Physiotherapy
About Physiotherapy, Physical Therapy, Sports Medicine at Remedy Wellness Centre
Physiotherapy, physical therapy, sports medicine, exercise therapy are all used to describe Physiotherapy in Victoria. Physiotherapists are Masters level trained primary health care professionals with a significant role in health promotion and treatment of injury and disease. They combine their in-depth knowledge of the body and how it works with specialized hands-on clinical skills to assess, diagnose and treat symptoms of illness, injury or disability.
Remedy Wellness Centre physiotherapists use a variety of orthopedic techniques for assessment, diagnosis and treatment of acute sport injuries, arthritis, back pain, headaches, spinal conditions, knee and ankle instability, rotator cuff injuries, wrist pain and carpal tunnel, plantar fasciitis and more. They also work with post- operative patients to recover from surgery and serious injuries. Physiotherapy is commonly provided to people who've been in a car accident, which is covered by ICBC. At Remedy Wellness Centre we direct bill ICBC for physiotherapy and other services like chiropractic, massage, acupuncture, kinesiology and counselling.
Physiotherapists have a broad scope of practice in BC. This means they have training and access to many treatment tools and types of equipment. At Remedy Wellness Centre we believe in utilizing the most evidence and science based treatment techniques, which means they have been proven to be effective in recent clinical trials and studies. Our physiotherapists use hands on manual therapy techniques, therapeutic exercise and movement, pain science/biophysiosocial approach, acupuncture, IMS, heat and cold therapies, muscle stimulation and TENS, joint mobilizations and more. Our phyiso has addition training to work with TMJ Dysfunction and Vestibular problems like dizziness and vertigo.
We believe in being focused on providing high quality care by treating one patient at a time. When you are here, you are the priority patient and your physio is dedicated to working with just you. We also have longer initial visits and follow up visits because we don't like to rush. Rushing leads to missing things and making mistakes. We take our time and focus on figuring out what is driving your dysfunction or pain, rather than coming up with a quick band-aide solution.
If you are a new patient to physiotherapy at Remedy Wellness Centre, we recommend you book an Initial Visit with our physiotherapist. Together you will determine a follow up treatment schedule and home-care plan.
Remedy Wellness Centre physiotherapists use a variety of orthopedic techniques for assessment, diagnosis and treatment of acute sport injuries, arthritis, back pain, headaches, spinal conditions, knee and ankle instability, rotator cuff injuries, wrist pain and carpal tunnel, plantar fasciitis and more. They also work with post- operative patients to recover from surgery and serious injuries. Physiotherapy is commonly provided to people who've been in a car accident, which is covered by ICBC. At Remedy Wellness Centre we direct bill ICBC for physiotherapy and other services like chiropractic, massage, acupuncture, kinesiology and counselling.
Physiotherapists have a broad scope of practice in BC. This means they have training and access to many treatment tools and types of equipment. At Remedy Wellness Centre we believe in utilizing the most evidence and science based treatment techniques, which means they have been proven to be effective in recent clinical trials and studies. Our physiotherapists use hands on manual therapy techniques, therapeutic exercise and movement, pain science/biophysiosocial approach, acupuncture, IMS, heat and cold therapies, muscle stimulation and TENS, joint mobilizations and more. Our phyiso has addition training to work with TMJ Dysfunction and Vestibular problems like dizziness and vertigo.
We believe in being focused on providing high quality care by treating one patient at a time. When you are here, you are the priority patient and your physio is dedicated to working with just you. We also have longer initial visits and follow up visits because we don't like to rush. Rushing leads to missing things and making mistakes. We take our time and focus on figuring out what is driving your dysfunction or pain, rather than coming up with a quick band-aide solution.
If you are a new patient to physiotherapy at Remedy Wellness Centre, we recommend you book an Initial Visit with our physiotherapist. Together you will determine a follow up treatment schedule and home-care plan.
