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Plantar Fasciitis: Why Your Heel Hurts in the Morning, What Helps and When to Get Checked

Practitioner massaging a patient's bare foot during treatment

You swing your feet out of bed, stand up, and a sharp stab hits the bottom of your heel. After a few minutes of hobbling around the kitchen, it eases off. If that sounds familiar, you may be dealing with plantar fasciitis, one of the most common causes of heel pain we see.

What is plantar fasciitis?

The plantar fascia is a thick band of tissue that runs along the bottom of your foot, from your heel bone to your toes. It supports your arch and acts a bit like a spring every time you take a step. When it’s loaded more than it can handle, it can become irritated and painful where it attaches to the heel.

Common signs include:

  • Sharp or stabbing pain under the heel or along the inside of the arch
  • Pain that’s worst with the first steps in the morning or after sitting
  • Pain that eases once you get moving, then builds again after a long day on your feet

Why does it happen?

Overnight, the fascia and calf muscles tighten up while you rest. Those first steps stretch them suddenly, which is why mornings tend to hurt most. The bigger question is why the tissue became irritated in the first place. Common contributors include:

  • A jump in activity. Adding running distance, starting a new walking routine or a weekend of hiking can all overload the foot.
  • Long hours standing. Retail, healthcare, trades and hospitality workers often spend most of the day on hard floors.
  • Tight calves and Achilles tendon. Less ankle flexibility means more strain on the bottom of the foot.
  • Foot shape and mechanics. Flat feet, high arches, or feet that roll in or out can change how load is shared.
  • Footwear. Worn-out shoes, flip-flops, or going barefoot on hard floors offer little support.

What can I do at home?

Simple, consistent changes often help. Give these a fair try for a few weeks:

  • Stretch before your first steps. Before getting out of bed, pull your toes back toward your shin for 20 to 30 seconds, a few times. A towel looped around the ball of your foot helps.
  • Stretch your calves. Lean into a wall with one leg back, heel down and knee straight, then repeat with the knee slightly bent. Hold each for about 30 seconds, a few times a day.
  • Roll the arch. Roll your foot over a frozen water bottle or a firm ball for a few minutes.
  • Wear supportive shoes, even at home. Choose shoes or slippers with a supportive arch and a bit of cushioning. Avoid going barefoot on hard floors.
  • Adjust, don’t stop. Cut back on the activity that flares it, like long runs or steep hikes, and swap in cycling or swimming for a while. Build back up gradually.

When should I get it checked?

Book an assessment if your heel pain hasn’t improved after two to three weeks of self-care, if it’s changing the way you walk, or if it keeps you from work, exercise or daily life. Heel pain can have other causes, such as Achilles problems, a stress fracture or an irritated nerve, so an assessment helps.

Get medical care right away (see your doctor, or go to emergency) if you have:

  • Heel pain after a fall or injury, especially with swelling, bruising or trouble putting weight on the foot
  • A sudden “pop” or kick-like feeling at the back of the heel or calf
  • Redness, warmth or swelling in the foot, or a fever
  • Numbness, tingling or burning in the foot
  • Diabetes along with foot pain, a sore that won’t heal, or changes in skin colour
  • Pain that’s constant, wakes you at night, or comes with pain and swelling in other joints

How we help with plantar fasciitis

Our team starts by looking at the whole picture: your foot, ankle, calf, hips, footwear and how you move. Then we build a plan that fits your work and activities. You can learn more on our plantar fasciitis page.

Physiotherapy

Physiotherapy focuses on calming the sore tissue and building strength and flexibility in the foot and calf, so it can handle your day again. Spirit Donahue, MPT centres his care on therapeutic exercise, manual therapy and patient education. Kanu Priya, MPT holds a Master’s in Sports Physiotherapy and uses manual therapy, dry needling (IMS), exercise prescription and functional rehab. Ivy Elling-Quaintance, MPT uses evidence-based exercise and movement and is particularly interested in athletic injuries and injury prevention.

Chiropractic and custom orthotics

Our chiropractors assess how your feet, ankles, knees and hips work together, and can treat the surrounding muscles and joints. They also assess and fit custom orthotics, using GaitScan pressure-plate technology and a foam cast of each foot. Orthotics may help if your arches, foot mechanics or long hours standing are part of the problem. Dr. Tessa Bryan, DC is certified in Custom Stabilizing Orthotics and uses soft tissue therapies, RockTape and exercise. Dr. Matthew Bryan, DC, Dr. Alexia Grelson, DC and Dr. Krisjan Gustavson, DC also fit custom orthotics.

Shockwave therapy

For heel pain that’s been hanging on, shockwave therapy is an option. It’s a non-surgical treatment that sends mechanical pulses into the sore tissue to stimulate the body’s healing response. Sessions take about 15 minutes, and a course is usually 3 to 6 sessions. Our post on the benefits of shockwave therapy explains more.

Massage therapy for tight calves and feet can also be a helpful part of your plan.

Book an appointment

If heel pain is making your mornings miserable or keeping you off the trails, we’d be glad to help you get back on your feet. We bill most insurance plans directly, so you can focus on feeling better.

Book online or call us at 250-382-0018. You’ll find us at 1063 Fort Street in downtown Victoria.

This article is general information and isn’t a substitute for an assessment by a qualified health professional.

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Tennis Elbow and Golfer’s Elbow: Causes, Self-Care and When to Get It Checked

Woman holding her sore elbow

You pick up your coffee mug or turn a doorknob, and a sharp ache shoots along the side of your elbow. You may not have touched a racquet in years. This common elbow pain usually comes down to tendons asked to do a bit too much.

What are tennis elbow and golfer’s elbow?

