ANSWER:
Exercise following a stroke should be regular but should not be overly vigorous. During the first few days following a stroke the muscles in the affected side will atrophy or waste. As the system returns to normal and the nerves start to send the appropriate signals to the affected muscles, slow and steady exercise if favoured. Acceleration of an exercise program will place an extra strain on the weakened system and leads to increased fatigue. From a mental standpoint, this can be very discouraging for the recovering patient and may cause setbacks to recovery.

Remember the tortoise and the hare and keep working at a slow and steady pace.

ANSWER:
Your golf conditioning program should include cardiovascular conditioning, strength and stretching exercises. Walking is a great way to improve cardiovascular ability. Stretching and strengthening of legs, core and upper body are important. Warm up stretches can also be done before you play. A physiotherapist or kinesiologist can assist you with a program. Being in good physical condition is the key to enjoying your golf game.



ANSWER:
Whiplash refers to the rapid backward and forward action when an individual is struck from behind as in a croscheck in hockey or a rear end motor vehicle accident. Normally the symptoms are neck pain due to stretching of soft tissue, limited movement, stiffness and headaches.



ANSWER:
The treatment for each injury of this type varies depending on the severity of the injury. In many cases people do not require treatment and are able to exercise away any of the stiffness over the next week or so. Where treatment is reuired it involves the following: reduction of discomfort, a stretching program to regain range of motion, and strengthening exercises to regain strength.

When the neck is injured, changes in sensation can occur in the upper back and sometimes into the shoulders and arms. This is not uncommon and generally changes in sensation resolve quickly.

ANSWER:
The best way is to start with a walk run program. Initially, the program will involve a higher amount of walking and then the balance of walking to running will change so that first an equal amount of walking, then a greater amount of running can be done.

A good source on the internet is www.runnersden.ca/walkrun.htm. If you need more help, contact Tara Peddie, our kinesiologist at Oceanside Physiotherapy.

ANSWER:
It is very important for you to maintain as much range of motion in the hip, and strength around the hip as possible. My suggestion would be to work the joint as much as possible without increasing the pain. Ways of doing this would be to swim or do exercises in a pool where your weight is supported. Weight bearing exercises may aggravate the pain so should be done with caution. The stronger you are going in the easier the recovery will be.



ANSWER:
Ice is normally recommended when swelling is present. This is usually in the early stages of an injury. The ice should be put on for 15 minutes and taken off for an hour before being re-applied. Heat is normally used for muscular injuries. Moist heat is usually better than dry heat and should be used for up to 30 minutes at a time. Caution should be taken to monitor the heat as it may cause burns on sensitive skin.



ANSWER:
Generally exercise is the major component for maintenence of range of motion and strength around an arthritic joint. It is important to be selective about the exercises which are done. As you have indicated some exercises can aggravate rather than benefit the arthritic joints. Discuss with your physician, physiotherapist, chiropractor or kinesiologist what exercises will benefit you without causing aggravation.



ANSWER:
It is not uncommon following a motor vehicle accident to experience headaches. These are usually associated with neck injuries and resolve as the individual regains range of motion, rebuilds the strength of the neck muscles, and overcomes the stress associated with the accident.



ANSWER:
Neck traction assists neck problems by stretching the structures in the neck muscle, ligament and vertebrae therefore reducing pressure which may be clamping down on a nerve and causing increased neck, shoulder and arm pain.



ANSWER:
Generally graduated aerobic exercise is beneficial to the fibromyalgia sufferer. Aerobic exercise combined with a gentle stretching program, warm water exercise instruction and postural retraining is beneficial to the fibromyalgia sufferer. As with all conditions, programs should be individualized to ensure that they are targeting the appropriate areas.

Discuss you condition with your physiotherapist or kinesiologist and have them assist you in developing an appropriate program.

ANSWER:
Some treatment suggestions to reduce discomfort are to use cold on the area for 15 minutes every few hours, and to use medication as directed by her physician. As the pain resolves, she should slowly increase the range of motion in the upper back and neck. Exercises for the neck are sometimes easier done when lying down. If she continues to have difficulty she should contact a physiotherapist for assistance.



ANSWER:
First priority should be cardiovascular. Walk for 30 minutes at a good pace at least 3 times per week. Increase this time by 10 minutes each week until you are up to 90 minutes. Work on stretching all groups of muscles involved in golf: shoulders, arms, trunk and legs. A program to strengthen your legs, core and upper body should be done 3 days per week. Contact your local physiotherapist or kinesiologist for assistance in developing a program for you.



ANSWER:
It is in your best interest to ensure that you maintain range of motion of, and strength the muscles in your neck with exercise. When you return to work ensure that all the activities you have to perform are safe. If any of them do not seem safe, make the necessary modifications.



