How can I tell if my pain following exercise is injury or normal muscle soreness?

When beginning a new exercise routine or other physical activity, it is normal to experience Delayed Onset Muscle Soreness (DOMS). The key is in the “delayed” portion, typical muscle soreness after exercise occurs approximately 24 hours later and can last for several days. Injury during exercise is usually associated with a traumatic incident as well as pain, swelling and loss of movement rapidly following onset.

Another difference between DOMS and injury pain is that DOMS is soreness when the muscle is used, while new injuries can cause pain even at rest and more severe pain when the injured area is used.  If you are still uncertain, time will tell the difference. DOMS will resolve over time and actually improves the more you exercise.

Injuries will take much longer to resolve and continued activity may aggravate the symptoms further. If you believe you have suffered an injury, consult your Summit physiotherapist, if you are experiencing DOMS try to think of it as forward progress!


The Benefits of Deep Breathing


Besides sustaining life, deep breathing techniques provide many health benefits. Deep breathing can reduce stress, blood pressure and pain. It releases endorphins (our natural painkillers) throughout our body. Good breathing techniques over time help to strengthen our abdominal muscles and encourage good posture. The movement of our diaphragm helps remove toxins from our organs, promoting better blood flow.

This results in better sleep at night and increased energy levels during the day. The improved oxygenation to our brain also relaxes our mind and reduces anxiety.

Try it now: Sit with good posture or lie in a comfortable position. Keep your shoulders relaxed. Breathe in through your nose for a count of five. Breathe deep, focusing on expanding your belly versus raising your upper chest. Hold for 2-3 seconds. Breathe out fully from a slightly parted mouth, for a count of five. Repeat throughout the day, 5-10 repetitions at a time to ensure you don’t hyperventilate.

The secret is simply to breathe deeply and often!


Why do many physiotherapists use acupuncture in their practice?

Acupuncture is not part of the standard training for physiotherapists across Canada, but many therapists have trained in acupuncture and needling techniques to use them in addition to standard treatment.

Acupuncture is the application of thin, fine needles to traditional acupuncture points and tender points in the body. Dry needling is the use of acupuncture needles to provoke muscle twitches, causing muscle relaxation afterwards.

Both techniques are effective as the needles stimulate the nerves, muscles and joints in the treated area. Both techniques provide significant pain relief in time, which is a very helpful addition to standard physiotherapy treatment.

If you have never tried acupuncture, I encourage you to discuss your options with your physiotherapist to see if it is right for you. 


What is Sport Physiotherapy?

Athletes put a lot of sweat and dedication into their performances.  Injury can reduce training quality, impair performance and disconnect an athlete from their sport or team.  You have worked too hard to be sidelined longer than absolutely necessary.

The best treatment of a sport related injury requires; knowledge of the physiology and mechanics of the sport, a detailed injury assessment, performance specific treatment planning and clear communication with the athlete, coach, parent and trainer.

Contact us today to see how we can help speed your recovery along!


At Summit we give you a clear recovery plan including; timeframes for recovery, cross training outline, return to sport plan, and comprehensive post injury maintenance program


What are concussions and what do you do when you have one?

Concussions are mild brain injuries which can be caused either by whiplash or a direct blow to the head. You do not need to lose consciousness to have a concussion! Concussion symptoms are variable but often include headaches, nausea, dizziness, light and sound sensitivity and decreased cognitive function.

If you receive a blow to the head or whiplash and believe you have a concussion you should seek immediate medical attention, either from your family doctor or urgent care facility and follow their medical advice.

In the very early stages of concussion rest is the best treatment. With proper rest the majority of people who sustain a concussion are symptom free within weeks, however with severe or repeated concussions symptoms often last longer.

If concussion symptoms linger physiotherapists can assist in rehabilitation and return to function, Concussion rehabilitation is complex and will address a variety of brain functions, including dizziness rehabilitation, balance and vision retraining, exercises to improve cognitive function and treatment of any neck injury.

