Physiotherapy Manual Therapy Pelvic Floor Rehabilitation Acupuncture Dry Needling GLAD™ Canada Hip and Knee OA Program Rehabilitation Products and Braces Patient Education Functional Capacity Evaluations Conditions We Can Help With Registered Massage Therapy Speech and Language Pathology Advanced Foot Care Pedorthics & Orthotics Clinical Psychology
Physiotherapy is a regulated healthcare profession dedicated to working with people to identify and maximize their ability to move and function throughout their lifespan.
Specifically, physiotherapists improve clients’ quality of life by:
- Promoting optimal mobility, physical activity and overall health and wellness;
- Preventing disease, injury, and disability;
- Managing acute and chronic conditions, activity limitations, and participation restrictions;
- Improving and maintaining optimal functional independence and physical performance;
- Rehabilitating injury and the effects of disease or disability with therapeutic exercise programs and other interventions; and
- Educating and planning maintenance and support programs to prevent re-occurrence, re-injury or functional decline.
Physiotherapy is anchored in movement sciences and aims to enhance or restore function of multiple body systems. The profession is committed to health, lifestyle and quality of life. This whole person approach incorporates a broad range of physical and physiological therapeutic interventions and aids.
Within the physiotherapy profession, manual therapy is defined as a clinical approach utilizing specific hands-on techniques, including but not limited to mobilization/manipulation, used by the physiotherapist to diagnose and treat soft tissues and joint structures for the purpose of modulating pain; increasing range of motion (ROM); reducing or eliminating soft tissue inflammation; inducing relaxation; improving contractile and non-contractile tissue repair, extensibility, and/or stability; facilitating movement; and improving function.
Pelvic Floor Rehabilitation
Pelvic Health concerns such as pelvic pain, incontinence, urgency and pelvic organ prolapse are very common and can affect a person’s day to day life. Unfortunately, these symptoms and conditions are not often talked about so many people can suffer in silence, not knowing that there are very effective solutions available.
Did you know that 1 in 3 women have some form of pelvic floor dysfunction? This can occur at any stage in life, starting as early as young athlete to pre and post-partum, as well as menopause. 1 in 9 men are incontinent; the most common cause of male incontinence is a radical prostatectomy. Pelvic floor dysfunction is not a normal consequence in life, and not something anyone has to live with. Pelvic floor physiotherapy can be extremely beneficial to manage various symptoms.
Do you experience any of the following symptoms?
Do you leak when you cough, sneeze, laugh or exercise?
Visit the bathroom more frequently than you used to?
Not always make it to the bathroom?
Have pain in the pelvic area, perineum and or tailbone that is affecting your quality of life?
Have genital / vaginal pain affecting your sex life?
Struggle with constipation / difficult bowel movements?
Have bulging / heaviness in the perineum?
We offer internal and external assessment and treatment for many women’s and men’s pelvic health issues. During the assessment, we are looking at overall posture and alignment, and breathing strategies. This will tell us the strategies for using your inner (core) unit.
We offer a thorough one hour assessment in a private room. We will first take a history of the area of concern, and then a physical assessment to determine a treatment plan individualized for your specific needs.
Pelvic floor physiotherapy requires an internal and external pelvic exam to assess and treat imbalances in the pelvic floor muscles. Specifically tailored exercises are prescribed to treat pelvic floor muscles that are either too weak or too tight. Exercises to coordinate the pelvic floor muscles with the diaphragm and deep abdominal and back muscles are integrated, as part of a core retraining program. Clients are empowered to learn new strategies for posture and movement and to develop mindful body awareness, healthy bladder and bowel habits, and safe exercises.
Commonly treated conditions for both men and women include:
There are 5 types of incontinence. Stress Incontinence is leaking of urine when coughing, sneezing or laughing. Vigorous exercise can also lead to leaking due to the over- recruitment of abdominal muscles and breath holding. If we are increasing intra-abdominal pressure, our muscles in the pelvic floor have to respond to the increased load and contract to not let any urine out. Urinary incontinence is generally caused by a weak pelvic floor. Doing Kegels and working with a Pelvic Floor Physiotherapist to determine if your pelvic floor is tight or weak (including an internal exam) is the only way to treat this type of incontinence. Urge incontinence is associated with a strong, uncontrollable need to void, with an inability to delay voiding. Mixed incontinence is a combination of both stress and urge incontinence. Other types of incontinence can include physical mobility issues getting to the washroom in time and frequent urination during the night.
