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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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Neck Pain and “Tech Neck”: Causes, Desk Fixes and When to Get It Checked

Woman holding the top of her shoulder and neck where it hurts

You finish a long day at the laptop, check your phone on the bus home, and by evening your neck feels stiff, achy and tight across the shoulders. Sound familiar? Neck pain is one of the most common reasons people visit our clinic, and the way we work and scroll today often plays a part.

What is “tech neck”?

“Tech neck” is a casual name for neck and upper back pain linked to long periods of looking down at a phone, tablet or laptop. It isn’t a formal diagnosis, but it describes a pattern we see often.

Your head weighs about as much as a bowling ball. When it sits balanced over your shoulders, your neck muscles don’t have to work very hard. As your head drifts forward and down, those muscles have to hold more of that load, for longer. Over hours and days, that can add up to:

  • Stiffness when turning your head, like checking your blind spot while driving
  • Aching or burning between the shoulder blades and across the tops of the shoulders
  • Tight, tender spots in the neck and shoulder muscles
  • Headaches that start at the base of the skull and wrap forward

Posture isn’t the whole story, though. There’s no single “perfect” posture. Staying in any position for too long tends to be the bigger problem. Stress, poor sleep, an old injury and low overall activity can all make the neck more sensitive too.

What can I do at home?

  • Bring the screen up to you. Raise your laptop or monitor so the top of the screen is near eye level, and hold your phone a little higher instead of dropping your chin to it.
  • Move often. Set a reminder to change position every 30 minutes. Stand up, roll your shoulders and look around the room. Small, frequent breaks beat one long stretch at the end of the day.
  • Try chin tucks. Sitting tall, gently glide your chin straight back (like making a double chin), hold for a few seconds and relax. Repeat 5 to 10 times, a few times a day.
  • Open up the upper back. Sit tall, squeeze your shoulder blades gently back and down, and hold for a few breaths. A walk with your arms swinging freely helps too.
  • Check your pillow. Your pillow should keep your head level with your spine, not propped up or sagging. Sleeping on your stomach often twists the neck.
  • Use heat or cold. Either can ease pain and muscle tension. Use whichever feels better. Our post on relief for a stiff neck has a few more simple ideas.

Movement should feel easy and comfortable. If an exercise makes your pain sharper or sends symptoms down your arm, stop and get it checked.

When should I get it checked?

Book an assessment if your neck pain lasts more than a week or two, keeps coming back, wakes you at night, or comes with headaches, or tingling or numbness in your arm or hand.

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

  • Neck pain after a fall, car accident or other injury
  • A sudden, severe headache unlike any you’ve had before
  • Fever with a stiff neck, especially with a headache or sensitivity to light
  • Weakness, clumsiness or loss of coordination in your arms or legs
  • Dizziness, trouble speaking or swallowing, double vision or fainting
  • Unexplained weight loss or a history of cancer along with new neck pain

How we help with neck pain

Neck pain often involves joints, muscles and everyday habits all at once. Having several disciplines under one roof means we can look at the whole picture and refer you in-house if another approach would suit you better.

Chiropractic

Our chiropractors assess how your neck and upper back are moving, and may use spinal manipulation and mobilization, soft tissue work, exercises and workstation advice to ease pain and improve movement. Dr. Tessa Bryan, DC combines manual and instrument-assisted soft tissue techniques, cupping, RockTape and therapeutic exercise. Dr. Alexia Grelson, DC blends manual, instrument-assisted and drop-table techniques tailored to each patient’s comfort, and enjoys working with busy professionals. Dr. Matthew Bryan, DC takes a collaborative, multidisciplinary approach to care. Dr. Krisjan Gustavson, DC has been in practice since 1986.

Physiotherapy

Our physiotherapists use manual therapy, education and a progressive exercise plan to build strength and endurance in the neck and upper back, so your body copes better with long days at a desk. Spirit Donahue, MPT centres his care on therapeutic exercise, manual therapy and patient education. Kanu Priya, MPT has over 10 years of experience and uses manual therapy, dry needling (IMS) and exercise prescription. Ivy Elling-Quaintance, MPT focuses on evidence-based exercise and movement, and has an interest in chronic pain management.

Registered Massage Therapy

Massage therapy can ease tight, tender neck and shoulder muscles and help you move more comfortably. 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, stretching and home care exercises, and works with neck, shoulder and arm pain. Morag Hart, RMT brings a particular empathy for chronic repetitive stresses on the body and tailors home care to each client.

