What are orthotics?
Orthotics are custom made inserts that are worn inside your shoe to control abnormal foot function.
Orthotics solve a number of biomechanically related problems, for example, ankle and knee pain, pelvis, hip, spinal pain. This is achieved by preventing misalignment of the foot, which significantly alters the way in which the bones move within their joints.
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How are custom orthotics made?
The process starts with the chiropodist, chiropractor or physiotherapist conducting a Biomechanical Gait analysis on a tablet that records your gait pattern & explaining the results to you. The chiropodist, chiropractor or physiotherapist may also take a 3D cast of your feet in a foam box.
The orthotics are then custom-manufactured in the lab based on your foot impressions & scan.
Once the orthotics are made & delivered to the clinic, the chiropodist, chiropractor or physiotherapist will have you come in for a fitting & explain to you the wear & care of the orthotics.
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Why choose Triangle Physiotherapy for your custom orthotics?
- State of the art technology
- Experienced chiropodists, chiropractors or physiotherapists trained in Biomechanical Assessments & Orthotic Prescription
- Lifetime warranty on the orthotics*
- Assistance with sending your claims in to your insurance.
Pacifying the Pain – All about Patella Tendon Tears
Despite it being named a “Tendon”, the patella tendon is both a ligament and a tendon. It connects to two different bones, the patella and the tibia. The patella tendon works in unison with the quadricepmuscles and quadricep tendons allowing them to straighten the knee. The tear within the patella tendon is either partial or complete and can be a disabling injury:
- Partial tear- More frayed and not complete, (think of a rope that is not completely torn)
- Complete Tear- The tissue is torn into two complete pieces
There are numerous causes that can contribute to the tear of a patella tendon:
- Patellar tendonitis- inflammation of the patellar tendon thus weakening the tendon, causing small tears.
- Chronic disease – Chronic renal failure, rheumatoid arthritis, Diabetes mellitus & metabolic disease, etc.
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Most patients have stated that they had felt a popping or tearing sensation when the patella tendon has torn. Additional symptoms recorded were:
- Indentation at the spot where the patella tendon is located
- Shift of the kneecap to thigh, due to un-attachment
- Difficulty walking due to weakness in the knee
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Once the initial pain and swelling has subsided, physiotherapy treatments can be started. Physiotherapy can restore strength and range of motion. Depending on the intensity of the injury, a brace may need to be worn. While the brace is worn, straight leg exercises are often prescribed to strengthen the quadriceps muscles. As the patellar tendon heals, eventually the brace may be removed, allowing the patient to move freely with a greater range of motion, with more exercises being put into use as healing progresses.
Recovery from patellar tendon tears is possible, and most individuals are able to return to work and regular activities. Even though patients may feel stiffness in the region after recovery, most regain nearly equal motion compared to the uninjured leg. At Triangle Physiotherapy, we are able to dispense custom-fit braces to aid in the recovery of patellar tendon tears. For more information visit our custom braces page at: https://www.trianglephysiotherapy.com/services/custom-bracing
What exactly is shin splints? Are they treatable? Shin splints is a condition characterized by damage and inflammation of the connective tissue joining muscles to the inner shin bone (tibia). Shin splints are known by many different names such as: Medial Tibial Tenoperiostitus, MTSS, Medial Tibial Stress Syndrome, Tenoperiostitus of the Shin, Inflammatory Shin Pain, Traction Periostitis, and Posterior Shin Splint Syndrome.
Several muscles lie at the back of the lower leg, and are collectively known as the calf muscles. The tibialis posteriror, flexor digitorum longus, flexor hallicus and soleus are muscles which lie deep within the calf and attach to the inner border of the tibia. Connective tissues are responsible for attaching these muscles to the tibia known as the tenoperiosteum. Every time the calf contracts, it pulls on the tenoperiosteum. When the tension becomes forced too much or is repeated frequently, damage is caused to the tenoperiosteum. The results are inflammation and pain. Shin splints can also occur in combination with other pathologies that cause shin pain such as compartment syndrome and tibial stress fractures.
Patients who suffer from shin splints experience a pain along the inner border of the shin. In other cases, the patient may experience an ache or stiffness along the inner aspect of the shin that increases with rest (typically and night or first thing in the morning). Areas of muscle tightness, thickening or lumps may also be felt in the same area of pain. There are several factors that predispose patitents to shin splints:
• Excessive training or exercise
• Poor foot posture (especially in patients with flat feet)
• Inappropriate footwear
• Inadequate warm up
• Training on hard or inappropriate surfaces
• Muscle weakness (especially in calve muscles)
• Tightness in specific joints (such as ankle)
• Tightness in specific muscles (calves especially)
• Poor lower limb biomechanics
• Poor training techniques or methods
• Leg length differences
• Poor balance
• Being overweight
• Poor core stability
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Physiotherapy treatment for patitents with shin splints is vital to speed up the healing process. Physiotherapy will ensure the most optimal outcome and reduce the likelihood of recurrence. Treatment may comprise of the following:
• Deep tissue massage
• Joint mobilization
• Dry needling
• PNF stretches
• Arch support taping
• The use of orthotics or shock absorbing insoles
• Biomechanical correction
• Ice or heat treatment
• Exercises to improve flexibility, balance, strength, and core stablility
• Activity modification advice
• Anti-inflammatory advice
• Footwear advice
• Weight loss advice where appropriate
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If you happen to suffer from shin splints and you are looking for a way to relieve pain, stress, and improve over-all health, try adding physical therapy to a routine wellness plan. Our physiotherapists at Triangle Physiotherapy can be a powerful ally when combating daily stress, muscle pain, and general health issues when it comes to shin splints. Not only does physical therapy relieve pain, increase energy levels, and improve overall physical and mental performance, it prevents further injuries. Our experienced, professional physical therapists at Triangle Physiotherapy are available at five convienient locations: Etobicoke, Oakville, Mississauga, Toronto, and Kings West. At Triangle we customize every physical therapy session to address your individual needs.
