offer. 

·     The New Hamburg Wellness Centre is a licensed service provider with the Financial Services Commission of Ontario (FSCO) and is able to provide treatment and bill your auto insurer directly for your treatments.

·  Our centre has the ability to utilize a combination of the following treatment modalities to help you recover quickly and completely:

• Rehabilitative Exercise & Physical Therapy
• Registered Massage Therapy
• Laser Therapy
• Medical Acupuncture
• Chiropractic Care
• Active Release Therapy
• Graston Soft Tissue Therapy
• Electrotherapy

·      MVA injuries are not limited to just Whiplash injuries of the neck.  Any body part can be injured.  Our experience, examination protocol and treatment regime is specifically tailored to treating MVA-related injuries, including headaches, neck pain, mid back pain, low back pain, and soft tissue injuries. Our unique, multi-faceted approach has successfully rehabilitated hundreds of individuals who have sustained MVA-related injuries.

FREQUENTLY ASKED QUESTIONS ABOUT MVA CLAIMS:

Below are some frequently asked questions and answers regarding MVA claims:

1.    Q: Do I need a referral from my insurance company or medical doctor to receive treatment for my MVA injuries?

A: No. Our doctors are primary health care providers and are readily accessed.

2.    Q: My insurance company (or medical doctor) has told me I have to go to a specific facility to get treatment for my injuries, but I would prefer to come to this facility (because of familiarity, location, convenience, hours, multi-disciplinary services). Can I choose where I can go to have treatment for my injuries?

A: Yes. You have the right to choose where you would like to have your treatments done. Our centre is capable of immediately initiating your claim and starting rehabilitation and treatment for your injuries. Our experience, examination protocol and treatment regime is specifically tailored to treating MVA-related injuries, including headaches, neck pain, mid back pain, low back pain, and soft tissue injuries. Our unique, multi-faceted approach has successfully rehabilitated hundreds of individuals who have sustained MVA-related injuries.

3.    Q: If I undergo care, will my insurance rates increase?

A: No. Your rates will not increase as a result of an injury claim only.

4.    Q: How much will care cost?

A: Under the present legislation, there is no net out-of-pocket expense for care. This means our centre will look after all billing on approved claims and all treatment services will be covered by the applicable insurance coverage available.

5.  Q: I was involved in an accident, and had little stiffness the next day.  Is it worthwhile to undergo care?

A: Maybe. In a number of instances there is a delayed onset of symptoms that can take weeks to show up after a seemingly innocent fender-bender. A thorough examination will help clarify a need for care or not.

If you have any specific questions that need to be addressed regarding injuries you have sustained in a MVA, please do not hesitate to contact our office.

Rehabilitation Of Ankle Sprains

By Dr. John A. Papa, DC, FCCPOR(C)

An ankle sprain is a very common injury that can happen to athletes, non-athletes, children and adults.  A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  One or more ligaments can be injured at the same time.  Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position.  This may occur while participating in sports and recreational activities, wearing inappropriate shoes, or running, walking or stepping on uneven surfaces.

Inversion ankle sprains constitute 90% of all ankle sprains.  This type of injury occurs when the foot is forced inward (inversion) and produces most of the pain on the outer side of the ankle.  Eversion ankle sprains are less common and occur when the foot is forced outward (eversion), causing the most pain on the inner side of the ankle.  A high ankle sprain is a unique and separate injury in which the ligaments around and above the ankle joint are injured.  This is known as a syndesmotic sprain.

Pain and swelling are the most common symptoms of an ankle sprain.  There may be bruising over the area of injury which may spread down into the foot towards the toes several days following the injury.  Individuals may also experience difficulty walking or weight bearing on their injured ankle.  Most ankle sprains can be managed conservatively.  However, obvious evidence or suspicion of a broken bone, fracture or joint dislocation necessitates the need for emergency medical care.

