Blog Archives

Heel pain? (Shock)Wave it goodbye!

1/31/2016

Vancouver was deemed the "most walkable city in Canada" this year, and with summer around the corner we'll soon be able to take full advantage of all the gorgeous walking trails and hikes throughout our city.

However, for as many as 1 in 10 Vancouverites, this may not be an option. Approximately 10% of people suffer from plantar fasciitis, a condition which can cause excruciating heel pain from simply standing or walking. While plantar fasciitis can be an extremely debilitating and frustrating problem, Shockwave therapy is a new treatment option that has been showing incredible results and reducing rehabilitation time greatly. So, if you've been struggling with nagging heel pain, don't despair! Read below to learn more about plantar fasciitis, and see how our therapists here at Granville Physio can get you back to hiking your favourite trails, pain free!

What is plantar fasciitis?

The plantar fascia is the connective tissue that runs along the sole of a foot. It starts at the base of the heel bone (calcaneus), and fans out to connect to each toe. The plantar fascia is very tough, thick, and fibrous, and plays an important role in walking and running.

When the plantar fascia becomes inflamed (often due to overuse, improper arch mechanics, and/or tight calf muscles), both the sole of the foot and the heel can become very painful and sensitive. As the fascia becomes more inflamed, the pain and sensitivity also increase. Eventually, the fascia can become so irritated that tiny bone formations can develop within the band of connective tissue, often closest to the heel.

You have likely heard of these before, by the name of heel spurs. Shockwave therapy is one of the only non-surgical options that is currently effective in treating heel spurs. Without treatment, both the heel spurs and the inflammation can cause longstanding pain and movement issues, with lengthy rehabilitative periods.

What does that feel like?

Pain often starts at the base of the heel, or along the bottom arch of the foot. Many people describe this pain as a bruise or an ache, while chronic conditions have been described as a sharp, jabbing pain. Oftentimes, plantar fasciitis begins as a subtle pain, and many patients dismiss initial symptoms. However, plantar fasciitis worsens over time, and over the span of a few months the pain experienced is usually too great to ignore. Pain is often present the instant that pressure is put on the feet, and can lessen once you begin to move around. However, prolonged periods of activity will cause an increase in the pain and sensitivity experienced.

How do we treat plantar fasciitis?

Except in very extreme cases requiring surgery, most individuals with plantar fasciitis are able to find relief through conservative treatments such as physiotherapy. Notably, stubborn cases of plantar fasciitis have been showing amazing recovery rates from a new technology, Shockwave therapy.

At Granville Physio, we are proud to be able to offer this new treatment option. With an incredible 91% success rate, Shockwave therapy has provided relief to individuals with even chronic plantar fasciitis cases, and has an extensive research basis to support these results.

What exactly does shockwave do?

To put it simply, the Shockwave machine used by your physiotherapist creates many quick, high energy pulses that are directed into the heel and plantar fascia. These pulses act as a "biological jackhammer", breaking down calcium deposits (heel spurs) and scar tissue. They also stimulate a recruitment of fibroblasts to the area, which are responsible for healing connective tissues like the plantar fascia. Therefore, the healing effects are twofold; not only are the bone spurs and scar tissue reduced, the body's natural healing mechanisms are stimulated to help promote recovery of the foot and heel. Patients have reported an exceptional reduction in pain after only one treatment! If you are interested in reading more about Shockwave therapy, you can visit our website at www.shockwavetherapyvancouver.ca for detailed explanations of the technology behind the machine, as well as the various conditions that it has been shown to treat.

Happy walking!
- Your Granville Physio Team

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5 Key Workplace mistakes you NEED to fix!

1/31/2016

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"Sitting is the new smoking."

It's a drastic statement, but it has caught much attention and popularity in recent years, as study after study has shown the drastically negative impact that sitting has on our overall health (read a few by clicking here or here). While simply sitting for less time may seem like the easy answer, unfortunately for a lot of us, sitting at a desk comprises a large portion of our work week.

In fact, we are willing to bet that you are sitting at a desk - whether your work station or at home - right now as you read this. If you are, freeze! Don't move! Take a moment to investigate your positioning right now, simple things like how far away from the computer you are, or where your mouse and keyboard are in relation to you. While sitting may not always be avoidable, we have five easy adjustments that you can make, to help reduce the negative impact your desk habits may be having on your health.

How many of our five key workplace habits do you think you are guilty of? Read on below to find out, and to see what our physiotherapists recommend to help alleviate these problems.

1. Distance from the monitor

Why it matters?
Sitting too close to the monitor can have serious consequences on your vision, while sitting too far away often results in individuals leaning forward, which creates poor posture. This in turn can lead to increased pressure on the low back, tension in the shoulders, and a strained neck.

