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Frequently Asked Questions

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Not able to squat properly
Heels lift Lower back hurts Knees go outwards Not able to hold position. Needs to sit and stand
  • Hi Alta,

    Thanks for your question.

    In my opinion, this would be a situation where you should see a physiotherapist, so that he/she may assess your situation and determine why you are having issues with squatting.  

    There could be multiple reasons for your difficulties in squatting.  Some examples may include but not limited to:  back issues, neurological issues such as lumbar radiculopathy (sciatica), neurodynamic mobility issues, SI joint, hip, knee or ankle issues.  There may be muscle weakness and/or imbalance issues (such as Vastus Medialis Oblique weakness, IT band tightness), tight calves.   These are just some issues that may be contributing to your difficulty squatting.  I am unable to diagnose your condition, but these are some of the things a physiotherapist would look at, given the symptoms you are describing to help figure out why you are having difficulty squatting.  

    A physiotherapist would be able to identify the the specific issues, diagnose and come up with a treatment plan to help you regain your ability to perform squats pain free. 

    I hope this helps.

    Bill Landry BScPT, BScH, CAFCI

    Registered Physiotherapist

    The Physio Store Inc.

    Bill Landry
Levator Scapulae, Trapezius, shoulder pain?
For over a year I have had neck, head and shouder pain. I have had tests and scans done with nothing found. I was wondering if my job may have something to do with continuing pain? I have been a cleaner for 4 years and I use a backpack hoover without a waist support, could this cause problems?
  • Hi Graeme,

    Thank you for your question.  The answer is a definite maybe.   You may be suffering from a postural dysfunction, overuse injury, an/or muscle imbalance.  This can be caused by sustaining a poor posture while working.  Postural dysfunction is caused by a person adopting poor posture over a sustained period of time. It is not uncommon to have Levator Scapulae, Trapezius, and shoulder pain from a cervical postural dysfunction. Usually this entails a sustained forward head posture. 

    A thorough assessment by a physiotherapist can help identify if a postural dysfunction maybe contributing to your issues and help treat the problem.

    Physiotherapy can help with cervical postural dysfunction by:

    • Improving posture
    • Alleviating pain
    • Improving strength
    • Improving flexibility
    • Improving workplace ergonomics
    • Promoting correct movement patterns
    • Preventing the problem from recurring

    I hope this helps give you some direction to what may be causing your pain in your neck, shoulders and upper back.

    Bill Landry, BScPT
Preventing Tendon Injury
Hello, I'm a 26 year old male. 1,83 meters tall (6 feet) and I weight 76 kilograms (167 lbs).I took a course of fluoroquinolones (Ciprofloxacin) for a Urinary Tract Infection last week. These last days I have been waking up with a nagging pain around my knees and today the pain got really serious, I can't move around without feeling pain.I haven't been doing any strenuous activity, just moving around in my daily activities, but I heard that fluoroquinolone can cause tendinopathies even several months after the treatment, the most serious being a tendon rupture.I don't think I got to that point yet but I would like to know what I need to do to avoid a tendon rupture and what I need to do to heal my knees tendons and ligaments better.Does massaging make it better or worse? Do I use cold or hot compresses? I have an horizontal stationary bicycle at home (no knee impact), using it at the lowest resistance in a low speed can help heal my knees? Or does it make it worse? Is it better that I stay at rest or just take some painkillers and move around?Thank you for your help and expertise!
  • Hi Rodrigo,

    I would first recommend you see your physician to rule out any other pathologies.   Since I am not doing an assessment or making a diagnosis I can only talk in general terms.  It would be recommended you see a physiotherapist for a full evaluation.  Having said, I can tell you this:  

    In general one would avoid high impact, explosive activities such as running, jumping, quick feet work etc.  Massaging can increase blood flow to an injured area, decrease tightness and spasms of muscle and help decrease pain.  Can it help, yes.  Can too much massaging a particular area aggravate the tissue yes.  For acute injuries where there is inflammation (such as in tendonitis) ice would be recommended (20 minutes maximum, not directly on skin if using ice).  After 3 -5 days depending on the situation, heat would be recommended during the sub-acute and chronic phase of an injury.  It is not recommended to ice and then do exercises or vigorous activity.  One would normally heat (15-20 minutes) muscle before performing an exercise and ice afterwards over the tendon that is injured.  For knee injuries physiotherapists often use stationary bikes to help reduce swelling, increase blood-flow and help improve function.  The movement is the critical component and not the resistance.  Lower resistance the better when one has an acute injury such as a patellar tendonitis.  Movement within moderation is always best.  This does not necessarily mean walking, running and doing activities is the right thing to do.  It depends on the level of injury and how one would feel hours after finishing the activity.  If you feel worse after a day due to the activity it was probably too much too soon.  

    Again, this is just a general interpretation and not specific to your case.  An assessment with a physiotherapist would help clarify exactly what would be appropriate in your situation.

    I hope this helps.

