Do You Have Knee Pain?

The majority of patients that complain of knee pain have what is known as Patellofemoral Syndrome (PFS).  Some clinical studies report as high as 1 in 4 patients with knee pain present with PFS.  The most common reasons for PFS are overuse, trauma, mal-alignment or instability.  Abnormal tracking of the patella (knee cap) is a predisposing factor for developing PFS.  The majority of patients present with a tight band on the outside of the knee  (iliotibial band) and a weak muscle on the medial aspect of the knee (VMO).  This imbalance causes a tug-of-war effect where the ITB overcomes the VMO and pulls the patella to the outside.  The patella should sit within a groove and glide upwards as you straighten your leg.  When the patella is pulled one way or the other, it no longer sits properly within that groove and begins to cause pain.

Decrease your risk of Patellafemoral Syndrome by properly stretching and strengthening the muscles around the knee to prevent this imbalance from occurring.

How do I Know if I have Patellofemoral Syndrome (PFS)

- Most common among adolescents and young adults

- Pain most commonly at the front of the knee, around or beneath the knee cap

- Difficulty going up and down stairs, running, sprinting, jumping

- Pain with squatting, kneeling or excessive knee bending

- Increased pain upon rising and after sitting for a prolonged period

- Joint locking or feeling of instability

- Grinding or cracking caused by the patella not sitting properly in its groove

What can a Physiotherapist Do?

A physiotherapist can properly assess your knee to determine if your knee pain is from PFS.  
Once diagnosed, an exercise program can be developed to help improve the mechanics of your knee,
ebalance the muscles surrounding the joint and help decrease your pain.

Building Stronger Bones

Osteoporosis is the gradual loss of calcium in the bones that over time weakens them and increases the risk of fractures.  Although peak bone mass is typically achieved by age 30, building bone density during your adolescent and teen years is crucial.

Studies show that exercises requiring muscle to pull on bones causes the bones to retain and even gain density.  "Impact" activities, such as soccer, volleyball and basketball are great bone-building activities for youth.  If you're at risk for osteoporosis, exercises such as brisk walking, slow jogging and bike riding can help to keep your bones healthy.  

Osteoporosis and Women

​Osteoporosis affects one in three women and one in five men over the age of 50.  Research has found that women who walk a mile a day have 4-7 more years of bone in reserve than women who don't .  Resistance exercise such as weightlifting can be very helpful.  Start off slowly, don't increase your weights by more than 10% per week, as larger increases can raise the risk of injury.  Your physiotherapist can design a program that is right for you.

Cigarette smoking one pack per day throughout adult life can lead to an additional 5-10% loss of bone mass.  It is well known that women are at increased risk for osteoporosis post-menopause, but did you know that smoking lowers estrogen levels and can lead to bone loss before menopause?

Include calcium rich foods in your diet.  Adults need 1200-1500 mg of calcium per day!  The average adult diet contains only about 750 mg of calcium daily.

Do you have fallen arches?  "Pes planus" is the medical term to describe fallen arches, or "flat feet".  We know that many painful foot and ankle conditions can be related to overpronation observed among individuals with flat feet.  Overpronation and other abnormal foot biomechanics can contribute to muscle and joint pain further up the kinetic chain and can be a potential cause of many painful knee, hip, and back conditions.  A custom orthotic can help to improve foot biomechanics and restore function.

Acupuncture:  What Is It and Does It Really Work?

Acupuncture is becoming more frequently used for the treatment of musculoskeletal injuries so it is important to know what it is all about.

Acupuncture can be traced all the way back to 1600 BC.  It has only become more popular in the west since the 1970s.  Acupuncture involves inserting thin needles into specific  acupuncture points along the body.  Acupuncture can be used to treat a vast number of ailments.  Physiotherapists commonly use acupuncture for acute and chronic pain, muscle spasm, tenderness and headaches. 

Fast Facts on Achilles Tendon Ruptures

                                                                                  - The mechanism of injury usually involves a forceful "push off" from a fully dorsi-flexed ankle.

                                                                                  - Individuals often report hearing a loud "pop" and describe the feeling like they were kicked in the back of
                                                                                     the lower leg or ankle.

                                                                                  - A ruptured achilles results in complete loss of the ability to point the foot downwards.

                                                                                  - Achilles tendon ruptures occur more frequently in men ages 30-50 years of age.

