Tendon Recovery: Why Rest Alone Isn't Enough

December 10, 2025

Tendon pain is one of the most common musculoskeletal issues seen in both active and sedentary populations. Whether it shows up as Achilles pain, tennis elbow, patellar tendon pain, or rotator cuff irritation, these injuries are notoriously slow to resolve. For decades, the standard advice was simple: rest, ice, and avoid anything that aggravates symptoms. While these strategies can be useful early on to calm pain, we now understand that rest alone does not lead to optimal tendon healing. In many cases, it may actually delay recovery.

Tendons connect muscle to bone and are designed to tolerate high levels of load. Unlike muscle, however, they have a relatively limited blood supply, which is one reason they heal more slowly. When a tendon becomes irritated or injured, the collagen fibers that give it strength and structure become disrupted. If the tendon is not appropriately stressed during the healing process, the body may lay down new collagen in a disorganized, weaker pattern. This can result in lingering pain, reduced strength, and a tendon that is poorly prepared for return to activity. This is why so many people experience recurring flare-ups after a period of rest—symptoms may settle, but the underlying tissue has not been properly reconditioned.

Ice and rest still have a place in the very early stages of tendon injury, particularly when pain is intense and movement is significantly limited. However, relying on them as the primary long-term strategy can be problematic. By avoiding load altogether, the tendon is deprived of the very stimulus it needs to rebuild. As a result, stiffness increases, load tolerance decreases, and return to sport or daily activity often leads to reinjury.

Current research now strongly supports progressive mechanical loading as the cornerstone of effective tendon rehabilitation. One of the most valuable early-stage tools is isometric exercise, which involves contracting a muscle without visible joint movement. These types of exercises place controlled stress through the tendon without excessive strain. Research has shown that isometric loading can help stimulate collagen production, encourage proper realignment of tendon fibers, and significantly reduce pain. A commonly used protocol involves 30-second holds, repeated four to five times, performed once or twice per day, depending on the individual, the joint effected and the severity of the condition being treated. This approach allows the tendon to begin adapting safely before advancing to more dynamic movement.

As symptoms improve, tendon loading must also progress. Tendons adapt to the demands placed on them, meaning rehabilitation must gradually expose the tissue to higher loads through slow strengthening exercises and eventually to faster, more powerful movements. This staged approach is what allows the tendon to regain its ability to tolerate real-world forces such as walking, running, jumping, lifting, and sport-specific movements. Skipping these stages or returning to full activity too quickly is one of the most common reasons tendon injuries become chronic.

Nutrition may also play a supportive role in tendon recovery. Emerging research suggests that taking hydrolyzed collagen along with vitamin C prior to tendon-loading exercise may help improve collagen synthesis. Vitamin C is essential for collagen formation, and when paired with targeted loading, this strategy may assist the body in building healthier tendon tissue. While supplementation alone will not heal a tendon, it may be a useful adjunct when combined with a structured rehabilitation program.

It is also important to recognize that not all tendon injuries should be treated the same way. The angle of loading, joint position, and type of exercise must be carefully selected based on the location of the injury. For example, the rehabilitation demands of tennis elbow differ significantly from those of Achilles or patellar tendon pain. What is considered appropriate load for one tendon may be excessive or ineffective for another. This is why individualized physiotherapy assessment and programming are critical for safe and effective recovery.

True tendon rehabilitation is rarely a quick fix. Instead, it follows a progressive process that typically includes early pain management, controlled loading through isometrics, gradual strengthening with slow and heavy resistance, and eventually higher-level energy storage and release activities such as hopping, running, or sport-specific training. Each phase builds on the one before it, ensuring the tendon is prepared for the demands that will be placed on it long term.

The key takeaway is this: tendons need stress to heal. While rest and ice can provide short-term symptom relief, they do not rebuild the strength, structure, and resilience required for lasting recovery. Appropriate exercise is not something to fear in tendon rehab—it is the very tool that drives healing. When guided correctly, progressive loading helps restore function, reduce pain, and prevent future flare-ups.

If you are dealing with persistent tendon pain that keeps returning despite rest, it may be a sign that the tissue has not been properly reconditioned for the demands of your work, sport, or daily life. A structured, individualized tendon-loading program guided by a physiotherapist can make the difference between ongoing frustration and a confident return to movement.

The Myth of Spinal Misalignment

November 12, 2025

Understanding what really happens when your back “goes out.”

For decades, people have been told that their spine can “go out of place,” and that a practitioner can “put it back in” with a manipulation or adjustment. It sounds logical — if something feels stuck or painful, it must have shifted, right?

In reality, our spines are far more stable and resilient than that. The idea of bones “popping out” and needing to be “realigned” doesn’t reflect what’s actually happening inside the body. But that doesn’t mean spinal manipulation isn’t helpful — it can be a safe and effective way to relieve pain and improve movement. The key is understanding how it works.

Where the Misalignment Idea Comes From

It’s common for people to imagine their spine like a stack of blocks — if one slips out, you just need to “put it back.” The crack or pop that follows a manipulation can feel like proof that something’s been corrected.

In truth, that sound is simply gas releasing from the joint as pressure changes — similar to cracking your knuckles. The feeling of relief that follows is real, but it’s not because a bone was moved back into place. It’s because manipulation affects how your nervous system senses and responds to movement and pain.

This misunderstanding has lingered partly because it’s such an easy image to picture and explain. “Your pelvis was out” feels straightforward. But it’s an oversimplification that doesn’t match the body’s anatomy or how pain actually works.

What’s Really Happening in the Body

Manipulation influences the nervous system, not the skeleton. When a joint is moved quickly through a small range, the stretch of the joint capsule changes how sensory receptors fire. This alters how the brain interprets pain and movement — often making things feel looser, lighter, or more mobile afterward.

Your spine itself is incredibly strong. Each vertebra is held in place by ligaments, discs, and deep muscles. If a bone truly “went out,” it would cause severe pain or nerve injury requiring emergency care — not a simple adjustment.

When pain does occur, it’s often due to muscle tension, joint irritation, or a protective response from the nervous system. Muscles may tighten to guard an area, giving the sensation that something is “out,” even though everything is still aligned. Manipulation can help ease this response and restore normal movement — but it isn’t “putting anything back in.”

Why the “Out of Alignment” Story Persists

So why does the misalignment story stick around?
It’s partly tradition, and partly communication. The idea of a spine being “out” is easy to explain and easy to believe. It offers a quick, tidy cause-and-effect: something moved out, and we put it back.

The reality, however, is that pain and stiffness are multifactorial — they involve not just muscles and joints, but stress, sleep, emotions, and how your brain perceives threat or safety. That can be harder to explain, but it’s far more empowering.

Some practitioners continue to use the “realignment” language because it’s familiar, but modern research supports a more accurate understanding: spinal manipulation works by modulating the nervous system and reducing pain sensitivity, not shifting bones.

Understanding the “Crack” and Other Common Questions

That satisfying “pop” during an adjustment — called cavitation — is a harmless pressure change in the joint fluid. It has nothing to do with bones moving or “realigning.” Sometimes it happens, sometimes it doesn’t, and it doesn’t affect whether the treatment was effective.

People often ask, “But what about spondylolisthesis or Ehlers-Danlos Syndrome?”
Yes — certain medical conditions can cause true structural instability. But these cases are rare. For the average person with back or neck pain, the issue is almost always functional, not structural. The spine hasn’t shifted out; it’s simply become sensitive, stiff, or protective — and those are problems that respond well to movement and reassurance.

Moving Away from Fear-Based Explanations

Unfortunately, the “something’s out” story can sometimes create unnecessary fear. When people are told their spine is fragile or that it can “go out” with everyday activity, they may become anxious about movement or overly dependent on being “put back.”

Pain is not always a sign of damage — it’s often your nervous system’s way of asking for attention or rest. When patients understand this, they regain confidence in their body’s ability to move and heal.

Practitioners who teach patients that the body is strong, adaptable, and self-healing empower them to recover faster — and with less fear.

What Manipulation Really Does (and Why It Still Matters)

When performed safely by a trained physiotherapist or chiropractor, spinal manipulation can:

Reduce pain and muscle tension
Improve temporary mobility
Help restore confidence in movement
Support progress when combined with active exercise and education

Manipulation works by changing how the nervous system processes pain and movement, not by shifting bones. It’s a tool — one that can be effective when used alongside movement retraining, strengthening, and patient education.

The Takeaway: Your Spine Is Strong, Not Fragile

Your spine doesn’t “go out,” but it can become sore, stiff, or sensitive — just like any other part of the body. Spinal manipulation can help by calming the nervous system and restoring comfortable movement, not by “realigning” your bones.

At Port Alberni Physiotherapy and Wellness, our physiotherapists use evidence-based manual therapy techniques — including spinal manipulation when appropriate — to help reduce pain, improve movement, and support long-term recovery. We take the time to explain what’s really happening in your body so you can move with confidence, understand your pain, and trust in your body’s natural resilience.

Managing Osteoarthritis with Movement and Rest

October 15, 2025

Imagine a vintage scale. On one side, you have movement — exercise, activity, and the daily tasks that keep your body mobile. On the other side, there’s rest — recovery, joint protection, and pain management strategies that allow your body to heal and recharge.

For people living with osteoarthritis (OA), maintaining this delicate balance is key. Lean too far toward rest, and joints can stiffen, muscles weaken, and pain may actually increase. Push too hard toward activity, and inflammation and soreness can flare. Finding that “just right” middle ground is one of the most important — and ongoing — parts of living well with OA.

Balancing Movement and Rest in Osteoarthritis.png

Osteoarthritis: A Condition to Be Managed, Not Cured

Osteoarthritis is the most common form of arthritis, affecting millions of Canadians. It’s a degenerative joint condition where the cartilage — the smooth tissue that cushions the ends of bones — gradually breaks down. As a result, joints can become painful, swollen, and stiff.

While there’s currently no cure for OA, that doesn’t mean there’s no hope. More up-to-date research shows that osteoarthritis is highly manageable with the right approach — and that keeping joints strong, flexible, and active can often delay or even reduce the need for surgery.

With long wait times for joint replacements and the reality that surgery may not be appropriate or ideal for everyone (depending on age, health status, and activity goals), learning to live well with OA becomes important.

Movement: Medicine for the Joints

Exercise may sound counterintuitive when joints hurt, but movement is one of the most effective treatments for osteoarthritis. The right type of exercise helps nourish cartilage, strengthen muscles that support the joints, and improve circulation.

Gentle, consistent movement — like walking, cycling, swimming, or strength training — helps reduce stiffness and pain over time. Even short bouts of movement throughout the day can make a difference.

The key is to choose exercises that feel tolerable, not painful, and to progress gradually. Working with a Physiotherapist, Kinesiologist, or Athletic Therapist can help you find the right balance between strengthening and joint protection.

Rest and Recovery: The Other Side of the Scale

Just as movement is medicine, rest is essential. Rest doesn’t mean inactivity — it means allowing your body to recover and using supportive strategies that reduce pain and inflammation.

This might look like:

Using ice or heat to calm sore joints or loosen stiff ones.
Taking medications as prescribed to manage inflammation and pain.
Sleeping with supportive pillows or cushions to take pressure off the hips, knees, or shoulders.
Wearing braces or compression sleeves to provide stability and reduce swelling.
Using walking aids to improve confidence and reduce joint strain.
Trying massage, acupuncture, or joint injections to reduce discomfort and improve mobility.

These strategies don’t replace movement — they support it. When used thoughtfully, they help restore balance to that internal scale, allowing you to stay active without overdoing it.

Learning Your Balance Point

The “perfect” balance looks different for everyone. Some days, your scale might tip more toward rest — especially if you’ve had a busy week or an increase in pain. Other days, you might feel strong and ready to move.

The goal isn’t perfection; it’s awareness. Over time, you’ll learn how to listen to your body, recognize early signs of fatigue or flare-ups, and adjust accordingly.

