How Do my Feet Affect my Knees?

THE FOOT TRIPOD

THE FOOT TRIPOD:

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1. Center of the calcaneus.
2. Head of the 1st metatarsal.
3. Head of the 5th metatarsal.

A healthy foot tripod is dependent on:
– Foot structure
– Flexibility of the joints.
– Strength, endurance and control of the muscles.

Dysfunction of one or more legs of the foot tripod can lead to plantar fasciitis (heel pain), pain in the ball of the foot, bunions, hammer toes and numbness to name a few.

CLINICAL APPLICATION:
Structural leg length discrepancies can cause lower back pain, amongst other complications. The body can compensate for this FUNCTIONALLY by increasing foot supination on the shorter side to equalise length. This is done by increasing downward movement and force under the head of the 1st MT, increasing the medial arch height.. compensating with your tripod.

The tripod can also FAIL functionally and create a leg length discrepancy (pictured). When the head of the 1st MT has a weakened or inactive downward force. A uniateral pronated or flat foot posture could result.

PHOTO_8

Can compensation for this occur higher up?

Definitely! If ‘re-supination’ cannot be achieved to restore leg length, another compensation can come from the pelvis.
If you anteriorly rotate the pelvis (ie the innominate rotates forward, bringing the ASIS forward) you can relatively increase leg length. This can be done favourably for one side and create pelvic torsion along with lateral tilt.

Please Welcome Carol, our New Kinesiology Student!

Carol Bryans, Co-Op Kinesiology student from University of Waterloo

I have always been fascinated with the human body and how rapidly you can recover from injuries. This interest has led me to pursue a degree in Kinesiology with a minor in Medical Physiology at the University of Waterloo. I am currently a third year co-op student who has the wonderful opportunity of working here for the next few months. I am looking forward to working with such a great team of physiotherapists and chiropractors!

My personal experience as a dancer and my own experience with injuries has inspired me to pursue a career in healthcare and rehabilitation science, and I’m excited to learn more about the techniques used in injury rehabilitation and prehabilitation. 

In my spare time I enjoy cooking, reading, exercising, and I enjoy being outside as much as possible. Most of the time you can catch me doing yoga or reading in the park!

UPPER CROSSED SYNDROME

By Dr. Matt Rhynold, DC

What is it?

Before you begin reading this post, take a look at how your body is positioned.

  • Are you slouched?
  • Is your head bent forward looking down at your phone?
  • Are your shoulders rounded?

If so, you’re not alone. Cell phone use is just one of many factors that can contribute to neck pain, as well as a condition I am highlighting today. Upper Crossed Syndrome is a very common condition experienced by many individuals. It is characterized by:

  • a head forward posture
  • rounded shoulders
  • and a specific pattern of weak and strong muscles that can contribute to stiffness and pain in the neck and upper back.

Think about a teeter totter – the more weight you put on one side, the more weight you need to add to the other side to keep the bar level. The same is the case with your neck.

The average human head weight anywhere from 20-30lbs. Head forward posture adds that weight to the front of the body, causing the muscles in the back of the neck and upper back to work on overdrive to keep your head level and your neck stable. Can you imagine holding a 20-30lbs weight for minutes, sometimes hours, on end? It’s no wonder that in Upper Crossed Syndrome, these muscles holding onto your head are overused and can become injured. Moreover, muscles critical for the normal maintenance of neck posture are underused and not properly recruited.

What factors can lead to Upper Crossed Syndrome?

  • Increased cell phone use
  • Increased laptop/computer use
  • Improper work ergonomics (especially while working from home)
  • Prolonged time sitting and slouching
  • Improper breathing techniques

Am I stuck like this forever?

No! In fact, corrective exercises have been shown to restore normal functioning of the neck muscles and improve posture. Exercises targeting underused muscles of the neck and lower trapezius can improve head forward posture, rounding of shoulders, and shoulder blade positioning.

Manual therapists like myself are able to identify which structures need to be addressed and create a treatment plan that incorporates hands-on care with exercises that can not only correct your problems now, but prevent them from returning.

If you are having neck pain and want it assessed and treated, please book an appointment with me.

My treating hours at Clarkson Sport & Physiotherapy are:

Tu 11:30am – 7:30pm
Th 10am – 3:30pm Fri 10am – 3:00pm Sat 10am – 3pm

https://clarksonphysio.ca/

Dr. Matthew Rhynold, D.C., B.Sc Kin (Hons)

Fitting my mask (see photos)

Gaps in our masks allow for virus entry. We often see these gaps around the nose and cheeks.