Acupuncture

Acupuncture is another option that may help relieve neck pain and muscle tension. Jun Liu, R.Ac is also a certified Pilates instructor with over 20 years in therapeutic movement, and works with musculoskeletal pain and postural concerns. Annie Wang, R.Ac, R.TCM.P includes posture-related and myofascial pain among her clinical focuses, using acupuncture, cupping, gua sha and Tui Na.

Book an appointment

If your neck is making workdays harder than they need to 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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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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How to Heal Your Pelvic Floor After Giving Birth | Pelvic Floor Physiotherapy Guide

Pregnancy and childbirth place significant stress on the pelvic floor muscles. Whether you had a vaginal birth or a C-section, it’s common to experience pelvic floor symptoms during the weeks and months after delivery. While many women recover naturally, others continue to experience leakage, pelvic heaviness, pain, or core weakness that can improve with the right treatment.

In this guide, we’ll explain what symptoms to look out for, what to expect during recovery, when to seek help, and how pelvic floor physiotherapy can support your healing.

In This Article

  • Signs Your Pelvic Floor May Need Extra Support
  • What Can Slow Recovery?
  • Week-by-Week Recovery Timeline
  • Common Postpartum Pelvic Floor Conditions
  • When to See a Pelvic Floor Physiotherapist
  • How Pelvic Floor Physiotherapy Helps
  • FAQs

Pregnancy and childbirth place significant stress on the pelvic floor muscles. Whether you had a vaginal birth or a C-section, it’s common to experience pelvic floor symptoms during the weeks and months after delivery. While many women recover naturally, others continue to experience leakage, pelvic heaviness, pain, or core weakness that can improve with the right treatment.

In this guide, we’ll explain what symptoms to look out for, what to expect during recovery, when to seek help, and how pelvic floor physiotherapy can support your healing.

In This Article

  • Signs Your Pelvic Floor May Need Extra Support
  • What Can Slow Recovery?
  • Week-by-Week Recovery Timeline
  • Common Postpartum Pelvic Floor Conditions
  • When to See a Pelvic Floor Physiotherapist
  • How Pelvic Floor Physiotherapy Helps
  • FAQs

Signs Your Pelvic Floor May Need Extra Support

During pregnancy and childbirth, the pelvic floor muscles and surrounding tissues undergo significant stretching. Some women may also experience muscle or perineal tears, which can contribute to pelvic floor symptoms during recovery. Here are some symptoms to look out for if you believe you’ve damaged your pelvic floor muscles:

  • Vaginal swelling
  • Urinary or fecal incontinence
  • A heavy feeling or visible bulge in the vagina
  • Pelvic or vaginal pain or discomfort (can be especially prevalent during intercourse)
  • Chronic constipation
  • Pelvic muscle spasms or deep aches

What Can Make It Worse or Delay Healing?

  • High impact activities such as running, jumping, or heavy weightlifting
  • Certain core exercises like sit-ups or crunches
  • Constipation or straining to have a bowel movement
  • Having intercourse too early after birth
  • Poor posture

Week By Week Recovery Timeline

It is always advised to speak to your OB-GYN or a Pelvic Floor Physiotherapist for advice on recovery timelines. Many pelvic floor physiotherapists will also have different modalities to help your recovery. Here is an approximated timeline of events:

Week 1: Rest and Healing

  • Rest frequently
  • Practice diaphragmatic breathing
  • Avoid heavy lifting
  • Gentle movement as tolerated

Try to lie down for 10-45 minutes at points throughout the day to take the pressure off your pelvic floor.  You can try diaphragmatic breathing as a gentle core engaging exercise, or very gentle light Kegels. Remember to listen to your body if any movement or exercises feel achy or painful.

Weeks 2-6- Gradual Return to Activity

  • Short walks
  • Gentle core activation
  • Follow your provider’s guidance
  • Avoid high-impact exercise

Increase activity levels gradually, however, remember to avoid overexerting yourself. You are now able to hold kegels for a bit longer, or do extra repetitions, aiming for about 5-10 in a single session. Try to incorporate a short walk into your daily routine to gently activate your core and pelvic floor muscles. You can also wear compressive underwear during this time to take pressure off your pelvic floor.

Weeks 7-12: Gradually Building Strength & Endurance

As your body continues to recover, you may be able to gradually increase your activity level, depending on your symptoms and guidance from your healthcare provider.