Patellar tendinopathy (also known as: patellar tendonitis, and tendonitis) is an overuse injury affecting the knee. The patella tendon is a short but very wide tendon that runs from the patella (kneecap) to the top of the tibia. It works with the muscles at the front of the thigh to extend the knee so it can perform physical acts like kicking, running, and jumping. Due to these elements, the patellar tendon has to absorb a lot of this loading and as a result is prone to injury in runners and jumpers. Unlike many running injuries, patellar tendonitis is somewhat more common in men than in women.
The stress on the patellar tendon results in small tears, which the body attempts to repair, but as the injury multiplies, it causes pain from inflammation and weakening of the tendon. When this tendon damage persists for more than a few weeks, it is called, “tendinopathy”.
Initial symptoms of patellar tendonitis can be:
- Anterior knee pain over the patella tendon
- Pain increased from jumping, landing or running activity, and on occasion prolonged sitting
- Onset of pain can be gradual and commonly relates to an increase in sports activities
- Localised tenderness over the patella tendon
- The tendon feeling stiff, mostly first thing in the morning
- The affected tendon may appear thickened in comparison to the unaffected side
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Typically, tendon injuries occur in three areas:
- Musculotendinous junction (where the tendon joins the muscle)
- Mid-tendon (non-insertional tendinopathy)
- Tendon insertion (eg. Into the bone)
If you try to work through your pain, ignoring your body’s warning signs, you could cause increasingly larger tears in the patellar tendon.
Knee pain and reduced function can persist if the problem is not addressed , which can progress to more serious patellar tendinopathy.
Treatment of this condition has two objectives: to reduce inflammation and to allow the tendon to heal. Rest is a must when the knee is painful and swollen. Avoid stair climbing and jumping sports. Keep your knee straight while sitting, and avoid squatting.
Icing the knee for twenty minutes two to three times a day is recommended, especially after any sporting activities. Exercises can also be used to stretch and balance the thigh muscles.
It is advisable however, to contact a physical therapist & approach proper physical therapy before you attempt any of these remedies, to avoid any further damage.
There are many forms of fractures, each causing a dilemma in our lives and requiring the help of a physiotherapist in order to heal safely and properly. One of the most common types of fractures seen in sports medicine today is called a “hairline” or “stress” fracture. Hairline fractures are caused by repetitive strain and excess training. Hairline fractures are minute cracks on the bones, which can become severe if not immediately treated. The main causes of a hairline fractures are:
- Traumatic Incidents
- Repetitive Stress
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Basically, hairline fractures are caused by the depressed response of the bone with the ground reaction forces that are applied to the bones during certain activities such as: running, jumping, or walking. Symptoms may include pain and tenderness to the affected bone. Repetitive stress or a sudden fall or strike to the area can also cause hairline fractures.
The best way to treat a hairline fracture is to refrain from any activities that can aggravate the injury. Recovery time can span from two weeks to a month and a half. Once the bone is healed from its minute cracks, you can gradually resume normal activities. In extreme circumstances, the affected area must be put at rest and must be immobilized by casting or bracing. The stages of healing a fracture through physiotherapy are as follows:
- Muscle Assessment
- Joint Mobilisation
- Massage Therapy
- Heat and Electro Therapy
- Gait Education
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Shoe inserts like supportive orthotics and walking crutches may also be recommended by your physiotherapist. Treatment through physiotherapy is advised through strengthening exercises that are non-weight bearing like swimming. Luckily, hairline fractures rarely need surgery because they can easily be mended with just two weeks of rest. However, the injury can worsen if not given the proper medical attention.
If you happen to suffer from a hairline fracture and you are looking for a way to relieve pain, and recover from an injury, adding physiotherapy to a routine wellness plan can maximize recovery time and optimize your healing process. Our physiotherapists at Triangle Physiotherapy can be a powerful ally when combating daily stress, muscle pain, and general health issues when it comes to hairline fractures. Not only does physicaoherapy relieve pain, increase energy levels, and improve overall physical and mental performance, it prevents further injuries. The experienced, professional physiotherapists at Triangle Physiotherapy are available at five convenient locations: Etobicoke, Oakville, Mississauga, North York and Toronto. At Triangle we customize your physiotherapy sessions to address your individual needs.
