Working from Home Ergonomics

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Working from Home Ergonomics

With everything going on in the world right now, many of us have had to adjust to the new reality of working from home for the foreseeable future. However, working remotely seems to have had mixed reviews; some miss the separation of home and work life and their ergonomic office setup, while others have embraced the opportunity to work in the comfort of their own home while wearing pajamas. Regardless of your opinion, working from home has the potential to wreak havoc on your body and health. So let’s talk about some common conditions that can appear after switching from office to home work life, as well as what you can do on your own to manage these symptoms!


Neck and Shoulder Pain

Neck and shoulder pain can be a fairly common complaint for people when working at a computer with a poor ergonomic setup for a prolonged period of time. This is usually due to muscular and postural changes in your neck, which can be broadly referred to as upper crossed syndrome. More specifically, upper crossed syndrome refers to the tightening of the chest and posterior neck muscles (specifically the upper traps and levator scapula) paired with the lengthening and inhibition of the scapular and deep neck flexor muscles. This mismatch can cause postural changes in your neck and shoulders, which has the potential to lead to significant pain and discomfort.


Carpal Tunnel

Carpal tunnel syndrome is likely a phrase you’ve heard of before, but what’s actually going on? Carpal tunnel syndrome occurs when the median nerve in the front of your wrist becomes compressed or impinged, causing symptoms like numbness, tingling, weakness, or pain into your wrist or forearm. It is most common for these symptoms to appear primarily on the palmar aspect of your hand and into the first 3-4 fingers. This is usually associated with prolonged repetitive motions, specifically during tasks like typing, writing, or playing video games.


So what can you do to fix or prevent these issues?

Steps can be made at home to improve your work station setup. These can include:

  • Adjust your computer and seat so that the screen is at eye level, preventing you from constantly looking downwards. Additionally, adjust your seat so that your feet can be placed firmly on the ground and your arms at a comfortable level
  • If possible, try using computer monitors and keyboards instead of a laptop (there are also vertical mouses that you can get that can help as well)
  • If you are stuck with using your laptop, try using an external keyboard and/or mouse. This will allow you to raise your laptop to eye level while keeping your arms in a comfortable position
  • If you are sitting in a chair with poor lumbar support, try adding a small pillow or towel behind your low back to keep the proper curvature in your spine
  • Every 30-60 minutes, make sure to stand up, stretch, and move around for a couple minutes


If you’ve been experiencing neck and shoulder pain as a result of working from home and haven’t been able to find a solution, come on in and let one of our Physiotherapists help you get moving and feeling better! Call us at 780-424-4804 or send us a message to book your appointment.

What is Vertigo? A little bit about Benign Paroxysmal Positional Vertigo (BPPV)

Benign Paroxysmal Positional Vertigo (BPPV)

If you have ever experienced any vertigo symptoms, you know it can really put a wrench in the works of your everyday life. However, it doesn’t have to become a permanent part of your life with right treatment and day-to-day modifications! While some vestibular disorders have more complex causes, a significant amount of cases are diagnosed as Benign Paroxysmal Positional Vertigo (BPPV). Not only is BPPV one of the more common disorders of the vestibular system but it’s also one of the easiest to treat!

What is it?

A condition that is not inherently harmful, comes on suddenly and for a brief amount of time, comes on only in certain head positions, and elicits a sense of the room spinning. 

Our inner ear has three fluid filled semicircular canals (SCC) that are depicted in this image below. These canals play a role in maintaining our sense of balance during movement. There are little crystals that are about the size of a grain of sand located at the base of these canals. Normally the crystals are attached to the base (called ampulla). These crystals are responsible for giving our brain a sense of direction during different head movements. However, sometimes with trauma or older age, the crystals will detach from the base and will end up free-floating in the canal. This free-floating crystal results in incorrect signals being sent to the brain resulting in a false sense of the room spinning, known as vertigo. In order to get rid of this sensation, the crystals need to come back to the base of the canal. 






Physical Therapy and Vestibular Rehabilitation 

In 85% of the cases it is the posterior SCC that is affected. One of the treatments to return the crystal back to the base of the canal is the Epley’s maneuver (shown here in the image below). This maneuver places the head into different positions resulting in the crystal moving through the canal, which does elicit the symptoms of vertigo during. Usually one to two treatments are sufficient to return the crystal back to the base. 









There is a higher chance of having BPPV if you have already had one incident or have been in a significant trauma where the head was jerked around suddenly.  

Depending on how long the crystal has been dislodged and free-floating in the canal, it may take some time for the body to return to a balanced state. For example, if the crystal has been dislodged for 5 years, the body will have adapted to that state and it may take a couple weeks for the body to become used to the new normal state. However, there are exercises that can help with this transition to the new normal. These exercises will include training your ear and eye coordination, balance, and habituation to specific movements. This type of rehabilitation can be thought of as strengthening exercises for your inner ear. 

If you think you may have BPPV, know that there are very effective treatments out there that will help you get back to doing the things you love!

Anastasia Muchinsky is a Physical Therapist with Corona Station Physical Therapy, experienced in BPPV assessment and treatment. Call us at 780-424-4804 or send us a message to book your appointment with her.


Understanding Chronic Pain

Chronic Pain and Physiotherapy

Chronic pain can be debilitating and if you suffer from chronic pain, you’ve probably been told at some point that you are to stay as active as possible. The very thought of this probably makes you cringe when just getting through your day to day can be hard enough.  Chronic pain is complex, but with Physiotherapy we can help you understand your body and give you the tools you need to start improving your life. First, let’s take a closer look at chronic pain. What is it? How exactly can Physiotherapy help?

What is chronic pain:

  • Chronic pain is pain/injury that has lasted beyond the expected period of healing (more than three to six months).
  • Persistent/Chronic pain usually develops after a minor injury. Instead of getting better over-time, the pain often increases, long after the initial injury has healed.
  • With Chronic pain, it becomes difficult to move, work, and enjoy a normal life.
  • Chronic pain sufferers often become depressed and isolated and develop a sense of frustration and helplessness.










What causes chronic pain?

Chronic pain persists after the initial injury has recovered. This means that the tissue that was initially at fault is now healed, but why do we still get pain in that area? In chronic pain, the body’s nerves and brain rewire themselves and become super sensitive to what would be normal stimuli like touch, or simple movements. Emotional stimuli such as stress and anxiety increase the pain by producing chemicals that make the body and brain sensors even more sensitive. Chronic pain itself often causes feelings of isolation, depression, and anxiety so chronic pain can be become a vicious cycle as illustrated in the info graph above.

How can Physiotherapy help?

 A Physiotherapist is uniquely positioned to help you with your chronic pain. They can give you a personalized strengthening program, a graded exposure plan, and non-pharmaceutical pain management techniques. Finding a Physiotherapist that you trust to help you through the process is important as a large portion of treatment is discussing and understanding the pain, working on activity plans, and goal setting. Some hands on treatment can be used to help with pain management, but the end goal is active treatments, self-management, and empowering the patient.

If you would like to know more about chronic pain or want to start your treatments today call 780-424-4804 to get started!

The Many Benefits of Massage Therapy

Therapeutic massage can play a role in managing acute or chronic soft tissue disorders, as well as contribute to an overall sense of well-being. Massage therapy can therefore be part of the rehabilitation process or a component of self-care to address the stresses of day to day life. In addition to physiotherapy, the services provided at Corona Station Physical Therapy includes those of a massage therapist who offers therapeutic, relaxation, sports and pre-natal massage therapies .

What Is Massage Therapy?

Massage therapy is the application of manual techniques to the soft tissues of the body, including muscle, tendons, fascia and the lymphatic system.  Techniques may include sweeping, kneading or circular motions or direct pressure to relax trigger points.