There are 2 main types of incontinence. Stress Incontinence is leaking of urine when coughing, sneezing or laughing. Vigorous exercise such as gymnastics or Crossfit can also lead to leaking due to the over- recruitment of abdominal muscles and breath holding. If we are increasing intra-abdominal pressure, our muscles in the pelvic floor have to respond to the increased load and contract to not let any urine out. Urge incontinence is associated with a strong, uncontrollable need to void, with an inability to delay voiding. Mixed incontinence is a combination of both stress and urge incontinence. Other types of incontinence can include physical mobility issues getting to the washroom in time and frequent urination during the night.
Over active bladder
Increased urgency to urinate.
Having to urinate throughout the night.
Pelvic Organ Prolapse
Pelvic organ prolapse occurs when organs such as the bladder, cervix, or rectum descend into the vaginal canal. This can occur more commonly after a pregnancy, and into menopause. Research has shown that lower levels of estrogen can contribute to loss of muscle mass and lead to weakness of the pelvic floor muscles. Physiotherapy can effectively treat and even cure mild to moderate cases of pelvic organ prolapse without any form of surgery.
Pre and post-natal education and exercisPre and post-natal physiotherapy provides a continuum of care through the childbearing years. It includes prenatal screening for pregnancy-related orthopedic or pelvic floor problems, prenatal exercise, education for labor and delivery, post-natal education and exercise, and gradual progressive training for return to sports or other recreational activities. A strong emphasis is placed on optimizing the flexibility, coordination, tone, and strength of the muscles of the pelvis and abdominal unit, especially the pelvic floor and abdominal muscles.
Blocked milk ducts
A plugged milk duct is a common problem during breastfeeding. A mother has a painful, swollen, firm mass in the breast that can cause pain during breastfeeding.
Chronic constipation is frequently a cause of damage to the pelvic floor muscles and fascial support (ligaments). Chronic constipation can cause stretching of the pudendal nerve due to prolonged and repetitive straining (leading to pelvic floor weakness secondary to nerve damage). Constipation also creates more pressure on the bladder and urethra which may cause increased urinary frequency or retention.
Fecal incontinence is the inability to control bowel movements, causing stool (feces) to leak unexpectedly from the rectum. Also called bowel incontinence, fecal incontinence ranges from an occasional leakage of stool while passing gas to a complete loss of bowel control. Common causes of fecal incontinence include diarrhea, constipation, and muscle or nerve damage. The muscle or nerve damage may be associated with aging or with giving birth.
Diastasis rectus abdominus
A Diastasis rectus abdominus is a separation in the rectus abdominis, also known as the “6-pack” muscle. It most often occurs during pregnancy. Sometimes it will spontaneously correct following birth, but it does not always.
Painful tail bone
Pelvic pain and abdominal weakness
There can be many reasons for experiencing pelvic pain from vulvodynia to dysmenorrhea (pain with menstrual periods) to pain with intercourse. There can be tightness or increased muscle tone in the pelvic floor muscles that may be contributing to pelvic pain. Internal manual therapy and breathing techniques can help release trigger points and stretch tight muscles, which can effectively treat these painful syndromes.
Heather Smyth is Rostered in Pelvic Floor Rehabilitation
Acupuncture is a system of assessment and treatment based on the Traditional Chinese Medicine (TCM) concept of balancing Yin-Yang energy and the flow of chi (i.e. life force energy). It involves the insertion of very fine needles into specific anatomical points to encourage natural healing and pain relief by promoting harmony within the body.
The method of acupuncture practiced by Heather Smyth at Erie Shores Rehabilitation combines TCM with a Western-medicine, scientific, evidence-based, approach and is known as Medical Acupuncture. Acupuncture can be very effective by itself, but is even more effective in combination with other forms of treatment, such as physiotherapy. It can also make it easier to perform manual therapy or complete exercises.
As a Registered Physiotherapist, Heather provides acupuncture within the scope of practice of physiotherapy, as part of a physiotherapy treatment.
Through scientific research, acupuncture has been shown to: promote blood flow at the treatment area, trigger the pain gate and release natural pain killers, natural anti-inflammatories, and numerous other beneficial hormones.
A number of scientific studies support the effectiveness of acupuncture in the treatment of:
• Lateral epicondylitis / Tennis elbow
• Low back pain
• Carpal tunnel syndrome
Dry needling is a clinical approach utilizing fine needles inserted into tightened muscle tissue (also known as trigger points) to decrease muscle tension and therefore decrease pain.
