Tag Archives: physiotherapy clinic mississauga

Let’s Play Ball!!

With the success of the Blue Jays making it to the playoffs last summer, baseball and softball clubs around the country are reporting a 20-25% increase in player registration this summer. With this increase in new players comes the need for education for parents, coaches and athletes on injury prevention and safety guidelines, in regards to throwing and pitching injuries commonly seen in baseball players. Statistics report that 25-40% of baseball players will experience shoulder pain during a single baseball season. What can you do to ensure that you don’t get stuck in the dugout resting an injury?

Why do throwing injuries occur?

  • Poor throwing biomechanics;
  • Overuse: Playing on multiple baseball teams/playing year-round/lack of rest between pitching;
  • Pitching with arm fatigue and soreness;
  • Lack of proper conditioning;
  • Lack of proper warm up

Common throwing Injuries:

A wide range of shoulder injuries can occur from throwing, but the most common include:

  1. Biceps/Rotator cuff muscle tendonopathy, tears and impingement:

Direct trauma can occur to the biceps or any of the rotator cuff muscles during the throwing action. However, the majority of throwing injuries result from overuse and repetitive strain on the soft tissue surrounding the shoulder. Regardless of whether the injury occurred suddenly or over time, there is usually a muscular imbalance in terms of strength and flexibility, which predisposes the shoulder to injury with repetitive throwing motions.

Athletes can prevent these injuries with a proper strengthening and flexibility program in order to restore adequate muscle balance. In addition, being taught proper throwing technique and ensuring adequate recovery between games and practices are key to preventing these injuries. If your league doesn’t have pitching guidelines, check out the guidelines outlined here.

  1. Labrum

The labrum helps improve stability and shock absorption in the shoulder. It can be injured as a result of direct trauma or due to repetitive strain, as seen with pitching and throwing. Research has shown that baseball players who have a decrease in the amount of shoulder internal rotation, as a result of tightness in the posterior shoulder capsule, are 25% more likely to develop a labral tear. A physiotherapist can help assess whether an athlete has an imbalance in the shoulder and provide exercises in order to help stretch what is tight and strengthen what is weak.

  1. Shoulder instability

Shoulder instability generally results from a history of repetitive microtrauma to the shoulder. As a result, the structures around the shoulder joint become loose and if the muscles are not providing enough stability, then the head of the humerus (shoulder joint) will shift out of its socket. If the head of the humerus does not stay centered during the throwing action than abnormal strain is put on structures that eventually lead to injury. A large focus of the rehabilitation is strengthening the shoulder and scapular stabilizers.

How can physiotherapy help if I am not currently injured?

The therapists at Sheddon Physiotherapy and Sports Medicine can help identify baseball players at risk for developing injuries, based on muscle imbalances, lack of flexibility and improper firing patterns. Studies have shown that muscular imbalances in the rotator cuff muscles are related to throwing injuries, and that a conditioning program isolating specific muscles can significantly reduce the amount of shoulder injuries experienced during the season. However, 50% of the force required for throwing comes from the rest of the body (not the arm). Therefore, isolating only shoulder muscles during a conditioning program is only half of the puzzle. A proper conditioning program also needs to address core strength, lower body strength and the integration of full body exercises to develop power. All athletes are given an individualized conditioning program in order to address their specific weaknesses to prevent injury.

Take home message:

  • Baseball players, coaches and parents need to be educated on proper throwing techniques and safe pitching guidelines
  • Identifying high-risk baseball players before the onset of injury is important for prevention.

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concussion types treatment Sheddon Physioyherapy Sports Clinic Oakville Mississauga

Bring your Golf Game to the Next Level

concussion types treatment Sheddon Physioyherapy Sports Clinic Oakville Mississauga

Would you like to improve your golf performance?

Are you constantly getting injured during the golf season?

Would you like to prevent golf injuries this summer?

If you answered “Yes!” to any of these questions, then keep reading. Sheddon Physiotherapy and Sports Clinics physiotherapist, Robin Valadares, recently attended a golf specific rehabilitation program taught by the Titleist Performance Institute (TPI). Robin is an avid golfer, and his love for the sport made him want to learn how to help golfers get stronger and play their best golf. TPI is the world’s leader in golf fitness, development and performance, with most of the top golfers in the world being advised/treated by TPI certified experts. During Robin’s certification program he learned TPI’s 16-step physical screening approach, which assesses how the body moves. These 16 tests analyze different movement patterns and how they can affect a player’s golf swing and potentially lead to injuries. Once specific limitations and faulty movement patterns are identified, the athlete can work towards enhancing or eliminating that physical limitation in order to maximize their game and prevent injury.