Initial conservative management of ankle sprains should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).  The P.R.I.C.E. principle helps decrease pain and swelling and can be used during the rehabilitative process as needed.  Additional treatment options include electrotherapy, ultrasound, laser therapy, taping, bracing, soft tissue techniques, and manual mobilization to assist in returning to full functioning.  Rehabilitative strategies should also include exercises that incorporate active range of motion, stretching and strengthening for the ankle joint and lower extremity, along with proprioceptive/balance training to minimize the risk of ankle instability and re-injury.

Assuming that proper rehabilitative strategies are employed, successful recovery from an ankle sprain injury will depend upon the severity of ligament damage.  Mild injuries usually heal completely without any residual consequence in 1 to 4 weeks.  Moderate injuries usually require 4 to 12 weeks to heal.  Severe injuries will take longer to heal.  In some circumstances, surgery may be required for severe ankle sprains.

An untreated ankle sprain may lead to chronic ankle instability.  This may also result in secondary foot, knee, hip, and back problems because of subtle changes in movement patterns.  If you are having difficulty with ankle pain, a qualified health professional can determine the cause of your pain and prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Understanding Bursitis

By Dr. John A. Papa, DC, FCCPOR(C)

A bursa is a thin, slippery sac found around a joint that releases lubrication called synovial fluid.  Its primary function is to provide cushioning between bone and surrounding soft tissue, such as skin, muscles, ligaments and tendons.  Under normal circumstances, the bursa provides a smooth surface that allows for minimal friction with movement between these structures.

 

The term "bursitis" refers to any inflammation or irritation of the bursa.  When this occurs, the bursa loses its gliding capabilities, and becomes thickened and swollen.  As a result, the added size of the swollen bursa causes more friction within an already confined space, and the smooth gliding bursa becomes gritty and rough.

 

There are approximately 160 bursae in the body.  Fortunately, only a handful of them usually develop bursitis. The most common areas to get bursitis include the shoulder, elbow, hip and knee regions.  Less frequently, bursitis may also occur in the wrist, buttocks, heel and big toe.  Symptoms of bursitis include swelling, pain, and tenderness in the affected region.  This may also be accompanied by reduced range of motion and strength which can lead to a significant decrease in physical functioning.

 

There are several factors that can contribute to the development of bursitis.  Activities that result in repetitive overuse or prolonged and excessive pressure on a body region are a common culprit.  An example of this would be constant overhead lifting using your shoulders or continuous kneeling on a hard surface with your knees.  A bursa can also become injured as a result of a blunt trauma or fall such as slipping on ice and landing on your hip.  Bursitis is more common in adults, especially in those over 40 years of age.  As soft tissues age they become less elastic and durable making them more susceptible to overuse and traumatic injuries.  Other possible causes and risk factors for developing bursitis which may require additional medical management include infection from an opening on the skin surface, rheumatoid arthritis, gout and diabetes.

 

Conservative self-care strategies for reducing the pain of bursitis should initially involve relative rest from any painful activities and ice application.  Altering or eliminating the situations that contributed to the bursitis is also important.  This may include activity modification such as using the correct technique, tools, and/or equipment.  In addition, taking breaks to relax overworked muscles and joints, and performing exercises to strengthen the body can also be effective.

 

Bursitis that does not respond to self-care strategies may require professional treatment.  This can include acupuncture and electrotherapeutic modalities to decrease pain, manual and soft tissue therapy to assist in healing, and specific rehabilitative conditioning training for the affected muscles and joints.

 

If you are having difficulty with a case of bursitis, a qualified health professional can prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Rehabilitation Of Ankle Sprains

By Dr. John A. Papa, DC, FCCPOR(C)

 

An ankle sprain is a very common injury that can happen to athletes, non-athletes, children and adults.  A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  One or more ligaments can be injured at the same time.  Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position.  This may occur while participating in sports and recreational activities, wearing inappropriate shoes, or running, walking or stepping on uneven surfaces.

 

Inversion ankle sprains constitute 90% of all ankle sprains.  This type of injury occurs when the foot is forced inward (inversion) and produces most of the pain on the outer side of the ankle.  Eversion ankle sprains are less common and occur when the foot is forced outward (eversion), causing the most pain on the inner side of the ankle.  A high ankle sprain is a unique and separate injury in which the ligaments around and above the ankle joint are injured.  This is known as a syndesmotic sprain.