Typically, positive results are apparent within 2-4 treatment sessions but can vary depending on the cause and duration of the symptoms, overall health of the patient, and experience level of the practitioner. Over a few sessions, the trigger point becomes deactivated and a reduction of pain and restoration of normal muscle length and function can be observed.
Since the needles used are quite thin, most patients will not feel the needle penetrate the skin. A muscle that is shortened or that contains active trigger points is more sensitive then a healthy, non-affected muscle. They may feel a slight discomfort once it advances into the muscle, often times feeling a sensation similar to a muscle cramp, which is called the “twitch response”.
Dry needling is an effective treatment for acute and chronic pain, rehabilitation from injury, and even pain and injury prevention, with very few side effects. This technique is unequaled in finding and eliminating neuromuscular dysfunction that leads to pain and functional deficits.
Ellen McCarthy is certified in dry needling.
GLAD™ Canada Hip and Knee OA Program
GLA:D® is an education and exercise program developed by researchers in Denmark for individuals with hip or knee osteoarthritis symptoms. Research from the GLA:D® program in Denmark has shown a reduction in progression of symptoms by 27%. Other outcomes include a reduction in pain intensity, reduced use of joint related pain killers, and fewer individuals on sick leave. Program participants also reported high levels of satisfaction with the program and increased levels of physical activity 12 months after starting the program.
Osteoarthritis is the most common lifestyle disease in individuals 65 year of age and older. It is also prevalent in individuals between the ages of 30 and 45. Current national and international clinical guidelines recommend patient education, exercise and weight loss if necessary as treatment for osteoarthritis. In Canada, treatment focuses largely on surgery and does not follow best practice guidelines for treatment and management of osteoarthritic symptoms.
Based on the success of the program in Denmark, the GLA:D® education and exercise program for knee and hip OA is now being made available in Canada. The program is being launched in regions within Ontario with plans for expansion across Canada over the several years.
GLA:D™ Canada is a program for all individuals who experience any severity of hip and/or knee osteoarthritis symptoms.
Our program is typically run in private, public, and hospital physiotherapy clinics. There is a small fee to participate in the program. You may participate in the GLA:D™ Canada program if you have a hip or knee joint problem that resulted in visiting a health care provider.
You may not be able to participate in the GLA:D™ Canada program if:
You have other reasons for your hip and/or knee problem (for example, tumor, inflammatory joint disease, result of hip fracture, soft tissue or connective tissue problems)
You have other symptoms that are more pronounced than the osteoarthritis problems (for example chronic generalized pain or fibromyalgia)
You are unable to understand and communicate in English
If you think you would benefit from the GLA:D™ Canada program, contact us
Heather Smyth is a certified GLA:D Instructor
Rehabilitation Products and Braces
We offer high quality rehabilitation products and braces to help you get back to work, life and sport. We custom order Donjoy®, Bauerfeind, Aircast®, Procare® and other bracing brands, with next day delivery available for most items.
- Hot/cold packs
- MediBeads® Moist Heat Packs
- Cervical Pillows
- Lumbar Supports/Rolls
- Foam Rollers
- Ankle, Knee, Back, Elbow and Wrist braces
- Theraband® Hand Exercise Balls
- Taping and Sport First Aid Supplies
Your physiotherapist will take time to teach you about your health, so that you can better understand your injury/condition. Some of the benefits our patient education provides are:
- Increased understanding
Patient education ensures that you are well-informed about your health. This could mean teaching you about your injury/condition, discussing your diagnosis, going through possible treatment options or looking at ways to prevent your injury/condition from deteriorating. This level of understanding could reduce your concerns or anxiety about your injury. An increased understanding puts you in a better position to make informed decisions regarding your healthcare.
- More active approach to healthcare
With education you may be able to self-manage certain elements of your care.
- Enhanced motivation and better outcomes
If you are well educated on your condition, you will no doubt understand what goals you need to work towards in order to improve your health.
Functional Capacity Evaluations
A functional capacity evaluation (FCE) evaluates an individual's capacity to perform work activities related to his or her participation in employment (Soer et al., 2008). The FCE process compares the individual's health status and body functions and structures to the demands of the job and the work environment. In essence, an FCE's primary purpose is to evaluate a person's ability to participate in work, although other instrumental activities of daily living that support work performance may also be evaluated.
Employers and insurance case managers may contact us to schedule FCE’s.
Conditions We Can Help With
There are many injuries and conditions in which physiotherapy treatment plays an integral role in the multi-disciplinary approach in their management.
The aim of physiotherapy is to assess, treat and rehabilitate you after your injury or surgery, or assist you to manage your condition, and to return you
to your activities in the shortest possible time and to prevent further injury and loss of fitness.
