This is a very frequently asked question on Physiotherapy.You don’t need to bring any equipment on your first session. We advice to wear some loose fitting clothes and bring a shorts or a tank top according to the area being treated. It makes it easier for the physiotherapist to access the part to be treated. On the day of your assessment, the physiotherapist may ask you to expose the area of injury for assessment. They always make sure a full informed verbal or written consent is given with the knowledge of withdrawing the consent anytime the patient wants.
Also, it is advisable to bring any X-ray, MRI, US reports if already done in the past for the records and assessment.

The regular musculoskeletal / orthopedic initial physiotherapy assessment usually takes 45 minutes to an hour. It depends on the condition and symptoms the patient has. It can take even longer than 1 hour if the pain is very acute and if the intensity of pain is too high. It usually takes longer due to more time required by the patient in transition of movements due to pain. We do a proper detailed assessment and a prepare a treatment plan and discussed by the physiotherapist to the patient. 

There are various kinds of physiotherapy treatments provided by our physiotherapist after a detailed assessment. Some of the conditions treated by the physiotherapist are: 
Sprains and strains like Tennis elbow, Golfer’s Elbow, MCL, LCL sprain, Ankle sprain, Wrist strain and sprain, Quadricep muscle strain, Hamstring Muscle strain, Calf muscle strain.  
Frozen Shoulder
TMJ Dysfunction Physiotherapy
Balance disorders
Vestibular Physiotherapy (Vertigo and dizziness)
Concussion Management
Pelvic Health Physiotherapy (Men AND Women)
Back and neck pain
Chronic Pain & Arthritis / Osteoarthritis / Rheumatoid Arthritis
Osteoporosis
Pre and Post fracture physiotherapy treatment
Workplace injuries through WSIB
Motor vehicle accidents
Fall prevention programs
Parkinson Syndrome
Post operative Physiotherapy such as hip replacements, knee replacements
Physiotherapy consists of many components of care to promote recovery: manual therapy, exercise, education and a home program, along with modalities such as laser, ultrasound and electronic interventions. Using comprehensive, evidence-based treatment practices, we implement personalized treatment programs. The Graston Technique is a form of manual therapy known as soft-tissue instrument-assisted mobilization. It is one of several manual therapy approaches that uses instruments with a specialized form of massage/scraping the skin gently.

You usually do not need any doctor note for the physiotherapy services. But some of your insurance companies do need them for reference. But it is always appreciated if you have one and bring a copy for us as well.

Our physiotherapist usually discusses the diagnosis with you after the assessment and tells you about how many treatments they think would take to treat the problem.  Generally, it takes 5 to 10 sessions to completely get pain free. It can take more or lesser sessions based on your symptoms and your effort and support.    

The pelvic floor consists of nerves, fascia and three layers of muscles. These muscles start from the Pubic bone and go to the coccyx (tailbone). Pelvic floor rehabilitation is the physiotherapy treatment of the conditions related to the pelvic floor (Men or women), pelvic girdle dysfunction or SI joint dysfunction, Pregnancy related rehabilitation and pain related issues in and around the pelvic region. Pelvic floor physiotherapy helps in increasing the muscle strength of the weak pelvic floor or increasing the flexibility of the tight pelvic muscles.

Tight pelvic floor muscles is HYPERTONICITY . Our pelvic Health physiotherapist at Curezone Physiotherapy, Mississauga aims to treat various issues related to men and women health. It generally contributes to Urinary and Fecal Urgency, Urge Incontinence, Chronic Pelvic Pain, Dyspareunia, Vaginismus, Vulvodynia, Pudendal Neuralgia, Interstitial Cystitis and Chronic Prostatitis.

A physiotherapist will design an exercise program for the individuals’ specific problem, involving muscle re education, bladder retraining and strengthening of the pelvic floor muscles. If the muscles are very weak, a physiotherapist may use electrical stimulation of the pelvic floor muscles.  The can teach strengthening of the pelvic floor muscles, which can help to reverse the process.

Our Pelvic physiotherapist divides your assessment in 3 parts.
 