  • Continue pelvic floor exercises if recommended by your pelvic floor physiotherapist.
  • Begin gentle core strengthening exercises, such as glute bridges, bird-dogs, or modified dead bugs, as tolerated.
  • Focus on good posture and breathing mechanics during daily activities and lifting.
  • Gradually increase walking distance and other low-impact exercise if comfortable.
  • Avoid high-impact activities if you’re experiencing pelvic heaviness, pain, or urinary leakage.
  • Consider booking a pelvic floor physiotherapy assessment if you haven’t already, especially before returning to more strenuous exercise

After Week 12: Returning to Higher-Level Activity

Many women are ready to begin progressing toward higher-impact activities around this stage, although recovery timelines vary.

  • Continue following your individualized rehabilitation program.
  • Progress pelvic floor and core strengthening exercises as recommended.
  • Return to running, jumping, or higher-impact activities gradually and only if you’re symptom-free or have been cleared by your pelvic floor physiotherapist.
  • Continue using proper lifting techniques and breathing strategies during exercise and childcare.
  • Monitor for symptoms such as urinary leakage, pelvic heaviness, or pain, and reduce activity if they occur.
  • Remember that recovery doesn’t end at 12 weeks—strength and function can continue improving for many months after childbirth.

Common Postpartum Pelvic Floor Conditions

Every postpartum recovery is unique. While many women recover naturally, some continue to experience symptoms that can benefit from assessment and treatment by a pelvic floor physiotherapist.

Urinary Incontinence

Leaking urine when coughing, sneezing, laughing, lifting, or exercising is one of the most common pelvic floor concerns after childbirth. Although it’s common, it isn’t considered a normal part of long-term recovery and can often be successfully treated with pelvic floor rehabilitation.

Pelvic Organ Prolapse

Pelvic organ prolapse occurs when the bladder, uterus, or rectum drops downward due to weakened pelvic floor support. Symptoms may include a feeling of heaviness or pressure in the pelvis, a noticeable vaginal bulge, or discomfort during daily activities. Early assessment can help manage symptoms and improve function.

Diastasis Recti (Abdominal Separation)

During pregnancy, the abdominal muscles naturally stretch to accommodate your growing baby. For some women, the separation between the abdominal muscles persists after birth. A pelvic floor physiotherapist can assess your core function and guide you through exercises that safely support recovery.

Pelvic Pain or Pain During Intercourse

Some women experience ongoing pelvic pain, vaginal discomfort, or pain during intercourse after childbirth. This may be related to scar tissue, muscle tightness, or changes in the pelvic floor muscles. Treatment may include manual therapy, relaxation techniques, breathing exercises, and individualized rehabilitation.

Pelvic Floor Weakness

Weakness of the pelvic floor muscles may contribute to urinary leakage, reduced support for the pelvic organs, and difficulty returning to exercise. A pelvic floor physiotherapist can determine whether strengthening exercises, relaxation techniques, or a combination of both will best support your recovery.

Constipation and Difficulty with Bowel Movements

Constipation is common after childbirth and can place additional strain on healing pelvic floor tissues. A pelvic floor physiotherapist can provide guidance on toileting mechanics, breathing strategies, pelvic floor coordination, and lifestyle modifications to help improve bowel function and reduce discomfort.

When Should I See a Pelvic Floor Physiotherapist?

If you’re experiencing any of the symptoms below, or your recovery doesn’t seem to be progressing as expected, a pelvic floor physiotherapist can help identify the cause and create a personalized treatment plan. Our clinic has multiple modalities to support postpartum recovery including pelvic floor physiotherapy and EMSELLA (for appropriate candidates). Postpartum recovery seems like a hard road, but with our multi-disciplinary approach, new moms don’t have to go far to find a team to help them get back on track.

Book an assessment if you have:

  • Leaking urine
  • Leaking stool
  • Pelvic heaviness
  • Painful intercourse
  • Persistent pelvic pain
  • Difficulty returning to exercise
  • Abdominal separation
  • Pressure in the vagina
  • Constipation that isn’t improving

How Pelvic Floor Physiotherapy Can Help

A pelvic floor physiotherapist can:

  • Assess how your pelvic floor muscles are functioning
  • Evaluate your breathing and core coordination
  • Help you safely return to exercise
  • Treat pain
  • Improve bladder and bowel control
  • Create a personalized rehabilitation program

A pelvic floor physiotherapist can determine whether your pelvic floor muscles need strengthening, relaxation, or a combination of both before recommending specific exercises. Even if you delivered by C-section, pregnancy alone places significant demands on the pelvic floor and core muscles, so some women may still benefit from an assessment.