                                                                                  - Ruptures often occur when returning to vigorous activity after a long lay off.

                                                                                  - "Weekend Warriors" are at higher risk for injury due to lower levels of physical conditioning and often poor


                                                                                 - Complete tendon ruptures can be surgically repaired or treated conservatively without surgery. 

                                                                                 - The incidence of re-rupture in conservatively managed cases is reported as high as 40%.  The incidence of

                                                                                    re-rupture following surgical repair has been reported to be around 5%.

Educational Article Library

Habits for a Healthy Back

Who hasn't experienced low back pain at some point of time?  There are many factors that contribute to the vast array of medical conditions that cause low back pain.  There are volumes of research articles and textbooks devoted to this common condition.  Here are a few simple suggestions to help you manage and perhaps even prevent some of the causes of mechanical low back pain.


Many occupations require long periods of time spent working in the same position.  Some of us sit, others stand, some of us work bent forward or in other awkward positions.  Make a point of getting out of static work positions frequently.  If you sit at a desk, stand up to do some filing or walk across the office to speak to a colleague instead of an e-mail.  If you work in a bent over position, try putting your hands on your hips and lean back 2-3 times every 20 minutes or so.  Your back will thank you!


Individuals that perform regular aerobic activities such as walking or bike riding tend to have less symptoms related to mechanical back pain.  Aerobic exercise can also help with weight control.  A slimmer waistline and less back pain sounds good to us!

Weight Training Injury Prevention Tips

Let's face it, lifting really heavy weights in the gym on a regular basis can be hard on the body.  Soft tissue sprains
and strains are common weight training injuries that many of us experience now and then.  Here are some injury
prevention tips for the average weight lifting enthusiast.

Tip #1:  Remember Your Goal

Most occupations, and most sports for that matter, don't require you to be able to lay on your back and bench
press a car!  If your sport or fitness goal doesn't require it, why do it?  Max effort singles don't build any significant
muscle mass, but they do come with a very high risk of soft tissue injury.  A new 1 rep max may be a real ego boost,
but not if you get injured doing it. 

Tip #2:  Increase Training Volume Gradually

If a bit of medicine is good for you is taking a lot even better?  Of course not!  No one takes a whole bottle of
Tylenol for a headache, yet too many of us forget this when we exercise.  Many of us add too much weight, too
many sets, or too many exercises, too soon.  Slow and steady progress always beats huge leaps and bounds over
​the long haul.  "Make haste slowly" is a good motto to follow.

Tip #3:  Don't Forget About Recovery

Balancing training with recovery is such a simple concept, yet many of the injuries we see in the clinic are a result
​of too much heavy exercise and not enough time between workouts.  Slight muscle soreness lasting a day is acceptable, but workouts that leave you unable to brush your teeth for days means you've overdone it and will require more recovery time.

Tip #4:  Do Some Stretching After Exercise

Exercise experts agree that a proper dynamic warm up prior to your workout and slow passive stretches after exercise is the right way to go!  That's right - I said after​ your workout.  Just a few minutes of stretching after your workout can be extremely beneficial for injury prevention and recovery.

Tip #5:  If it Hurts, STOP Doing It!

Real exercise, the kind that changes the number on the bathroom scale is often hard work.  Even so, the old "No Pain, No Gain" philosophy is wrong.  If you do start to suffer aches and pains from your workouts, don't ignore them.  Early treatment and some good advice fro your physiotherapist can help you manage the occasional injury and get you back to your workouts sooner.

It's really too bad that many of us tend to put away our walking shoes and prepare to hibernate for the winter!  Fall is a great time of year to incorporate a bit more physical activity into our daily schedules.  Try a brisk walk or a bike ride after supper.  How about raking the leaves, or cleaning up that flower bed or garden?  Get the whole family involved!

Even after the snow arrives there are still a wide variety of activities to get involved in.  Start up a bowling team or join a curling league.  Be adventurous and try something new, like salsa or ballroom dancing.  Perhaps Tai Chi or yoga are more your style.  Consult your Leisure Guide for other activities that catch your interest.

It doesn't really matter what activity you choose, just make up your mind to remain more physically active this fall and winter.  Your body will thank you for it!

Is Your Family in Motion?

​There is a strong correlation between the activity level of children and that of their parents.  Inactive 


2605 Main Street, Winnipeg 

- Arthritis

- TMJ Dysfunction

Stay in Motion!