 

Pain and swelling are the most common symptoms of an ankle sprain.  There may be bruising over the area of injury which may spread down into the foot towards the toes several days following the injury.  Individuals may also experience difficulty walking or weight bearing on their injured ankle.  Most ankle sprains can be managed conservatively.  However, obvious evidence or suspicion of a broken bone, fracture or joint dislocation necessitates the need for emergency medical care.

 

Initial conservative management of ankle sprains should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).  The P.R.I.C.E. principle helps decrease pain and swelling and can be used during the rehabilitative process as needed.  Additional treatment options include electrotherapy, ultrasound, taping, bracing, soft tissue techniques, and manual mobilization to assist in returning to full functioning.  Rehabilitative strategies should progress to include active range of motion, stretching and strengthening exercises for the ankle joint and lower extremity.  Proprioceptive/balance training is crucial in minimizing the risk of ankle instability and re-injury.

 

Assuming that proper rehabilitative strategies are employed, successful recovery from an ankle sprain injury will depend upon the severity of ligament damage.  Mild injuries usually heal completely without any residual consequence in 1 to 4 weeks.  Moderate injuries usually require 4 to 12 weeks to heal.  Severe injuries will take longer to heal.  In some circumstances, surgery may be required for severe ankle sprains.

 

An untreated ankle sprain may lead to chronic ankle instability.  This may also result in secondary foot, knee, hip, and back problems because of subtle changes in movement patterns.  If you are having difficulty with ankle pain, a qualified health professional can determine the cause of your pain and prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

 

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Rehabilitation Of Ankle Sprains

By Dr. John A. Papa, DC, FCCPOR(C)

An ankle sprain is a very common injury that can happen to athletes, non-athletes, children and adults.  A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  One or more ligaments can be injured at the same time.  Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position.  This may occur while participating in sports and recreational activities, wearing inappropriate shoes, or running, walking or stepping on uneven surfaces.

Inversion ankle sprains constitute 90% of all ankle sprains.  This type of injury occurs when the foot is forced inward (inversion) and produces most of the pain on the outer side of the ankle.  Eversion ankle sprains are less common and occur when the foot is forced outward (eversion), causing the most pain on the inner side of the ankle.  A high ankle sprain is a unique and separate injury in which the ligaments around and above the ankle joint are injured.  This is known as a syndesmotic sprain.

Pain and swelling are the most common symptoms of an ankle sprain.  There may be bruising over the area of injury which may spread down into the foot towards the toes several days following the injury.  Individuals may also experience difficulty walking or weight bearing on their injured ankle.  Most ankle sprains can be managed conservatively.  However, obvious evidence or suspicion of a broken bone, fracture or joint dislocation necessitates the need for emergency medical care.

Initial conservative management of ankle sprains should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).  The P.R.I.C.E. principle helps decrease pain and swelling and can be used during the rehabilitative process as needed.  Additional treatment options include electrotherapy, ultrasound, taping, bracing, soft tissue techniques, and manual mobilization to assist in returning to full functioning.  Rehabilitative strategies should progress to include active range of motion, stretching and strengthening exercises for the ankle joint and lower extremity.  Proprioceptive/balance training is crucial in minimizing the risk of ankle instability and re-injury.

Assuming that proper rehabilitative strategies are employed, successful recovery from an ankle sprain injury will depend upon the severity of ligament damage.  Mild injuries usually heal completely without any residual consequence in 1 to 4 weeks.  Moderate injuries usually require 4 to 12 weeks to heal.  Severe injuries will take longer to heal.  In some circumstances, surgery may be required for severe ankle sprains.

