The Ultimate Guide to Physiotherapy

What is a Physiotherapist?

A physiotherapist is a health care professional who has education, training and certification in treating injuries and conditions by assessing your whole body biomechanics and function in relation to your individual needs as a person and in relation to the specific requirements of your condition or injury. To help you on your journey to recovery, a physiotherapist uses various skills and techniques that include good listening and understanding of your needs, as well as clear communication and education.

What are the Top 5 Benefits of Physiotherapy?

  • Decreased pain: in addition to finding and fixing the root cause of your problem, the best physiotherapists also use various techniques and modalities to lessen your pain so that your daily life is more manageable and you feel better sooner rather than later
  • Increase strength and stabilization: your physiotherapist will find where you are weak or unstable and help you to fix those deficits so that you can fully recover
  • Improved range of motion and mobility: if you are tight or lacking joint range of motion, your physio will use hands-on skills and other techniques to fix these
  • Better balance and coordination: injuries often occur due to lack of joint balance or limb coordination so your physio will help to correct this with neuromuscular and proprioceptive retraining
  • Strategies to prevent re-injury: the best physiotherapists spend the time to properly educate you on what to do at home or in your gym to achieve and maintain good body functional strength and stabilization to best ensure that you can prevent injuries in the future

Table of Contents

Physiotherapy at GRSM

Physiotherapy at GRSM focuses on sport and activity-specific rehabilitation. Our goal is to return you to your activity as soon and as safely as possible.

Your Initial Assessment:
  • You will be assessed by a Registered Physiotherapist
  • Your appointment will be approximately 60 minutes long
  • You may need to bring shorts/tank top/ running shoes – depending on the location of your injury
  • Together, you and your Physiotherapist will determine the frequency of future visits to ensure you achieve your treatment goals
  • Initial Assessments are $145 and can be billed directly to your insurance (if it allows).  We also have various payment options.
Your Registered Physiotherapist Will:
  • Provide you with a clinical diagnosis
  • Explain the nature of your injury and the factors that will contribute to your rehabilitation
  • Educate you regarding your prognosis (how long it will take you to get better)
  • Discuss your goals for treatment
Our Approach includes:
  • Whole body biomechanical assessment – poor biomechanics often contribute to localized injuries
  • Manual therapy – “hands-on” techniques used to restore joint function
  • Acupuncture, electrotherapy and ultrasound – to decrease pain and inflammation
  • Individualized home or gym rehabilitation programs – including sport-specific strengthening and stretching exercises
  • Video analysis – athletic technique (e.g., pitching technique, running gait, golf swing) is recorded on video and analyzed on computer
Your Rehabilitation Team May Also Include: 
  • A co-op student from high school, college, or university
  • A volunteer
Your Return Visits:
  • Will be 30, 45 or 60 minutes of individualized care from a Registered Physiotherapist.  The length of the appointment will be determined through discussion with your Physiotherapist
Your Treatment May Include:
  • Education regarding your condition and prognosis
  • Manual treatment (hands on treatment for the joints/muscles)
  • Completion of Outcome Measures to help measure your progress
  • Instruction in therapeutic exercise (in clinic exercises and/or a home program)
  • Modalities (may include ultrasound, interferential current, muscle stimulation, acupuncture, Gunn intra-muscular stimulation)
Your Role In Physiotherapy Is An ACTIVE One! Be sure to:
  • Engage in open and honest discussion with your Physiotherapist
  • Comply with your home and in-clinic exercise program
  • Ensure you book and keep your appointments 

Booking Your Appointments

  • If you have a busy lifestyle or restricted schedule, we recommend you book your appointments two weeks ahead to ensure you get the appointments you need
  • Ask about the cancellation list if you cannot get the number of appointments and/or the specific times that you prefer
  • Please call before 2pm the day before your appointment to cancel your appointment and avoid the $50 missed appointment fee
  • EVENING APPOINTMENTS AVAILABLE (Note: they book up quickly!)

Common Conditions We Treat

GRSM Physiotherapy Programs

Intramuscular Stimulation

IMS is a total system for the diagnosis and treatment of myofascial pain syndromes (chronic pain conditions of the musculoskeletal system) (Gunn, 2013).

Pelvic Health Physiotherapy

Pelvic floor dysfunctions causing pain or continence problems can be successfully treated by physiotherapy. An internal examination reveals details about strength, control, and specific zones of weakness.

Acute Injuries Rapid Response

GRSM is committed to providing a Rapid Response in assessing and treating Acute Injuries that have been referred by Physicians.

