What causes leg pain?

There are various causes of leg pain. If the pain is accompanied by significant swelling, it is strongly recommended that you consult a doctor to rule out other diagnoses.

A common cause of pain in the leg is an irritation of a nerve coming from the spine such as the sciatic nerve. A low back injury is the usual culprit that can result in this type of nerve irritation, which can cause numbness, tingling, or a weakness in the leg or foot. Conservative treatment for such an issue usually involves physiotherapy through manual therapy and exercise for the low back.

Another contributing factor for leg pain is biomechanics, which can involve decreased joint mobility or muscle weakness. Joint stiffness in the hip, the knee, or the foot can have repercussions for the rest of the leg since these joints work in concert with each other like the gears of a machine. Weakness in a muscle can at times lead to a lack of joint mobility. Furthermore, this weakness can cause muscle tension which results in pain. Manual therapy and specific exercises help improve joint mobility. Certain exercises can also target muscles that need strengthening. In short, physiotherapy helps restore proper biomechanics to reduce pain in the legs.

For more information, you can consult my website francisphysio.com or contact me 514-963-0519.

Pelvic Floor Physiotherapy

What is pelvic floor physiotherapy? It is the field of physiotherapy that aims to strengthen and optimize the functioning of the pelvic floor. The pelvic floor is the group of muscles, tendons, fascia (connective tissue), and ligaments that are located at the bottom of the pelvis. Its functions include:

1) urinary and fecal continence

2) support for the pelvic organs (bladder, uterus, vagina, prostate, rectum)

3) sexual function

4) participation in breathing (synchronized movement with the diaphragm)

5) one of the stabilizers of the trunk and of intra-abdominal pressure (part of the core)

When there is weakness, abnormal tone, surgery, or injury that occurs in this region, it can affect one or more of its functions. Pelvic floor physiotherapy helps to address these issues through specific exercises, patient education regarding their case, and external or internal manual techniques. This domain of physiotherapy can treat various conditions:

  • incontinence

  • pelvic and genital pain

  • urinary issues

  • sexual dysfunctions

  • pelvic organ prolapse

  • post-partum

  • post-pelvic surgery

  • post-prostatectomy

Due to taboos and misconceptions surrounding the pelvic and perineal area, there are multitudes who live with problems in this important part of the body. For more information, ask a doctor or a physiotherapist.

514-963-0519

francisphysio1@gmail.com

francisphysio.com

Reference: Pain during sex? Incontinence or constipation? You might benefit from pelvic floor physiotherapy – Health e-News (mcgill.ca)

Dizziness and Vestibular Rehab

Balance control is made up of 3 components: vision, proprioception, and the vestibular apparatus of the inner ear. All three work in concert to orient us within our physical environment. When there is a problem with one of these elements, it causes balance issues including dizziness and vertigo.

Dizziness means a sensation of instability in space. Vertigo is the phenomenon whereby one has the impression that their surroundings are spinning around them.

The most common vestibular diagnosis that physiotherapists treat is BPPV (benign paroxysmal positional vertigo). Within the vestibular apparatus of the inner ear (consisting of three semicircular canals), there are very tiny crystals that are fixed onto hair cells, which transmit information about the position of the head to the brain. In BPPV, these crystals have become detached from the hair cells, which confuses the signals coming from the vestibular apparatus and consequently elicits vertigo. To remediate this issue, the physiotherapist prescribes specific maneuvers to remove the detached crystals from the affected semicircular canal.

Dizziness is also one of the concussion symptoms that physiotherapy can address. Due to the cerebral trauma leading to a concussion, the coordination of various cerebral processes such as the oculomotor reflexes is disrupted. The oculomotor reflexes refer to the automatic eye movements that occur in response to the head movements. When these reflexes are affected, dizziness can ensue. In physiotherapy, the patient performs progressive exercises that improve the coordination between the eye movements and those of the head and body.

Cervicogenic dizziness is another form of dizziness which is caused by excess muscular tension and stiffness of the neck (cervical) vertebrae. Muscles and ligaments particularly those of the neck contain proprioceptors, which are nerves responsible for the orientation of the body part controlled by the muscles and ligaments. When there is significant tension and stiffness in the neck, the signals coming from the proprioceptors become confused, which can cause dizziness. Through manual techniques and certain exercises, physiotherapy can help resolve this problem.