The other problem we notice is masks slipping down the face because they aren’t fanned out properly.

This puts you and your practitioner at risk, especially with the more contagious variants!

Imagine dust particles (motes) floating in the sunshine and that’s how the virus is suspended in the air.

We want all of our breath to be THROUGH the mask, not out the gaps.

Try the PUFF TEST to see if your mask balloons out or if you feel air flowing into your eyes or cheeks. The mask needs to puff out!

Walking speed, part 1: How fast should I walk to cross the road safely? Fast facts about walking speed

The Bottom Line

  1. Our walking speed changes as we age and is predictive of our life expectancy and changes that are likely to occur in other areas of functioning. 
  2. Men have faster speeds than women probably because they are taller.
  3. Walking at 1.14 metres/second means that you can cross the street safely in time before the light changes.

In this two-part series of blog posts on walking speed we look at what you need to know and how to improve your walking speed. In Part 1, we’ll look at some of the basics and a simple test you can do to determine your walking speed. In Part 2, we discuss how to improve your walking speed.

What advice do you have about walking as I get older?

Walking speed (gait speed) or mobility is necessary for most tasks that humans undertake. Slowing of walking speed is associated with aging in all persons. Walking speed has also been associated both with how long a person will live (survival) (1;2) and with changes that occur when older persons are having difficulty or become unable to do tasks (3;4). In research studies walking ability has been assessed by tests where persons are either asked to walk at their usual speed (sometimes called self-selected walking speed) OR fast walking speed where a person is instructed to walk as fast as they can safely.

How fast do I need to walk to cross the road safely?

To undertake various activities within the community that involve walking, the average distances required to walk vary from 200-600 metres (5;6). The task that usually concerns older persons most in relation to walking speed is how quickly they need to walk in order to cross a road safely. The critical speed cited for this task is 1.14 meters/second and has been broken down in the following way:

  1. Crossing a 2 lane road (4 metres/lane) in 10 seconds (5 seconds per lane),
  2. And 3 seconds to get up and down off either curb (1.5 seconds per curb).
  3. The critical speed is 8 metres/7 seconds = 1.14meters/second.

The speed we are able to walk decreases as we age. There are several reports that indicate some normal ranges for older persons. For example, general walking speeds for community activities are 1.2-1.4 metres/sec until 80 years and 1.0-1.8 metres/second until 90 years and older (4;7-10).

Older persons who have a walking speed of less than 1metre/second have reported ceasing involvement in any regular physical activity (11). Self- selected walking speed associated with frailty has been reported as less than 0.65 metres/second if you are short (i.e. = 159cm) and 0.75m/sec if you are taller (height >159cm) (12).

How does my walking speed compare to others of my age?

Below is a Table (8) of usual walking speeds given for women and men by different age groups.

GenderAge group Total number of persons in each study Average self-selected walking speed (metres/second)Range within which the average value might fall (metres/second) 
 Women 40-49 142 1.39 (1.34-1.41) 
  50-59 456 1.31 (1.22-1.41) 
  60-69 5013  1.24 (1.18-1.30)
  70-79 8591 1.13 (1.07-1.19) 
  80-99 2152 0.94 (0.85-1.03)
 Men 40-49 96 1.43  (1.35-1.51) 
  50-59 436  1.43  (1.38-1.49) 
  60-69 941 1.34 (1.26-1.41)
  70-79 3671 1.26 (1.21-1.32)
  80-99 1091 0.97 (0.83-1.10)

Assessing your own walking speed

You can assess your walking speed using the 10 metre walk test. You need a 20 metre path with 5 metres to get up to normal speed, 10 metres for measurement of your normal walking pace and 5 metres to slow down. You should measure how long it takes you to walk the 10 metre length or get someone else to time your walking speed over this distance. The figure below illustrates how to do this.Image showing 10 metre test


AUTHOR DETAILS

Julie Richardson

Julie Richardson is a Professor in the School of Rehabilitation Science at McMaster University. Her research interests include identifying persons at risk for functional decline and rehabilitation interventions it and maintaining health status in persons with chronic illness. Recent work has involved clinical trials examining complex rehabilitation interventions in primary care settings. There are no conflicts of interest.

