Arthritis Clinic

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.

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.

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

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.