Sports Concussion

GRSM is committed to providing an efficient and comprehensive assessment and treatment of sport concussions in the high standard of care that GRSM is renowned for.

How do I Find the Best Physiotherapist Near Me?

When you do an online search to find a good physiotherapist, you will undoubtedly come up with dozens of options.  So how do you choose between the many physios in your area?  How do you figure out which physio is right for you?  How do you determine if your physio is any good?  You want to find a physio who is well qualified, offers high quality of care, and can connect with you and your condition or injury on an individual basis.  Here are the important steps to finding a good physiotherapist near you:

  • Certifications and credentials: make sure that your physiotherapist is a registered physiotherapist with the College of Physiotherapists of Ontario, and has other special certifications that suit your individual needs depending on your injury or condition
  • Recommendations from friends and family: there is nothing better than getting a recommendation from someone close to you who you trust, who has had a good experience with a physiotherapist.  It is still important to look at all the factors in finding the best physiotherapist for you since even though your friend or family may care for you a lot, they may not know the particulars of your injury or condition

  • Recommendations from your physician or other health care provider:  physicians and nurse practitioners commonly refer to physiotherapists; although, it is difficult for physicians and nurse practitioners to know every physiotherapist or the strengths of every physiotherapist, should be able to give you some good direction based on their experience in referring to physios
  • Recommendations from a coach or trainer: although coaches may not have in depth knowledge about particular injuries, they have often had experience with physios who have treated their athletes
  • Google or other online reviews: doing Google searches is important as we tend to search everything online these days; however, Google reviews and ratings can sometimes be manipulated and/or be uncertified, so look at the total number of reviews, the average rating compared, whether the actual reviews appear real or not
  • Focused areas of practice and specific training: does the clinic offer physiotherapists who have focused areas of practice that will better suit your needs for your particular condition or injury.  Examples of focused areas of physiotherapy include: sports medicine, pelvic floor, foot & ankle, TMJ (temporomandibular joint), concussions, vestibular, neurological, running, core & hip stabilization
  • Clinic cleanliness, space and equipment: make sure the clinic environment is clean and safe, enough space to do rehab exercises, enough space to do sport-specific training, equipment and machines that help in the rehab process, is the clinic environment pleasing to be in
  • Administrative staff: do they seem happy, do they treat you with respect, do they genuinely try to help you or are they just trying to sell you something
  • Practical issues: direct insurance billing, online booking
  • Assess the physio at the first appointment: ensure that the physio takes enough time to assess you and your situation fully so that your needs are well-understood; ensure that you have good rapport with the physio and that the physio can communicate with you clearly; ensure that the physio genuinely cares about you and your goals and is not just see you as a number.

What are the Top Techniques used by the Best Physiotherapists?

  • Whole body biomechanical assessment: the physio should assess not just the injured body part but should assess your whole body and how it functions; poor biomechanics often contribute to localized injuries and a good physiotherapist takes the time and puts in the effort to analyze you comprehensively
  • Manual therapy: “hands-on” techniques are often needed to restore joint function, improve mobility, relieve tightness… all of which are important to healing your injury or condition
  • Modalities: such as acupuncture, electrotherapy and ultrasound are part of treatment and in relieving pain but these should not form the basis of your treatment
  • Home or gym rehab programs: your physio should be giving you the tools to take care of yourself to heal your injury and to prevent re-injury; this includes a comprehensive but convenient home exericise program to restore strength, mobility and full function, and that is individualized to your personal situation and injury
  • Motion and video analysis: to get you back to full health, your physio needs to carefully assess how you move and function for your sport or activity, as well as for your movements of daily life
  • Education and communication: your physiotherapist should be good at communicating the diagnosis, underlying biomechanical issues, treatment plan, expectations for improvement, and in teaching you how to help yourself now and in the future
  • Neuromuscular retraining: the best physiotherapists understand that the recovery process involves retraining the whole neural pathway from your brain to your muscles, so that you can regain full function

What are the Top Types of Physiotherapists?

physiotherapist demonstrating proper exercise techniques

Sports & Exercise Physiotherapist

Has special training and experience in treating injuries and conditions related to sports and exercise; in a multidisciplinary full-service sports medicine centre, the sports injuries are the “bread and butter” of the physios who works there.

Orthopedic Physiotherapist

Has added certifications in the techniques needed to treat orthopedic injuries and conditions (i.e., related to bones, muscles, tendons and joints); in a sports medicine clinic, it is important for the physios to also have special orthopedic training.

Physio assisting patient with TMJ exercises

TMJ (Temporomandibular Joint) Physiotherapist

The clicking, snapping and pain in your jaw can be very annoying and disconcerting; a TMJ physiotherapist has special knowledge and techniques to address this condition.