James Rowan's suggested fix:
Avoid poor postural mistakes or eye strain by ensuring that your monitor is set up at a proper distance. Your gaze should naturally fall within the top third of the screen, and the monitor should ideally be between 18-20 inches from your face. Adjusting your keyboard to an easily accessible position at this distance, or investing in a desk chair that enables a proper height, are two great options to help make this new position seem more natural.

2. Sitting too long

Why it matters?
  As we mentioned above, prolonged periods of sitting have a wide array of negative health effects. Interestingly, studies have found that many of the negative effects of sitting are irreversible, meaning that the damage done over long periods of sitting cannot simply be undone by a later change in habits. Complications such as disc herniation, hypertension, diabetes, and even cancer are drastically reduced when individuals make an effort to sit less and move more. In fact, the Conference Board of Canada predicts that if only 10% of Canadians were to make an effort to reduce their sitting hours, national health care costs would be reduced by 2.6 BILLION dollars!

Damien Wild's suggested fix:
     While options like a sit-stand desk are fantastic alternatives to the traditional workplace, they are not always financially feasible. Instead, try incorporating some of these simple ideas into your everyday work routine:

Take the stairs, not the elevator
Stand up when on the phone
If an email recipient is in your office, opt for walking over and verbally relaying your message
Refill your water glass every hour
After you eat lunch, take a 5 or 10 minute walk
Set a timer for yourself, and try to incorporate some gentle stretching or exercises at your desk throughout the day
Organize walks with coworkers, instead of seated meetings

You may get a few silly looks from your coworkers at first, but we are confident that by incorporating these simple activities into your routine, you will feel better, be more focused and productive, and may even inspire others to make healthier changes for themselves as well!

3. sitting angle

Why it matters?
Studies have shown that the angle at which we sit has a drastic effect on the amount of pressure that we place on our intervertebral discs. As you can probably guess, this pressure is not a good thing, and over time can lead to disc herniation, chronic pain, and decreased range of motion.

Jim Bowie's suggested fix:
By simply adjusting the angle of your seated position, disc pressure can be reduced by up to 85%! As you can see in the image above, Nachemson et al. demonstrate that relative to standing, sitting at an angle of 110 degrees (leaning slightly backwards from the monitor) places only marginally more pressure on the spine, whereas leaning forwards into the screen can almost double the pressure our discs undergo. Ensure that your desk chair can facilitate these healthier postures, press your hips as far back into your chair as they can go, and be conscious of your shoulders slumping forward. It is important to note as well, that the old adage "sit up straight" is not necessarily true; as you can see from the image above, trying to hold yourself perfectly erect actually places more strain on the back. Instead, try to find a comfortable position that is lengthened but relaxed, and remember to incorporate movement at regular intervals.

4. Hip tilt

Why it matters?
The majority of us tend to sit favouring one side over the other, without even realizing it. If you are unsure whether or not you are guilty of this, simply take note of how you typically sit at work. Do you find yourself leaning on one armrest more than the other? Do you lean your head onto the same hand regularly, or cross your legs with the same leg always on top? These habits indicate an imbalanced pelvis, which can cause movement and alignment problems, as well as back pain.

Damien Wild's suggested fix:
Since so many people are unaware of this lean, simply being more conscious of your seated position will drastically help alleviate the strain that the pelvic imbalance is creating. Avoid crossing your legs, and leaning forward onto your desk or armrest. Try to feel both sides of your buttocks and hips pressing equally into the chair, and if you are feeling tired or need to lean, try standing up and moving for a few minutes instead.

5. Mouse positioning

Why it matters?
Improper positioning of the mouse can cause individuals to bend wrists, and lift or reach arms out for extended periods of time. This in turn places increased stress on the wrist and elbow joints, over time weakening these systems and creating pain and dysfunction.

James Rowan's suggested fix:
Make sure that your mouse is placed in the "Usual Zone" pictured above, within 25 cm of your seated position. The hand and forearm should maintain a straight line, and the upper arm should not have to extend or elevate to use the mouse. By keeping the mouse in the green zone displayed above, regular reaching motions are eliminated, strain on the elbow is reduced, and your body will thank you!

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Heel pain? (Shock)Wave it goodbye!

What is plantar fasciitis?

What does that feel like?

How do we treat plantar fasciitis?

What exactly does shockwave do?

5 Key Workplace mistakes you NEED to fix!﻿

1. Distance from the monitor

​2. Sitting too long

3. sitting angle

4. Hip tilt

5. Mouse positioning

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5 Key Workplace mistakes you NEED to fix!

2. Sitting too long