by Colin Beattie | Apr 14, 2025 | news
Lasting Relief from Achilles Tendinitis Through Expert, Research-Backed Care
At South Island Physiotherapy in Victoria, BC, we believe injuries are opportunities—not setbacks. One of the most common tendon injuries we help patients recover from is Achilles tendinitis. Whether you’re dealing with a new injury or persistent Achilles tendon pain, this guide covers the current evidence-based treatments for both acute and chronic stages of recovery.
What Is the Achilles Tendon?
The Achilles tendon is the largest and strongest tendon in the body. It connects your calf muscle to your heel bone and plays a key role in walking, running, and jumping. This lower leg tendon absorbs large amounts of force—especially during sports or high-impact activities.
When this tendon becomes irritated or damaged, you may experience pain, swelling, or stiffness near the heel. These symptoms are typically grouped under the broader term Achilles tendinopathy.
Types of Achilles Tendon Injuries
- Achilles Tendinitis (Tendonitis)
Achilles tendinitis, sometimes spelled tendonitis, is an early-stage injury marked by inflammation in the Achilles tendon. It often results from overuse, sudden changes in activity, or poor biomechanics in the foot and ankle.
When tendon pain becomes chronic and the inflammation subsides, the tendon itself may begin to break down. This condition is called Achilles tendinosis and is associated with thickening, reduced blood flow, and changes to the tendon’s structure.
This general term refers to any pain or dysfunction in the Achilles tendon, including both tendinitis and tendinosis. It’s the term most used in current sports medicine research and clinical guidelines.
- Insertional Achilles Tendinopathy
This form of Achilles tendinopathy occurs when the Achilles tendon attaches to the heel bone. Known as insertional Achilles, it may involve bony spurs and often feels worse when walking uphill or wearing unsupportive shoes.
In severe cases, the Achilles tendon can partially or completely tear—a condition called Achilles tendon rupture. This often occurs during explosive movements and may require a walking boot or surgical repair, followed by physical therapy.
Diagnosing Achilles Tendonitis and Tendinopathy
Diagnosis begins with a physical exam. Your physiotherapist will assess the range of motion, strength, and tenderness in the lower leg, heel, and ankle.
When needed, imaging such as magnetic resonance imaging (MRI) or ultrasound can confirm the extent of the damage or rule out a tendon rupture. However, most cases can be diagnosed and treated based on symptoms and function.
Evidence-Based Treatment: Acute Achilles Tendinitis
During the acute phase of Achilles tendinitis, the focus is on reducing inflammation, managing pain, and preventing further damage.
Activity Modification
Avoid aggravating movements like running or jumping. Replace them with low-impact activities such as swimming or cycling to stay active without straining the Achilles tendon.
Ice and Elevation
Apply ice to the painful area for 15–20 minutes several times a day. Elevating your lower leg can also help reduce inflammation.
Footwear and Orthotics
Supportive footwear with proper cushioning can take pressure off the heel and tendon. A heel lift or custom orthotic can provide short-term relief, especially for insertional Achilles issues.
Walking Boot (When Needed)
In more serious cases, especially where pain limits walking, a short-term walking boot may be used to offload the tendon and allow healing to begin.
Evidence-Based Treatment: Chronic Achilles Tendinopathy
If symptoms persist for more than six weeks, they’re considered chronic, and treatment shifts from rest to active rehabilitation. At South Island Physiotherapy, our team uses targeted physical therapy techniques backed by strong research.
Eccentric Strengthening Exercises
The gold standard for Achilles tendinopathy treatment is eccentric loading—slowly lowering the heel off of a step under body weight. This exercise strengthens the calf muscle and encourages tendon remodelling.
Examples include:
- Straight-leg heel drops (for the gastrocnemius)
- Bent-knee heel drops (for the soleus)
A typical program runs for 12 weeks and gradually increases in intensity.
Stretching
Tight calf muscles can put excess strain on the Achilles tendon. Gentle daily stretching of the calf and ankle helps improve flexibility and reduce tension on the tendon.