IMS (Intramuscular Stimulation)
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IMS is a technique used by our physiotherapists at Remedy Wellness Centre in Victoria. IMS stands for Intramuscular Stimulation and is used for treatment of both chronic and acute pain. A very fine acupuncture needle is inserted into a specific spot of a muscle that has become dysfunctional and shortened. Shortened muscles are typically uncomfortable or painful and they restrict range of motion at your joints which can cause further biomechanical issues. This IMS technique triggers a neurophysiological reflex that causes the muscle to contract or twitch, which “resets” the connection between your brain and the muscle, where your brain sets the resting tone of that muscle. In this way we can over ride the dysfunctional tone and allow the muscle to relax, lengthen and move again. This in turn relieves the discomfort and pain, restores length and range of motion and prevents further biomechanical dysfunction.
IMS is appropriate for soft tissue pain with no obvious tissue damage or acute inflammation. For example, IMS can be used to release back pain, neck pain, headaches, tennis elbow, hip pain, knee pain and more. |
If you think IMS may be an appropriate treatment for you, you can book an appointment with any of our physiotherapists. If you have questions, you can book a free phone consult in advance, to discuss your symptoms and what your best treatment options are.
Like most treatment techniques, the effects and benefits of IMS are cumulative. Each needling session relieves some of the pain and dysfunction, improves the length of the muscle and allows you to gain more range of motion. This helps to teach your nervous system that it’s okay to let go of the guarding around the area. IMS can provide lasting relief, when other approaches have failed, and there are very few side effects.
Treatment is usually recommended once a week for a series of 3-5 treatments, which allows time between each session for your body’s own natural healing processes to occur. This frequency of treatment will vary depending on what you are having treated, how long you’ve been dealing with it, if scar tissue is a factor, and how quickly your body heals. Our physiotherapist can help guide you through this process and give you a better idea of what to expect after your first visit.
IMS was developed in the 1970’s by Chan Gunn, a Vancouver Physician while he was working with the Workers Compensation Board. He is currently a professor at the University of Washington and teaches IMS at the Physical Medicine Research Foundation and The Institute for the Study and Treatment of Pain (ISTOP). He has been honored with several medical awards including the Order of Britich Columbia and the Order of Canada, for his work with resolving chronic pain.
What is the difference between acupuncture and IMS?
The only similarity is the tool used. The philosophy and approach are completely different. Acupuncture is an ancient and scientifically proven method of balancing systems of the body. It is used to treat a very broad scope of conditions from hormone imbalance and digestive issues, to musculoskeletal pain and stress. IMS is a relatively new, but effective method used to treat musculoskeletal pain and dysfunction by triggering a twitch reflex in the target muscle. Both are effective, but the goal is very different.
Like most treatment techniques, the effects and benefits of IMS are cumulative. Each needling session relieves some of the pain and dysfunction, improves the length of the muscle and allows you to gain more range of motion. This helps to teach your nervous system that it’s okay to let go of the guarding around the area. IMS can provide lasting relief, when other approaches have failed, and there are very few side effects.
Treatment is usually recommended once a week for a series of 3-5 treatments, which allows time between each session for your body’s own natural healing processes to occur. This frequency of treatment will vary depending on what you are having treated, how long you’ve been dealing with it, if scar tissue is a factor, and how quickly your body heals. Our physiotherapist can help guide you through this process and give you a better idea of what to expect after your first visit.
IMS was developed in the 1970’s by Chan Gunn, a Vancouver Physician while he was working with the Workers Compensation Board. He is currently a professor at the University of Washington and teaches IMS at the Physical Medicine Research Foundation and The Institute for the Study and Treatment of Pain (ISTOP). He has been honored with several medical awards including the Order of Britich Columbia and the Order of Canada, for his work with resolving chronic pain.
What is the difference between acupuncture and IMS?
The only similarity is the tool used. The philosophy and approach are completely different. Acupuncture is an ancient and scientifically proven method of balancing systems of the body. It is used to treat a very broad scope of conditions from hormone imbalance and digestive issues, to musculoskeletal pain and stress. IMS is a relatively new, but effective method used to treat musculoskeletal pain and dysfunction by triggering a twitch reflex in the target muscle. Both are effective, but the goal is very different.