During your initial assessment, a detailed history of current and previous injuries will be addressed, as well as your golf performance goals. A physical assessment will also be completed in order to identify any areas of weakness or potential limitations. From this assessment, a plan will be put in place addressing any areas needing improvement, which is usually achieved through physiotherapy and golf specific exercises that will be taught to you.

As a physiotherapist, I look for areas where the body may be at risk of injury as well as working with players to overcome injury. We are part of the team, with the fitness coach/professional and most importantly the golf professional. I will NOT teach swing mechanics, but I will help foster a more apt body for those mechanics.” Robin Valadares

Don’t wait until injury prevents you from a swinging a club. Get assessed while the season is just starting in order to find out how to prevent injuries, get stronger and bring your golf game to the next level. Robin Valadares, Jason Kobrick and Erin Shapcott have all completed golf specific rehabilitation courses and can help answer any questions you may have.

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Heading in Soccer: Is it Safe for the Brain?

Concussions make up roughly 22% of all soccer related injuries. As such, concussion prevention is a main focus, with efforts being made to help recognize how and why concussions occur, and if aspects of the sport can be changed to decrease the prevalence of head injuries. Lately, attention has been focused on whether or not heading in soccer can lead to concussion directly or if the cumulative effects of sub-concussive impacts, as seen with multiple headers in one game, can result in brain injury.

Research has shown that the majority of concussions in soccer occur as a result of player to player contact or player to ground contact, with roughly 30% of concussions occurring during heading. However, the majority that occurred during heading (60-78%) were not related to ball contact; they were related to contact with another player. Furthermore, studies have looked at the acceleration forces (linear and rotational) required to sustain a concussion, and soccer headers produce a mean acceleration well below the concussion threshold. 

If heading the ball generally doesn’t produce enough force to cause a direct concussion, can the cumulative effects of repetitive heading lead to brain injury? A review of 7 high quality studies, all examining the effects of heading on cognitive functioning immediately following practices or games, found no significant effects between heading and neurocognitive functioning. However, research that has examined long term effects of soccer participation and heading is less understood. Some studies have shown that high level soccer players who have played for a number of years have cognitive deficits related to attention, memory, visual processing and concentration when compared to non-soccer athletes. However, most of these studies examining long term effects of playing soccer and heading on brain injury are not well done. For example, most studies were completed retrospectively and relied on the athletes memory of their heading and concussion history. There was usually no history taken into account for mental health issues, drug abuse, stress, education, pre-soccer baseline testing, or other factors that could have caused the cognitive deficits. As such, current research regarding the long term effects of heading in soccer is inconclusive. 

Take home message:

  • There is no evidence that heading in soccer causes permanent brain injury or neurocognitive dysfunction.
  • There is limited evidence that heading causes concussion.
  • No definitive research exists to show long term effects of heading on cognitive impairment.
  • In order to decrease the prevalence of concussion in soccer, coaches and trainers should focus on teaching safe and proper heading techniques, with a reduction of athlete-to-athlete contact.

Maher et al., Concussion and heading in soccer: A review of the evidence of incidence, mechanisms, biomarkers and neurocognitive outcomes. (2014). Brain Injury; 28(3): 271-285.

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Baseline test concussion Sheddon Physioyherapy Sports Clinic Oakville Mississauga

Baseline Testing: The Key to Effective Concussion Management

Concussion management programs have become a major focus in sports medicine clinics due to the increased public awareness and recognition of concussions. One of the biggest concerns following a concussion is the possibility that an athlete returns to sport before the brain has fully healed and sustains a second concussion, which has the potential to cause irreversible brain damage. Unfortunately, there is no single clinical test that can be done to know when an athlete has fully recovered from a concussion. Furthermore, research has shown that symptom resolution occurs much sooner than brain recovery, which may put athletes at risk for returning to sport too quickly, especially if sport clearance is based solely on symptoms. How are health practitioners, coaches and parents supposed to know when an athlete is ready to return to sport? In order to know when an athlete has fully recovered, the different areas of the brain that could potentially be affected with a concussion must be assessed, including:

  • Balance;
  • Strength;
  • Reaction time;
  • Neurocognitive performance;
  • and visual processing.