Think of it as living in partnership with your joints. When you respect their limits and nurture their strengths, you can keep doing the things you love for as long as possible.

Living Well with Osteoarthritis

Osteoarthritis may be a lifelong condition, but it doesn’t have to define your life. By finding that equilibrium between movement and rest — between strengthening and self-care — you can manage symptoms, protect your joints, and maintain independence and quality of life.

So next time you imagine that vintage scale, remember: every choice you make — whether it’s a walk around the block, an exercise session, or a quiet evening with a heating pad — helps keep that balance in check. And it’s within that balance that long-term joint health truly lives.

Why Do Injuries Feel More Common in Your 30s?

September 10, 2025

If you’re in your 30s and noticing that injuries are showing up more often, you’re not alone. Many people find that the shift from their 20s into their 30s is the first time their body doesn’t “bounce back” as easily. Workouts that once felt easy can now leave you stiff for days, and a sprained ankle or sore back might take longer to settle than it did a decade ago.

The good news? These changes are a natural part of how the body adapts over time — and with the right strategies and education, you can stay strong well past your 30s. Think of this stage as the perfect opportunity to build the routines that will support you into your 40s, 50s, and even into your later decades. Let’s look at why injuries can start creeping up more often in your 30s and what you can do to make your body more resilient.

Why Injuries Can Increase in Your 30s

1. Recovery Takes Longer

In your late teens and 20s, your recovery systems work at full capacity. Muscles repair quickly, connective tissues are more elastic, and hormone levels like growth hormone and testosterone are naturally higher, all of which speed up healing.

By your 30s, some subtle but important changes begin:

Muscle repair slows down — small tears from exercise take longer to heal.
Lower collagen production — tendons and ligaments don’t rebound as quickly, making you more prone to sprains.
Hormone shifts — growth hormone gradually decreases, which plays a role in recovery.
Sleep challenges — busy careers, families, and stress often mean less high-quality, restorative sleep.

This doesn’t mean your body is “old” at 30 — it just means the quick recovery strategies that worked before may no longer be enough.

2. Pushing Through Pain Isn’t the Answer Anymore

In your 20s, ignoring pain often worked — most minor injuries disappeared after a day or two. But as you age, brushing off sharp ongoing pain can backfire. Small problems can become persistent if they’re not looked at more closely.

That’s why taking care of your body before things get worse is important. Here are some strategies to incorporate into your exercise routine:

Warm-ups are essential. Increasing blood flow and preparing your muscles reduces the chance of injury.
Cool-downs aid recovery. Stretching and gentle movement after exercise helps circulation and reduces soreness.
Listen to warning signs. Sharp or persistent pain shouldn’t be ignored — it’s a signal, not an obstacle to push past.

In your 30s, your body is still capable and strong, but it needs more respect. Preparation and recovery should be treated as part of training itself.

3. Lifestyle Factors Catch Up to You

In your 20s, you may have gotten away with poor sleep, inconsistent meals, or late-night workouts. By your 30s, those habits accumulate and start showing up as reduced mobility, fatigue, and recurring injuries.

Common culprits include:

Desk jobs and screen time — long hours sitting lead to tight hips, weak cores, and rounded shoulders.
Chronic stress — work and family pressures increase cortisol, which can slow tissue repair.
Nutrition gaps — lower protein or missing nutrients affect healing.
Less movement overall — outside of structured exercise, the rest of the day often becomes more sedentary.

These lifestyle shifts make injuries more likely — but they also point to clear areas for improvement. Small changes, like standing breaks at work or prioritizing balanced meals, can go a long way.

4. Preventative Care Matters More Than Ever

Think of your body like a vehicle — it runs better with regular maintenance. Preventative care is especially valuable in your 30s to reduce injury risk before something breaks down.

Options to consider include:

Physiotherapy: Even without pain, a physiotherapist can identify weak points or imbalances and help you address them.
Massage Therapy: Massage eases muscle tension, supports circulation, and helps manage stress.
Acupuncture: Shown to reduce pain, promote relaxation, and improve recovery.
Mobility and strength training: Building stability and range of motion keeps joints and tissues healthy.

The goal is to shift from a reactive mindset (“I’ll deal with it when I’m injured”) to a proactive one (“I’ll support my body so I can stay injury-free”).

5. Other Contributing Factors

Muscle loss unless maintained. Without regular training, adults lose 3–8% of muscle mass each decade after 30. Known as sarcopenia, this loss makes injuries more likely. Strength training is the best way to fight it.
Slower reflexes. Reaction time naturally decreases, making slips, twists, or falls more common. Agility and balance training help counter this.
Accumulated wear and tear. Old injuries, repetitive movements, or years of sport may resurface as recurring issues if not addressed.

How to Stay Injury-Free in Your 30s

The key isn’t slowing down — it’s training smarter. Here are practical ways to keep your body resilient:

Strength train regularly to protect joints and maintain muscle mass.
Incorporate mobility and flexibility through stretching, yoga, or Pilates.
Prioritize quality sleep — recovery happens at night.
Eat for recovery, focusing on protein, hydration, and micronutrients.
Schedule rest days — adaptation happens when you recover.
Vary your training to avoid overuse injuries.
Invest in preventative care like physio, massage, or acupuncture.
Address pain early, not after it sidelines you.

If you’re getting injured more often in your 30s, it’s not a sign your body is wearing out — it’s a reminder that it needs different care than it did a decade ago. Recovery takes more time, warm-ups and cool-downs matter, and prevention is the key to staying active. By learning to respect your body’s evolving needs now, your 30s can become a decade of strength, health, and resilience that carries you well into the future.

Why Strength and Conditioning is the Key to Returning Stronger After Injury

August 27, 2025

Recovering from an injury is rarely a straight path. The first steps often involve rest, hands-on treatment, and targeted physiotherapy to reduce pain, restore mobility, and rebuild foundational strength. But what happens after you’ve completed your rehabilitation sessions? For many athletes and active individuals, the transition back to sport or higher-level activity requires more than just being pain-free—it requires rebuilding resilience, power, and confidence.

That’s where strength and conditioning sessions come in. This stage of recovery bridges the gap between rehabilitation and performance, ensuring you don’t just get back to activity, but return stronger, more confident, and less likely to re-injure.

1. Where Strength and Conditioning Fits in the Recovery Timeline

Physiotherapy is often the first stop after injury, focusing on pain management, restoring mobility, and re-establishing baseline strength. Once those building blocks are in place, many people wonder what’s next. Jumping directly back into sport or high-intensity training without additional preparation often leaves athletes at risk of setbacks.

Strength and conditioning fits into the late stages of rehabilitation—when you’re largely pain-free, moving well, and ready for more. It focuses on:

Bridging the gap between rehab and sport-specific demands.
Progressively loading tissues to build resilience in the injured area.
Developing higher-level movement skills like agility, coordination, and power.

Think of it as the “performance phase” of rehab: you’re no longer just recovering; you’re preparing to excel again.

2. Why a Tailored 60-Minute Session Matters

Generic training plans can only take you so far, especially after an injury. A 60-minute individualized strength and conditioning session gives you the opportunity to focus on:

Your specific injury history. Whether you’re coming back from an ACL tear, shoulder instability, or chronic ankle sprains, the program can target the movements and muscle groups most critical for your recovery.
Technique correction. Small adjustments in how you squat, jump, or land can dramatically reduce stress on vulnerable joints and tissues. Guided feedback during your session ensures you move efficiently and safely.
Pushing harder, safely. Many people are hesitant to load an injured area again, which can stall progress. A structured session provides reassurance and guidance so you can progressively challenge yourself with the right balance of intensity and recovery.

This individualized approach allows you to recover faster, train harder, and return to your sport or activity with greater confidence.

3. How Strength and Conditioning Complements Physiotherapy

Physiotherapy and strength and conditioning are different but complementary. Physiotherapy is clinical in nature. It focuses on diagnosis, reducing pain, restoring mobility, and addressing impairments. The aim is to get you back to a functional baseline.

Strength and conditioning is performance-driven. It builds strength, speed, power, and endurance while correcting movement inefficiencies. The aim is to help you return to your sport or activity at your best.

Together, they form a complete recovery journey. Physiotherapy gets you back to moving well; strength and conditioning makes sure you can move well under pressure, at speed, and in sport-specific contexts.

4. Confidence: The Missing Piece in Many Recoveries

One of the biggest barriers athletes face after an injury isn’t physical—it’s psychological. Fear of re-injury can hold people back from moving naturally, cutting, sprinting, or lifting the way they did before. This hesitation often leads to compensations that can increase the risk of new injuries.

Strength and conditioning helps rebuild this confidence by exposing you to controlled, progressive challenges. You relearn how to move powerfully and safely, gaining trust in your body again. By the time you step back onto the field, court, or gym floor, you know you’re ready.

5. Injury Prevention: Preparing for the Future

Participating in structured strength and conditioning after injury isn’t just about getting back to your previous level—it’s also about staying there. Targeted training improves:

Joint stability through strengthening supporting muscles.
Balance and coordination, reducing the likelihood of falls or awkward movements.
Movement efficiency, ensuring your body absorbs and transfers force effectively.

These improvements not only reduce the risk of reinjury but also enhance overall performance.

6. Who Benefits From Post-Injury Strength and Conditioning?

This approach isn’t just for elite athletes. Anyone who wants to return to activity after an injury can benefit. Common examples include:

Athletes preparing for their return-to-play protocols.
Active adults wanting to get back to running, skiing, or weightlifting.
Older adults looking to rebuild strength and reduce their risk of future injury.
Youth athletes who need guidance in safe technique and long-term development.

If your goal is to move better, get stronger, and prevent reinjury, strength and conditioning can help.

Takeaway: Don’t Stop at “Pain-Free”

Being pain-free is a milestone, not the finish line. The real measure of recovery is whether you can return to the activities you love at full capacity—and stay there. Strength and conditioning is the missing link for many people, turning a good recovery into a great one.

With individualized programming, expert guidance, and a focus on both performance and prevention, you can shorten your recovery timeline and build resilience for the future.

Ready to take the next step? Book a strength and conditioning session with Athletic Therapist Abbey Peters by calling 250-723-5112, and set yourself up for a stronger, safer return to the activities you love.

Stay Safe While Gardening: Tips from Port Alberni Physiotherapy

July 23, 2025

Gardening is a great way to stay active and enjoy time outside. By being mindful of how you move and care for your body, you can work comfortably and reduce strain. Simple adjustments in posture and technique can help you stay comfortable while digging, planting, and lifting.

In this blog, we’ll provide practical tips on proper body mechanics, exercises to build strength and flexibility, useful ergonomic equipment , and advice on handling any injuries should they arise. Whether you’re experienced or new to gardening, these tips can help you stay comfortable and keep gardening enjoyable.

Body Mechanics: How to Move Safely in the Garden

The way you move while gardening has a big impact on preventing injuries. Being aware of your posture and the techniques you use to bend and reach can protect your muscles and joints. Here are some tips on how to move properly:

Bend your hips and knees, not your waist. Squatting or kneeling to reach low areas takes pressure off your lower back.
Avoid staying in the same posture for too long. Take breaks to stand up, stretch, and change positions every 30 to 60 minutes.
Use raised garden beds or tables when possible. Elevating your workspace helps reduce repetitive bending and neck strain.
Turn your whole body rather than twisting your spine. Pivot your feet and hips to reach sideways instead of twisting your back.

Gardening-Friendly Strength and Stretching Exercises

Building muscle strength and flexibility helps protect your body from common injuries. Stronger muscles support your movements and reduce fatigue during repetitive tasks, while flexible joints maintain comfortable range of motion. Here is a list of exercises to get you started:

Core strengthening: Planks, bridges, and bird-dogs help stabilize your spine.
Lower body workouts: Squats and lunges build strength in muscles used for bending and lifting.
Upper body strengthening: Rows and shoulder presses prepare your arms for repeated motions.
Stretching: Regularly stretch your hamstrings, hip flexors, and lower back to improve mobility and reduce stiffness.

