What are my rehab goals? 

Whether it is going back to work, starting to drive again, or returning to other daily activities, it is important to think about what you would like to accomplish in rehab. This can sometimes be difficult, so you may want to talk about your goals with your current health-care team before choosing your rehab provider.

Does the provider have experience with my health condition(s)? 

Ask about the qualifications of providers and ensure that the facility has experience providing care for people with condition(s) similar to yours. For example, if you have a burn or an amputation as a result of your motor-vehicle collision, or have complex cognitive needs, choose a rehab provider that has experience in providing treatment for these conditions.

What services are available at the clinic?

Find out if the clinic offers services that fit your rehab goals and needs, and what to expect from a typical appointment. You may want to ask about:

• The different types of services offered at the clinic: Usually, treatment services available for people who have had an MVC includes physiotherapy, occupational therapy, massage therapy, social work, and/or psychology.
• How the treatment will be provided: How long are your appointments? How much individual time will you have with your therapist? Group-based treatment options can help give you social support as you work on your recovery. Some providers can offer treatment virtually, depending on your needs.
• Other services available at the clinic that are important to you: Does the clinic have other services such as pool therapy, chiropractic, or acupuncture? Talk to your current health-care team about which services and therapies can help you.

How does the clinic communicate with my insurance adjuster?

Your rehabilitation costs are covered under your insurance accident benefit claim. There is a limit to the amount of money available for rehab and you will need to keep track of how much you are using for your therapy services. You can ask about the clinic’s process for submitting information about your rehab services to your adjuster. Never sign a blank treatment plan and always make sure that you will have the chance to review and ask questions before the clinic submits your treatment plan.

How will my care be coordinated?

Do you have someone that can help you coordinate your rehab services? Does the clinic have a team that works together with you to achieve your rehab goals? How does the clinic regularly communicate with insurance adjustors, lawyers, and others involved in your care? Communication between everyone on your team is important in helping to make sure you are getting the care you need.

How far am I willing to travel for my rehab care? 

You might need to go for your appointments for a few weeks or months. It is important that you go to all your appointments so that you reach your rehab goals. Don’t let distance or transportation be a barrier and plan accordingly. Think about other ways to get to your appointments, such as a family member, public transit or insurance-funded taxis.

Visit the GTA Rehab Network Rehab Finder to find a facility that’s right for you. You could also go to professional regulatory websites – such as the College of Physiotherapists of Ontario or College of Occupational Therapists of Ontario – to find licensed health-care professionals near you.

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The post How to choose your outpatient rehab provider after a motor vehicle collision appeared first on Your Health Matters.

When the Jennifer Tory Trauma Recovery Clinic opened at Sunnybrook in April 2021, physiotherapist Carly Orava was one of the first people to join the newly-created team.

“I was excited about the creation of this clinic because we’re able to follow and care for trauma patients for up to a year after they are discharged from the hospital. This model gives us a deeper level of insight into our patients’ recovery process that we didn’t necessarily have before,” she says.

Carly says the patients they see are dealing with a variety of issues after an injury, including physical disability, pain, mental health problems and the effects of brain injuries. The new clinic operates in a dedicated space where patients receive care from a range of health professions including physiotherapy, occupational therapy, social work, physiatry, psychology, clinical psychiatry and pain services.

Before the clinic opened, a trauma patient who had been discharged but still required follow-up with multiple care providers would have needed to visit several different areas of the hospital. Patients who live further away from the hospital may have also had trouble accessing care in their home communities.

“Now, we can identify and address gaps in care pathways to make sure no one is falling through the cracks,” says Carly, who has worked with trauma patients at Sunnybrook since 2013, first as a student in the inpatient trauma unit and then at St. John’s Rehab.

The clinic, which is the first of its kind in Canada, has booked close to 1,900 appointments over the past year. Carly says that while there are ebbs and flows, no two days are the same.

“Some days I may only have a few patients scheduled, but then one of the occupational therapists identifies a patient who may benefit from physiotherapy during one of their appointments, so I will drop in to do an assessment. Or, I could be called to the inpatient trauma unit to evaluate a patient and help put together their discharge plan. You definitely have to start your day with an open mind,” she says.

As the team celebrates the successes of the clinic’s first year, they’re already looking ahead to the future.

“We’re still growing and figuring out how best to meet the needs of all our patients,” says Carly.