Both are overuse problems in the tendons that attach your forearm muscles to the elbow. The difference is which side hurts:

Tennis elbowGolfer’s elbow
Where it hurtsOutside of the elbow (thumb side)Inside of the elbow (pinky side)
Muscles involvedMuscles that lift the wrist and straighten the fingersMuscles that bend the wrist and grip
Often worse withGripping, lifting with the palm down, typing, using a mouseGripping, lifting with the palm up, swinging, throwing

Despite the names, most people who get these conditions don’t play tennis or golf. Pain often builds slowly and may come with a weaker grip.

Why does it happen?

Tendons adapt to the load we give them, but they adapt slowly. When gripping and wrist work ramps up faster than the tendon can keep up, it gets irritated. Common culprits include:

  • Fall yard work. Raking leaves, pruning, splitting wood and hauling bags of mulch are classic triggers this time of year.
  • Trades and hands-on work. Using hammers, drills, screwdrivers or paintbrushes for long hours.
  • Desk work. Long days with a mouse and keyboard, especially with the wrist bent back.
  • Racquet sports, golf and the gym. More playing time, new equipment, or heavy pulling exercises.

What can I do at home?

Tendons usually do best with smart activity, not complete rest. Give these a fair try for a few weeks:

  • Ease the load, don’t stop moving. Cut back on the tasks that flare it, take more breaks, and split big jobs like raking into shorter sessions.
  • Change your grip. Lift with your palm facing up for tennis elbow, or facing down for golfer’s elbow. Use both hands when you can, and choose tools with thicker, padded handles.
  • Set up your desk. Keep your wrist straight while typing, bring the mouse close to your body, and rest your forearm on the desk or armrest.
  • Try gentle stretches. With your elbow straight, use the other hand to gently bend the wrist down (for tennis elbow) or back (for golfer’s elbow). Hold about 30 seconds, a few times a day.
  • Consider a forearm strap. A counterforce brace worn just below the elbow may ease pain during activity for some people.

When should I get it checked?

Book an assessment if your elbow pain hasn’t improved after two to three weeks of self-care, if it keeps coming back, or if it’s getting in the way of work, sleep or the things you enjoy. Elbow pain can also come from the neck, a pinched nerve or the joint itself, so an assessment helps sort out where it’s really coming from.

Get medical care right away (see your doctor, or go to emergency) if you have:

  • Elbow pain after a fall or injury, especially with swelling, bruising, a deformity or trouble moving the arm
  • A sudden “pop” with pain and weakness when bending the elbow
  • Redness, heat or swelling around the elbow, or a fever
  • Numbness, tingling or weakness in the hand that’s getting worse
  • Arm pain with chest pain, shortness of breath, sweating or nausea (call 911)

How we help with tennis and golfer’s elbow

Our team looks at the whole arm, from your neck and shoulder down to your wrist and grip, plus your work and hobbies, then build a plan to settle the pain and help the tendon handle your day again. You can learn more on our tennis elbow page, and our earlier post on golfer’s elbow has more on the inside-elbow version.

Physiotherapy

Physiotherapy focuses on gradual strengthening exercises that help the tendon tolerate load again, plus hands-on treatment. All three of our physiotherapists also use IMS and dry needling for tight, irritated forearm muscles. Spirit Donahue, MPT centres his care on therapeutic exercise, manual therapy, patient education and pain management. Kanu Priya, MPT holds a Master’s in Sports Physiotherapy and uses manual therapy, dry needling (IMS), exercise prescription and functional rehab. Ivy Elling-Quaintance, MPT uses evidence-based exercise and movement, and has a particular interest in athletic injuries and injury prevention.

Chiropractic

Our chiropractors assess how your neck, shoulder, elbow and wrist work together, and treat the surrounding muscles and joints. Dr. Tessa Bryan, DC uses soft tissue therapies, instrument-assisted techniques, RockTape and therapeutic exercise. Dr. Matthew Bryan, DC has a passion for working with athletes. Dr. Alexia Grelson, DC and Dr. Krisjan Gustavson, DC round out our chiropractic team.

Shockwave and laser therapy

For elbow pain that’s been hanging on, shockwave therapy is an option. It’s a non-surgical treatment that sends mechanical pulses into the sore tendon to stimulate the body’s healing response. Sessions take about 15 minutes, and a course is usually 3 to 6 sessions. Class IV K-Laser therapy is another option. If you’d prefer a needle-free option for tight muscles, ask about eToims.

Acupuncture

Acupuncture may help ease pain and improve function in the forearm and elbow. Annie Wang, R.Ac, R.TCM.P focuses on acute and chronic musculoskeletal pain and myofascial tension, using acupuncture, cupping and Gua Sha. Jun Liu, R.Ac has over 20 years of experience in therapeutic movement and rehabilitation.

Massage therapy for tight forearm and shoulder muscles can also be a helpful part of your plan. Craig Lawrence, RMT focuses on trigger point release.

Book an appointment

If elbow pain is making your workday, your yard work or your game harder than it should be, we’d be glad to help. We bill most insurance plans directly, so you can focus on feeling better.

Book online or call us at 250-382-0018. You’ll find us at 1063 Fort Street in downtown Victoria.

This article is general information and isn’t a substitute for an assessment by a qualified health professional.

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Shoulder Pain and Rotator Cuff Problems: Causes, Self-Care and When to Get It Checked

Woman holding her sore shoulder at an outdoor sports field

You reach up to a high shelf, or grab the seatbelt behind you, and a sharp ache catches you at the top of the arm. At night, rolling onto that side wakes you up. Shoulder pain is one of the most common reasons people come to see us, and the rotator cuff is often part of the story.

What is the rotator cuff?