What Are The Benefits Of Massage Therapy?

Scientific research has demonstrated a number of benefits to massage therapy.  These include:

  • alleviation of muscle tension and trigger points
  • increased neural mobility and joint space
  • decreased anxiety and improved mental health
  • improved circulation and lymphatic drainage
  • improved sleep
  • decreased headaches
  • increased range of motion

Who Is Appropriate For Massage Therapy?

Almost anyone can benefit from massage therapy!  Whether you have an acute or chronic injury or, are using massage prophylactically to prevent myofascial pain, most people are excellent candidates.  There are some contraindications or cautions when considering massage, including skin diseases, bleeding disorders or use of blood thinning medications, and deep vein thrombosis.  Our massage therapist is happy to accommodate any health concerns or limitations!

7 Tips for Healthy Aging


Photo credit: Pexels

7 Safe and Easy Tips on Healthy Aging

People are living longer. As a result, it’s important to maintain or improve your quality of life and make the most of it. Medical experts continue to identify activities and characteristics that can slow the process of aging. Here are some simple and affordable ways you can age in a healthy way.

1. Stay physically active

Research suggests that even if physical activity isn’t sufficiently vigorous to boost fitness, it’s still important. Safe and easy activities include going for regular walks, aqua aerobics, and yoga. Some yoga studios and fitness centers offer yoga for seniors, which tailors to your needs specifically. Try to avoid sitting down all day. After 30 minutes of sitting, get up and move around for a couple of minutes.

2. Stimulate your mind

There are a number of fun brain teasers and puzzles you can do to get your mind going. Strong scientific work shows that exercises like crossword puzzles can even help slow the onset of some age-related mental illnesses by improving cognitive reserve and memory. Try sudoku or other puzzles that require concentration and memory. Putting together a picture puzzle will also help you focus.

3. Go to the doctor regularly

Go to regular check-ups and make sure your medication is up to date. Your doctor will also be able to help you decide which kind of physical activity would be best for your situation. Ask yourself simple questions about your medical history and prior visits so you can ensure the next one is beneficial and productive.

4. Eat lots of fiber

Eating a well-balanced diet that is high in fiber and antioxidants is one way to strengthen the brain through the stomach. Fiber can do all sorts of things: improve your sleep, keep your digestive system regular, and help you maintain a healthy weight. You can use high-fiber supplements, but regular fruits, vegetables, and whole-grain foods will do the trick too.

5. Sleep well and often

Sleep disorders become increasingly common as people age, and the effects can contribute to poor overall health. Make sure you get at least 6 or 7 hours of sleep at night. Avoid eating fatty food a couple hours before bed. Wind down with relaxing activities instead of activities that may wake up your brain. When you can’t sleep, get up and do mundane activities that will help your brain calm down so you can get back to sleep.

6. Activate your social life

One long-term study from Harvard suggests that a key to aging gracefully is having strong, positive relationships. These relationships can be with anyone in your life: family, neighbors, and old and new friends. If you’re looking to meet new people, there are many types of meetup groups you can find online and get together with in person. Look online for people who share common interests with you.

7. Stay positive

Sometimes, life can be a little bit difficult, but staying positive and being grateful can do wonders. Science even shows that positivity is an integral part of healthy aging. Some situations will be harder than others, but try to find the silver lining in your situations and see what you can learn. It will make all the difference.

When you stay physically active, eat healthy, and get a solid night’s sleep, you feel a lot better. As you feel better, you will enjoy life and make time to do meaningful activities. These are simple things that will come at no extra cost to you but will pay dividends.

Cryotherapy for Faster Injury Recovery

Cryotherapy for Faster Injury Recover

In 2016, Corona Station Physical Therapy talked about physical therapy as a way to speed up the recovery of injured runners. One of the things that can enhance the process is cryotherapy. It is a simple, non-invasive, and inexpensive way of enhancing rehabilitation for injuries.

What is cryotherapy?

Cryo is the Greek word for ‘cold’ and cryotherapy simply means cold therapy. It uses low temperatures on localized regions or generally to treat injuries. You can either directly apply the cold to a specific area of the body—for instance, an ice pack on a sprained ankle—or expose the entire body to low temperatures such as an ice bath.

Cold treatment is most effective for minor injuries. It is used to treat superficial tissues such as injured muscles or ligaments that are inflamed or in pain. Intense workouts, especially for athletes, put the muscles in constant breakdown and repair mode. That makes them more vulnerable to injuries than the average person.

How does cryotherapy work?

Cold treatment stimulates a process called vasoconstriction or the narrowing of blood vessels. It reduces blood flow to the affected area and has a numbing effect. After the ice application, the body initiates vasodilation or the enlargement of blood vessels which causes increased blood flow to the area. Experts theorize that this sudden rush of blood improves the healing process of injuries. The cold therapy removes the heat which then improves blood flow around the injury. This in turn supplies oxygen and nutrients to the cells which is a much-needed part of the healing process. The better the blood circulation around the body, the faster it will rehabilitate.

The typical application for an ice pack should be 10-15 minutes multiple times a day. Another icing technique is an ice massage where you gently knead the affected areas with ice. Very Well Fit cautions against going beyond 15 minutes of cold treatment as it can be damaging to soft tissues. Leaving it on for too long may even lead to frostbite. As for water immersion therapy or ice baths, allot the same amount of time.

Who uses cryotherapy?

Cold therapy is used a lot in sports due to its benefits in injury recovery. In 2016, former Barcelona ace player Neymar was spotted with an ice pack on his leg after straining his adductor muscle. Although it was confirmed that there were no signs of an underlying injury, ice application can offer instant pain relief for muscle fatigue. It was not the last time that the Brazilian athlete got injured during a game either. A Ladbrokes feature on the 10 most famous injuries detailed how Neymar was out for two months this year due to a metatarsal fracture. The soccer star, who now plays for Paris Saint-Germain, almost took a pass in this year’s World Cup due to the incident. Although an ice pack cannot reconnect a broken bone, a quick injury response with cold treatment can help lessen pain and inflammation.






(image: Pexels)

Aside from athletes, there are other conditions where cryotherapy can be beneficial. For instance, patients with arthritis can provide temporary relief for inflamed joints and improve range of motion. A study on Reuters even discussed a similar effect on surgical wounds. Patients who underwent surgery reportedly experienced decreased pain when ice packs were applied to their wounds on top of their regular pain medication.

Although the science behind cryotherapy techniques is still being studied, the bottom line is that it has helped many people with injuries and soreness. The main claim is that it relieves inflammation, which can lessen pain symptoms of musculoskeletal damage. If that is something that you think you might need, there’s no harm in giving cryotherapy a try.

Article written for the sole use of


What is Pelvic Health Physiotherapy

What is Pelvic Health Physiotherapy?

Kaitlyn Sereda PT, MScPT, BKin

Hi! My name is Kaitlyn and I am a Pelvic Health Physiotherapist.

Now, if you are thinking “what is a Pelvic Health Physiotherapist, and what do they do?!” you are in the same boat as many others. It was not until the final year of my master’s degree that I had even heard the title of ‘Pelvic Health Physiotherapist’. This is unfortunate as many women could benefit from seeing a Pelvic Health Physiotherapist for conservative management before immediately seeking more invasive treatments such as medication or surgery, or continue living with the pain or discomfort of a pelvic issue.

And for those who have heard of this specialized profession, Pelvic Health Physiotherapy is NOT just about doing “Kegels”. Each individual’s pelvic floor issues may be caused by a variety of reasons; weakness, tightness, inability to relax or contract the muscles around the pelvic floor and many more. A Pelvic Health Physiotherapist can give you a personalized treatment plan based on a thorough examination.

So what does a Pelvic Health Physiotherapist treat? Here are four common conditions that can be treated by a Pelvic Health Physiotherapist and how they might present.