Manual Therapy
Hands-on treatment by your physiotherapist can improve joint mobility in the ankle and soft tissue quality around the tendon and heel.
Gradual Return to Sport
Your therapist will help you build a step-by-step plan to return to running or sport safely, using low-impact activities first and progressing based on tendon tolerance.
Advanced and Adjunctive Treatments
Shockwave Therapy
Some research supports extracorporeal shockwave therapy (ESWT) for chronic Achilles tendinopathy. It may improve pain when used alongside exercise therapy.
Injections and Surgery
Corticosteroid injections are not commonly used due to the risk of tendon rupture. In rare, stubborn cases where conservative care fails, surgical treatment may be considered.
Preventing Achilles Tendon Injuries
Even after recovery, it’s important to protect your Achilles tendon and avoid re-injury. Here’s what you can do:
- Warm up before activity and cool down after
- Progress training loads slowly—no more than 10% increase per week
- Regularly strengthen your calf muscles
- Stretch daily to maintain range of motion
- Use proper shoes and orthotics if advised
- Include low-impact activities like biking or swimming in your routine
When to Seek Help
If you’re experiencing persistent heel or ankle pain, don’t wait. The sooner Achilles tendinitis or tendinopathy is treated, the better the outcome. At South Island Physiotherapy, we provide tailored physical therapy programs rooted in sports medicine principles and designed to help you move freely and confidently again.
Ready to Start Healing?
Achilles tendon pain can slow you down—but with the right support, it doesn’t have to stop you. Whether you’re managing acute tendonitis or chronic Achilles tendinopathy, our team is here to help you recover through education, strengthening exercises, and movement-focused care.
Book an appointment at South Island Physiotherapy today, and let’s get you back to doing what you love—pain-free and stronger than ever.
by Colin Beattie | Feb 13, 2025 | news
Cervical Radiculopathy – “Pinched Nerve” Management in Primary Care
Cervical radiculopathy, often called a “pinched nerve in the neck,” happens when a nerve root in the cervical spine (neck) gets compressed or irritated. This can cause pain, tingling, numbness, and muscle weakness that spreads from the neck to the shoulders, arms, and hands. While severe cases may require surgical treatment, most people can find relief with conservative (nonsurgical) treatment options.
This article explores the common causes, symptoms, diagnosis, and conservative treatment options for cervical radiculopathy.
What Causes Cervical Radiculopathy?
Cervical radiculopathy is often caused by conditions that put pressure on the nerve root.
Common causes include:
- Cervical disc disease: Age or trauma-related changes in the discs between the cervical vertebrae can lead to bulging or herniated discs, which press on the spinal nerve root.
- Cervical spondylosis: Age-related degenerative cervical changes can lead to bone spurs that put pressure on the nerves.
- Injury or trauma: Accidents or sudden movements can damage the cervical spine and cause nerve compression.
- Spinal stenosis: Narrowing of the spinal canal can put pressure on the nerve roots.
Symptoms of Cervical Radiculopathy
Patients with cervical radiculopathy may experience:
- Neck and upper extremity pain: Pain that radiates from the neck to the shoulders, arms, and hands.
- Tingling or numbness: Affected nerve roots may cause a “pins and needles” sensation in the arms or hands.
- Muscle weakness: Some people notice difficulty gripping objects or lifting their arms.
- Radicular symptoms: Symptoms that follow the path of the affected nerve, including pain, burning, or electric shock sensations.
- Neurological symptoms: Loss of reflexes and coordination in the arms and hands.
It’s important to distinguish between cervical radiculopathy and cervical myelopathy. While radiculopathy affects the nerve roots, cervical myelopathy involves spinal cord compression, which can lead to more severe symptoms, including balance and coordination problems.
Diagnosing Cervical Radiculopathy
A Physiotherapist, Chiropractor or Medical Doctor will diagnose cervical radiculopathy based on a patient’s symptoms, medical history, and physical examination. Some tests that may be used to confirm a cervical radiculopathy diagnosis include:
- Magnetic resonance imaging (MRI): This is the most effective imaging test for detecting nerve compression, herniated discs, and other spinal issues.
