Physiotherapy (Physical Therapy) is a branch of rehabilitation medicine that focuses on physical rehabilitation of musculoskeletal injuries. These include injuries to joints, bones, muscles, ligaments, and the systems required for healing and normal function.
All of our Victoria Physiotherapists are registered to practice physiotherapy with the College of Physical Therapists of British Columbia and are members of the Canadian Physiotherapy Association. They are a motivated group of professionals that have achieved the highest Orthopaedic Designation obtaining their Diploma of Advanced Manual and Manipulative Physiotherapy, or are actively working towards this goal.
Physiotherapy at Shelbourne Physical Therapy Health Solutions in Victoria encompasses the following:
1) Assessment of the patients' subjective complaints and objective findings of their injury/complaint.
2) Treatment specifically designed for the individual's immediate needs and long-term goals.
- Ongoing re-evaluation as required to produce maximum results from treatment
- Communication with and/or referral to other health professionals deemed appropriate for the patient's care.
- A long-term treatment and/or home care plan specific to the patient.
Referral not required
Physiotherapists provide “Direct Access”, meaning that you don’t require a doctor’s referral to book an appointment. In fact, many of our Victoria patients turn to a Physiotherapist before they see a doctor for guidance with musculoskeletal problems.
All our Victoria Physiotherapists are trained to use their hands for joint and soft tissue mobilization and joint manipulations. These are important treatment techniques for increasing joint mobility, soft tissue extensibility, improving spinal fitness and restoring range of motion. The specific joint mobility assessment techniques determine the appropriate course of manual therapy treatment.
Phone: 250-598-9828 Website: http://www.shelbournephysio.ca
Specific exercises, dependent on assessment findings, are introduced into the treatment program to enhance healing and return to activity in a safe, effective manner. Home exercise programs are an integral part of each individual's exercise rehabilitation program and preventative maintenance.
Kinesiologist and Medical Exercise Specialist Heidi Nottelman works in our Exercise Studio located at 200B-3200 Shelbourne Street in Victoria. To reach Heidi please call 250-598-9828 extension 2. Practicing Kinesiologists Kira Graham, Evan Rogers, and Anna Marie DeZwager treat clients at our Gordon Head Recreation Centre Clinic. To reach them please call 250-595-5858. Registered Physiotherapists Brad Curry, Chris Nelson, Nicole Gill, Jenna Peters and Penny Salmas have degrees in Kinesiology and are well suited to look after your exercise needs.
Kinesiologists are human movement specialists offering a wide variety of assessments and services to the public to assist with both injury/illness prevention and injury management. Their practice is based on the core sciences of anatomy, physiology, biomechanics and psychomotor behaviour. Kinesiologists work in the fitness industry, clinically, and in industrial environments.
Scope of Kinesiology Practice
Kinesiologists provide services through the application of the science of human movement and deliver quality solutions through prevention, objective assessment, and evidence based intervention.
The assessment and search for the cause and treatment of dizziness, vertigo, and balance problems are within the realm of physiotherapy.
Registered Physiotherapist Jennifer Kolot has received special training and is well qualified to treat vertigo, balance and dizziness disorders. Jennifer Kolot practices at our downtown Victoria Physiotherapy clinic located at 308-1175 Cook St., Victoria, BC, V8V 4A1. To book an appointment with Jennifer please call the Cook Street Clinic at 250-381-9828. Their website is www.physiotherapyvictoria.ca
Vestibular rehabilitation therapy (VRT) is a specific form of physical therapy designed to habituate symptoms, and promote adaptation to and substitution for various aspects of deficits related to a wide variety of balance disorders. VRT is effective in improving the functional deficits and subjective symptoms resulting from unilateral and bilateral peripheral vestibular hypo function as well as from central balance disorders.