Stress Incontinence

Have you ever been afraid to cough or sneeze, even laugh because you might “leak”? You may have a type of incontinence called Stress Incontinence, and it is not a normal result of aging or from giving birth. This type of incontinence occurs when the pelvic floor is put under stress, when the pressure in the abdomen overcomes the closure of the urethra, like when you cough. A weak or “hypotonic” pelvic floor can often be the cause of stress incontinence.

(Retrieved from:








Over active Bladder (OAB)

You are standing in line at the grocery store or sitting in your son/ daughter’s music recital and suddenly… oh no! you have to get to the washroom ASAP. OAB can be wet (as in you will pee your pants if you are unable to get to a toilet in time), or dry (as in you have s strong urge to urinate but you have never leaked). You may find yourself urinating frequently throughout the day (we are talking more than once every few hours – normal voiding is 5-7x per day) and waking up several times a night to urinate. Overactive bladder can be caused by many things which your Pelvic Health Physio will assess

Pelvic Organ Prolapse

Do you have a feeling of heaviness in your vagina or rectum, or feel like you are “falling out”? You may find yourself straining to urinate or have a bowel movement and often have complaints of constipation. If so, you may have a pelvic organ prolapse. Your doctor may have also told you about your prolapse during a routine medical check-up.

Pelvic organ prolapse is a protrusion (bulge) at or near the vaginal opening, which may or may not be accompanied by perineal pressure (pressure between your vagina and anus), which is aggravated by standing, jumping or straining and relieved by lying down.

This pressure can be caused by the bladder (cystocele), rectum (rectocele) or uterus itself descending into the vaginal canal.

Pelvic Pain 

Pelvic pain is a very generic statement for a very complex issue. Pelvic pain is defined as any type of pain or discomfort in the lower abdomen to groin region between the hips and into the genitals. Pain experienced in the pelvis can be constant, intermittent or only come on with certain activities ie. Sexual activity. There are many reasons that an individual could develop pelvic pain including:

  • Trigger points, also known as muscle knots
  • Connective tissue dysfunction, which is essentially tension in the tissue between the skin and the muscle
  • Neural tension, which is tension along the nerve pathway, causing difficulty with the normal sliding and gliding of the nervous system
  • Pelvic congestion caused by varicose veins, or poor circulation
  • Sacro-iliac joint problems
  • Tension organs of the lower abdomen including the bladder, prostate, uterus and ovaries

These are just some of the many conditions a pelvic health physiotherapist can help manage. If you find that you can relate to one or more of these issues, or have any other questions about your Pelvic Health, it may be time to contact your Doctor or Physiotherapist directly to schedule a Pelvic Health appointment.


Pelvic Health Solutions; Resources for the patient. Retrieved from: November 12, 2016.

Philip, V.  (2015, November 3). Looking Beyond Kegels… Positively Pelvic Blog. Retrieved from:

8 Tips from Dietician Brianna Meghawache on Cleaner Eating and Living in the New Year!

8 Nutritionist-Approved Ways to Detox in the New Year

Brianna Meghawache, Registered Dietitian at Nourished by Bri

“Eating clean” is all the rage this New Year’s! How discouraging it might be, with current diet trends all over the map, to find many different definitions of clean eating when you simply want to tackle your health issues the right way. Popular diets today range widely in their foundation and restrictions: we’ve got ultra-low-carb ketogenic diets, ancient (though pseudo-science-founded) Paleo diets, newer and trendy 30-day recipe plans, seemingly extreme and expensive versions of fasting, and finally – dare I say it out loud in carnivorous Albertan territory – vegan and vegetarian diets. Unfortunately, most dieting programs, plans and philosophies are quite inconsistent in their rules according to who you talk to, and lack valid scientific backing for their effectiveness.

If you’d like to achieve health in a sustainable manner, not taking steps backward and regaining weight, consider that small yet intentional steps toward removing non-nutritious foods and including nutrient-dense foods is the most effective way to achieve a healthy weight, reduce systemic inflammation, and achieve your best health!

I promote disease prevention through foods all the time, but it’s not just unhealthy foods that load our body down with extra unnecessary tasks of cleaning itself out! The most commonly found toxins that affect us are bisphenol-A (BPA), heavy metals, PCBs, and pesticides. Here are my top 8 ways to clean out the body by removing potential carcinogens, hormone disruptors, disrupted hormones, and chemical or hormonal potentiation of chronic disease.


8 Nutritionist-Approved Ways to “Detox” in the New Year!


  1. Eat more plants! Plant-based proteins and diets are SO IN right now!

There is not one person I have met that thinks they eat enough vegetables. Whole plant foods are chock full of antioxidants, vitamins, and minerals. Take one step further to increasing your intake of plant-based foods by trying a new recipe containing beans, your favourite vegetable, or a new ancient grain that you haven’t tried yet. Note that if you are concerned about organic versus non-organic, it is better to include non-organic vegetables and fruits than to exclude them for the purpose of avoiding pesticides (further explained in this video!). For more information on how a slightly more or drastically more plant-based diet can help you, check out this blog post.


  1. Replace added sugars with lower sugar substitutes and WEAN yourself off sugar.

Some people are cautious to remove added sugars from pop, honey, syrups, cane sugar, and sweets with artificial sugars, and understandably so. There has been lots of controversy surrounding artificial sweeteners in the past 20 years. There have been some thoroughly-tested safe natural sweeteners such as stevia and xylitol, that, added in small amounts, can satisfy your sweet tooth. Try substituting regular sugar in your recipes and hot beverages with half the volume of Truvia – a stevia-containing baking substitute – or use raw fruits, blackstrap molasses, or a few dates to add sweetness to a breakfast, salad dressing, or sauce. Over time, reduce the amount of sugar you use – don’t worry, your taste buds will adjust!


  1. Reduce toxic load from plastics – on yourself, and on the environment!

Do not, do not, do not, use plain water bottles. BPA-free plastic containers and BPA-free water bottles should be number one on your shopping list if you don’t already possess or use them. Consider the tons of plastic waste, wraps, and bottles from the foods and beverages cleaned out by customers at just one grocery store in a year, let alone the entire globe! A lot of it ends up in oceans and is very dangerous to marine life.

Some plastics containing the recyclable label 3 and 7 contain BPA – avoid heating and using these if you can. Canned foods are also sometimes lined with BPA-containing resin, so as for the items you would usually get canned, try to cook from scratch.

While we’re at it, go bag-less and receipt-less at the grocery store. Bring your own bags – remind yourself by writing it at the top of your grocery list so that you grab them before you run out the door!

Printed receipts contain bisphenol-A – which is numerous in other products – but this is one item you might touch daily, so avoid touching them if you can and ask for them to be put in your bags if you need to keep them. If you must work with receipts, try to use gloves.

If you must use plastic containers, avoid putting them in the dishwasher or heating them in the microwave. The plastic may break down over time and leach into foods. Click here for beautiful, biodegradable beeswax cling wrap, here for trendy ocean blue BPA-free glass food storage containers, or here for reusable sandwich and snack bags.


  1. Eliminate body negativity and worry. (Listen to Bob Marley’s “Don’t Worry, Be Happy” if you need a reminder!)

Stress hormones (adrenaline and cortisol) are certainly linked to a depressed function of the immune system, which then leads your body to be less able to fend off illness, toxins, and chronic health issues. One significant source of stress in a lot of people I meet and work with is their struggle with body image.

Your journey to health is not going to end next week, next month, or likely even next year. It’s going to last your entire life, and therefore there isn’t a reason in the world that we should give ourselves permission to sit comfortably in a state of body negativity. Take every day as an opportunity to bless yourself and others. Seek to emulate that irresistible joy that radiates from people who accept and love who they are. Stop trying to “punish” yourself with a workout after eating treat foods. Instead, reward your heart, lungs, and brain for working so hard all day for you with cardiovascular care in the form of exercise. Then, fuel appropriately so that your muscles and blood vessels have all the tools they need to rebuild, recover, maintain, and strengthen your body.

