We have now been seeing patients in the clinic for two full months and while things are a little different, providing first class care remains the same.

During the shut down we took this time as an opportunity to revamp our internal software system.  This dramatically improved our ability to take online bookings for many practitioners.  You can start by going here to see all your options.  We also started providing "virtual appointments", which we continue to provide as an option for those patients who feel more comfortable starting with an online visit.

1. If you are not feeling well, please stay home and give us a call.  We have options to "see you" virtually, and if that doesn't work we will waive any cancellation fees that might otherwise apply.
2. We are staggering appointments to avoid clinic congestion on arrival and departure.
3. Call us when you arrive, and we will let you know when it is safe to enter.  You can wait in your car or outside and when ready we will show you directly into one of our treatment rooms. If you do enter the clinic before your practitioner is ready we do have limited room in our waiting area which respects physical distancing.
4. When you enter the clinic you will be required to wear a mask, and sanitize your hands.  Practitioners will wear masks during the treatment, and will wear face shields as appropriate for close face to face examination and treatment.  They also wash hands between patients or wear gloves.  Please respect other patients and staff by keeping a 2 metre separation.  Avoid the clinic washroom where possible.
5. For your safety we complete regular cleaning that supersedes Public Health standards.  We sterilize each room after each patient and change linens.  We also regularly sanitize other clinic surfaces.
6. When you are done we are able to bill private insurance directly and/or take touchless payments using debit, Visa and Mastercard.  We can also provide you with receipts emailed directly to you.

While Ontario has done very well so far to bring Covid numbers down, we continue to recognize the need to be vigilant to help avoid local outbreaks and the feared second wave.  Please help us in this endeavor when you come to visit.

As you get back into your regular exercise routine rest assured that we are here to help with any issues or injuries that you encounter.

Thank you very much for your continued business!

When your doctor tells you that physiotherapy would be a good way to reduce the pain and increase the function of your sore joint or muscle, it can be overwhelming.   Some physicians will refer you to a clinic that they prefer.  Some own the clinic they refer you to and therefore have reasons other than your health to refer you there.   We find that most people go home, do a google search, read the reviews and pick a clinic that is convenient, but still seems to be a strong candidate.

But what should you look for in terms of proper treatment?

Recently, the British Journal of Sport Medicine printed an article by Lin et al.  to help answer that question.     They looked at 6232 records and 44 practice guidelines to determine what the best practices are for treating musculoskeletal injuries.    They found that there were 11 things that should be considered when treating injuries:

1. Care should be patient centered.  Decision-making should be shared, taking in the patient’s lifestyles and goals.
2. A screen should be done for serious pathology or red flags.
3. Psychosocial factors should be assessed.   How is this injury affecting your lifestyle – can you still work, take care of your family and enjoy leisure activities?
4. Imaging should be limited – use only if a serious pathology is expected, or if the patient is not responding to conservative treatment.
5. Physical examination including a neurological screen and assessing mobility and strength should be completed.
6. Progress should be evaluated using outcome measures.
7. Education should be provided regarding the problem and how to manage it.
8. Management should address physical activity and exercise.
9. Manual therapy should be used in addition to other treatments.
10. Non – surgical care should be attempted prior to surgical care
11. Facilitate continuation or resumption of work.

​Take this information and ask questions during your assessment.  A high-quality therapist will be able to answer all of your questions confidently, and will be able to address the items above.   If your treatment consists solely of machines and hot packs, or even hands on therapy without exercise, you may not be getting all of the benefits of treatment.  This not only wastes time and money – but keeps you from being the best that you can be. 

I thought that I would spend today answering some of the most common questions that we get about physiotherapy.   If you have a question, please feel free to comment below or reach out to one of our staff.

1. Is physiotherapy covered by OHIP? 

The medical services at Physio Sport Med of Oakville are the only services that are covered by OHIP.   This means that if you are booked in to see one of our medical doctors (not chiropractors), we are able to bill the provincial services.   If you need an injection, there will be a charge as we cannot bill OHIP for the cost of the medication.
 