The shoulder is a shallow ball-and-socket joint. That shape gives it a huge range of motion, but it also means the joint relies on muscles to keep it steady. The rotator cuff is a group of four small muscles and their tendons that wrap around the top of the arm bone. They hold the ball centred in the socket while bigger muscles lift and move the arm.

When the cuff gets irritated or overloaded, you may notice:

  • A dull ache on the outside of the upper arm, sometimes spreading toward the elbow
  • Pain when reaching overhead, behind your back or out to the side
  • Pain lying on the sore side, or a deep ache at night
  • A feeling of weakness when lifting or carrying

Why does it happen?

Most rotator cuff problems build up slowly. The tendons adapt to the work we give them, but they adapt slowly. When overhead or reaching work ramps up faster than they can keep up, they get sore. Common causes include:

  • Fall chores. Raking leaves, cleaning gutters, pruning trees and hanging holiday lights all put the arms up and out for long stretches.
  • Desk posture. Rounded shoulders and a forward head change how the shoulder blade sits, which can crowd the tendons when you lift your arm.
  • Sport and the gym. Swimming, throwing, racquet sports, paddling and overhead lifting, especially after a break.
  • Age. Tendons naturally change over time, so cuff problems become more common after about 40.
  • A fall or sudden pull. Landing on an outstretched arm or catching something heavy can strain or tear the tendon.

Other things can cause similar pain, including bursitis, arthritis, frozen shoulder and pain referred from the neck. That’s why a proper assessment matters if it isn’t settling.

What can I do at home?

Most shoulders do better with gentle, regular movement than with complete rest. Give these a fair try for a couple of weeks:

  • Keep it moving, within comfort. Avoid holding your arm still against your body for days. Stiffness can make things worse.
  • Try pendulum swings. Lean forward with your good hand on a table and let the sore arm hang. Gently swing it in small circles for 30 to 60 seconds, a few times a day.
  • Change how you reach. Use a step stool instead of reaching overhead, keep loads close to your body, and break up raking or gutter work into shorter sessions.
  • Sleep smarter. Lie on your good side and hug a pillow, or lie on your back with a pillow under the sore arm.
  • Ease the ache. Ice or heat for 10 to 15 minutes may help. Use whichever feels better.
  • Check your desk. Bring your keyboard and mouse close, rest your forearms, and sit back so your shoulders can relax.

When should I get it checked?

Book an assessment if your shoulder hasn’t improved after two to three weeks, if it keeps you up at night, or if you’re losing the ability to lift your arm or reach behind you. Early care can help keep a sore shoulder from turning into a stiff one.

Get medical care right away (see your doctor, or go to emergency) if you have:

  • Sudden, severe shoulder pain after a fall or injury, especially with a deformity, swelling or bruising
  • Sudden weakness where you can’t lift your arm at all
  • A hot, red, swollen shoulder, or shoulder pain with a fever
  • Numbness, tingling or weakness in the arm or hand that’s getting worse
  • Shoulder or arm pain with chest pain, shortness of breath, sweating or nausea (call 911)

How we help with shoulder pain

Our team looks at the whole picture: your shoulder, shoulder blade, neck and upper back, plus your work, sport and sleep. Then we build a plan to settle the pain and get the shoulder strong again. If your main problem is stiffness, our earlier post on rehab for frozen shoulder has more on that condition.

Physiotherapy

Physiotherapy is a common first step for rotator cuff problems. Treatment focuses on exercises that gradually build cuff and shoulder blade strength, plus hands-on care to restore movement. Our physiotherapists also use IMS and dry needling for tight, painful muscles around the shoulder. Spirit Donahue, MPT centres his care on therapeutic exercise, manual therapy, patient education and pain management. Kanu Priya, MPT has over 10 years of experience and uses manual therapy, dry needling (IMS), exercise prescription and functional rehab. Ivy Elling-Quaintance, MPT uses evidence-based exercise and movement, and has a particular interest in athletic injuries and injury prevention.

Massage therapy

Registered massage therapy can ease tight muscles across the shoulder, chest and upper back, which may make it easier to move and exercise. Craig Lawrence, RMT has practised since 2006 and focuses on trigger point release. Braedan Pearce, RMT has worked extensively with neck, shoulder and arm pain, using myofascial release, trigger point release, stretching and home care exercises. Alex Baan-Meiklejohn, RMT combines stretching with Swedish massage and trigger point therapy, and enjoys working with active people.

Chiropractic

Our chiropractors assess how your neck, upper back and shoulder work together, and treat the surrounding joints and muscles. Dr. Tessa Bryan, DC uses soft tissue therapies, instrument-assisted techniques, cupping, RockTape and therapeutic exercise. Dr. Matthew Bryan, DC has a passion for working with athletes. Dr. Alexia Grelson, DC and Dr. Krisjan Gustavson, DC round out our chiropractic team.

Shockwave and laser therapy

For tendon pain that’s been hanging on, shockwave therapy is an option. It’s a non-surgical treatment that sends mechanical pulses into the sore tissue to stimulate the body’s healing response. Sessions take about 15 minutes, and a course is usually 3 to 6 sessions. Class IV K-Laser therapy is another option that may help ease pain and stiffness.

Book an appointment

If shoulder pain is making it hard to reach, lift or get a good night’s sleep, we’d be glad to help. We bill most insurance plans directly, so you can focus on feeling better.

Book online or call us at 250-382-0018. You’ll find us at 1063 Fort Street in downtown Victoria.

This article is general information and isn’t a substitute for an assessment by a qualified health professional.

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Tension Headaches and Migraines: How to Tell Them Apart, What Helps and When to Get Checked

Woman pressing her fingers to her temples with a headache

It starts as a dull squeeze around your forehead by mid-afternoon. Or it’s a throbbing pain behind one eye that sends you looking for a dark, quiet room. Headaches are very common, and knowing which kind you have is the first step toward finding what helps.