These exercises are just suggestions. For a more individualized list that takes your previous injuries and concerns into account, visit your local physiotherapist. Doing strengthening and stretching 2–3 times per week is ideal, but any consistent addition will create positive change

Helpful Tools for Ergonomic Gardening

The right gardening tools can ease your workload and help you avoid unnecessary strain. Selecting equipment designed to support good posture and reduce repetitive stress helps you enjoy gardening for longer periods and keeps you safe. Here are some examples of ergonomic gardening equipment:

Kneeling pads: Cushion your knees and provide comfort when working close to the ground.
Portable or foldable gardening tables: Raise your work area to avoid constant bending.
Lightweight fabric hoses: Easier to handle than traditional hoses, they reduce arm and shoulder strain.
Gardening stools and benches: Let you sit while planting or weeding, reducing pressure on your knees and back.

What to Do If You Get Injured

If you experience pain or develop an injury while gardening—particularly in your lower back—it’s important to address it early. Taking the right steps, such as modifying your activity, using ice, and incorporating gentle movement stretches and mobility, can help speed up recovery and get you feeling better quicker. Here are some general tips on how to deal with a gardening injury.

Rest briefly but keep moving gently. Avoid long periods of inactivity. Gentle stretches like cat-cow poses or lumbar rotations 2 to 3 times daily can help.
Apply ice or heat during the first 48 hours. If there’s no bruising, either option works well. But if you see a visible bruise, applying ice is the better choice.
Use over-the-counter pain medication as needed. Consult your doctor or pharmacist if you have questions.
Seek help from a physiotherapist if pain continues or you want tailored guidance on healing and exercises.

Gardening offers a fantastic way to stay active and enjoy the outdoors. By using mindful body mechanics, strengthening key muscles, choosing the right tools, and addressing any injuries promptly, you can keep your garden time safe and enjoyable.

If you have questions about preventing injuries or recovering from one, don’t hesitate to contact us at Port Alberni Physiotherapy.

How to Prepare for Surgery Recovery: Setting Yourself Up for a Smooth Journey

June 11, 2025

If you’re facing surgery soon, it’s natural to focus on the procedure itself—but often, the real work begins once you’re home. Whether it’s a knee replacement, shoulder repair, or any other surgery, having a recovery plan in place can make a big difference in how smoothly things go. From moving around safely to staying nourished and supported, here’s what to consider before your surgery day.

Home Equipment: What You Might Need and Where to Find It

After surgery, everyday tasks like walking to the bathroom or getting out of bed can feel challenging. That’s why having the right equipment at home can really help. What you need depends on your surgery, your mobility, and your home setup, but here are some common tools that support recovery:

Mobility aids:
- Walker: Great for lower-body surgeries when you need extra stability.
- Crutches: Useful if you’re more mobile but need to keep weight off one leg.
- Cane: Helpful as you regain balance and confidence.
Bathroom safety gear:
- Raised toilet seat: Makes sitting and standing easier without bending too much.
- Grab bars: Extra support in the shower or near the toilet to prevent falls.
- Shower chair: Perfect if standing in the shower feels tiring or unsafe.
Other helpful items:
- Reacher/grabber: Pick things up without bending or twisting.
- Sock aid or long-handled shoehorn: Makes dressing easier when you’re stiff or sore.

The best news? You don’t usually need to buy these yourself. Many items can be borrowed through the Canadian Red Cross Health Equipment Loan Program—a fantastic option for short-term needs after surgery. Ask your physiotherapist or surgical team for a referral, and they’ll help you get started.

👉 Fill out the Red Cross Equipment Loan form for BC and Yukon here

Meal Prep: Nourish Your Body for Healing

Surgery puts a big demand on your body. Healing tissues, reducing inflammation, and regaining strength all take energy — and that means good nutrition is key. But cooking when you’re sore or tired? Not always realistic.

If you can, prepare and freeze meals ahead of time—things like soups, casseroles, or stews freeze well and are easy to reheat on low-energy days. If cooking isn’t your thing, there are also local meal delivery options that offer healthy, ready-to-eat meals to keep you fueled without the fuss.

Here are some Alberni Valley options to explore:

Wholesome Meals on Wheels (Port Alberni): Delivers hot, nutritious meals Tuesday–Saturday (with extra for Sun/Mon), ideal for seniors or those recovering from surgery; call 250‑730‑0390 to arrange—local, volunteer-run, and non-profit.
Valley Home Meals: Frozen home-style meals with dietary options (gluten-free, vegetarian, etc.) delivered to Port Alberni on Thurs & Fri afternoons; order online or call 250‑339‑2625.
Culinary Comforts (Port Alberni): Locally-made comfort food available for pick-up or delivery via DoorDash; open Sat–Mon, 11 am–10 pm—order through their website or social media.
Fresh Coast Market (Port Alberni): Grab-and-go meals like casseroles, soups, and salads, ready to heat and eat; visit in-store at 4905 Cherry Creek Rd—check Facebook for daily specials.

Managing Pain and Swelling: Ice Packs or Cryocuffs?

Controlling pain and swelling is a big part of the first days after surgery. Ice therapy is one of the best tools you have, and there are two main options:

Ice packs: Easy to use, reusable, and great for quick relief. Just remember to remove after 15–20 minutes and refreeze.
Cryocuffs: These combine cold and compression by circulating ice water through a cuff around your joint. They offer consistent cold and gentle pressure, which can be especially helpful after surgeries like knee replacements, ACL repairs or rotator cuff surgery.

Cryocuffs are often available to rent from surgical clinics or medical supply stores, and some extended health plans may cover them. Not sure which is right for you? Your physiotherapist or surgeon can help guide you.

Support is Key: Don’t Go Through Recovery Alone

Even if you're normally independent, having help after surgery can make a world of difference. Tasks like getting out of bed, cooking, and attending appointments can feel overwhelming in those first few days.

If you have family or friends nearby, ask someone to stay with you or check in regularly during your initial recovery. If that's not an option, Port Alberni has local support services that can help:

Comfort Keepers – Provides personal support with daily activities during recovery.
Just Like Family Home Care - provides personalized support after surgery or hospitalization to help you recover safely and comfortably at home. This service is available in Parksville, Qualicum Beach, Tofino and surrounding areas.
Island Health Home Support – Government-funded home care may be available if you qualify. Ask your discharge nurse or family doctor how to apply.

Preparing for surgery can feel overwhelming, but with the right support, equipment, and planning, you can set yourself up for a smoother recovery. Stock your freezer, arrange some help, and lean on your physiotherapy team to guide you every step of the way. At Port Alberni Physiotherapy, we’re here to support you on your journey back to health—because your recovery matters to us.

Bunions: Why They Happen and How Physiotherapy Can Help

May 21, 2025

A bunion is a bony bump that forms at the base of your big toe, while a bunionette shows up at the base of your little toe. Since bunions are more common, we’ll be focusing on those in this blog — but it’s worth noting that similar issues can develop on the outside of your foot as well. So if you’re noticing a small bump or discomfort near your pinky toe, it might be the start of a bunionette.

With bunions, what’s happening is that the big toe gradually starts shifting toward the second toe. Over time, this misalignment causes the joint at the base of the big toe to stick out, creating that visible bump. The medical term for this is hallux valgus. For some people, it’s mostly a cosmetic concern. But for others, the change in toe alignment can cause pain, make it difficult to wear certain shoes, and even limit walking or physical activity.

Why Do Bunions Develop?

Bunions usually form because of a mix of genetics, how your foot moves, and the shoes you wear. One of the biggest contributors is improper footwear—think narrow shoes, tight toe boxes, or high heels that push your toes together. Over time, this constant pressure can cause the big toe to shift inward, leading to that telltale bump.

Other factors that can play a role include:

Genetics – If bunions run in your family, you may have inherited a foot shape that makes you more prone to developing them.
Foot mechanics – Conditions like flat feet, overpronation (your foot rolling inward too much), or loose ligaments can all increase your risk.
Inflammatory arthritis – Rheumatoid arthritis and similar conditions can damage the joint and accelerate the misalignment.

In most cases, it’s not just one thing—but a combination of these that causes a bunion to form and progress over time.

What Can You Do at Home?

If you’re starting to notice a bunion—or dealing with one that’s been around for a while—there’s a lot you can do at home to keep things comfortable and possibly slow things from getting worse. The key is to reduce pressure on the joint and keep the surrounding tissues happy.

Here are a few simple strategies that can make a big difference:

Choose better shoes – Go for styles with a wide toe box, low heels, and good arch support. This gives your toes room to breathe and reduces pressure on the bunion. Look for brands that offer wide versions like Birkenstocks, New Balance, Nike, Hoka, and Sketchers.
Try bunion pads or toe spacers – These little tools can help prevent rubbing and encourage better toe alignment inside your shoes.
Ice the area – If your bunion feels sore or swollen after a long day on your feet, apply ice for 10–15 minutes to calm things down.
Take breaks when needed – If you’re experiencing a flare-up, try to avoid standing for long periods or doing high-impact activities until things settle.

Making a few of these changes early on can really help keep pain levels down and prevent the bunion from progressing more quickly.

When to Seek Treatment

If your bunion is starting to interfere with your day-to-day life—whether that’s ongoing pain, difficulty walking, or noticing your toe drifting more over time—it’s a good idea to check in with a healthcare provider. Early attention can help you avoid bigger issues down the road.

Treatment usually starts with conservative options, like:

Custom orthotics – These can improve your foot mechanics and take pressure off the bunion.
Medication – Over-the-counter anti-inflammatories like ibuprofen can help reduce pain and swelling during flare-ups.
Toe spacers or supportive footwear – Often recommended as a first step to ease symptoms and slow progression.

If those strategies aren’t enough and the pain sticks around, your provider may suggest cortisone injections to calm inflammation—though keep in mind, these don’t correct the bunion itself.

In more severe cases, especially when the joint becomes very painful or the alignment gets significantly worse, surgical intervention might be the next step. Surgery can realign the joint and relieve chronic discomfort, but it's usually considered only after other options haven’t helped.

The earlier you catch it, the more you can do to stay comfortable and active without jumping straight to surgery.

How Can Physiotherapy Help?

Physiotherapy can play an important role when it comes to managing bunions without surgery. A physio can assess how you walk and move (your gait and posture) to figure out what might be putting extra stress on the big toe joint. From there, treatment might include manual therapy to ease stiffness in the joint, strength and stability exercises to support better alignment, and education on the best footwear and how to pace your activity to avoid flare-ups. The goal? Keep you moving comfortably and prevent things from getting worse.

Here are a few bunion-friendly exercises you can try at home to get started:

Toe Spreads – Sit with your feet flat on the floor. Try to spread your toes apart and hold for 5 seconds. Repeat 10–15 times to activate the small stabilizing muscles.
Towel Scrunches – Lay a towel on the floor, and use your toes to scrunch it toward you. This helps strengthen the foot’s arch. Try for 1–2 minutes per foot.
Big Toe Stretch – Gently pull your big toe away from the second toe using your fingers. Hold for 10–15 seconds and repeat 5 times.
Resistance Band Toe Pulls – Loop a band around your big toe and gently pull it to encourage proper alignment. Hold for 5 seconds and repeat 10 times.

If you're unsure where to begin or want a more tailored plan, booking a session with a physiotherapist is a great first step.

Bunions don’t have to stop you from doing what you love. With the right combination of footwear, daily foot care, physiotherapy, and consistent exercises, many people can manage their symptoms without surgery. If you're noticing changes in your foot shape or dealing with persistent toe pain, reach out to your physiotherapist for guidance and support.

Understanding Diastasis Recti: What It Is and How Physiotherapy Can Help

April 11, 2025

If you've recently had a baby, or even if it's been a while, you may have noticed a soft bulge or gap in your midsection that just won’t seem to go away. This could be a sign of Diastasis Recti, a change that’s more common than most people think — and one that can absolutely be improved with the right support.