Having trouble with setting body-positive and healthy, but not overwhelming goals on your own? Send me a personal message here detailing what you are experiencing and I’ll see how I can help. If your stress response runs deeper than just food and body image, perhaps seek out a counselor or psychiatrist or psychologist in your area to assist you in dealing with the stresses in your life.


  1. Review the ingredients in your toiletries. (Not just for the ladies!)

This one’s not just for the ladies. Listen here to a snippet about the latest on aluminum-containing antiperspirants. You can then further review the things that you apply daily and weekly to your skin or rinse in your mouth. Look beyond the claims touting products as “natural” and “organic”, and screen the labels for any POSSIBLE hormone-disrupting or carcinogenic chemicals, such as those listed here, to help not only yourself, but the wildlife of planet Earth. Watch out also for hair dyes – every time you have your hair lightened or bleached, you’re infusing your scalp with a hefty dose of ammonia. Best to have a low-maintenance ‘do if anything!


  1. Get moving and get your sweat on!

Just 30 minutes of moderately-intense, almost-short-of-breath physical activity is enough to help your blood vessels clean out nasty cholesterol plaques. Combined with not smoking and eating a plant-based diet, exercise is an important part of the formula to halt and even reverse heart disease. Many of us 9-to-5 folk spend a lot of the day sitting. Start by getting up out of your chair a few 15 minute intervals a few times a day – even just marching in place – and gradually increase to a point where you have trouble completing a run-on sentence like this one. Sweating and rehydrating helps your skin and organs to clean out your blood – so if you are able, do an activity that gets you sweating a bit!


  1. Increase your fiber intake.

Most Canadians and Americans get no more than 15 grams of fiber each day, whereas the minimum recommended intake is 25 grams for females and 38 grams for males. Make sure that your breakfast begins with a hefty dose of fiber – not just from Metamucil or Benefiber. Fruits, vegetables, whole grains and legumes (lentils, split peas, chickpeas, and other beans) include special antioxidant compounds that are bound up in fiber that also help your body in other ways besides elimination from the gut. If you have cancers of the bowel in the family, diverticulosis, hemorrhoids, irritable bowel disease, or irritable bowel syndrome, it’s time to speak to a Dietitian and optimize your fiber intake!


  1. Drink water as your main source of fluids.

This goes without saying, especially if you are sticking to tip number seven. While you increase fiber, make sure to increase water intake. Plenty of added calories from the typical diet come from liquids. Your brain does not recognize liquid calories as a sign that it has had enough to eat – it recognizes bulk in the stomach and commands your appetite from that signal. You can drink various teas or a bit of black coffee, but choose water or infused water as your beverage of choice. If you are curious about juicing, read my Juicing 101 guide!


When it comes to dieting or “detoxing”, research tells us that efforts to lose weight as “dieting” will result in the weight coming back within a few years for the most of us, with a vengeance! More and more people are taking charge of their own bodies and health, and are benefiting from professional and individualized support and help from a trusted health care provider, namely, nutritionists or Dietitians. While you’re contemplating what it might be like to have someone working one-on-one with you according to your needs and lifestyle, check out the other blog posts and recipes on my personal website, !


All the best in health and wellness,


Brianna Meghawache, Registered Dietitian



“Will Alberta Health Services Cover the Cost of My Physio Treatments?”

The Alberta Health Care Funding Model Explained

Some of the most common questions we field in physical therapy are concerning the funding model for assessment and treatment through Alberta Health Care.

A number of clinics in the Edmonton area are allotted a monthly and yearly allowance for community rehabilitation.  Wait times vary depending on demand, though clients typically are seen within the week for their initial assessment at Corona Station Physical Therapy.

Those clients who have undergone surgery or suffered a fracture are automatically approved for an additional six visits through Alberta Health Care.  Clients who are on certain government subsidy programs, or are considered to be low income will qualify for a one time per year allowance of six additional visits with three treatments covered for any subsequent injuries that are not fractures or surgeries.  Should further treatment be needed at the completion of these treatments, the physical therapist can complete a Request for Review Funding form, applications are reviewed on a case by case basis with some individuals receiving additional treatment if it is determined to be necessary.

Those clients who have not had a fracture or surgery or are not low income may qualify for an additional two visits as determined by the Determination of Need rubric that is completed by the physical therapist.  This tool takes into account the severity of the person’s injury, the benefit they are likely to receive from treatment and the impact that delay would have on a favourable outcome.  The funding is based on certain body areas so, for example, if a client fractures their wrist and has the misfortune of later injuring a second body part, they can again access Alberta Health Care funding.  The health care year renews annually in April.

If clients are dissatisfied with an assessment where they are deemed ineligible for funding, they are entitled to a second assessment through Alberta Health Care.  Those individuals injured in a motor vehicle accident or at work must access different funding sources for their treatment.  Some services, such as vestibular rehabilitation, women’s health, concussion management and running gait analysis are not covered by the community rehabilitation program and must be paid for privately.  For further information, visit or contact us at the clinic at 780-424-4804.

Injury Prevention in Golfers

Injury Prevention for Golfers

As the weather gets warmer and the grass greener, the itch for golfers to begin their season inevitably grows stronger.  Unfortunately, this excitement to start the season right where they left off the previous year can lead to injury for amateur golfers.  The most common injuries seen in golfers include:



  • The shoulder complex is a complicated region of the body, trying to balance its large amount of mobility with stability. We rely heavily on the shoulder’s musculature to provide stability, especially when doing demanding tasks like swinging a golf club.  75 percent of shoulder injuries occur to the lead shoulder in golfers.  It is crucial that golfers train the proper muscles before their season starts, to prevent injury.



  • Most people assume a common elbow injury in golf would be “golfer’s elbow”, however the more prevalent injury is tennis elbow, otherwise known as lateral epicondylitis. It is normally seen on the lead elbow and can be caused by gripping the club too hard, changing the grip, or bending the elbow on the follow-through or take-away phase of the swing.  Golfer’s elbow, or medial epicondylitis, will more often be seen on the trail elbow and is the result of “early casting of the club in the downswing” (Davies et al, 2010).  Strengthening the forearms pre-season can help prevent both golfer’s and tennis elbow.



  • Wrist injuries most often occur when the club contacts something before it hits the ball; for example, the ground, a tree root or the mat at the driving range. The club and the wrist both decelerate rapidly which, without proper training, can cause stress and injury to the wrist.  Once injured, it is hard to continue playing as each swing will stress the wrist joints, therefore it is important to strengthen the wrist before injury occurs.


Low back

  • Low back pain accounts for 36 percent of injuries in amateur golfers. The golf swing incorporates high velocity end range rotation, with the spine in a flexed position, and this position puts golfers at higher risk for low back injury.  Any hypomobility or hypermobility at any of the involved joints can result in compensations in the kinetic chain and, thus, lead to injury. Having good core and back strength, along with full lumbar spine mobility, can help prevent injury.



  • Fast rotation of the hips, pelvis and trunk is crucial for a proper swing. When strength or range of motion is lacking in the hip, the body makes compensations that can “stress muscles, ligaments, tendons and joints in the area” (Davies et al, 2010) and can result in pain.  It becomes near impossible to have an efficient swing without proper hip rotation, without which, golfers risk further injury or even worse – a few extra strokes on the score card!

