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Q&A with our Chiropractor Dr Stephanie Tabbert

2/27/2020

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Can you define your role as a Chiropractor? 
My role is first and foremost to help my patients.  What that entails fully depends on the person but most often the underlying reason to seek care is not so much an injury but a functional barrier.  Something has either become difficult or unmanageable. My job is to get patients back to the activities and lifestyle they enjoy at the level they desire.  
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What does a chiropractor treat? 
Any condition that affects the joints, muscles, or nerves of the body.  From headaches to toe sprains (and of course back pain) we do it all.
What are the top three most common issues you help clients address?
Conditions due to overuse, underuse, or the unlucky people that have had some kind of mishap that resulted in injury. Or better known as sprains/strains, postural related pain/discomfort, and sports injuries.
What types of treatment methods/approaches do you use?
I’m going to break that down into 3 main categories:
  1. Education and Problem-Solving.  I try to figure out if there is something simple patients are doing or can do in their everyday lives that impacts their recovery or performance.  This means going over routines, training plans, movement patterns, habits and lifestyle.  
  2. Restore Flexibility and Motion (mobility).  I use a number of different joint and soft tissue (think muscle, ligament, and connective tissue) techniques.  The main ones would be joint mobilization (gentle rhythmic joint movement), Active Release Technique, Fascial Stretch therapy, and exercises.  I do adjust (crack) joints, but typically only when patients prefer. this method or I cannot get the desired outcome with another technique. 
  3. Improve Stability and Control (strength).  My preferred method is to teach exercises that patients can do at home or incorporate into existing gym routines.  I am also trained in Rehabilitative Pilates and while that influences my exercise prescription, I do offer Pilates sessions as a stand-alone service at Rebound for patients who need a little extra help in this area (or are needing assistance increasing their activity level).

What is your treatment philosophy?
Personalize every aspect of care.  What each patient needs, expects, and experiences is completely different.  Their treatment plans should reflect that.
What might a typical appointment look like with you? What is involved in an initial assessment?
Follow up appointments vary quite a lot from person to person.  They usually include some combination of catching up on how things have gone since the last visit, troubleshooting any setbacks, hands-on care, and self-care (exercises, mobilization, positioning/posture).   

Initial appointments follow a more routine pattern.  First I discuss with my patient what brings them in. My goal is to get a good understanding of what is happening, their general health status and how it impacts their day to day life.  That information drives my assessment, usually this involves moving around (think bending, squatting, turning) and some orthopaedic tests to confirm what anatomical structures are involved.  From there I communicate my diagnosis and explain what to expect in terms of recovery and treatment. Often a hands-on treatment along with education on what can be done at home to improve outcomes is given on the first visit as well.



What is a common question patients ask you?
Honestly… how many years of school it takes to become a Chiropractor and how many years I’ve been in practice.  The answer is 4 years of undergraduate studies (mine is in Biology and Psychology), 4 years of Chiropractic College, and over 5 years in practice now; and I’m still learning every day.

If you could give everyone one piece of advice this winter what would it be?
Wash your hands!
What do you like to do for fun/or tell us something most people don't know about you?
I’m obsessed with UK gardening shows.  It gets me through winter until I can get outside myself.

<<<Click here to Book an appointment with Dr Stephanie Tabbert>>>



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Condition Focus: Upper Crossed Syndrome

12/29/2019

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Complied By Binumon Joseph, Registered Physiotherapist

Upper crossed syndrome refers to a particular configuration of overlapping overactive and under-active muscle groups in the neck, chest, and shoulders. Typically, poor posture causes the syndrome, including the forward head posture, which occurs when people use electronic devices, read, and drive. Those with upper crossed syndrome usually have the same or similar set of postural irregularities that people may describe as slouching. Many different stretching and strengthening exercises exist that usually offer relief for symptoms of upper crossed syndrome.