What is Diastasis Recti?

Diastasis Recti (DR) is a separation of the rectus abdominis muscles, the two long “six-pack” muscles that run down the front of your abdomen. These muscles are connected by a band of tissue called the linea alba, which can stretch and thin during pregnancy or with excessive intra-abdominal pressure, causing a gap.

While it’s most commonly associated with pregnancy and postpartum recovery, Diastasis Recti can also affect men and women outside of pregnancy due to factors like poor lifting mechanics, chronic straining, or abdominal surgery.

How Do You Know If You Have It?

Common signs of Diastasis Recti include:

A visible bulge or “doming” along the midline of your abdomen, especially when getting up from lying down.
A feeling of weakness or instability through your core.
Lower back pain, pelvic floor dysfunction, or poor posture.
A gap between the abdominal muscles (often measured by a physiotherapist during a hands-on assessment).

The best way to know for sure? A physiotherapy assessment, especially from someone trained in women’s health or pelvic floor rehab.

How Can It Be Treated?

The good news is: Diastasis Recti is treatable — and in most cases, surgery isn’t necessary.

Physiotherapy is a first-line treatment for DR, especially when guided by a practitioner with training in core and pelvic health. Treatment often includes:

Reconnecting with your deep core muscles, including the transverse abdominis and pelvic floor.
Learning how to manage intra-abdominal pressure during daily movements.
Gradually strengthening your core without exacerbating the gap.
Education on body mechanics, posture, and breathwork.

While physiotherapy is often very effective for Diastasis Recti, there are a small percentage of people who may not see full resolution with conservative care alone. Here are the main next steps or alternative options if physiotherapy hasn’t resolved the issue:

1. Consultation with a Plastic Surgeon (Abdominoplasty/Tummy Tuck)

If the diastasis is large (typically more than 4-5 finger-widths), persistent, and impacting quality of life despite physiotherapy, surgical repair could be considered.

Surgical options include:

Abdominoplasty (tummy tuck) – often includes suturing the linea alba to bring the rectus muscles back together.
Mini-abdominoplasty – for smaller separations.
Laparoscopic repair – a less invasive option for some.

An important Note: Surgery is usually considered elective and is best done when core strength is already optimized through physio — so recovery is smoother.

2. Support Garments or Abdominal Binders

These don’t fix the separation, but they can offer support during movement or postpartum recovery. They can be helpful short-term while working with a physio or if surgery isn't an option.

3. Continued Monitoring and Maintenance Physiotherapy

In some cases, the abdominal separation may not fully close — but that doesn’t mean recovery hasn’t happened. If symptoms like pain, core weakness, or pelvic floor dysfunction improve and you're able to move confidently and without discomfort, further treatment may not be necessary.

Many people return to high-level activity even with a small remaining gap, as long as they’ve learned to manage intra-abdominal pressure effectively and avoid movements that cause doming or bulging. Your physiotherapist can help you maintain your progress, modify your exercise routine as needed, and ensure your core is functioning well in your day-to-day life.

How Can Women’s Health Physiotherapy Help?

Women’s health physiotherapists specialize in the unique needs of people during pregnancy, postpartum, and beyond. When it comes to Diastasis Recti, they offer:

Detailed assessments of the abdominal wall and pelvic floor.
Safe and individualized rehabilitation programs.
Hands-on guidance to improve posture, alignment, and movement patterns.
Support with other concerns that often go hand-in-hand with DR, like pelvic floor weakness, incontinence, or prolapse.

Whether you’ve just had a baby or are years postpartum, it’s never too late to seek help.

What Exercises or Movements Should Be Avoided?

Certain exercises and movements can put extra strain on the abdominal wall and may worsen Diastasis Recti — especially in the early stages of recovery. These include:

Traditional crunches or sit-ups
Double leg lifts or aggressive core work
Heavy lifting without proper core engagement
Planks or pushups, if they cause doming or bulging of the abdomen
Any movement that causes visible coning or discomfort along your midline

Your physiotherapist will help you identify what’s safe for your body and when.

What Exercises Are Good for Diastasis Recti?

Healing your core starts with gentle, controlled movement. Some beginner-friendly exercises include:

Deep core breathing (also called diaphragmatic breathing)
Pelvic tilts and small bridges, focusing on core activation
Heel slides or marching with deep core engagement
Modified side planks (with support) as your strength builds
Bird-dog exercise with slow, controlled movement

The key is not just the movement, but how you do it. Learning to recruit your deep core and manage pressure is essential — and that’s where a trained physiotherapist can make all the difference.

Final Thoughts

If you suspect you may have Diastasis Recti — whether you’re newly postpartum or it's been years — know that there are solutions. Working with a physiotherapist, especially one trained in women’s health, can help you safely rebuild core strength, restore function, and feel more like yourself again.

Have questions or want to book an assessment with our women’s health physiotherapist, Lauren Siddall, we’re here to help.

Contact Us at 250-723-5112 or book online at portalberniphysiotherapy.ca

How To Pick Your Perfect Running Shoe

March 17, 2025

Shopping for new running shoes can be both exciting and a little overwhelming. With so many styles, features, and brands available, it’s easy to feel unsure about what’s best for you. The right pair of running shoes can enhance comfort, improve performance, and help prevent injuries—whether you’re a beginner, training for a race, or just looking for a solid everyday running shoe. Here’s what to consider when making your choice.

Finding the Right Fit

A proper fit is essential to avoid discomfort, blisters, and potential injuries. Your running shoes should fit securely around the heel, while leaving about a thumb’s width of space between your longest toe and the front of the shoe. They should feel snug but not restrictive—your foot shouldn’t slide around, but you also don’t want any pinching or tightness.

When trying on shoes, wear the socks you plan to run in. It’s best to try them on later in the day when your feet are slightly swollen, mimicking how they’ll feel during a run. Walk or jog around the store to test for comfort and fit.

Consider Where You Run

The terrain you run on plays a big role in choosing the right shoe. Are you running mostly on pavement, trails, or a mix of both?

Road Running Shoes: Designed for pavement and packed surfaces, these shoes provide cushioning and shock absorption for smooth, efficient strides. The tread is designed to be harder-wearing to handle the impact of pavement.
Trail Running Shoes: If you frequently run on trails, look for shoes with a more aggressive tread, added traction, and a durable outsole to handle uneven terrain. The tread tends to be a bit softer and can wear down quicker if used on pavement.
Hybrid Shoes: If you run on both roads and trails, consider a versatile shoe that balances cushioning and durability for mixed conditions.

Know Your Foot Type

Your foot shape and arch type influence how you move and what kind of support you need. Most runners fall into one of these categories:

Neutral: A medium arch with even weight distribution. Neutral shoes with balanced cushioning work best.
Overpronation: If you have low arches or flat feet, your feet roll inward as you run. Stability shoes with added support help control excessive motion.
Supination: If you have high arches, your feet tend to roll outward. Cushioned shoes with extra shock absorption can help distribute impact more effectively.

Want a simple home solution to check your foot type? Try the “wet test” by stepping on a piece of paper with damp feet to see your footprint shape. You can also visit a physiotherapist or a specialty running store for a foot and gait analysis.

Cushioning & Support Levels

The amount of cushioning you need depends on your personal comfort, running style, and injury concerns. Running shoes come in varying levels of cushioning:

Minimal Cushioning: Lightweight shoes that provide a more natural feel and ground contact. Ideal for experienced runners who prefer a more responsive shoe .
Moderate Cushioning: A balanced mix of support and softness, suitable for most runners.
Maximum Cushioning: Soft, plush shoes designed for high-mileage runners or those needing extra joint protection.

Top Running Shoe Brands & Models

If you're wondering which shoes to consider, here’s a breakdown based on support levels:

Lightweight & Minimal Support
For runners who prefer a barefoot-like experience:

Altra (Zero-drop design, wide toe box): Escalante, Lone Peak
Saucony (Lightweight, minimal cushioning): Kinvara, Type A
Merrell (Minimalist trail shoes): Trail Glove, Vapor Glove
New Balance (Natural movement focus): Minimus 10v1

Moderate Support & Cushioning
Ideal for most runners looking for a balance of comfort and performance:

Brooks (Smooth ride, soft cushioning): Ghost, Glycerin
Asics (Responsive yet cushioned feel): Gel-Nimbus, Gel-Cumulus
Nike (Versatile support): Pegasus, React Infinity Run
Hoka (Moderate cushioning for longer runs): Clifton, Arahi
Saucony (Balanced comfort and responsiveness): Ride, Freedom

Maximum Cushioning & Extra Support
Great for long-distance runners or those needing injury protection:

Hoka (Maximalist shoes for soft landings): Bondi, Stinson ATR
Brooks (Highly cushioned for extra protection): Glycerin, Addiction Walker
Asics (Stability and cushioning combined): Gel-Kayano, Gel-Foundation
Saucony (Soft cushioning for long runs): Triumph, Omni
New Balance (High-mileage protection): 1080v11, Fresh Foam 880v11

Consider Your Running Style

Everyone has a unique way of running, and different shoes cater to different movement patterns. Whether you land on your forefoot, midfoot, or heel, choosing a shoe that accommodates your gait can improve comfort and efficiency. If you’re unsure of your running style, a gait or running analysis can provide insight into how your feet strike the ground and what type of shoe will work best for you.

If you're interested in a gait or running assessment, many running shops and most physiotherapy clinics offer this service. The level of detail provided can vary based on their training and equipment. However, it can be a very useful tool, especially if you're prone to repetitive stress and strain injuries or if you have an intense training plan this season.

Final Thoughts

Choosing the right running shoes is about finding a balance between comfort, support, and durability. Everyone’s feet and running needs are different, so it’s essential to understand your unique requirements before making a purchase. Take the time to test different shoes, get the right fit, and consider your specific running conditions. When in doubt visit your local running store or make an appointment with a physiotherapist for a gait or running assessment. Your feet will thank you on your next run!

To book at Port Alberni Physiotherapy & Wellness, click here or call us at 250-723-5112.

How Acupuncture Can Help Relieve Chronic Pain

February 10, 2025

Dealing with chronic pain can be exhausting, frustrating, and sometimes even overwhelming. Whether it's from an old injury, a health condition like arthritis or fibromyalgia, or something else entirely, living with persistent pain can take a real toll on your day-to-day life. While pain meds, physical therapy, and even surgery are common treatment options, more and more people are turning to acupuncture as a natural, effective way to find relief.

What is Acupuncture?

Acupuncture is a traditional Chinese medicine practice that has been around for thousands of years. It involves placing thin, sterile needles at specific points on the body to restore balance and promote healing. According to traditional Chinese medicine (TCM), acupuncture works by balancing or unblocking the flow of energy, known as "Qi" (pronounced "chee"), through meridians in the body. From a modern perspective, acupuncture stimulates the nervous system, increases circulation, reduces inflammation, and helps the body release its own natural painkillers—endorphins—all of which contribute to pain relief.

How Does Acupuncture Help with Chronic Pain?

Acupuncture offers several benefits when it comes to managing chronic pain. Through the placement of specific needles, acupuncture addresses both the physical and neurological aspects of pain. Here is how it works:

1. Stimulating Natural Painkillers

Acupuncture prompts the body to release endorphins and enkephalins, which are natural pain relief chemicals in the body. These neurotransmitters help reduce the perception and physical feeling of pain, providing a natural and drug-free way to manage constant discomfort.

2. Reducing Inflammation

Chronic pain is often linked to inflammation, a natural immune response that can be prolonged with certain conditions. Studies have shown that acupuncture can help decrease inflammatory markers, thereby alleviating pain associated with conditions like arthritis, tendonitis, and fibromyalgia.

3. Improving Blood Circulation

By stimulating specific points in the body, acupuncture enhances blood circulation, which helps deliver oxygen and nutrients to injured tissues. Improved circulation promotes healing and reduces muscle stiffness, making it particularly beneficial for those suffering from conditions like chronic back pain or migraines.