There are some physiotherapy clinics in Ontario that are covered for qualified patients.  However, they have a different model of service and you will not get the quality one on one time with your physiotherapist.   For more information, please go to:  http://www.health.gov.on.ca/en/public/programs/physio/pub_clinics.aspx
 
2. Do I need a referral?

Our physicians are specialists, and although it is not mandatory, it is preferred that you get a referral from your family doctor to see them.   This helps with communication between professionals and makes sure that our physicians have all the information they need to give you the best quality care.
 
Our other professionals do not need a referral.  However, please note that your insurance may require a referral for it to be covered.   Please check your personal plan or with your human resources department to determine if a referral is needed for insurance coverage.
 
3. How does billing the insurance work?
At Physio Sport Med, we can bill many insurance companies directly for you, as long as your plan allows it.   This means that you are only pay the co-payment at the time of your visit.  
 
4. How do I know that physiotherapy/chiropractic will work for me?
The physiotherapists and chiropractors at Physio Sport Med are experts in injuries and illness of the bones, joints, muscles and how they work together.   If you have any problems with the musculoskeletal system, there is probably something that we can do to help.  However, if you are still uncertain, we ask you to book a free 15-minute consult where we can discuss your concerns directly.
 
5. What can I expect from the first treatment?
Your first appointment should take almost a full hour, your therapist will look at your range of motion, strength and movement patterns.   A range of special tests will be done to determine which structures are damaged and what is causing the damage.   A complete assessment will involve the joints below and above the pain and may also look at joints far from the injury.    After the assessment is complete, you will start your treatment right away.
 
6.Do I need to wear special clothes?
You might.  We do need to have access to the joint that is sore, and usually that means being able to get right to the skin.   This means that if it is your shoulder or arm that is sore, a loose t-shirt or tank top is preferred.   Shorts are necessary to treat your knees and hips.   Do not worry if you forget, if have a small supply of items that you can borrow if you need to.
 
7. Will it hurt?
Some people find that the assessment is a little unpleasant.   We do need to determine what structure is sore and what movements cause the pain.  However, if you provide your therapist with a lot of feedback and let them know as soon pain starts, your discomfort will be minimal. 
 
There are some treatments that can be tender.   Again, feedback to your therapist is necessary to keep this to a minimum.    Remember that you are in charge.  All treatment, including risks, will be discussed with you before they begin.   If you are not okay with it, just let your therapist know and an alternative will be found.
 
8.What if I don’t want to get acupuncture needles?
That is okay.   The risks and benefits of all treatments, including acupuncture, will be discussed before treatment begins.  If you are not comfortable, then just let us know and we will seek another tool.   With over 50 years of combined practice, we have a lot of experience to draw from. 

Many individuals feel like they have their nutrition under control, and then BAM, it’s the holiday season. The holiday season usually means lots of rich, sweet, and high fat foods that don’t necessarily fit with a healthful diet.
 
One of the biggest problems for many people is the development of an all-or-nothing mindset. You’re either on track with your healthy eating efforts or you give up on them all together and get back on track when the New Year passes. This binary way of thinking doesn’t account for shades of grey, and can be responsible for a great deal of negative evaluation of yourself.
 
The reality is, you can remove yourself from both of these categories, because it’s totally possible to stick to your healthy eating plan while fully enjoying the food and festivities this holiday season.
 
Use these tips to help make the holiday season stress-free when it comes to food.
 
1. Balance your plate and make it colourful
Create a balanced plate by filling 1/2 your plate with vegetables and fruit, 1/4 of your plate with whole grains, and the last 1/4 of your plate with lean protein.
 
With vegetables and fruit, aim for colour and variety! And remember,  potatoes don’t count as vegetables.
 
Whole grains include whole wheat, barley, wheat berries, quinoa, oats, brown rice and foods made from them. Whole grains offer a “complete package” of health benefits, unlike refined grains, which are stripped of valuable nutrients during processing.
 
Fish, poultry, and beans are all healthy, versatile protein sources—they can be mixed into salads, and pair well with vegetables on a plate. Limit red meat, and avoid processed meats such as bacon and sausage.

It has happened - the first snowfall of the year.  In my house, it is always an event filled with excitement and promise.  Promise of hitting the slopes in the days (okay, months) to come.  For me, that means tuning the skis and endless reps of squats and twists to prep the quads.   But my boys are snowboarders, how does their prep differ from mine?  How do they prep for the slopes to keep up with their Mom?