However, one thing she knows for sure is that the collaborative environment of the clinic has made for a seamless experience for patients.

“Our patients are happy knowing that somebody still cares about their recovery, even when the acute care phase of their journey is complete, and we are happy to be able to provide that to them,” she says.

The post Physiotherapist reflects on first year of Jennifer Tory Trauma Recovery Clinic appeared first on Your Health Matters.

How long have you been a physiotherapist?

Two years. I started working at Sunnybrook in the Schulich Heart Program, helping patients recover functionally after heart surgery. For me, it’s very rewarding working in the hospital setting with patients and their families, seeing them progress. I get to help acutely ill patients get stronger and back to their lives.

How did you become a part of the COVID unit?

I volunteered as staff were being recruited for the unit because I had experience working with cardiac surgery patients in the intensive care unit (ICU) setting. In the ICU, my patients were on ventilators, which are machines that help them breathe. Through active mobility and breathing exercises, patients are able to wean off of the ventilators and return to their previous level of function. I thought my skill set would be a good fit.

Another reason I volunteered is because my partner is a nurse in a Toronto-area emergency department, and she was already on the frontlines screening patients. She never hesitated going to work, so she inspired me to help out where I can. At the time I volunteered, I didn’t really think about all the different ways this would affect my life.

What has the work been like?

At first, I was very anxious about all the different situations that could arise and how I would keep safe. But from day one, I felt very protected as we have access to appropriate personal protective equipment (PPE), safety officers and the updated infection prevention and control protocols. The team here is very collaborative and many volunteered to be here, and are great to work with.

I’ve adjusted to the day-to-day processes, but that said, policies and procedures are always changing. We started out as a COVID-19 ward, then it became a full ICU about four weeks into my placement. Working in an environment with frequent changes in patient populations, policies and procedures has been stressful, but we all try to take it one day at a time.

What does your work entail?

My role focuses on helping patients rehabilitate while preventing respiratory complications. I often help patients recover functionally after they have been intubated. This procedure is hard on the body, as a tube is inserted through the throat down into the windpipe so a ventilator can breathe for them. Even if they haven’t been intubated, prolonged bed rest can weaken muscles. I help patients preserve and build up their functional strength by doing things like helping them sit up, perform bed and breathing exercises and eventually walk again.

These areas of focus apply for COVID-19 patients, but if they are more critically ill, there are different aspects I focus on during treatment. One thing we’ve been doing frequently is “proning” patients, as research has found placing them on their stomachs helps with breathing over time on a ventilator. Even for patients not on a ventilator, if they are able to prone themselves, that appears to help improve their oxygen levels and breathing.

On the COVID-19 unit, we’re also receiving patients from all over the hospital, including those sustaining burns, traumas or strokes. That means we have to be very adaptable with the kind of treatments we are using. Anyone can get COVID-19, so we see all types of patient populations.

How are you doing now?

My overall anxiety has improved, but no matter what, working in this environment means there is a level of background stress that can have numerous effects. A lot of us are just feeling more tired in general. That’s not because we are doing more physical labour, but rather coping with the heightened stress and day-to-day changes that COVID-19 is causing, both inside and outside of the hospital.

At home, my partner and I can really relate to each other’s work settings, so it’s nice to have that deep understanding. COVID-19 news is everywhere, and in the beginning, I was really immersed in it. Now, I try to limit checking the news to just once a day for any big changes. Creating a bit of an escape at home helps me manage my mental health and level of worry.

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The post Inside the COVID-19 unit: Helping patients regain their strength through physiotherapy appeared first on Your Health Matters.

“The Saturday afternoon I became an unwitting participant in a crash,” says Andrew Lawlor, 51, of Unionville, Ontario. “I remember I kissed my wife as I dropped her off at the spa. Apparently then, I got back into my jeep, drove home and headed out on my motorcycle.”

Andrew says ‘apparently’ because he doesn’t remember much else about that day in July 2018.

He was admitted to Sunnybrook. “The teams in trauma and in critical care did surgeries to treat the many fractures in my arms and pelvis, and later did procedures to repair serious nerve injuries in my right shoulder,” he says. His left leg was badly mangled in the crash, and he had to undergo a transfemoral [above-knee] amputation.

