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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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Sciatica...a pain in the butt!

4/30/2019

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By: Dr Sonya Hamilton​

In our clinic, one of the most common issues I get asked about is sciatica. So what actually is sciatica anyways? Sciatica is a term used to refer to pain which radiates along the sciatic nerve. Sciatic nerve pain is a symptom of an underlying musculoskeletal problem. 

The sciatic nerve is the largest single nerve in our body. It begins from your lower lumbar region (L3), and travels through the buttock region, down the back of your thigh before it branches below the knee. When it becomes irritated, you may experience leg pain/tingling/numbness, lower limb weakness, burning or ‘electrical’ sensations down the back of your leg from the buttock to the ankle.  

The length of the sciatic nerve, and the fact that it originates from the low back, makes it susceptible to irritation from a number of different sources. Most commonly, sciatic nerve issues result from lumbar disc injury or herniation, degenerative disc disease, spinal stenosis, and low back muscle strains. Additionally, it can arise from piriformis syndrome, as the nerve passes through the muscles in the buttock region. Pregnancy and sacroiliac joint issues can also lead to sciatic nerve pain. Some may find the pain is made worse with sitting, and sometimes the pain may not travel beyond the buttock.

Treatment for sciatic nerve pain is individualized for each patient, due to the fact that the pain may come from one of many sources. If you encounter sciatic nerve pain, you should work with your chiropractor to determine the cause of your pain, and the best course of treatment. Exercise and activity are important steps you can take towards improving your symptoms. Staying active will keep your muscles conditioned, and will encourage movement in the spine resulting in an improved flow of nutrients to your ligaments and joints. You should avoid high impact activities, and continue with your regular tasks and light exercise. Contrary to common belief, bed rest is not appropriate and may lead to your symptoms being prolonged or worsened.  Bed rest is only appropriate in rare cases -if your pain is so severe you cannot move- and should be limited to only a day or two.
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Some of the common recommendations I make to patients include walking, gentle strengthening of core muscles, stretching of target muscles, low impact aerobics, and nerve flossing. It is important to seek out advice on which activities would help your specific cause of sciatic nerve pain, as the wrong exercises may in fact worsen your symptoms. Chiropractic care helps to decrease your symptoms, and your chiropractor can provide advice on how to prevent future sciatic nerve pain from reoccurring. For most, symptoms of sciatica should resolve with appropriate conservative treatment.

Feeling some Sciatic nerve symptoms? Book your assessment with Dr Hamilton >>>>

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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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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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Q & A about Fascial Stretch Therapy (FST) with Dr Tabbert

7/6/2018

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What is FASCIA? Does FST have anything to do with stretching my face?
A very common question! And no- fascial stretch is not  a facial stretch!
Fascial Stretch involves fascia- fascia is the connective tissue that wraps and connects muscles, joints, nerves, bones, and organs. Similar to muscles, fascia can get tight and bound down, however it responds better to movement and stretching and than to traditional massage and other therapies.

Can you tell me more about FST? What can I expect? How long is a session? Is it covered by benefits?
Fascial Stretch Therapy (FST) is a pain free, hands on treatment that targets the fascia. FST is a unique, complete and complementary system of table-based assisted stretching. It focuses on the fascia and joint capsule as the key elements in achieving optimal flexibility, strength, performance and pain relief. FST will help uncover areas of tightness you didn’t realize existed, while simultaneously creating release through a gentle, pain free, traction/contract and relax approach. FST is compatible with other forms of treatment and training. Results are often seen within 1-3 sessions and accumulate over time. Combined with exercises to help maintain mobility and strengthen your body in its new range FST will help you move and feel better for whatever your needs may be.

Sessions last 60 minutes, and cost $100. FST is offered by a licensed Chiropractor, if you have extended health coverage for Chiropractic care FST sessions will be eligible (check with your plan for specific details on chiropractic coverage). Certain plans can be direct billed in our clinic.

What are the benefits of FST?
Benefits of FST include: 
-increased flexibility and mobility 
-decreased pain 
-decreased joint compression and impingement 
-improved posture 
-improved sport performance and muscle function 
-increased blood supply 
-reduced risk of injury 
-reduced mental and physical stress 
-better sleep 

Book an appointment with Dr Stephanie Tabbert>>

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Q&A with our Chiropractor Dr Sonya Hamilton

6/1/2018

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What are the top three most common issues you help clients address?
  1. Acute neck or low back pain- patients who have injured themselves, with a sudden onset of pain
  2. Headaches and Migraines -I often see people suffering from headaches and migraines, research strongly supports the fact that chiropractic care can reduce the frequency and severity of many different kinds of headaches
  3. Shoulder pain – Being located in a gym probably makes this a more common issue with our patients, many people don’t realize that I can treat all areas including your shoulders (and knees, and wrists, etc!). Acupuncture is a fantastic option for these issues.
 
What approaches or techniques do you use as a chiropractor use to treat issues of the musculoskeletal system?
Depending on the issue someone presents with, I use an individualized approach based on current evidence, and clinical experience. This means that I do not follow a cookie cutter approach for everyone. I have a variety of techniques in my “toolbox” as a chiropractor, depending on the area of concern. Treatments often include some soft tissue therapy (muscle release), joint mobilizations to improve motion and decrease pain, and other techniques which include medical acupuncture, instrumented soft tissue treatment, and taping. I also work with my patients to address their ergonomics, sleep positioning, exercise routines, and I provide stretching and strengthening advice when needed.

If you could give everyone one piece of advice this summer what would it be?
Listen to your body! If you are sore and achy during work, take a break- get up and stretch, go for a walk, and stop eating your lunch at your desk! When gardening or exercising, if you feel a strain consider what you are doing before it’s too late.

What is new and exciting on the Chiropractic horizon for this summer?
Chiropractors in Ontario are working harder than ever before to become an integral part of your primary health care team. As musculoskeletal experts, we continue to collaborate with medical doctors, and work to improve patient outcomes in reducing chronic pain.

How is a chiropractor different than a physiotherapist?
Chiropractors and physiotherapists work towards the same goals of improving your function and mobility, while decreasing pain. Chiropractors study conditions and diseases of the musculoskeletal system extensively, and as a result are legislated with the right to diagnose and communicate a diagnosis and are legally permitted the term Doctor. Chiropractors are allowed to provide more forceful mobilizations to the spine known as adjustments; physiotherapists with extra certifications can also do this as well. Both chiropractors and physiotherapists often have a focus on rehabilitation to decrease the possibility of your condition returning. Physiotherapists tend to work more hands on with their clients to complete their rehabilitation exercises.

What can someone expect an initial appointment with you to look like?
An initial assessment includes a thorough health history, and an orthopedic examination. After discussing your current concern, I will examine the area at issue, using a variety of orthopedic tests to determine the root cause. If it is something I can treat, we will discuss my recommended treatment plan, and I start off with some treatment and recommendations. If needed, I will refer you to another appropriate practitioner such as your family doctor, or for an x ray for further assessment.

Dr Hamilton provides free 15 minute consultations to discuss treatment options, and to learn more about chiropractic (please note no health advice is given during these sessions). Click here to book online >>

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