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Kevin Durant, Durantula, easymoneysniper, whatever you want to call him is a superstar basketball player and is regarded by many as the second best basketball player in the world. Unless you have been living under a rock in Toronto, you should know his name and the impact of his eventual return to the NBA Finals.  Moreover, if you’re a therapist like me, you may feel disgusted about the mismanagement of his return to the court on Monday.

Here are the facts:

  • Kevin Durant was diagnosed with a right calf strain on May 8th, 2019, which many suspected was an Achilles strain to begin with. Grade 1 Calf Strain can take anywhere from 7-10 days to resolve. Durant was out for a whole month!
  • Kevin Durant was cleared for practice on June 9th and he did so with his teammates (unsure of the extent of this practice as it was closed off to the media)
  • After his practice, Kevin Durant is noted leaving practice with a slight limp and ice on his right Achilles (to help with possible pain/inflammation?)
  • A few hours before tip off he is upgraded to questionable to play in game 5 of the NBA finals, and 90 minutes before tip off it is known that he is cleared to play and will start in game 5, with no minutes restriction. WHAT?
  • Kevin Durant does indeed start game 5, and starts off hot connecting on his first 3 attempts beyond the arc and scoring 11 points in the first quarter.
  • At 9:46 of the second quarter, Durant came up the court and tried to accelerate past Ibaka with his right foot planted, and that was enough. Durant fell to the ground holding his right Achilles.
  • Teammates and opposing players help him back to the locker room, and post game Durant is seen leaving the Scotiabank Arena in a walking boot and crutches
  • Durant is expected to fly to New York to have an MRI done, which many believe will confirm a right ruptured Achilles.

What is an Achilles Tear/Rupture and what does it mean for Durant?

The Achilles tendon is the largest tendon in the body. It connects your calf muscles to your heel bone and is used when you walk, run, and jump.

Achilles tendon ruptures can occur spontaneously in individuals and one symptom many people display is the pop or gunshot sound of their Achilles tendon rupturing. If you look in the video above, you can notice the pop of the Achilles and the subsequent vibration of the calf muscles accordingly.

Detailed in an article by Physio Works it states:

Achilles Ruptures occur mostly in middle aged men, most of whom play recreational sports Injury often occurs during recreational sports that require bursts of jumping, pivoting and running.

They can happen in these situations:

  • You make a forceful push-off with your foot while your knee is straightened by the powerful thigh muscles. One example might be starting a foot race or jumping.
  • You suddenly trip or stumble, and your foot is thrust in front to break a fall, forcefully overstretching the tendon.
  • You fall from a significant height.

The biggest risk factor for Achilles tendon rupture is tendon cell death which occurs as a result of poorly managed tendinopathy.  

As noted in the bold statements, these are the exact scenarios which led to the possible tendon rupture for Kevin Durant, with strong emphasis on the second statement!

While we don’t know the extent of Kevin Durant’s Achilles tear, we can only speculate that it is a complete rupture and thus provide this comparative timeline on his return to that of another NBA player, Rudy Gay, who tore his Achilles in 2017 at the same age, and has the body frame similar to that of Durant.

If the MRI on Tuesday confirms a complete tear and Durant follows a similar timeline to that of Gay

  • Durant will undergo surgery to repair the tendon
  • He will be on crutches and in a boot for the next six weeks.
  • He will start physical therapy in two weeks and formal rehabilitation at eight weeks post-surgery.
  • >12 weeks post he can begin sport specific training
  • Return to sport is anticipated in 6 months

Now if Kevin Durant is able to follow the same path as Rudy Gay, what are the implications to his career? He was a free agent this year hoping to be signed to a max contract with the team of his choosing as every team salivated at the idea of signing him (Brooklyn, Knicks to name a few). Will teams take that gamble anymore? It’s Kevin Durant, so I am sure they will. Yet, he may be forced to stay in Golden State another year as he returns to the court to prove that he isn’t damaged goods. Keep in mind, numerous athletes in the past were never the same after facing a similar injury. Kobe is one that comes to mind, and this ultimately led to his retirement. Currently we see the same with Durant’s teammate Demarcus Cousins who went from being an all-star to a bench caliber player. Moreover, Rudy gay was quoted as saying that it took him almost a full year and a half to feel 100% again. Which scenario will apply to Durant? How long, if ever, will it take for him to be truly 100% again, as he sits in the prime of his career? All valid questions probably going through Kevin Durant’s head as he awaits his MRI results on Tuesday.