4. Regulating the Nervous System

Chronic pain is often the result of an overactive nervous system. Acupuncture has been shown to calm the nervous system and adjust how your body responds to pain. This is particularly helpful when someone is struggling with neuropathic pain, such as sciatica or diabetic neuropathy.

5. Enhancing Overall Well-being

Beyond physical relief, acupuncture can improve sleep quality, reduce stress, and promote relaxation—all of which contribute to better pain management. Many patients report feeling a sense of calm and balance after acupuncture sessions, which can be essential for managing chronic pain holistically.

What Conditions Can Acupuncture Help With?

Acupuncture is commonly used to treat various chronic pain conditions, including:

Lower back pain – One of the most common reasons people seek acupuncture, studies have shown it can provide significant relief for those with chronic lower back pain.
Osteoarthritis – Acupuncture may help reduce joint pain and stiffness associated with osteoarthritis by improving circulation and reducing inflammation.
Fibromyalgia – Many fibromyalgia sufferers experience pain relief, improved sleep, and increased energy levels with regular acupuncture treatments.
Migraines and tension headaches – Acupuncture has been found to reduce the frequency and severity of migraines and chronic headaches.
Neck and shoulder pain – Often caused by poor posture, stress, or repetitive movements, acupuncture can help alleviate tension and restore mobility.
Sciatica – By reducing nerve inflammation and improving blood flow, acupuncture may provide relief from the radiating pain associated with sciatica.

What to Expect During an Acupuncture Session

If you’re considering acupuncture for chronic pain relief, here’s what you can expect:

Initial Consultation: Your acupuncturist will discuss your medical history, pain symptoms, and overall health.
Treatment Plan: Based on your symptoms, a personalized treatment plan will be created, including the number of sessions recommended.
Needle Insertion: Thin, sterile needles are inserted into specific acupuncture points. The process is generally painless, though some people may feel a slight tingling or warmth.
Relaxation Period: The needles are typically left in place for 15-30 minutes while you relax in a comfortable position.
Post-Treatment Sensations: Many people report feeling relaxed and a sense of calm after a session, with some experiencing immediate pain relief while others notice gradual improvements over multiple treatments.

Is Acupuncture Right for You?

Acupuncture is a safe and effective treatment for many people, but it’s important to consult with a qualified acupuncturist to determine if it’s the right approach for your specific condition. It can be used as a standalone treatment or in conjunction with other therapies such as physiotherapy and massage therapy.

If you’re looking for a natural way to manage chronic pain, or an additional treatment in your care plan, acupuncture may be worth exploring. By addressing both the physical and neurological aspects of pain, acupuncture offers a more natural solution that promotes healing and pain relief.

What to Expect After a Total Knee Replacement

January 13, 2025

Undergoing a total knee replacement can feel like a daunting process. There’s a lot of uncertainty, and while surgeons provide valuable information, they often don’t have enough time to cover every detail about recovery. Our goal with this blog is to give you a clear understanding of what to expect after the procedure and address common questions about the total knee replacement journey in British Columbia.

What to expect in the hospital:

Depending on the type of surgery, you’ll likely stay in the hospital for a few hours to a couple of days, with most people staying 1–2 days. During this time, the focus will be on helping you manage pain, avoid complications, and get you moving safely so you’re ready to go home. Here’s what to expect:

Pain Management: The nurses will give you medication to keep your pain under control, either by mouth or through an IV. Don’t hesitate to let them know if you’re uncomfortable before returning home—they want to make sure you’re feeling well enough to rest, move, and start your recovery. Managing pain is an important part of healing and will help you stay active, sleep better, and complete your exercises more easily.
Monitoring: Your health will be closely watched to catch any signs of infection, blood clots, or other concerns. Compression devices or stockings may be used to improve blood flow and reduce swelling.
Getting Moving: A physiotherapist will usually visit you within a few hours or by the next day to help you sit up, stand, and take your first steps with support. Moving early is important to avoid complications and get you on the road to recovery.
Preparation for Home: Before you leave the hospital, you’ll receive clear instructions on how to care for your incision, take your medications, and will be given a pamphlet or booklet with simple exercises to help the initial phase of rehabilitation.

What to expect the first week:

The first week after surgery is key to setting a strong foundation for your recovery. While it’s normal to feel discomfort, staying proactive and consistent with your care can make a big difference:

Pain and Swelling: It’s common to experience swelling and bruising around the knee. To help reduce inflammation, use ice packs or a compression ice machine (like a CryoCuff) and keep your leg elevated whenever possible. Follow the prescription medication from your doctor closely at this time. If your pain becomes unmanageable, it can be challenging to bring it back under control.
Mobility Aids: You’ll likely need a walker or crutches to move around safely. Gradually increase your walking distance, focusing on good posture and weight-bearing as tolerated.
Wound Care: Keep the incision site clean and dry, and watch for any signs of infection such as redness, warmth, or unusual discharge.
Exercise & Physiotherapy: Gentle exercises such as ankle pumps, quadriceps squeezes, and range-of-motion movements are key to improving circulation, reducing swelling, and preventing stiffness in your knee. These exercises are typically outlined in a booklet or pamphlet provided before you leave the hospital—be sure to follow the instructions closely. This is also a good time to call and schedule your physiotherapy appointment, ideally within 1–2 weeks of your surgery date, to ensure a smooth start to your recovery.

What to expect from physiotherapy:

Physiotherapy plays a crucial role in your recovery after a total knee replacement. Here’s what you can expect:

Initial Session (1-2 Weeks Post-op): During your first visit with a physiotherapist, your range of motion, strength, gait, and overall progress will be assessed. The physiotherapist will also ask about your pain levels, medications, and daily activities at home. You'll complete a few questionnaires to track your progress over time. Based on this evaluation, your physiotherapist will provide you with initial exercise progressions and education.
Follow Up Sessions (Week 0-6): For the first 6 weeks, you'll attend physiotherapy sessions weekly. The focus will be on improving range of motion, reducing swelling, walking, and strengthening key muscle groups. Your goal during this phase is to achieve a knee flexion of 110 degrees and be able to straighten your knee with no more than 3 finger widths of space behind it. You'll begin partial revolutions on a stationary bike and gradually incorporate weight-bearing exercises for your quadriceps, hamstrings, glutes, and calves to enhance strength and mobility.
Follow Up Sessions (Week 6 -12): After the first 6 weeks, you'll see your physiotherapist every other week. At this stage, the focus remains on improving range of motion, with a goal of achieving 120 degrees of knee flexion and full knee extension. You should be able to use the stationary bike for full revolutions and walk up and down stairs without difficulty. By this time, you can also discuss with your surgeon when it's safe to return to driving.

How to manage your pain:

Effective pain management is crucial for a smooth recovery. Here are some strategies to help you manage pain during your rehabilitation:

Medications: Taking pain medication as prescribed is essential for managing discomfort early on. Once pain becomes unmanageable, it can be much harder to control. Starting with good pain management allows you to get enough rest, sleep well, and successfully complete your physiotherapy exercises in the early stages, which is vital for your recovery.
Ice and Elevation: To reduce swelling and alleviate discomfort, apply ice packs or use an ice compression machine (like a Cryocuff) for 15-20 minutes every 2-3 hours. Elevating your leg when resting helps promote circulation, further reducing swelling and aiding the healing process.
Pacing: Be mindful of your daily activities to avoid overexertion. Long periods of standing or walking, such as cleaning or cooking, can hinder your recovery. Instead, break up tasks into short 10-15 minute intervals, ensuring you don’t overdo it and prevent the energy needed for your physiotherapy exercises. This approach helps you balance activity with rest and ensures better pain control.
Mobility Aids: Use your prescribed mobility aids (crutches, walker, or cane) as directed by your physiotherapist or surgeon. These devices are designed to reduce pressure on your operated leg, preventing discomfort and promoting healing. Avoid putting too much weight on the operated leg to prevent unnecessary strain that could delay your recovery.

Physical activity going forward:

Staying active is crucial for your recovery, but balancing activity with adequate rest is key. Here’s what to keep in mind throughout your rehabilitation:

Early Recovery (0-12 Weeks): Begin with short, frequent walks around your home and neighborhood. As you build strength and confidence, you can gradually increase your walking distance. During this period, it’s important to focus on your prescribed physiotherapy strengthening exercises. These exercises will help lay the foundation for improved strength, flexibility, and range of motion as you continue your recovery.
Post-Rehabilitation (3-6 Months): At this stage, low-impact exercises like swimming, cycling, and using an elliptical machine are excellent options to stay active without putting excess strain on your new knee. Continuing to incorporate strengthening exercises for your quadriceps, hamstrings, glutes, and calves will be beneficial for maintaining and improving strength and stability.
Post-Rehabilitation (6 Months and Beyond): If you’re interested in returning to higher-impact activities, such as running, jumping, or contact sports, it’s essential to consult with both your surgeon and physiotherapist. Each person’s situation is unique, and while high-impact exercises can increase wear and tear on the knee replacement, there may be modifications, techniques, and guidance that will help you safely return to the activities you love.

When can you drive again?

The ability to drive depends on several factors, including which leg was operated on, your range of motion, and whether you’re still taking pain medications. Most patients can return to driving within 6 weeks post-surgery, but it’s essential to:

Consult Your Surgeon: Get clearance from your surgeon before getting behind the wheel.
Practice in Park: Practice pressing and releasing the pedals in a parked car to ensure your reflexes are sharp.

When can you return to work?

The timing of your return to work after a knee replacement depends on several factors, including the nature of your job, your recovery progress, and your overall health. Below are some general guidelines to help you plan:

1. Sedentary Work (Office Jobs, Desk Work):
If your job primarily involves sitting and minimal physical activity, you may be able to return to work as early as 2-4 weeks after surgery. However, it's important to ensure you're able to comfortably sit for long periods and manage any swelling or discomfort.

2. Light Duty (Standing, Light Walking):
For jobs that require light standing, walking, or minimal lifting, a return to work may be possible around 4-6 weeks post-surgery, depending on your recovery progress and comfort level.

3. Moderate to Heavy Physical Work (Lifting, Heavy Walking, Kneeling, or Squatting):
If your job involves heavy physical demands, such as lifting, long periods of standing or walking, or frequent squatting or kneeling, you may need to wait 3-6 months before returning to full duties. Your physiotherapist or surgeon can guide you on gradual return-to-work strategies and ensure you're ready for these activities.

We hope this blog has answered most of your questions about total knee replacement surgery and what to expect. If you still have questions or would like more information, consider booking a pre-operative appointment with one of our physiotherapists. This appointment will provide you with helpful exercises and tools to make your post-surgical recovery smoother and more efficient. To book an appointment, call us at 250-723-5112 or schedule online at www.portalberniphysiotherapy.ca.

Understanding Vestibular Physiotherapy

November 11, 2024

Vestibular physiotherapy is a specialized form of physical therapy that focuses on addressing issues with the vestibular system—the inner ear and brain structures that help control balance and eye movements. When the vestibular system is affected, people may experience dizziness, vertigo, and unsteadiness, which can significantly impact their life. Vestibular Physiotherapy offers targeted exercises and strategies designed to alleviate these symptoms, helping individuals regain confidence in their movement and balance.

Who Should Seek Vestibular Physiotherapy?

Anyone experiencing dizziness, vertigo, balance disorders, or unexplained feelings of disorientation should consider seeking Vestibular Physiotherapy. Specialized physiotherapists are trained to diagnose vestibular conditions, though it is recommended to consult a doctor if symptoms come on suddenly or without explanation. If you’ve already been diagnosed with a vestibular condition like BPPV, vestibular neuritis, or Meniere’s disease, you can often directly book an appointment for treatment. In many cases, a referral is not required to start treatment.

What Conditions Benefit from Vestibular Physiotherapy?