Exercise Therapy/Sports Medicine
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Physiotherapy for Sports Injuries
At Remedy Wellness Centre in Victoria, our physiotherapists are experienced in assessing, diagnosing and treating injuries from sports and over-training. With the right interventions at the right time, most acute injuries like ankle or knee sprain, contusion or a muscle strain, will heal completely within a reasonable time frame like 6 to 8 weeks. We can offer guidance on what to do and sometimes more importantly, what NOT to do in the healing phase. These things are typically pretty straight forward. We can determine if there are any underlying dysfunctions that may have led to the injury, prescribe specific exercises to keep you moving and promote the body's natural healing process. Other injuries like concussion, bone breaks, dislocations and joint instability, tendonitis/tendonosis may require a bit more in depth treatment to get you all the way through to full recovery. |
We are here to offer our expert guidance on what to expect. How much should I rest? How long will it take to heal? Should I keep moving it? Is it okay to move it if it still hurts? How much should it hurt when I move? When should I return to my sport? Should I do modified activities before I return to my sport? Do I need to stretch more, strengthen more? These are all valid questions that we can answer for you.
We also have a lot of personal experience as active people who have had injuries. We understand what it feels like and how frustrating the healing process can be. Through this experience, we have learned a lot and can pass on that experience to you. Our goal is to get you back to doing what you love, feeling great doing it and feeling confident that you can rely on your body to perform.
We also have a lot of personal experience as active people who have had injuries. We understand what it feels like and how frustrating the healing process can be. Through this experience, we have learned a lot and can pass on that experience to you. Our goal is to get you back to doing what you love, feeling great doing it and feeling confident that you can rely on your body to perform.
Manual Physiotherapy
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At Remedy Wellness Victoria, our Physiotherapists have completed additional orthopedic manual therapy training. With Manual Physiotherapy your physiotherapist uses their hands for joint and soft tissue mobilization and joint manipulations. Myofascial release is an example of a type of manual therapy that our physiotherapists uses in practice.
These are effective and non-invasive treatment methods for increasing joint mobility, soft tissue pliability, improving spinal health and restoring ease of movement and range of motion. Remedy Wellness Centre physiotherapists have extensive experience working with all kinds of conditions and injuries from TMJ Dysfunction to Concussion to knee injuries. Since our moto is "hand on healthcare," you can expect this to be incorporated into your treatment plan. |
Physio For Motor Vehicle Accident Rehab - ICBC
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Unfortunately, having been in a car accident is a common reason that people seek physiotherapy at Remedy Wellness Centre. Some of the most common things we treat here are back pain, headaches, concussion, whiplash and other spine injuries, rehab post immobilization from a bone break, post surgical recovery and more.
Physiotherapy is often combined with other therapies like massage therapy, chiropractic, kinesiology, counselling or acupuncture depending on your symptoms. Physiotherapy is a good place to start if you've sustained injuries in a car accident. Our physiotherapist can do an in depth assessment and then recommend any adjunct therapies if they would be additionally beneficial to your recovery. We are always aware of the possibility of over-treatment, so please don't assume that all of these approaches would be recommended just because they are covered. We also recommend that you try to keep all therapies under one roof, so your practitioners can communicate (with your permission) and keep you on a reasonable and effective treatment plan. |
How Does ICBC Coverage for Physiotherapy Work?
ICBC covers physiotherapy and all of these other services within a 12 week period from the date of your accident. If you require continued care your practitioners can apply for an extension from ICBC. With the new program that ICBC introduced in April 2019, you are automatically covered. You don't need approval from an adjuster. Your first physiotherapy visit is 45 minutes and is always 100% covered by ICBC. Follow up visits are 30 mins and there is a patient fee of $6.00 per treatment. We direct bill the ICBC portion of the fees so you don't have to pay that portion out of pocket and get reimbursed. ICBC will cover up to 25 visits within the first 12 weeks from the date of your accident. We direct bill the ICBC fees so you don't have to pay that portion out of pocket.
When you book your initial visit, we will need you ICBC Claim number, date of the accident and your adjuster contact info. If you have any questions, please don't hesitate to call, email or live chat with us.