References

  1. Studenski S, Perera S, Patel K, Rosano C, Faulkner K, Inzitari M, et al. Gait speed and survival in older adults. JAMA 2011 Jan 5;305(1):50-8.
  2. Hardy SE, Perera S, Roumani YF, Chandler JM, Studenski SA. Improvement in usual gait speed predicts better survival in older adults. J Am Geriatr Soc 2007 Nov;55(11):1727-34.
  3. Abellan van KG, Rolland Y, Andrieu S, Bauer J, Beauchet O, Bonnefoy M, et al. Gait speed at usual pace as a predictor of adverse outcomes in community-dwelling older people an International Academy on Nutrition and Aging (IANA) Task Force. J Nutr Health Aging 2009 Dec;13(10):881-9.
  4. Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing 1997 Jan;26(1):15-9.
  5. Andrews AW, Chinworth SA, Bourassa M, Garvin M, Benton D, Tanner S. Update on distance and velocity requirements for community ambulation. J Geriatr Phys Ther 2010 Jul;33(3):128-34.
  6. Brown CJ, Bradberry C, Howze SG, Hickman L, Ray H, Peel C. Defining community ambulation from the perspective of the older adult. J Geriatr Phys Ther 2010 Apr;33(2):56-63.
  7. Waters RL, Lunsford BR, Perry J, Byrd R. Energy-speed relationship of walking: standard tables. J Orthop Res 1988;6(2):215-22.
  8. Bohannon RW, Williams AA. Normal walking speed: a descriptive meta-analysis. Physiotherapy 2011 Sep;97(3):182-9.
  9. Lusardi MM. Is walking speed a vital sign? Absolutely. Topics In Geriatric Rehabilitation 2012;28(2):67-76.
  10. Chui K hEKD. Meaningful changes in walking speed. Topics In Geriatric Rehabilitation 2012;28(2):97-103.
  11. Shimada H, Suzukawa M, Tiedemann A, Kobayashi K, Yoshida H, Suzuki T. Which neuromuscular or cognitive test is the optimal screening tool to predict falls in frail community-dwelling older people? Gerontology 2009;55(5):532-8.
  12. Bohannon RW. Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. Age Ageing 1997 Jan;26(1):15-9.

Welcome to Dr. Matt Rhynold, DC

Chiropractor

Dr. Matthew Rhynold was born and raised in Toronto, Ontario. As an avid baseball and hockey player growing up, Matt utilized chiropractic care to overcome various injuries to his shoulder, neck, and back. Seeing the positive impact Chiropractors could make in people’s lives, he knew from age 13 that he wanted to be a Chiropractor. Matt received his Bachelor of Science (Honours) in Kinesiology from McMaster University, and a Graduate Certificate in Exercise Science & Lifestyle Management from Humber College. Matt then received his Doctor of Chiropractic degree from the Canadian Memorial Chiropractic College (CMCC). Dr. Rhynold is passionate about providing a safe space for all people to feel comfortable being whoever they are while receiving the best possible care. Dr. Rhynold has received specialized training in the GLA:D and PEAK protocols for treating knee osteoarthritis, treating spinal stenosis, as well as a host of other common and sports-related injuries. Dr. Rhynold is also a certified Functional Range Release (FR® Release) Provider for the Spine.

Dr. Rhynold uses a combination of hands-on manual therapy and rehabilitation exercises In his treatments such as:

  • Adjustments
  • Soft tissue release
  • Muscle Release Therapy (MRT)
  • Joint mobilizations
  • Vibration Therapy
  • Active Rehabilitation

Dr. Rhynold is a member of the Ontario Chiropractic Association, Canadian Chiropractic Association and the College of Chiropractors of Ontario.

Outside of clinic, Matthew spends his time exploring new culinary experiences, and staying committed to a healthy and active lifestyle.

Welcome to Mary, our University of Waterloo Co-Op Student!

I believe that one of the most rewarding joys of life is being able to move freely and enjoy the activities you love, and this has led me to pursue an undergraduate degree in Kinesiology at the University of Waterloo. I am currently a second year co-op student who has the pleasure to be here for the next few months! Previously, I also attended high school at King’s Christian Collegiate in Oakville. 

My personal experience with physiotherapy and my passion for fitness has inspired me to seek a career in healthcare and rehabilitation sciences. I am excited to learn more about various kinds of physical therapy, and I look forward to assisting the team in providing quality care for you throughout your health journey. 

