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Toronto Dietitian / Holistic Nutrition
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Toronto Custom Bracing
Bracing is a non-invasive and economical way of treating many different types of joints. Bracing is extremely effective and acts as a load sharing modality that helps preserve a joint by transferring the load from the joint to the brace system during weight bearing. This effectively off-loads the joint to prevent further degeneration of a joint or can allow an injured joint component such as a torn ligament heal.
At Activecare, your therapist will use bracing as an adjunct to your therapy in order to increase treatment outcomes or to prevent further injury while your joint is healing. Individualized measurements are taken to yield a truly custom brace specific to your needs and goals.
Our facility uses Bledsoe Brace Systems, a reputable name in the orthopaedic industry. Bledsoe products are used by orthopaedic specialists, primary care physicians, physical therapists, podiatrists, chiropractors and other healthcare professionals to treat patients with musculoskeletal conditions resulting from degenerative diseases, traumatic events and sports-related injuries. In addition, athletes and patients rely on Bledsoe’s medical devices for injury prevention and at-home physical therapy treatment.
Custom bracing can be covered by many insurance policies with a referral from your treating physician, sport medicine doctor or orthopaedic surgeon.
Custom Foot Orthotics
What are custom foot orthotics?
Custom foot orthotics are prescription insoles which are custom-moulded to the shape of an individual’s feet with appropriate adjustments/features designed to address specific symptoms/conditions.
Many conditions can benefit from custom foot orthotic therapy including, but not limited to:
- Plantar fasciitis
- Clawed/hammered toes
- Knee pain
- Back pain
- Leg length discrepancy
How are custom foot orthotics prescribed/dispensed?
Any individual being considered for a custom foot orthotic prescription will undergo a full assessment by a registered chiropodist. This assessment will include:
- Thorough history
- Biomechanical assessment (weightbearing and non-weightbearing)
- Gait analysis
- Footwear assessment
Treatment options will be discussed. If custom foot orthotics are an appropriate treatment option then both feet will be casted with plaster of paris in a non-weightbearing subtalar joint neutral position (this is the optimal position for a foot to function in). The custom foot orthotics typically take 2-3 weeks to manufacture.
A dispense appointment will be scheduled once the new custom foot orthotics arrive. Please bring shoes that are used most frequently for any physical activity to this appointment (feel free to bring any shoes that will be used with the new orthotics). This appointment will include:
- Verifying fit of the orthotics to the individual’s feet
- Fitting the orthotics to footwear
- Providing “break-in” instructions for getting adjusted to the new orthotics
Is there any warranty/guarantee for custom foot orthotics?
Even though custom foot orthotics are created using custom foot casts there is still sometimes a need to modify custom foot orthotics after they are manufactured. These modifications are free for the first three months after custom foot orthotics are dispensed. An extra fee may apply if a modification is required after the initial three month period has passed.
There will be a few check-ins and follow ups after new custom foot orthotics are dispensed.
1st check in: 1 month after dispensing of the orthotics
2nd check in: 1 year after dispensing of the orthotics
As with any medical intervention there is no guarantee that this treatment will be completely successful. Many of the conditions that custom foot orthotics are prescribed for tend to involve many factors that contribute to the symptom presentation. While custom foot orthotics will address abnormalities present at the feet they are still only one part of a treatment plan and all recommendations provided by your healthcare providers should be followed in order to achieve best results.
Chiropody Services and Treatments Provided by Activecare:
- Treatments for conditions affecting the skin such as calluses, corns, warts, Athlete’s foot and fungal infections
- Treatments for conditions affecting the toe nails such as in-grown toe nails, fungal infections, and thick nails
- Diabetic foot care and education
- Assessment of foot pain
- Biomechanical analysis and gait analysis
- Custom made foot orthotics
- Footwear advice
What is a Chiropodist?
Chiropodists are primary health care providers, who specialize in the assessment, treatment and prevention of conditions affecting the foot. Chiropody is a regulated health profession in Ontario.
Do I need a referral to see a Chiropodist?
Chiropodists are primary health care providers. A referral is not necessary to be seen.
Are Chiropody Services covered under OHIP?
No, unfortunately Chiropody services are not covered under OHIP. Visit costs and items such as custom made foot orthotics may be covered under an extended health benefits plan of a private health insurance policy. If eligible, a per‐visit fee is paid which would then be reimbursed to you by your insurance provider.
What is the difference between a Chiropodist, Podiatrist and Pedorthist?