An untreated ankle sprain may lead to chronic ankle instability.  This may also result in secondary foot, knee, hip, and back problems because of subtle changes in movement patterns.  If you are having difficulty with ankle pain, a qualified health professional can determine the cause of your pain and prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Rehabilitation Of Ankle Sprains

By Dr. John A. Papa, DC, FCCPOR(C)

An ankle sprain is a very common injury that can happen to athletes, non-athletes, children and adults.  A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  One or more ligaments can be injured at the same time.  Sprained ankles often result from a fall, a sudden twist, or a blow that forces the ankle joint out of its normal position.  This may occur while participating in sports and recreational activities, wearing inappropriate shoes, or running, walking or stepping on uneven surfaces.

Inversion ankle sprains constitute 90% of all ankle sprains.  This type of injury occurs when the foot is forced inward (inversion) and produces most of the pain on the outer side of the ankle.  Eversion ankle sprains are less common and occur when the foot is forced outward (eversion), causing the most pain on the inner side of the ankle.  A high ankle sprain is a unique and separate injury in which the ligaments around and above the ankle joint are injured.  This is known as a syndesmotic sprain.

Pain and swelling are the most common symptoms of an ankle sprain.  There may be bruising over the area of injury which may spread down into the foot towards the toes several days following the injury.  Individuals may also experience difficulty walking or weight bearing on their injured ankle.  Most ankle sprains can be managed conservatively.  However, obvious evidence or suspicion of a broken bone, fracture or joint dislocation necessitates the need for emergency medical care.

Initial conservative management of ankle sprains should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).  The P.R.I.C.E. principle helps decrease pain and swelling and can be used during the rehabilitative process as needed.  Additional treatment options include electrotherapy, ultrasound, taping, bracing, soft tissue techniques, and manual mobilization to assist in returning to full functioning.  Rehabilitative strategies should progress to include active range of motion, stretching and strengthening exercises for the ankle joint and lower extremity.  Proprioceptive/balance training is crucial in minimizing the risk of ankle instability and re-injury.

Assuming that proper rehabilitative strategies are employed, successful recovery from an ankle sprain injury will depend upon the severity of ligament damage.  Mild injuries usually heal completely without any residual consequence in 1 to 4 weeks.  Moderate injuries usually require 4 to 12 weeks to heal.  Severe injuries will take longer to heal.  In some circumstances, surgery may be required for severe ankle sprains.

An untreated ankle sprain may lead to chronic ankle instability.  This may also result in secondary foot, knee, hip, and back problems because of subtle changes in movement patterns.  If you are having difficulty with ankle pain, a qualified health professional can determine the cause of your pain and prescribe appropriate therapy and rehabilitation strategies specifically for your circumstance.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Classification Of Common Muscle And Joint Injuries

By:  Dr. John A. Papa, DC
 
Physical injury to your muscles and joints can occur with workplace, household, sporting, and recreational activities.  Common mechanisms of injury include slip and fall or collision-impact type accidents, overstretching a body part, twisting awkwardly, or performing repetitive movements or activities.  This can cause pain, stiffness, and swelling in a joint or muscle, leading to injuries such as sprains, strains, and contusions.

A sprain refers to a stretching or tearing of a ligament.  Ligaments are tough bands of fibrous tissue that connect one bone to another.  They help stabilize joints, preventing excessive movement.  One or more ligaments can be injured at the same time.  Common locations for sprains are the ankle, wrist, and knee joints.

A strain refers to a stretching or tearing of a muscle or tendon.  Muscles are responsible for producing force and causing motion, whereas tendons are the tough fibrous extensions of muscle that attach to bone.  A strain injury can occur when the muscle-tendon complex suddenly or powerfully contracts, or when it is overstretched.  This is called an acute strain.  Overuse of certain muscles over time can lead to a chronic repetitive strain.  Strains are commonly referred to as “pulled muscles” or "tendinitis".  The shoulders, forearms, low back, and leg regions are common locations for strains to occur.

Contusions are commonly called “bruises”, and occur when small blood vessels in the skin, muscles, or bones are subjected to trauma.  Sprain, strain, and contusion injuries can exist on their own or in combination with each other.