ANSWER:
It is important to maintain excellent strength in your thigh muscles and around your knees. The best way to ensure that the possibility of injury is limited is to strengthen those muscles. As you have been injured it would be worth while visiting your local physiotherapist to get a good set of exercises. Dependent on the injury you sustained, the exercises may require to be more specific to meet your needs.



ANSWER:
There are two main muscle groups that support the knee: the quadriceps in the front of the thigh and then hamstrings on the back of the thigh. It is important to strengthen both muscle groups to provide the required support for the knee. Exercises such as straight leg lifts and shallow knee bends are both appropriate exercises for those muscle groups. If you wish a more specific program, it is important to contact your local physiotherapist for advice.



ANSWER:
Many people wear thongs or sandals in the summer which do not provide any support to the feet. This will cause the feet to flatten out and the knees fall inward causing increased stress on the inside of the knee with resultant discomfort. Wearing a good pair of shoes is essential. Acting now will save you from investing in expensive orthotics in a few years.

ANSWER:
A 'frozen shoulder' is normally when the capsule tissue around the shoulder joint becomes bound down, limiting the movement of the shoulder. The most common cause is irritation to either tendons around the shoulder or a bursa which lies above the shoulder joint itself. The irritation causes pain and the individual stops using the shoulder. This causes the shoulder capsule to become bound down. Shoulder pain from either the neck, or in occasional cases, from heart conditions, also leads the individual to believe the shoulder is injured and a frozen shoulder occurs.



ANSWER:
The knee has four major ligaments which stabilize it. Spraining the knee means that one of more of the ligaments have been stretched. The stretching means disruption of some of the fibers of the ligament. This causes swelling which is best treated with rest, ice and elevation. The knee should then be assessed by a physician of physiotherapist to determine the extent of the damage and develop a treatment plan.



ANSWER:
There are two main reasons. Athletes are in excellent shape and therefore the impact of an injury is not as great on them as it would be for you or me. Hockey is their job and the teams establish a back up medical system paid privately which accesses the best diagnostic techniques and medical care in the shortest possible time. Trainers or physiotherapists are on the ice as soon as the injury occurs. Team doctors and specialists are in the dressing room when the player is taken from the ice. Athletes are treated as many times through the day as need be. There return to function is accelerated with the best care, provided in a timely manner and supported by excellent education.



ANSWER:
Yes, physiotherapy can assist some people with correcting knock knees. The cause of the knock knees will influence whether the physiotherapist can assist or not. A physiotherapist can assist by providing exercises and may identify the need for corrective footwear or orthotics. If orthotics are required, the physiotherapist will refer the client to an orthotist or podiatrist. Some physiotherapists are trained in specific assessment and fitting of orthotics and will provide this service themselves.



ANSWER:
Physiotherapy treatment to relieve back pain may involve heat, cold, electrical treatment, ultrasound, mobilizing, exercises, stretching and in some cases, acupuncture. Massage may also be used to assist in relieving muscle spasm during the early stages of back pain. Treatment varies dependent on the individual aspects of the condition.



ANSWER:
It is possible that a fracture can occur at the pelvis in such a situation but this is generally not common. Increased pain could be caused by many things including aggravation of an arthritic condition, or muscular or ligamentous damage around the hip.

Your dad should be seen by a physician who is able to order x-rays and can fully assess what has occurred. The family physician is the best choice as he will know your father's history.

ANSWER:
This is very common as we walk slowly and any postural deficiencies are accentuated.

For the short term, sit on one of the benches, put one leg up, then lean forward to stretch your hamstring and back. For the long term, a good core strengthening program will help. Your local physiotherapist or kinesiologist will assist you if you need further advice.

ANSWER:
While traveling by car, take breaks every couple of hours. Stretch your legs, stretch your upper back and neck by doing side to side and forward and backward movements with your head, as well as shoulder rolls. Walk around the car and do some squatting exercises to stretch your legs.

If traveling by plane, stretch your arms on a regular basis, stretch your neck both forward and backward and then from side to side. Get up and walk around the cabin of the aircraft when it is opportune.

It is important to keep the circulation in your legs moving whether you are traveling in a car, bus or plane, so do some ankle stretches and point your toes up and down at least once every half hour.

ANSWER:
First, I would suggest that you review your work station to identify if it is set up properly. The Worker's Compensation Board of BC supplies excellent material, which would be of assistance.

Second, make sure you take frequent breaks from the sitting position. Stand up and walk around your desk every half hour or so to ensure that you are getting some movement in your back rather than maintaining a constant position. Third, check with a physiotherapist or kinesiogist for exercises to maintain movement in the lower back. Health professionals focus on exercises to deal with the specific problem that each individual is having.