Golf is a wonderful low-intensity sport that can be played by all ages, however, the injury rate of 40% is a barrier for participation.  “A major factor in the development of injury is the lack of sport-specific training and inadequate preparation prior to golfing” (Brandon et al, 2009).  Having a proper stretching and strengthening program will help prevent injuries from occurring. At Corona Physiotherapy, we can provide you with a program so you can start your pre-season training, and assist you if you get injured during your season.  Contact us to book an appointment!



Davies, C., & DiSaia, V. (2010). Golf anatomy. Champaign, IL: Human Kinetics.

Brandon, B., & Pearce, P. (2009).  Training to Prevent Golf Injury.  Current Sports Medicine Reports, 8(3), 142-146.

Q and A with Rise Up Challenge’s Cody Price – Prepping for your Adventure Race!

Interview with Cody Price –  Rise Up Challenge

Q) I am new to adventure racing, is this something I am going to be able to do?

A) Absolutely! Whether you are new to the sport, or to a fitness inspired lifestyle in general, you will be able to do it. Our courses and the obstacles laid out throughout them are designed to be tough and challenging, both from a physical and mental perspective. I’m not going to lie, there may be times when you’re on course and you ask yourself if you will be able to finish, or if it was a good idea to start this race in the first place. You may doubt yourself, but if you remember WHY you signed up and why you ventured past the starting line on to the course to take on this challenge, you will find the determination and motivation inside you to keep moving forward and finish. You can run a race or you can walk it. It doesn’t matter how you run a race, at the end of the day it all comes down to how you finish, not how fast.

Q) I would like to try adventure racing but where do I start?

A) Sign Up! Give yourself a tangible goal that is 3, 6 or 9 months from now and start working towards completing that goal. With the race and date on the horizon, you will be motivated to work towards it. Whether it is going for a walk or run, going to the gym, playing with your kids at the park or staying active in general; each step is a step forward in the right direction. You don’t have to start your journey already in tip-top shape, the journey is how you get there. Over time as you prepare you will notice yourself getting stronger, having more energy, and building self-confidence that accomplishing the goal is within reach.

Q) How can I be most effective with my training for Rise Up Challenge?

A) The simplest and easiest way I recommend people train for an event such as the Rise Up Challenge is to enjoy the outdoors. All the tools you need to get ready for an obstacle course race can be found in nature and within your city’s trails, river valley, parks and suburbs. These tools may include natural elements such as logs, rocks, water and varied terrain and hills. They could also include more man-made structures like stairs or playground equipment. After a few Google searches and YouTube videos it can be easy to learn how to workout outside and train for your first Rise Up Challenge or OCR event. OCR has a handful of basic moves you can focus on to train outside and prepare yourself for race day. These moves consist of lifting heavy objects, carrying the objects from point A to point B. Climbing on, under and over structures such as walls and cargo nets, grip strength for using your upper body and of course running on trails, through water and up and down hills.

Here’s an example of how you can use the outdoors as your training grounds. Take a fallen log or rock for example. These objects are great tools to build functional strength and endurance. They could be used for carrying up hills, or weighted hikes. They could become your new dumbbells for building strength in your back, arms, shoulders and legs.

Another example you may find outdoors are retaining walls or fences. It may seem silly at first but these are great tools for building your climbing abilities, calling on all types of functional strength in your legs, back, arms and hands.

One last piece of equipment you’re sure to find in any part of your neighbourhood or city is a Playground. These structures are great for all types of fitness and they’re a lot of FUN! The best part about playgrounds is that if you have young kids, they can play as you workout. Playgrounds are great spaces to work on tough obstacles like monkey bars, slippery walls (think running up a slide) and simply running through mud or sand.

When it’s all said and done, keeping these basic moves in mind will give you the ability to build your level of fitness and get ready for your first obstacle course race.

Q) What should I wear on event day?

A) I personally always wear shoes and clothes that I don’t mind throwing away afterwards if they get too dirty or wrecked as I run through the mud and over obstacles. Make sure you wear something that is comfortable when you’re dry and wet and can move freely in, at all different angles. Clothes that don’t retain water or act like a sponge when wet are also very advantageous. Depending on the type of person you are and how confident you are with staying hydrated, I would wear a camel-backpack or carry a water bottle. You never know when you will come across a water station, and it is important you can stay hydrated. The last thing you want to happen on a tough obstacle course is to run out of water.

Oh and remember, don’t take any valuables on course like earrings, wedding rings, car keys or cell phones.

Q) Any other tips on how I can make my run a success?

A) It’s simple, get outside, enjoy the fresh air and sunshine (even in the winter) and have fun! If you’re having fun, you won’t even notice how hard you’re working.

Q and A with Personal Trainer Devon Chang – Returning to the Gym Following Injury

Q and A with Personal Trainer Devon Chang – Returning to the Gym Following Injury

We get a number of questions from our clients who are eager to return to the gym and their other regular activities.  This month’s guest blogger, Devon Chang, is a CESP – Certified Personal Trainer at World Heath Club (Jasper Ave location) and has some excellent information for those looking to transition back to the gym after an injury!


Q) I’ve had an injury and my physiotherapist says I can start back at the gym; where should I start?

A) With the green light from your physiotherapist, it would be the best to start with the very basics. The goal here is to re-groove the basic movement patterns and muscle activation that you were doing prior to your injury; such as core and glute activation, squatting and hip hinging, and pushing and pulling movements to name a few. We want to avoid jumping right back into our old training as we need time to allow our bodies to rebuild what was lost during the healing process.
In summation, we are looking to regain our full range of motion, move effectively and start to rebuild our strength as a whole. Regardless of your experience, type of injury or goals moving forward, it would be in your best interest to consult a fitness/ post rehab professional.

Q) How often should I be working out once I am back to training?

A) Coming back from an injury is tough. Our habits are thrown off and our bodies don’t feel like working like they used to…yet.  It is important to rebuild those lost habits (or continue) and get back on track. Starting 3 times a week working with resistance training with the addition of 1-2 maintenance (focus on injured area; mobility/ flexibility; active recovery) days is a fantastic place to begin. From here we can look to increase our gym frequency and continue to progress to where we left off prior to injury. If you were training less than 3 times a week prior to injury then continue to move forward in your programming and coming back even strong than before.

Q) What is the advantage of consulting with a fitness/ post-rehab professional following an injury?

A) One of the greatest advantages to consulting and working with a fitness/ post-rehab professional is it takes the guess work out of the process. The job of your coach is to help you progress efficiently through your program and support you in rebuilding your habits and overall health and fitness.

Moreover, the main goal is to rebuild functionality and strength within your injured area and regain your confidence in that body part or parts. Whether that is guiding you through a program built by your physiotherapist or assessing you and building a program for you from scratch, your coach will help get you back to where you want to be and beyond.

A) What should I keep in mind to prevent re-injury?

Q) Injuries happen. Whether you’re a competitive athlete or a weekend warrior and casual gym goer, injuries still happen. Our responsibility is to prepare ourselves to avoid them the best we can.  Many injuries are freak accidents while others could have been prevented. However, we should keep in mind how we got injured in the first place and what plans we need to follow to build everything back up stronger and more stable.

More specifically, we target and strengthen the previously injured area and surrounding area.  I know that’s a very broad statement but keeping in mind the necessity of building a strong foundation stemming from your core and moving outwards and towards all areas; including the injured ones.  Be patient and ease back into your program while being extremely mindful of your form and muscle activation. The best approach is to consult a professional to help get you started on the right track.

Q) I’ve never lifted weights before but my physiotherapist recommended weight training to help prevent injury in the future; where should I start?

A) This right here is one of the biggest road blocks many people face. And that’s ok. You don’t know what you don’t know. So please don’t be afraid or too proud to ask for help. If your car broke down would you try and fix it yourself or would you call a mechanic? Now you mechanics out there shush, you know what I’m getting at. Same goes for bouncing back from an injury or simply learning how the gym works.