Fast facts on upper crossed syndrome
  • Common causes include a hunched over posture, often an effect of repetitive tasks, such as computer use and office work.
  • Symptoms include neck and back stiffness or aches.
  • Exercises are the main treatment and can help strengthen the weakened muscles of the syndrome.
  • It is not usually serious, but chronic issues of pain and damage to the muscles may mean treatment is usually wise.

With upper crossed syndrome the muscles of the shoulders, neck, and chest have become deformed.
Specifically, the back muscles of the neck and shoulders (upper trapezius, and levator scapula) become extremely overactive and strained. The muscles in the front of the chest (the major and minor pectoralis muscles) become shortened and tight. As a result of these overactive muscles, the surrounding counter muscles become underused and weakened. In upper crossed syndrome, this causes weak muscles in the front of the neck (cervical flexor muscles) and in the lower shoulders (rhomboid and lower trapezius muscles). The condition gets its name from the "x" shape that develops when regions of overactive and under-active muscles overlap.

Poor posture can be a cause of upper crossed syndrome.
Different movements can cause upper crossed syndrome, but most cases develop through poor posture, specifically sitting or standing with the head forward for prolonged periods. Activities that promote this postural position include:
  • computer and laptop use
  • driving
  • watching TV
  • cellphone browsing, texting, app, or game use
  • reading
  • biking
In some cases, injury or congenital disabilities may also contribute to the development or creation of the condition.

Symptoms
Common characteristics of upper crossed syndrome include:
  • the head is consistently or often in a forward position
  • inward curvature in the portion of the spine containing the neck (increased cervical lordosis)
  • outward curvature in the part of the spine that includes the upper back, shoulders, and chest (increased thoracic kyphosis)
  • elevated, protracted, or rounded shoulders, where the muscles are in a continuous state of being pulled or stretched forward
  • the visible portion of the shoulder blade sits out instead of laying flat (scapula winging)
The deformed muscles associated with upper cross syndrome put stress on the surrounding muscles, tendons, bones, and joints, causing most people develop symptoms that include:
  • headache
  • neck pain
  • strain in the back of the neck and often a weakness in the front
  • chest pain and tightness
  • pain in the upper back, especially the shoulders
  • sore shoulder blades
  • pain in the jaws
  • tiredness
  • difficulty sitting, reading, and watching TV
  • driving for more than a short period because of pain or muscle tightness or soreness
  • restricted range of motion in the neck or shoulders
  • numbness, tingling, and pain in the upper arms
  • pain and reduced range of motion in the ribs
  • lower back pain
Exercises
The best way to treat upper crossed syndrome is through exercise and postural changes. Though some people may feel a lot of discomfort when stretching, it is important that they attempt some form of gentle exercise as restricting activity can cause stiffness and soreness.
People must ensure they warm up their tissues before exercising, either with gradual, gentle motions or by having a warm bath or shower. Begin all exercises gently and build up slowly.
 
Prevention
The best way to prevent and treat upper crossed syndrome is to avoid activities that require stretching the head forward for extended periods of time.
Other tips for preventing upper crossed syndrome include:
  • limiting time spent watching TV, reading, using laptops and computers, or driving
  • taking breaks every 15-20 minutes while sitting or engaging in problem activities
  • getting enough cardiovascular exercise, ideally 30 minutes daily from low-impact activities, such as walking or swimming
  • being aware of motions, movements, or activities that worsen symptoms and avoiding them for as long as discomfort continues
  • doing stretches that target sore muscles of the back neck, shoulders, and chest
  • doing strengthening exercises to target weakened muscles in the upper front neck and lower shoulders
  • making sure the steering wheel, book, TV, or computer screen is sitting at eye level
  • using a lumbar roll in chairs
  • using a headset for long telephone calls or transcribing
  • using a single pillow that retains its shape

Correcting or practicing proper posture is also an important part of avoiding and treating upper crossed syndrome.

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What is Medical Acupuncture, and How can it help?