Vestibular Physiotherapy can be effective for a variety of balance-related conditions. Some of the most commonly treated conditions include:

Benign Paroxysmal Positional Vertigo (BPPV): The most common cause of vertigo, often triggered by changes in head position.
Vestibular Neuritis or Labyrinthitis: Inflammation of the vestibular nerve or inner ear structures can lead to sudden, intense dizziness and imbalance.
Meniere’s Disease: Characterized by vertigo, hearing loss, tinnitus, and fullness in the ear, Meniere’s disease can disrupt balance and coordination.
Concussion and Post-Concussion Syndrome: Head injuries often affect balance, coordination, and vision, making vestibular therapy a critical part of concussion recovery.
Persistent Postural-Perceptual Dizziness (PPPD): A chronic dizziness condition that can develop after a vestibular disorder.

What to Expect During a Vestibular Physiotherapy Session

In a vestibular physiotherapy session, a trained vestibular physiotherapist assesses your symptoms, including dizziness triggers, balance, and coordination. Sessions often start with a thorough examination that evaluates your vision, balance, and gait. Based on this assessment, your therapist will design a personalized exercise program, which may include:

Balance and gait exercises: These exercises improve stability and coordination.
Vestibular habituation exercises: These help your brain adjust to movements that trigger dizziness, gradually reducing the symptoms over time.
Vision stability exercises (gaze stabilization): These exercises train your eyes to stay focused while your head is moving, minimizing blurred vision or dizziness.
Canalith repositioning maneuvers (for BPPV): If you have BPPV, specific maneuvers can be performed to help move the displaced crystals in your inner ear back into place, effectively relieving vertigo.

Consistency and follow-up are essential for optimal results, and your therapist will adjust your program as you progress. Depending on the origin of our diagnosis, most people find significant relief from their symptoms after a few sessions, but some may need ongoing therapy depending on the severity of their condition.

Book Your Vestibular Physiotherapy Session

If you’re experiencing symptoms of dizziness, vertigo, or balance issues and think vestibular therapy may help, Port Alberni Physiotherapy is here to support you. Our vestibular therapist, Natasha Prokop, specializes in assessing and treating a wide range of vestibular conditions. You can book an appointment online at www.portalberniphysiotherapy.ca or call us at 250-723-5112.

Physio-Approved Gifts: Health and Wellness on a Budget

November 11, 2024

Looking for a thoughtful, health-focused gift this holiday season that won’t break the bank? We’ve got you covered! In this blog, we’re sharing a list of our favourite health and wellness items that are practical, budget-friendly, and high-quality—plus, they’re guaranteed to get plenty of use. Best of all, these products are physio-approved, so you know they are coming from a reliable source. We’ve included links to our top picks for easy shopping, but if you’re eyeing something else that didn’t make the list, feel free to ask us at your next appointment. We’re always excited to talk about anything that keeps people healthy and moving!

Foam Roller:

Foam rollers are excellent tools for muscle recovery and relieving tension, perfect for home use and in between physiotherapy or RMT sessions. When selecting a foam roller as a gift, look for one with a smooth surface, unless a specific texture is asked for. Choose a roller made of high-density, quality foam for durability. Also, consider the size—rollers come in various lengths. Think about where and how it’ll be used: will it travel to sports events or mainly stay at home? A compact 12-18 inch roller is ideal for travel, while a 26-36 inch roller offers the most versatility for home use.

Most Versatile on a budget: Amazon Basic Foam Roller

Best for Travel: GRID 13 Inches

Best All Around: GRID 26 Inches

Resistance Bands:

Resistance bands make a fantastic gift for the home workout lover or the family member who's always on the go. They’re lightweight and versatile, easy to pack for travel, and take up minimal space at home. With options in different materials, lengths, and shapes (long vs. circular), it can be tricky to choose the right one. For a simple, practical gift, we recommend a high-quality fabric looped band, which can easily add intensity to bodyweight exercises. Look for a durable fabric band with silicone strips to prevent slipping. For a great stocking stuffer, a bundle of varying resistance levels in elastic loop bands is a thoughtful, versatile choice.

Best for Lower Body: Polygon Fabric Resistance Bands (thick) or Peach Bands (thin)

Best Stocking Stuffer: Gritin Resistance Bands

Most Versatile: Arena Strength Bands

Yoga Mat:

If you’re buying a yoga mat as a gift, keep a few key features in mind. First, consider thickness—a mat that’s around 5mm or thicker provides extra cushioning, ideal for joint support during floor exercises. Next, look at the material. High-quality, eco-friendly options like natural rubber or TPE are durable and often offer better grip than standard PVC. Speaking of grip, a textured, non-slip surface is essential to prevent sliding, ensuring safety for poses and exercises. Lastly, think about size and portability. For those on the go, a lightweight, standard-sized mat with a carrying strap is ideal. For someone who primarily exercises at home, a thicker mat with extra cushioning is the crème de la crème.

Best Quality on a Budget: Gaiam Yoga Mat

Best All Around: Jade Yoga Mat

Most Versatile (Double Sided): Lululemon “The Mat” 5mm

Best Travel Mat: Jade Travel Mat

Fitness App Subscription:

A fitness app subscription makes a fantastic gift! Popular platforms like the Peloton App , Nike Training Club, and Alo Moves offer a wide range of online classes guided by expert instructors. On days when motivation is low, having pre-made workouts ready to go can be a game-changer. These apps let users filter workouts by length (20, 30, or 45 minutes, etc.), equipment (like body weight or dumbbells), and even music style—making it easy and enjoyable to jump right in. Peloton and Nike Training Club are among our favourites for their user-friendly design, well-instructed workouts, and fantastic features. A one-year subscription could be the perfect way to keep your loved one moving all year round.

Athletic Socks:

We get it… socks as a holiday gift may seem a little lame. But for a fitness fanatic, high-quality athletic socks are actually a fantastic gift! They’re one of those items people rarely buy for themselves, which makes them a thoughtful, practical choice. If your family member enjoys Barre or Pilates, look for specialty grip socks to help them move easily in class—it’s a small touch that shows you notice their hobbies and want to support them. For the runner or gym goer in your life, breathable socks with extra cushioning are a winner, providing comfort and support.

Socks for the Millenials: Lululemon Power Stride Socks

Best Crew Socks: Gym Shark Crew Socks

Best Pilates / Barre Sock: Happy Full Foot Sock

If you're searching for local holiday gifts, feel free to give us a call (250-723-5112) or check out our social media platforms (Instagram and Facebook) for more ideas. We have a variety of items in stock, including Biofreeze, TENS machines, water bottles, Pilates and yoga equipment, and sports tape—perfect for stocking stuffers or last-minute gift ideas.

Desk Ergonomics and Postural Pain

October 7, 2024

Postural back and neck pain is a common condition often seen in physiotherapy clinics. As more people work from home without having education on proper office ergonomics, musculoskeletal issues such as back pain, neck strains, and carpal tunnel syndrome are becoming more prevalent. The two main contributing factors to neck and back pain in office workers are poor desk ergonomics and lack of postural strength and mobility. Physiotherapists are trained to address both issues through ergonomic assessments and can provide guidance on suitable exercises for work and home.

In this blog, we will discuss desk ergonomic suggestions to promote good posture and prevent pain, as well as suitable desk exercises to reduce muscle pain at your desk.

Ergonomic Suggestions:

Below you'll find some tips for improving your desk ergonomics. Remember, everyone's needs are different, so it's best to get a personalized assessment from a local physiotherapist, your workplace occupational therapist, or health and safety coordinator. If that's not possible, or if you just want some simple suggestions to get you started, take a look at our tips below.

Desk and Chair Height

In any ergonomic assessment, we start with the desk and chair position. These are the most important and will make the biggest impact on your comfort level. Here are our suggestions:

Seated Desk Height: Your desk should be at a height where your forearms are parallel to the floor when typing. Typically, this means the desk should be around 29-30 inches from the floor, but it can vary based on individual height.
Standing Desk Height: If you use a standing desk, the height of the desk should be just below your elbow. Your elbows should be able to sit at 90 degrees when typing. Typically, this is around 38-46” inches.
Chair Height: Adjust your chair so that your feet are flat on the floor and your knees are at a 90-degree angle. Your thighs should be parallel to the floor, and your feet should rest comfortably on the ground. If you can’t achieve this with your current office setup, using a footrest can be helpful.
Chair Lumbar Support: Ensure your chair has good lumbar support to maintain the natural curve of your lower back. You can use a lumbar roll or a small cushion if your chair lacks built-in support.
Backrest: The backrest should support the natural curve of your spine. It should be reclined slightly, at an angle of 100 to 110 degrees, to encourage an open hip angle and reduce pressure on your lower back.

Monitor Position

Monitor position can significantly impact your neck, shoulders, and wrists. If you experience neck pain at work, check your monitor's height and position.

Monitor Height: The top of your monitor should be at or slightly below eye level. This position prevents you from tilting your head up or down, which can strain your neck. If needed, use a monitor stand or a stack of books to elevate your screen.
Monitor Distance: Place the monitor about an arm's length away from you. This distance helps reduce eye strain and allows you to view the entire screen without excessive head movement.
Laptops: Try using a laptop stand and a separate keyboard if your main computer is a laptop. This will help position your neck and head correctly and allow your wrists to be in a more ergonomic position.
Dual Monitors: If you use dual monitors determine which one is for primary use or if you use both equally, that will help with the setup. If you have a primary monitor it should be set up directly in front of you and the distance and position suggested above. The secondary monitor should be placed next to the primary monitor, at the same height and distance. It should be angled slightly towards you to minimize head and neck movement. If you use both monitors equally, place them side by side and angle them inward slightly to form a slight curve. The point where the monitors meet should be directly in front of you, ensuring minimal head movement.

Keyboard and Mouse Placement

Your keyboard and mouse position has an impact on your wrist, hands and believe it or not - your shoulders. Good ergonomic placement can prevent wrist strains, carpal tunnel, and even upper back pain and tension headaches.

Keyboard: Your keyboard should be directly in front of you, with your wrists straight and your hands at or slightly below elbow level. A negative tilt keyboard tray can help maintain a neutral wrist position.
Mouse: Position your mouse close to your keyboard to avoid overreaching. If you use a mouse frequently, it is recommended to try an ergonomic mouse since it provides a more natural position and can prevent wrist and thumb strains.
Keyboard and Mouse Supports: You can also try a gel keyboard or mouse pad with wrist support to allow for a more neutral and relaxed wrist position.

Additional Tips

Document Holder: If you frequently refer to documents, use a document holder placed at the same height and distance as your monitor to avoid repetitive neck movements.
Lighting: Ensure your workspace is well-lit to prevent eye strain. Position your monitor to reduce glare from windows or overhead lights.

Desk Posture and Exercises:

As physiotherapists, we commonly get asked “What is "good" desk posture?”. Well, the truth is your best posture is always your next posture. Humans are meant to move; we are not meant to be stuck in one position for long periods. Holding a stiff upright posture can feel just as bad as being slumped over a computer desk if maintained for too long.

So why do we all think that a slumped posture is a "bad" posture? Well, it's because most of us spend way too much time in that position. We work for 8 hours at a computer, drive home slumped over our steering wheels, and then sit on a sofa peering down at our phones. It's not that it is a bad position; we just spend too much time in it. And what happens if we spend too much time in one position? You guessed it... pain.

The solution to solving postural pain is intuitive - to prevent postural pain, try your best to incorporate more movement into your weekly routine. This can include a balanced functional strengthening routine, mobility exercises, or even stretches at your desk. Just by moving your body more frequently, you should notice your neck, back, and shoulder pain start to alleviate. Movement is key to fixing postural pain!

We have gone ahead and selected exercises that are easy to incorporate at your desk, at home, or at the office to get you started at building strength and moving more.

Seated Cat Cow: This exercise is great for moving your full spine through flexion and extension. It is simple to do at a desk and doesn’t require equipment. You can start with the following amount: 1-2 x 10 reps

Scapular Squeezes: This exercise targets your rhomboid muscles and thoracic spine. It moves your spine into extension helping you get out of a slumped position and strengthens the muscles between your shoulder blades. Try 2 x 10 reps to start.