In my spare time, I love to cook and spend time with my friends, as well as move my body in any way possible, be it going for walks, strength training, or stretching.

What is Virtual Care/Telerehab and How Can It Help Me With My Pain?


What is Virtual Chiropractic Care and Physiotherapy and How Does it Work?

Virtual care uses secure, encrypted audio and/or video conference technology to provide health care services to patients who are unable to attend the clinic.

Before your appointment, you will receive an email link for the session.

You will need to consent to the video session, and complete an intake form prior to your appointment.

Which services are available via virtual care?

  • Physiotherapy
  • Chiropractic care

What device(s) do I need to access my appointment? Do I need to install any special software?

Any laptop, smartphone or tablet with a camera and microphone.

Testing your camera beforehand can be very helpful.

You will need to use an internet browser other than Internet Explorer. Acceptable browsers include Firefox, Chrome and Safari.

Is virtual care for covered by my insurance/health benefits?

Most extended health insurance companies provide coverage for virtual care! Please reach out to your benefits provider to inquire about your coverage limits.

How do I book a virtual care appointment?

Simply go to clarksonphysio.janeapp.com 

You may select your practitioner and a suitable time. If you would like to request a time outside of what you see online, we are happy to accommodate that if you email or call the clinic.

What can I expect from my first virtual care appointment?

At the beginning of a Virtual Care session your clinician will review your intake form. 

They will also obtain consent from you to participate in the session via the electronic communication platform. 

Once that is complete, they will proceed with the assessment or treatment in a similar manner as for an in-person appointment. 

This includes discussing your goals, medical history, concerns and current status. Any questions or concerns you may have about Virtual Care, such as privacy or follow-up sessions, can be addressed during the session.

What are some key differences between virtual care and an in-person appointment?

The services are largely the same for education, diagnosis and exercise prescription.

Our clinicians are required to meet the same regulatory and legislative requirements and adhere to their respective Standards of Practice and Code of Conduct, just as they are for in-person services. 

Clarkson Sports and Physiotherapy has strict privacy and information security policies and procedures in place regarding the management of information when using electronic communication technologies.

Virtual Care services offer several advantages for our patients, such as:

  • Keeps both parties safe during covid
  • Removes accessibility and/or mobility barriers
  • Connects you with service providers regardless of location
  • Protects your privacy through safeguards and robust policies
  • Reduces travel time while still ensuring you receive quality care
  • Allows your therapist to see your work or home environment
  • Allows you to care for your children, attend your appointment, and avoid paying for a babysitter

How much does virtual care cost?

Is it more than an in-person appointment?

We are offering a free 15 min consultation to help you decide if this is a good fit for you. 

The next session will be approximately 60 minutes for a detailed assessment. Rates are posted when you book online or call us.

https://clarksonphysio.janeapp.com/

Will I be able to see my usual Physiotherapist or Chiropractor for a virtual care appointment?

Yes!

Is virtual care secure and private?

Yes. Patient privacy is of the utmost concern to all levels of staff at Clarkson Sports and Physiotherapy.

All virtual care sessions are provided through a secure, encrypted connection, and only your therapist will be present on their end of the connection for the duration of your appointment.

What if my practitioner records my virtual care session? Will I be informed?

Clarkson Sports and Physiotherapy does not record the audio or video of any virtual care physiotherapy sessions. 

The software we use to provide virtual care is private, secure and HIPAA and PIPEDA compliant.

The software only takes note of, and archive, session start times, end times, and any chat messages sent between you and your practitioner.

What happens if my therapist and I experience technical difficulties or get disconnected during my session?

No worries if this happens! Our practitioners will initiate the session again.

Clarkson Sports and Physiotherapy will have your phone number on file in order to reach you in the event that you are disconnected.

Should any technical issues persist and prevent you from carrying out your session as planned, we will work with you to reschedule your virtual care session as soon as possible.

PLEASE HAVE YOUR POWER CORD NEARBY!

Are there any limitations or risks to participating in a virtual care session compared to an in-person service?

There are some limitations like the inability to apply hands-on evaluation and treatment, but this would not be necessary as part of the virtual care service you are receiving.

There are inherent risks to participant information when using electronic communication technologies (ECT); however, Clarkson Sports and Physiotherapy has strict privacy and information security policies and procedures in place to evaluate and address these risks; and our virtual care providers are expected to meet the same regulatory and legislative requirements and adhere to their respective Standards of Practice and Code of Conduct, just as they are for in-person services.