- X-rays: Can show degenerative cervical changes, such as bone spurs or disc narrowing.
- Electromyography (EMG): Assesses nerve function and helps distinguish between nerve and muscle problems.
Conservative Treatment Options
Most cases of cervical radiculopathy improve with nonsurgical treatment. A primary care doctor or physical therapist may develop a treatment plan that includes:
1. Physical Therapy
Physical therapy is one of the most effective conservative treatments for cervical radiculopathy. A physical therapist can teach exercises to relieve pain, improve mobility, and strengthen muscles that support the neck and upper back. Key techniques include:
- Deep cervical flexor exercises: Strengthening these muscles can help relieve symptoms and reduce pressure on the nerve.
- Cervical traction: A method that gently stretches the neck to relieve pressure on the nerve root.
- Postural correction: Improving posture can reduce strain on the cervical spine and help treat cervical radiculopathy.
2. Medications
Over-the-counter and prescription medications may help relieve pain and inflammation. Common options include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Such as ibuprofen or naproxen, to reduce pain and inflammation.
- Muscle relaxants: Can help with muscle tightness and spasms.
- Oral corticosteroids: Sometimes, a doctor may prescribe steroids to reduce swelling around the affected nerve.
3. Use of a Soft Cervical Collar
A soft cervical collar can temporarily support the neck and reduce movement that may worsen symptoms. However, it is generally recommended only for short-term use, as prolonged use can weaken neck muscles.
4. Cervical Pillow and Nighttime Support
A cervical pillow can help maintain proper neck alignment while sleeping, reducing pressure on the affected nerve.
5. Lifestyle Modifications
- Ergonomic adjustments: Using a supportive chair, keeping screens at eye level, and maintaining good posture can help prevent worsening symptoms.
- Activity modification: Avoiding repetitive neck movements or heavy lifting can reduce pressure on the cervical nerve.
6. Epidural Steroid Injections
For severe pain that does not improve with other treatments, a doctor may recommend an epidural steroid injection to reduce inflammation and relieve pain.
When Surgery May Be Recommended
While most patients with cervical radiculopathy get better with conservative treatment, some cases may require surgical treatment if symptoms persist for several months or worsen. Surgical options include:
- Anterior cervical decompression and fusion (ACDF): A procedure where the affected disc is removed and the vertebrae are fused to stabilize the spine.
- Artificial disc replacement: Instead of fusing the spine, an artificial disc is inserted to preserve motion.
A doctor may recommend surgery if a patient has severe nerve root pain, progressive muscle weakness, or signs of spinal cord compression.
Cervical radiculopathy is a common cause of neck and arm pain when a nerve in the neck is compressed. Fortunately, most cases improve with conservative treatment, including physical therapy, medications, cervical traction, and lifestyle adjustments. While surgical treatment may be necessary for some patients, nonsurgical options can effectively reduce pain, improve function, and help individuals return to daily activities.
If you are experiencing symptoms like neck and arm pain, muscle weakness, or numbness, our expert team at South Island Physiotherapy in Victoria, BC, can help! Contact us for a proper diagnosis and treatment plan. With the right approach, most patients can successfully relieve symptoms and avoid surgery.
by Colin Beattie | Jan 28, 2025 | news
Maximizing Injury Recovery Through Strength Training: An Evidence-Based Guide
Muscle recovery and generally recovering from an injury overall requires a well-rounded approach that includes rest, rehabilitation, and most importantly, strength training. Incorporating targeted exercises into your recovery process enhances muscle repair, reduces muscle soreness, and helps you regain functional strength. This guide will explore how to maximize recovery following an injury by focusing on evidence-based strength training principles.
The Role of Strength Training in Injury Recovery
When recovering from an injury, it’s essential to address both muscle damage and loss of strength. Resistance exercises promote muscle repair and stimulate the growth of stronger muscles. By engaging different muscle groups, you can rebuild stability and reduce the risk of future injuries.
How Strength Training Aids Recovery
– Muscle Repair: Exercise causes micro-tears in muscle fibres, which trigger the body’s healing process. Proper strength training accelerates muscle repair by enhancing blood flow and nutrient delivery.