ICBC covers physiotherapy and all of these other services within a 12 week period from the date of your accident. If you require continued care your practitioners can apply for an extension from ICBC. With the new program that ICBC introduced in April 2019, you are automatically covered. You don't need approval from an adjuster. Your first physiotherapy visit is 45 minutes and is always 100% covered by ICBC. Follow up visits are 30 mins and there is a patient fee of $6.00 per treatment. We direct bill the ICBC portion of the fees so you don't have to pay that portion out of pocket and get reimbursed. ICBC will cover up to 25 visits within the first 12 weeks from the date of your accident. We direct bill the ICBC fees so you don't have to pay that portion out of pocket.
When you book your initial visit, we will need you ICBC Claim number, date of the accident and your adjuster contact info. If you have any questions, please don't hesitate to call, email or live chat with us.
Post Operative Physiotherapy Rehabilitation
Patients who have undergone surgery for a musculo-skeletal conditions or injuries are regularly referred to Remedy Wellness Centre for assessment and treatment with our physiotherapists. Physiotherapy treatment after surgery for spinal, shoulder, elbow, wrist/hand, hip, knee, and ankle problems is essential to the recovery process. Treatment focuses on reducing and eliminating pain, improving mobility and strength as per the surgical protocol and assisting you in return to your usual activities. We will help you understand the expectations for regaining range of motion, strength, and return to normal function. Our Physiotherapists can help you recover from a variety of procedures including:
Achilles Tendon Repair Surgery
ACL/MCL/PCL Knee Ligament Repair Surgery
Arthroscopic Knee Surgery
Knee Replacement Surgery
Knee Meniscus Surgery
Foot and Ankle Ligament Surgery
Hip Replacement Surgery
Hip Resurfacing Surgery
Shoulder Acromioplasty Surgery
Shoulder Ligament Repair Surgery
Shoulder Rotator Cuff Repair Surgery
Shoulder Replacement Surgery
Thoracic Outlet Syndrome Surgery
TMJ Dysfunction-Post Dental Surgery
Spinal Disc Surgery -Cervical, Thoracic and Lumbar
Spinal Stenosis/Decompression Surgery
Post Fracture/Dislocation Surgery
Wrist and Hand Surgery
EXERCISES RESOURCE FOR POST SURGICAL PATIENTS: http://rebalancemd.com/resources/
Achilles Tendon Repair Surgery
ACL/MCL/PCL Knee Ligament Repair Surgery
Arthroscopic Knee Surgery
Knee Replacement Surgery
Knee Meniscus Surgery
Foot and Ankle Ligament Surgery
Hip Replacement Surgery
Hip Resurfacing Surgery
Shoulder Acromioplasty Surgery
Shoulder Ligament Repair Surgery
Shoulder Rotator Cuff Repair Surgery
Shoulder Replacement Surgery
Thoracic Outlet Syndrome Surgery
TMJ Dysfunction-Post Dental Surgery
Spinal Disc Surgery -Cervical, Thoracic and Lumbar
Spinal Stenosis/Decompression Surgery
Post Fracture/Dislocation Surgery
Wrist and Hand Surgery
EXERCISES RESOURCE FOR POST SURGICAL PATIENTS: http://rebalancemd.com/resources/
Taping
Taping is often used to treat sports injuries, but it can also be useful for other issues. For example, taping a shoulder that dumps forward into place to help offload the neck is commonly used for desk workers, aka everybody. This is called postural taping. It can also be used to support joints and help give the patient a sense of stability and higher awareness of the area. This is also sometimes called proprioceptive retraining.
TMJ (Jaw) Dysfunction
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TMJ Physiotherapy
Our Victoria Physiotherapist, Daniel Rashid C. has specialized training to treat your Temporomandibular Joint (TMJ) problems. We also have several RMT's who have additional training and certification including Kasey Thompson, Bogdan Pyasta and Jenn Maurice. What is TMJD (Temporomandibular Joint Dysfunction) and how can physiotherapy for TMJD help me? The TMJ, is the jaw joint and all of the associated connective tissues that attach to it. You can find it by poking around directly in front of your ears, below your temple. Your TMJ is used for a lot of very important things like chewing, talking, yawning and drinking. It is considered dysfunctional when it is either painful, subluxes, causes inner ear pain, causes headaches, causes dental pain, or is linked to other dysfunctions in your body. For example, when the jaw doesn't track evenly straight up and down like it should, it can change your perception of where your centre is. This can cause dysfunction in other areas, most commonly the lower back, hips, shoulders and neck. Clicking alone, is not necessarily considered to by dysfunction and may not need to be corrected. |
What causes TMJ Dysfunction?