9/30/2019

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By Dr Sonya Hamilton, Chiropractor

Acupuncture is an ancient component of Chinese Medicine (TCM) which has gained immense popularity in North America during the past decade due to it's efficacy in relieving pain, and improving quality of movement. 

Medical acupuncture is an effective treatment approach aimed at reducing and/or relieving pain and improving muscle function and activity of affected areas of the body.  A thin, disposable needle is inserted into the skin and tissue in specific areas of the body (as mapped out by TCM Meridians), through the use of western biomechanical principles.

Acupuncture stimulates the body to produce its own pain relieving neurochemicals, and it can encourage natural healing through the reduction of inflammation. The use of acupuncture is safe and very effective (as the building body of research literature indicates). The improved energy and biomechanical balance produced by acupuncture stimulates the body's natural healing abilities, and patients often feel better within 5-8 treatments.

Acupuncture is very effective in treating a variety of painful disorders such as:

Low back pain, Osteoarthritis, Headaches (Migraine/Tension), Neck pain, Rotator cuff tendinitis, IT Band Syndrome, Muscle tightness, Shin splints, Lateral epicondylitis (tennis elbow), Knee pain, Jaw pain, Plantar fasciitis 

Commonly Asked Questions:

What is a treatment like?
Contemporary medical acupuncture is generally used by our chiropractor in combination with other manual therapy treatment techniques such as joint mobilization, soft tissue techniques, and rehabilitation exercises. Dr Hamilton will first complete a comprehensive clinical exam and discuss with you her diagnosis, and clinical options to effectively treat your specific diagnosis.

How long might my treatment last?
The length depends on the goal of the treatment and individual response. For many local uncomplicated injuries the needles can be inserted for up to 15 to 20 minutes to produce an appropriate effect. Research shows that long lasting results take effect from 5-8 visits.

Is it painful?
In general, most people report that they barely feel an acupuncture needle being inserted with no pain reported. A short and minor feeling of sharpness occasionally happens when a needle is inserted but it is nothing to worry about. Acupuncture is generally a comfortable experience for most.

Interested in booking an Acupuncture Assessment with Dr Hamilton? Click Here>>
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Q&A with our Massage Therapist Charisse

8/1/2019

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What influenced your decision to become a Massage Therapist?
I knew I wanted to pursue a career in healthcare and what pushed me to choose massage therapy was the opportunity to create and build on client relationships and having the chance to really make a positive difference to someone’s health and lifestyle. I love being able to communicate with my clients about their goals and their progress.

What are the top three most common issues you help clients address?
 The top 3 most common issues that I help clients address are postural awareness, common tension areas, and the importance of movement and exercise.

What types of conditions/injuries do you enjoy treating?
 I can’t name a particular condition or injury that I enjoy treating the most but I can say that of all the areas of the body I do enjoy treating the neck and shoulders the most. I feel that most – if not all – people carry tension and stress in the neck, and some don’t even know how severe the tension really is until they get a massage.

What types of treatment methods/approaches do you use?
 Aside from general Swedish techniques I incorporate Fascial Stretch Therapy into my treatments if I find it necessary and I feel it can benefit my clients. I’m thankful to have been certified with Fascial Stretch because it really helps clients let go if I find that they are really tense and having a difficult time relaxing on the table. Fascial Stretch also provides a deeper stretch in certain areas that client’s may not be able to feel if they were to stretch on their own. I will also be taking an acupuncture course this fall which I am very excited about and I cannot wait to provide this treatment for my clients

What is a common question patients ask you?
Patients always ask me, “Don’t you get tired from massaging?” The truth is, after a long day it can get tiring. However, being mindful of my body mechanics and my posture when I treat really helps to prevent any heavy strain on my own body and I think that incorporating fitness and activity into my own lifestyle has helped with my endurance and longevity as a health practitioner.

