Our ServicesHere's a list of our services
ACUPUNTURE & PHYSIOTHERAPY
Many of our physiotherapists have received post graduate training and certification in acupuncture. Acupuncture involves inserting thin needles in specific parts called acupuncture points. The needles may be stimulated by movement or an electrical stimulator.
Acupuncture can be used for many disorders. Most physiotherapists use acupuncture as part of a complete rehabilitation approach. The positive effects of acupuncture include pain relief, diminishing spasm, & promote healing. Acupuncture works through the nervous system as well as stimulating the release of natural pain inhibiting chemicals such as endorphins.
Treating pain is often a good first step to regaining normal mobility and function, thus ensuring long term rather than short term results.
This is physiotherapy done in the water using the buoyancy of the water to facilitate the exercises.
Aquatic therapies give the patient an alternative exercise experience that they can build onto their individual program. Patients do not need to be able to swim as the program can be adjusted to be in the shallow end where they can touch the bottom or done with a life-jacket on. The therapist is at the pool with the patient and works with them so that they understand the exercises and learn to work on their own.
This is offered at the McPhillips clinic and they are in the development stage at St. James and your therapist can refer you to this program.
Arthritis is a term that applies to any joint (arthro) in which the joint is inflamed (itis). There are two main types of arthritis; osteoarthritis (OA) and rheumatoid arthritis (RA). OA is most common is the result of wear and tear. RA is more of a whole infection and usually starts in the peripheral joints (fingers and toes) before involving the larger joints.
Physiotherapy uses several therapeutic non-painful modalities and manual therapy techniques to decrease swelling in the joints, educates the patient to how not to aggravate the joint and at times prescribes exercises for the muscles around the joint to decrease the stress on that said joint.
Physiotherapy cannot take away the arthritis but with care and support can control and reduce symptoms so that a patient is pain free and more comfortable.
CORE STABILIZATION PROGRAM
This is an exercise program that strengthens the muscles that enhance good posture, support the lower back and gives you an athletic platform for upper body and lower body activities.
The muscle of the core were once thought of as only to be the abdominal muscles and people used to do sit-ups only to train the core. Back patients would only do a ‘pelvic tilt’
Now the core is considered to include your front, back and side areas running from your shoulders to your knees. All exercises involve controlled breathing with your diaphragm as the focus. Progressive muscle strength training in dynamic and isometric holds are trained to keep control of your center of gravity for ‘stabilization’. The stable center of gravity ensures smooth efficient movement for all activities.
People with back problems are taught specific exercise of stabilizers all around the mid portion of the body… the center of gravity area…. so that they can work and play without aggravating their symptoms in a pain free environment.
The care stabilization program follows the detail assessment by your physiotherapist, who individualizes the exercises for your personal needs.
DBP promotes that “exercise is medicine”
To enhance your recovery exercises are done in the clinic and a home exercise program is individually prepared for you.
Hand-out sheets with pictures of the exercises, a description of the exercises and the exercise prescription (weights, tubing, repetitions and sets) will be provided. The exercises can be emailed to you for your permanent records. The DBP physiotherapist will walk you through the your exercise program so that you will do them properly between appointments. You can click on the emailed exercises provided and a video will start to demonstrate how to do the exercises at home.
The home exercises are a very important part of your recovery process so the more committed you are to the exercises the shorter your recovery process.
FMS Functional Movement Screening assesses seven basic movement patterns to help identify muscle asymmetries, tightness, weakness and other risk factors for injury by examining the mobility and stability of the hips, core, shoulders, knees, spine and ankles.
HEADACHES / TMJ
Headaches associated with jaw, dental problems or neck problems are all addressed differently.
There is a complex relationship with ones bite, jaw movement, grinding teeth and headaches. Usually DBP physiotherapists work with dentists to resolve the problem using physiotherapeutic techniques, modalities, night guards and bite guards. Education in oral hygiene and food management are also addressed.
Headaches of a soft-tissue origin are treated with manual therapy, ergonomic postural changes for work, computer work, rest and reading. Direction on pillows, sleeping position and glasses are addressed.
This type of treatment for soft tissue usually does not work like a light switch (one treatment one technique all gone). Changes in symptoms are gradual with usually first changes are in the headache’s intensity, then the area of the symptoms becoming smaller, than symptoms are more intermittent with more time between episodes lastly than at times massage therapy only is need for headache / tension management.
There should be a gradual decrease in the need for any medication.
ICE AND HEAT
When do you use ice and heat?
Ice is used immediately after injury with compression, elevation and support. Ice is used to control swelling, decrease bruising, decrease bleeding and decrease muscle spasm. It should be applied where there is normal sensation for 10min every 2hr while the person is awake for the first 24-72 hrs after the injury. Never apply directly to the skin but in a towel or pack. Movement can be done within the pain free range of movement while the ice is on and the limb elevated.