After three months in the intensive care unit and critical care, the writer and father of two boys gained more support from team members — including physiatrist Dr. Amanda Mayo and prosthetist David Smith — during his rehabilitation stay at St. John’s Rehab.

He is continuing therapy there on a weekly basis. Physiotherapist Vera Fung (above) is teaching him how to walk, and she is helping with conditioning, strengthening and flexibility. This will help prepare him for the positions and posture he will eventually need to walk with a lower-extremity prosthesis.

Occupational therapist John Cho (below) generally helps patients with upper body exercises and functional-related range of motion for lifting, reaching overhead, carrying, pushing and pulling. He is working with Andrew on improved range of motion in his right shoulder and arm, flexibility in the wrist and dexterity in the fingers.

Below, Andrew talks about his healing journey and living with limb loss:

What has helped you cope in your journey so far?

It’s Day 264 since the crash. Keeping track of the days helps me stay focused. I’ve had a lot of help. I awoke on August 19 and my wife, Lesley had already put up things in my room and she knows I’m goal oriented. She thought: ‘let’s put a list on the wall and let’s work towards those goals.’ Lesley really helped shape the plan with me, together with my care team.

Healing is a community exercise, whether your community is one, or three, or a whole town. We live in a tight-knit community in Unionville. On the Tuesday morning after the crash, Lesley found a homemade casserole on our front porch with an unsigned note that simply read: Because I had to do something. To this day, we don’t know who did this kind gesture, but we are forever grateful. There was a groundswell of support in our community led by amazing friends. People started an online campaign to send us well wishes and encouragement.

Support came from individuals, sports leagues and businesses in Unionville. A local grocer helped the boys stay healthy throughout the crisis, and a group of friends pitched in to buy us snow plowing for the winter.

Sometimes ‘what can I do to help?’ or ‘let me know if I can help’ can turn into action — that if there is something I can do to help, I can think to do it — and that’s what many of our friends and the community did for us.

What do you have a greater appreciation for?

My family has always been important to me, and yet, I have gained an even deeper appreciation for them.

All the things you might take for granted as an unencumbered, fully capable person — the seemingly easy things — you now don’t take for granted. I can’t drive, so simply getting milk at the corner store becomes a plan. Yes, it puts a dent in your freedoms, but you learn to adapt.

I have also found that my focus has been much better. I’m me. I’m a dad. I’m a husband, son, friend, boss, worker — I am all of these. When those things have the possibility of being stripped away, it brings your focus to a pretty fine point. Right now, I have one job to do, and that’s to get better. And I’m fortunate because I know not everyone has that opportunity to focus on that one job.

I’ve also learned perspective. When I first got to St. John’s Rehab, both my arms were in casts. It took five members of the team to move me out of a bed. They brought me in to therapy one day, and this young man says to me: Don’t worry. They’ll take good care of you. Here is this young man with third degree burns helping me by saying that everything’s going to be okay.

I have great respect for this young man who showed and shared such courage.

I have also learned self-advocacy — to be involved, to be engaged in my health care and in how the rehab teams support my continued healing.

Even now, I try to come early to therapy, so I can talk to others living with limb loss — to connect with them about what they’re doing, how they are doing, and getting in contact with guys ahead of me to ask, ‘how do you do it?, ‘what works for you?’

What would you want the community at large to understand about living with limb loss?

I am the first amputee I’ve ever met… and I don’t know how I would react. Everyone generally has good intentions. It’s in our nature to want to help, and to want to be supportive.

We are all our own unique experience — as is the case too, for people living with limb loss or limb difference. I’ve developed my own ‘icebreaker’ mechanism. When I meet someone for the first time, I try to make eye contact and to speak early, offering a connective comment. That approach often helps diffuse any tensions or misperceptions that may be forming.

For me, I am now part of the community of individuals living with limb loss. If I met another individual, I’d want to share and exchange stories and experiences. But only if the individual was open to it.

It’s back to that idea of giving back. I’d like to do what I can to help others, going through their own journey. One of the messages Lesley put on my wall from day one still resonates with me — it’s a quote from the author Max Lucado:

The key is this: Meet today’s problems with today’s strength. Don’t start tackling tomorrow’s problems until tomorrow. You do not have tomorrow’s strength yet. You simply have enough for today.

The post Months after a motorcycle crash, Andrew reflects on his healing journey and living with limb loss appeared first on Your Health Matters.