By improving vestibular function and promoting mechanisms of central adaptation and compensation, VRT aims to do the following:
- Improve balance
- Minimize falls
- Decrease subjective sensations of dizziness
- Improve stability during locomotion
- Reduce overdependency on visual and somatosensory inputs
- Improve neuromuscular coordination
- Decrease anxiety and somatization due to vestibular disorientation
The process of compensation depends on various mechanisms, including substitution strategies, prediction strategies, and cognitive strategies. Components of VRT may involve learning how to trigger the symptoms in order to ”desensitize” the vestibular system (habituation) for positional or motion-provoked symptoms, adapting to improve the gain of the vestibuloocular or the vestibulospinal reflexes, and substituting alternative senses to replace lost vestibular function by biasing use away from the dysfunctional vestibular input. When combined, this results in a progressive waning of symptoms of imbalance, disequilibrium, and motion-induced unsteadiness. As compensation occurs for a vestibular deficit, the remaining CNS processes allow sufficient control of eye, head, and body movements to maintain stable gaze, posture, and position.
Substitution strategies use several techniques, including alternate sensory inputs to drive motor output, alternate secondary motor responses instead of primary motor responses, and incorporating strategies of prediction and anticipation of intended motor behavior. The cervical-ocular reflex (COR) may be developed as an alternate source of visual stability during head movements. This is an example of a substitution strategy for deficits in the VOR.
VRT also takes advantage of the adaptive characteristics of the CNS to reestablish homeostasis within the vestibular system. Adaptation refers to long-term change in the neuronal response with the goal of reducing symptoms and normalizing gaze and postural stability. This results in increased VOR accuracy, refinement of oculomotor skills, improvement in postural control, and use of appropriate movement strategies. Adaptation serves to extinguish symptoms of dizziness provoked by motion or visual stimulation. Specifically tailored exercises promote adaptation by altering the input-output relationships of the VOR, including gain, timing, and direction. Adaptation exercises have been shown to improve symptoms of patients who are post-surgery for resection of acoustic neuroma.
Habituation exercises, first described by Cawthorne and Cooksey in the 1940s, consist of a series of eye, head, and body movements that provoke vestibular symptoms, which theoretically fatigue the vestibular response and force the CNS to compensate by habituation to the stimulus. Habituation exercises are used for patients experiencing from motion or position-provoked symptoms.
An assessment by a trained Shelbourne Physiotherapist is undertaken and results communicated to the referring physician and patient. Referrals for consultations are initiated to trained specialists as necessary. Conditions treated by the physiotherapist are those that require joint mobilizations/manipulations, manual therapy techniques, and home exercises.
Utilizing mechanical traction can benefit certain cervical, thoracic, and lumbar problems. It can improve your spinal fitness. The patient is comfortably positioned lying down to take pressure off affected structures such as discs, facet joints, and neurological tissue. Our specialized equipment is top of the line, imported from England.
Traction is sometimes referred to as spinal decompression. The cost for traction/spinal decompression treatment is $1/minute. A typical treatment lasts 15-20 minutes. All patients must be assessed by a Registered Physiotherapist at our clinics in Victoria prior to receiving spinal decompression/traction to ensure it is the appropriate treatment.
Included in this group of treatments are those modalities used to assist the manual therapist in achieving patients' treatment goals. These include:
Ultrasound - a mechanical and thermal agent that uses high frequency sound waves for a variety of therapeutic effects to aid in healing and pain relief.
Interferential current - a modality incorporating two interfering currents that produce a resultant therapeutic frequency that affects tissues. These include, but are not limited to, alterations in the transmission of pain and effects on the inflammatory process. Interferential current therapy is a treatment to relieve pain and promote soft-tissue healing. It involves passing electrical currents through the affected area of the body. The current tends to penetrate deeper than other electrical modalities, and has a number of physiological effects that have therapeutic value. The physiological effects include:
An increase in localized blood flow, which can improve healing by reducing swelling (the additional blood flowing through the area takes edematous fluid away with it). It also helps to remove damaged tissue, bring nutrients necessary for healing to the injured area, increase the permeability of the cells, and improve venous and lymphatic.
The stimulation of local nerve cells, which can have a pain-reducing/anaesthetic effect by potentially blocking the transmission of the pain signals (pain gate mechanism) at the spinal cord level. It can also stimulate the release of pain reducing endorphins (opiod mechanism).
Muscle stimulation, which allows the muscle spasm to decrease and overcome some of the muscle inhibition, often caused by local injury and swelling.