514-963-0519

francisphysio1@gmail.com

francisphysio.com

Pelvic and Genital Pain

Did you know that certain types of pelvic and genital pain can be treated by physiotherapy? Certain nerves that originate from the lower part of the spine innervate the pelvic region. When these nerves become irritated, this can cause pain and abnormal muscle tension in the pelvis and the genital areas, which can lead to urinary or fecal incontinence. Treating the joints and muscles of the spine and pelvis can relieve the pain and address the incontinence. Consult your doctor to find out if physiotherapy can address your pelvic and genital issues. For further information or to book an appointment, you can reach me at 514-963-0519 or consult my website francisphysio.com

I am open despite COVID-19

I have made the transition to telerehab (virtual sessions) to be able to continue to help people who are experiencing pain or functional difficulties.

My goal remains the same: to help enable you as efficiently as possible to perform your daily and recreational activities.

Through virtual sessions, specific therapeutic exercises and tailored advice in accordance with your issues are the main modes of treatment. If necessary, a family member or a friend can perform certain manual techniques under my guidance.

We can treat various conditions via telerehab:

● injuries

● musculoskeletal conditions

● certain neurological issues

● headaches and dizziness

● cardiorespiratory problems

The fees are $25 per 15 minutes. For more information or to make an appointment, you can reach me at 514-963-0519 or by email frank_pt77@hotmail.com

Telerehab

During this period of social distancing, physiotherapists need to have recourse to remote sessions for cases not requiring in-person treatment and for physically vulnerable patients. Through teleconferencing, I am able to carry out an assessment, provide advice, and prescribe therapeutic exercises. For further details, you can reach me by telephone 1-514-963-0519.

Persistent pain in the upper and lower limbs

I have treated several patients suffering from persistent pain in the upper and lower limbs. Despite imaging exams that did not reveal lesions in the painful region, and despite having undergone other treatments, these patients continued experiencing symptoms. In most of these cases, the main cause of the issue can be found above or below the problematic area. As an example, pain in the elbow can be triggered by a biomechanical issue at the wrist, or originate from the neck due to the nerve connections. By a similar reasoning, a lack of hip or ankle joint mobility, or nerve irritation stemming from the low back, can lead to knee pain. A detailed assessment will allow us to formulate a treatment plan that will consist of manual therapy and specific exercises. For further information, or to schedule an appointment with me, please leave me a message at 514-934-2334 ext 509.

Headaches

There are certain types of headaches that can be treated by physiotherapy. Joint stiffness in the neck, and tension in the upper back as well as in the sub-occipital muscles located at the back of the neck and just below the skull can provoke headaches. The treatment regimen consists of manual therapy (joint mobilizations) and specific exercises. If, however, you are experiencing intense and unrelenting headaches, it is strongly recommended that you consult a doctor.

Calf pain

If you are experiencing pain in the calf, you must examine it for swelling, redness, and a temperature increase. Redness with an elevated temperature likely indicates a circulatory problem. In this case, it is imperative that you immediately go to the emergency room! If there is no redness, you can consult a doctor or a physiotherapist.

Diaphragmatic Breathing

Diaphragmatic breathing involves the adequate contraction of the diaphragm while breathing in. Many people tend to overuse the muscles of the neck during respiration, which can lead to negative consequences:

 - pain in the neck and upper back due to excess muscle tension and stiffness in the spine and ribs
- a reduction in oxygen intake by the lungs due to the insufficient contraction of the diaphragm, which acts as a pump
- pain in the low back and the pelvic area resulting from a decrease in diaphragmatic contraction, which can contribute to a lack of muscular stabilization in the back and the pelvic region

A method for practicing diaphragmatic breathing:

- place the hands on the abdomen
- take a deep and slow breath through the nose while applying a light pressure on the abdomen with the hands to stimulate contraction of the diaphragm
- exhale slowly through the mouth

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3924606/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4183256/

For further information, you can contact me at 514-934-2334 ext 509.

Does treating the mid-back affect the low back and the hip?

