PHYSIOTHERAPY

In addition to athletic development, here at ARC by Pivotal, we’re passionate about athlete recovery. Every day, our physiotherapists help their patients become closer to achieving their full physical recovery potential. Beyond the athlete recovery strategies we offer with our recovery centre, physiotherapy services include the professional help of a physiotherapist. Using evidence-based practices and standards, we offer movement screening tests, sport injury rehabilitation, and concussion management services to athletes.

MANUAL THERAPY/JOINT MANIPULATION
Manual therapy can be helpful for the treatment of joints that lack adequate mobility and range of motion. It is a specialized form of physical therapy delivered with the hands as opposed to a device or machine. It’s an application of accurately determined and specifically directed manual force to the body in order to improve mobility in areas that are restricted. This physical treatment is primarily provided by physiotherapists to treat musculoskeletal pain. This typically includes mobilization and manipulation of joints and muscles.


EXERCISE PRESCRIPTION
Exercises are prescribed as part of your physiotherapy treatment plan. The type of exercises range from strength, mobility, stretch, and sport injury exercises.


ACUPUNCTURE
Acupuncture is an ancient technique that was developed thousands of years ago used to help the body naturally heal itself. Studies have shown that it can help accelerate the healing process, improve pain management, and improve function when used in rehab medicine. During a typical treatment session, the fine needles stay placed in the body up to 15 mins before it’s withdrawn from the body.


INTRAMUSCULAR STIMULATION (IMS)
Intramuscular Stimulation, commonly referred to as IMS, is a technique used to treat chronic pain that is caused by neuropathy (damaged, injured or dysfunctional nerves). IMS targets areas of tightness in the muscles. A fine needle, similar to an acupuncture needle, is inserted multiple times into tight muscles, causing them to have a reflex and relax response. As opposed to acupuncture, the needles are inserted then immediately withdrawn from the body, they do not stay in the body during IMS treatment.


DRY NEEDLING
Dry needling, also known as Functional Dry Needling or FDN, is a treatment technique similar to Intramuscular Stimulation (IMS). Benefits of dry needling include effective treatment of acute and chronic pain. It involves multiple insertions of an acupuncture needle into the dysfunctional muscle, which typically contains a ‘trigger point’. If the muscle is tight, the individual may feel a “twitch response”. A twitch response is a spinal cord reflex to get the muscle to relax. The fine needles do not stay in the body during dry needling treatment; they are inserted then immediately withdrawn from the body.


FASCIAL STRETCH THERAPY
Fascial Stretch Therapy (FST) is table-assisted stretching performed by a physiotherapist that targets the fascia and joint capsules. Fascia and joint capsules are connective tissue that surrounds muscles, bones, and joints. When this connective tissue is restricted, it can cause muscle tightness, tendonitis, scar tissue formation, and can even lead to osteoarthritis. Therefore, the main goal of FST is to achieve optimal flexibility, strength, performance, and pain relief.


BLOOD FLOW RESTRICTION EXERCISE (BFR)
BFR exercise is the newest hype in performance and rehab worlds. With the BFR technique, an athlete who has sustained an injury; and therefore, lifting lower loads, will still be able to build muscle strength. This is possible because the BFR cuffs are placed proximally on the leg or arm to restrict the blood flow to the muscle being exercised. With the restriction of blood flow, less muscle protein is broken down; and because of this, there is still room to build muscle strength. At ARC, we use the BFR technique along with sport injury exercise prescription.

ARC professionals are educated in BFR exercise through Owen’s Recovery Science www.owensrecoveryscience.com


ATHLETE MOVEMENT SCREENING AND PERFORMANCE PROGRAMMING 

  • Y-BALANCE TEST

The way we provide movement screening tests at our facility is unique to ARC. First, an entry level movement screen called a Y-balance test is conducted by a physiotherapist or kinesiologist to understand an athlete’s movement baseline. This test will identify deficits in mobility and stability of an athlete.

  • MOVEMENT SCREENING/FUNCTIONAL MOVEMENT SCREEN

We then use the Functional Movement Screen (FMS) method to assess fundamental movements such as deep squat, inline lunge, shoulder mobility, and trunk stability. The results are then entered into a software where the athlete’s “numbers” are compared to other athletes of the same age and functional level.

  • SELECTIVE FUNCTIONAL MOVEMENT ASSESSMENT (SFMA)

Lastly, a Selective Functional Movement Assessment (SFMA) is conducted to diagnose why an athlete would receive certain “grades” on their movement pattern. At ARC, the diagnosis is then given to the S&C coach for strength and conditioning programming. Thus, here at ARC, we take a multidisciplinary approach of movement screening and performance programming.