The electrical current is applied to the affected area using four electrodes. The four electrodes are placed in such a way that the two currents produced cross each other in the affected area. For example, when treating a knee injury, the two currents can be applied so that they cross deep within the knee joint. The two currents meet in the centre. Visualize the letter X, the greatest electrical impulses are at the intersection of the letter X.
There is no discomfort from the application of the interferential current. An ultrasonic gel is placed between the electrode and the patient’s skin, which allows the current to pass through to the body. If discomfort is felt, it is usually because the current is turned too high and needs to be adjusted slightly.
During treatment, patients feel a tingling or “pins and needles” sensation at the contact area of the carbon electrodes, and may feel a tingling sensation throughout the area being treated. This sensation may continue for a brief period following treatment as well. The intensity of the current is increased within the patient’s comfort level. A stronger current will usually have a more beneficial effect, but the intensity should not be turned up so high as to cause pain.
Electrical muscle stimulation - an electrical current with a frequency targeting muscle. It is used in muscle re-education and/or relaxation post injury.
High-voltage galvanic stimulation - a higher voltage current with a low average amperage used for acute injuries where pain and swelling are a major factor.
Our Victoria Physiotherapists are experienced in treating injuries resulting from sports and physical over-training. Our Victoria Sports Physiotherapist Brad Curry is a Member of Sport Physiotherapy Canada and has extensive post graduate training in treating sports injuries.
We have the added benefit of first-hand combined knowledge of various sports through the participation in the following sports:
Racquet sports, soccer, martial arts, weight-lifting, gymnastics, dance, running, skiing, ultimate frisbee, triathlons, pilates, snowboarding, golf, cycling, rugby, surfing, swimming, basketball, football, and rowing.
We realize the importance of returning injured athletes back to their sport as quickly and safely as possible, without jeopardizing the healing process. Sport specific rehabilitation functions to transition the athlete from an injured state towards progressive return to activity.
The unfortunate event of a motor vehicle accident (MVA) is a common reason to initiate treatment at Shelbourne Physiotherapy & Massage. Physiotherapy, often in combination with Massage, Kinesiology or Clinical Pilates, is an effective approach to your active rehabilitation in Victoria. Communication with ICBC adjusters or other private insurers and Personal Injury Lawyers is undertaken as part of treatment.
If you have been in a car accident and require physiotherapy you may have benefits through the Insurance Corporation of British Columbia (ICBC). Your accident benefits cover everyone injured in a crash who is riding in a vehicle that is licensed and insured in British Columbia. It also covers any cyclist or pedestrian hit and injured by a vehicle that is licensed and insured in B.C.
Once you are approved for funding by ICBC, they will pay for the majority of the cost of your therapy visit. However, there is a user fee per visit of $30.00. If the accident was deemed not your fault you should be able to be reimbursed for the user fees by ICBC. Please consult your Insurance adjuster to clarify any questions that you may have regarding the user fee payments.Any treatment fees not covered by ICBC will be the responsibility of the patient. Our 3 Shelbourne Physiotherapy Clinics in Victoria are approved by ICBC to provide Physiotherapy, Massage Therapy, Kinesiology and Rehabilitation Services after a car accident. We look forward to helping you recover quickly!
Our Billing Manager Amanda Blahey will be happy to answer any questions you have. Her contact number is 250-598-9828 or email: email@example.com.
The importance of physiotherapy treatment after surgery for spinal, shoulder, elbow, wrist/hand, hip, knee, and ankle problems are fully realized at Shelbourne Physiotherapy. Patients who have undergone surgery for a musculo-skeletal condition or injury are regularly referred to us for assessment and treatment. treatment focuses on decreasing pain, improving mobility and strength as per the surgical protocol and assisting you in return to your usual activities.Treatment progresses according to the specific Victoria RebalanceMD Orthopedic surgeon's protocols. Expectations regarding range of motion and function are communicated to the patient, and variations from the norm are addressed. Our Physiotherapists follow the Victoria RebalanceMD orthopedic surgical protocols and can help you rehabilitate from the following surgeries;
- ACL/MCL/PCL Knee Ligament Repair Surgery
- Arthroscopic Knee Surgery
- Knee Replacement Surgery
- Knee Meniscus Surgery
- Foot and Ankle Ligament Surgery
- Achilles Tendon Repair Surgery
- Wrist and Hand Surgery
- Hip Replacement Surgery
- Hip Resurfacing Surgery
- Shoulder Ligament Repair Surgery
- Shoulder Rotator Cuff Repair Surgery
- Shoulder Acromioplasty Surgery
- Shoulder Replacement Surgery
- Thoracic Outlet Syndrome Surgery
- TMJ Dysfunction-Post Dental Surgery
- Spinal Disc Surgery -Cervical, Thoracic and Lumbar
- Spinal Stenosis/Decompression Surgery
- Post Fracture/Dislocation Surgery
Registered Physiotherapist Mark Gottfried has a special interest in treating post operative knee injuries. To book an appointment with Mark please call our main Physiotherapy clinic located at 100B-3200 Shelbourne Street, Victoria, B.C. at 250-598-9828.