Chiropodists and Podiatrists both specialize in the assessment, treatment and prevention of conditions affecting the foot. What we do is very similar. The main difference is where the practitioner has received their education and training. In Ontario, to become a health care provider who treats conditions of the foot, one would undergo schooling to become a Chiropodist. Those practicing here under the title of “Podiatrist” have received their education outside of Canada (i.e., U.S.). Although there are some differences in education and training, Podiatrists practicing in Ontario do so under the “Chiropody scope”.
Pedorthists are trained in the manufacturing, fitting and modification of foot orthotics and footwear. Pedorthics is not a regulated health profession in Ontario. Pedorthists do not diagnose and prescribe foot orthotics and footwear, but can manufacture and dispense these items.
Toronto Custom Compression Stockings
Compression stockings are specialized hosiery or socks, designed to help prevent the occurrence of, and guard against further progression of venous disorders such as edema, phlebitis and thrombosis. Compression stockings promote better venous flow by gently exerting pressure against your legs to help return blood to the heart. This helps to control swelling, varicosities, leg fatigue and other problematic leg conditions.
Compression stockings are specifically constructed to apply gradient compression at measured intervals. The highest amount of pressure is applied at the ankle, and gradually decreases up the length of the stocking. If you have varicose or spider veins, are pregnant, or have just had surgery, your doctor may prescribe compression stockings. Wearing stockings can help relieve achy and heavy legs, reduce swelling, and prevent blood clots, especially after surgery or injury when you are less active.
During a fitting at Activecare, our therapists take the time to carefully measure, fit and select an appropriate medical compression garment custom to an individual’s needs. There are many different types of compression stockings available, which vary in pressure (15-20 mmHg, 20-30 mmHg, 30-40 mmHg), length (from knee-high to thigh-high), and colour.
Compression stockings are covered by most insurance plans.
Toronto Vestibular Rehabilitation
What is vestibular rehabilitation?
Vestibular rehabilitation is an exercise-based program, designed by a specialized physiotherapist, to improve balance and reduce dizziness-related problems.
At your appointment, a physiotherapist will evaluate your symptoms and review your medical history. He or she will identify any problems with your balance, your gait (how you walk), neck motion, visual stability, as well as examine other potential problem areas. Based on the findings, a plan of care is developed. The goal of your treatment plan is to improve any deficits that were identified. This, in turn, will improve your ability to function in activities of everyday living, reduce your risk for falling, and ultimately, improve your quality of life.
Who benefits from vestibular rehabilitation?
Patients who are typically referred for vestibular rehabilitation therapy are those diagnosed with dizziness, imbalance, vertigo, Meniere’s syndrome, benign paroxysmal positional vertigo (BPPV), neck-related dizziness and migraines. Other candidates are patients who have had a stroke or brain injury or who frequently fall.
How is dizziness defined?
Dizziness is defined as feelings of unsteadiness; wooziness (swimming feeling in head); lightheadedness; feelings of passing out; and sensations of moving, spinning, floating, swaying, tilting, or whirling (sensations known as vertigo).
These sensations can occur when standing still, lying down or when changing positions. The symptoms can last from seconds to minutes to days. For some people the symptoms are constant; others experience only short episodes of symptoms.
What causes dizziness?
Each year over 10 million patients visit a physician due to dizziness. It is the most common complaint of patients over the age of 75, but can occur in patients of any age.
Dizziness is generally not serious, but is often a sign of a mechanical problem. Dizziness can be due to an inner ear disorder, a side effect of medications, a sign of neck dysfunction, or it can be due to a more serious problem such as a brain or a heart problem.
Common symptoms that can be helped with vestibular rehabilitation include:
- Dizziness or blurry vision with head movements
- Neck tightness, stiffness and/or pain
- Imbalance or the need to hold onto objects when walking
- Frequent falls
- Generalized “dizziness, wooziness and foggy head” feelings
What are some examples of the types of exercises I will learn?
Some examples of exercises you might learn include: vision stability training, posture training, stretching and strengthening exercises, balance retraining, walking, neck motion exercises, and if needed, general fitness exercises. Ergonomic advice may also be given. (This advice is given so that workplace furnishings can be adjusted to improve a person’s posture and decrease any discomforts.)
No two exercise treatment plans are exactly alike. Your exercise program is developed by identifying your deficits. For example: if your symptoms have been linked to an inner ear problem, you will also learn how to do some self-treatment exercises. Continuing an exercise plan at home can help prevent and/or treat new dizziness and balance episodes.