The physiotherapists at Summit are specially trained to identify the unique needs and subsequent management of an individual’s concussion.


Nutrition Tips for (Hockey/Soccer)


Keeping well hydrated is important to your performance. Calculating your personal sweat rate is the key to knowing what you need.

  1. Know your sweat rate.
    1. Weigh before activity (naked, voided bladder) = 40kg
    2. Weigh after activity (naked, voided bladder) = 39kg
    3. Difference is weight lost. 1 kg = 1 Litre = your water loss.  If you drink during practice then add that volume to your starting weight (eg. 500ml = .5kg to your starting weight).
  2. Drink fluids and preferably water – regularly throughout your training and competition sessions according to your sweat rate. The stomach can tolerate up to 1Litre but it’s safe to say 500ml-750ml/hour is tolerable.
  3. A weight loss of greater than 2-3% of total body weight from sweating affects performance but you should not try to gain weight either. Drink enough to keep your weight loss under this limit.
  4. Before exercise – drink 150 – 400ml 45 minutes ahead of your game or practise. Choose the lower amount if you are 10years old and the higher amount if you are in your teens.
  5. After exercise – drink 150% of your losses. So if you lose approximately 1 kg then drink 1.5 Litres of water + eat salty foods OR consume a sport drink to obtain the electrolytes that you have lost with your sweat.


Pre-Exercise or Competition (Tips for a solid pre exercise/competition) meal – 2 – 4hrs ahead.

Topping up your blood sugar and ensuring you have ‘energy to burn’ is important to your performance.  Here are some tips to help you.

  1. Choose to consume at least 1.0g carbohydrate/kg your body weight and 10-30g protein as part of the pre-exercise/game meal.
  2. Choose foods higher in complex carbohydrates (rather than sugar), moderate protein and fat. The closer to practice or game-time, the smaller the meal should be. Examples include:
    1. Stir-fry chicken and vegetables with brown rice;
    2. Whole wheat pasta with meat and tomato sauce, salad with oil and vinegar dressing;
    3. Peanut butter (or almond butter) and banana sandwich on whole wheat bread with chopped vegetables on the side.
  3. Drink 500ml of water with the meal. Sport drink is unnecessary.
  4. Choose familiar and easy to digest foods – game time is no time to experiment.
  5. Test the limits of “how much”. A good starting point is 100calories/hour before exercise.  1hr = 100 cal. snack, 2hrs = 200 cal. snack, 3hrs = 300cal small meal or snack… and so on.  People sometime hold back on the pre-exercise meal not realizing that they might perform better with a little more food.  Over-consuming also has its drawbacks.



Post-Exercise Recovery

Looking after your post exercise nutrition helps you both recover from your most recent training session as well as prepare you for your next one.

  1. Ideal timing after a hard workout is within 30 minutes. This starts the recovery process for the muscles and helps to refuel the carbohydrate tanks for the next time.  Please try to get to a real meal within the hour after your snack.
  2. Consume 1.0-1.5g carbohydrates/kg your body weight. If you weigh 50kg then your post exercise recovery snack could include 50-75g of carbohydrate.
  3. With that also consume 15-25g protein.
  4. With that also consume 150% of your weight loss in fluids (reminder of sweat rate).
  5. Your post-exercise intake should reflect your energy expenditure. If you didn’t see a great deal of play, then rehydrate and get to a meal within the hour.

Sample post exercise combinations

1 Bagel (45g carbohydrate) + 1 large banana (40g carbohydrate) +75-100g Turkey (25g protein) 500ml water
500ml chocolate milk (58g carbohydrate) Includes  (18g protein) + 500ml water



Tournament Play

Tournament play can be challenging for many reasons.  Having a plan and some standard and healthy ‘go-to’ foods available throughout the day will help to keep your energy and keep you sharp.