Foot & Ankle Physiotherapist

Foot & Ankle Physiotherapist

Has special training and knowledge in treating foot and ankle conditions and injuries.

Core & Hip Stabilization Physiotherapist

Stabilizing your “core” (deep lower abdominal and lower back muscles) and hips (gluteal, buttock muscles) can be very complex and difficult to teach; but physios who have a focused interest in this area are especially helpful in treating hip and back problems.

Back Pain Physiotherapist

Back Pain Physiotherapist

Back pain can be very difficult and painful; physios who have a focused practice in treating back pain have a special interest and knowledge in this area and typically have special training in core strength, Pilates and pelvic floor.

Physio giving patient a neurological assessment

Neurological Physiotherapist

Neuro Physiotherapy helps optimize recovery from neurological injury with a focus on normalizing movement and function. Neuro Physiotherapists have taken additional post-graduate courses to better understand the complex nature of the brain and nervous system, and to learn how to help retrain the brain.

Vestibular Physiotherapist

Vestibular Physiotherapist

Has special training in treating conditions that affect the vestibular system which result in problems with balance, dizziness, vision, etc.

Concussion Physiotherapy

Concussion Physiotherapist

Concussions are very common and can cause a lot of chronic disability if not treated properly; a concussion physiotherapist has focused knowledge in the issues that contribute to concussions or are important in the recovery process (neck injury; vestibular and balance problems; retraining the brain and body to return to work, school and sport; visual problems).

Post-Surgical Physiotherapist

Post-Surgical Physiotherapist

Have experience and training in helping patients recover from orthopedic surgeries such as knee ACL reconstruction, shoulder stabilization, shoulder rotator cuff repair, knee meniscal tear, hip and knee joint replacement.

Pelvic Floor Physiotherapist

Pelvic Floor Physiotherapist

Pelvic health physiotherapists have specialized training in treating the pelvic floor. This is a group of muscles, joints, and nerves that contribute to bowel and bladder function, sexual function and stability of the pelvis, hips and back. Assessment and treatment of the pelvic floor is done externally as well as internally (vaginally and/or rectally), as many of these muscles cannot be felt from the outside. It is tightness and/or weakness in these muscles that can cause pain and incontinence. Like many other areas of the body, through physiotherapy treatment, the pelvic floor can return to normal function.

Guide to Treatment of TMJ Disorders

Have you been told that you have temporomandibular joint (TMJ) dysfunction? Do you have jaw pain, tightness, or clicking? Do you clench or grind your teeth? Do you experience headaches, tinnitus, or neck pain? TMJ dysfunction (TMD) often presents with a wide range of symptoms, beyond the jaw itself. Considering how often we use our TMJ – talking, eating, smiling, yawning – TMD can be a major source of pain and disability. However, many individuals are unaware of the treatment options available, including physiotherapy.

What is TMJ Dysfunction?

The TMJ is the joint that sits in front of the ears and connects your jaw to your skull. The muscles of the TMJ function to allow the jaw to open, close, move side to side, and move forward and back. These muscle span over the jaw and up into the side of the head. There is a disc within the TMJ that provides cushioning to the joint. Dysfunction of any of these structures can lead to TMD. This may include muscle tightness, joint hypermobility, joint hypomobility, or disc displacement (movement of the disc). Symptoms may include jaw or facial pain, tightness, clicking, locking, headaches, and tinnitus to name a few.

Why Do You Have TMJ Dysfunction?

TMD is a common condition, and many people have signs of TMD. Both males and females may experience TMD, however, it is more common in females. The cause is often complex but can be related to underlying dental issues such as missing teeth or over/under bite, teeth clenching and grinding, trauma, poor posture (for example, due to increased computer use), anxiety and stress, ligament laxity, arthritis and hormonal changes.

How Can Physiotherapy Help With TMJ Dysfunction?

Physiotherapy is an effective treatment method for TMD. Physiotherapy can help people with TMJ pain and dysfunction by:

  • Reducing muscle pain and tightness
  • Improving TMJ mobility
  • Addressing and correcting TMJ biomechanics and improving motor control
  • Addressing postural factors involving the neck, shoulder, and upper back
  • Providing education on activity modifications

Your TMD physiotherapist will assess:

  • TMJ range of motion and joint mobility
  • Muscle tension – including an extraoral and intraoral assessment
  • Biomechanics of TMJ during opening and closing
  • Neck, shoulder, and upper back mobility and posture

Physiotherapy Treatment for TMD may include:

  • Exercise prescription (specific to each patient)
  • Joint mobilizations
  • Myofascial release
  • Postural exercises
  • Activity modifications

Here are some specific examples of TMD exercises and activity modifications:

TMD Exercise examples:

  • Mouth opening with tongue on roof of mouth
  • Guided mouth opening with your finger
  • Chin tucks
  • Thoracic mobility exercises
Physio assessing patient with TMJ
Physio assisting patient with TMJ exercises

What is Neuro Physiotherapy?