Frequently Asked Questions

Is urinary leakage normal after having a baby?

Urinary leakage is common after pregnancy and childbirth, but it isn’t something you simply have to live with. Leakage when coughing, sneezing, laughing, or exercising can often improve with pelvic floor physiotherapy and an individualized rehabilitation program. If symptoms persist beyond the early postpartum period or are affecting your daily life, it’s a good idea to seek an assessment.

When should I see a pelvic floor physiotherapist after giving birth?

Many pelvic floor physiotherapists recommend an assessment around 6 weeks postpartum, even if you’re feeling well. However, if you’re experiencing significant pain, pelvic heaviness, bladder or bowel issues, or concerns about your recovery, you may benefit from being seen sooner if your healthcare provider feels it’s appropriate.

Do I need to do Kegel exercises after every pregnancy?

Not necessarily. While some people benefit from strengthening exercises, others have pelvic floor muscles that are tight, overactive, or not coordinating properly. A pelvic floor physiotherapist can assess your muscles and recommend whether strengthening, relaxation, breathing exercises, or a combination of treatments is most appropriate for you.

How long does it take for the pelvic floor to recover after childbirth?

Recovery is different for everyone. Many tissues undergo significant healing in the first 12 weeks, but improvements in strength, endurance, and function often continue for several months. Factors such as the type of delivery, tearing, pregnancy history, and overall health can all influence recovery.

When can I return to running or high-impact exercise?

Returning to running or jumping should be gradual and based on how your body is recovering—not just the number of weeks since delivery. A pelvic floor physiotherapist can assess your strength, balance, and pelvic floor function to help determine when it’s appropriate to return safely.

What symptoms could mean my pelvic floor needs treatment?

You may benefit from an assessment if you experience:

  • Urinary leakage
  • Difficulty controlling gas or bowel movements
  • Pelvic heaviness or pressure
  • A visible or noticeable vaginal bulge
  • Pain with intercourse
  • Persistent pelvic or low back pain
  • Difficulty returning to exercise
  • Ongoing abdominal separation (diastasis recti) concerns

Can pelvic floor physiotherapy help years after having children?

Yes. It’s never too late to seek treatment. Many women notice improvement months or even years after childbirth with a personalized pelvic floor rehabilitation program.

What happens during a pelvic floor physiotherapy assessment?

Your first appointment typically includes a discussion about your symptoms, pregnancy and birth history, bladder and bowel function, activity goals, posture, breathing, and core function. With your consent, your physiotherapist may also perform an internal pelvic floor examination to assess muscle strength, coordination, and relaxation. If you prefer not to have an internal exam, alternative assessment methods are available.

Is EMSELLA safe after having a baby?

EMSELLA may be an appropriate treatment for some postpartum individuals experiencing urinary incontinence or pelvic floor weakness, but it isn’t the right choice for everyone. A pelvic floor physiotherapist can help determine whether EMSELLA, pelvic floor physiotherapy, or a combination of treatments is most appropriate based on your symptoms and goals.

Do I need a referral to see a pelvic floor physiotherapist?

No. In British Columbia, you can book directly with a pelvic floor physiotherapist without a physician’s referral. However, some extended health insurance plans may require a referral for reimbursement, so it’s worth checking with your insurer before your appointment.

Still have questions about your postpartum recovery?

Every recovery journey is unique. If you’re experiencing pelvic floor symptoms or would like guidance on returning to exercise, our pelvic floor physiotherapists are here to help. We’ll assess your recovery, answer your questions, and create a personalized treatment plan to support your goals.

Ready to Start Your Recovery?

Every postpartum recovery is different, and you don’t have to navigate it alone. Whether you’re six weeks postpartum or six years postpartum, pelvic floor symptoms are treatable. If you’re experiencing leakage, pelvic pressure, pain, or you’re unsure whether your recovery is progressing as expected, our pelvic floor physiotherapists can help.

At Diversified Health Clinic in Victoria, BC, our pelvic floor physiotherapists help women recover after pregnancy and childbirth through individualized assessments and evidence-based treatment plans designed to help you regain strength, confidence, and return to the activities you enjoy.

