Protecting Yourself from Serious Injury
The Healthy View
Because so many of us make resolutions and goals for the new year, we typically see an increase in injuries during the first few months of the year. People begin new workout routines, push themselves and their bodies too quickly, slip and fall on the snow and ice… Hazards are all around us. And if you’re not prepared with a proper workout plan, or don’t understand the signs and symptoms of your injury that may indicate something more severe, you can cause yourself more harm.
We’re happy to announce that the Sport Medicine Clinic remains open during the city’s latest lockdown. Our therapists continue to treat patients out of the Adelaide Health Clinic (located in First Canadian Place), and our hours remain 7:30am - 6:00pm, Monday - Friday.
To book an appointment, please call 416-865-0903 or email our reception. We look forward to seeing you soon!
Please remember to wear a mask to your appointment.
Tips for Novice Runners
With gyms remaining closed through the continued lockdown and many of us setting goals and resolutions for this year related to getting healthier, we’re all trying to find ways to get our cardiovascular exercise in outdoors.
As a registered physiotherapist at the Sport Medicine Clinic, I have experience with assessing and treating runners of varying levels - from novice, to 10km, to 1/2 or full marathon. I have worked with triathletes from beginner to Ironman level and have had the opportunity to speak at a few events about injury prevention, running mechanics, and managing injuries when they occur. I have completed courses on the prevention of running injuries via The Running Clinic and really enjoy sharing the knowledge I have gained both from coursework and experience.
I often get asked by patients or staff who want to start running again what my tips are for starting a program and preventing injury. Please note: these tips in no way serve as an exhaustive list of all factors a runner should consider, and if you sustain an injury, I really do recommend completing an assessment with an experienced rehabilitation therapist who has experience specifically with running injuries. This list in no way replaces good rehabilitation advice but is a good starting point of items to consider when starting a running program.
Allow your body time to adapt to the new load introduced by running
Often, people increase their running volume way too quickly and then end up injured and in my office. This is the number one error I see from most novice runners. Make sure it’s not more than a 10% increase in volume per week or an increase of 10min to your weekly long run per week. Your joints and soft tissue (i.e., muscles, tendons) need time to adapt to the load (especially if you are not currently running). If you have a specific race you are training for, make sure you start your training well in advance and give yourself time to work up to that mileage!
This can be very effective in allowing you to work on your running technique while also gradually working up your cardiovascular fitness to run at a constant pace.
I have all of my novice runners start with an interval program, they gradually work upwards ensuring that they’re not having pain during a run, immediately after a run, or the following morning. I highly recommend using an interval program for novice runners if you are just starting out, as it will allow you to gradually adjust to impact exercise.
Learn about Cadence and Track it
Cadence is the number of strides you take per minute. Your cadence should be between 170-190 strides per minute.
You can track and set your cadence using a basic metronome on your phone, download a running playlist from Spotify that has a set cadence as the music beat, or some GPS watches now measure cadence for you.
Tracking your cadence will help improve your running technique (in a nutshell, it helps prevent overstriding and limit unwanted forces on your joints and soft tissue).
Practice Makes Perfect
Work on your running technique: Running drills are great for this! ABCD drills will actually help you improve your running technique. A great resource of these, from The Running Clinic, can be found here.
Run Often: You need to make sure you practice running. Research shows that if you run 4-5 times per week, you are less likely to sustain an injury.
Make sure you Warm-up
I recommend completing a progressive jog to get your heart rate and temperature up. Followed by some dynamic exercises. No static stretches until after your run.
Pick your Shoes before you start a Program, if you can
It can take time to transition from a shoe with more support to a shoe with less support; this often requires at least 6 months to transition, depending on what shoe you go from and to. If you want to change shoes, do it before you start running. It’s a lot simpler that way.
You’ll have to read my next article on choosing a shoe, as there is a lot more to consider...
Get Professional Advice
Work with a running coach, have a video analysis of your running technique completed by a professional…
Coaches are great resources. They have a lot of experience and you will learn a lot from working with one. If you are a novice runner it is often quite helpful to have a video analysis completed of your running technique.
The Running Clinic
Briana Bradstreet, MPhty, BSc Kin
Understanding Concussions and How we can Help
What is a concussion?