Tension headache, migraine or neck headache?

There are many types of headache. Three of the most common are tension-type headaches, migraines and cervicogenic headaches (headaches that start in the neck). Here’s a rough guide to how they often feel:

TypeHow it often feelsCommon clues
Tension-typeA dull, pressing band or tight cap around the head, usually on both sidesTight neck and shoulders, stress, long days at a screen. Usually mild to moderate.
MigraineThrobbing or pulsing pain, often on one side, lasting hours to a few daysNausea, sensitivity to light or sound, worse with activity. Some people see visual changes (an “aura”) beforehand.
Cervicogenic (neck-related)Pain that starts at the base of the skull and spreads forward, usually on one sideNeck stiffness, pain that changes with neck movement or certain positions

This is a starting point, not a way to diagnose yourself.

Why do headaches happen?

Tension-type and neck-related headaches are often linked to how our muscles and joints are coping. Tight muscles in the neck, shoulders, jaw and scalp can refer pain into the head. Stiff joints in the upper neck can do the same. Long hours at a desk, clenching your jaw, poor sleep and stress all tend to stack up.

Migraine is different. It’s a neurological condition, and it often runs in families. Attacks can be set off by triggers such as missed meals, dehydration, changes in sleep, hormonal changes, bright light, strong smells, alcohol or stress. Our older post on what triggers your migraine covers several common ones.

What can I do at home?

  • Keep a headache diary. Jot down when each headache starts, how it feels, what you were doing, what you ate and how you slept. After a few weeks, patterns often show up.
  • Keep the basics steady. Regular meals, plenty of water and a consistent sleep schedule (even on weekends) can make a real difference, especially for migraine.
  • Take screen breaks. Every 30 minutes, look away from the screen, roll your shoulders and gently turn your head side to side. Raise your monitor so you aren’t looking down all day.
  • Relax your jaw. Notice if you clench while you concentrate. Lips together, teeth apart, tongue resting on the roof of your mouth.
  • Try heat or cold. A warm pack on the neck and shoulders may ease a tension headache. Some people with migraine prefer a cool cloth on the forehead or neck.
  • Use pain medication wisely. Using pain relievers on many days each month can lead to “rebound” headaches. If you’re reaching for them often, talk to your doctor or pharmacist.

When should I get it checked?

Book an assessment if your headaches are frequent, are getting worse, keep you from work or sleep, or come with neck pain and stiffness. If you think you have migraines, see your family doctor as well. Migraine has specific medical treatments, and a diagnosis helps everyone on your care team.

Get medical care right away (see your doctor, or go to emergency) if you have:

  • A sudden, severe headache that peaks within a minute, or the “worst headache of your life”
  • A headache with fever, a stiff neck, rash or confusion
  • A headache after a fall, blow to the head or car accident
  • Weakness, numbness, trouble speaking, drooping of the face, loss of balance or vision changes
  • A new headache pattern after age 50, or a headache that keeps getting worse over days or weeks
  • A headache that wakes you from sleep and comes with vomiting

How we help with headaches

Our team looks for what may be feeding your headaches, especially the neck, shoulders and jaw. We’ll work alongside your family doctor when that’s the right fit. You can learn more on our neck pain and headaches page.

Chiropractic

Our chiropractors assess the joints and muscles of your neck and upper back, which can play a part in tension-type and neck-related headaches. Care may include spinal manipulation or gentler low-force options, soft tissue work, exercises and posture advice. Dr. Tessa Bryan, DC uses soft tissue therapies, instrument-assisted and manual techniques, cupping and therapeutic exercise. Dr. Alexia Grelson, DC has additional training in cranial techniques and is especially interested in helping patients shift out of tension and into ease. Dr. Matthew Bryan, DC takes a collaborative, multidisciplinary approach. Dr. Krisjan Gustavson, DC has been in practice since 1986.

Registered Massage Therapy

Massage therapy can ease tight neck, shoulder, jaw and scalp muscles and may help reduce tension headaches. Craig Lawrence, RMT has practised since 2006 and focuses on trigger point release, often for working professionals dealing with desk-bound aches and tension headaches. Braedan Pearce, RMT uses myofascial release, trigger point release and stretching, with a calming pace that supports stress relief. Alex Baan-Meiklejohn, RMT trained in trigger point therapy and stretching,. Morag Hart, RMT and McKenzie Connell, RMT tailor each treatment to your needs.

Acupuncture

Acupuncture is another option that may help with headaches, muscle tension and the stress that often comes with them. Lauren Ching, R.Ac supports people with pain and stress management, sleep and emotional regulation, using techniques including scalp acupuncture and cupping. Rebecca Thompson, R.Ac, R.TCM.P includes chronic pain, insomnia and mental and emotional health among her clinical focuses. Annie Wang, R.Ac, R.TCM.P works with myofascial tension, postural pain and stress-related concerns. Jun Liu, R.Ac works with musculoskeletal pain, postural concerns and insomnia, and provides care in English, Mandarin and French.

Book an appointment

If headaches are getting in the way of your work, sleep or weekends, we’d be glad to help you sort out what’s going on. We bill most insurance plans directly, so you can focus on feeling better.

Book online or call us at 250-382-0018. You’ll find us at 1063 Fort Street in downtown Victoria.

This article is general information and isn’t a substitute for an assessment by a qualified health professional.

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Low Back Pain: Why It Happens, What Helps, and When to Get It Checked

Woman at her desk holding her lower back in pain

Low back pain is one of the most common reasons people walk through our door on Fort Street. Most adults will have it at some point. It can come on after lifting something awkward, after a long weekend of gardening, or for no obvious reason at all when you get out of bed. The good news is that most back pain settles, and there’s a lot you can do to help it along.