Here are some of the injuries and conditions that we commonly treat:
Registered Massage Therapy
According to the College of Massage Therapists of Ontario, “Massage therapy consists primarily of hands-on manipulation of the soft tissues of the body, specifically, the muscles, connective tissue, tendons, ligaments and joints for the purpose of optimizing health. Massage therapy treatment has a therapeutic effect on the body and optimizes health and well-being by acting on the muscular, nervous and circulatory systems. Physical function can be developed, maintained and improved; and physical dysfunction and pain and the effects of stress can be relieved or prevented through the use of Massage Therapy.”
Massage therapy can help people of all ages and many conditions. It can help provide relief from:
- Inflammatory conditions such as arthritis and tendinitis
• Stress relief and associated conditions
• Headaches and migraines
• Muscle and related conditions such as spasms, strains and sprains
• Back pain
• Repetitive strain injury
• Circulatory and Respiratory problems
• Pregnancy and labour discomfort
• Post-injury and post surgical rehabilitation
Speech and Language Pathology
Speech Language Pathologists are skilled, health-care professionals with specialized knowledge, skills, and clinical training in the assessment and management of communication and swallowing disorders in children and adults. They hold a Master’s or Doctorate degree in speech-language pathology and are regulated by the College of Audiologists and Speech-Language Pathologists of Ontario (CASLPO), which ensures that clinicians meet stringent professional and ethical standards.
Often taken for granted, the ability to communicate effectively is essential to achieve and maintain quality of life. Speech, language and associated cognitive disorders can adversely affect academic performance, workforce integration, and social interaction.
Treatments that speech-language pathologists are uniquely qualified to provide can help individuals expressive and receptive language, articulation, fluency, voice, resonance and cognitive communication disorders (e.g., memory, organization, problem solving) reach their full communicative potential.
Registered Speech and Language Pathologist: Paula Filangeri operates and independent business at Erie Shores Rehabilitation
Advanced Foot Care
Advanced foot care is provided by a Registered Nurse or Registered Practical Nurse with specialized training in the assessment, prevention, and care of common foot problems including ingrown toenails, calluses, corns and fungal nails. This service is especially important in preventing serious complications for those with diabetes.
• therapeutic foot and nail soak;
• complete foot assessment;
• trimming and filing of the toenails;
• application of moisturizing lotion application
Registered Practical Nurse: Emily Stevenson operates an independent business at Erie Shores Rehabilitation.
Pedorthics & Orthotics
Canadian Certified Pedorthists – C. Ped (C) – are foot orthotic and orthopaedic footwear experts. They are one of the few healthcare professionals trained in the assessment of lower limb anatomy, muscle and joint function. With specialized education and training in foot orthotics and footwear, Pedorthists help to alleviate pain, abnormalities and debilitating conditions of the lower limbs and feet.
If required, all ages can benefit from a foot orthotic. From discomfort in the foot to severe problems such as diabetic foot ulcers, a foot orthotic can help a wide range of patients. A detailed assessment from a footwear and orthotic expert such as a Canadian Certified Pedorthist can confirm if a foot orthotic will assist a patient with a particular foot, leg, or even back problem.
At your initial visit a medical history will be taken, followed by weight bearing and non weight bearing testing. Weight bearing testing will consist of observing posture, special muscle testing and a biomechanical analysis, and observation of the client through their whole gait process, looking for any deviation from the standard gait pattern.
The Pedorthist also does a footwear analysis to check wear patterns on the shoes, as this is often a good indicator of the underlying injury. Once it’s determined if custom orthotics would be beneficial for your specific issue, a foam box impression is taken to start the manufacturing process.
Canadian Certified Pedorthist: Jacob Simpson operates an independent business at Erie Shores Rehabilitation.
Clinical psychology is a broad branch of psychology that focuses on diagnosing and treating mental, emotional and behavioral disorders.
Dr. Natasha Whitfield has an integrative approach to therapy, which incorporates different theoretical strategies that are tailored to each client’s unique needs. Her areas of practice include individual therapy and family therapy with children, adolescents, and adults. Dr. Whitfield’s treatment approaches include, but are not limited to, psychoanalytic/psychodynamic, cognitive behavioral, humanistic, art-based, play-based, and trauma-focused therapies. She works collaboratively with clients toward achievement of their goals. Services are available in both English and French. For more information visit Dr. Whitfield’s website at www.drnatashawhitfield.com
Clinical Psychologist: Dr. Natasha Whitfield operates an independent business at Erie Shores Rehabilitation