– Muscle Growth and Stability: Resistance exercise builds muscle mass around the injured area, improving overall stability and reducing compensatory strain on other muscles.
– Improved Blood Flow: Strength training increases circulation, which delivers oxygen and nutrients necessary for recovery.
Key Principles of Strength Training for Recovery
- Gradual Progression
It’s important to pay attention to your body’s signals and progress slowly. Start with light resistance exercises using body weight or resistance bands. Increase the weight or intensity as your muscles feel stronger and more resilient.
– Listen to Your Body: Pain during strength training may indicate further injury. Adjust your workout routine to avoid exacerbating the issue.
– Number of Repetitions: Begin with higher repetitions of low-resistance exercises, then gradually decrease repetitions as you increase the load.
- Targeting Different Muscle Groups
Injury often leads to muscle imbalances. A comprehensive fitness program addresses these imbalances by working on all relevant muscle groups.
– Alternate Muscle Groups: Rotate between different muscle groups to avoid overloading any one area. This approach gives your muscles time to recover and supports overall muscle repair.
– Larger Muscle Groups First: Focus on strengthening major muscle groups that stabilize and support the injury site.
Active vs. Passive Recovery in Injury Rehabilitation
Active recovery involves light physical activity to promote healing, while passive recovery refers to complete rest. For most injuries, a combination of both methods yields the best results.
Benefits of Active Recovery
– Increased Blood Flow: Active recovery days, such as walking or low-intensity cycling, enhance circulation without adding stress to the injury.
– Muscle Flexibility: Active stretching reduces stiffness and helps muscles recover efficiently.
The Role of Rest
While complete rest (passive recovery) is essential in the early stages of injury, prolonged inactivity can lead to muscle atrophy. Incorporating strength training as soon as it’s safe is critical to maintaining muscle mass and preventing further weakness.
Best Practices for Strength Training During Recovery
- Resistance Training
– **Body Weight Exercises**: Begin with body weight movements that don’t strain the injury. Progress to resistance bands and light weights as tolerated.
– **Resistance Bands**: These provide controlled, gradual resistance that is ideal for rebuilding strength.
- Progressive Overload
Gradually increase the resistance to stimulate muscle growth. Use small increments to prevent further muscle damage and allow for adequate recovery time.
– Exercise Guidelines: Follow physical activity guidelines for Americans, which recommend strength training two to three days per week.
- Rest Days
Injury recovery demands proper scheduling of rest days. Avoid working out the same muscle groups on consecutive days to give your muscles time to recover.
Active Recovery Workouts for Injury Rehabilitation
Incorporating active recovery activities can reduce delayed onset muscle soreness (DOMS) and prevent stiffness:
– Swimming: Provides low-impact resistance.
– Yoga: Enhances flexibility and reduces muscle tension.
– Walking: Maintains blood flow without straining joints.
Reducing Muscle Soreness and Fatigue
Strength training promotes post-workout recovery by improving muscle resilience. Here’s how to optimize your recovery:
– Nutrition: Protein-rich meals support muscle repair, while carbohydrates replenish energy.
– Hydration: Staying hydrated facilitates nutrient transport to recovering muscles.
– Sleep: Aim for seven to nine hours of sleep to give your body time to rebuild muscle fibres.
Monitoring Your Recovery Progress
Tracking your progress helps ensure you’re able to recover fully before returning to intense workouts.
– Recovery Periods: Balance challenging workouts with adequate recovery periods.
– Listen to Your Body: If soreness or pain persists, consult a medical center or physiotherapist.
Conclusion
Strength training is a powerful recovery method that supports muscle repair, reduces injury risk, and restores functional movement. An effective recovery plan balances active recovery, proper rest, and progressive resistance exercises. Whether using resistance bands or weights, focus on gradual progression and pay attention to your body’s signals. Incorporate strength training into your fitness routine to help your muscles recover and return to peak performance.