Mechanical low back pain is often made worse by poor lower quadrant flexibility.  Stretching your hips and legs on a regular basis can help manage and even prevent many causes of back pain.


Sit-ups and crunches are okay, but a proper core strengthening program includes exercise  for the obliques and lower back as well.  If you're not sure how to target these important muscles, or if you have questions about any of our other habits for a healthier back, consult your physiotherapist.

- Rotator Cuff Tendonitis

- Headaches

- Ankle Sprain

​- Knee Pain / Bursitis / Capsulitis / Ligament Injuries

Acupuncture works by stimulating the body's neuroendocrine system to produce its own natural pain relievers known as endorphins.   Endorphins are chemicals within the body that help the body heal and decrease the amount of pain perceived.  Acupuncture needles are inserted into neuroreactive sites to induce autonomic,  sensory and/or motor neuromodulatory responses.  People may experience a dull ache upon insertion, which should fade quickly. 

Acupuncture is not painful and is very safe.  Only disposable sterilized needles are used.  People's response to acupuncture varies.  Some people experience immediate pain relief, others gradual or no relief. Occasionally some people may experience nausea, dizziness, minor bruising or temporary aggravation of symptoms.  Treatment time varies from 20-40 minutes and may be used alone or together with other physiotherapy treatment techniques.

Common Conditions Acupuncture May Be Useful For:

- Frozen Shoulder                                                  
- Plantar Fasciitis                                                                                                           
​- Myofascial Pain                                                                          
- Neck and Back Pain                 

- Shin Splints

- Carpal Tunnel

- Hip Pain / Arthalgia 

- Tennis or Golfer's Elbow

children are more likely to have less physically active parents.  Active children are more likely to model an active living lifestyle themselves.  Currently it is recommended that kids are involved in 60 minutes of moderate physical activity and 30 minutes of vigorous physical activity daily.   The "Healthy Schools in Motion" program recommends Manitoba schools aim for 30 minutes of daily physical activity 5 days a week.  The rest is up to us parents.  Are you making sure your child is "in motion" outside of regular school hours?  Make it your goal to model active living and get your whole family in motion today!​

Are Orthotics Right For You?

Should Everyone Get Orthotics?

So, should everyone with abnormal foot mechanics be fitted with a custom orthotic?  This topic remains controversial among many health care providers.  A common sense approach to orthotic prescription would be to only correct abnormal biomechanics that are contributing to symptoms.  Many professional athletes for example, perform at the top of their game and remain pain free despite having less than perfect feet.  Prescribing a custom orthotic does not guarantee that the athlete will perform any better.  In fact, needlessly altering their foot biomechanics may even have a negative impact on their athletic performance.

Is An Orthotic Right For You?

The most important question to ask when considering orthotic correction is, "Will this orthotic improve the symptoms I'm currently experiencing?"  If the answer is yes, a custom orthotic may be right for you.

Orthotics and Your Insurance Company

Many group benefit plans include orthotic coverage.  Some insurance providers require a doctor's prescription for orthotic coverage.  Other third party payers will allow your treating physiotherapist to provide the prescription for your orthotics.  It's usually a good idea for you to contact your insurer regarding the details of your individual policy prior to being fitted with an orthotic.  If you have any questions regarding the purchase of orthotics, give our staff a call.  We would be pleased to help.

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Safe Snow Shoveling

Winter is upon us!  As always, our cold Manitoba winters mean snow shoveling and lots of it!  Here are a few helpful tips to keep in mind when braving the cold this winter.

Choose the Right Shovel
- A longer handle requires less forward bending.  This means less back fatigue.

- A bent handle shovel can reduce forward bending by up to 16% and will help reduce back pain.

- Choose a shovel with a plastic blade.  Plastic shovels are much lighter and make moving heavy
   snow easier.

- Shovels with slightly smaller blades help prevent lifting too much at once.

 Shovelling Tips

- Pace yourself.  Take frequent rest breaks when moving heavy loads.

- Keep your hands wider apart on the handle for better leverage and less strain.

- Push the snow on the ground, then lift and throw.  Try to take a step in the direction you are throwing to reduce back strain.

Riverbend Physiotherapy Main Street

Clinic Hours:  

Monday - Thursday:  7:00 am - 8:00 pm      

Friday:  9:00 am - 5:00 pm     

Saturday and Sunday closed