Initial conservative management and first aid of such injuries should follow the P.R.I.C.E. principle (Protection, Rest, Ice, Compression, Elevation).  This can significantly reduce swelling, tissue damage, inflammation, muscle spasms, pain, and recovery time.  With a mild injury you should experience progressive improvement within 2 to 3 days.  You should gradually begin using the injured area after this time.  Mild injuries usually heal completely without any residual consequence in 1 to 4 weeks. Moderate injuries usually require 4 to 12 weeks to heal and may require basic rehabilitative treatment and exercises.  Severe injuries will take longer to heal.  Healing times may also vary dependent on a persons age, physical condition and general health.

You should seek immediate medical care under the following circumstances:  a popping sound heard during the injury accompanied by a feeling of joint instability or inability to weight bear; obvious evidence or suspicion of a broken bone, fracture or joint dislocation; or injuries at risk for infection.  For less serious injuries, you should contact a licensed health professional who deals in the diagnosis and treatment of muscle and joint pain if symptoms do not subside.  A qualified health professional can determine the cause of your pain and prescribe appropriate therapy, exercises, and rehabilitation strategies specifically for your circumstance.  Join us next month when we take a closer look at muscle and joint first aid utilizing the P.R.I.C.E. principle.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.

Treatment And Prevention Of Whiplash Injuries

By Dr. John A. Papa, DC, FCCPOR(C)

The unique forces generated during a motor vehicle collision (MVC) cause more than 100,000 whiplash cases in Canada each year.  This article will specifically focus on the treatment and prevention of whiplash injuries.

 

The term WAD (Whiplash Associated Disorder) is used to describe a range of injuries that can be attributed to whiplash.  This may include:  neck pain, whole body muscle pain/ache, jaw pain, referred arm pain, shoulder or other joint pain, mid back pain, low back pain, headaches, dizziness, and tinnitus.

WAD Grades 1 and 2 represent the majority of whiplash cases and are amendable to conservative management.  Early treatment and consultation can greatly improve the recovery process and prevent future complications and chronic pain.  Effective treatment strategies may include: pain controlling modalities such as electrotherapy and acupuncture to help facilitate and promote activity and functioning; manual and soft tissue therapy to assist in the healing of injured tissues; education on how to safely re-integrate into activities of daily living; and rehabilitative exercises that may include range of motion, flexibility, strengthening, and balance/coordination training.  An independent home exercise program should also be provided.

The goal of treatment is to get the injured individual back on their feet and up to their normal level of activity.  The majority of people with WAD Grades 1 and 2 experience no significant disruption to their normal activities of daily living.  Some may experience a temporary disruption to their normal activities, but usually improve after a few days or weeks.  Occasionally, symptoms may persist over a longer period of time.  A return to normal activities of daily living may be assisted by active treatment and rehabilitative exercise prescription as described above.

Included below are some tips that may help prevent a MVC and/or whiplash injury (courtesy of the Alberta College and Association of Chiropractors):

1.    Drive defensively.  Always anticipate the actions of other drivers.

 

2.    Wear your seatbelt at all times.

 

3.    Make sure your headrest is positioned properly, that is, the top of the headrest should be no lower than the top of your ear.  If more than one driver uses the car, remind each other to always check the headrest height.

 

4.    Never operate cell phones or other electronic equipment while driving.

 

5.    When road conditions are poor (i.e. icy, wet, dark, or crowded), slow down accordingly.

 

6.    Be sure your car is always in good working order, particularly your brakes, tail lights, headlights, and directional signals.

 

7.    Engage in regular physical activity consisting of cardiovascular, strength, and flexibility training.  This will help keep your body strong and offer some protection in the event your are involved in a MVC.

 

If a whiplash injury is interfering with your activities of daily living, consider chiropractic care.  A chiropractor can prescribe appropriate conservative therapy, rehabilitation and self-management strategies specifically for you.  For more information, visit www.nhwc.ca.

This article is a basic summary for educational purposes only.  It is not intended, and should not be considered, as a replacement for consultation, diagnosis or treatment by a duly licensed health practitioner.