ANTI INFLAMMATORY MODALITIES
The use of anti Inflammatory modalities are typically included in your physiotherapy treatment. These modalities are used to relieve pain, improve circulation, decrease swelling and reduce muscle spasms.

Game Ready
The Game Ready System is best used following a musculoskeletal injury. It combines dynamic compression therapy and circumferential cold therapy in one application. The Game Ready System continuously circulates cold water from the control unit’s ice reservoir to the anatomical wrap allowing heat to be removed from the treatment site. Simultaneously, the control unit pumps air into the separate, outer chamber of the anatomical wrap, intermittently inflating and deflating according to the pressure setting that is selected. The compression not only assists in preventing/ limiting swelling, but also conforms the anatomical wrap to the contours of the body. This increases the surface contact and aids the delivery of the circumferential cold therapy.

Info taken from https://gameready.com/

Cupping
Used to help relieve muscle stiffness and to stimulate fresh blood flow to the affected area to promote deep tissue healing.

Cupping therapy involves the use of plastic or silicone cups. A gentle manual vacuum pump creates a negative pressure that draws the soft tissue into the cups. The cups can be moved around or placed into stationary positions. The cupping therapy used at Pivotal Physiotherapy works on a myofascial level, much deeper than a practitioner’s hands can achieve.

Some of the benefits of cupping therapy include increase in circulation, decrease in inflammation and myofascial restrictions, increased range of motion, and improved tissue pliability. Cupping therapy can be used solely as a musculoskeletal treatment or can be placed in line with acupressure points to aid in organ toning and to relieve anxiety/stress on the mind and body.

Normatec
It’s recommended to use NormaTec within a few hours after exercise to expedite your recovery process. Post-workout recovery sessions are generally 20 to 60 minutes long with a moderate to high intensity level (it is safe to pump as long as you want).

The NormaTec Recovery system is dynamic compression therapy that helps reduce muscle soreness and improves circulation. The unit uses compressed air and pulse technology to massage your limbs, mobilize fluid, and improve circulation. The pulse technology, as opposed to static compression, mimics the muscle pump of the legs, which enhances the movement of fluid out of the limbs after an intense workout.

Info taken from https://www.normatecrecovery.com/

Whirlpool tubs– contrast baths
Useful in treating soft tissue and bone injuries. Hot water immersion results in vasodilation (enlarging of blood vessels) and a resultant delivery of nutrients including oxygen to the sore extremity. Cold-water immersion results in the opposite; vasoconstriction (shrinking of blood vessels) and a resultant removal of metabolic waste from the sore extremity. It is suggested that cold-water immersion blunts the inflammatory response to injured tissue, reducing oedema, haematoma formation, and pain. Alternating between the two results in a pumping effect with the net effect of a quicker recovery time.

PowerPlay
PowerPlay is best used following a musculoskeletal injury. At approximately one pound, PowerPlay is convenient for travel or home use. It combines the benefits of both cold therapy and compression therapy to get you optimized results. Cold therapy has been shown to be effective in decreasing muscle spasms, pain, and swelling in injured or overworked joints and muscles. PowerPlay takes these benefits further by adding active compression therapy mimic the body’s natural muscle contractions, pump edema out of the injured area, stimulate tissue healing, increase blood flow and delivery of oxygen to the site, and optimize lymphatic drainage.

Info taken from https://powerplay.us


CONCUSSION BASELINE TESTING
The biggest concern surrounding concussions comes from the energy deficit that occurs in the brain following injury. When the brain is in this low energy state, it has been well established that the brain is extremely vulnerable to additional trauma, where even smaller impacts can lead to another concussion; and these second concussions can cause severe brain injuries with potentially permanent or fatal outcomes.

The problem is that symptoms (meaning how someone feels) do not coincide with brain recovery. The only way to know when the brain has fully recovered and out of this “vulnerable period” is to compare current brain function to when the individual was healthy; this is what is known as a “baseline test”.

A baseline test is a battery of tests that measures every area of brain function that could potentially become affected following a concussion (you need more than computer tests!!). The reason that the test is termed a “baseline” is because it is done BEFORE the athlete gets injured. In order to know when an athlete has fully recovered, we first have to know where they were when they were healthy. Without having this information, there is no way to truly know when an athlete has fully recovered and is safe to return to their sport.

Baseline testing is the most important thing to get done prior to beginning your sports season on a yearly basis.


CONCUSSION MANAGEMENT
How to treat a concussion has become an important point of discussion for both amateur and professional athletes around the world. Concussion recovery is best managed by professionals who have received research-proven training and have the adequate skills to treat concussions. Here at ARC by Pivotal, our physiotherapists have received the specialized training needed and are competent, qualified and capable of treating concussions.