In most cases the pain is caused by muscle imbalance between the medial and lateral pterygoids, masseter, temporalis and supra-hyoid, infra-hyoid muscles. The most common pattern we find is the masseter on one side and the lateral pterygoid on the opposite side are working too hard or you rely on them too much for things like chewing. Maybe you habitually chew on one side. This causes the jaw to track unevenly, so your jaw moves to one side a bit when you open and close. There can also be issues with the disk that sits in the joint. It can become hypermobile and this is where you will typically experience clicking. The clicking may or may not be painful. In some cases it can lead to osteoarthritis of the TMJ later in life, so it's worth getting it assessed. An ounce of prevention is worth a pound of cure they say.
We also see a lot of bruxers or grinders. This can be in conjunction with uneven tracking and/or clicking. Clenching and grinding can happen at night while you sleep and/or during the day. If this is you, your dentist may have recommended a night guard, which is helpful for protecting your teeth from wear and tear or stress fractures. Unfortunately, night guards don't do anything to address the underlying mechanical problem.
Clenching and grinding the jaw is also typically linked to stress and anxiety, neck or back pain, but not always. It could be something you've done since you were a kid, or it was triggered by a life event or high stress time period. Other things linked to TMJD include dental procedures especially invasive ones, facial or head injuries like taking a punch or concussion. Its a common symptom in people with whiplash.
The pain of TMJ dysfunction can be sharp, searing and catching, or dull and constant. It can be mild or extremely debilitating. Symptoms you may experience include:
Fortunately, a trained Physiotherapist or RMT can help you with your TMJD. You can expect an in depth assessment which will give us some indications of what the underlying cause is. Manual therapy will be applied by your physio or RMT, which may include soft tissue release/massage to the affected muscles around the jaw, some gentle joint mobilizations and corrective exercises. Relaxation techniques may also be incorporated and treatment to other areas may also be indicated. We are big on patient education and empowering our patients by teaching at home techniques and exercises that you can use yourself. TMJD is not typically a one off treatment and will likely require repeated treatment, which you can help with by doing your prescribed homework. Typically patients do start to see some immediate improvement when the right treatment approach is applied to TMJD.
In most cases the pain is caused by muscle imbalance between the medial and lateral pterygoids, masseter, temporalis and supra-hyoid, infra-hyoid muscles. The most common pattern we find is the masseter on one side and the lateral pterygoid on the opposite side are working too hard or you rely on them too much for things like chewing. Maybe you habitually chew on one side. This causes the jaw to track unevenly, so your jaw moves to one side a bit when you open and close. There can also be issues with the disk that sits in the joint. It can become hypermobile and this is where you will typically experience clicking. The clicking may or may not be painful. In some cases it can lead to osteoarthritis of the TMJ later in life, so it's worth getting it assessed. An ounce of prevention is worth a pound of cure they say.
We also see a lot of bruxers or grinders. This can be in conjunction with uneven tracking and/or clicking. Clenching and grinding can happen at night while you sleep and/or during the day. If this is you, your dentist may have recommended a night guard, which is helpful for protecting your teeth from wear and tear or stress fractures. Unfortunately, night guards don't do anything to address the underlying mechanical problem.
Clenching and grinding the jaw is also typically linked to stress and anxiety, neck or back pain, but not always. It could be something you've done since you were a kid, or it was triggered by a life event or high stress time period. Other things linked to TMJD include dental procedures especially invasive ones, facial or head injuries like taking a punch or concussion. Its a common symptom in people with whiplash.