Going through your intake form and discussing your subjective history
External Examination to make sure if you have any underlying cause externally.
Internal Examination with fully informed consent: Patient must understand what you are doing & why maintain your patients’ dignity at all times.Vaginal /rectal palpation is the recommended technique for Physiotherapist to understand, teach and give feedback to patients for Pelvic Floor Muscle (PFM) tone globally and assessing the ability  to do a pelvic floor contraction.

It usually takes around 1 hour to 75 minutes and sometimes may need 2 sessions to complete the full assessment. In those cases, the physiotherapist discusses the issues to be treated followed by the education about the condition and the treatment required.  

Yes, the physiotherapist starts the assessment with the external examination after discussing and going through your detailed symptom monitor questionnaire which is given to be filled out before the appointment. It is generally recommended to come 20- 25 minutes earlier to fill up the questionnaire.

Yes, sport injuries are covered by all insurance companies. Usually sports injuries are due to overuse or improper training and techniques. The licensed registered physiotherapist in our sports injury clinic Mississauga is to plan patient oriented customize exercise program that is progressed gradually by sports injury prevention program.

Our physiotherapist usually discusses the diagnosis with you after the assessment and tells you about how many treatments they think would take to treat the problem.  Generally, it takes 5 to 10 sessions to completely get pain free. It can take more or lesser sessions based on your symptoms and your effort and support. 

Sports Injuries can be avoided by various ways. Our physiotherapist usually recommends and provides you proper forms and movement techniques will perform sports and activities. They sometimes may advise you to get a video or record your activities so as they can watch and find the ways to improve the form and correct the right movement strategy. They may also recommend following options for support.          
Bracing and Sports Tapping
Muscle reconditioning Exercises
Propioception and balance training
Custom made Orthotics
Custom made Braces

Of course, our registered physiotherapist makes sure to provide a proper home exercise program on your first initial physiotherapy assessment. They start with light basic exercises followed by strengthening exercises and weights on the follow up visits. Home exercise program helps in speedy recovery and less sessions.

The goal of a massage therapy treatment is set by you e.g., relaxation, soft tissue or muscle pain alleviation, increasing range of motion etc. The massage therapist will work with you in establishing a clear goal of your treatment by asking questions about your symptoms & health history. The massage therapist will then establish a treatment plan based on your goals and recommend the massage treatment best suited for your symptoms and goals.  Your consent for the said treatment plan will be sought. The plan will elucidate the techniques, areas and type of treatment that the massage therapist will use. You can at any point during the treatment ask the massage therapist to use techniques and pressure you are most comfortable with.

Swedish massage treatment’s primary goal is used to relax the entire body. But Swedish massage therapy goes beyond relaxation. It helps in improving circulation and flexibility while easing tension & helps in decreasing levels of the stress hormone. The massage therapist lubricates the skin with massage oil or lotion and uses various gliding massage strokes. These movements warm up the muscle tissue, releasing tension and gradually releasing muscle knots.

Deep tissue massage uses more pressure than a Swedish massage.  Mostly used for chronic muscle soreness, injury or imbalance. It can help relieve tight muscles & chronic muscle pain. Deep tissue massage uses both slow strokes and deep pressure to relieve tension from your deepest layers of muscles and connective tissue.  Deep tissue massage is more intense than the Swedish massage, and with any massage treatment, 24-48 hours of soreness is expected. However, it should not hurt. If during the treatment any deep technique feels too intense for your comfort level, you should always communicate that to the massage therapist. The massage therapist can change or reduce the pressure as per the comfort level.

Deep tissue massage is more intense. Depending on the injury and stage of injury it may not be recommended. However, whether deep tissue is safe or not can only be established after taking a health history and injury history with a patient. Some injuries require healing prior to applying intense techniques. If the injury is more acute then a more cautioned approach to intense pressure is required. If the injury is more chronic, then more pressure can be applied to relieve tension and tightness. However, at all times, patient’s comfort level is kept in mind. Kick back pain is to be avoided at all times.

Trigger points are taut bands in a muscle that can refer pain to other parts of the body.  By focusing on relieving trigger points, this massage can reduce pain. Trigger point massage will include broad flowing strokes that are gentle and relaxing combined with stronger, deeper pressure on specific (single) areas of release.  Myofascial release focuses on pain believed to arise from myofascial tissues – the tough membranes that wrap, connect and support your muscles. Myofascial release uses sustained pressure to stretch and lengthen the fascia over a broad area of muscle and tissue rather than at single points.

