Speciality Programs

Running Biomechanical Assessment
Persistent/Chronic Pain Program
Compression Clothing
Orthotics
Facial Neuromuscular Retraining
Custom Knee Braces
Vestibular Therapy
Hand Program
GLA:D Program
Running Biomechanical Assessment

The comprehensive assessment will be performed by one of our running biomechanical experts and will consist of:

  • Video analysis of your running mechanics on a treadmill from multiple angles
  • Graphic analysis of your cadence/ vertical oscillation/ground contact time/ ground contact time which allows us to see where improvements can be made to improve your running efficiency
  • Testing of key areas for strength, endurance and flexibility
  • Data collection of past injuries
  • Data collection of performance in your races
  • Analysis of your running shoes and foot posture along with your running mechanics to determine if you are in the correct type of running shoe

From all the data gathered, we can compile a detailed program of areas that need to be worked on.

We offer group training programs or individual sessions where our team of experts will work with you to:

  • Strengthen critical areas
  • Correct abnormal/inefficient movement patterns/running posture
  • Ensure that you have good mobility through the critical joints/myofascial structures
  • Correct breathing patterns.
Persistent/Chronic Pain Program

Why do we care about persistent/chronic pain?

  • 1 in 5 Canadians older than 18 years old live with persistent pain that is 1 in 5; 50% experience persistent pain for >10 years3
  • Persistent pain is defined by ongoing pain for ≥3 months
  • Arthritis is reported as #1 cause of pain5
  • Most commonly reported sites of arthritic pain are: Lower back -> Upper back ->Knee5.
  • Yet there’s a low association between the experience of pain (i.e., low back pain) and arthritis (Figure 1)
  • Studies show degenerative changes and tears in the spine, knees, shoulders and hips seen on imaging (e.g., MRI/x-ray/ultrasound) has a POOR relationship to your current pain/function & DOES NOT predict future episodes of pain1,2,4
  • For example, ‘abnormal’ scan results are found in pain-free individuals (i.e., 91% disc degeneration, 56% disc herniation, 72% shoulder labral tear & 97% meniscus injury)
  • Strong evidence against unwarranted imaging as it can lead to poorer health outcomes, greater disability and work absenteeism2

Here at Bayview Physiotherapy & Sports Medicine Clinic, Sam Lee has developed widely popular and fast growing online evidence based platform called Neuro Ortho Based Approach (NOBA). This includes:

  • Explaining to you why the pain experience is different in every individual
  • What factors influence your perception of pain
  • Explaining why pain doesn’t always equal harm and why pain doesn’t always mean tissue injury
  • How we can deal with other factors that influence our persistent pain
  • Setting realistic short and long term goals
  • Empowering and giving you the tools to self-manage in order to live your life to the fullest
  • You will find that some of the internationally recognized physiotherapists and leaders in the field of rehabilitation are following NOBA to keep up with the latest evidence!

Figure 1: Poor relationship between arthritis and low back pain. You can have severe arthritis and no pain. You can have severe pain and no arthritis. Mind blown? You bet!

References:

  1. Beattie et al. (2005). Abnormalities Identified in the Knees of Asymptomatic Volunteers Using Peripheral Magnetic Resonance Imaging.
  2. O’Sullivan et al. (2014). Acute Low Back Pain. Beyond Drug Therapies.
  3. Schopflocher et al. (2011). The Prevalence of Chronic Pain in Canada.
  4. Schwartzberg et al. (2016). High Prevalence of Superior Labral Tears Diagnosed by MRI in Middle-aged Patients with Asymptomatic Shoulders.
  5. Videman et al. (2003). Association Between Back Pain History and Lumbar MRI Findings.
Compression Clothing
  • Compression clothing (socks, sleeves, shorts, etc.) are worn by elite level athletes or runners to help improve performance and facilitate recovery
  • ↑ running endurance, muscle temperature, circulation & recovery process
  • ↓ rate of injury, muscle pain and inflammation

Orthotics
  • Your feet play a huge role for any daily activities
  • Your feet are sensors & stabilizers and allows you to help balance during standing and walking
  • Your feet are the only parts of the body that is in contact with the earth
  • People with extreme low arches (over-pronation) may add unnecessary stress on knee, hip and low back joints thereby contribute to ↑ risk of injury
  • Extreme high arch (over-supination) feet have poor ability to absorb shock from the ground thereby it can contribute to ↑ risk of injury
  • Those who are experiencing foot symptoms should consider orthotic inserts.

Book an appointment with one of our therapists to determine if you require orthotic inserts.

Facial Neuromuscular Retraining
  • Facial nerve paralysis or weakness can result from conditions like Bell’s palsy, Acoustic Neuromas and other tumours, herpes zoster, facial trauma and congenital problems. Patients with any of these conditions may benefit from facial neuromuscular retraining, even years after onset.
  • Facial neuromuscular retraining is a treatment approach individualized to each patient, based on a detailed assessment at the first appointment. The goal of treatment is to relief any facial muscle tension and discomfort, improve facial movements and symmetry and to decrease any involuntary muscle contractions.
  • Treatment techniques include various facial relaxation techniques (such as self-stretching and massage) and specific exercises to retrain facial movement. Patients are taught what they can do at home and return to the clinic for treatment progressions.
  • Frequency of clinic sessions is discussed and planned at the initial visit.
  • Treatment techniques are based on research that have proved efficacy.