Moreover, as we await the results of the MRI, I also question the doctors, therapists, and ownership of the Golden State Warriors on making the decision for Kevin Durant to return to Game 5. I get that the athlete has the final say as to whether they want to play or not (Kawhi Leonard comes to mind here ironically), but considering the immense amount of pressure put on Durant to help the Warriors avoid upset, and amplify his legacy, one can only point the finger at the medical and management team for allowing him to go out there. He was clearly still nursing a calf strain (and/or possible grade 1 Achilles strain). He was clearly not pain free, nor was he recovered from a metabolic and vascular standpoint in that calf to Achilles region. So, was the chance at a three-peat really worth risking the health and career of one of the best players in the league?

I guess now that we know the outcome of that decision, all members involved will have to carry that guilt. Just remember therapists, don’t lose your credibility as a health care practitioner with unrealistic outcomes for some championship trophy, financial gain, or anything to inflate your ego. Always do what you clinically know is right for your client, and PLEASE educate patients that no pain no gain is not a real motto.

Amrit Tiwana, M.Sc. PT

The post Kevin Durant & the “Calf Strain” Gone Wrong! appeared first on Triangle Physiotherapy.

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The post 2018 80’s style Christmas Party appeared first on Triangle Physiotherapy.

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What is Autism?

Autism is a developmental condition, present from early childhood, that is characterized by a great difficulty in communicating and forming relationships with other people and in using language and abstract concepts. It is also known as Autism Spectrum Disorder (ASD). People with ASD have delays and limitations in many areas. They may have low muscle tone, or have a tough time with coordinated muscle movement with activities like running, kicking, throwing, etc. These issues can hinder the smooth functioning of day-to-day tasks and ASD is almost certain to interfere with physical and neurological development.

How can Physiotherapy help with Autism?

People with ASD often have physical symptoms that range from having difficulty with coordinated tasks to significantly lacking muscular strength. Physiotherapy can help children with ASD improve their basic motor skills like sitting, rolling, standing and playing. They may also work with parents to show them techniques that can be used at home to help their child build strength and improve coordination.

For adults, physiotherapy may help in more advanced fine-motor skills such as skipping, kicking, throwing and catching. A physiotherapy session will assess the person’s overall motor function, identify difficulties, and provide an intervention to address the underlying difficulties. Strategies used as part of physiotherapy treatment can include:

  • Specific exercises for building muscle strength and improving posture, endurance, motor skills and balance.
  • Recommendations to improve the person’s positioning, bracing, and taping skills.
  • Feedback to improve body posture and range of motion.
  • And complete support to participate in community-based physical activity programs.

Physiotherapists are trained specialists that deal with all the concerns related to Autism and can help teach a child or an adult to stretch shortened muscles or strengthen weaker ones. In some cases, a physiotherapy session can simply look like organized fun, and while it should be enjoyable, all of the exercises are geared towards functional improvement.

The post Physiotherapy For Autistic Children appeared first on Triangle Physiotherapy.

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What is a Custom Molded Splint?

It is a hand-made brace which is usually made from a thermoplastic material and requires the skill of a therapist to measure, trace, and adjust in order to accurately fit their patient’s hand. Custom splinting is used to either immobilize or mobilize structures to promote healing or function.

How is a Custom Molded Splint made?

While the procedure itself is fairly straightforward, the making of the splint takes a lot of expertise and practice. A hard sheet of thermoplastic material is used to create a pattern that is perfectly molded to the patients’ hand. This template is then heated to over 160° in order to allow the temperature-sensitive material to become flexible. After it cools down, the material is placed and molded directly on the patient, providing a fit matching the curves and contours of the client’s hand. Splinting is a very effective way to facilitate a patient’s recovery for a variety of conditions.