New technique improves quality of life for burn patients in rehab

Thanks to a form of therapy typically used in orthopaedic rehabilitation, burn survivor Jerry Louvis, 46, now talks about regaining his strength. “I am much closer to where I was and what I was able to do.”

In spring 2016, Jerry was treated at the Ross Tilley Burn Centre at Sunnybrook for severe burns to most of his body from a chemical fire, receiving care as an inpatient at Sunnybrook’s St. John’s Rehab. By the summer, he was back at home but continuing to go to St. John’s Rehab for therapy appointments.

The goals of burn therapy include improving patients’ range of motion and function, minimizing contracture and supporting their social reintegration. Jerry had regained some muscle strength but felt that his movements were “wooden” and clumsy. An accomplished scientist with a very precise mind, he longed to be able to do things with more accuracy and finesse.

A year and a half later, he had surgery for heterotopic ossification – a condition that sometimes affects patients after severe burns or orthopaedic trauma – when bone grows in muscle or tendons, which can be painful and can significantly restrict movement.

During rehabilitation, Jerry received both standard manual therapy and a new approach called myofascial release technique. Standard manual procedures are helpful and effective and have been used for decades in burn rehabilitation. They involve scar massage, joint exercises, stretching, the use of pressure garments and silicone-based gels to treat scars, as well as splints to help control how a burn heals.

“More people are fortunately surviving larger burns, and there is greater need to help them improve their ability to move and carry out activities every day, [which] helps enhance their quality of life,” says Lisa Giardino, a physiotherapist in outpatient rehabilitation services at St. John’s Rehab.

Myofascial release techniques are a type of manual therapy used with orthopaedic patients – those recovering from conditions of the bones and joints. Lisa is now researching these techniques for the first time in patients with burn injury. Having worked with burn patients for 15 years, Lisa felt there was more that could be done to improve her patients’ outcomes.

It made sense to her that the same techniques used in orthopaedic recovery could be used to overcome the scarring caused by burn injuries. She set out to prove her hypothesis.

Scars can affect many aspects of the body, including muscles and fascial systems. Fascia, the layer of connective tissue under the skin that forms a network surrounding other kinds of tissues, including muscles, bones, blood vessels and organs, connects those tissues like woven fabric. Healthy fascia is relaxed and can glide easily over underlying tissues. Injuries to the body, such as burns, can restrict mobility of the fascia, causing tension and pain.

“Scars are like icebergs – what you see is only part of the story. The bigger part is how the scar has been laid down, underneath. You have to feel it to know,” says Lisa.

Myofascial release techniques involve loosening the fascia within the scar tissue, using massage. This technique frees up the scar from the underlying tissues, so those tissues can glide over each other more freely, making it more comfortable for the patient and restoring function.

“Considering the significant impact of burn injury on tissue integrity, using myofascial techniques to improve scar outcomes could be an innovative approach to burn care in patients with closed wounds,” Lisa points out. “Myofascial release techniques are a good enhancement to standard approaches. They’re another tool in a clinician’s toolbox.”

Patients often report that the techniques are gentle and comfortable. Some find it so restful they fall asleep. This new approach gave Jerry more range of motion that has since stayed with him. “I was a skeptic at first, but then I really noticed the difference. There I was, trying to move muscle that had been stuck for a year,” he recalls.

Over the next six to 12 months, Lisa will continue to measure changes in patients in terms of their range of motion, function, scar characteristics and quality of life to benchmark the use of myofascial release techniques in therapy. “Burn rehab is a team effort,” notes Lisa, who is collaborating with her colleagues and encouraging them to learn more about the technique.

“My ability to move has become a lot more refined since this type of therapy. I can now write, type and do repairs around the house,” says Jerry. “For me it’s about getting to the subtleties of range of motion – not just getting up in the morning, but instead, sitting up in bed with the confidence of knowing I can move with measure and precision.”

Below: range-of-motion outcomes for a 39-year-old patient with 11 per cent total body- surface-area burns who had myofascial release therapy for 30-minute sessions twice a week for 8 weeks.

The post Orthopaedic rehab technique is improving quality of life for burn patients appeared first on Your Health Matters.

The cognitive-augmented mobility program (CAMP) of biweekly sessions over eight weeks allows patients to participate in 90-minute individualized, goal-oriented, task-specific exercises in a group environment.