Why does my lower back hurt?

Most low back pain is what clinicians call “mechanical.” That means it comes from the muscles, joints, ligaments and discs of the spine rather than from a serious disease. Common contributors include:

  • Muscle strain from lifting, twisting or a sudden awkward movement
  • Stiff or irritated joints in the lower spine or the SI joints where the spine meets the pelvis
  • Disc irritation, which can sometimes send pain down the leg (sciatica)
  • Long hours sitting, at a desk, in the car, or on the couch
  • Weak or tired core and hip muscles that leave the back doing more than its share
  • Stress and poor sleep, which really do make pain feel worse

Often it’s a mix of several of these. That’s why a proper assessment matters: two people with the same “sore back” can need quite different care.

What can I do at home?

  • Keep moving. Bed rest used to be the standard advice, but research now shows that gentle activity, like short walks, usually helps you recover faster. Move within what’s comfortable.
  • Change positions often. If you sit for work, get up every 30 to 45 minutes, even for a minute.
  • Try heat or cold. Warmth often feels good on stiff, tight muscles. Some people prefer cold in the first day or two. Use whichever feels better.
  • Don’t panic. Back pain can be very painful without meaning anything is seriously damaged. Most episodes improve within a few weeks.

When should I get it checked?

Book an assessment if your pain isn’t improving after a week or two, keeps coming back, travels down your leg, or is stopping you from working, sleeping or doing what you enjoy.

Get medical care right away (see your doctor, or go to emergency) if back pain comes with any of these: loss of bladder or bowel control, numbness in the groin or inner thighs, leg weakness that’s getting worse, fever, unexplained weight loss, or pain after a serious fall or accident.

How we help with low back pain

Because we’re a multidisciplinary clinic, you don’t have to guess which kind of practitioner to see. Our team works together and can refer you in-house if another approach would suit you better.

Chiropractic

Our chiropractors assess how your spine, pelvis and hips are moving and use hands-on care such as spinal manipulation and mobilization, soft tissue work and exercise to ease pain and restore movement. Our chiropractors are Dr. Tessa Bryan, DC, who uses soft tissue therapies, manipulation, cupping and therapeutic exercise; Dr. Alexia Grelson, DC, who has a background in personal training and extra training in prenatal care; Dr. Matthew Bryan, DC; and Dr. Krisjan Gustavson, DC, who has been practising since 1986.

Spinal decompression

For back pain related to discs or pinched nerves, especially pain that hasn’t settled with other care, spinal decompression is a non-surgical, drug-free option. A specialized table gently and gradually takes pressure off the lower spine. Your practitioner will let you know whether it’s a good fit for you.

Physiotherapy and IMS

Our physiotherapists focus on getting you moving with confidence through manual therapy, education and an exercise plan built around your goals. They include Kanu Priya, MPT, who has over 10 years of experience in musculoskeletal and sports rehab; Ivy Elling-Quaintance, MPT, whose evidence-based approach looks at the whole person; and Spirit Donahue, MPT, who centres care on therapeutic exercise and manual therapy. For tight, guarded muscles, IMS (intramuscular stimulation) may also be an option.

Registered massage therapy

When back pain comes with tight, sore muscles, massage therapy can help them relax and make it easier to move. Our RMTs include Morag Hart, Craig Lawrence, McKenzie Connell, Braedan Pearce and Alex Baan-Meiklejohn.

Kinesiology

Once the pain is under control, the goal is keeping it from coming back. Our kinesiologists, Angelina Schaaf and Christian Schwarz, build practical strength and movement programs that fit into your life.

Book an appointment

If your back has been bothering you, we’d be glad to help. We bill most insurance plans directly, so you can focus on getting better.

Book online or call us at 250-382-0018. You’ll find us at 1063 Fort Street in downtown Victoria.

This article is general information and isn’t a substitute for an assessment by a qualified health professional.

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Sciatica: Nerve Pain or Tight Muscle? Signs, Self-Care and When to Get It Checked

Man's lower back with the painful area highlighted in red

That sharp, burning or electric pain that runs from your buttock down the back of your leg has a name most people have heard: sciatica. It can make sitting, driving or even putting on your socks feel like a project. But not every pain in the back of the leg is actually sciatica, and knowing the difference can help you get the right care sooner.

What is sciatica?

Your sciatic nerve is the largest nerve in the body. It starts from several nerve roots in your lower back, travels through the buttock and runs down the back of each leg to the foot. “Sciatica” describes pain that follows the path of that nerve because something is irritating or pressing on it.

Common causes include:

  • A bulging or herniated disc in the lower back pressing on a nerve root
  • Narrowing around the nerves (spinal stenosis), more common as we get older
  • Tight or irritated muscles in the buttock, such as the piriformis, which the sciatic nerve runs close to
  • Long hours of sitting, heavy lifting or sudden twisting that aggravate an already sensitive back

Nerve pain or muscle pain?

Here’s where it gets tricky. Tight muscles and irritated joints in the low back and hips can also send pain into the leg. This is called referred pain, and it often gets mistaken for sciatica. The two can feel similar, but there are some clues:

More likely nerve-relatedMore likely muscle or joint
How it feelsSharp, shooting, burning or electricDeep, dull, achy
How far it goesOften below the knee, sometimes into the footUsually stays above the knee
Other sensationsPins and needles, numbness or weaknessStiffness and tender spots
What aggravates itCoughing, sneezing, bending or sittingCertain movements or positions, pressing on the sore area

These are only clues, not a diagnosis. Many people have a bit of both. A hands-on assessment is the best way to find out what’s driving your symptoms, and that shapes which treatment makes sense. If you suspect your pain starts deep in the buttock, our older post on piriformis syndrome is worth a read.