Custom Knee Braces

Utilized for a number of common knee injuries or pathologies including:

  • Anterior cruciate injury
  • Medial or lateral collateral ligament injuries
  • Osteoarthritis
  • The customized brace is designed to off load stresses in the area of injury/pathology and allow normal biomechanical loading through the joint.
  • Our bracing expert will go through a detailed assessment of your injury/pathology and take specific measurements of your leg to ensure you get an optimally fitting/customized brace

Vestibular Therapy

What is Vestibular Rehabilitation?

Vestibular Rehabilitation is an education and exercise-based physiotherapy approach to the treatment of vestibular issues. It involves a customized program of exercises that are designed to help the brain learn how to compensate for the loss of inner ear function. It also involves doing manoeuvres that helps to reposition your ear crystals in cases of Benign Proxysmal Positional Vertigo (BPPV). It is possible to significantly reduce dizziness and improve balance with this approach.

A typical vestibular rehabilitation program may includes:

  • Specific exercises to reduce dizziness
  • Eye-head coordination exercises
  • Balance exercises
  • General Physical Exercise Routine
  • Education about specific inner ear conditions and how to best manage them

What to expect on your appointment

Initial Assessment (60 minutes)

Vestibular Rehabilitation starts with a detailed physiotherapy assessment. The initial assessment lasts for about one hour. The Physiotherapist will assess your inner ear with a wide range of tests to determine the most appropriate physiotherapy intervention. Also, some walking tests will be performed as well as some balance testing. Vestibular exercises are then individually tailored for each patient based on the initial assessment findings.

Follow Up (30 minutes)

The Physiotherapist will book you in for follow up sessions. You will be reassessed and treatment will be progressed as you are able to tolerate more.

What are the likely outcomes?

Vestibular rehabilitation has been show to be effective in reducing dizzy symptoms with movement, improving balance, walking more steadily, reducing the risk of falls and improving confidence and endurance. It can help you get back to normal everyday activities like maintaining balance in the shower, walking, sport, or housework. It can also help to reduce fatigue and increase independence.

Diagram showing inner ear

The cases we usually see are: 

  • BPPV (Benign Paroxysmal Positional Vertigo)
  • Ear Infections (Labrynthitis, Vestibular Neuritis)
  • Ototoxicity (Medication affecting the inner ear)
  • Meniere's Disease
  • Head Trauma/Post Concussion
  • Falls risk due to balance/gait disorders
  • Other Vestibular Disorders
Hand Program
  • Our team of specialists include both a Physiotherapist and an Occupational Therapist who have a comprehensive knowledge of the structure and function of the hand/wrist
  • They specialize in the treatment of hand and upper limb injuries and pathologies
  • This area of specialty also includes the design and construction of custom splints for specific injuries or after surgery on tendons or joints
  • You will undergo a detailed assessment of your condition/injury after which a comprehensive individualized program of rehabilitation will be constructed
  • Types of conditions treated include:
    • Post surgical tendon repair
    • Post bone injury to the hand and wrist
    • Carpal tunnel syndrome
    • Rheumatoid arthritis
    • Osteoarthritis
    • Tendonitis/tendinopathy of the hand and wrist
    • Mallet finger

GLA:D Program

GLA:DTM Canada: What is it?

  • 8-week education and supervised group exercise program developed in Denmark
  • Suitable for those with stiff or painful knees / hips due to osteoarthritis
  • Research from GLA:DTM in Denmark showed positive long term outcomes in 10,000 participants, including the following at one-year follow-up:
  • Pain intensity decreased by 27%
  • Pain medication use for knee / hip patients decreased by 37% / 45%, respectively
  • Self-reported physical activity levels increased by more than 30%
  • Percentage of participants on sick leave decreased from 30% to 20

Who can enroll in the GLA:DTM Canada Program?

  • Anyone experiencing knee/hip OA symptoms, with mild to severe symptoms
  • People who are waiting for joint replacement surgery

GLADTM Canada is made up of 2-3 education session and 12 exercise sessions:

2-3 Education sessions, each 90-minutes long, covering topics such as:

  • What is osteoarthritis, risk factors, and symptoms
  • Current available treatments for osteoarthritis
  • How to self-manage symptoms
  • Why and how exercise can help with your osteoarthritis
  • Why and how exercise can help with your osteoarthritis

https://www.youtube.com/channel/UCpi8TJfiA4lKGkaXs__YdBA

12 Supervised group-exercise sessions, 60 minutes each, 2x a week for 6 weeks, led by a certified therapist, in small groups 4-6 people so the client gets more one on one coaching. In these sessions the clients will:

  • Learn how to control movements and proper posture
  • Build muscular strength through functional exercises
  • Learn how to apply these exercises to everyday activities