“The small group format created a social and welcoming setting and allowed for individual learning styles while, at the same time, we could guide the sessions using best evidence in stroke rehabilitation,” notes Katherine Dittmann, a physiotherapist at St. John’s Rehab and CAMP’s clinical research coordinator.

The program adopts aspects of an approach that is also being explored at St. John’s Rehab – Cognitive Orientation to daily Occupational Performance (CO-OP).

“We asked, ‘What is important to you?’ and [we] involved patients in setting their own goals,” says Dittmann. “One patient wanted to be able to lift his two-year-old grandchild. Another patient wanted to walk with ease from the subway station to his office. We help patients learn to problem-solve on their own – and continue to set and achieve goals when they no longer have a therapist with them.”

Although the research is at a very early stage, investigators report that, to date, all patients have made and maintained clinically meaningful changes on at least one outcome measure. The largest improvements have been on self-selected goals and on balance and mobility scores.

The post Helping recovering stroke patients make gains in mobility appeared first on Your Health Matters.

For years, physiotherapist Anisha Rehmtulla took the conventional approach with her stroke patients. She would set goals for them, assess their mobility and give them exercises to strengthen an arm or help them walk unassisted. She’d direct them through their tasks – “Try to keep your feet apart. Now lift your leg.”

She has recently taken a completely different approach with her patients at St. John’s Rehab at Sunnybrook. It starts by asking patients what their own goals are. Depending on the patient’s particular situation, the goal may be as simple as getting in and out of bed on their own, or as complex as returning to play golf.

An elderly patient, for example, recently mentioned he wanted to get back to woodworking. And there was that young father who said the most important thing to him was to be able to take care of his toddler again. “Okay,” Anisha would then say. “So how do you think you can do that?”

Rather than being therapist- driven, that new approach – cognitive orientation to daily occupational performance, or CO-OP for short – “puts the patient in the driver’s seat,” explains Beth Linkewich, director of the Regional Stroke Centre and North and East GTA Stroke Network at Sunnybrook.

CO-OP was first developed in the late ’90s for children with skills learning challenges. A decade ago, Sara McEwen, scientist with a physiotherapy background, began to adapt the approach for stroke patients. After conducting several studies to show that CO-OP works theoretically, Sara and Beth have teamed up to assess how it can be applied in a real-world rehab setting, where time is more limited.

In October 2016, Sara, Beth and their colleagues secured a grant from the Canadian Institutes of Health Research to support training of occupational therapists, physiotherapists, nurses, speech therapists and other therapy assistants at St. John’s Rehab in the COOP approach. Patients are now being helped with CO-OP, and the goal is to train enough staff to be able to offer it to everyone.

The CO-OP approach uses a problem-solving strategy that has four steps: Goal, Plan, Do, Check. Therapists also use guided discovery, rather than telling patients what to do.

First, stroke patients set goals and are then guided to create their own plans to achieve those goals.

For example, the father who wanted to take care of his toddler recognized that he would need to carry the child, this despite reduced control and weakness on one side of his body. In physiotherapy, he practised carrying a sandbag up stairways. In occupational therapy, he would practise drawing with his finger across an iPad, so he’d be able to play games with his son.

Since CO-OP was introduced, patients are much more engaged in therapy, as they work together with therapists to better develop the best learning strategies.

With CO-OP, not only do patients define what they want to work on, they’re also defining how they want to do it. They have to write down or verbalize the steps in their plan. For patients who want to dress themselves and put a foot into a pant leg, for instance, Catherine Chuang, an occupational therapist at St. John’s Rehab, might ask, “What do you think you can do to achieve that?” The patient might suggest bringing her foot to her lap, which will then be added to the plan. It’s an approach that’s analogous to the ancient saying about teaching someone to fish instead of just giving the fish.

When patients leave rehab and go back home, their therapists are not there to coach them through each step. With CO-OP, however, earlier studies conducted by Sara showed that patients tend to continue making gains post-therapy, likely because they have been shown how to solve problems on their own.

“It builds confidence,” explains Sara. “If I can’t do something, it doesn’t mean that I should give up. It means I have to go back to my plan and change something. Maybe I need to put my hand in a different place or maybe I need some adaptive equipment.” Eventually, patients start breaking down all tasks with an open-minded, can-do approach.