The number one difference is the calves.   Working the toe edge of your board can really take a toll on your calves.    Calf raises are a great way to work the muscle in your calf.    Standing on one foot, slowly raise up onto your toe and lower.  For a little extra work, hold onto a 10- to 20-pound dumbbell.  To get a little bit of bonus balance work, stand on a foam pad or boscu ball while doing the exercise.

Obliques are working a little harder as well.   I am not saying that skiers don’t need to work those twisting muscles, but the demands are higher in boarding.    I am currently a big fan of the standing twist exercise as muscles are very position specific and generally, we are trying to avoid laying on our backs on the hills.   For this exercise, you will need a partner.   Grab a medicine ball that is the right weight for you,  stand in a slight squat position on the “ball” side of the boscu ball.   Have your partner stand behind you, twist to one side and hand the ball to your partner.   Twist fully to the other direction and grab the ball from your partner.  Keep going for 30 reps.  Make sure to repeat the exercise to the other side.

Of course, there is one big similarity.   Quads! Boarders need to be doing their squats and lunges too.   Adding a jump squat is a great way to improve performance on the jumps or in the parks.  

How do you prep for the season?  Let us know by commenting below.
​
See you on the slopes!

We are pleased to announce that our physicians are now doing Platelet Rich Plasma injections, more commonly known as PRP, at our clinic.  You may have heard about PRP in the news as it is commonly used among professional and elite athletes. 

However, PRP is not just a treatment option for athletes. There are many people who could benefit from PRP injections. 

PRP involves injecting a more concentrated level of platelets from the patient’s blood back into the area of concern.  Blood consists of liquid, known as plasma, as well as solid particles such as red and white blood cells and platelets.  Platelets contain many growth factors which play an important role in the healing process.  The purpose of PRP is to create a higher concentration of platelets in the blood, hence the name – Platelet-Rich Plasma.

In order to increase the concentration of platelets, blood is drawn from the patient, spun in a centrifuge, and separated into it’s components.  The platelet-rich portion is then injected back into the area of concern.

It is thought that by increasing the concentration of platelets in the injured area, and therefore increasing the number of growth factors, it will speed up the healing process.

PRP can be effective in treating arthritis, tendon and ligament injuries in the elbow, shoulder, and knee, among others.  The research into this method is ongoing.     
​
If you are interested in PRP, you can call us at 905-257-3456 for more information.  You will need a consultation with one of our sports medicine physicians prior to receiving PRP treatment to make sure that this is an appropriate treatment option for you. The consultation is covered by your provincial health plan (such as OHIP).

As an athlete, there are many reasons why you may choose to play through an injury.  Firstly, as an athlete, your love for the game makes it devastating to sit out and watch your team from the stands.  You may also feel bad that you are unable to help your teammates reach their goals.  Finally, you may feel pressure from coaches, teammates, parents, or trainers to return to sport before you are ready. 

As a former athlete, I understand this predicament first-hand.  In my second year of varsity lacrosse at the University of Guelph, I experienced a chain of injuries starting with a pulled quad during training camp.  As I played through each injury, my body compensated for the weak/injured area and a new issue would appear.  As a result, I woke up the first morning of our championship weekend completely unable to bend over without my legs giving out because of a back injury.  Had I taken the appropriate amount of time to recover from the minor pulled quad, I would have been able to help my team and play in our championship weekend.

​I spent the next two seasons at countless physiotherapy appointments so that I could make it through game days with as little pain as possible.  It’s been 5 years since my last season and I still experience back pain to this day.

Since Durant’s recent quick exit from the NBA series, calf injuries have been a hot topic of conversation.  What was the initial injury?  How did it change so drastically?

First, a little anatomy lesson is needed to understand what happened.  The calf is made up of two or three muscles.  The deepest is a very small muscle called the plantaris.  About 20% to 30% of the population do not even have this muscle, however they do not have any change in function or athletic ability.   More critical to function, are the soleus and gastrocnemius.   These muscles are large, powerful muscles that propel the body up (as in jumping) and forward (as in running).  They blend together to form a strong tendon called the Achilles tendon.    