The pain of TMJ dysfunction can be sharp, searing and catching, or dull and constant. It can be mild or extremely debilitating. Symptoms you may experience include:
- Inner ear pain, fullness/pressure in the ears, ringing in the ears
- Tension headaches, especially at the temples and base of the skull
- Facial pain, Neck pain
- Sore, tight, tender jaw muscles
- Temple, cheek, tooth or jaw pain while swallowing, yawning, talking or chewing
- Jaw popping, clicking or locking upon opening or closing, or while chewing
- Reduced ability to fully open or close the mouth
- Muscle pain and spasms in the face, head and neck
Fortunately, a trained Physiotherapist or RMT can help you with your TMJD. You can expect an in depth assessment which will give us some indications of what the underlying cause is. Manual therapy will be applied by your physio or RMT, which may include soft tissue release/massage to the affected muscles around the jaw, some gentle joint mobilizations and corrective exercises. Relaxation techniques may also be incorporated and treatment to other areas may also be indicated. We are big on patient education and empowering our patients by teaching at home techniques and exercises that you can use yourself. TMJD is not typically a one off treatment and will likely require repeated treatment, which you can help with by doing your prescribed homework. Typically patients do start to see some immediate improvement when the right treatment approach is applied to TMJD.
Vestibular Physiotherapy
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Vestibular Physiotherapy Assessment and Rehabilitation Assessment and treatment of dizziness, vertigo, and balance problems are within the realm of physiotherapist who have completed additional training in this area. Daniel Rashid C. is certified and experienced in vestibular physiotherapy. Vestibular Rehabilitation Therapy (VRT) is proven to be one of the safest and most effective methods of treating a wide range of balance disorders. This approach can help you improve your balance, minimize the risk and occurrence of falling, decrease experienced dizziness, improve your stability and improve your motor coordination. This leads to reduced anxiety and greater confidence in movement and activities. Lets get you moving again! |
How Does Vestibular Physiotherapy Work?
There are various mechanisms that may be contributing to your symptoms including compensational strategies, prediction strategies and cognitive strategies. Part of the physiotherapy assessment and diagnosis process may involve figuring out the underlying cause by attempting to trigger or recreate your symptoms. This tells us a lot. For example, positional or motion-provoked symptoms can be recreated by putting you in certain positions, which will either confirm or deny that position or motion is a component for you. We then have a variety of strategies we can use to adapt your vestibuloocular or the vestibulospinal reflexes.
We can also work on substituting alternative senses to replace any lost vestibular function. These may include alternate sensory inputs, alternate secondary motor responses and incorporating strategies of predicting or anticipating your motor behavior or using the cervical-ocular reflex as an alternative for visual stability while you move your head. You can expect your symptoms of imbalance, disequilibrium and motion induced unsteadiness to improve gradually. You will have to practice these techniques on your own as well. VRT works with your central nervous systems ability to adapt withing the vestibular system. For long-term change to happen and take root in your CNS, these strategies need to be repeated over and over again. Its much more cost effective and efficient for us to teach you how to do this at home, rather than have you come into the clinic daily. Your physiotherapist will walk you through everything in an easy to understand way so you feel confident and have some tools and strategies to manage things.
There are various mechanisms that may be contributing to your symptoms including compensational strategies, prediction strategies and cognitive strategies. Part of the physiotherapy assessment and diagnosis process may involve figuring out the underlying cause by attempting to trigger or recreate your symptoms. This tells us a lot. For example, positional or motion-provoked symptoms can be recreated by putting you in certain positions, which will either confirm or deny that position or motion is a component for you. We then have a variety of strategies we can use to adapt your vestibuloocular or the vestibulospinal reflexes.
We can also work on substituting alternative senses to replace any lost vestibular function. These may include alternate sensory inputs, alternate secondary motor responses and incorporating strategies of predicting or anticipating your motor behavior or using the cervical-ocular reflex as an alternative for visual stability while you move your head. You can expect your symptoms of imbalance, disequilibrium and motion induced unsteadiness to improve gradually. You will have to practice these techniques on your own as well. VRT works with your central nervous systems ability to adapt withing the vestibular system. For long-term change to happen and take root in your CNS, these strategies need to be repeated over and over again. Its much more cost effective and efficient for us to teach you how to do this at home, rather than have you come into the clinic daily. Your physiotherapist will walk you through everything in an easy to understand way so you feel confident and have some tools and strategies to manage things.