Have you suffered an neurological injury or are you suffering from a neurological conditionNeuro Physiotherapy can helpNeuro Physiotherapy helps optimize your recovery from a central nervous system injury with the focus on normalizing your movement and functionNeuro Physiotherapists have taken additional courses to better understand the complex nature of the brain and nervous system, and how to help retrain your brain from injury. 

What Does Neuro Physio treatment Involve?
  • A comprehensive assessment looking at your whole body movement including day-to-day activities like dressing, transfers, balance, walking and other mobility goals.  
  • Sessions are usually an hour and can involve stretching/mobilizations, facilitations with movement, active gym work, education and home programs.  
  • Neuro Physios help you with tone management, including stretching, bracing, and injections.                                                                                                                            

Who Can Benefit From Neuro Physiotherapy?

Anyone who has experienced: 

  •  A neurological injury  
  • A neurological condition  

Some examples include: 

  • Acquired Brain Injury – post surgical, tumour, trauma 
  • Stroke 
  • Parkinsons 
  • Multiple Sclerosis (MS) 
  • Brain Tumour 
  • Guillain-Barre Syndrome

Our goal is to work with you to achieve optimal function.                                                                                                                                           

Physio giving patient a neurological assessment

Treating Acute Sports Injuries

Most athletes have experienced an acute injury at some point in their career. The sudden change in direction, accidental hit or fall, a divot in the ground, that takes you from the game to the sidelines.  There are many variables that affect the intensity and severity of the injury, some are within your control, some are not.

Physiotherapy is one you do have control over. Receiving prompt, comprehensive and effective management of these injuries facilitates not only recovery but also return to peak performance. In this article, we review the many ways physiotherapy serves as a cornerstone in the treatment and rehabilitation of acute sports injuries.  

What is an Acute Sport Injury?

An acute sports injury describes any injury that occurs during your sporting event and usually means that your injury is recent, typically within the preceding two weeks Acute injuries can affect a wide variety of tissues, including muscle, bone, ligament, tendon and joints. Severity, or the extent of tissue damage, can also range, from more minor sprains and strains to joint dislocations, fractures or full ruptures.  Regardless of the tissue involved or the severity of the injury, getting assessed quickly and accurately gets you back on the road to sport.  

Common Types of Acute Sports Injuries:

Sprains: An over stretch injury to ligaments- the connective tissue that joins a bone to another bone and provides a joint with stability. Injury to ligaments can vary from a mild pull to a tear, rupture or even an avulsion, where a piece of bone comes off as the ligament pulls away. It will present with swelling, bruising, pain and affect how the joint moves.  

Strains: An overstretch or overload injury to a muscle to tendon – a tendon is the connective tissue that joins a muscle to bone. The severity can range, as can the symptoms, from mild tightness, to swelling, bruising and limited range.   

Fractures: A break in a bone, often from an extreme load such as a fall or impact. Hairline fractures can be very small and difficult to see on X-ray imaging. Other fractures can be large and easily identifiable. Not being able to move the area or weight-bear are key indicators that an X-ray is needed.  

Dislocations: Joint dislocations occur when a bone is forced out of its normal position. This usually requires an extreme load, such as a fall or impact, but can occur more easily if a pre-existing injury is present (such as a previous dislocation). A dislocation can affect the connective tissue around the joint (such as the ligaments, labrum or capsule) and can also cause fractures or injury to nerves. Dislocations can sometimes relocate on their own, so it may be very obvious that a bone is not in the right position, or it may not be. Careful and thorough examination is key. Range of motion will be limited post dislocation.   

Contusions: Also known as bruising, they are caused by trauma to an area that leads to bleeding beneath the skin.  You can also get contusions affecting the muscle, tendon, cartilage and bone.  

Concussions: Traumatic brain injuries that can occur from a blow to the head, or severe whiplash with a hit or fall.  

How Your Physio Provides immediate Treatment for Acute Sports Injuries

Immediate Physio Treatment: Physiotherapists are often present at games, ready to provide immediate first aid and assess the extent of injuries.  Quick assessment and intervention by your physiotherapist can help to minimize further tissue injury and determine next steps for treatment.  If your physiotherapist is not present, seeking out an assessment as soon as possible is key to getting back into the game.   