Unresolved elbow pain generally leads to chronic scar tissue formation and constant dull ache. 
It can also decrease the muscle tone of the extensor muscle group, increase muscle weakness, tenderness on palpation of the extensor muscle group. It can also lead to disability and inability to perform normal day to day activities and household chores.   

They usually recommend you icing at the initial stage of injury or symptoms. Icing is recommended after the treatment due to muscle soreness. After 2 -3 sessions, the physiotherapist usually recommends using a heat to promote faster healing. They provide you a proper guidance as they go along with the treatment. 

It all depends upon your severity of symptoms and loss of muscle tone and strength of the extensor muscle group. After your initial assessment and treatment the physiotherapist decides the exercises and gives you a proper guidance of the activities they can perform. Our physiotherapists are usually an expert and best in providing elbow pain treatments. Their goal is to implement a treatment plan where you can continue your normal day to day activities without restricting or bracing your elbow.

The Physiotherapist explains in detail the treatment planned and the machines beneficial for the treatment. The treatment is usually a bit painful but they sure it is within the limits of your pain. They prefer using some modalities such as Laser, Ultrasound, Shockwave Therapy, and Electro Acupuncture for faster recovery.  

Inner elbow pain is mainly called as Golfer’s elbow or medial epicondylitis and outer elbow pain is called as tennis elbow or Lateral epicondylitis. Tennis Elbow is the inflammation of the tendon outside of the elbow called as extensor muscle group, while a person suffering from golfer’s elbow will experience inflammation on the inner side of the arm of the flexor muscle group.

It is caused by activities that require repeated flexing or twisting of the wrist.  Repetitive tasks like gardening, shoveling, prolonged hours of cooking and cleaning, typing, throwing a ball, painting and similar activities all put you at risk for golfer’s or tennis elbow. It can also be seen in weight trainers with poor technique, as well as those who work in carpentry, painting or electrical works which require repetitive bending and straightening the elbow.

The common injuries which can cause Knee pain are ACL Injury, Torn Meniscus, Knee Bursitis, Patellar Tendinitis, Osteoarthritis, Rheumatoid Arthritis, Gout, Loose bodies, Obesity, Iliotibial band syndrome, Jumper’s Knee, Osgood Schlatter Syndrome very common injury in younger age groups. 

Cortisone treatments help to relive pain and inflammation in your knee due to tendonitis or bursitis around the knee joint area. They are generally used when other treatments are not effectively helping in reducing the symptoms. The effect of cortisone should kick in one or two days later. They can provide relief from few weeks to months depending on the condition.  

Surgery may be recommended if your pain is very severe or you have mobility problems. If you have tried all forms of treatments and still experience massive mobility issues. Your doctor will discuss with you what the surgery may involve. The type of Surgery is usually recommended based on your age, the activities involved and your future goals in life.

Physiotherapy can help you to manage pain and improve your strength and flexibility. A physiotherapist can provide a variety of treatments, help you understand your problem and get you back to your normal activities.They provide you specific exercises based on your assessment. They may also use modalities such as Ultrasound, Laser Therapy or Shockwave Therapy based on the diagnosis and your symptoms. 

Curezone Physiotherapy, Mississauga provides a wide variety of custom made Knee braces and Off the shelf customized knee braces. These braces are helpful to manage knee injuries or prevention. They provide the stability, help in improving the Knee ROM and recover quickly and prevent re-injury to the knee, whether it is for sports, daily functions, pain reduction or post-surgery. The physiotherapist generally recommends you the brace based on your activities. They take the measurements and do the fitting for you providing you the right knee brace. The cost of your knee brace is usually covered through your private healthcare insurance. 