The initial injury was called a calf strain.   This is a small tear or fray of the muscle of the calf.   Although technically it can occur anywhere in the gastrocsoleus complex, it most commonly occurs where the head of the gastrocnemius gradually blends into a tendon.   If you were to look at a muscular calf, the surface muscle, the gastric, is made up of two circular heads that come together about two-thirds of the way down the shin bone.   Where these circular heads come together is where the tendon starts.   This is the most common location for a strain.   Medically, we grade strains as first, second, or third.   A first-degree strain is when the muscle pulls and stretches beyond what is comfortable, but there is no tear of the fibers.   A second-degree strain is where the stretch tears some of the muscle fibers, but the muscle is still securely connected to the bones at each end.   A third-degree tear is when the muscle tears in two.
​

The injury suffered by Durant during the finals was an Achilles tear or rupture.   This is very similar to a Grade three strain.  The tendon has been torn in two and is no longer connecting the two bones.   This means that the muscle is no longer able to generate any power.  Thus, Durant can no longer run or jump.   Surgery or serial casting is needed to repair this injury.  Each case is analyzed by an orthopedic surgeon and the most appropriate way of completing the repair is decided.   Factors considered include age, athletic demands, time span until return to sport, and severity of tear.   Complete rehabilitation of this injury typically takes 6 months to return to sport, although we all know that a professional player may bend this rule slightly.
​
I think the critical lesson for those of us in sports medicine is that we need to make sure that we are not encouraging our athletes to return to sport too early.  Proper strengthening and healing is critical because although the risk of reinjury may be small, the consequence is huge. ​

Concussion is a hot topic in schools.  Thousands of students from Kindergarten to university suffer concussions each year. This can be from a fall, a car accident or from sports.   Following a concussion, cognitive and physical rest is prescribed.  Recent studies have shown us that this rest should be limited to approximately 24 to 48 hours.   After that amount of time, sub-symptomatic activities can actually be beneficial in restoring brain function and reducing symptoms. 

We often hear about athletes returning to sports.   Our professional athletes will have “red jersey” practices where they get back to their technical and fitness skills but refrain from contact.  When tolerated, they begin contact and eventually return to the games they love.

But how does a student return to school?  What are the steps?

There are some simple guidelines:

1. For student athletes, return to school should precede any attempt to return to sport

2.  Like return to sport, return to learn should be coordinated by a trained medical professional.  Ideally, a team of professionals including therapists and doctors is best.

3. There are four stages to return to learn.  A student progresses through each stage when the current demand is met without any increase in symptoms for a minimum of 24 hours.

4. If symptoms increase as they progress, they are to return to the previous level for a minimum of 24 hours. ​

The stages of return to learn include:

1. Light cognitive activity: this includes reading and games done at home

2. School type work/light physical activity:  this is work done that is similar to the demands of school, but in 30-minute blocks.   Some light activity, such as going for a walk, is encouraged.

3. Part time school:  this can be divided into light load and moderate load, indicating the time spent in school, including hours per day or days per week

4. Nearly normal workload progressing to full time demands: Time and homework are increased as tolerated.   At this point, accommodations are often needed as only certain aspects will increase symptoms (ie: reduced computer time).  Physical Education class is not included as it should be increased during the return to sport phase. 

For more information please visit: 
http://horizon.parachutecanada.org/wp-content/uploads/2017/06/RTL-Parachute-2018May.pdf.  
 
The staff at Physio Sport Med work as a team to help guide you through these challenges.  If you think that we could help you or someone you love, please give us a call.  ​

Habits of musicians are often compared to elite athletes.   They practice for hours a day to perfect their skills to achieve success in a very competitive environment.  Like the athlete, these habits can cause damage to the body and result in injury.   Injuries that mean time away from gigs, income, and in the worst-case scenario, a change of career.   So, what can be done?

There are two main factors that contribute to overuse injuries in musicians.
 
1. Repetition:  As it sounds, this means that the body is performing an act over and over again until it is perfected.  However, damage begins when there is not adequate rest.   Initially, the musician will complain of fatigue and tension near the end of the session.   This develops into pain during the session, and then lingering pain when one is away from their instrument.   The most common overuse injury is tendonitis. 