R.I.C.E – Rest, Ice, Compression, Elevation:

  • Relative Rest: means to offload the specific region from additional stress or strain- for example using crutches, braces, or avoiding lifting/heavy use of an area. In some cases, it means no use at all- particularly if there are concerns for dislocation or fracture. But it other cases it means having some movement, to help with circulation, pain relief and avoiding excessive stiffness. A Physiotherapist will help determine what course of action is best, given your specific injury.   
  • Icing: helps to reduce swelling and pain.  
  • Compression such as a wrap, bandage, or brace can help to provide support and reduce swelling.  
  • Elevating the limb helps to minimize swelling.  

How Your Physio Decreases Your Acute Pain: Acute injury often means sharp and severe pain. Your physiotherapist has a variety of different pain management strategies that can help reduce pain, allow you to move more comfortably, and most importantly, sleep so that your body can heal.  Physiotherapists can help you navigate through different pain management options to find which are best for you. These can include: 

  • Manual therapy (hands on work to the soft tissue, joints and nervous system)
  • Modalities (machines such as ultrasound or interferential current) 
  • Assistive devices (braces, crutches, canes).   

Physio Detailed Assessment and Referral: Physiotherapists have the knowledge and skill set to conduct diagnostic assessments to determine the severity and nature of injuries. They are also equipped with the ability to screen for cases that require further medical attention. In those circumstance, Physiotherapists can facilitate referrals to other health care professionals to keep you moving forward.   

Physiotherapist applying an ice pack to patient's acute sports injury
Foot & Ankle Physiotherapist

Physiotherapy for Hip Pain

The hip joint is a ball and socket joint located in the groin area, really close to the midline of your body. Your hip joint works very closely with your lumbar spine for movement of the hip and back, and very closely with your foot for shock absorption and propulsion during gait and sport. Because of its role in so many actions, if injury occurs to the hip joint, the pain and limitation in movement can have big impacts on your quality of life. 

In this article, we review how physiotherapy is used as a guiding force in relieving hip pain. Physiotherapists perform a detailed physical assessment in order to create an individualized treatment plan. When it comes to getting back to your sport or activity following hip joint pain, physiotherapy is the place to start.   

How Physiotherapy Supports Your Healing Process

Physiotherapy helps your hip pain by using a comprehensive approach, with the main goals of reducing pain, enhancing mobility, improving strength, and addressing the underlying factors contributing to your hip discomfort. Physiotherapists want to help you learn how to care for yourself and get back to the activities and exercise that you love.   

Reducing Hip Pain

  • Helping to reduce pain with hands-on techniques, the use of modalities or braces enables you to get moving quicker and easier.   
  • Reduced pain also allows you to begin targeted exercise that further alleviates pain and begins addressing some of the underlying issues contributing.   

Restoring Movement & Function

  • Restoring range of motion and flexibility ensures that you can load an area properly, limiting or eliminating the need for compensation strategies.  
  • Preventing compensation early can help minimize load imbalances that can become habitual, and something that will need to be unlearned over time.   

Hip Strengthening 

  • Exercises specific to weak muscles helps to share load around the hip joint, reduce compression and shear at the joint level and improves overall function.

Hip Joint Mobilization

  • Often called  “manual therapy, joint mobilizations help to restore the natural movement at the joint surface, improve circulation and reduce the neural output in the area.  

Postural Correction

  • No single posture is good or bad, but living in only one posture is.  
  • Identifying habitual positions that contribute to uneven load distribution is important in ensuring long term health and movement patterns around the hip.   

Preventive Strategies for Hip Pain

  • Preventing re-injury or aggravation is a crucial element to comprehensive rehabilitation.   
  • Through exercises, education, and lifestyle modifications, you can learn how to maintain gains and prevent reinjury.   

Patient Education

  • Empowering you with knowledge about your condition, self-care strategies, and exercises for ongoing hip health.  
Physio Treatment for Hip Pain

Physiotherapists are skilled in different ways to help your healing. Each tool in the toolbox is used in a manner specific to your injury and needs, contributing to a personalized and effective treatment plan.  