In treating sports injuries, taping to protect injuries joints for return to sports is often essential. It is also used for proprioceptive retraining of other joints and muscles. Postural taping is used to retrain "proper" posture and as a feedback mechanism when posture strays from within the normal limits.
Registered Physiotherapist Lindsay Baker has received special training in athletic taping. Lindsay is a qualified kinesiotape practitioner. To book an appointment with Lindsay please call our downtown Victoria Physiotherapy Clinic at 250-381-9828.
There are different indications for heat and cold, dependent on desired effects and the stage of healing.
Heat - Some of the effects include increased soft tissue extensibility, decreased pain perception, increased blood flow and decreased muscle spasm.
Cold - Some of the effects include decreased edema formation, decreased spasticity, decreased pain perception and decreased muscle spasm.
A variety of conditions not previously recognized as being treatable by qualified physiotherapists are considered in Women's Health rehabilitation.
Specialized assessment and treatment of the following patient populations are mostly seen: post-partum women, urinary incontinence problems, sexual dysfunction/pain, aging population, chronic pelvic pain, bladder problems, sacro-iliac and coccygeal dysfunction, pelvic floor weakness and blocked breast ducts of nursing mothers.
These are extremely common problems and most people can eliminate or significantly reduce their symptoms with some basic pelvic floor exercises, as well as diet and lifestyle modifications.
Registered Physiotherapists Cathy Stedman, Laura Werner and Lindsay Baker have a special interest in women's health core retraining, incontinenece and pelvic floor engagement. They have received specialized training and are well qualified to treat these conditions. To book an appointment with Laura, Cathy or Lindsay please call our downtown Cook Street Physiotherapy clinic located at 308-1175 Cook Street, Victoria B.C. at 250-381-9828.
To find out more visit the Canadian Continence Foundation Website
If you have been injured at work, WorksafeBC/ WCB may fund the cost of your Physiotherapy treatment. You must visit a medical doctor and tell them that your injury is work related which will get the injury claim started. If your Family Doctor or a Walk-In Clinic Doctor has provided you with a referral and the injury claim has been approved by WorksafeBC, you are eligible for up to 22 treatments over an 8 week period. There are no user fees involved since WorksafeBC will pay for the full cost of your treatment for approved claims. The initial week for Physiotherapy is always paid for even if the claim is not approved so don't delay in getting an initial assessment appointment.
Our experienced Physiotherapists will provide treatment that will help you get back to work and prevent re-injuring yourself. They will coordinate with Nurse Advisors and Adjudicators to ensure a safe re-integration back into the workforce. Our Victoria Physiotherapists Michelle Kao, Cathy Stedman, Mark Gottfried, Leslie Bradwell-Spohr, Nicole Gill, Chris Nelson, Kim Lobb, Brad Curry and Jenna Peters have contracts with WorksafeBC to treat your injuries and get you active again.
Experienced Physical Therapists Chris Nelson and Kim Lobb provide Hydrotherapy in the pool at the Gordon Head Recreation Centre for WorksafeBC injured workers. Hydrotherapy treatments can be arranged in conjunction with your Physiotherapy or Chiropractic treatments with approval from your WCB Adjudicator. To find out more please call our Rehabilitation Coordinator Larraine Hickson at 250-595-5858.