If you could give everyone one piece of advice this summer what would it be?
 My advice would be: make the most of all of your days, not just for the summer but all year round! The hot weather is always nice, but don’t just wait for summer in order to go out and experience things. I find that it’s tough sometimes to find that work-life balance. I myself am guilty for working too much sometimes but this year, I have made sure to make time for things and people that make me happy.

What do you like to do for fun/or tell us something most people don't know about you
I love anything to do with the outdoors like hiking, camping, kayaking to name a few! In my free time I enjoy going to the gym. It is the BEST outlet for me to distress, recharge, and I just feel absolutely amazing after a good workout. I don’t talk about it often but I l also love to dance. I did Filipino cultural dance for about 10 years and I did competitive hip-hop dance in University. Don’t be surprised if you see me and I’m dancing to no music but the one playing in my head!

BOOK AN APPOINTMENT WITH CHARISSE > > >

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Snow Shovelling Tips!

1/29/2019

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Here are some great tips from the Ontario Chiropractic Association!

Winter weather can pack a punch and, with the season’s heavy snowfalls, injuries often result. Improper snow shovelling is often to blame.
But shovelling out after a storm doesn’t have to leave you stiff and sore. With a little know-how, you can clear your driveway without the all-too-common back, neck and shoulder pain cramping your style. Here’s how:
Before You Start
  • Drink plenty of water. Dehydration is just as big an issue in the winter months as it is in the summer.
  • Dress in several layers so you can remove a layer as you get warm.
  • Wear proper footwear. Shoes and boots with solid treads on the soles can help to minimize the risk of slips and falls.
  • Pick the right shovel. Use a lightweight, non-stick, push-style shovel. A smaller blade will require you to lift less snow, putting less strain on your body. An ergonomically correct model (curved handle) will help prevent injury and fatigue. Also, if you spray the blade with a silicone-based lubricant, the snow will slide off more easily.
  • Before beginning any snow removal, warm up for five to 10 minutes to get your joints moving and increase blood circulation. A brisk walk will do it.
All Set to GoPUSH, DON’T THROW.Push the snow to one side and avoid throwing it. If you must throw it, avoid twisting and turning — position yourself to throw straight at the snow pile.
BEND YOUR KNEES.Use your knees, leg and arm muscles to do the pushing and lifting while keeping your back straight.
WATCH FOR ICE.Be careful on icy walkways and slippery surfaces. Intermittent thaws and subsequent freezing can lead to ice building up underfoot, resulting in nasty slips and falls. Throw down some salt or sand to ensure you have a good footing.
Once you’ve mastered safe snow shovelling techniques, you’ll be free to have fun and stay fit all winter.
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Q&A with our new physiotherapist Steven Hua

11/1/2018

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This month we sat down to chat with our newest physio Steven. He is in clinic Tues/Thurs, and every other Sunday!

What influenced your decision to become a physiotherapist? 
I had many sports injuries growing up and have always tried to find ways to help myself rehab from those injuries. My interest in learning about the human body grew stronger when I enrolled in the Kinesiology program at York University and took courses in athletic injuries. However I soon realized that there was more to rehab than just helping athletes, I wanted to treat all kinds of injuries and that’s why I decided to go into physiotherapy. In this field, I can combine my passion for helping athletes return to their sports and also help treat pain and injuries that are affecting the lives of the general population.

What is your treatment philosophy?
I believe TENS and electrical modalities has its place in physiotherapy but I do not believe it should be used as the ONLY treatment option. I also believe that patients will have better results in their rehab if they spend more time with the physiotherapist instead of assistants. I believe that these two things are what separates Rebound Health and Wellness from other clinics, I do not use any assistants during my treatment sessions and so you will spend one on one times with me for your entire visit. Our treatment sessions will include more than just a heat pack on your back as well!

What can someone expect an initial appointment with you to look like?
We will first try to figure out the cause of your pain by taking a detailed history of your pain to narrow down the cause. Next, we will go through specific movements and special tests to pinpoint which exact treatment you will need. The rest of the initial appointment will be treatment of your problem areas using specific strengthening and stretching exercises, joint mobilizations, soft tissue massage, athletic taping, and electrical modalities.