Manual Therapy

  • Massage and Soft Tissue Mobilization: Hands-on soft tissue work can help to improve circulation, reduce neural output and guarding/muscle tension, and reduce overall pain.   
  • Joint Mobilization: Based on the shape of the joint, mobilizations can be used to help restore movement at the joint surface, increase circulation, reduce neural output and overall pain.  
Exercise Prescription
  • Hip Strengthening of the hip joint stabilizers, especially iliospoas, gluteus med/min and the adductors are key to helping share load across the hip joint. 
  • Hip Static stretching meaning holding a stretch for an extended period of time, to increase the length of the muscle and the range of the joint.  
  • Hip Dynamic stretching meaning shorter holds, or stretching a muscle while moving through a range, helps to reduce neural output and muscle guarding. 
  • Functional Movement Patterns Integrating exercises that mimic daily activities or sports specific tasks to promote functional recovery.  

Physiotherapy for Back Pain

Back pain is one of the most common conditions around the world and can have massive effects on your ability to participate in sport, day to day activities and your overall quality of life. Back pain is multifaceted, with a number of different variables that contribute to its intensity, severity and duration. Physiotherapy is a powerful intervention used to successfully address many of those variables and provide you with the tools to get back to the things you love.

This article aims to look at some of the ways physiotherapy helps you to understand, address, improve and maintain both physiological and psychological aspects of back pain so that you can return to the things you love with confidence.  

Physiotherapy Comprehensive Assessment and Treatment to help Your Back Pain

Your physiotherapist will look at the different variables that contribute to your particular situation. This customized, comprehensive and patientspecific approach ensures a complete understanding of what body tissue is angry, why it is angry and how to promote recovery and prevent reinjury.    

Comprehensive Physio Assessment:

  • Assessment involves a thorough taking of your medical history, including previous injuries, training regimes and lifestyle factors.   
  • Assessment also includes a detailed analysis of gross motor function, meaning large, functional and sport specific movements, as well as specific and individual joint and muscle functions.  

Physio Modalities:

  • Physiotherapists may use different modalities to help manage pain and inflammation.   
  • Techniques can include taping or bracing, heat therapy, cold therapy, ultrasound, and/or electrical stimulation.  

Physiotherapy Manual Therapy:

  • Hands-on techniques to facilitate joint motion, soft tissue mobility, circulation, neural mobility, fascial mobility and nervous system regulation.  

Exercise Prescription From Your Physio:

  • Long term change comes from you- which is why tailored exercise programs are the key to lasting change.   
  • Patient specific programs that focus on strengthening the core muscles, improving flexibility, and correcting muscle imbalances are vital to improving pain and function, and ensuring patients stay healthy.  

Postural Correction:

  • Poor static and singular posture is a common contributor to back pain.  
  • Physiotherapists work with you to correct imbalances through exercise and lifestyle adjustments.  
  • Ergonomic recommendations can also be made regarding your home and work set-up to improve load sharing and mobility. 

Physiotherapy Core Strengthening:

  • The core muscles play a crucial role in supporting your spine and pelvis, transmitting load, and keeping you moving well.  
  • Physiotherapy emphasizes core-strengthening exercises to enhance stability, mobility and reduce the strain on your lower back.  

Flexibility Exercises From Your Physio

  • Shortened muscles can contribute to range limitations, poor neural or fascial mobility and load imbalance.   
  • Physiotherapists incorporate flexibility training to address muscle shortening and improve the range of motion in your spine and surrounding areas.   
  • Stretching exercises are tailored to your specific needs and areas of tightness. 

Education on Ergonomics and Lifestyle:

  • Your physiotherapist will educate you on proper ergonomics, both at work and at home.  
  • This can include gross motor guidance, such as lifting techniques, as well as modifications to work-station set up.  

Physiotherapist Biomechanical Analysis:

  • Your physio will conduct a  thorough biomechanical analysis to assess how your body moves 
  • By identifying imbalances, inefficient movement patterns and/or habitual avoidance, your physio can guide you through corrective strategies and exercises to better spread load.

Patient-Centered Goal Setting:

  • Physiotherapy is first and foremost about YOU, the patient – with each session and treatment plan tailored to your individual goals, aspirations and functional needs.  
  • Physiotherapists work you to set achievable and meaningful objectives as you get back into activity.   

Psychosocial Support From Your Physiotherapist:

  • Pain, particularly persistent pain, can have significant impact on your psychological and emotional wellbeing. 
  • Physiotherapists provide psychosocial support through open discussion, identifying coping strategies, stress management techniques, and providing encouragement and opportunities for success.  
Physiotherapist doing a a back assessment
Physiotherapist helping patient's poor posture habits
Patient receiving support for her back pain from physiotherapist

Gluteal Strengthening for Knee Osteoarthritis

Are you one of the millions of Canadians who has knee osteoarthritis? Do you struggle with pain, stiffness and inability to do sports and exercise, or worse yet, with activities of daily life? Do you want to do something about it… something that you can do yourself on your ownGluteal strengthening may be something you are looking for that can help you regain function and mobility, and regain control of your quality of life.   