Banded W’s: If you need something a little harder, Banded W’s work on the postural muscles between the shoulder blades, mid-back and neck with a bit of resistance. You can start with 2-3 x 10 reps

Neck Stretch: This exercise focuses on elongating and stretching the muscles in your neck, specifically your scalene muscles. Your scalene muscles can become exceptionally tight from a slumped forward posture, and stressful breathing. Try 3 x 10 second holds on each side to get started.

Figure 4 Stretch: The Figure 4 stretch targets your glute and piriformis muscles. These can become tight if you are seated for long periods of time. It is a simple exercise to incorporate at your desk, no equipment required. Try 3 x 10 second holds on each side

Hip Hinge: This exercise helps move your hips through a full-range flexion and extension. It also strengthens your glutes and extends your thoracic spine. It is a great exercise for people who sit most of the day. Start with 1-2 x 10 reps during your work day.

Lateral Lunge: This exercise is a great hip opener, taking your hips through a big range of motion. Lateral lunges focus on hip abduction, which is not a common position for desk workers. It’s a nice stretch. Try 3 x 10 repetitions alternating left and right.

Setting up your office desk correctly is crucial for preventing postural pain and ensuring long-term comfort and productivity. An ergonomic workspace can significantly reduce the risk of developing musculoskeletal issues such as back pain, neck strain, and carpal tunnel syndrome.

If you’ve read through this blog and are struggling to get your desk ergonomics right, have more specific questions, or need more individualized exercises, reach out to your local physiotherapist. At Port Alberni Physiotherapy, we offer in-person Ergonomic Assessments at your place of work or home office. You can call us at 250-723-5112 to book an appointment.

A Small Blurb on The Benefits of Women's Health Physiotherapy

August 19, 2024

When we think about physiotherapy, the first thing that often comes to mind is sports injuries, chronic back pain, or post-surgery rehabilitation. But did you know that physiotherapy plays a crucial role in women’s health too? Women’s health physiotherapy is a specialized field that addresses a wide range of issues unique to women, from pregnancy-related discomforts, like abdominal separation, coccyx pain, and pelvic girdle pain to pelvic floor disorders, like urgency incontinence and prolapse. A lot of these conditions are VERY common and are not something you need to struggle with. Symptoms can be reduced if managed properly and addressed in a timely manner by a women's health-specific physiotherapist. Let’s dive into how these women’s health services can be beneficial.

Pregnancy and Postpartum Care

Pregnancy is a beautiful experience, but it can also be physically demanding. Your body undergoes tremendous changes, which can lead to discomfort, pain, and sometimes more serious issues like pelvic girdle pain or incontinence. Women’s health physiotherapy offers tailored assessments, exercises, and treatments that help manage these challenges, making your pregnancy journey smoother.

During postpartum recovery, physiotherapy can be invaluable. It helps in restoring core strength, improving posture, and addressing any issues that may have arisen during pregnancy or childbirth, such as diastasis recti (abdominal separation), pelvic floor dysfunction, incontinence, back pain, or pelvic girdle pain. With the right guidance, you can regain your strength and confidence as you navigate the early stages of motherhood.

Pelvic Floor Health

The pelvic floor is a group of muscles that support the bladder, uterus, and bowel. Strong pelvic floor muscles are essential for bladder and bowel control, sexual function, and overall core stability. Unfortunately, many women experience pelvic floor dysfunction due to childbirth, aging, or other factors. This can lead to issues like incontinence, pelvic organ prolapse, or chronic pelvic pain.

Women’s health physiotherapists are trained to assess and treat pelvic floor disorders. Through a combination of exercises, manual therapy, and education, they can help you strengthen and control these muscles and improve your quality of life. Whether you’re dealing with minor discomfort or a more severe condition, physiotherapy can make a significant difference.

Supporting Women in Every Stage of Life

Women’s health physiotherapy isn’t just for pregnancy and postpartum care; it’s beneficial throughout every stage of life. For young women, it can address menstrual pain or help with sports-related injuries. For those going through menopause, physiotherapy can help manage symptoms like pelvic floor weakness or osteoporosis-related issues.

As women age, maintaining mobility, strength, and balance becomes increasingly important. Physiotherapy can help prevent falls, manage arthritis, and keep you active and independent for as long as possible. Women’s health physiotherapists are physiotherapists with a specialty. Most have experience with orthopedic conditions and they have the benefit of addressing a multitude of issues and combining treatments.

Tailored Care Just for You

One of the most significant benefits of women’s health physiotherapy is the personalized care it offers. Your physiotherapist will take the time to understand your specific needs and goals, creating a treatment plan that’s uniquely yours. This individualized approach ensures that you receive the care and support you need, whether you’re recovering from surgery, managing a chronic condition, or simply looking to improve your overall health.

Women’s health physiotherapy is more than just a treatment—it’s a pathway to better a better quality of life, and a smoother entry and recovery from pregnancy. By addressing the unique health challenges that women face, this specialized care can help you stay strong, active, and confident. If you’re experiencing any issues that you think might benefit from physiotherapy, consider booking an appointment with a women’s health physiotherapist. At Port Alberni Physiotherapy & Wellness, Lauren Siddall has special training in women’s health services, as well as orthopedic conditions, and clinical pilates. To book an appointment visit us at portalberniphysiotherapy.janeapp.com

Understanding Osteoarthritis and How to Manage

August 13, 2024

Have you started noticing stiff and painful knees or hips? Are you experiencing swelling in your knee(s) after activity or running errands? Are you struggling to get out of bed due to joint pain and stiffness? Does your knee pain limit your ability to be physically active or restrict your job demands? These are all initial signs of osteoarthritis. As physiotherapists, we get a lot of people asking questions about osteoarthritis (OA), with over 20% of Canadians struggling with some sort of arthritic condition. In this blog we are going to break down the condition step by step and give you tips on how to manage it effectively.

What is Osteoarthritis?

Osteoarthritis, commonly referred to as OA, is the breakdown of joint cartilage (the tough material that covers bone), and changes to the underlying bone and surrounding joint structures.

The features of OA include:

Loss of articular cartilage with narrowing joint space
increased density and cysts of the underlying bone
stiffening of the joint capsule
degeneration of the meniscus, often with meniscus tears
osteophyte formations

The picture below shows the differences between a healthy knee joint and a knee joint with OA.

How does Osteoarthritis develop?

OA develops when the degradation of articular cartilage super-seeds the synthesis of healthy articular cartilage. Meaning, that cartilage covering your joint surface is disappearing faster than it is being reproduced.

We won't bore you with the underlying metabolic process that causes these changes but know that a lot of research has been done to show how this occurs. If you want to learn more about the science you can click here to read more.

Factors that cause cartilage degradation include:

Too much mechanical stimuli or use (i.e a previous trauma to the joint, too much use of the joint due to work or sport, joint mal-alignment or poor biomechanics, muscle weakness, and increased body weight)
Too little mechanical stimuli (i.e not enough use - living a sedentary lifestyle)
Inflammation mediators (body weight and genetics)

Basically, a joint must be used a healthy amount with good alignment to build and maintain healthy cartilage… think of Goldilocks, not too much, not too little, but just right.

What are the main risk factors for developing Osteoarthritis?

We often receive the question "What did I do to cause the osteoarthritis?" In some cases, there is nothing you could have done differently. Some people are more predisposed to developing osteoarthritis than others. Genetics, gender, and age play a significant role and are factors that cannot be changed. Below, we have categorized the risk factors for osteoarthritis into two groups: non-modifiable (things you can't or couldn't have changed) and modifiable (things that can or could be changed).

Non-Modifiable Risk Factors for OA

Age: Being over 40 years of age
Gender: Being Female
Genetics: Having a family history of OA

Modifiable Risk Factors for OA

Being Overweight
Having a prior joint injury
Having a hard physical occupation
Overuse of joints in spare time (i.e choosing a sport or hobby that is hard on your joints).

What can I do to prevent Osteoarthritis?

A consistent strength and cardiovascular routine can reduce the risk of developing OA. Canadian Physical Activity Guidelines recommend for the ages of 18-64 an accumulation of 150 minutes of moderate-vigorous physical activity per week and two strength training sessions using major muscle groups per week. If you are over 65, the recommendation is the same as above, with the addition of physical activities that challenge balance.

Strength training can help prevent osteoarthritis by building stronger muscles around a joint, providing better joint support and stability, reducing the load and stress on the joint, maintaining proper alignment, and reducing the risk of joint damage. Additionally, it can aid in weight management by building muscle mass and increasing your metabolic rate. Regular strength training also promotes the flow of synovial fluid, which nourishes the joint cartilage and keeps it healthy. This fluid also helps lubricate the joint, reducing friction and wear.

Cardiovascular activity is also important for joint health. Regular gentle cardio like running, swimming, and biking help to control your weight, keep your joints moving in a healthy way, can increase muscle strength, and help with circulation.

Overall, movement in the right amount with proper joint alignment is a key factor in reducing the risk of osteoarthritis.

How do I manage a diagnosis of Osteoarthritis?

here are various approaches to managing osteoarthritis, and the chosen pathway is usually based on the patient's prior treatments and the severity of the condition.

The first stage of OA treatment involves education, evidence-based exercises, and weight management. Education focuses on the development, signs and symptoms, management strategies, and treatment options for osteoarthritis. This helps patients understand the physiology of OA, what causes flare-ups, and what options are available to them. Education also empowers patient, helping them advocate for themselves and make informed decisions about their treatment. In addition to education, it is recommended to start an evidence-based exercise program targeting the muscles surrounding the affected joint, as well as implementing weight management strategies (such as nutrition plans).

If a patient is not showing signs of improvement in the first stage of treatment, pharmacological interventions are introduced. This would include pain medication, possible steroid injections, or weight management medications. In tandem, some patients will select to try an offloading brace (for knee OA) which can be prescribed by your physiotherapist or doctor and requires a custom fitting. Custom braces can be expensive but are typically covered by extended healthcare plans.

If a patient has tried education, evidence-based exercises, weight management, pain medication, possible injections and bracing and not managing well (i.e having difficulties at work, unable to perform daily tasks, or describing a lower quality of life), then joint replacement surgery becomes a viable option. In Canada, surgery is a final treatment option as it is the most invasive choice. Joint replacement surgery comes with risks like all surgical interventions and if this can be avoided with other conservative methods it is advised. Joint replacements typically only last 15-20 years, before needing a revision. Therefore, if a joint replacement is completed on a patient in their 40’s they may need two or three revisions in their lifetime. This is why a surgeon or doctor may ask a patient to wait until they are older before surgery is suitable.

Because of the complexity and frequency of osteoarthritis resources have been created to support patients on their journey with the condition. One of the best resources available is GLA:D Canada, there are online tutorials and education available, as well as in-person exercises and education programs around the country.

If you have been diagnosed with osteoarthritis or would like to learn more about the condition, reach out to your local physiotherapist. Physiotherapists can guide you through each stage of the process, assist with an evidence-based exercise program, discuss or prescribe bracing options, and provide you with education on the condition.

At Port Alberni Physiotherapy, we have physiotherapists with special post-graduate certifications in osteoarthritis management who would be happy to help you. To book an appointment, please visit our website www.portalberniphysiotherapy.ca or call us at 250-723-5112.

5 Best Places to Paddle Board Around Port Alberni

July 22, 2024

Port Alberni has some amazing local paddleboarding spots to explore. Paddleboarding has become more popular over the past few years, which has inspired us to highlight the areas around the Alberni Valley. We are extremely fortunate to live close to Strathcona Park and have lake and ocean access offering a simple way to stay active close to our community. If you are looking for a new summer activity or just new inspiration we have sussed out the best spots to get started.

