Arthritis Clinic

Our physiotherapist Jacek has extensive experience helping patients with arthritis. He has over 26 years of experience working at the Mary Pack Arthritis Centre and is regularly referred arthritis patients from rheumatologists and other healthcare professionals.

Why Choose Bentall Physiotherapy?


We always warmly welcome new patients and make every effort to schedule you in at a convenient time.


We direct bill major insurance providers, ICBC, WCB, and extended MSP so that you can focus on getting healthy.


We’ve been helping Vancouverites treat and prevent injuries for over 20 years!

Book Online

We offer 24/7 online appointment requests for your convenience.


All of our treatments are 1 on 1. We use advanced technology and techniques for more accurate treatment planning and quicker results.


We’re an award winning clinic with an average 4.8 / 5 rating from over 25 reviews.

The Bentall Physiotherapy Difference


We focus on the source of the problem and not the symptoms…

We want you to get back to a normal and active life as quickly and safely as possible. Instead of treating your symptoms for temporary pain relief, we focus on identifying the source of the problem and treat that for long lasting results.


We focus on education and habit / movement pattern modification…

We want you to see lasting results. Our team members will assess a variety of movement patterns and postures while empowering you with education and exercises so that you can reduce the risk of re-injury and prevent new injuries from occurring.


We take a holistic approach to treatment…

We understand that the human body is incredibly interconnected. We use a variety of technology and techniques to detect and treat not only the underlying cause of your problem but also other areas of your body that might be contributing to the problem.


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To book an appointment call 604-683-8138 or click on the book now button below. Please note to book an appointment online, a CELL phone and email address are required.


We offer our physiotherapy service: Monday to Friday 7am – 6 pm.

Reception Desk Hours are: Monday to Friday 8 am – 5 pm.

Physiotherapy interventions such as modalities and therapeutic exercise can be extremely effective at reducing the pain caused by arthritis, preventing further joint deterioration and maintaining independent living.

Arthritis is a general term meaning inflammation of one or more joints. This inflammation can be caused by a number of things such as: injury to the joint, disease, deterioration, strain and/or fatigue and results in varying levels of pain ranging from tolerable to unbearable. When a joint becomes too damaged, surgical intervention in the form of a joint replacement is required.

There are over 100 different forms of arthritis. The most common form is osteoarthritis (or degenerative joint disease), usually caused by trauma to the joint, infection of the joint, or age. Rheumatoid arthritis is another common form of chronic, inflammatory diseases  which falls into the category of autoimmune disorders while spondyloarthropathies are a group of inflammatory diseases that affect the joints of the spine. Osteoporosis is a disease that affects the quality and quantity of bone.

Physiotherapy Treatment Techniques

After a thorough assessment of the muscles, joints and ligaments in your area of injury or pain, your physiotherapist will create a treatment plan. This treatment plan,unique to your specific needs and goals, will involve several different treatment techniques and will evolve as you improve.

Your physiotherapist will explain what they are doing and why, but if you desire further information or are curious about what physiotherapy treatment techniques we offer at Bentall Physiotherapy, they are explained in this section of our website. Feel free to contact us if you have any further questions.

Please consider this information to be a general guide to a very complex and diverse science. The techniques we use are all evidence based and our physiotherapists are well qualified to perform them.

Spiral Stabilization

Spiral Stabilization is an unique exercise method effective in prevention and treatment of spinal disorders, muscle imbalance and mechanical problems of peripheral joints(shoulders, hips, keens and feet). This unconventional movement approach relies on the concept of spiral muscle chains producing traction of the spine that relieves pressure in the intervertebral discs and joints and allows for the proper nutrition and regeneration. Muscle spirals also allow for optimal spinal mobility while aligning the spine into a centralized axis.

The exercises are performed with an elastic cord and incorporate all important elements of strengthening, stabilization, stretching, relaxation, coordination and balance in every exercise.

They are easy to learn as they are based on the natural movement patterns of the body regularly used during walking and running.

How does it work?

Initially the focus goes to reducing muscle imbalances in the shoulder. We continue by correcting the muscle imbalance in the pelvis and later in the abdominal region. We stretch the muscles compressing the spine – long muscles located along the spine. We renew the activity of the short muscles that coordinate the mutual alignment of the vertebrae. We exercise the muscle spirals through body’s main section – the external, internal oblique and transverse abdominal muscles, which contract the area of the waist and create an upward force. After correctly performing the exercises with an excellent technique standing on both feet, we continue by exercising on only one foot. Exercising on one foot develops a sense of balance and increases the effect of spiral stabilization (intensively strengthens the abdominal muscles) and supports the arch of the foot.