Custom Splints vs. Over-the-Counter Splints

Over-the-counter splints, which can be found at drugstores or online stores, are typically available in small, medium, and large sizes. They are not created to specifically match your hand and can be difficult to adjust. By investing in a custom splint that is made to fit your hand specifically, you will be more likely to use the splint and to achieve better clinical outcomes.

Benefits of Custom Molded Splints

A common group of diagnoses for which splinting is indicated includes: tennis elbow, golfer’s elbow, trigger finger, carpal tunnel syndrome, and many others. These types of conditions are caused by overuse of muscles that cross a specific joint or by compression caused by the joint itself. Wearing a splint prevents movement of the relevant joint which allows affected structures to rest, and along with a therapy program, can resolve symptoms. Splints that are specifically tailored to a patient’s functional limitations can make a difference in a person’s life by relieving pain, stabilizing joints, and protecting vulnerable tissues. This, in turn, promotes physical well-being.

Additional benefits from splinting can be found in those with degenerative arthritis. Osteoarthritis often first manifests at the joint located at the base of the thumb, also known as the carpometacarpal (CMC) joint. The CMC is used excessively in our daily lives, especially for those that have occupations that require the forceful use of the thumb (like hand therapists). This joint can break down over time, leading to joint instability and pain. A custom splint provides the external support the thumb needs to compensate for the internal support the joint no longer provides. Patients often notice immediate pain relief with the use of a splint and, with accompanying education from the therapist, become more functional with daily activities.

Though splinting can be highly effective for a wide variety of conditions, it is only a supplement to treatment. Long-term splint usage is rarely indicated and should be discontinued based on healing and symptoms. Splint wear without a therapy program can lead to joint stiffness, weakness, and other problems. Splinting can prevent further injury, but does not repair the body. Splinting and a comprehensive therapy program work hand-in-glove to resolve the underlying pathology while preventing further structural damage. The art of Custom Splinting has changed drastically over the past several years. With advanced qualities of the thermoplastic material and splinting accessories, along with increased knowledge of biomechanics and theory, wrist and hand splinting has become an effective and important part of therapeutic treatment for upper extremity disorders.

The post Custom Molded Hand Splint appeared first on Triangle Physiotherapy.

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We’ve all heard how good running can be for you. Running helps to lose weight, prevent disease, lower stress, strengthen joints, manage blood pressure… the list goes on and on. But there’s a suprising problem you may be experiencing if you’re a long distance runner. It’s called leaky gut. I know, it sounds gross, but if you’re a runner then it’s something to keep in mind. How do you know if you have a leaky gut? Read on to find out common symptoms and how to treat it.

What is leaky gut, anyway?

Leaky gut, also known as intestinal permeability, is a dysfunction in the lining of our intestine. Our intestinal walls are only one cell layer thick. Their job is to absorb nutrients and prevent bacteria from getting into our bloodstream. When the cells of the gut lining start to separate and let bacteria enter the bloodstream, we get what we call leaky gut. This can lead to all kinds of health issues, including:

  • allergies
  • asthma
  • autoimmune disease
  • eczema
  • psoriasis
  • rheumatoid arthritis
  • food sensitivities
  • irritable bowel syndrome
  • Crohn’s disease
  • ulcerative colitis
  • thyroid problems
  • acne
  • nutrient deficiencies
  • depression and other mood disorders
How does running lead to leaky gut?

It’s actually not just running that can lead to leaky gut. Powerlifters and people who do cross-fit are at risk, too. Same goes for anyone who does vigorous strength training or heavy exercise. The gut lining becomes more permeable due to the amount of stress put on your body by these types of activity. High physical stress leads to higher metabolic demands. Endurance sports do appear to have the most profound effect on leaky gut though, which is why you might be more concerned if you’re a marathon runner, cyclist, or triathlete.

When you exercise, plant-derived carbohydrates are digested and fermented by the gut. This can create some harmful byproducts that play a role in creating leaks in your gut. Once you have a leaky gut, toxins are more easily able to cross from your intestines into your bloodstream.

Endurance exercise can also increase our secretion of pro-inflammatory cytokines. This means that more inflammation is happening in the gut, which can throw off the balance of good bacteria versus bad bacteria in the intestines.