But that’s not to say implementing CO-OP has been easy. “As physiotherapists, we’re so used to telling patients what to do,” says Anisha. “It’s hard for us to stand back and let them try to figure it out for themselves.”

Sara remembers feeling trepidation years ago, when she first used the CO-OP approach. Asked what his goals were, her patient, a man in his 40s, talked about helping his wife around the yard, but when he mentioned his personal goal to bike again, his eyes really lit up.

“He wanted to have that sense of speed again,” recalls Sara. “I was terrified. Here’s someone who was walking at a snail’s space, with a cane, wanting to get on a bike.”

Incredibly, after five hour-long sessions, she watched as her patient pedalled down the street, turning corners and managing inclines.

“He had to take a leap of faith and I had to take a leap of faith,” says Sara. “And the result was amazing.”

The multidisciplinary stroke rehabilitation team at St. John’s Rehab work together to help patients and their families get back to life after a stroke. (Photograph by Kevin Van Paassen)

Team effort

After a stroke, patients are learning how to move with major weakness or partial paralysis. They may have memory loss and cognitive issues.

During their stay at the rehab centre, patients experience a holistic approach. They will have access to a health-care team that includes:

• an occupational therapist to enable patients to return to their daily tasks such as dressing, bathing and cooking
• a physiotherapist to help patients maximize their physical functions such as getting in and out of bed, walking and climbing stairs
• a speech-language pathologist to address communication changes and swallowing concerns
• nurses available to patients around the clock to help manage all activities, medications and appointments
• a psychiatrist to talk about mental health challenges including feelings of anxiety or depression
• a dietitian to educate patients regarding healthy eating after a stroke
• a social worker to provide support and coordinate the care that patients will need after they leave rehab
• a physiatrist to provide medical support for the patient’s rehabilitation and recovery

The post CO-OP approach puts stroke patients in the driver’s seat appeared first on Your Health Matters.

When Linda Veres, Ross Winter and Robert Morassutti happened to sign up for the same physiotherapy class, little did they know the difference group therapy would make.

In fact, studies show that patients who participate in group-based physiotherapy after joint replacement surgery achieve statistically and clinically important improvements in mobility and function, and with similar satisfaction levels as patients who receive one-on-one therapy at home.

“In that group setting, they connected through their experiences of getting through surgery, and a common goal to get moving well again,” says Suzanne Denis, advanced practice physiotherapist, Holland Musculoskeletal Program who remembers Linda, Ross and Robert called themselves ‘the knee people’. They had knee replacement surgery at Sunnybrook’s Holland Centre then returned to join one of the group physiotherapy classes led by physiotherapist Mark Anunciacion.

Even though classes have ended, Linda, Ross and Robert continue to exercise together twice a week, motivating and supporting each other.

Beyond the clinical evidence, here are their reasons why getting together to exercise works:

Camaraderie – social + exercise: Ross says, “Doing physio alongside Linda and Robert who had a similar post-op (post-surgery) sensibility, allowed us to share with each other, experiences, knowledge, advice.“

Context – motivate yourself, but know your limits! “Doing therapy with others helps give you context. Everyone is different, even though we all had the same surgery,” says Robert. “And in some ways, it helped to ‘normalize’ things. We would ask each other: are you still using your cane? Being together gave you permission to either still be using the cane. Or not.”

Commitment: “Sometimes, I’d be thinking to myself: I’d rather not do this [the exercises],” says Robert, “but as a group, we had made a commitment. To be there for each other.” “And keep ourselves motivated,” adds Linda.

Commiserate, but with consideration: “Misery loves company and it’s better to share the pain than to suffer alone,” says Ross. “Group physio gave everyone the occasion to express frustration about their lack of progress, or the discomfort. But temper those occasional complaints, with humour,” says Linda. She recalls the generosity of the volunteers who would get ice for class participants. One particular day, she was feeling quite low and as the volunteer arrived with the ice, she joked, ”Do you have gin with that?”

And because knee replacement is a ‘big deal’ even if some say it isn’t, Linda, Ross and Robert also offer words of encouragement:

• Connect with friends and family: “As you prepare for surgery, think about what you will need, after surgery. It’s hard to ask for help, but do! And ask for specific help!” “Until you know the ‘new’ you, you need someone there, to help you.”
• Careful: “Pace yourself, for yourself, and DO NOT fall!”
• Consistency: “You have to keep at it [exercise]! Keep moving! Stretching and strengthening.”
• Continuum: “Keep up the momentum even after ‘formal’ physio.”
• Celebrate! “Everyone has their markers — milestones of progress, success, recovery.” “Celebrate being closer to what you used to do – getting on a streetcar, being able to put the rugs down again at home, driving a car, taking the bus to go to a movie with a friend…”

The post Exercising together: the benefits of group physiotherapy appeared first on Your Health Matters.