Heat is used for 10-20min to an area with muscle spasm or stiffness symptoms 48-72hr after injury or for long standing problems. The person should be awake and the area should have normal sensation.
The person can exercise or stretch with the heat on to assist the movement after the heat. Heat can be done by hot pack (moist and most penetrating), heating pad, hot tubs, sauna etc.
Physiotherapist start and end treatment with ice and heat so that patients recovery is enhanced with exercises, mobilizations, manipulation or other modalities.
This is a new area of consulting to business and labour to enhance their safety and reduce individual’s work injuries and time off work.
Industry values their employee so is it important to invest time into
- Analysis of injuries to decrease the number of injury days of the employees per year.
- Site review to look at areas of injury incidences and suggest labor saving methods (lifts, ramps, rollers, carts, dolly and hoists) to help the workers with the job.
- Human Resources hiring practices to screen potential employees to hire the least likely to injure themselves. This is similar to a team selection in sports. Your work team is selected so that physically you don’t place new hires into positions with the physical demands of the job would have them fail physically and get hurt.
- Staff education on site that would remind employees of lifting techniques and correct product handling techniques.
- Circuits for pre-shift stretching and encouraged exercise programs to enhance employee fitness can also be consulted on.
- Work organization so the jobs are rotated to reduce repetitive strain injuries.
Manipulation is a technique frequently utilized by physiotherapists in the treatment of their patients. It involves a “skillful high velocity low amplitude thrust of either a spinal joint (neck, mid back, low back or pelvis) or peripheral joint (ie. wrist, ankle, elbow)”. Often there is a click/pop associated. For many patients the research strongly supports physiotherapy manipulation as an integral component in the management of their musculoskeletal disorder.
Some potential effects of manipulation include:
- Decreased pain
- Increased mobility and range of motion
- Improved functional outcome
The vast majority of patients will be provided with an exercise program after the manipulation to maintain the benefits of the technique and allow for a progression toward independently managing their condition.
Massage Therapists at D’Arcy Bain Physiotherapy are graduates of accredited schools with knowledge in the fields of Anatomy, Physiology, Kinesiology, Pathology, Massage Theory & Techniques, and Remedial Exercises, and have successfully passed written, oral and practical entrance examinations. They are licensed practitioners within the province of Manitoba.
Almost everyone can benefit from massage! Massage is a useful way of treating muscular tension, strains and sprains.
It also improves muscular performance, and is an excellent way to warm-up before games or any form of exercise, as well as relieving delayed muscle soreness after exercise.
In treatment of pregnant and post-partum women, massage can relieve low back pain, swollen legs, and diminish the pain and tension which sometimes follows delivery.
Massage aids in the treatment of headache, poor circulation, and respiratory problems such as bronchitis and asthma.
Anyone who finds it difficult to relax should investigate the benefits of massage.
MINIMIZE RISK OF INJURY
D’Arcy Bain Physiotherapists can assess a person’s physical abilities (strength and all joints range of movement) and the person’s cardio vascular abilities to minimize the risk of injury when starting a new job or exercise program. The physiotherapist can prescribe a plan for progressive resistance exercises to strength all muscle groups so that the person can perform to best of their abilities, reach personal goals and not have any injury setbacks reaching their goals.
ORTHOTICS AND PHYSIOTHERAPY
An orthotic is a prescribed food-bed that goes inside your footwear or sports footwear to support and improve your biomechanical performance of your foot and lower extremity.
This type of support is made through an assessment taking your history of symptoms, examining your foot and lower extremity and your foot wear. Yes your daily shoes, athletic shoes, skates or ski boots tell the physiotherapist how you weight bear. So we order the correcting materials, rigidity and prescribe corrections that will make you pain-free or perform better (get those edges).
From casting to manufacturing may take a few weeks. Orthotics can take 2-3weeks to get used and may need to be modified for a satisfactory fit. Your feet change so after 2-4yrs the orthotics may have to be replaced or recovered. Orthotics are used to control foot pain, ankle and knee symptoms and occasionally hip and back aching.
POST SURGICAL REHABILITATION
Pre-Hab refers to the exercises that a patient may due prior to their surgery. The exercises are done before the surgery to enhance the recovery period from the surgery. Hip and knee replacements have such programs.
Most orthopedic surgeons who operate on joints or repair, re-construct and/or replace joints have post-operative (after surgery) detailed week by week exercise protocols. The surgeon wants these exercises and increases in activity followed each week.