What types of treatment methods/approaches do you use?
Once I find out what issues my patients have, I like to use a variety of techniques to treat those issues.

-Cervical, thoracic and lumbar mobilizations using various Maitland, Kaltenborn, Mulligan, traction, and Snag Techniques
-Mobilization of SI joint, knee, ankle, shoulder, elbow, wrist and phalanges
-McKenzie Method of Mechanical Diagnosis and Therapy for neck and low back pain
-Soft Tissue release techniques including Petrissage and Kneading Massage, Percussion Massage, Deep Friction Massage, Trigger Point Release Technique, GTO release
-Myofascial release techniques for commonly tight muscle groups including: trapezius, suboccipital, scalene, lats, hip flexors, piriformis, hamstring, gastrocs, quadriceps, supraspinatus, plantar fascia
-Therapeutic taping techniques using Leukotape and KT Tape

What are the top three most common issues you help clients address?
1. Shoulder pain (either from a rotator cuff issue or shoulder impingement) - don’t know if I should be specific or general
2. Neck pain (from pinched nerves in the that causes pain to radiate down the arm)
3. Low back pain

If you could give everyone one piece of advice this winter what would it be?
Hmmm, I would advise everyone to watch their steps and be careful of the slippery ice! It is much easier to prevent a fall than to deal with all of the pain and complications that come from a nasty slip and fall!

What do you like to do for fun?
 I like to play basketball, volleyball, badminton and basically any sport for fun. If I’m not being physically active, I like to relax by reading up on the news while listening to music or watching TV shows.

Book Online with Steven>>

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Orthotics...for back pain?

10/1/2018

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By Dr Sonya Hamilton, BSc MSc DC

Believe it or not, your feet can be a factor in the development of chronic low back pain. Your feet act as a very important foundation for your body, and can dictate how you adapt to stresses and changes in activity. Your feet strike the ground and propel you forwards, and faulty foot biomechanics can result in pain and dysfunction in other joints and structures in the body. If you think of your body as a kinetic chain from the ground up, your weight-bearing feet and ankles function as shock-absorbers for the whole body. If your feet are not working effectively at this job, the shock and stress makes its way up the biomechanical chain in your body. This concept often gets lost in translation, and people do not always understand the missing link between the feet and the back. 


The most common offending foot dysfunction leading to back pain and other issues is over-pronation, or the inward rolling/dropping of the arches. As the foot over-pronates, the feet become flat and therefore absorb less shock when you walk or run. The rest of your body is then forced to compensate for faulty foot mechanics; your pelvis may slightly drop, your knees may rotate, and you may develop a slight lean. Over time, this adaptation may lead to the development of pain in other areas of the body such as in the back, neck, knees, hips, Achilles tendon, and plantar fascia. In one study, it was found that women with flat feet are almost 50% more likely to develop low back pain.  
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When faulty foot mechanics are a factor in low back pain, one way to approach is to consider supporting your foot as you walk or run. When I see patients with chronic back or hip pain that are not responding to treatment and exercise recommendations, I often look to the feet as a possible solution. Using foot orthotics to support your feet can help you with foot pain, and they can change the way your whole body moves and adapts.

Orthotics have been shown to be beneficial for low back pain in a number of studies on groups exposed to higher levels of foot stress (such as in runners, military recruits, and golfers). The idea behind using orthotics for back pain- as your feet are better supported, your body becomes more balanced as you stand and walk. Eliminating imbalances in your feet will cause a ripple effect up the biomechanical chain in your body. Studies show that people suffering from chronic or re-occurring low back pain tend to respond very well to custom orthotics within 6 weeks of wearing them. So if you have been suffering from low back pain which continues even after a course of conservative care/exercise, consider taking a look to your feet as another part of the puzzle.
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