To avoid getting hurt again or falling off the wagon, it is imperative to learn the basics of human movement and functionality. I’m not talking about training for the next Olympic Games (unless you want to then by all means go for it!) but I’m talking about keeping your body happy and healthy. This is where consulting and if it’s a good fit, hiring a professional to teach you how to do it.  You learn. You apply. You learn. You apply. The internet can teach you theory and provide good instructional videos (make sure it’s a credible source) but being hands on with someone who knows what’s up will go even further to becoming knowledgeable and more independent. That is how you will build your foundation and understand how this whole gym and training thing works.

Q) I’m back at the gym following an injury and haven’t noticed any of my old symptoms, how quickly can I ramp up my training?

A) First and foremost, consult with your physiotherapist and/or the fitness professional you are working with. Better to be safe than sorry right? One rule of thumb that I personally apply is this:  if it hurts stop doing it!  Now that’s pretty vague but essentially I mean ease into increasing the difficulty and be patient. Make sure your body is stable and in proper position. The litmus test is pain or transitioning into bad form. That is where you dial it back and reassess.

Q) I would like to return to my group exercise classes now that my symptoms have almost been resolved; any tips for success?

A) Ah yes. Group exercise!  A fantastic place for camaraderie and getting your butt whooped by someone twice your age. Kudos to that person!  Group exercise is great and always a very diverse place of skill level and intensity. When getting back into the groove of group ex we have to keep in mind basically everything we just covered above and then some. It is important to push ourselves but also important not to compete with the other 40 people attending the class. We are coming off an injury and have to be diligent in performing the class with solid form and at the pace that is conducive to our post-rehab goals.
In group ex we lack the advantage of having someone analyze and cue our every move so it is up to us to follow and perform the movements led by the instructor to a tee. Otherwise we could jeopardize our recovery and perform the exercises with poor form and movement patterns. Go at your own pace and use the appropriate weights and movements for where you’re at in your recovery. If in doubt ask for help or advice from the instructor leading the class. Always consult with your physiotherapist or the professional leading your recovery.


Devon Chang is a 2013 University of Alberta graduate with a Bachelor of Physical Education and Major in Sport Performance and Physical Activity. Originally from Yellowknife, Northwest Territories, he came to Edmonton as a young teenager in pursuit of hockey excellence and ended up finding his passion for helping people with their health and fitness. Devon has been a CSEP-Certified Personal Trainer since 2012 and is currently working with the team at World Health Jasper Avenue as an Elite-Level Trainer and club Integration Manager.


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Workplace Ergonomics

Workplace Ergonomics

Workplace ergonomics is becoming an important consideration in injury prevention given the increasingly large number of people who spend the majority of their day working at a desk.  Some relatively easy and inexpensive adjustments in the workplace can have a significant impact on many postural and repetitive strain type injuries including chronic neck and back pain, tennis elbow, shoulder impingement and carpal tunnel syndrome.


The Chair

Ideally, a chair should be adjustable not only in a vertical direction but in all three planes of movement to accommodate various body types.  The height of the chair should be adjusted to be able to slide the chair under a desk while maintaining hip flexion of 90 degrees or slightly greater, a foot stool can be used to achieve this if needed.  An ergonomic chair will also include an area of lumbar support.  Used properly, this curve at the bottom of the chair helps to support the spine’s natural lordosis.  Depth of the chair will vary depending on leg length, a two inch clearance between the back of the knees and the chair is recommended.


The Desk

Sit to stand desks are becoming increasingly popular and are a great option for alleviating some of the health concerns typically associated with prolonged sitting.  Employers are becoming better educated on the advantages of sit to stand desks and will sometimes consider an upgrade if recommended by a health care professional.  Often however, these more expensive substitutes are not in the budget.  Desk set up can be optimized by having the monitor 20 to 30 inches from the eye with the top of the monitor at approximately eye height and centred in front of the face.  Having room under the desk to allow the legs to move and stretch is also advised.


The Keyboard and Mouse

A drop down keyboard allows a worker to keep the elbows close to the body and the forearm parallel with the floor, decreasing the amount of reach and subsequent strain on the shoulder, elbow and wrist.   Newer ergonomic mouses and keyboards keep the wrist in a more neutral position, lessening the risk of repetitive strain injuries to the wrist and hand.


These small changes can have a big impact but further consultation with a physical therapist can help to address additional factors that are specific to the individual.

Injury Prevention in Runners

Injury Prevention In Runners

50% of people who take up running will quit within the first year due to an injury! The majority of injuries suffered by runners are repetitive strain type injuries related to tissue overload with inadequate time for tissue adaptation. Most of these injuries can be diagnosed clinically and will respond well to conservative management with imaging and medical specialist referral often not required.

Most Common Running Injuries

  1. Patello-Femoral Pain Syndrome
    • characterized by anterior knee pain usually felt above the patella, worse with stairs, kneeling and prolonged sitting.
  2. Ilio-tibial Band Syndrome
    • characterized by lateral knee or hip pain, occasionally a click or catch at the lateral knee, onset often at specific mileage or duration of run
  3. Plantar Fasciopathy
    • arch pain, usually worse in the morning, may be related to the addition of plyometrics to training
  4. Achilles Tendonopathy
    • achilles tendon swollen or tender to palpation, may be related to the addition of hills to training
  5. Medial Tibial Stress Syndrome/stress fracture
    • anterior shin pain, overload type injury related to increased mileage
  6. Patellar Tendonpoathy
    • anterior knee pain below the knee cap, may be related to increased hill training


Runners presenting with any of these conditions would benefit from physical therapy treatment. Visiting a physical therapist who specializes in running analysis can facilitate a speedy recovery and help to maximize  performance as well as prevent future injury. Evidence based running analysis is now being offered at Corona Station Physical Therapy. Foot strike pattern, cadence, shoe choice, strength, biomechanics and training habits will all be evaluated to ensure that you are running safely and efficiently. If you have an upcoming race, training plans can be developed to maximize adaptation to mechanical and physiological loads.

Ashley Cripps and Ehryn Crane are both physical therapists certified through The Running Clinic as Specialists in injury prevention in runners.

The Cervical Deep Neck Flexors

The Cervical Deep Neck Flexors

A large percentage of skeletal stability is afforded by muscles.  Muscles are designed to stabilize the skeleton in mid range, functional positions and are the only system that can compensate for changes in articular integrity.

All muscles are important for motion and support, however, not all muscles function in the same manner but rather fill specialized roles.  The more superficially positioned neck muscles can maintain head position against gravity and have a greater torque producing capacity than their deeper counterparts.  These superficial muscles, however, are not suited to provide fine segmental motion control.  The deeper cervical muscles situated immediately adjacent to and spanning shorter sections of the spine, form a sleeve around the cervical and craniovertebral regions.  Their anatomical design allows them to provide effective segmental motion control and support spinal curves.  (Mayoux Benhamou 1994, Boyd-Clark 2002)  Segmental buckling would occur if the superficial muscles were to work on their own without adequate activation of the deep muscle network.  (Winters and Peles, 1990)  Balanced activation of the deep and superficial flexor and extensor muscle networks is necessary to optimize function and minimize the potential for a pain state.

Numerous studies of individuals with neck pain have identified changes in relative activity of the deep and superficial neck muscles.  Individuals with neck pain show decreased strength and endurance of their deep neck flexors (Longus Capitis and Longus Colli) when compared to control subjects.  They also exhibit increased superficial muscle activity (SCM and Anterior Scalenes) compared to control subjects.  (Jull et al 1999, 2000, 2004, 2009; Gupta et al 2013; Elsig et al 2014)  Decreased activation of the deep cervical flexors with concurrant increase in superficial flexor activity will typically result in altered movement strategies and increase the potential for dysfunction.