Sproat Lake

This is an easy suggestion, but definitely one of the best. We are incredibly lucky to have such an amazing lake on our doorstep with public access. You can easily take an inflatable or fiberglass board to Sproat Lake Provincial Park. Parking is relatively easy, just make sure you get there early on a weekend as the parking lot can fill up fast. There is a small trail leading to the lake access that wraps around to the east giving you more spots to launch.

Taylor Arm Park is also an easy place to launch. We recommend using an inflatable paddleboard since there is a small trail under an overpass you will need to walk under. This park tends to be less busy and offers beautiful quiet views of the lake.

Fossil Park has slightly more secluded public access to Sproat Lake. There is a beautiful old-growth forest trail leading to the lake. The trail takes about 30 minutes to walk making it more suitable for an inflatable paddle board. Once you get there, there is a beautiful pebble beach and flat grassy area to pump up.

Canal Beach

This previous plywood mill site has been revitalized into a public green space and has access for non motorized water sports, making a great place to paddle board on the Alberni Inlet. This area is on the ocean so be careful of a small tide and possible currents. Click here for more information about the park.

Loon Lake

Photo Courtesy of Mosaic Forestry Management

Loon Lake is situated 10 km east of Port Alberni and can be accessed by the public through the Mosaic Campground sites. Recently, Mosaic Forestry Corp. constructed a public dock, making it easier to reach the lake. There is a small gravel road that you will need to drive down, so it's important to have a good vehicle with proper tires. Both inflatable and fiberglass boards would be suitable.

Nahmint Lake

Photo Courtesy of Vancouver Island Off Road & 4x4

There are two possible access points to Nahmint Lake: Nahmint Lake Recreational Site and Blackies Beach. To reach both points, you will need to drive down active logging roads. The roads are well maintained, but we recommend having adequate clearance and good tires. Once you are at the lake, you will see gorgeous mountain views, a gravel beach, a quiet environment and away from the hustle and bustle of Sproat Lake. If you are looking for an enjoyable quiet paddle with some privacy, Nahmint Lake is the perfect spot for you.

Doran Lake

Doran Lake is located 40 km west of Port Alberni on your way to Ucluelet and Tofino. After turning off Highway 4, you will drive for about 20 minutes down a logging road that tends to be less maintained the further you go. To access this spot, you'll need an AWD or 4x4 vehicle. Since it is only accessible by car, both fiberglass and inflatable paddleboards are suitable for use. Upon reaching the lake, you will find clear water and ultimate privacy, as it's rarely accessed other than by anglers and the occasional local. Most of the lake is rocky, which can make launching a bit tricky, but you'll be able to find a suitable spot if you take a walk around.

Let us know if you've tried out any of these recommended spots by snapping a pic and tagging @portalberniphysiotherapy on Facebook or Instagram. We would love to be a part of your stand-up paddle-boarding adventure!

How to Wear Your Hiking Backpack

May 15, 2024

As hiking season approaches, many people are gearing up to spend more time outdoors to stay active. With the increase in heavy backpack usage, we've noticed an uptick in the number of individuals visiting our clinic with complaints of back, neck, and shoulder pain after long hikes. Properly wearing your backpack is crucial for reducing muscle tension and pain during your treks. Below, you'll find our tips and tricks on how to wear your backpack correctly, pack it to distribute the load appropriately, and some additional tips on using hiking poles for added fun. So, sit back or buckle up and have a read...

How to Wear Your Hiking Backpack

Wearing your hiking backpack correctly can make a huge difference in preventing shoulder, neck, and back pain. Before we delve into this, it's crucial to have a properly sized backpack. If you hike frequently, it's worth investing in a backpack with a suspension system to ease the load on your shoulders and provide better breathability. There are also male and female versions of backpacks, with the primary difference being the width of the frame. Female backpacks are generally more narrow, offering a snugger fit across the chest and shoulders. Hiking backpacks are typically sized once you reach the 40-50L range and above. It's best to have someone measure you to ensure you purchase the correct size. The main issue with having the wrong size is that the frame may be too long, preventing you from being able to look up, and the hip belt may be in the wrong place, making it more difficult to carry weight around your hips.

Once you have the correct size backpack, you are ready for the next stage… how to wear it properly.

Step 1: Locate the top of your hips, place the hip belt firmly around your waist and cinch tight.

You can find the correct spot by placing your hands on the tops of your hips or natural waistline, this is also called the iliac crest. It would be the same place you would carry a child or a laundry basket.

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Step 2: Lean forward and pull the side straps tight. You want to feel cinched in but comfortable at this step. Your lower body should be holding most of the backpack‘s weight at this stage.

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Step 3: Adjust the top straps for balance. This step is a personal preference. You can lengthen or shorten your top straps based on how you want your backpack to feel. You should be able to easily fit your 1-2 fingers between your upper straps and your shoulders.

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With the correct backpack size and fit, your hips and lower body should be supporting most of the backpack’s weight. This will reduce stress and strain on your neck, back, and shoulders, making it more comfortable for both long and short treks

How to Pack Your Hiking Backpack

Packing your backpack correctly is a crucial step in making your hiking experience more comfortable. Having your heavy and light items in the appropriate place can alter your pack’s weight distribution changing the way the backpack feels.

Step 1: Light Non-Essential items on the bottom.

You want to pack light non-essential items first so they sit at the bottom of your bag. This would include things like:

Sleep bags
Towels
Air mattress
Camping pillow

Placing soft items on the bottom of your backpack also gives your backpack a cushion when you take it off. The soft items will protect more expensive things like your stove, gas canisters, food etc.

Step 2: Heavy items in the middle

Heavy items get packed second so they are in the middle of the pack. This brings the heavy items closest to your center of gravity, making them easier to carry. Heavy items would include

Food
Clothes
Camelbak (Extra Water)
Stove
Gas

Step 3: Lighter Easy to Grab Essentials on the top.

The top of your backpack should be packed with essential items that you need quick access to, but that are not too heavy. Things like:

Sunscreen
Light snacks
Toiletries
First Aid Kit
Rain Jacket

Organizing your backpack with light non-essential items near the bottom, heavy items in the middle, and light essential items at the top allows your back to be properly balanced. This positioning aligns your pack with your center of gravity, providing greater stability and making your back, neck, and shoulders more comfortable during hiking.

How to Use Hiking Poles

Hiking poles are a great way to reduce stress and strain on your muscles and joints. They give another point of contact while hiking, which can make you more stable going up and down hills. To use hiking poles, you want to lengthen the poles so that your elbows are just under 90 degrees while holding onto the handles.

When hiking steep uphill terrain you can shorten the poles slightly to make them easier to use. When hiking steep downhill terrain you will want to lengthen your poles to make it easier to contact the ground and give you support.

We hope this information helps and you have an amazing hiking season ahead. As always, if you have specific questions or want to be shown how to do this in person, book an appointment at our clinic, Port Alberni Physiotherapy & Wellness.

Exploring the Rotator Cuff

April 10, 2024

Have you ever heard the term rotator cuff, but wondered what it is? Maybe you’ve had a rotator cuff injury but were never shown shoulder anatomy, and were left feeling confused. Well, we are here to break it down and make it simple. By understanding shoulder anatomy, you can better understand why your physiotherapist gives you those funky exercises, why your shoulder may be painful in certain places, or why particular movements may make your pain worse.

The rotator cuff is a common sight for shoulder injuries and pain but many patients struggle to understand its anatomy. The rotator cuff is made up of four muscle groups (sometimes 5 depending on who you ask) with the acronym S.I.T.S - referencing the first letter of each muscle - Supraspinatus, Infraspinatus, Teres Minor, and Subscapularis. Some practitioners will also include the Long Head of the Biceps in this grouping as well.

Let’s dive a little deeper into each muscle group…

**Supraspinatus Muscle:** This is the most superior muscle of the rotator cuff, sitting on the top portion of the scapula (shoulder blade) in a gully called the supraspinatus fossa. The tendon runs through a narrow space in the shoulder complex and attaches to the humerus (arm bone). Because of this muscle's orientation, it commonly gets compressed or squashed due to poor shoulder posture or biomechanics.
Its main action is to lift the arm out to the side, or abduction, for the first 10-15 degrees. It also assists the deltoid in abduction between 15-90 degrees.

**Infraspinatus Muscle:** Sits on the back of the shoulder blade and attaches to the outer side of the head of the humerus.
Its main action is to rotate the shoulder outwards (external rotation) and helps with extending the arm back..

**Teres Minor:** This muscle sits very close to the infraspinatus on the back of the shoulder blade but is much smaller, and also attaches to the outside of the head of the humerus.
Similar to the infraspinatus, its main action is to externally rotate the shoulder and assist with extension of the arm.

**Subscapularis:** This is the largest and strongest muscle of the rotator cuff. It sits on the front of the shoulder blade, between the shoulder blade and the ribcage, and attaches to the front of the humerus.
Its main action is to rotate the shoulder inward (internal rotation)

Understanding the four main muscles of the rotator cuff, their orientation, and the actions they are responsible for can help you comprehend why certain positions or movements may cause pain.

The Role of the Rotator Cuff

The rotator cuff is responsible for creating stability of the shoulder while assisting with movement. The four muscle groups form a “cuff” around the shoulder to aid in its stability, hence the term rotator cuff. The anatomy of the shoulder joint is inherently unstable, with a large humeral head making contact with the shallow surface of the scapula. In practical terms, think of a golf ball sitting on a golf tee, this seems unstable right? A small force could cause instability to the golf ball or cause it to fall off altogether. This rings true for the shoulder as well. The rotator cuff keeps the “golf ball on the tee” increasing the stability of the joint.

The rotator cuff is also involved in almost every movement of the upper limb, providing the “fine-tuning” of the shoulder. When you throw a baseball the rotator cuff is working, when you carry your groceries the rotator cuff is working, when you type at your desk… guess what, the rotator cuff is working. A healthy rotator cuff means you can type for 8 hours during a workday pain-free, while also heading to a tennis match and producing big forceful swings with confidence. It’s important to have a balance of strength and flexibility in these muscle groups to maintain good function of the entire shoulder complex.

It is well documented that if the balance of strength and flexibility is unequal in the rotator cuff, this then leads to dysfunction, pain, and impaired capabilities.

Common Rotator Cuff Injuries

Rotator cuff injuries can occur at any age. In the younger population, we typically see rotator cuff injuries from a trauma (like a fall) or from overuse with overhead activities (i.e. volleyball, baseball, and swimming). In the older population, rotator cuff injuries are typically due to impingement, and muscle degeneration, which can lead to calcification and tears. Poor biomechanics of the shoulder, like having rounded shoulders at your desk, can prematurely affect the quality of the rotator cuff muscles and tendons due to constant pressure and friction, making it more likely to develop pain, inflammation and tears.

The most common rotator cuff injuries are:

Rotator Cuff Tendonitis (acute inflammation of the tendon)
Rotator Cuff Tendinopathy (chronic inflammation and disorganization of the tendon)
Rotator Cuff Tears (small or large tear(s) of the muscles or tendons)
Impingement Syndrome (biomechanical dysfunction of the shoulder complex resulting in abnormal wear and tear)

Common Symptoms of Rotator Cuff Injuries

The most common symptoms of a rotator cuff injury are:

Pain on the front or side of the shoulder, often radiating down the arm
Painful range of motion, most commonly above shoulder height or when lifting the arm through abduction, external and internal rotation.
Muscle Weakness, most commonly in abduction and external rotation.
Functional Impairments - unable to push or pull without pain, lift overhead, or hand behind the back

It is worth noting that not all rotator cuff injuries are marked with pain or loss of function. Some people may have a significant tear on a scan but no loss in function or reported pain.

With all of this additional information about the rotator cuff, we hope you have a better understanding of the anatomy of the shoulder. Understanding the “why” behind your rehabilitation or the causes of your pain can be a powerful tool in your recovery.

If you have more questions reach out to your local physiotherapist. If you live locally in Port Alberni, reach out to one of us at www.portalberniphysiotherapy.ca or call us at 250-723-5112.

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