Functional Dry Needling (FDN) is also known as Intramuscular Stimulation. It is a very effective modality used by trained and skilled practitioners to help manage neuromusculoskeletal pain and muscle impairment.

FDN involves inserting a fine, acupuncture needle into muscle trigger points to elicit a twitch response to help relax tight muscles and muscle knots. When a trigger point is relaxed, muscle function improves, and pain is reduced. FDN can also be used to stimulate muscles that have been inhibited, allowing for improved muscle contractions.

Acupuncture, performed within the scope of physiotherapy, is also known as Anatomical Acupuncture. This technique is performed by a trained, skilled practitioner and involves inserting an acupuncture needle into specific areas of the body to help relieve pain, reduce tension and inflammation, and normalize nervous system function.

Previous injuries or pain can result in changes to our basic movement patterns, resulting in increased risk of injury and new pains. The SFMA is a tool used to assess and identify the cause of these disorders so we can provide treatment to restore normal movement.

SFMA is a diagnostic system that is based on both the quality and limitations of movement that are present. Large movement patterns are broken down into their components to identify the cause of the dysfunction. This information is then used to provide appropriate treatment, allowing for the restoration of normal pain-free movement.

Bone Fit is a program developed by Osteoporosis Canada in conjunction with expert clinicians and academics to help train certified fitness and health professionals working with osteoporosis patients. The goal of the program is to help reduce fractures and promote health and disease management and prevention for patients with or at risk of osteoporosis or osteopenia.

Health professionals trained in the Bone Fit program are qualified to provide the knowledge and practical skills necessary to prescribe and adapt appropriate, safe, effective, and evidence-based exercises designed for patients with osteoporosis.

Concussion is defined as “a complex pathophysiological process affecting the brain, induced by biomechanical forces,” according to the Consensus Statement on Concussion in Sport, Berlin 2016.

The brain moves within the skull due to the biomechanical force resulting in the neuronal covering being stretched. This results in Potassium leaving the cells and entering the fluid between the cells while at the same time calcium enters the cells. The higher levels of calcium within the cells decreases blood flow to the area at the very time that you need more glucose to be delivered in order to fuel the pump that returns the potassium back to the cells. This creates an energy imbalance. There is no damage or death to the cells they are simply working sub-optimally resulting in the symptoms that we see following a concussion. This explains why there is no imaging that can confirm a concussion as there is nothing unusual to see.

The biomechanical force can be from a jarring force through the body or contact with the head. These forces result in cellular changes that lead to an energy crisis within the brain. This is further complicated by changes in blood flow to the injured area.

It can take 10-14 days for an adult brain to physiologically recover from the injury and up to 30 days for a younger brain to recover. In some cases, symptoms last well beyond the time it takes for physiological healing to occur.

The forces required to produce a concussion are greater than those required for Whiplash Associated Disorder. As a result, frequently people who have sustained a concussion, have also injured their neck.

Concussions can affect your body’s ability to regulate autonomic functions including heart rate and blood pressure, which is why return to physical exertion should be done under medical guidance. They can also affect both your vestibular system and oculomotor system (visual), as well as their integration. The vestibular system is located inside your ear and connects deep into the brain. It is responsible for helping you keep your balance and to know where you head is in space. Our visual system is complex, with 70% of our brain’s sensory processing being dedicated to it. Our vestibular and visual systems are extensively integrated. One of the most important things this allows us to do is to keep focused on something visually while we are moving, for example, reading a sign as you are driving by it. This is only one example of how this integration allows us to function in the world.

During the assessment with the physiotherapist, you will discuss your current symptoms, your past medical history, and the mechanism of injury. They will then evaluate your cervical spine, your vestibular and ocular systems, your balance, and your autonomic systems. This information will be used to develop an individualized treatment plan to deal with your unique presentation.
The physiotherapist will be able to provide you with guidance about safely returning to your regular activities. The Buffalo Concussion Treadmill Test can provide guidance as to how intensely it is safe to work out. Physiotherapists can provide manual therapy as well as exercises for strengthening and range of motion for the neck. We can provide treatment for the vestibular and balance systems, along with visual exercises specific to your issues.

Vestibular Rehab, performed by a physiotherapist, is aimed at alleviating issues provoked by vestibular disorders including vertigo, dizziness, gaze instability, and/or imbalance and falls. Research shows that a vestibular rehabilitation plan can be effective at improving symptoms related to vestibular disorders. Vestibular issues can evoke the above symptoms but also can result in nausea, vomiting, reduced ability to concentrate or focus, and fatigue.

Symptoms due to vestibular disorders can diminish quality of life and affect all aspects of life and can contribute to emotional problems such as anxiety and depression. Sufferers often reduce their activities to avoid eliciting the symptoms and can become isolated and physically deconditioned as a result. The treatment strategies used in vestibular rehabilitation can help with the some of the secondary effects experienced.

What is Vestibular Rehab?
Vestibular Rehab is a specific program of physiotherapy intended to alleviate both the primary and secondary problems associated with vestibular disorders. It is primarily an exercise-based program designed to reduce the sensations of vertigo and dizziness, as well as improve gaze stability and reduce imbalance and fall risk. The program will also address other physical impairments brought on as a consequence of the vestibular impairment.

There is a specific issue known as BPPV that can be resolved and managed. Most issues with the vestibular system, however, are not as easily reversed, and instead the focus is on symptom reduction and improving compensations. Vestibular Rehab will provide an individualized program designed to address each specific issue that the individual is experiencing. The individualized program will be designed based on the comprehensive assessment that the physiotherapist will perform. Most interventions fall in one of three categories: 1) Habituation 2) Gaze Stabilization 3) Balance Training

Habituation Exercises are designed to reduce dizziness through repeated exposure to the specific movements or visual stimuli that trigger the individual’s response. By exposing oneself to these exercises that produce a mild to moderate reaction, the brain can learn to ignore the abnormal signals, thereby resulting in less symptoms.

Gaze Stabilization exercises improve control of eye movements. These exercises work to improve control of your eye movements which allow you have clear vision when you are moving your head around.

Balance Training exercises are used to improve steadiness, both when standing still and when moving around. The exercises will be tailored to the specific deficits that you are experiencing. The exercises you are given should be challenging but safe enough for you to do at home without falling.