Most of the shoulder pains are overuse injuries or due to constant or prolonged positioning of the arm above the shoulder. Sometimes, the shoulder pain can be a result of direct blow to the shoulder or fall Injury. They usually fall under 4 categories.
Direct blow to the shoulder( Fractures, Bruising, Rotator cuff muscle spasm)
Arthritis ( Osteoarthritis, Rheumatoid Arthritis)
Tendon Inflammation or tear
Instability of the shoulder

Your doctor can prescribe medications to reduce swelling and inflammation. Rest and modification in activities of daily living is recommended for a faster recovery. Physiotherapy is one of the other options for treating shoulder pain. Physiotherapy treatment comprises of change in lifestyle activities and workout plans, manual therapy, Fascia stretch release, Active exercises such as strengthening and stretching exercise, Movement strategy training, Work conditioning approach, Postural corrections, open and closed kinetic chain exercises for improving shoulder joint reposition sense. The electrical stimulation to the rotator cuff during exercise activity has shown beneficial results to improve muscle fiber recruitment and contraction. Dynamic stabilization exercises are also performed to re-establish dynamic joint stability. Modalities such as Shockwave Therapy, Laser Therapy have proven results in shoulder pain treatments.

Arthroscopic surgeries are recommended on severe cases such as Full thickness tear, Muscle fiber tear, non comminuted fracture or non-displaced fractures causing a lot of constant pain. Shoulder with multiple chronic dislocations and instability needs surgical intervention followed by physiotherapy treatments to retraining and re education of the rotator cuff muscle.
Shoulder replacement or arthroplasty are usually done for irreparable tears of the rotator cuff, rotator cuff arthropathy, and avascular necrosis of the humeral head. 

Dull to Constant Pain all the throughout the day
Disturbed sleep or unable to sleep at all
Loss of Shoulder Range of motion  
Repeated shoulder dislocations
Repeated instances of the shoulder giving out
A persistent sensation of the shoulder feeling loose, slipping in and out of the joint.
Tenderness to touch around the shoulder
Pain after repetitive shoulder movements in certain directions

Rotator cuff is the group of four muscles around the shoulder joint.  These tears occur over time with wear and tear and causes slower progression of pain and related symptoms.
The most common symptoms of rotator cuff injuries include:
Pain with motion and at rest
Muscle weakness, especially lifting or moving the shoulder in specific direction.
Popping or clicking sounds triggered by motion
Limited range of motion of the shoulder

Disabling pain in the knee joint with functional impairment such as severe osteoarthritis and osteoporosis.
Radiographic evidence of significant arthritic involvement
Failed conservative measures including ambulatory Aids like canes, NSAIDS, and lifestyle modification.
Deformity of the knee such as bow legs.
Inability to fully straighten the knee
Extreme weakness or instability of the knee
Inability to walk independently

Active Physiotherapy management for the knee pain (Osteoarthritis or Rheumatoid Arthritis) such as Mobilizations, active exercise program, distraction techniques, Active myofascial release for the muscles around the knee, modalities such as Laser, Shockwave therapy and Custom made knee braces are generally tried treating for Osteoarthritis of the knee causing knee pain. Active Home exercise program is also provided for pain relief. Medications or Injections such as corticosteroids, platelet rich plasma, stem cells are also recommended by the doctors.

It can take up to three months for you to return to most activities, and likely six months to one year to fully recover to maximal strength and endurance following total knee replacement surgery. At week 12, keep doing your exercises and avoid high-impact activities that could damage your knee including
running
aerobics
skiing
basketball
football
high-intensity cycling
At week 12, you will likely have less pain or no pain during normal activities and recreational exercise, and a full range of motion in your knee.

You may experience some pain and mild swelling in your leg after the knee replacement. Elevation of the leg, wearing a compression hose and applying ice pack for 15 to 20 minutes at a time will help to reduce the swelling. You may be permitted to take continuous passive movement exerciser (CPM) machine home with you for few weeks to encourage knee bending. While you can expect some good days and some bad days, you should notice gradual improvement and gradual increase in your endurance over the next 6 to 12 months. Swelling is normal for first three to six months after surgery elevate your legs slightly and apply ice.

90-95% chance that your joint will last 10 years, and a 80-85% that it will last 20 years. With improvements in technology, these numbers may improve.