    Bill Landry BScPt

    Registered Physiotherapist

    Bill Landry BScPT Registered Physiotherapist
sartorius muscle
Hi,I got a bit of soreness and pain 1 month ago on the upper sartorius muscle (next to groin). It's a sharp pain that occurs when i try to lift up my leg for example running, kicking etc.I've literally tried everything, seen my team physio at my club (didn't help much) and have done some research on my own.So far I've done this:Gone gym for 2 weeks - didn't help Leg raises with and without elastic band for 2 weeks - didn't help Self massage for 2 weeks - didn't help Paid massage (4 times) - didn't help Rested, iced and applied deep heat for 1 week - didn't helpI swear I've tried everything! I can't seem to get this tiny paid on the upper sartorius muscle to go! It's just that, pain at the top of the sartorius muscle next to the groin, I cannot lift my leg to run, kick etc. I've had a much worse injury and was able to come back 120%, but this is just really frustrating because no matter what I do it just doesn't improve at all!Please feel free to reply soon, thanks!
  • Hi Azam,

    It is hard to pinpoint what the true issue might be.  I can talk about a rare situation where an avulsion fracture may occur at the ASIS that does effect the Sartorius ms.  The Sartorius muscle attaches to the Anterior Superior Iliac Spine (ASIS). 

    Rarely an avulsion fracture can occur at the ASIS that effects the sartorius muscle.     Bendeddouche et al discusses this in an article from a young soccer player who had difficulty kicking a ball.  I would continue to work with your health care team in regards to helping you fully recover.  Discuss the issues and your frustration at the lack of progress thus far.  Be open with your health care providers if the treatment thus far is not working.  They may look at other issues that may be going on.

    (1) Bendeddouche I, Jean-Luc BB, Poiraudeau S, Nys A. Anterior superior iliac spine avulsion in a young soccer player. Annals of Physical and Rehabilitation Medicine 2010 201011;53(9):584-590

         Abstract Avulsion fractures of the anterior superior iliac spine are rare. They usually occur in teenagers during sport activities. Cases concerning adults are very uncommon. We report here the case of a 23-year-old man who was admitted for recent pain of the left hip that worsened while kicking a ball in a soccer match eight days earlier. The examination found pain when moving the left hip in extension. Radiographs showed an avulsion fracture of the left anterior superior iliac spine, which was confirmed by computer tomography. The treatment was conservative consisting in rest and non-weight bearing with releasing of pain a few weeks later.

Plantar Fasciitis
I've had plantar fasciitis for several months now. Healing is very slow and it has really restricted my active lifestyle. Can you suggest exercises or actions I can take to help speed up healing? Can you also recommend ways to keep active while I'm healing that won't aggravate the problem? Thanks!
  • Hi Karina,

    Since I am not doing an assessment or making a diagnosis I can only talk in general terms.  I would recommend you see a physiotherapist for a full evaluation.  Having said that, I can tell you this about Plantar Fasciitis (PF):  The management of PF depends on the stage of recovery.  Acute management (less then 6 weeks post injury) involves protection of the area, decreasing the inflammation and swelling, gentle stretching and avoiding activities that aggravate the tissue.  Chronic management (> 6 weeks post injury) involves starting to load the tissue, strengthening, more aggressive activities and stretches.  A physiotherapist would be able to determine where you are in your recovery and best recommend what exercises to start with.

    Here are some general exercises we give to patients who have been diagnosed with PF.  We would not necessarily give a patient all of these exercises.  It would depend on what issues are actually causing the plantar fascia to be irritated and inflamed.   It would also depend on the stage of recovery (acute or chronic).  

    General Exercises - Plantar Fasciitis-The-Physio-Store

    What can aggravate the plantar fascia?  

    It could be due to footwear; tight musculature (such as calves), muscle imbalance and weakness, abnormal range of movement of your foot, foot, ankle, knee, or hip; due to gait mechanics, foot mechanics (example - flat feet); bone spurs; systemic issues and diseases such as diabetes; etc.  This is just a small sample of things physiotherapists look at to come up with a picture on what the issues are and help in making a decision on what exercises may be of help.  

    Other options besides an exercise program that physiotherapists may use in helping recovery include but may not be limited to: stretching, shock wave therapy, ultrasound, electrotherapy (TENS, IFC), manual therapy, acupuncture, massage techniques (cross frictions), gait retraining, orthotic prescription, icing (rolling foot over frozen water bottle for example), bracing to support the plantar fascia, compression sleeve, taping, use of a gel heel pad.

    In general, to keep active you would want to make sure you do not overdo it.  Moderation is the key.  You would want to stretch before and after doing your activities (calf, plantar fascia), wear good shoes that support your foot.  Using ice often to reduce the inflammation, Use therapies to help support your plantar fascia while doing activities such as taping, a gel heel wedge or a brace/compression sleeve to help reduce swelling and pain while performing activities.  Massaging and stretching the area around the heel may help reduce the pain and speed up heeling.  A physiotherapist would be able to educate you on how to perform these techniques.

    I hope this helps answer some of your questions.  The answers are general and may not apply in your case.  A physiotherapist would be able to help guide you to a full recovery.

    Bill Landry, BScPT, BScH, CAFCI, CWCE

    Registered Physiotherapist

    The Physio Store Inc.

    Bill Landry
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