If you need to contact WorksafeBC the phone number is 1-888-WORKERS.
Our Victoria Physiotherapists Jennifer Kolot, Kim Lobb, Jenna Peters and Nicole Gill have special training and are well suited to treat your TMJ problems. Registered Massage Therapist Molly Rose Scott has special training in treating the TMJ.
What is the Temporomandibular Joint (TMJ)?
The TMJ is located directly in front of your inner ear, below your temple, and is a part of the body we use many times during the day when we talk, yawn, eat, drink or chew (see diagram). Usually, you are only aware of this joint when it becomes painful.
What causes TMJ Dysfunction?
The pain and tenderness of TMJ dysfunction can be caused by the disc in the joint moving out of place and causing pressure on sensitive structures around the joint.
Other causes of TMJ Dysfunction include:
- Clenching or grinding of the teeth, both during the day and while sleeping at night
- Extended periods with mouth propped open during dental surgery
- Poor posture, leading to strains or overuse of muscles in the face and neck
- cervical or thoracic spine dysfunction
- Inability to relax
- Poor diet
- chronic torticollis or other muscle imbalance
- Lack of restful sleep
- Alignment or structural problems present since birth
- Injuries to the face, head or neck, such as concussions, facial blows, or motor vehicle accidents
Symptoms of TMJ Dysfunction
The pain of TMJ dysfunction can be sharp, searing and catching, or dull and constant. It can be extremely debilitating.
Other symptoms include:
- Ear pain, or fullness of the ears
- Facial pain
- Sore, tight, tender jaw muscles
- Temple, cheek, tooth or jaw pain while swallowing, yawning, talking or chewing
- Jaw popping, clicking or locking upon opening or closing, or while chewing
- Reduced ability to fully open or close the mouth
- Frequent headaches or neck aches
- Muscle pain and spasms in the face, head and neck
- Ringing in the ears
Physiotherapy and TMJ Treatment
Are there treatment options?
Fortunately, a trained Physiotherapist can help by teaching you relaxation, stretching and strengthening exercises for the face, head and neck muscles. These exercises can also help to augment the effect of the appliance or mouth guard your dentist may have already provided to you.
Your program may include one or more of the following:
- Stretching and strengthening exercises of the jaw, head and neck
- Postural correction, relaxation and breathing exercises
- Manual Therapy, stretches and mobilizations of the jaw and neck joints
- Ultrasound and electrical stimulation to improve healing
- Acupuncture or dry needling
What can you expect?
At Shelbourne Physiotherapy , you will work directly with a certified Physiotherapist, trained through post graduate course work, in the assessment and treatment of TMJ dysfunctions.
The temporomandibular joint (TMJ) is the joint directly in front of the ear canal on either side of the head. The TMJ, which opens 2,000 – 3,000 times per day, is the most frequently used joint in the body. It is used for functions like talking, chewing, swallowing, or yawning. The temporomandibular joint is complex and is composed of muscles, tendons, bones and a disc sitting between the bones of the skull (temporal bone) and the jawbone (mandible).
The upper neck is also a very intricate part of the jaw complex and often involved in ongoing symptoms.
- Some of the common causes of TMJ pain and joint dysfunction (TMD) include:
- Grinding and/or clenching of teeth<
- Poor habits like gum chewing, cheek biting, and fingernail biting
- Dental problems and poor alignment of teeth
- Trauma inflicted on a jaw such as a motor vehicle collision or sports injury
The temporomandibular joint (TMJ) is a common source of pain and dysfunction. Some of the more common symptoms include clicking or popping with opening or closing of the mouth, headaches, facial pain, ear aches, and ringing in the ears. TMJ dysfunction can be caused by trauma such as a whiplash injury, excessive stress on the joint due to grinding of teeth or chewing gum, postural abnormalities especially a forward head posture, emotional stress, myofascial pain syndrome, arthritis, or dislocation of the disc within the joint.
The jaw is also known as the TMJ or Temporomandibular Joint. It can be painful as the result of injury, inflammatory disease, poor postures and habits or growth disorders. This leaflet gives you advice on managing your jaw pain. The TMJ is made up of several parts: the lower jaw (or mandible) and the socket (or temporal bone). In between the mandible and the socket is a disc. The disc allows the joint to glide smoothly on opening and closing. The joint is also held in place by muscles and ligaments.