These different test results need be compared to pre-injury values in order to know when an athlete has returned to their normal pre-concussion baseline values. As such, the best way to ensure that you return to sport safely following a concussion is to get baseline tested before a concussion even occurs. At Sheddon Physiotherapy and Sports Clinic we offer the most comprehensive concussion baseline testing of any sports medicine clinic in the Mississauga and Oakville area.

Why choose us for baseline testing?

Most clinics will tell you that they provide concussion baseline testing, but that doesn’t mean they do it properly. Traditional baseline programs focus solely on computerized neuropsychological tests, such as the ImPACT test. Although vital for assessing neurocognitive function, research has shown that neuropsychological tests should not be used in isolation, since they only address one aspect of concussion. In order to properly manage concussions a baseline test must be multidimensional, assessing the full spectrum of concussion outcomes (i.e., balance, reaction time, visual processing, physical capacity). All of the therapists at Sheddon Physiotherapy and Sports Clinic have undergone extensive training with the Complete Concussion Management program in order to be educated with the most recent research-proven concussion management strategies.

How often should an athlete undergo baseline testing?

As young athletes mature, their baseline scores can change greatly from one year to the next. Therefore, it is recommended that athletes get a baseline at the beginning of each season. Also, if an athlete sustains a concussion during the season, a new baseline will be done following full recovery from the concussion, in case a second concussion occurs during the year.

We are one of the top private clinics in Canada in volume of concussion baseline testing through Complete Concussion Management. In addition, we have successfully treated hundreds of sports-related concussions and have an extensive network of specialists, including a sports medicine physician, vestibular physiotherapists, chiropractors and athletic therapists. We offer the highest quality of concussion testing and management in the Mississauga and Oakville area. If you are interested in learning more about our baseline testing for individual athletes or teams, please contact us at 905-849-4576

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Predicting the Stormy Weather Through our Pain

We probably all know at least one person who is considered to be a human barometer as they can predict upcoming weather changes due to headaches or achy joints. How and why is pain/stiffness weather sensitive? Is it actually backed by scientific findings, or is it purely psychological?

Unfortunately, the majority of studies have found no significant relationship between different weather conditions and pain. Furthermore, findings were strictly subjective pain ratings without objective medical findings. Does this mean it is purely psychological? It is highly unlikely that so many people are wrong. As you can imagine, it is hard to control for weather in a study, as so many weather variables would have to be taken into consideration, that it makes it very difficult to find relationships between any one specific variable. For example, at least 50% of headache sufferers believe that weather changes trigger their migraines/headaches. However, wind speed, temperature, humidity, barometric pressure and sunlight have all been reported as triggers. In addition, some individuals have headaches triggered by falling barometric pressure, while others report headaches with rising barometric pressure. These individual differences make it hard to see specific correlations with any one weather variable.

Overall, the studies that showed specific relationships between pain and weather generally found that cold and damp weather conditions influenced reports of pain in subjects with arthritis, headache, fibromyalgia, gout, low back pain and chronic pain.

Interestingly, one study that took place over a two-year period, examining the effects of weather on active individuals with osteoarthritis, found no relationship between weather and joint pain or stiffness. The authors concluded that exercising regularly, may have diminished the effects of weather on pain (Wilder et al., 2003).

How does weather affect symptoms?

Some studies have tried to explain the physiological effects that weather has on the body, but there haven’t been any conclusive results.

  • Some studies have shown that low vitamin D (less sunshine and less light) may play a role in increasing arthritis symptoms;
  • Some researchers suggest that mood may play a role. Damp and cold conditons are associated with a more negative mood, which in turn has been associated with higher pain levels. One study found that individuals reported the least number of symptoms on warm sunny days, due to more exercise, better sleep and a more positive mood;
  • Colder temperatures may increase joint stiffness and pain, due to an increase in viscosity of synovial fluid;
  • A decrease in barometric pressure will allow tissue to expand, therefore putting more strain on joints;
  • Increased humidity can cause increased joint swelling/stiffness.

Take home message:

There’s not much you can do to change the weather, studies have looked at different climates around the world, and they have yet to find the ideal location. As such, you need to focus on what you can control to help keep your headaches and achy joints happy.

  • Regular exercise may help prevent flare-ups of pain during poor weather conditions;
  • Add layers over your achy joints in order to keep them warm during cold and damp days;
  • Try to remain positive even if the weather is gloomy.

 

Aikman (1997). The association between arthritis and the weather. International Journal of biometeorology.

Wilder et al., (2003). Osteoarthritis pain and weather. Rheumatology. 955-95