Frequently Asked Questions
- When should I come in for Physiotherapy?
- What is Vestibular Rehabilitation?
- How do you treat Vestibular Disturbances?
- Do I need a Doctor’s Referral for Physiotherapy?
- Should I use Ice or Heat?
- How often should I change my Orthotics?
- Who benefits From Orthotics?
- How much does my Extended Health Benefits cover?
When should I come in for Physiotherapy
When starting any new activity it is common to feel an increased amount of soreness associated with utilizing and stressing muscles which need to adapt to an increased work load. This is referred to as delayed onset muscle soreness and includes an inflammatory response. This pain is common for ~24-48 hours following increased activity and does not mean that you have caused soft tissue or joint injury. With appropriate rest to allow the tissue to heal the pain should subside within 48 hours. If increased pain levels last beyond 48 hours and especially up to a week then you should contact a physiotherapist for appropriate treatment and guidance.
Typically the quicker that an individual sees a physiotherapist for conditions that are chronic in nature, and did not involve a specific injury, the less treatment the patient will need for a positive outcome and full resolution of symptoms. This is because as time elapses with no treatment the body learns compensatory movements to avoid pain and affected muscles weaken. Therefore, when an individual waits for treatment the physiotherapist then has to not only alleviate the inflammatory response but also retrain proper movement patterns and provide more extensive muscle strengthening.
What is Vestibular Rehabilitation?
Vestibular Rehabilitation involves the treatment of dizziness and balance problems often caused by disturbances in the inner ear via a specific, exercise-based program. Exercises often rely on co-ordinating the vestibular system with both vision and proprioception. What are some common symptoms reported by patients with vestibular disturbances?
- Unsteadiness/balance problems
How do you treat Vestibular Disturbances?
A comprehensive assessment of the vestibular, neurological, & balance systems, and the cervical spine is completed. Infrared goggles are used to evaluate fine motor movements of the eye, such as nystagmus. Based on the information gathered during the assessment, vestibular rehabilitation treatment programs are individualized for each patient.
Some commonly used techniques include:
- Positional maneuvers and Retraining of normal balance systems using specific exercises
- Treatment of cervical spine dysfunction
- Education on positions,
- movements, environmental conditions to minimize degree of symptoms and/or avoid recurrent exacerbations.
Do I need a Doctor’s Referral for Physiotherapy?
No, you do not need a doctor’s referral to attend physiotherapy. Physiotherapists are seen as primary health care providers and an appointment can be booked without a doctor’s prescription.
However, if you are utilizing your extended health care to pay for your sessions certain providers request a doctor’s referral in order to reimburse you for treatment provided. Therefore, it is important to first check with your extended health care provider for the specific requirements of your plan prior to booking a physiotherapy assessment to ensure reimbursement of payment.
Should I use Ice or Heat?
Ice should always be used if one suspects swelling/inflammation because it reduces inflammation. Therefore, if one notices redness, bruising, abrasions or swelling ice should be placed on the affected area to reduce blood flow to the damaged tissue and decrease bleeding and bruising. Ice is typically used during the acute stage of an injury (first 48-72 hours) or anytime during recovery of an injury. It is the preferred choice of treatment for swelling, local pain relief and muscle spasm.
Heat should be used following the acute stage of injury (greater than 72 hours) to increase blood flow to the injured area and improve circulation. It is typically used for complaints of stiffness, dull/achy pain and stress. Heat can decrease pain and reduce tension by relieving muscle spasm.
In conditions where there is lingering persistent inflammation i.e. two weeks post ankle sprain, alternating heat and cold is highly effective. It works as a pump to increase and decrease blood flow to the affected area and flush out residual inflammation.
Heat or ice should be used for 15 minutes 2-3 times per day. It is important to remember not to place the heat or ice directly on the skin to avoid skin burns. Protect the skin with adequate layers. Also, when using heat or ice make sure that the affected area has normal sensation as to avoid potential burns.
How often should I change my Orthotics?
If orthotics are worn regularly in shoes for everyday use they are exposed to daily wear and tear from ambulation and typically lose their congruency within 2 years after which they should be replaced.
If orthotics are used in shoes used for sporting activities such as running or basketball, the orthotics will lose their congruency within 1 year after which they should be replaced.
Who benefits From Orthotics?
Here is a brief checklist:
- When weight bearing my arch collapses inward
- When standing my heel turns outwards
- I experience foot and/or heel pain
- When standing I am bowlegged or knock kneed
- When standing my feet point outwards
- I experience increased low back pain with prolonged standing
If you answered yes to any of the above then you could benefit from orthotics and physiotherapy interventions.
How much does my Extended Health Benefits cover?
Each individual extended health care provider’s package is different, therefore it is recommended that you contact your provider to confirm the specific coverage that you have for services such as physiotherapy, massage therapy and custom fitted orthotics.
For more information call us at 905-455-4488 to discuss how we can help.