What can I do at home?

  • Stay gently active. Short, regular walks are usually better than lying in bed. Move within what’s comfortable.
  • Break up sitting. Sitting is a common aggravator. Stand up and move every 20 to 30 minutes, and try a small rolled towel behind your lower back when you do sit.
  • Find your position of relief. Many people are more comfortable lying on their side with a pillow between the knees, or on their back with their knees supported.
  • Go easy on hard stretching. Irritated nerves don’t like being pulled on. If a stretch makes the leg pain sharper or spread further, back off.
  • Try heat or cold. Either can ease pain. Use whichever feels better for you.

The encouraging news is that many cases of sciatica improve over a period of weeks with the right care and activity.

When should I get it checked?

Book an assessment if leg pain lasts more than a week or two, keeps coming back, comes with numbness or tingling, or is getting in the way of work or sleep.

Get medical care right away (see your doctor, or go to emergency) if you have:

  • Loss of bladder or bowel control, or trouble passing urine
  • Numbness in the groin, genitals, buttocks or inner thighs
  • Leg weakness that’s getting worse, or a foot that drags or slaps when you walk
  • Symptoms in both legs at once
  • Fever, unexplained weight loss, or a history of cancer along with new back pain
  • Pain after a serious fall or accident

How we help with sciatica

Because leg pain can come from a disc, a joint, a muscle or a combination, having several disciplines under one roof helps. If another approach would suit you better, we can refer you in-house. Learn more on our sciatica and nerve pain page.

Chiropractic

Our chiropractors assess how your lower back, pelvis and hips are moving, check nerve function, and use care such as spinal manipulation and mobilization, soft tissue work and exercise to ease pain and improve movement. Dr. Tessa Bryan, DC uses soft tissue therapies, manipulation and nerve flossing as part of her care. Dr. Alexia Grelson, DC blends manual, instrument-assisted and drop-table techniques tailored to each patient’s comfort level. Dr. Matthew Bryan, DC takes a collaborative, multidisciplinary approach and has a special interest in working with athletes. Dr. Krisjan Gustavson, DC has been practising since 1986.

Spinal decompression

When sciatica is related to a bulging or herniated disc, or hasn’t settled with other care, spinal decompression is a non-surgical, drug-free option. A computer-controlled table gently and gradually reduces pressure on the discs of the lower back. Your practitioner will let you know whether it’s a good fit.

Physiotherapy and IMS

Our physiotherapists use manual therapy, education and a graded exercise plan to calm irritated nerves and build strength and confidence in movement. When tight, shortened muscles are adding to the problem, IMS (intramuscular stimulation) may help release them. IMS uses very fine needles placed in tight muscle bands or near the spine where a nerve root may be irritated.

Kanu Priya, MPT has over 10 years of experience, works with people with persistent pain and complex musculoskeletal conditions, and includes dry needling (IMS) in her care. Ivy Elling-Quaintance, MPT has training in AN-IMS dry needling and an interest in chronic pain management. Spirit Donahue, MPT centres his care on therapeutic exercise, manual therapy and patient education.

Book an appointment

If leg pain is slowing you down, we’d be glad to help you figure out what’s behind it. We bill most insurance plans directly, so you can focus on getting better.

Book online or call us at 250-382-0018. You’ll find us at 1063 Fort Street in downtown Victoria.

This article is general information and isn’t a substitute for an assessment by a qualified health professional.

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CryoDerm in Victoria: Cold vs. Heat, How to Use It, and Where to Get It

Patients keep asking us about CryoDerm, and several have told us they couldn’t find it anywhere in Victoria. We carry it at Diversified Health Clinic on Fort Street. Here’s what it is, how to choose between Cold and Heat, and how to get the most out of it.

What is CryoDerm?

CryoDerm is a topical pain reliever that you rub or roll onto sore muscles and joints. It is made for clinics, so you’ll mostly find it through chiropractors, physiotherapists and massage therapists rather than at the drugstore.

It comes in two versions:

  • CryoDerm Cold Therapy cools the skin. Its active ingredient is 10% menthol, with arnica, boswellia, eucalyptus and peppermint oil, and MSM added.
  • CryoDerm Heat Therapy warms the skin. It uses menthol and camphor (3.85% each) with a small amount of capsaicin, the compound that makes chili peppers hot.

Both are free of dyes, parabens and silicone.

Our clients love it because the main ingredients are natural ingredients, so it makes it less chemically-based than some of the competitors on the market. It also dries quite quickly, and leaves behind less of a “greasy” feel after application.     

How does it work?

Menthol switches on the cold-sensing nerves in your skin. That strong cooling signal competes with pain signals from the muscle or joint underneath, so the ache feels quieter. Capsaicin in the Heat version works the same way with warming nerves.

It gives temporary relief. It doesn’t fix what’s causing the pain, but it can make it easier to move, stretch and do your exercises, and that’s often what helps you recover.

Cold or Heat: which one should I use?

If your pain is…TryWhy
A fresh strain or sprain, or a joint that feels hot or swollenColdCooling feels better on irritated tissue
Sore after a workout, a run or a long dayColdClean, fast cooling that doesn’t feel greasy
Stiff, tight muscles like neck and shoulders, or a stiff lower back in the morningHeatWarmth helps tight muscles feel looser
Ongoing achy jointsEitherTry both and use the one that feels better

Not sure? Ask your practitioner at your next visit. They can tell you which suits your injury.

Which format is right for me?