Who can benefit from Spiral Stabilization Exercises?

Spiral Stabilization is especially for those who suffer from:

  • Disc degeneration/prolapse/herniation – with the help of muscle chains the body develops upward strength that relieves pressure on the intervertebral discs and joints and allows for their regeneration and treatment.
  • Scoliosis (kyphosis, lordosis) – exercises will change the insufficient activity of the muscle spirals to its correct functioning and create a dynamic stabilizing muscle corset, which will cause upward traction force, bringing the spine to the central axis.
  • Failed back surgery syndrome – treatment and prevention of complications after unsuccessful spinal surgeries.
  • Hip and knee surgery – treatment and prevention of unstable walking after hip or knee surgery or as a preparation for surgery.
  • Children/Youth – the exercise is aimed at regeneration focusing on reversing poor posture, which is frequently caused by long periods of sitting at a desk at school, also kyphosis, lordosis, scoliosis and Scheuermann’s disease.
  • Middle aged/General pain sufferers – the exercises will be aimed at rectifying muscle imbalances caused by a sedentary job and asymmetric loading such as overworking or overusing. We concentrate on renewing muscle balance, releasing painful muscle tension and optimizing movement coordination

Joint Replacement

What is a Joint Replacement?

Total joint replacement (TJR) is a very effective surgical procedure for persons with advanced arthritis in the hip or knee. In a total hip replacement (THR), the ball and socket joint is typically replaced with metal and plastic components. The ball on the end of the femur is removed and replaced with a metal ball attached to a stem that is cemented or firmly pressed into the femur. The socket in the pelvis is cleaned out and a plastic cup is cemented or firmly pressed in place.

With a total knee replacement (TKR), the ends of the femur (thigh bone) and tibia (shin bone) are trimmed and metal components are typically cemented into place. A high density plastic tray is placed on top of the tibial portion and a plastic button is attached to the back of the patella (knee cap) to help it glide smoothly

When is it Time for a Joint Replacement?

Joint replacement is always an elective procedure. A doctor may recommend it, but you must weigh the benefits and risks and come to your own decision about whether, or when, to undergo this major surgery. Although your age is an important factor, the decision to have a joint replacement is based on your disability — how much pain you’re in and to what degree your joint problems limit your activities. It may be time to consider knee or hip replacement if one or more of the following statements apply to you:

  • You are unable to complete normal daily tasks without help.
  • You have significant pain daily.
  • Pain keeps you awake at night despite the use of medications.
  • Nonsurgical approaches — such as medications, the use of a cane, and diligent physical therapy — have not relieved your pain.
  • Less complicated surgical procedures are unlikely to help.
  • Pain keeps you from walking or bending over.
  • Pain doesn’t stop when you rest.
  • You can’t bend or straighten your knee, or your hip is so stiff that you can’t lift your leg.
  • You are suffering severe side effects from the medications for your joint symptoms.
  • X-rays show advanced arthritis or other damage.

Physiotherapy Before a Joint Replacement

It should be stressed that a physiotherapist supervised exercise program before surgery may be very beneficial in recover period. It is wildly supported by literature that keeping the hips and knees moving, and the muscles around the joints strong, contributes greatly to protecting the joints and preventing additional damage caused by arthritis. The pre-op program addresses key areas:

  • weight-bearing low impact cardiovascular activity like walking, swimming and cycling, to keep your bones strong and your heart healthy;
  • muscle strengthening activity, to relieve strain on the joints;
  •  flexibility and range of motion, to help prevent falls and keep your joints mobile;
  • Proprioceptive and balance exercises;
  • Joint protection and energy conserving techniques;
  • Pre –operative education for patient and family.

After an initial period of protecting the healing tissue by following post-operative precautions, you should regain enough range of motion in the operated joint for day-to-day function and appropriate sports and recreational activities.

Physiotherapy After a Joint Replacement

The goal of post-surgery physiotherapy program is to maximize strength and flexibility while limiting abnormal forces across the hip or knee joint, possibility of dislocation or excessive wear on the new joint.