2. Asymmetry: This refers to the need to hold the body in an unbalanced position for an extended period.  An example is a violinist tilting their head to support the instrument as they play.    This can alter the movement patterns of a joint, increasing the risk of injury.  For example, our violinist may develop a nerve impingement on the side towards her violin due to neck posture and reduced space for the nerves to travel from the neck to the arm.
​

1. Reduce time. I know that sounds difficult, but it can be done.   Use a desktop and full keyboard whenever possible.  Even a laptop is less stressful on your hands than a handheld device. 
2. Break the habit.  This is part of reducing time.  If you find yourself checking social media for the third time in an hour, it may be time for a break.
3. Lift it up.   Hold your device higher.   This reduces the amount that your neck must bend.   Always holding your device in your lap creates a lot of stress on the neck.  Ideally, hold it at chest level, or even higher.
4. Roll the neck.   You can look down two ways.   The first is letting your chin jut out making most of the work come from the upper back and lower neck.   This is very stressful for the muscles of the neck.   When looking at your device, think about bringing your chin to your throat or Adam’s apple, this will curl the upper spine and stretch the back of the neck.   Try it and feel the difference.  It is a current adage that should become as important as “lift with the knees.”
5. Put it down.   Whenever possible, place your device on a table or a desk.   Not only does this reduce wrist stress from holding it, but you can then use both hands and all your fingers for typing.
6. Avoid the thumb scroll.  Commonly, smartphone users will use the thumb of their dominant hand to scroll through their screen.   This is very difficult for the thumb and can add up over time.   Think about it, the strength of our thumbs is for gripping.  This motion is very different than most other demands on the thumb.  Instead, hold the device in both hands and use the index finger to scroll.  
7. Talk and listen.  When possible, use a talk to text command to avoid typing and sweeping.  A blue tooth connection prevents the urge to hold the phone between your shoulder and ear, preventing neck cramping and injury.

If you do notice pain and swelling in your hands, heat and slow motions through range can help restore blood flow and reduce pain.  If the problem persists, see your physiotherapist.  We are here to help. 

So now, here is the real question.  How do I maintain or continue to progress my training while dealing with an injury?

First, I took a couple of days rest.  Although fitness will decrease quickly with complete rest, healing was necessary.   Since I am training for a triathlon, swimming is an obvious first choice.     My ankle and foot quickly returned to full range-of-motion.  This is something that should be achieved before returning to any activity involving the injury.    If not, your technique will suffer, and you risk an injury to the compensating joint.   Now, I have already stated that I love to swim.  So, hitting the pool with a few extra laps of freestyle was not an issue for me.  But if you are not a swimmer, consider doing a leg only pattern to keep the legs strong and the heart rate high.   The other option is water running.   Holding a pool noodle under your arms, run through the water with the same mechanics as on land.   It is slow and arduous, but again your heart and lungs will work hard, while keeping the foot healing.

Next came cycling, which has been difficult this spring due to cold rainy days.  Due to this, my initial training happened on a stationary bike.   This was a good place to return.     Stationary bikes offer more control with intensity.   You can also stop if you notice symptoms returning.   This can be difficult to do if you are 1.5 km from home, but we won’t bring that up again.    Now the sun has come out and I have returned to cycling outside.   It is going well, but I was unpleasantly surprised how much work your foot does when you are out of the saddle.   This means that I plan my routes carefully.  I want to hit some hills so that I am increasing the workload of my training, without causing too much discomfort.  Slow gradual hills seem to be the answer.   Luckily in Halton Hills, these are easy to find. 

​Medical testing - not usually the best place to start:

Traditional testing such as MRI and X-rays are not typically useful when treating low back pain.   Your doctor may order tests to rule out serious pathology, but these results are used to rule out serious issues and are typically less valuable at pinpointing the actual cause of pain.   For example, it may clearly tell you that there is no fracture of the bone, or tumour in your spine.   However, it is misleading to say that the Degenerative Disc Disease (DDD) or disc bulge is the cause of your pain.  