What is Knee Osteoarthritis?

Osteoarthritis is a degenerative condition that leads the breakdown of the joint cartilage which acts like a shock absorber and forms a nice smooth rubbery later for the bones to glide against each otherWith OA, the cartilage later become rougher and thinner, the joint often develops swelling, bone spurs and capsular tightness, and the muscle around the joint tend to become weakerThe resulting inflammation and structural changes in the knee contribute to pain and reduced joint function, which affects your ability to perform sports and exercise and can even severely impact everyday activities. 

Why Does Gluteal Strengthening Help Knee Osteoarthritis?

The gluteal muscles are a group of three muscles in your buttock: the gluteus maximus, the gluteus medius and the gluteus minimusThese gluteal muscles play in important role in the biomechanics of the knee and the entire lower extremitiesThese muscles, the “glutes” play a crucial role in stabilizing the pelvis, controlling hip  and knee movement, and maintaining proper leg and knee alignmentIn particular, the gluteal muscles are extremely important in stabilizing and decreasing strain on your knee cap during activities such as walking, running, and ascending or descending stairs.  Recent research has highlighted the significance of gluteal muscle strength in influencing knee joint mechanics and the role they play in decreasing the symptoms of knee OA and in preventing the progression of the degeneration in the knee joint.

How Can My Physiotherapist Help Me With Gluteal Strengthening Exercises for Knee Osteoarthritis?

Gluteal strengthening exercises can have a profound beneficial effect on decreasing symptoms, as well as improving function and quality of life, when you have knee OA.  Although most people can safely and effectively do a gluteal strengthening program, you should strongly consider seeing a physiotherapist before starting your home program.  A physiotherapist who is experienced and knowledgeable in treating knee OA will be able to guide you in the process to optimize your progress and better ensure it is done safely.  

Trying to strengthen your gluteal muscles can often be tricky as it is often difficulty to get the right muscles working (i.e., are you actually using your glutes when you do the exercise?), and sometimes glute strengthening exercises can aggravate pre-existing conditions in the back and hip if not done properly.  

Your physiotherapist will: 

  • Individualize your program that that it suits your abilities and your biomechanics.   
  • Instruct you on how to do the exercises safely to minimize the risk of worsening your pain  
  • Instruct you on the correct technique which will improve your chance of success and ensure you are not wasting your time and effort   
  • Help you in the often difficult process in “activating” your glutes while doing the rehab exercise but also in more complex functional movement patterns.  
  • Guide you along the process on how to properly progress the exercises to make them more challenging over time and to suit the needs of your daily life and exercise goals.  
What Physio Gluteal Strengthening Exercises for Knee OA can I do at Home? 
Hip Abduction
Side-Lying Leg Raises: 
  1. Lie on your side and lift the top leg upward while keeping your hip and knee straight
  2. Hold for a few seconds, then lower it back down
  3. You should feel your buttock muscle working more than the side of your hip working

Clamshells:

  1. Lie on your side with your hips and knees bent
  2. Open and close your knees like a clamshell while keeping your feet together

Standing hip hikes:

  1. Stand with holding on toe a railing or table for support if needed for balance
  2. Lift one foot off the floor by bending your knee
  3. Using the glutes in the opposite buttock, tilt your pelvis up and lower it down (“hike” your hip up)
  4. Again, you should feel the glutes in the opposite hip working

Hip Extension

Bridges:

  1. Lie on your back with knees bent and lift your buttocks/hips off the ground
  2. You want to feel your glutes activating and working
  3. Hold for a few seconds, then lower your buttocks/hips back down

Standing Hip Extensions:

  1. Stand and lift one leg backward while keeping it straight
  2. Activate your glutes at the top of the movement, then lower your leg
  3. Make sure you don’t arch your lower back   

Functional Movements

These exercises are more complex and have a higher risk of aggravating your knee OA if not done properly. You need to ensure that you are feeling your glutes working hard when you are doing these exercises. Ideally you are contracting your core muscles at the same time and you do no want to be arching or slumping your lower back. 

You do NOT want to feel pain in your knee and you do now want to feel like your thigh muscles are doing the majority of the work. It is the glute muscles that should feel like they are working hard.  