Low back pain can be due to various reasons such as mechanical low back pain, pain due to postural dysfunction, muscle spasm, sciatic pain, degenerative disc disease, Spinal stenosis, disc herniations and many more. Physiotherapy is preferred as the first line of treatment for the lower back pain. Your doctor may refer you to a physiotherapist or you might arrange an appointment yourself in the times of severe back pain or spasm. Your physiotherapist may recommend exercises, modification in lifestyle, wide range of treatments and techniques and change in ergonomic activities which may help to improve your pain and restricted range of motion. If your back pain has lasted more than a few weeks, it’s always recommended to book and appointment with our physiotherapists. They are specialized and trained in McKenzie methods of treatments towards back injuries and have more Hands On manual therapy approach in treating the patient.  

A lower back pain treatment generally requires 8 to 10 sessions depending upon the severity and the cause of the back pain. An acute low back muscle spasm or pull may need fewer sessions than a disc Herniation or nerve compression causing the back pain. On your 1^st visit the physiotherapist usually does a detailed assessment followed by treatment and explains you the treatment time required to heal the problem.

Don’t do imaging for low back pain within the first six weeks, unless red flags are present. (Red flags include, but are not limited to, severe or progressive neurological deficits (e.g., bowel or bladder function), fever, sudden back pain with spinal tenderness, trauma, and indications of a serious underlying condition (e.g., osteomyelitis, malignancy). The majority of disc herniations will regress or reabsorb within eight weeks of onset.

It’s important to know that one of the biggest differences between nerve pain and muscle pain is chronic pain. Chronic pain has long-lasting side is ongoing and constant. The damaged tissue that causes nerve pain often leads to chronic pain.
Nerve Pain
Burning, tingling, pins and needles, numbness, sharp sensation
Unable to move or walk in acute phase
The pain tends to be chronic pain (lasting for 6 months or more)
Usually resides in arms, hands, legs and feet
Affects weak immune and orthopedic patients.
Muscle Pain
Tender, throbbing, stiffness sensation
Pain in muscles and joints
Often caused by injury or inflammation
The pain is generally short-term pain
Your Registered Physiotherapist usually does a detailed assessment and discusses with you a proper management protocol.

Spinal Decompression / Lumbar Traction for the spine
Corticosteroid injection
Nerve blocks around the nerve root
Back Brace for support
12% of Americans with low back pain AND depression had seen a psychologist or psychiatrist in the past year, and only 8% were prescribed cognitive behavioral therapy.

Possible treatments for wrist pain include: Ultrasound, interferential therapy also called as muscle stimulation treatment, hot wax treatment, laser treatment, acupuncture, exercises, cryotherapy, and hands on Manual therapy with mobilization Physiotherapy Treatments.

Carpal tunnel syndrome is a condition that causes pain, numbness, tingling, and weakness in the hand and wrist. It happens due to repetitive movements of the hand causing increased pressure within the wrist on a nerve called the median nerve. This nerve provides sensation to the thumb, index, and middle fingers, and to half of the ring finger. Pain and numbness at night are very common symptoms of carpel tunnel syndrome.

Any repetitive movement of the wrist like heavy lifting or typing, writing can cause wrist pain.
Carpal tunnel syndrome
Osteoarthritis
Rheumatoid arthritis
De Quervain’s disease
Repetitive motion syndrome
Triangular fibrocartilage complex injury
Wrist tendonitis
Wrist bursitis.

Wrist tendinosis symptoms usually include pain and sometimes weakness with activities using the wrist or hand.

It is possible that a wrist brace may be helpful depending on the cause of your wrist pain. We do not recommend wearing a brace continuously all day and night for long periods. The wrist will become very weak and might cause prolonged recovery at times. Certain types of wrist pain benefit from the use of a brace. We would also recommend reducing the activities that aggravate the wrist pain. It is advisable to be assessed by a Registered Physiotherapist to determine the cause of your wrist pain. Your physiotherapist will be able to tell you if a wrist brace is a good idea for you to wear. At Curezone physiotherapy, we carry many different braces if they are required for your wrist pain.

Surgery is a last resort for many of the wrist conditions such as carpal tunnel syndrome. The majority of other wrist injuries can be treated conservatively with Registered Physiotherapy, modalities such as ultrasound, hot wax, interferential therapy treatment and exercises. All of the conservative Physiotherapy Treatments and the exercise equipment’s needed for exercises and recovery can be offered by Curezone physiotherapy at our location.