​Studies have tested people with and without pain.  The results are the same – prevalence of DDD and disc bulges were evident in symptomatic and asymptomatic patients (people in pain, and not in pain).   Furthermore, the most common age to complain about low back pain is 40 -59 and as people age DDD continue to progress whereas the pain typically resolves.  If DDD were the direct case of pain, the pain should increase as we age instead of getting better.  This supports the belief that pain is actually a result of other, possibly related, factors.

What to do?  Have a trained physiotherapist, registered massage therapist or chiropractor look at your movement patterns.  If you are not moving ideally, muscle and joints can be stressed resulting in pain.  X-rays, CT scans and MRIs are pictures taken when you are VERY still.   They do not indicate how well things are moving.   In life, we need to keep moving.

Change of attitude:

We need to get away from thinking that bedrest is helpful for low back pain.   Although reduced activity may be necessary in an acute situations it is important not to stop completely.   Gentle movement and strengthening can help to break up spasm and decrease inflammation.   Perhaps more effectively then ice and heat, and definitely better than bed rest. 
With mild to moderate low back pain, exercise and strengthening decreases back pain significantly.   This is done partially by adding muscular support to your spine.   However, pain responses are much more complex then that.    Simple movement and strength teaches your brain what normal movement feels like and helps your nervous system adapt to tissue changes.     Knowing how your back moves and exercises that reduce discomfort, gives people control over their pain.   It may not resolve completely but having the knowledge to reduce the severity and frequency of bad days is great power.
Non-Steroidal Anti-inflammatories (NSAIDS – Like Aspirin, Advil, Voltaren etc.), surgery or more complex medical care is useful in only a few cases and typically should only been prescribed when exercise and education have not been successful in returning function and controlling pain.

Tricia Hayton is a Registered Physiotherapist and Partner at Physio Sport Med

1. Choose a method of eating that is enjoyable, sustainable and fits with your lifestyle
   The reason that so many diets fail is that they’re just not sustainable in the long run Diets tend to approach nutrition and weight loss as a temporary state of mind. I mean we can only endure juicing cleanses or eat cabbage soup for so long!! The reality is, there’s no such thing as a one-size-fits-all diet. Different methods work for different people. Find an approach that you’re actually going to enjoy and be able to stick to over time.
   
   
2.  Identify your values and rise to the challenge
   Changing your eating habits can be difficult! Get over this road block by reflecting on why you want to change your eating habits. Is it to have more energy? To be able to be more active? To have more self-confidence? No matter what the reason, write it down and refer back to it when you feel like giving up. Yes, it may be challenging, but you are worth it!
    
   
3. Meal prep-seriously, it’s a game changer!
   Meal prepping can be as simple as preparing freezer smoothie packs for breakfast or more complex like cooking complete dinner for the upcoming week. No matter how you slice it, there’s no one right way or method to meal prep-it’s about what works best for you. Too often people get bogged down by the details, when in reality, sticking to the basics will probably do more good. Set aside an hour or so each week to plan your meals, grocery shop and do some basic food prep (chop of veggies, etc). This little time investment will make it much easier to stay on track.
    
   
4. Make enough at dinner so you have leftovers for lunch
   This could almost be a part b) to the last tip. When choosing your dinners for the week, plan to make a little extra so you can take the leftovers for lunch the next day. Some foods actually taste better the following day since it allows more time for the flavors to combine and develop.
    
   
5. Don’t force foods you don’t like
   Find healthy foods that you actually like. Don’t force yourself to eat foods that you don’t enjoy just because they’re ‘healthy’ (what does that word even mean anyway). Keep experimenting with different foods until you find options that work for you.
    
   
6. Enjoy your favorite foods
   If you love chocolate, allow yourself to enjoy it in moderation. Otherwise you’ll leave yourself feeling deprived longing for a taste of that mouth-watering, rich, milky, creamy, bitter delight!  Remember that healthy eating is not about denying yourself your favorite treat foods, it’s about enjoying them along side nourishing, whole foods.
    
   
7. Get friends and family on board
   Invite your friends and family to join you on this journey. Healthy eating becomes a lot easier when you have support and people to share your experiences with along the way. Create a recipe swap or a meal exchange group and have weekly check-ins to hold each other accountable.
   