Thank you for reading our guide on injury recovery through strength training. At South Island Physiotherapy in Victoria, BC, we’re here to help you regain strength and mobility with personalized rehab plans. Ready to enhance your recovery? Contact our expert team today to schedule a consultation and start your journey back to peak performance.
by Colin Beattie | Jan 24, 2025 | news
Alternatives to Shoulder Replacement Surgery: Exploring Your Options
Shoulder replacement surgery is a highly effective solution for severe shoulder joint issues, but it’s not the only path to recovery. For those seeking alternatives to shoulder replacement surgery, there are several non-invasive and minimally invasive treatment options available. These alternatives focus on managing chronic shoulder pain, improving range of motion, and reducing inflammation and pain. Here’s an evidence-based look at the options:
Understanding Shoulder Replacement and Why Alternatives Are Sought
Shoulder replacement, also known as shoulder arthroplasty, involves replacing damaged parts of the shoulder joint with artificial components. This is often recommended for conditions such as severe osteoarthritis of the shoulder, rheumatoid arthritis, or irreparable damage to the rotator cuff. However, shoulder replacement options, including reverse total shoulder replacement or partial shoulder replacement, are major surgical procedures with significant recovery periods.
For some, surgery may not be the best option due to age, health conditions, or personal preference. In these cases, exploring alternatives to shoulder replacement can provide relief and improve shoulder function without the need for invasive surgery.
Non-Surgical Alternatives to Shoulder Replacement
Physical therapy is a cornerstone of conservative treatments for shoulder pain and injuries. A customized therapy program strengthens the muscles around the shoulder blade and joint, improving stability and range of motion.
- How It Helps: Strengthening the muscles attached to the shoulder blade supports the joint and reduces strain on damaged tissues.
- Best for: Chronic shoulder pain, shoulder osteoarthritis, and frozen shoulder.
2. Stem Cell Therapy for the Shoulder
Stem cell therapies, including adult stem cells harvested directly from the patient’s body, are a promising alternative treatment for shoulder joint issues.
- Mechanism: Stem cell injections aim to repair damaged cartilage and reduce inflammation, promoting natural healing in the shoulder joint.
- Evidence: While studies are ongoing, clinics like the Mayo Clinic and other medical centers offer resources on stem cell therapy as a potential treatment for shoulder osteoarthritis and injuries.
3. Platelet-Rich Plasma (PRP) Injections
PRP therapy involves using the patient’s own blood plasma, which is rich in growth factors, to stimulate healing in the shoulder joint.
- Benefits: PRP can reduce inflammation and pain while promoting tissue repair.
- Best for: Chronic shoulder pain, early stages of osteoarthritis, and rotator cuff injuries.
4. Alternative Therapies
- Hydrotherapy: Performing exercises in water reduces joint strain while maintaining mobility.
- Massage Therapy: Targets tight muscles around the shoulder blade to alleviate pain.
- Acupuncture: May reduce pain and inflammation in chronic conditions.
Lifestyle and Conservative Treatments
1. Pain Management
- Medications: Over-the-counter pain relievers and anti-inflammatory drugs can reduce inflammation and pain.
- Topical Treatments: Creams and gels with active ingredients like capsaicin or menthol offer localized relief.
2. Exercise and Stretching
Engaging in a regular fitness routine tailored to your condition can improve shoulder function.
- Range of Motion Exercises: Help maintain mobility in the shoulder joint.
- Strength Training: Focus on strengthening the muscles attached to the shoulder blade to enhance joint stability.
3. Lifestyle Adjustments
- Weight Management: Reduces strain on joints.
- Postural Improvements: Proper posture minimizes stress on the shoulder and elbow joints.
When to Consider Shoulder Replacement Surgery
While alternatives to shoulder replacement surgery can be effective, they may not work for everyone. If chronic joint pain significantly impacts your quality of life and conservative treatments fail, consulting a shoulder specialist is crucial. A specialist can help determine whether surgical treatments, like total joint replacement or reverse total shoulder replacement, are necessary.
Alternatives to shoulder replacement provide valuable options for managing pain and improving shoulder function without undergoing surgery. From physical therapy and stem cell injections to PRP therapy and conservative treatments, these methods can reduce inflammation and pain while preserving the joint.