Rehabilitation program following joint replacement will include:

  • Positioning and weight bearing precautions
  • Prevention of deep vein thrombosis and other post-surgical complications
  • Functional activities- use of walkers, canes, stair climbing
  • Range of motion exercises
  • Retraining of motor control of key muscles
  • Strengthening exercises with progression
  • Restoration of muscle balance to reduce your risk of falling
  • Correction of biomechanical foot dysfunction

Current research and personal observation of our experienced physiotherapists suggest that physical therapy and individually-tailored exercise programs produce noticeable improvements in physical and functional limitations well beyond 12 weeks.

In the long term, matching patient’s individual limitations to ones specific goals is crucial in achieving a successful outcome (e.g. golfer needs good hip rotation).

For more information on hip and knee replacement surgery and what to expect, visit VCH-OASIS or the Canadian Orthopaedic Foundation.


Osteoarthritis (OA) is a degenerative form of arthritis that affects about 1 in 10 Canadians and as much as 80% of persons over age 65. While once considered a normal consequence of aging and a result of ‘wear and tear’ on the cartilage (hard tissue that covers and protects the ends of bones), OA is now recognized as a disease affecting the entire joint. The cartilage, synovium (tissue that lines the joints and creates the fluid), bone, ligaments and muscles are all involved.

Factors that increase a person’s risk of developing OA include previous injury to the joint, poor joint alignment (e.g. bow legged), obesity, certain occupations that involve repetitive motion, genetics (family history), and other medical conditions such as gout or diabetes.

Osteoarthritis can develop in any moveable joint; however, most often it affects the spine, hips, knees, hands and big toe. Persons with OA experience pain (with movement and later, at rest as well), stiffness and loss of function in the involved joints. An X-ray may show the damage from OA in the later stages yet this damage doesn’t always match the pain and loss of function you may be experiencing. Medical treatment for OA includes pain killers (e.g., Acetaminophen), nonsteroidal anti-inflammatory drugs (NSAIDs), topical creams and gels (e.g., Capsaicin) and occasionally, injections into the joints with corticosteroids (to restore the cushioning and lubricating properties of normal joint fluid).

Physiotherapy can help with OA through education and appropriate exercise to improve joint range of motion, strengthen supporting muscles around the joint as well as the muscles that stabilize your trunk (core muscles), and increase overall fitness level. Physiotherapists will also assess your posture and gait (walking style) to ensure you are not placing unnecessary forces on problem joints. If pain is a primary concern, there are a number of options that the physiotherapist can provide guidance on including use of heat or cold, electrical modalities (e.g., TENS) and joint protection strategies such as using a cane or proper footwear. In some cases, manual techniques including traction or mobilizations (gentle oscillations to restore normal joint play) are helpful in reducing pain and improving joint movement.

For more information on OA, download the brochure from The Arthritis Society.


Osteoporosis is a disease that affects the quality and quantity of bone. Your bone stock (density) peaks at about 30 years of age. After that, we all begin to lose bone stock very gradually – about 1% a year. Some factors increase the risk of developing osteoporosis:

  • female gender
  • Caucasian or Asian race
  • thin and small body frames
  • family history of osteoporosis (for example, having a mother with an osteoporotic hip fracture doubles your risk of hip fracture)
  • personal history of fracture as an adult
  • cigarette smoking
  • excessive alcohol consumption
  • lack of exercise
  • diet low in calcium
  • poor nutrition and poor general health

The most common areas in the body to develop osteoporosis are the hip, wrist and vertebrae in the mid-portion of the spine. When vertebral bone becomes thin, it is prone to collapse from relatively minor forces. These are called ‘compression fractures’. Over time, you may notice a progressive loss of height or even a forward stooped posture. In persons with osteoporosis, a fall can lead to fractures in the wrist and hip. Osteoporosis typically appears after the age of 40 and affects one in four women over the age of 50. Women are four times more likely to develop osteoporosis than men.

With such high occurrence rate prevention is very important because, while treatments are available for osteoporosis, no cure currently exists. Prevention of osteoporosis is an effective approach and involves nutrition, exercises, lifestyle, and early screening:

  • Eating well balanced diet from early childhood which supplies essentials nutrients and is high in calcium and Vitamin D. Good sources of calcium include dairy products, dark green and leafy vegetables, saltwater fish, tofu and almonds. An adequate level of Vitamin D is necessary for the body to absorb calcium from the diet.
  • Weight-bearing exercises like walking, hiking, jogging, climbing stairs, playing tennis or soccer, jumping rope, and dancing, during childhood and adolescence increase bone density and strength and help to reach its peak density in early adulthood.
  • Resistance exercises which build muscle strength and also strengthen bones.
  • Saying NO to smoking and alcohol consumption as those damage bones and disturb body’s chemistry.
  •  Early detection of low bone mass (osteopenia) or porous bones (osteoporosis), allows the patient and the doctor to take action to stop the progression of bone loss. With lifestyle changes and appropriate treatment strategies recommended by a doctor, osteoporosis can be prevented and treated and the consequences of osteoporosis (broken bones and disability) can be avoided.