   

So there you have it, seven tips to help you with your ‘Eat Healthier’ resolution. Working with a registered dietitian can help you navigate these tips so you can start the year off on the right foot.

Often in our training schedule, we will purposely increase volume and/or intensity of training load in order to potentiate physiological adaptations that would result in longer term increase of performance.  This is called overreaching.  Yes, this is a good thing, but we must plan a proper recovery period or else this may lead to something called overtraining syndrome. 
 
In a nutshell, overtraining involves the accumulation of stress, leading to a decrease in physical and mental performance in sport.  Most often, there is a mismatch between the load (the training stimulus) and adaptation (or I should say, maladaptation).  Not only can we see performance changes, but it's also associated with hormonal, immunologic, neurological, and psychological disturbances.  
 
Before we go over this list, it's important to note that it is always OK to visit your healthcare provider when you are not feeling well.  That's what we are here for!
 
Here are 11 signs and symptoms that you may be overtraining:
 

1. Immune system alterations.  
2. A loss of appetite.
3. For the gents, a loss of virility
4. Fatigue
5. Being in a depressive state
6. Increased irritability
7. Loss of motivation
8. Lack of mental concentration
9. Heavy, sore, stiff muscles
10. Losing weight
11. Decreased performance despite increase in effort

 
Please be aware that this is not an exhaustive list as there can be other signs and symptoms as well associated with overtraining.  Additionally, some of these signs and symptoms may be related to more sinister conditions, which is why it is always a good idea to visit your healthcare provider if you are not feeling well!
 
However, if you are feeling any of these symptoms, it is important to realize that you must take a step back and re-evaluate.  Recovery must be your emphasis.  Make sure your nutrition is on point, reduce your training load, implement meditation to keep the stress down, and I would also urge you to visit your healthcare provider to tailor specific recovery methods to you.
 
THE best way to treat and injury or illness is to avoid it all together!  Here is a short list of things that you can monitor about yourself that may provide hints if you are on the road to overtraining.
 

1. Heart Rate Variability (HRV).  This would involve you buy a heart rate monitor that has Bluetooth and link it to an app on your phone. There are several apps to choose from (I personally use Elite HRV).  When your HRV is getting low, this can be a sign that you may need to increase your recovery.  Remember, HRV is something that's more accurate when you measure it every single day.
2. If you do not want to get a heart rate monitor, you can simply take a morning resting heart rate.  Measure your heart rate when you first wake up while you are still laying down. Log this number daily.  If your heart rate is significantly higher than your norm, you may need to increase recovery.
3. Monitor training load.  Try not to increase in load more than about 10% per week.
   
4. Monitor your weight.  Are you unintentionally losing weight?
5. Just like how you have routine checkups with your dentist, I recommend having routine checkups with your manual therapist.  

 
To conclude, I leave you with these final words:
 
If you train hard, recover harder. 

The day was topped off with a staff dinner and the Alexander Platz Christmas Market. 

As for the team, they continue to progress to Tokyo 2020.   Both the men’s and women’s teams proudly stood on the podium winning bronze in the Team Pursuit.    Including, taking 2 seconds off the Canadian Record.

Our single racers had top 10 finishes in the Omnium.   Although the sprinters had a more difficult time, personal bests were achieved, and we continue to learn from mistakes and technical errors.

Next up is a 17 day stint in New Zealand, where the team will continue to train and excel in the Track Cycling World.

Motor Vehicle Accidents make up a substantial percentage of physiotherapy treatments.   And although most people get back to work and play, it can be a long and sometime painful process that would be better avoided.  