If you’re suffering from shoulder osteoarthritis or chronic joint pain, explore these alternatives and consult a specialist to find the best treatment option for you….or stop by our physical therapy clinic in Victoria. With the right approach, it’s possible to avoid surgery while maintaining an active and pain-free lifestyle.
by Colin Beattie | Dec 20, 2024 | news
Choosing a Massage Therapist: Your Essential Guide
Finding the right massage therapist can be transformative, enhancing not just your physical well-being but also your mental relaxation. Whether you’re seeking relief from chronic pain, stress reduction, or simply a moment of tranquility, understanding how to choose the right massage therapist is essential. This guide will walk you through the key steps to ensure your next massage therapy session meets your needs and exceeds your expectations.
1. Define Your Needs and Preferences
Before you book a session, take time to consider what you want from massage therapy. Are you looking for relaxation, treatment for a specific injury, or relief from chronic tension? Knowing your goals will help you choose a massage therapist who specializes in the techniques you need. For example:
– Relaxation: Therapists trained in Swedish massage focus on gentle, flowing techniques to calm the mind and body.
– Pain Relief or Recovery: Deep tissue or sports massage specialists can target specific problem areas.
– Holistic Well-being: Therapists who incorporate aromatherapy or reflexology can enhance the overall experience.
By identifying your preferences, you’re more likely to find someone who aligns with your goals.
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2. Research Qualifications and Specializations
Massage therapists must meet certain educational and licensing requirements, which vary by region. To ensure you’re receiving professional treatment, look for therapists who hold recognized certifications and memberships in professional organizations.
Some therapists may specialize in areas like prenatal massage, lymphatic drainage, or myofascial release. If your needs are specific, choose a therapist whose qualifications match your desired treatment. Their specialized knowledge ensures you receive safe and effective care tailored to your situation.
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3. Seek Recommendations and Read Reviews
Word of mouth is one of the most effective ways to find a great massage therapist. Ask friends, family, or healthcare providers for recommendations. Online reviews and testimonials can also offer valuable insights into a therapist’s approach, professionalism, and ability to meet client expectations.
When reading reviews, pay attention to:
– Consistency: Are clients regularly praising their experiences?
– Environment: Does the session space contribute to relaxation?
– Personalization: Do clients mention that the therapist adapted treatments to their needs?
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4. Consider the Therapist’s Communication Style
A successful client-therapist relationship is built on trust and open communication. During your initial consultation, ensure the therapist takes the time to understand your health history, preferences, and goals. They should also explain how their techniques can enhance your well-being and address any concerns you might have.
Effective communication fosters a sense of safety, which is vital for relaxation and achieving the best results during your session.
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5. Assess the Environment
The setting where the massage therapy session takes place plays a significant role in your overall experience. Look for a space that promotes relaxation through elements like soothing lighting, comfortable tables, and calming scents. A clean and professional environment also reflects the therapist’s commitment to high standards of care.
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6. Trial and Feedback
Sometimes, the best way to determine if a massage therapist is right for you is through a trial session. Afterward, evaluate the experience:
– Did the therapist address your needs and preferences?
– Was the pressure and technique suitable?
– Did you feel comfortable and relaxed?
Share your feedback with the therapist to ensure future sessions better align with your expectations.
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7. Focus on Long-Term Benefits
Choosing the right massage therapist isn’t just about one session. It’s about finding someone who can work with you over time to enhance your overall health and well-being. A skilled therapist will monitor your progress, adapt treatments as necessary, and provide recommendations to complement your sessions, such as stretches or lifestyle adjustments.
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Choosing South Island Physio for Massage Therapy
As point #3 says above, make sure you check out massage therapist reviews before making a decision. The journey to finding the right massage therapist is deeply personal. By defining your goals, researching qualifications, seeking recommendations, and fostering open communication, you can ensure your massage therapy sessions are both enjoyable and effective. Remember, the right therapist isn’t just someone who meets your expectations but someone who helps you exceed them—turning every session into a step toward enhanced health and relaxation.