A concussion is something that most people have heard of, but few truly understand. Simply put, it is a mild traumatic brain injury (mTBI) caused by either a direct blow to the head, face, neck, or another part of the body that transmits force to the head. The amount of force needed to cause a concussion far exceeds the amount required to cause a mild neck strain. Therefore, it is safe to say that most, if not all patients suffer a neck strain during the injury event, requiring therapeutic intervention. A concussion is triggered through rapid acceleration and deceleration of the head, causing short-lived changes in brain chemistry. These chemical changes resemble a depressive state, and have been proposed to be an underlying cause of associated migraines and symptoms. Blood flow to the brain has also been shown to decrease as a result of a concussion and may be impaired for up to 14 days following injury.
Concussions typically involve rapid onset of transient functional neurologic impairments that spontaneously resolve. In some cases, these impairments can evolve over a number of minutes to hours. It is important to note that the acute clinical symptoms of a concussion represent a functional disruption as opposed to a structural injury. These symptoms will resolve within 7 to 10 days in most cases (80 – 90%), but some may be prolonged.
How do you recognize a concussion?
Many of the symptoms and signs that present after a head injury are not unique to concussions. If any of the following are present after a collision event, a prompt assessment by a healthcare practitioner should be sought.
- cognitive/emotional/behavioural changes
- sleep/wake disturbances
- dizziness, blurred vision, or balance problems
- memory loss
- a feeling of slowness or fatigue
- concussive convulsions/impact seizures
- confusion or attention deficit
- memory disturbance (sport setting - unaware of time, opponent, game score)
- loss of consciousness
- neurological deficit
- balance impairment
- poor coordination
- distracted/concentration issues
- vacant stare/glassy eyed appearance
- slurred speech
- double/blurred vision
What is our role?
The treatment of concussions will generally follow a 3 phased approach. The first phase involves the prevention of further injury and appropriate referral. In the second phase, a therapist helps the patient regain primary functions. The third phase is where complete recovery of lost functions is accomplished using a specialized rehabilitation program.
Appropriate clinical management is necessary, and the resumption of normal activity should be carefully monitored. In sport related concussions, the main concern of returning to play too early is that the athlete is at a dangerously high risk to sustain further injury due to impaired cognitive function. Players should not return to competition until they have completely recovered from their concussive injury and should NOT return on the day of a suspected head injury. “When in doubt, sit them out!” If a player begins playing while symptomatic, the post-concussive symptoms may be prolonged and any resulting injury would be more severe. An association has been observed between sustaining multiple concussions and cumulative effects on cerebral function, cognition, and early onset of memory issues. After a concussive injury, players should work with a professional to develop an appropriate rehabilitation program once clinical signs and symptoms have resolved and cognitive function has returned to pre-injury state.
In conjunction with standard return to play protocols, we have introduced Brain Gauge technology to our Clinic to further evaluate brain function following concussion. Brain Gauge has the unique ability to assess brain processing of precise stimuli without conscious involvement of the patient, and produce measurable numerical scores. These scores can reflect nutritional imbalances, neurotransmitter levels, or a slow cognitive decline. Contact the Clinic for more information on concussion management, prevention, and education.
Dr. Paul Glancey
Relieve your OA pain with Cingal
Whether you’re pushing 50 years of age or well past it, you’re likely familiar with the discomfort caused by osteoarthritis (OA). This common wear and tear condition can often create more than just joint achiness. Knee joint pain, in particular, can suddenly flare intensely enough to make climbing stairs or walking nearly impossible. Fear not, swallowing anti-inflammatory pills and injecting cortisone, although appropriate in some cases, aren’t your only options.
While hyaluronic acid can be injected like a joint lubricant, it tends to work best for lower grade osteoarthritic pain and its effect is seen over a long period of time. Cortisone works very well for acute flares but its positive effect doesn’t last long (typically 3 – 6 weeks only). Enter the latest invention, a combination of both of these in a single injection. When OA pain and swelling spike, it may be wise to try to get the short-term benefit of a type of cortisone with the longer-term benefit of a hyaluronic acid all in one shot, pun intended.
A Canadian company produces this product known as Cingal and it’s certainly making waves in the industry. Although it’s not covered by OHIP, almost every extended benefits plan covers it. So, don’t simply take a pill and hope for the best. You may be a candidate for this innovative approach. Once you’ve blunted the nasty pain and addressed the swelling, you’re well prepared to get yourself back to the three pillars of OA management: general exercise, weight control, and specific rehab.
Dr. Tim Rindlisbacher
Consultant Sports Medicine Physician