Some Conditions We Treat
Spinal Cord Injuries
SCI or Spinal Cord Injury is an injury that causes damage to a specific level of the spinal cord. A spinal cord injury are categorized as a complete or incomplete injury. It is either caused by compression or disruption of the spinal cord tissue. The result of an SCI causes loss of muscle power and loss of sensation to organs and skin. The location of the SCI will determine if the individual has quadriplegia (4 limbs) or paraplegia (lower extremities). Quadriplegia is caused by an SCI to the neck or upper chest area of the spine. An individual with paraplegia has suffered an injury to the spinal canal of the lower chest or low back. Some individuals who have suffered a spinal cord injury may be able to walk; others will require a wheelchair for mobility.
Acquired Brain Injuries
An ABI or Acquired (or traumatic) Brain Injury ranges from a Concussion to a blow to the brain, mostly due to the result of an external force. The brain can be injured through high velocity ‘shaking of the brain’ and through a ‘head injury’ causing compression of brain tissue as a result of a hit to the head.
High-velocity movement of brain tissue causes disruption of neural pathways or ‘diffuse axonal injury.’
A hit to the head can cause localized compression of brain tissue with subsequent death of brain cells.
Stroke or CVA
A CVA or Cerebro-Vascular Accident is a brain injury that takes place within the brain, either through an internal bleed or loss of blood flow to a specific area of the brain. Individuals who suffered a stroke may lose their ability to move upper and lower extremities on one side of the body. Speech and cognitive abilities may also be impaired. It is not uncommon to find TIAs (Trans-ischemic attacks) before the main stroke. However, these events often remain undetected and are only visible through specific brain scans.
There are many sources that cause neck pain. Neck pain might be the result of muscular imbalance, changes in alignment of the small joints of the vertebras of the neck or the result of an external force such a whiplash, caused by a car accident. Poor postural habits can also cause neck pain.
Neck pain is frequently the source of headaches or referred arm pain.
The origin of a headache requires a thorough assessment of the neck, the bones of the head and above all a careful evaluation of the individual’s history. A concussion may cause headaches due to brain tissue disruptions. Whiplash may be the source of a headache due to changes in the small joints and muscles at the base of your head. Tension headaches are very common and might be the result of poor postural patterns or repetitive movement.
The temporomandibular joint is also called TMJ. It is located just below your ear and is very closely connected to vertebras of your neck. The TMJ is the joint that connects the jaw to the head. It is rather loose and moves somewhat like a bucket handle. It allows us to eat and speak. Frequently, individuals with TMJ pain are unable to open their mouth to bite into an apple or hamburger. At times TMJ pain is the result of headaches. A therapist specializing in TMJ joint treatment is the most suitable provider to address this type of condition.
The shoulder is one of the most complex joints in the body. It has a very small joint surface and requires muscular precision to move within this joint. Shoulder pain will require a careful assessment and a detailed history to identify whether the source of the problem is of muscular, joint or ligamentous nature. It will also be important to identify what type of activities the individual used to do, as well as postural and movement pattern during these activities.
The scapula or shoulder blade sits like a loose hand on top of our ribcage in the back. It only has one joint that attaches it to the rest of the trunk: the acromioclavicular joint. The scapula carries the weight of our arm. This very mobile bone requires precise muscle balance to stay in its most suitable position or move with the arm as we do the things we like to do. Changes in muscle length and power around the shoulder blade can cause significant pain, either around the shoulder blade, the arm, the neck or the middle of your back.
Lower Back Pain
Low Back Pain is one of the most frequent complaints in today’s society. The low back (lumbar spine) includes the largest vertebras of the spine because it needs to carry the top of our body: the chest, the head and both arms. However, the lumbar spine is a very mobile section of the body and is only protected by muscles at the front/side and back. The balance of back and abdominal muscles is very important to protect the lumbar spine. The lumbar vertebras sit on top of each other like building blocks. These bones are cushioned by discs to allow us to move and absorb each shock as we run, walk or carry objects. When these discs get injured by uneven loading, they cause pain or even put pressure on nearby nerves, causing ‘radiating’ pain into the leg or buttocks.
Hip and Knee Pain
Hips and knees carry our weight and allow us to move to where we need to go. Hips and knees are best preserved when we carry our weight in a well-aligned pattern to allow equal weight-bearing throughout the joint, making sure the cartilage does not break down.
Knee pain, however, is the source of many sports injuries. We plant our foot and turn, putting excessive strain on the ligaments trying to hold the joint in place and this results in one of the sources of ligament and meniscus injuries to the knee.
The ankle is another rather complex system of bones that hold our weight and allow us to move along. We are not born with perfect bodies, and individuals might either have a low and others or a high arch. An individual might also have decided to wear footwear that is unsuitable for their type of foot. Ankle pain may be the source of poor mechanics of all the joints as we walk to where we need to go.
For others, ankle pain might be the result of a sporting injury, possibly a twisted ankle. Careful evaluation of the individual’s daily life routines, the mechanism of injury and the range of the ankle will assist in understanding the main source of the problem.
Muscle Strains and Tears
Strains have several degrees of severity. A strain is a ‘pulled muscle’ that only presents with pain in the location of the strain. Once the strain becomes a tear, we might be able to find a small indent in the muscle where the injury took place. Larger tears may require surgical intervention and bracing to allow it to heal. If treated well, a muscle can close the gap created by the tear.
Ligaments are short and tough cords that hold our joints together. We are frequently born with either looser or tighter ligaments. Each joint has specific ligaments. A strain or a tear can injure ligaments. Depending on the degree of the strain/tear, treatment will vary from wearing an over the counter brace or a tensor to time specific casting. At times an individual might need to use crutches for a while to avoid putting weight on the injured extremity. Depending on the severity, treatment might not commence until the ligaments have tightened. Ligament stability can be tested and this will determine when an individual can put weight on the extremity and start the rehab to recover range, strength and balance.
Neurogenic means: pain that originates from nerve tissue, either peripheral nerves or the spinal cord. It often tends to affect one limb in the body and feels like a deep pain. When neurogenic pain originates at the nerve root, it can often be treated by decompressing the site where the nerve is compressed. If the pain originates at the spinal cord, it might require medication or techniques to reduce the irritation at the segment of the spine.
A bone can break (or fracture) in many different ways. A fracture can affect one or more bones in the body. However, it is important to note that some bone fractures are stable enough to grow back together with proper bracing/casting. A physician will recommend: ‘non-weight bearing’, ‘partial weight-bearing’ or ‘weight-bearing as tolerated’ to allow the fracture to heal.
When a fracture is unstable, surgical repair might be recommended, using plates, screws or nails, depending on the site. After a recommended time of bracing/casting, treatment might start with the gentle movement of the joints above and below and progressive weight bearing training following the surgeon’s protocol.