ProductBest forPrice

$24.99

Cold Therapy roll-on (3 oz)Small areas.
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The Benefits of Shockwave Therapy Treatments

The Benefits of Shockwave Therapy Treatments

Do you suffer from chronic pain or an old injury that interferes with your range of motion and the activities you enjoy? If so, physiotherapy accompanied by shockwave therapy treatments may be ideal for you. Shockwave therapy has been shown in studies to effectively reduce pain, break down old scar tissue and stimulate healing in stubborn injuries and joint pain without the cost or downtime of surgery. Continue reading to learn more about shockwave therapy’s many benefits.

What Is Shockwave Therapy?

Shockwave therapy is a non-surgical, non-invasive procedure whereby mechanical pulses of acoustic energy stimulate tissue repair, increase circulation, and help relieve pain where the treatment is applied. Physiotherapists may incorporate shockwave therapy as part of a patient’s injury rehabilitation treatment plan to help provide natural relief for acute or chronic pain and to stimulate the body’s natural healing response. In addition, shockwave therapy can be an excellent treatment for stubborn conditions or old injuries that haven’t responded well to other alternatives.

Conditions That Shockwave Therapy Treats

Shockwave therapy can be beneficial in many different applications but is especially helpful for treating muscle, ligament, tendon, bone and joint-related injuries and pain commonly associated with conditions including but not limited to:

  • Rotator cuff injuries
  • Stress fractures
  • Tennis elbow (lateral epicondylitis)
  • Golfer’s elbow (medial epicondylitis)
  • Achilles tendinopathy
  • Runner’s knee (patellofemoral pain syndrome)
  • Jumper’s knee (patellar tendonitis)
  • Calcified tendonitis
  • Trigger finger
  • Bursitis of the hip, knee, or shoulder
  • TMJ disorders
  • Shin splints
  • Back pain
  • Plantar fasciitis
  • Shoulder/rotator cuff tendinitis
  • Overuse strains and sprains
  • Injuries caused by accidents
  • Chronic muscle tension and pain

What to Expect From Shockwave Therapy Treatments

After assessing your condition and devising a treatment plan, your physiotherapist will start your treatment by applying a cool conductive gel (similar to ultrasound jelly) to the area being treated so that the handpiece used to deliver the acoustic energy pulses can easily be maneuvered. Treatments usually take around 15 minutes and are typically carried out a week apart.

What does it feel like?

Topical numbing agents, painkillers and anti-inflammatories are not required during shockwave therapy and are discouraged because they can interfere with shockwave therapy’s inflammatory response, which initiates tissue regeneration and healing. Shockwave therapy treatments typically feel like dull pulsing sensations in the tissues being treated. Treatment discomfort depends on the intensity of the treatment and the tenderness of the area being treated but is usually tolerable, and your physiotherapist can adjust the intensity to ensure your comfort. You may feel slight tingly sensations, warmth or tenderness in the treated area for up to a few days following treatment while the tissue’s healing response occurs.

Is there any downtime?

The beauty of undergoing non-invasive shockwave therapy treatments is how you can resume light activity following your treatments. Your physiotherapist will, however, ask you to avoid any rigorous or strenuous activity for two or more days following treatment, depending on your condition. You may also experience slight swelling or tenderness in the area treated for a few days following your procedure. Inflammation following your shockwave treatments is normal and indicative of the healing process taking place.

How many treatments will I need to see results?

Some patients notice pain reduction following their first treatment, with improved healing and pain relief as treatments progress. Shockwave treatment plans typically consist of 3 to 6 sessions spaced one or more weeks apart. Your physiotherapist will tailor a treatment plan ideal for your specific condition and requirements.

Find Out Whether Shockwave Therapy Is Right for You!

Don’t ignore pain. Start the healing process today by booking your appointment with one of our expert physiotherapists. Call Diversified Health Clinic at (250) 382-0018 or book an appointment online.

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Piriformis Syndrome: A Real Pain in the Butt

Piriformis Syndrome: A Real Pain in the Butt

Are you noticing a dull ache or shooting pain in your glutes after standing, sitting, cycling, training or running? If so, piriformis syndrome may be to blame. Continue reading to learn more about piriformis syndrome, including what makes it a potential cause of sciatica and what you can do to treat it and relieve the pain. 

What is Piriformis Syndrome and What Causes It?

The piriformis muscle anatomy as it relates to piriformis syndrome.

Piriformis syndrome is a condition that, as the title of this article implies, causes pain in the buttocks. Piriformis syndrome is a term used to describe a condition affecting the piriformis muscle located deep within the middle posterior gluteal region (behind the gluteus maximus). The piriformis muscle is one (and arguably the most important) of the six lateral hip rotators. It is responsible for externally rotating your hip and upper thigh, abducting your hip when flexed, and stabilizing your sacroiliac joint. 

What causes it?

Piriformis syndrome is caused when the piriformis muscle spasms, compressing and irritating surrounding nerves and soft tissues (often including the sciatic nerve), resulting in pain, tingling and/or numbness in the buttock area, which can sometimes also be felt down the back of the upper and lower leg and foot. While the root cause of piriformis syndrome is not yet well understood, the sciatic nerve’s involvement may be due to anatomical anomalies and variations between each individual or, more commonly, due to soft tissue inflammation or muscle spasms/contractions that compress the sciatic nerve as a result of piriformis muscle tightness from muscle or postural imbalances.

A common cause of sciatica pain

The sciatic nerve’s proximity to the piriformis muscle makes it susceptible to compression and irritation caused by the muscle spasms related to piriformis syndrome. Therefore, when lumbar issues such as disk herniation are ruled out as a cause for sciatica pain, and buttock pain isn’t accompanied by lower back pain, piriformis syndrome is most likely the cause. 