Throughout my extensive experience in treating back pain, it is clear that the mobility of the thoracic spine (mid-back) and rib cage plays a key role in issues in the upper and low back as well as in the pelvic region and the hip. Currently, I have patients experiencing pain in the lumbosacral area (low back) and the hip, who have greatly benefited from manual therapy (joint mobilizations) at the thoracic spine. I am also treating a dancer with pain and chronic stiffness at the lumbar spine, the sacro-iliac joint (between the base of the spine and the pelvis), and the hip, who experienced significant positive results from manual therapy and McKenzie exercises (specific repeated movements) targeting the thoracic region.

There are two main reasons for the effectiveness of treatments at the thoracic region for the lumbopelvic area and the hip: (1) The functional connectivity between the thoracic spine, the low back, and the pelvis means that these areas work in concert with each other to enable the execution of various movements; (2) the thoracolumbar fascia functions as a crucial muscular link between these different parts.

Pain and the Connectivity of Different Parts of the Body

Recently, I was treating a patient who had knee pain and difficulty doing certain sports activities. Radiological exams did not reveal any lesions in the knee. During the physiotherapy assessment, the knee pain could not be elicited. However, I found a muscle weakness in the hip/gluteal area as well as a significant lack of joint mobility in the foot. Thus, my clinical impression is that the issues in the hip and the foot were contributing to the knee pain, since the entire leg like other regions of the body functions as a whole, like a chain. In the end, without having to directly treat the knee, we succeeded in eliminating the pain and in significantly improving his athletic performance. In conclusion, in certain cases, the factors contributing to pain in a specific part of the body can originate from elsewhere due to the connectivity of various areas.

Physiotherapy and Sexual Function

Although sex is often a delicate and even a taboo subject, it is a significant part of human life and activity. With regards to physiotherapy, it is the "activity" aspect that is pertinent. Sexual intercourse involves most of the body, from the head to the feet. Musculoskeletal pain and nerve-related symptoms (tingling, numbness) can hinder sexual acts or be aggravated by the latter. As a health care professional, helping people improve their sex life by treating biomechanical issues forms part of the clinical skills of the physiotherapist. For more information, you can contact me at 514-934-2334 ext 286.

The Thoracic Region: an area less often explored

When talking about back pain, upper and low back issues are commonly seen. Even though we do not often hear about pain in the thoracic region (the mid-back), it is nevertheless an area that plays a significant role in problems in other segments of the spine and even in the arms.

Considering the spine is a chain, issues that arise in the neck and in the low back can indeed come from the thoracic spine. A significant lack of mobility or faulty biomechanics in the thoracic zone can lead to pain and tension in the neck, the lumbopelvic area (the low back and the pelvis), the shoulders, and the arms. The fact that arm movements entail vertebral movement and muscle activity in the thoracic area demonstrates the link between these two parts of the body. Therefore, treatment of the neck, the low back, the shoulder, and the arm can involve the thoracic region.

Shoulder Tendonitis

Shoulder tendonitis involves an inflammation of a tendon, the part of the muscle that attaches to the bone. Repetitive movements and positions or sudden awkward movements can lead to tendonitis.

Contributing factors often include faulty biomechanics, which is one of the main targets of physiotherapy. Anatomical components that can adversely affect biomechanics are joint mobility limitations in the shoulder or upper back region, erroneous positioning of the arm or the back during certain movements, and an imbalance in the strength of muscles in the upper extremity and the back.

Assessment in physiotherapy helps determine the factors causing pain, and a treatment plan is then formulated according to these factors and the patient's needs and goals. The treatment sessions often entail a combination of manual treatments, exercises, and advice regarding posture and the proper execution of specific movements. Consult a licensed physiotherapist to begin the process towards recovery!

My Tailored Physiotherapy Approach

Assessment in physiotherapy involves a systematic analysis of the problem at hand (pain, lack of movement, etc) in order to devise a treatment plan that is congruent with the patient's / client's goals.

My clinical approach consists of determining the contributing factors by evaluating the joint mobility (manual therapy), the movements that relieve and aggravate the symptoms (McKenzie method), and the biomechanics of the affected movements and activities (postural approach).

This detailed analysis allows us to establish the relative importance of the above methods in the patient's care, which is carried out through manual treatments, patient education, and prescribed exercises.