  1. Book-end your day with a solid breakfast and dinner. These should include foods higher in complex carbohydrates, lean protein, moderate amount of fat and fluids (preferably water).
  2. Focus on your post-exercise recovery snack and hydration between matches or games especially when you have less than three hours between.
  3. Get to a meal as soon as possible after your last game – still including your post exercise recovery snack within the 30min following your game.
  4. Keep all food choices of highest quality. As little extra sugar and fat as possible
  5. Stay with familiar foods. No experimentation during a tournament.

Sample tournament intake

Breakfast Post-game 1 Post-game 2 Dinner

Berries or dried fruit

Greek yogurt

Hard cooked eggs (2)

500ml water

Water or sport drink, homemade cookies (or a sandwich if there is enough time between games), chocolate milk, fruit Water, drinking box of real fruit juice, cheese and crackers, fig bars or  homemade cookies Pasta with tomato and meat sauce, cheese, salad with oil and vinegar dressing  or Vegetarian pizza with extra vegetables, salad with oil and vinegar dressing AND lots of water.




What is Spinal Disc Degeneration and Herniation?

Spinal discs are rubbery pads between the vertebrae (bones) in our spine. Healthy discs have a tough, fibrous outer membrane and an elastic core. As we age, our discs become less elastic, lose fluid and the outer protective membrane becomes weaker.

Disc problems are sometimes lumped together under the term degenerative disc disease. Poor muscle tone, poor posture or excessive strain on the spine are some of the causes of non-age-related degeneration. Furthermore, injuries and repetitive activities involving bending, twisting or heavy lifting can cause low back disc herniations. This is when a disc’s inner material swells and pushes through a weak spot in its outer membrane.

All or part of the disc’s core material may press against surrounding nerves, or the spinal cord in extreme cases. Herniated discs are most common from ages 30 to 50, although they can also occur in active children and young adults.

Summit Physiotherapy can provide intervention and tips for injury prevention – contact us today!


What can I do if I have Osteoarthritis?


In normal joints of the body, cartilage provides a smooth surface for joint motion. Osteoarthritis (OA) is a chronic condition affecting the cartilage of the joints. It causes pain, stiffness and swelling in the joints and can lead to reduced movement. OA commonly affects the knees, hips, lower back, neck and hands.

While it may be hard to think of exercising when your joints hurt, moving is an important part of managing OA. Basic range of motion exercises and/or simple, non-impact activities are best for the joints. Swimming or water aerobics, cycling, light walking or using an elliptical machine all provide little joint impact. Cross country skiing or snowshoeing are good outdoor options this time of year. Lastly, strengthening your muscles help support your joints.

Physiotherapy can assist in the long-term management of OA by helping to manage symptoms, improve joint strength and mobility, and helping choose the right form of exercise for you. Talk to your Summit physiotherapist to help you get moving!


How can I strengthen my legs for the ski season?

If you want to hit the slopes opening day without burning out by lunch, it is time to start working on your endurance! Downhill skiing requires a high degree of eccentric and isometric strength: the ability to lower and hold your weight. Most other sports and activities require primarily concentric strength: the ability to lift and push powerfully.

If you want to build your eccentric endurance, you could try the following.  Slowly lower into a squat or tucked position for a count of five, hold for a count of five, stand back up to a count of one. Repeat this as many times as needed to “feel the burn”. You could also hold the squat while performing calf raises, or for the next level replace the stand up with a jump.

If you have any questions for optimal training for the upcoming season consult a Summit physiotherapist or personal trainer.


How can I deal with foot pain from holiday shopping?

More time on your feet searching malls likely means more foot pain. If you are one of the unlucky few who will suffer from plantar fasciitis this season here are some tips for you!
Shoes with more cushion and arch support are helpful, and some people prefer to add their own insoles with an arch support or heel pad.
Self massaging the arch of the foot with a ball will help with pain control, as will calf and arch stretching.
If you are having acute or severe pain taping the arch will mitigate the pain.
For more chronic pain an exercise program to strengthen the foot and arch is helpful.
If you are experiencing heel pain try some of the techniques above and come see your Summit physiotherapist for a treatment plan specific to you!