What are the signs and symptoms of TMJ dysfunction?
Pain is the most common symptom of TMJ problems, although not everyone gets pain. Symptoms can include:
- Pain in the jaw joints and facial muscles
- Clicking, grinding or locking of the jaw
- Headaches & Dizziness
- Difficulty opening or closing the mouth comfortably
- Pain on talking, chewing (especially hard food) & yawning
- Ear pain, ringing in the ears (tinnitus) & hearing loss
What causes TMJ pain?
There are a number of causes and frequently it is a combination of
these rather than one single cause:
- Trauma, for example a blow to the jaw either directly to the joint or elsewhere on the jaw.
- Overactivity of the jaw muscles. This can occur from continuous
- Clenching or grinding the teeth.
- Wear and tear of the cartilage inside in the joint
- Increased sensitivity to pain linked to stress
What are the aims of Physiotherapy treatment?
- Relieve pain
- Minimise stiffness
- Restore normal function and mobility
Water is a wonderful medium for exercise, offering exciting opportunities for movement not available within land-based exercise programs. At the Shelbourne Physiotherapy Gordon Head Recreation Centre Clinic we offer Aquatic Physiotherapy individual and exercises classes to assist recovery from injury or surgery under the guidance of a qualified Physiotherapist or Kinesiologist. The classes incorporate individual programs, devised and based on an initial assessment. The aim of the classes is to incorporate each individual’s goal. Goals can include improving mobility and overall function; specifically strength, flexibility, posture, sporting performance, to speed up recovery, and/or minimise pain.
Why is water so beneficial?
Aquatic Physiotherapy, traditionally known as "hydrotherapy" uses the unique properties of water to improve and restore function after injury, surgery or illness or as part of a general fitness and conditioning program. When used properly, the physical properties of water can promote joint range, muscle strength, endurance, balance and fitness as well as increasing exercise confidence in older or de-conditioned populations. The buoyancy provided by being immersed in water alleviates joint stress and promotes freedom of movement. Water buoyancy can improve functional range of knees, shoulders and hips following joint replacement or musculoskeletal injury. In water there is less post exercise soreness compared to land based programs meaning exercise can commence sooner after injury or surgery and be better tolerated by those with painful joints from chronic conditions such as osteoarthritis. The warmth of water can help muscle relaxation, making exercises more comfortable and stretches more effective when performed under water. Under the guidance of a trained professional the viscosity and turbulence of water as well as the use of floats, paddles and other equipment can be used to promote strength and power to weak muscles. specific exercises can promote greater balance, coordination, and aerobic fitness and help speed the recovery process following injury or surgery. The properties of water (hydrostatic pressure, buoyancy, thermal conductivity, turbulence and resistance) are utilised to assist and support patients in the early stages and can be progressively increased to create a strong training environment towards the end stages of rehabilitation.
Is Hydrotherapy for me?
Rehabilitation is vital to help regain strength and movement following surgery or injury. Aquatic exercise can be well tolerated at any stage of your recovery and may help you get back to land based home exercises and gym programs sooner. The hydrotherapy sessions conducted by Shelbourne Physiotherapy at the Gordon Head Rec Centre are fully supervised and conducted by a Physiotherapist or Kinesiologist using specialized techniques to maximize the numerous benefits the water has to offer.
Hydrotherapy is recommended following surgery such as;
- Total hip or knee replacement
- Shoulder arthroscopy or rotator cuff repair
- Knee reconstruction and/or arthroscopy
- Ankle arthroscopy
Hydrotherapy can also be used to:
- Relieve neck and back pain
- Recover from Work Injuries
- Increase aerobic fitness
- Improve general mobility
- Rehabilitate Joints and muscles in conditions that are non weight bearing such as leg fractures
- relieve pain from arthritic joints
Experienced Physiotherapists Chris Nelson, Jenna Peters and Kim Lobb provice pool therapy to clients at our Gordon Head Recreation Centre Clinic. Call our Rehabilitation Coordinator Larraine Hickson at 250-595-5858 for more details.