If you know me, you know I don’t like talking about health issues without some scientific studies to back up what I’m saying. So let’s take a look at one. Researchers looked at LPS (lipopolysaccharide) levels in athletes. They chose to look at LPS because it is a toxin found in bacteria. They measured LPS from blood samples of 29 athletes before, immediately after, one hour after, two hours after, and 16 hours after a triathlon. What they found was that LPS in the blood increased immediately after the race. But guess what? LPS was even higher than that one hour later. This demonstrated that there was an increase in leaky gut both during and after intense exercise.

I think I might have a leaky gut… now what?

Don’t hang up your running shoes just yet, folks. There might be a solution to those leaks in your gut. Remember how I mentioned that the balance between good and bacteria in the gut can get thrown off? Well, one way to help restore that balance is by taking probiotics. Probiotics are known as the good, healthy bacteria that we want and need in our gut. There are many different strains of probiotics. The two that have been shown to be most helpful with leaky gut is called Lactobacillus and Bifidobacterium. These strains help cells of the intestinal wall to tighten up the gaps between them.

A study demonstrated that probiotic supplements reduced LPS levels in the blood. This led to less leaky gut as well as an increase in the amount of time it took to reach fatigue while exercising in hot temperatures. This means that probiotics could actually help to improve athlete performance, too!

If you are a runner and suspect you may have a leaky gut, don’t wait until deteriorating health issues come along. Act now by calling the clinic to book your appointment with Dr. Corina Kibsey, ND today.

The post The surprising problem you might have if you’re a runner appeared first on Triangle Physiotherapy.

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Exercises are great, and if done regularly they are one of the most important aspects of a healthy lifestyle. They help manage your weight and reduce the risk of chronic diseases development. For certain conditions, specific exercises can be even more beneficial as they can help with condition management and prevention. Spondylolisthesis exercises can help patients suffering from Spondylolisthesis or back pain, thigh pain and stiffness in the back and legs.

What is spondylolisthesis? Triangle Physiotherapy Spondylolisthesis

Spondylolisthesis is a condition which affects the lower vertebrae, or lumbar spine. It involves one vertebrae slipping forwards or backwards in relation to the vertebra below. It causes pain in the back itself and can also cause nerve impingement of the nerves of the lower back. While it may sound like surgery would be the only option for a condition like this, exercises can play a significant role in managing symptoms and increasing range of motion in this condition.

Now that we know more about Spondylolisthesis, let’s look at some of the causes

  1. Causes can vary with age, health, lifestyle and heredity. While children can suffer from Spondylolisthesis as a result of birth defect, people from all ages are susceptible to the condition.
  2. Any sport that causes stress on your lower back can result in the development of this condition. Some examples are: gymnastics, weightlifting, football, etc.
  3. Any trauma or injury, such as in a car accident, can also be the reason for vertebra to slip forward or backward.
Spondylolisthesis exercises

Spondylolisthesis or spondylolysis exercises are recommended by clinicians as they focus on improving range of motion and strength in order to and reduce muscle strain. The following are good beginner exercises to improve overall spine health:

  1. Pelvic tilt
  2. Dead Bug
  3. Partial curl
  4. Gluteal stretch
  5. Double-knee to chest
  6. Bird-dog
  7. Side Plank
  8. Twisting the lower back

Avoid high impact exercises and heavy weight lifting. At Triangle Physiotherapy, we will conduct a thorough assessment of your condition and develop a custom treatment plan which will involve exercises that address your individual needs. Book an appointment today with one of our clinicians and feel relief from your back pain once and for all!

The post Spondylolisthesis exercises appeared first on Triangle Physiotherapy.

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Our knees support the weight of our bodies with each step we take. When we begin to experience knee pain, it can be very debilitating, especially if the pain is severe. Some common causes of knee pain are: joint strain or damage, patellar maltracking, obesity, poor foot biomechanics, and many others. In some cases, severe osteoarthritis (OA) can be the cause of the knee pain. While exercises are extremely beneficial in building muscular support and managing the effects of the OA, a knee brace can be a good intervention to provide support and delay any surgical intervention. It can help to reduce swelling and pressure on the joints and can shift weight away from the damaged and painful areas of the joint. This can significantly improve a person’s mobility by decreasing their pain.