The craniocervical flexion test (CCFT) is a simple yet proficient test to screen for neuromotor control of the deep neck flexors.  It assesses for activation and isometric endurance of the deep cervical flexors.  In addition, it monitors for early or excessive activation of the superficial neck flexors.  The CCFT can serve as an effective retraining tool in cases where dysfunction is identified, progressing the individual through increasing levels of difficulty.  (Jull GA et al. 2008)  The CCFT is used routinely by physiotherapists at Corona Station as both an assessment and treatment tool with favourable results.

Stages of Tissue Healing

Stages of Healing


One of the most common questions we hear as physical therapists is “How long will it take for me to recover”?  Soft tissue injuries such as ligament sprains and muscle strains follow a characteristic pattern of healing with three general phases, the inflammatory phase, the proliferative or fibroblastic phase and the maturation or remodelling phase.  These stages may overlap and are not always linear, injuries may progress or regress through the phases depending on certain patient specific factors that may be either intrinsic (such as severity of the injury and age) or extrinsic (such as anti-inflammatory use or repeated re-injury).

The inflammatory phase is characterized by a complex cascade of events at the biomechanical and cellular levels.  The net result is clotting of any ruptured blood vessels with a return to homeostasis, followed by vasodilation and the introduction of antibodies, white blood cells, enzymes, nutrients and growth factors to the wounded area.  Pain, swelling and redness are typically noted during this initial phase, which lasts five to ten days.

Once the damaged tissue has been cleared with the inflammatory phase, the body can begin laying down new tissue during the proliferative phase.  This tends to be a relatively inelastic type of scar tissue that is different in make – up than the original tissue of the ligament, tendon or muscle.  This stage of healing can last from four to six weeks.

The final phase of healing is characterized by remodeling of the collagen fibers, which will become more parallel with the lines of stress applied to the injured tissue.  Tensile strength will continue to increase, providing greater mechanical integrity and reducing the susceptibility to injury in the future.  This process can continue for up to a year, the clinical implications being that a client may still feel some mild residual symptoms and may be prone to injury with lesser insult.

Given the stages of healing typical of a soft tissue injury, clients can expect a six to eight week recovery process, with the understanding that that the final phase of healing can continue for up to a year following the injury.  Also of note, the stages of healing are affected by client specific factors including age, the severity of the injury, previous injuries, co-morbidities, job demands and compliance with activity modifications recommended by the therapist.  For further information or to speak with one of our physical therapists, please contact Corona Station Physical Therapy directly at

What is Manual Therapy?

What is Manual Therapy?

The term manual therapy is widely used in physical therapy practice but is perhaps less widely understood. Manual therapy is a broad phrase used to describe the “hands-on” work performed by physical therapists and can include soft tissue techniques, joint mobilization and mobilization with movement, manipulation and myofascial release. These techniques form a cornerstone of the physical therapy profession and all treatment plans typically include at least some form of manual therapy.


What are Mobilization and Manipulation?

These interventions are forms of manual therapy and aim to restore motion, decrease pain, improve function, and can indirectly decrease muscle tone. They are based on a biomechanical model. Along with the particular movement of a bone in space (an osteokinematic movement) there is a consistent associated glide at the joint (arthrokinematic movement). For example, when we flex the finger, the distal bone glides in a palmar direction on the proximal bone at each of the interphalangeal joints. Clinically, this means that if an individual is limited into flexion following a hand injury, a physical therapist can aim to restore motion by performing a palmar glide of the distal bone. Manipulation is defined as the skillful application of a high velocity, low amplitude thrust and is used when a joint is fixed, in cases where mobilization is no longer providing improvement, as a means of improving muscle tone via neuromuscular feedback, and in incidences where there is a loose body in a joint. Often there is a cavitation or popping sound as gas is released from the joint. Manipulations can be applied so that the force is perpendicular to the joint surface, causing a gapping or distraction of the joint, or so that the force is parallel to the surface of the joint, causing an arthokinematic type glide and restoring motion in a particular direction.


Is There Evidence to Support The Use of Manual Therapy?

There is a growing body of evidence addressing the efficacy of manual therapy. To date there is evidence to support the use of manual therapy in treating numerous conditions including ankle sprains, rotator cuff tendinopathy, cervical spine dysfunction and chronic low back pain (1, 2, 3, 4). Manual therapy is rarely used in isolation and is more often one component of a comprehensive treatment plan that will include education, therapeutic exercise, dry needling and modalities. For more information or to speak to one of our physical therapists, please contact the clinic directly.



  1. The Efficacy of Manual Joint Mobilisation/Manipulation in Treatment of Lateral Ankle Sprains: A Systematic Review. Loudon JK1,Reiman MP,Sylvain J. Br J Sports Med 2014;48:365-37
  2. The Efficacy of Manual Therapy for Rotator Cuff Tendinopathy: A Systematic Review and Meta- analysis. Ariel Desjardins-Charbonneau, Jean-Sébastien Roy, Clermont E. Dionne, Pierre Frémont, Joy C. Macdermid, François Desmeules. J Orthop Sports Phys Ther. 2015; 45(5):330-350
  3. Manipulation and Mobilization of the Cervical Spine: A Systematic Review of the Literature. Hurwitz EL1, Aker PD, Adams AH, Meeker WC, Shekelle PG. Spine (Phila Pa 1976). 1996 Aug 1;21(15):1746-59
  4. Manual Therapy and Exercise Therapy in Patients With Chronic Low Back Pain: A Randomized, Controlled Trial With 1-Year Follow-up. Aure, Olav Frode PT; Hoel Nilsen, Jens PT; Vasseljen, Ottar PhD. Spine: 15 March 2003 – Volume 28 – Issue 6 – pp 525-531

The Physiology of Fat

The Physiology of Fat by Jack Haworth MScPT, BSc

The World Health Assembly in May 2012 stated a goal of ‘no increase in obesity or diabetes levels’ from 2010 by 2025. Ezzat et al (2016) conducted a meta-analysis from 1975-2014 and now state that if trends continue there is zero percent chance of meeting the global obesity target. The correlation between chronic disease and sedentary lifestyles are well documented. Getting more physical activity and losing weight is something the majority of people would say they need, but whose job is it to tell you this medically, and who do you ask for advice? When does that advice become more than ‘eat less refined sugar and exercise more’?

How Does the Body Use and Store Energy?

Pancreatic release of the hormones insulin and glucagon dictate what gets used as energy and what is stored in reserve. The food we eat is broken down in the stomach and the energy floods into the blood stream at differing rates, depending on factors such as glycemic index and fibre content. Increased blood sugar levels trigger the release of Insulin which gathers the excess circulating metabolites for storage. They are then transported to the muscles and liver and stored as glycogen (which have a limited capacity), or lumped together as a TAG (3 free fatty acids-FFA, and a glycerol) and stored as adipose. So it makes sense that if our diets contain high concentrations of sugar and fat, then our body mass index will increase. When we haven’t consumed energy for a few hours, Glucagon is released as blood glucose levels are low. FFAs are liberated from the adipocyte to the bloodstream by the hormonal reaction – lipolysis. Transport proteins deliver the FFAs to the working muscles, where they are utilized inside the mitochondria as energy. If insulin is the storing hormone then glucagon is the mining hormone. That being understood, exercise can now be utilized to manipulate whether we burn off exogenous or endogenous energy by ensuring we don’t exercise immediately after food consumption.