Activity is a natural remedy for arthritis. It helps feed the joint cartilage, keeping the joints moving freely. Activity maintains muscle strength that is important for balance and decreases the overall risk of falls. It makes everyday activities easier by decreasing stiffness and boosting energy. Staying active also opens the door to, quite literally, exercising some control over your condition.

So what kind of physical activity is best if you have sore joints? Denis says there are many options, but keep in mind that the type of activity you do will affect the strain on your joints (known as “loading”) as well as overall joint wear and tear.

Here are some common activities and how they stack up:

• Standing on both legs: 80 per cent of your body weight is going through both knees
• Walking at an average speed (about 5km/h): four times your body weight is going through hips and knees
• Jogging (9 km/h): nine times your body weight is going through hips and knees
• Cycling (medium resistance): four times less load through your hips and knees compared to walking
• Swimming in chest depth water: only half your body weight is going through your hips and knees compared to walking on dry land

At work, home and play, you can reduce your risk of injury by using good body mechanics and safe work practices. Make sure you are fit for the activity you are about to do. Where appropriate, use properly fitting protective equipment.

Physical activity is also an important part of a healthy lifestyle because it promotes a healthy body weight, improves mood, reduces the risk of and manages a number of diseases as well as taking strain off the joints. Even a small weight gain can put a serious strain on your body. For example, gaining 10 pounds around your waist equates to 30 pounds of extra pressure around your hips, and 30 to 60 pounds around your knees, every step you take!

Activities to avoid

For people with joint pain issues, there are some activities you’ll want to avoid, including anything with high impact (i.e. running and jumping), twisting (i.e. racquet sports) and high speed uncontrolled movements. When possible, avoid forcing end-range of movement, which includes vigorous forced stretches. It’s also important to listen to your body. Red flags during activity include joint pain during or after exercise, sharp pain that escalates or a swollen, red or hot joint.

Denis says new evidence finds strengthening muscles can reduce the risk of developing knee arthritis, as well as reduce pain and improve overall functioning.

It’s also a good idea to talk to your doctor before starting any new activities. Remember that small steps can lead to major life changes!

The post Best and worst exercises for arthritis and joint pain appeared first on Your Health Matters.

Define your fitness goal

Before you get started, ask yourself, why you are doing this? Is your goal to become stronger, to lose weight, reduce your need for medication, or to just get healthier overall? Defining the purpose will provide positive motivation for the work you put in while keeping you on track.

Love it and list it

You will have far more success in the long-term by engaging in activities you really enjoy. For extra motivation, sign on to a class or group session of a certain activity, keep a daily journal or use a fitness tracker to mark your progress.

Get the green light

Although most people living with a chronic disease or health issue can greatly benefit from activity and exercise, it’s a good idea to meet with your doctor before starting to ensure they are safe and right for you.

Ready to go? Start slow

A mistake that many people make is starting their new regimes too enthusiastically. Too much too soon can lead to pain and risk of injury, and a higher probability people will quit within the first two weeks of a new program. Your body will take some time to adjust to new movements and levels of activity, so humble beginnings are key.

Once you have had success during the first week, keep building on that (no more than a 10 per cent increase per week) and incorporate a bit more time/weight/distance onto what you did the day before. Varying the types of activities you are doing will give certain muscle groups a chance to recover. If the activity you are doing requires equipment, make sure you are using it properly to avoid injury.

Get comfortable with feeling uncomfortable

It’s normal to feel muscle groups you haven’t before after starting a new type of activity. That means you are pushing yourself out of your comfort zone, helping build new muscle groups and overall strength. But if your pain is persistent and debilitating, make sure you seek medical assistance.

The big picture

There is an expression that you can’t outrun your fork, and it’s true! Any successful fitness regime is built on the foundation of a healthy lifestyle, which includes a balanced diet. Adequate sleep, not smoking and limiting alcohol intake will all help you achieve faster positive results with your new physically active lifestyle.

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