What is Osteoarthritis?

Osteoarthritis (OA) is the most common joint condition. At its core, it is the deterioration of the cartilage which lines our joints and makes movement fluid and pain-free. While mild OA is a normal age-related change, severe OA involves a significant reduction in the amount of lubricating fluid (known as synovial fluid) within the joint. This can cause significant pain with movement, stiffness, and imbalance because of a more bone-on-bone type of feeling.

Knee brace for Osteoarthritis

As mentioned above, a knee brace can be a good management option for dealing with the effects of OA. A good knee brace will offer the support you need in order to balance and evenly distribute your weight in order to have a more comfortable walk or run. Material used to make braces can be plastic, metal, or sometimes composite materials. In addition, synthetic rubber is used for positioning and padding. It’s made in way so that your skin can breathe while your knees are supported.

Types of knee braces in osteoarthritis

There are three styles of braces: Basic, Compression and Unloader for three different levels of support.

  1. Basic braces are for those who suffer from mild pain that worsens with activity and motion. Most people wear them while exercising or walking/running for long periods of time.
  2. Compression sleeves/advanced braces provide support for moderate osteoarthritic pain. They are generally worn during exercise in order to keep the joints warm and hold the knees in proper alignment.
  3. Unloader braces are for severe osteoarthritis. They are worn when a person is suffering from severe pain due to their knee OA and will physically unload the joint, causing less pressure to go through it.

We at Triangle physiotherapy will assess you knee joints and develop a complete treatment plan for you. Our expert physiotherapists can help you choose the correct knee brace to manage your OA. Book your appointment now and feel some relief so you can get back to your normal life as soon as possible!

Visit Here: http://www.trianglephysiotherapy.com

The post Knee brace for Osteoarthritis appeared first on Triangle Physiotherapy.

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Triangle Physiotherapy by Darshan Jain - 6M ago

The ankle joint, or talocrural joint, is a synovial joint (meaning lubricated joint) which mimics a hinge. It has a unique design that allows it to withstand 1.5 times a person’s body weight when walking and about 8 times a person’s body weight when running. The ankle is divided into 5 main sections, which are:

  1. Bones and joints
  2. Ligaments and tendons
  3. Muscles
  4. Nerves
  5. Blood vessels

Ankle bones

The ankle joint consists three bones: The ankle bone (Talus), shin bone (Tibia), which holds the Talus at the lower end along with a parallel thinner bone (Fibula) and the heel bone (calcaneus). The talus has a socket-like structure which allows it to work like a one-directional hinge.

Ligaments and Tendons

Ligaments and Tendons serve similar functions but in slightly different ways. While they are both referred to as “soft tissue” structures, ligaments attach bones to bones while tendons attach muscles to bones. Both of them are made of collagen fibers.

Muscles

Muscles work by stretching and contracting, which allows us to walk, run and jump. Below are some of the most prominent muscles of the lower leg:

  • The peroneals (peroneus longus and peroneus brevis) are located on the outside edge of the ankle and are mainly responsible for bending the foot down and out.
  • The calf muscles (gastrocnemius and soleus) connect to the calcaneus by the Achilles tendon. When the calf muscles tighten, they bend the ankle down.
  • The tibialis posterior muscle supports the arch of the foot and helps turn the foot inward.
  • The tibialis anterior pulls the ankle upward.

Nerves

The nerves on the outer edge and front part of the ankle control muscle movement and provide sensation to the top and outside edge of the foot.

Blood Vessels

There are many arteries which supply blood to the ankle such as the dorsalis pedis, tibial artery, etc. Without adequate blood supply, the muscles of the ankle would not be able to function and would cause significant impairments.

We have 6 clinics located across the GTA: EtobicokeOakvilleMississaugaNorth York, and Toronto (King Street West and Yonge Street. If you are suffering from foot or ankle problems you may benefit from treatment. Don’t suffer any longer! Call or email us today and we will be happy to answer all of your questions.

The post Ankle Anatomy appeared first on Triangle Physiotherapy.

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