Adenosine Triphosphate (ATP) is what we spend as energy and is a derivative of metabolites such as muscle glycogen and fat. ATP demand positively correlates with the power output of an exercise bout (Egan and Zierath 2012). Exercise intensity however, can be manipulated to determine where the ATP source derives from. Romijn et al. (1993), & Van Loon et al (2001) found both intra-muscular and extra muscular levels of FFA utilization are at their highest during low-moderate (<65% V02 and aerobic) exercise, and as the intensity increases, muscle utilization of the circulating FFA declines, whereas glucose utilization increases (anaerobic >65%). It therefore stands to reason that if we want patients to lose weight, exercising at lower intensities for longer periods of time is sound advice. This advice is also in line with the safety precautions we would take when prescribing exercise as an intervention in patients with HBP and CHO, and even AS, DM and angina. If the goal of exercise is weight loss, then knowing when and how to exercise is the key to being efficient and safe.

What Does This Mean for Those Looking to Lose Weight?

Consuming an energy drink high in glucose before exercise causes glucose to flood the blood stream and is readily transported to working muscles for conversion to ATP. So in this instance you are burning the sugars which you have just taken in, not your own reserve, therefore they are counterproductive if your goal of exercise is weight loss. Conversely, following a fasting period >3hours or overnight, the high levels of glucagon and low levels of insulin mean that adipocyte reserves have been liberated and increased blood concentrations of FFA are been transported to the muscle for ATP, thus you are burning fat as energy. This metabolic state is only achieved through a period of fasting, otherwise glucose and FFA levels in the blood are high due to a recent feed, along with high levels of insulin, so in this state if you are not exercising you are most certainly increasing your adiposity reserve. First thing in the morning glucagon release has been facilitating homeostasis via lipolysis throughout the course of the night, but relatively speaking we don’t need much energy to maintain a sleeping body. The notion of breakfast being the most important meal of the day does ring true, but why not capitalize on this perfect window of natural lipolysis first with some low intensity exercise? In low risk patients, how you capitalize and burn off more endogenous fat is patient preference, walking, jogging or intermittent exercise will all be effective. In higher risk patients we know we need to restrict intensity and duration boundaries via RPE, heart rate and blood sugar levels but all can be manipulated to facilitate efficient weight loss.

The purpose of the above was not to give prescription parameters of exercise but to establish the chain of metabolic events when we eat, fast and exercise and how it’s possible to manipulate these events to make exercise more efficient when weight loss is the goal. For the prescription of exercise parameters a comprehensive understanding of cooperating energy systems is needed, along with the potential co-morbidities of the patient.


Romijn. E., et al (1993). ‘Regulation of endogenous fat and carbohydrate metabolism in relation to exercise intensity and duration’. Am. J. Physiology. 266. pE380-E391.


Ezzati., M. (2016) ‘ Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants’. The Lancet. 387. p1377-96.


Egan., B & Zierath., J. (2012). ‘Exercise metabolism and the molecular regulation of skeletal muscle adaptation’. Cell Metabolism. 17. p162-184. World Health Assembly (2012). Resolutions and decisions. Geneva May 21-26.

Transversus Abdominus and Its Role in Lumbar Spinal Stabilization

Transversus Abdominus and its Role in Lumbar Spinal Stabilization 

Spinal stability is dependent upon three sub-systems: the active or contractile system, the passive or non-contractile system and the neural control system. (Panjabi, 1992). If dysfunction is present in any one or a combination of these sub-systems, the stabilizing capacity of the spine will be compromised and painful movement more likely to occur. While all muscles contribute to spinal stability and movement, some are better suited than others to provide dynamic stability. In the lumbar spine (L/S), the deeper muscles, close to the axis of joint motion, with a predominance of Type I muscle fibers, have proven more effective as stabilizers than the larger, more superficially located lumbar spinal muscles.

Research has shown that: 1) people with low back pain (LBP) present with atrophy and altered activation of the deep spinal muscles when compared with persons without LBP (Hodges et al., 1996; Hides et al., 1994) and 2) the deep spinal muscles play a key role in developing inter-segmental motion stiffness which translates into improved dynamic control of the spine (Hodges et al., 2003).

Transversus Abdominus (TA) is an important dynamic stabilizer of the L/S. TA is able to directly increase intra-abdominal pressure which converts the trunk into a more solid cylinder. This reduces compression and shear forces acting on the L/S and transmits them over a wider area (Twomey & Taylor, 1987). TAs attachment to the thoracolumbar fascia further increases its ability to stabilize the L/S.

The success of specific spinal stabilization training for TA and other deep muscles lies in: 1) teaching clients to activate the dysfunctional muscle in isolation of other muscles; 2) effectively retraining slow twitch muscle fiber function through isometric contractions (low loads, sustained hold times); 3) repetition: to aid motor reprogramming; 4) teaching co-contraction of the target muscle, first with other deep muscles, then the global muscle network and 5) training carryover for physical and functional tasks of increasing levels of difficulty.

“Exercises that target the deep abdominal muscles with minimal external loading in the spine have been shown to be effective in increasing lumbar stability, thus treating and preventing the recurrence of LBP.” (Teyhen et al., 2008; Axler & McGill, 1997).

The physiotherapists at Corona Station Physical Therapy recognize the importance of specific exercise prescription and a properly executed home exercise program to ensure optimal rehabilitation results. Time is spent educating the client as to the importance of the exercises they are given, while frequent review ensures proper exercise technique and allows for appropriate progressions. We believe it pays to be picky! For more information, please contact us at the clinic by phone or email and ask to speak to one of our physiotherapists.

Plantar Fasciitis

Physiotherapy Treatment of Plantar Fasciitis

What is Plantar Fasciitis?

Plantar fasciitis is a common condition causing pain in the heel, which can radiate into the foot. It is typically seen in people age 40-60 but can also occur in younger people who are on their feet a lot, like athletes or soldiers. Plantar fasciitis may present in one foot or both feet. The plantar fascia or arch ligament runs under the foot from the calcaneus to the metatarsal heads at the ball of the foot. It is thought to be an inflammatory condition as well as involving some degeneration of the collagen fibres close to where the plantar fascia attaches to the calcaneus. 

A variety of causes or contributing factors exist for plantar fasciitis. Some of the most common causes include:

  • excessive weight load on the foot due to obesity or prolonged standing
  • mechanical imbalances through the joints of the foot
  • sudden increase in walking or running (overuse)
  • tight calf muscles, which also insert into the calcaneus
  • wearing shoes with poor support, including flip-flops

The most common treatments for plantar fasciitis include:

* icing the affected area

* use of custom-made orthotics with your shoes

massaging the plantar fascia

* nonsteroidal anti-inflammatory drugs (NSAIDs)

* steroid injections

* strengthening the foot and lower quadrant muscles

* wearing a night splint

* wearing shoes with arch support

* stretching the calf muscles

* physiotherapy (which often includes many of the above)

Clinical Implications:

There is no single cure for plantar fasciitis. Whilst many treatments can be used to ease pain, in order to treat it effectively long-term, the cause of the condition must be addressed. A recent randomized controlled trial (2011) investigated the effects of trigger point (TrP) therapy combined with a self-stretching program for patients with heel pain. After one month, the patients receiving a combination of calf muscle and plantar fascia stretching and TrP release had significantly greater improvements in their calcaneal pressure pain thresholds, functional and pain scores as compared to those receiving only the self-stretching program.

Physiotherapy Treatment: 

For patients presenting with plantar heel pain it is important that all contributing factors be addressed. At Corona Physio-Rehab Centre, we are able to address the biomechanical factors and provide education, custom orthotics if indicated, and personalized home programs of stretching and strengthening. We also assess the gastrocs and soleus muscles for tight bands, knots, and trigger points and treat them using various deep tissue release techniques. Dry needling has also been found to be very effective in releasing these trigger points. For further information, please contact us at the clinic and ask to speak to one of our physiotherapists.


Renan-Ordine R et al Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: a randomized controlled trial. J Orthop Sports Phys Ther. 2011 Feb;41(2):43-50. Epub 2011 Jan 31