Physiotherapy plays an important role in preventing and managing osteoporosis as well rebuilding bone mass. Your program may include weight-bearing exercises such as walking or low-impact aerobics to help strengthen bones. Resistance (strengthening) exercises help by placing healthy stress through bone and have the added benefit of increasing muscle strength. Strong muscles will improve your balance and may help to prevent a fall that could lead to a fracture. Exercises like Tai Chi and yoga may help to further improve your balance and coordination. If you have had a fracture, physiotherapy can help you with pain control and regaining function and mobility after it has healed or been repaired through surgery.

For more information on osteoporosis, visit The Arthritis Society or Osteoporosis Canada.

Rheumatoid Arthritis

Rheumatoid Arthritis (RA) is an inflammatory form of arthritis that affects the musculoskeletal (muscles and joints) and other ‘systems’ in the body including the cardiovascular (heart and lungs), skin, and eyes.  RA is considered an autoimmune disease – that is, the body’s own immune system attacks healthy tissue resulting in inflammation and damage. While the primary cause of RA is unknown, researchers are gaining greater understanding of how genetic factors and the immune system interact and lead to the chronic inflammation seen in RA. More than 1 in 100 Canadians have RA, which usually develops between the ages of 25 and 50. RA is three times more common in females.

With RA, you may experience symptoms such as pain in many joints throughout the body (especially the small joints in the hands and feet), prolonged joint stiffness in the morning, fatigue and low grade fever. Early diagnosis and targeted treatment are critical to reduce the inflammation and prevent or minimize joint damage. Download ARthritisID, a free App for your iPhone, iPod or iPad, which features evidence-based information to help detect, treat and manage arthritis.

Medical treatment for RA involves early and if needed, aggressive treatment. Disease-modifying anti-rheumatic drugs (DMARDs) are the first line of treatment as they act to slow down the processes that drive the chronic inflammation and help to prevent damage. DMARDs are often used together with non-steroidal anti-inflammatory drugs (NSAIDs) and/or low dose corticosteroids. For more severe RA, a group of DMARDs known as “biologics” may be prescribed to target specific parts of the immune system that lead to inflammation and joint damage.

Physiotherapy can help with RA through education and appropriate exercise to maintain joint range of motion, strengthen supporting muscles around affected joints and increase your overall fitness level. Regular exercise reduces pain and fatigue, improves function, enhances sleep and alleviates depression. If pain from inflammation is a primary concern, there are a number of management options including use of cold, electrical modalities (e.g., TENS, LASER) and joint protection strategies such as using a splint or proper footwear.

For more information on RA, visit The Arthritis Society website.

Ankylosing Spondylitis

Spondyloarthropathies (spon-dee-lo-ar-throp-a-theez) refers to a group of diseases involving the spine. These inflammatory arthritis conditions include Ankylosing Spondylitis (AS), and spondylitis associated with inflammatory bowel disease and psoriatic arthritis. Ankylosing Spondylitis is the most common type and affects about 1 in 1000 Canadians. In this ‘autoimmune disease’, the body’s own immune system causes inflammation in ligaments and tendons where they attach to bone – this includes sites along the spine as well as the heel (Achilles tendon), knee (patellar tendon) and arch of foot (plantar fascia). In AS inflammation usually starts at the base of the spine, where it attaches to the pelvis (sacroiliac or SI joints). This inflammation and resulting pain and stiffness can spread upwards to other parts of the spine. In severe cases, it can involve the entire spine.

AS is a systemic disease so also affects other systems in the body such as the eyes and less often, the heart and lungs. Persons with AS often experience fatigue and prolonged joint stiffness in the morning. Younger males (aged 15 to 30) develop AS more often than females.

Medical treatment for AS and other spondyloarthropathies includes nonsteroidal anti-inflammatory drugs (NSAIDs), disease modifying antirheumatic drugs (DMARDs) and a newer group of DMARDs called biologics. Biologics have ‘revolutionized the treatment of AS’ by suppressing inflammation and helping to prevent damage to the joints of the spine.