Step-Ups:

  1. Step up onto a platform or a stair with one foot
  2. Step back down and repeat on the other side
  3. You want to activate and feel your glutes working

Squats:

  1. Start by standing with feet shoulder-width apart, toes slightly turned out
  2. Initiate the squat by pushing your hips back, keeping your chest up, and bending your knees while ensuring they track over your toes
  3. Focus on a controlled descent and ascent, keeping the depth comfortable for your knees, and emphasize pushing through your heels to engage the gluteal muscles while maintaining proper knee alignment

Lunges:

  1. Stand with feet hip-width apart
  2. Take a step forward with one leg, lowering your body until both knees are bent to about 90 degrees
  3. Make sure your torso is straight and not leaning too far forward or backwards
  4. Make sure you don’t arch your back
  5. Activate your glute muscle in the leg that is forward and push you body back up to the starting position  
GRSM Physiotherapist helping a patient with Knee Osteoarthritis

Insurance Covered & Submitted For You

Your treatments are covered by most insurance plans. We also direct bill your insurance company when available.

All GRSM physiotherapists are registered with the Ontario College of Physiotherapists of Ontario. For more information on physiotherapy, visit the Ontario Physiotherapy Association or Canadian Physiotherapy Association.

physiotherapy patient learning stretching techniques with physiotherapist
Client doing ladder exercises for physiotherapy
GRSM physiotherapist demonstrating proper exercise techniques
Client learning exercises with physiotherapist
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FAQs

Here are the most frequently asked questions about our Physiotherapy services.

We always encourage involving your family doctor, but you do not need a referral to consult with the professionals at GRSM. Many of our patients call the clinic and make their own appointments while others are referred by their family physicians. A referral may be required by your extended health care provider to receive benefits. 

Appointments may be made in person or by calling (519) 622-4529 (Cambridge) or (519) 571-7111 (Kitchener-South) or (519) 804-9164 (Kitchener-Downtown). You can also fill out our online form and one of our staff will call you. Remember: Please give us at least 24-hours notice if you need to cancel, so we can give that time to another patient.

GRSM is able to bill directly to the following insurance companies for Physiotherapy and Chiropractic visits:

  • Sunlife
  • Manulife/OTIP
  • Greenshield
  • Great West Life/Canada Life
  • Bluecross
  • Manion
  • Industrial Alliance
  • Johnson Inc.
  • Claim Secure
  • Equitable
  • SSQ
  • Desjardins
  • RWAM
  • Co-operators
  • Johnson Group

Please Note:
– Your plan must allow for direct billing (not all plans permit direct billing).
– It is the responsibility of the patient to review specific insurance requirements including whether a medical referral is required by insurance and specific coverage information.

Contact your Employee Benefits or Human Resource Department to determine what extended health care benefits are. Don’t forget to ask how much coverage you have for various services. Most plans have an annual deductible or co-payment amount that the employee must pay.

Shorts should be worn for lower extremity (below the waist) injuries and tank tops are preferred for upper extremity (above the waist) injuries. We have washrooms and a change room if you need them, and your valuables can be locked safely at the reception desk.

Your first physiotherapy appointment usually takes 60 minutes and will include assessment and treatment.  After that, treatments can last either 30, 45 or 60 minutes. 

Yes. All of the physiotherapists at GRSM are registered to practice in Ontario.

Services

SPORTS MEDICINE

Our physicians specialize in sports medicine and are certified with the Canadian Academy of Sport & Exercise Medicine (CASEM). They provide expert medical care for high performance athletes, recreational athletes and active individuals.

PHYSIOTHERAPY

Our physiotherapists focus on sport- and activity-specific rehabilitation. Our goal is to return you to your activity as soon and as safely as possible.

CHIROPRACTIC

Our chiropractors utilize functional assessments to diagnose and determine the appropriate treatment plan and therapeutic methods. These techniques include Active Release Technique (ART), Athletic Movement Assessment (AMA), Diversified chiropractic Manipulation technique.

MASSAGE THERAPY

Our Registered Massage Therapists use preventative and restorative therapies to help you maintain, rehabilitate and improve physical function or relieve your pain.

ATHLETIC THERAPY

Our Certified Athletic Therapists use a full range of treatments to rehabilitate, prevent injury and help you return safely to your sports and other activities.

FOOT ORTHOTICS

Our pedorthists are trained in assessing, casting, design and fitting of foot appliances (orthotics) and in fitting of footwear to reduce painful and debilitating conditions of the lower limbs and feet.

BRACING

Our bracing professionals help fit you with a stocked or custom brace so that you may be able to return to sports or recreational activities sooner and safer.

DIETITIAN & NUTRITION

Our Dietitian and Sports Nutritionist helps to promote good nutrition habits that can help you maintain your energy levels, weight and muscle mass and can lower your risk of certain diseases.

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