DBP has most of the surgeons protocols as well as those from the world renown surgeons published in the literature. This includes the protocols for shoulder, neck, back, hip, knee and ankle surgeries. Our patients appear to progress uneventfully through these protocols.
DBP tries to educate the patient to be able to do the exercises with weekly or bi-weekly progress appointments so they can do a lot of their exercises at home.
At time, protocols will last for months. The slow, gradual, uneventful progression is needed to have the best and lasting results.
PROGRESSIVE GOAL ATTAINMENT PROGRAM (PGAP)
PGAP can best be described as a life-role re-integration program. Within PGAP, disability is viewed as a condition that prevents individuals from participating in many of the life-role activities that characterized the individual’s day-to-day life prior to illness or injury. The goal is to identify life roles that have been disrupted, and assist the individual in resuming his or her participation in these life-role activities.
PGAP was designed specifically to target the psychosocial risk factors that have been shown to contribute to disability. Research shows that psychosocial factors are often the primary determinants of disability.
Symptom reduction is not an objective of PGAP. Rather, PGAP aims to assist individuals in resuming their occupational involvement. Return to work is positioned as a central objective of PGAP because return to work is the highest level of independence that we can offer our clients. Since return to work is achieved through progressive reintegration in life-role activities, no client fails at PGAP. Even for the client who is unable to return to work, life-role resumption will nevertheless contribute to the client’s quality of life.
PGAP was designed specifically to target psychosocial risk factors. However, unlike most psychosocial interventions, in PGAP psychosocial risk factors are targeted through the use of strategic activity involvement as opposed of psychotherapeutic intervention.
PGAP is a standardized intervention consisting of a maximum of ten weekly sessions between a client and a PGAP provider
Spinal Traction and Decompression Therapy & Physiotherapy
Manual or mechanical traction is applied to the spine (neck or lower back) to ease symptoms in the neck (arms, elbows, hands) or the lower back (buttock, leg, calf, foot). The pull of the traction should cause the symptoms to centralise (come out of the arm or leg). Usually the symptoms are caused by pressure on a nerve from a disc degenerative, herniated, sciatica or spinal stenosis. Traction reduces (decompresses) the pressure and the symptoms should change.
Therapists can do this manually or mechanically (with a machine). Treatment is a continuous or off/on pull for 30minutes. Symptoms should reduce but not resolve with the traction on. This is part of a treatment and should be combined with education, resting positions and exercises. Traction is not a substitute for exercises.
TAPING AND PHYSIOTHERAPY
There are lots of kinds of tape for different therapeutic uses
Supportive Taping: prevents extra range of movement and gives support for sport/daily/work activities to the ankle, plantar fascia, thumb, wrist, fingers and elbows. The larger joints (hip, knee and shoulder) taped reduces function and is not that effective.
Kinesiotaping: provides muscle, tendons and ligaments tactile feedback which helps to limit symptoms. Some tape provides directional support for shoulder impingement, back strain/sprain, tennis elbow, golfer’s elbow, knee problems and ilio-tibial band tension.
Compression Taping: provides pressure to limit/control swelling after an injury or during rehab. It works well for symptoms in the ankle, fingers, elbows, wrists, contusions/bruising and knees.
Physiotherapists take extra courses to apply the tape and it takes practice applying the tape. The patterns for taping are not always done the same but they all support the anatomy underneath the area being taped.
People can be allergic to the tape. Tape on the shoulder not be worn too long or there could be skin breakdown.
TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS)
Transcutaneous electrical nerve stimulation (TENS) is the use of electric current produced by a battery-operated device to stimulate the nerves for therapeutic purposes. The unit is usually connected to the skin using two or more electrodes on trigger or acupuncture points. The benefit of TENS for pain relief is controversial as not all research has definitive results. Physiotherapy uses TENS as part of a treatment session and if TENS is going to be effective should be immediate and last for 2-4hr. Therapists add exercises, re-train movement and mobilize joints with TENS for the patient’s symptom and functional improvement.
Therapeutic ultra-sound (US) modality used in physiotherapy emits a sound wave to promote healing and range of movement.
Therapeutic US does not take a picture but the sound wave on a continuous mode can heat the tissue and with the sound waves mechanical effects can enhance the alignment of collagen fibers in healing. The collagen fiber alignment can help gain range of movement.
The sound head is moved by the physiotherapist over an area (maximum twice the size of the sound head) for at least 5-7min. The physiotherapist uses a gel on the skin to enhance the contact and sound wave transmission into the skin. The area (ankle, knee, hand, shoulder) should be exercised immediately after the treatment for the best results.
US is only part of the treatment session; exercises should be provided to ensure the treatment range of movement gains are maintained. The physiotherapist will guide your treatment dosage and exercise prescription.