Amyotrophic lateral sclerosis (ALS) is the most common type of adult- onset motor neuron disease. Neurological disorders are characterized primarily by progressive degeneration and loss of motor neurons. ALS involves upper and lower motor neurons and presents as an idiopathic , progressive degeneration of anterior horn cells and their associated neurons, resulting in progressive muscle weakness, atrophy, and fasciluations.
ALS is a gradual onset disease. The first initial symptoms of ALS varies person to person. One person may have trouble with their grip, such as holding a cup or pen, while another person may experience change in pitch in their voice while speaking. The rate at which ALS develops also varies person to person, with the mean survival time ranging three to five years. Although there are cases in which people have lived five, and ten or more years. Onset symptoms can begin in the muscles that control speech and swallowing, or in the hands, arms, legs or feet. Not all people who suffer from ALS experience the same symptoms as others or the same sequences or patterns of progression. Although, universally progressive muscle weakness and paralysis is experienced.
ALS is a somewhat difficult disease to diagnose. There is not one test or procedure to instantly establish the diagnosis of ALS. Through the use of clinical examination, and a series of diagnostic tests, often ruling out other diseases that mimic ALS, that a diagnosis can be established. A comprehensive diagnostic check-list includes most, if not all, of all the following procedures:
- Electrodiagnostic tests- Electomyography (EMG) and Nerve conduction velocity (NCV)
- Blood & Urine studies
- Spinal tap
- X-rays including MRI
- Myleogram of cervical spine
- Muscle and/or nerve biopsy
- A thorough neurological examination
These tests are done at the discretion of the physician, usually based on the results of other diagnostic tests and the physical examination. There are several diseases that have some of the same symptoms as ALS, and most of these conditions are treatable.
Treatment of ALS can be done with physiotherapy, focusing on stretching and daily range of motion (ROM) exercises. Our physiotherapists at Triangle will focus on the emphasis of energy conservation and teach patients and caregivers methods for performing safe, efficient transfers. Our therapists at Triangle can also provide instruction for strengthening exercise programs. In one study, individualized, moderate-intensity, endurance-type exercises for the trunk and limbs performed 15 minutes twice daily was shown to significantly reduce spasticity as measured by the Ashworth scale. At Triangle, we may have to recommend wheel chairs to anticipate the patients future needs. Initially, a lightweight wheelchair should be rented, with future plans to purchase a heavier chair when the patient is no longer able to ambulate. Modifications will be recommended on the basis of the patients condition and tolerance for gadgets.
What is Plantar Fasciitis?
Plantar fasciitis is the most common cause of heel pain. Plantar fasciitis is a repetitive strain injury to the plantar surface of the foot. Tiny micro tears can develop in the ligament with repetitive use.
This condition is most common in middle-aged populations however you can develop it at any age. It occurs in people who are on their feet a lot such as athletes and construction workers. You can develop plantar fasciitis in one or both feet.
What is the Plantar Fascia?
The plantar fascia is a flat band of tissue that connects your heel bone (Calcaneus) to the base of the toes (Metatarsophalangeal joints). This ligament assists in supporting the arch of your foot.
Symptoms of Plantar Fasciitis
Most people experience pain during the first few steps after they get out of bed in the morning. It can also cause irritation, inflammation, weakness and swelling to the bottom of the heel and foot. Symptoms may decrease throughout the day with increased activity but it typically worsens after prolonged sitting, standing, walking or at the end of the day.
Factors that predispose you to developing Plantar Fasciitis
There are many factors that can contribute toplantar fasciitis. The most common causes of plantar fasciitis are biomechanical imbalances within the body. This includes tight or weakened muscular structures, leg length discrepancies and excessive flat feet (pronation) or very high arches (supination) of the foot. It often develops with overtraining and repetitive overuse of the foot and ankle. More specifically, plantar fasciitis develops with training or working on unyielding surfaces such as concrete and occupation related footwear such as steel-toed boots.It can also occur with prolonged standing and weight bearing activities such as walking or running. As we age, tissue degeneration occurs weakening the supporting structures of the arch of the foot. In addition, during pregnancy hormonal changes can cause weakening of ligaments such as the plantar fascia. Excessive weight gain also compromises the integrity of this ligament. It can also occur from wearing worn down or unsupportive footwear.
Treatment Options Available for Plantar Fasciitis
If this sounds familiar, contact your physiotherapist to set up an initial assessment. Physiotherapists offer a wide variety of treatment options to help decrease the paina ssociated with plantar fasciitis. Your physiotherapist will create an individualized treatment plan for you consisting of soft tissue techniques, manual therapy joint mobilizations, modalities and a targeted exercise program involving stretching and strengthening the muscles of the foot and ankle. They can also provide you with education regarding proper gait mechanics, running technique, orthotics and splinting options for day and night use.
Written by: Natalie Langstaff, Physiotherapy Resident
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