Piriformis Syndrome Symptoms

The most common symptom of piriformis syndrome is a deep, dull ache, burning, shooting pain, and tingling and numbness that can be felt in the buttock (typically on one side of the body). The pain may also be felt down the back of the thigh, calf and foot and may be accompanied by a reduced range of motion in the hip flexors. 

Piriformis syndrome pain is typically most noticeable:

  • When walking uphill or taking the stairs
  • After sitting, driving, standing or cycling for extended periods
  • Following activities such as walking, long-distance running or strength training
  • After a traumatic injury, including collisions and falls
  • When flexing or rotating the hip and thigh inwards and outwards

The Good News

Surgical correction or steroid injections may be required in rare cases of piriformis syndrome (caused by anatomical anomalies or trauma). However, the good news is that most cases of piriformis syndrome can be successfully treated with the following interventions and rest:

Proper assessment and diagnoses 

After ruling out sciatic pain caused by spinal issues, your physiotherapist or health practitioner will use a series of movements to indicate whether or not the piriformis muscle is causing sciatic nerve compression and pain.

Tailored treatment

Treating piriformis syndrome typically requires physiotherapy to help stretch the piriformis muscle and improve hip mobility, posture and muscular conditioning. 

At-home maintenance and prevention

Following the stretches and exercises your physiotherapist gives you can help prevent the recurrence of pain caused by piriformis muscle tightness, spasms and nerve compression.

Treating Piriformis Syndrome and Sciatica Pain in Victoria, BC

Don’t ignore pain. Start the healing process today by booking your appointment with one of our expert physiotherapists. Call Diversified Health Clinic today at (250) 382-0018 or book an appointment online.

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Fact or Fiction? Is Joint Pain Worse in Cold Weather?

Fact or Fiction? Is Joint Pain Worse in Cold Weather?

Do you notice increased joint pain or aches from past injuries in cold climates? If so, you’re not alone. A phenomenon occurs this time of year when Vancouver Island’s warm summer climate is replaced by a cooler and wetter fall and winter. The 2,400-year-old phenomenon I’m referring to is a sudden increase in people being bothered by joint pain. Is it a seasonal coincidence, or is there a correlation between colder, wetter weather and worsening aches and pains? 

Does Weather Affect Joint Pain?

The short answer is that it’s possible that a sudden or prolonged drop in barometric pressure negatively affects arthritis and joint pain, but at this point, the correlation has yet to be proven. While the jury is out on what exactly causes the notable increase in winter aches and pains, a couple of theories are worth considering as follows:

Blame it on the rain (and barometric pressure):

If you notice sudden or worsening pain or swelling on rainy days, this theory may explain why. Drops in barometric pressure, typical during periods of rain, can cause your muscles, tendons, interstitial fluids and tissues to expand slightly, affecting how much pressure is placed on surrounding nerves. The degree of swelling and pain may depend on contributing factors such as arthritis, edema and past or present injuries.

Drops in activity:

While many islanders are active year-round, it’s natural for some of us to stay inside and reduce our overall physical activity and energy output when it’s cold, wet and generally “blah” outside. Just as too much activity can leave muscles sore, too little activity — especially when your body has become accustomed to being active — can increase the sensation of joint pain and general achiness. Drops in activity coupled with a colder climate can decrease circulation and increase muscle tension and fluid retention around joints, causing muscles and tendons to feel more stiff and sore than usual. 

Simple Ways to Reduce Winter Aches and Joint Pain

Warm Up:

When fall and winter chills aggravate aches and pains, the easiest thing to do is warm up at home with a heating pad, hot water bottle, or warm bath. Take essential precautions when using an electrical heating pad, hot water bottle, microwaveable bean bag or any other compresses: 

  • First, the temperature you apply should be comfortably warm and not hot – heat builds up on your skin the longer a warm compress is applied;
  • Always use a towel or cloth between the heat source and your skin to prevent burns;
  • Never fall asleep while using a heating pad or hot compress (opt for electrical heating pads with built-in timers) or use a warm beanbag or hot water bottle wrapped in a towel;
  • Never apply heat if wounds are present or infection is suspected;
  • Apply heat in 10-20 minute intervals or shorter;
  • Pay attention to how you feel — the heat you apply should never feel hot, and if the pain or swelling increases instead of improving, stop and consult with a physician or trusted health practitioner immediately.

Get and Stay Active:

You may not feel like being active during darker, wetter and colder seasons, but consider that staying active not only helps mitigate aches and pains while keeping you fit year-round, but regular exercise can also help banish the winter blues. Be sure to take a few minutes at the end of your activities to stretch your muscles — paying extra attention to the areas that tend to bother you most. One important word of caution, consult with a health practitioner before starting a new workout routine or increasing your activity — especially if you have preexisting health conditions or old injuries. 

Get Help and Relief From Massage Therapy and Physiotherapy:

When joint pain, old injuries, and muscle tension persist or interfere with the activities you love and your overall well-being, a professional massage therapist or physiotherapist can help. Massage therapy and physiotherapy can help improve circulation, mobility and strength where it’s needed most while helping prevent re-injury and soreness from unaddressed muscle imbalances and suboptimal movement patterns. Booking an appointment and consultation with a massage therapist or physiotherapist is a great place to start, and they will likely give you pain-reducing tips and exercises you can perform between sessions at home.

If Your Pain Persists or You’re Unsure Where to Start

Give our team of practitioners a call at Diversified Health Clinic today at (250) 382-0018 or book an appointment online. If you’re unsure who to book your appointment with, ask us when you call. Our diversified approach and initial consultation process ensure you’ll be placed in the best care possible, with a practitioner and plan tailored to your specific situation and needs.

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