Physiotherapy is the primary form of treatment for AS. The physiotherapist will prescribe exercises to maintain your spinal and soft tissue flexibility, strengthen the muscles that support proper posture and breathing, and maintain or increase your overall fitness level. With the progressive stiffness that is common with AS, it is very important to exercise and stretch on a regular basis to maintain mobility and function. Physiotherapy may also include use of heat or electrical modalities to reduce pain and help you exercise successfully.

For more information on AS, visit The Arthritis Society website.

  • “I ‘m an active professional with very little time to spare; so when I need help with my aches and pains I go to the best.  At Bentall Physiotherapy therapists are experienced, professional and dedicated to helping us, the patients, feel really good again. An assessment is always focused on the root of the problem not the symptom and I always leave with exercises and suggestions on how I can participate in this healing process. Keep up the great job, you guys! I’m sure I will be back.”

    Sharon M.
  • “Mariola’s knowledge of human body, hands-on approach, professional and friendly manner has made a world of difference in dealing with my chronic low back pain. Now I have my life back and I am grateful for all the help.”

    Susan W.
  • “Experienced, professional and knowledgeable physiotherapists, empowering experience”

    Victor T.
  • “Just wanted to share with you how much I have appreciated the fine work Mariola has done helping to heal my back. Her cheery disposition and professional manner brightened many of my “rainy “days.”

    Janet C. RN
  • “Most of my family and I have been visiting Jacek for almost 15 years with various sports related ailments. Jacek is the best Physiotherapist we have found to get us pain free and moving again.”

    Strat L.
  • “After a shoulder injury I wanted to give up and curl into a ball and pass my days with self pity. Jacek believed in the benefits of exercise and encouraged me to try even when I felt grumpy and frustrated. He told me that the journey might take some time, but that it would be worthwhile. As part of my therapy he challenged me with 10,000 steps a day, and naturally I doubted myself because it was easier not be accountable. Jacek was determined to stand his ground and encouraged me every step of the way – to have courage and to “stick with the program”. Walking 10,000 steps is now a breeze for me, and each day I set new challenges with tremendous pride in myself. I cannot thank Jacek enough for believing in me when I had given up on myself.”

    Rhona M.
  • “Jacek gave me back my life. After I was diagnosed with Rheumatoid Arthritis, Polymyositis and now Osteoarthritis, I struggled for many years with the disease until I found Jacek. He is very knowledgable and skilled to deal with the complexity of my disease and he is flexible with his time in order to bring me relief. His treatments relived me of my joint pains which enabled me to gradually reduced my pain medications. He eventually helped me achieved remission. I’m now off medication and lead a normal life. Jacek is my Physiotherapist of choice whenever I have a flare up for 20 yrs. and recommended him to my family and friends.”

    Joyce M.
  • “My 86 years old mother and I, we are both having arthritis, osteoporosis and osteopenia. We are Jacek’s patients for over 15 years or so, and I told him once that he is not allowed to retire ever! Without his treatments, we would be having very poor life quality. He takes the time to listen and helps you understand what is going on. He is knowledgeable, skilled, intuitive and so thorough. He is confident and inspires you to reach for the highest possible level of physical functioning despite your limitations. And when we talk and joke about his native Poland or our Serbia, our minds are forgetting the painful stretching or twisting that we have to endure in order to improve the range of motion or muscle strength. I have to say that even the toughest manual adjustments are done with extremely gentle approach. Jacek genuinely wants you to be in the best shape you could be. I would absolutely recommend this great professional to anyone!”

    Mirjana A.
  • “Jacek is a very special physiotherapist, my family and I are very grateful to be under his care. I never thought that a physiotherapist would teach me how to breath. Jacek educates about the fundamentals and awareness required to live in your body aligned and healthy. Of course, the process is one of co-creation—his wisdom and guidance and your action incorporating his prescribed posture and exercises. Jacek is a Master at his craft. His passion in understanding the integrated workings of the human body are incredible to say the least. With the depth of Jacek’s knowledge and wisdom in his field, coupled with his presence, makes is easy for me to say, that everybody would be well served to have a session with Jacek!”

    Briege F.


We direct bill all major insurance companies, ICBC, WCB, and extended MSP so that you can focus your time and energy on getting better.


We always warmly welcome new patients to our office and direct bill all major insurance companies. To book an appointment please feel free to call us or book online. If you have a question, please feel free to fill out the form or give us a call.


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