How long is a typical vestibular rehabilitation program?
Some patients may be seen for only 1 to 2 sessions; other patients may need continued treatment for a few months. The therapist makes individualized recommendations based on the needs of the patient, severity of symptoms, and response to therapy.
What type of recovery/outcome can I expect from vestibular rehabilitation?
Expected vestibular rehabilitation outcomes include:
- Decreased fall risk
- Decreased dizziness symptoms
- Improved balance
- Improved ability to stabilize vision/gaze
- Increased body strength
- Return to prior level of movement/function
- Increase in confidence in ability to maintain balance
- Improved neck motion, reduced symptoms
How successful is vestibular rehabilitation therapy?
Many times vestibular rehabilitation therapy will be the only treatment needed. Other times, it is a part of the presurgery/postsurgery treatment plan. In most cases, if patients continue to perform the exercises they have learned, balance and dizziness problems decrease significantly or completely disappear.
Toronto Pelvic Health Physiotheraphy
Patients are more and more frequently being referred to physiotherapy for a wide range of pelvic pain and incontinence issues. There is growing evidence for what physiotherapy can do to treat pelvic conditions in men and women and in our practice we see excellent outcomes for our patients.
We treat a variety of conditions including:
- Urinary incontinence
- Male and female pelvic pain
- Vaginal pain
- Pelvic organ prolapse
All patients are assessed by a licensed physiotherapist who is specifically trained and rostered in pelvic health management. They will take account of your full history and include any issues related to your low back, hips, core strength, previous injuries, surgeries or pregnancies. Treatments may include manual therapy, exercises, lifestyle and dietary advice depending on your particular needs.
Initial assessments last approximately one hour and follow up appointments are typically 30 minutes. In addition to an in-depth history of the patient’s complaint and screening for low back issues, the physiotherapists will carry out an internal examination (vaginally and/or rectally), much like a gynecological examination.
Toronto Contemporary Medical Acupuncture
Acupuncture is a therapeutic intervention (a technique) that can be used as an adjunct to therapy in treating specific health dysfunctions. These conditions may include but are not limited to musculoskeletal pain and movement disorders, sports injuries, functional imbalances, problems of dysregulation, headaches, stress-related disorders and chronic pain.
Contemporary Medical Acupuncture is a precise peripheral nerve stimulation technique, in which fine solid needles (acupuncture needles) are inserted into anatomically defined acupuncture points and stimulated manually or with electricity for therapeutic purposes. At Activecare, we use sterile, single use acupuncture needles.
During the initial assessment, your treating therapist will conduct an exam which will identify dysfunctions within the neuromuscular system. Therapeutic goals and treatment targets are selected based on the identified neurological and muscular dysfunctions contributing to the clinical presentation of the symptoms. Contemporary Medical Acupuncture is a physiological intervention similar to exercise that elicits existing available regulatory mechanisms through the up-regulation and down-regulation of specific cellular processes.
Contemporary Medical Acupuncture can be effective in treating various disorders, such as low back pain, sprains and strains, IT Band Syndrome, osteoarthritis, rotator cuff tendonitis and headaches. It can provide an effective adjunct to your physiotherapy, chiropractic or massage therapy treatments.
Toronto Shockwave Therapy
Shockwave therapy is a non-invasive alternative to surgery for those suffering from joint and tendon disorders. Shockwave therapy sends shock waves into the bone or soft tissue, reinjuring the area on a cellular level and breaking up scarring that has penetrated tendons and ligaments. The controlled reinjuring of tissue allows the body to regenerate blood vessels and bone cells. The resulting revascularization leads to faster healing and a return to pre-injury activity levels.
Shockwave therapy is effective for pain management for multiple reasons: The shock waves stimulate a metabolic reaction in the affected tissue, causing stress fibers to develop and/or change in their permeability: they generate cavitation bubbles that break down calcific deposits; and they induce an analgesic reaction mechanism, which blocks pain messages.
Shockwave therapy provides a safe, non-surgical alternative for those suffering from rotator cuff tendinopathy, tennis elbow, Jumper’s knee, Achilles tendinopathy, and plantar fasciitis. The number of shockwave therapy sessions required often varies depending on the severity and chronicity of the injury. A typical treatment protocol usually requires 3-5 treatments at weekly intervals. After the treatment sessions are finished the injured area continues to heal with maximum recovery occurring approximately 3 months after the treatment sessions end.