Here are some tips to minimize injury and quicken recovery:

1. Prevention!  If possible, it is best to avoid accidents altogether.  During winter weather, drive slower and leave more space between you and the car ahead.   Snow tires are a great investment in safety.  Ensuring that your car is well tuned is also helpful.  Finally, pay attention to the road and vehicles around you.  
2. Position yourself well.    Adjust your seat so that it is as far away from the air bags as possible while still being able to comfortably reach the steering wheel.   Check to see if the steering wheel is pointed at your chest or face.   If it is pointing at your face, adjust it to be in line with your chest.   Feet flat on the ground.   This may be more relevant for passengers than drivers, but with feet crossed or resting on the dashboards, the safety features of the car can do as much damage as good.  Finally, keep your thumbs off the cross piece of the steering wheel.   Airbags eject with speed and power; your thumbs may be injured if they engage. 
3. Relax and release the brake.  If you see an impending impact, try to relax the muscles of your neck and shoulders. Instinctively, most people tense to try to minimize the movement, however, the forces are generally too big for your muscles to overcome.   Relaxed muscles will end up with less injury.  If it is safe, release the brake of the car.   This will allow the forward momentum of the car to absorb some of the impact.   Injuries are often less if the car is moving slightly versus at a stand still.    However, if movement will create an impact with another car, keep the brake applied.
4. Keep it moving.  If you have pain in the neck or limited movement, go to the emergency room to get checked by a doctor.  Once you have been cleared from serious injuries, try to keep your neck moving through the pain-free range of motion.   This will quicken recovery and get you back to your best as soon as possible.  
5. Seek treatment early.   It is common that the pain will increase during the first few days after an accident.  Studies show us that early intervention through a registered healthcare provider can quicken recovery.

 
Remember that we are here to help.   The first few days after an accident can be a scary and stressful time.   Our practitioners have been through it many times before and can assist you with navigating the experience. 

If you have osteoporosis or osteopenia and are not sure where to go for help, reach out to any of our associates for advice.   We can look at your diet, create and exercise class and get you the on the right path to health.   Remember we are here to help.
 
The statistics in this article were found on the Osteoporosis Canada website.   For more information please follow this link:  https://osteoporosis.ca/

Two nutrients are key in the post-exercise period, protein and carbohydrate. Protein is important to repair, maintain and build new muscles. Carbohydrate rich foods will help to replenish a young athlete’s carbohydrate stores, also know as glycogen, in the muscle and liver. Foods that are a great combination of both protein and carbohydrate are milk, Greek yogurt and cottage cheese.
 
Hydration
Young athlete’s should monitor their hydration across the day, both before and after an exercise session. The color of an athlete’s urine can provide a good indicator of hydration. Ideally, urine should be pale yellow, corresponding with a state of hydration. The darker the colour, the more dehydrated the athlete.
 
Working with a Sports Dietitian
Fueling properly before, during and after exercise is highly individual and will also depend on the type and timing of the workout. A sports dietitian can help young athlete’s understand these guidelines by translating the science of meal timing into practical examples of what, when, and how much food and fluid to consume at any given time. Consider working with a sports dietitian to help fuel your young athlete to their next personal best!

Check out the full article on our Learn Page, or Download the PDF.

Stephanie works out of Physio Sport Med as a Dietitian / Nutritionist, in association with Ben Sit and Evolved Sport and Nutrition.

1. Bundle up!    Although it may not tempt you to enjoy a morning stroll when it is -20 Celsius in January, buying warm and wicking layers can extend your enjoyment of autumn a little longer.   This will allow you to enjoy everything that Canada has to offer from a walk through the autumn leaves, and eventually an outdoor skate in a local park.
   
2. Join a club.   Studies show us that those who exercise with a friend or a group are more likely to achieve their goals and complete their exercise session.  For some joining a gym can be expensive and intimidating, however look to your local community center or recreational programming to find something that interests you and others with the same level of fitness. Private clubs are also available for many sports.
   
3. Try something new.  Whether inside or out be adventurous enough to try something new to you.  If you are someone that skis, why not try an afternoon on a snowboard or ski skates?   If you are more of a warmth seeker, there is always indoor rock climbing or even adult learn to skate lessons. 
   
4. Go Surfing – the net that is.   There are many alternatives to workout videos that you can do today.  You can even join a virtual gym so that you can see others are up and as dedicated as you are.
   
5. Make exercise fun.  Turn exercise into a social outing.  On rainy fall days check out a local bowling alley or laser tag location.   Once the snow falls, nothing beats an hour or two tobogganing.
   
   

Being outside and active may be easier in the warm summer months, but all it takes is a little creativity to keep moving through out the year.

Tricia Hayton