Book your pelvic floor physiotherapy assessment today and take the first step toward returning to exercise, reducing leakage, and feeling confident in your recovery. Book online at diversifiedhealth.janeapp.com or call us at 250-382-0018 to get started.

Reviewed by: Dr. Tessa Bryan, Chiropractor, Diversified Health Clinic

Published: July 2026

Last Updated: July 2026

References

  • Canadian Physiotherapy Association
  • Pelvic Obstetric and Gynaecological Physiotherapy
  • International Continence Society
Book with Diversified Today!
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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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Searching for a Personal Trainer in Victoria to Help You Achieve Your Goals?

Searching for a Personal Trainer in Victoria to Help You Achieve Your Goals?

Are you on the search for a personal trainer in Victoria? Whether you’re a gym novice who needs help designing a fitness program or a seasoned athlete who is aiming to improve performance or rehabilitate following an injury, here’s how our personal trainer and certified kinesiologist, Angelina Schaaf, can help you get on track, stay the course and achieve your optimal fitness and performance goals this year.

How to Choose the Right Personal Trainer in Victoria for You

There are a lot of personal trainers in Victoria to choose from, and selecting the right one for your specific needs can be a challenge. People often ask their friends for recommendations, but that doesn’t always result in a good match because what works for one person may not lead to a successful outcome for another. Fitness training isn’t one-size-fits-all. You need a trainer with the right experience to understand where you are in your fitness journey now, what tweaks and adjustments may be required to avoid injury, and the specific volume and stimulus required to ensure continual progress. For example, here are just a few of the main reasons people choose Diversified Health Clinic’s personal training services:

  • Certified kinesiologist: Angelina Schaff is an experienced personal trainer and a certified kinesiologist. Her in-depth knowledge enables her to identify, correct and ensure optimal lifting techniques, posture and movement patterns that avoid injury and effectively isolate the right muscles. Angelina also knows what each fitness program requires to balance muscle groups for optimal results and performance. 
  • Injury Rehabilitation: When embarking on a new fitness routine or exercise, the last thing you want is to compromise an old injury. Personal training at Diversified Health Clinic can be tailored for safe and effective injury rehabilitation and improved strength and mobility. 
  • Sports conditioning and training: On-season and off-season, Angelina Schaaf offers bespoke fitness programs that improve speed, strength and performance while correcting suboptimal movement patterns to avoid muscle imbalances or injury. Our programs can be tailored to each sport, including pre and post-season conditioning. 
  • Goal Specific: Angelina will design your fitness programs according to your immediate and long-term goals. A client whose goal is to lose weight and build lean muscle will require a program that is vastly different from a client whose goal is to increase power, combustive strength and muscle mass. Personal training at Diversified Health Clinic starts with a thorough health assessment to clarify your goals, followed by a physical evaluation to determine your current conditioning before custom-designing an effective program just for you.

Fitness programming isn’t a one-size-fits-all approach — it has to be tailored.

Ensuring Good Habits Stick

It’s no coincidence that the post-holiday period between January and February brings many people to the gym, full of enthusiasm about improving their fitness. While getting started is half the battle, the real challenge is making new habits stick. Consider how many resolutions you’ve made in the past that fell to the wayside when other things got in the way. Working with a personal trainer gives you an accountability partner and helps motivate you long after your natural enthusiasm has worn off. 

Focus and Privacy

Diversified Health Clinic has a private gym space with everything needed for a comprehensive training program. Clients appreciate the one-on-one focus they receive from our personal trainer, and our safe and uncrowded gym space is ideal for injury rehabilitation programs and sports conditioning. 

Building Optimal Outcomes

How to choose the right personal trainer in Victoria.

Why hire a personal trainer when you can show up to the gym and simply “wing it” as you go? As the old adage goes, “failing to plan is planning to fail.” While it’s true that you can still benefit from working out without a program, if your goal is to make improvements and other changes, you’ll likely require a plan to see results. Fitness programming is crucial because our body always seeks homeostasis and the path of least resistance. Training without a plan can often result in a lot of time spent exercising with few physiological changes to show for it. It can also result in performance plateaus due to the body becoming accustomed to stimulus. 

An experienced personal trainer such as Angelina will know which exercises are best suited to your current situation and goals and how much volume, intensity and change are required to deliver ongoing and progressive results. And let’s face it, a few things are more motivating than noticing a positive change from the time and effort you put in at the gym. 

Take the First Step Towards a Happier, Healthier and Fitter You This Year!

Call Diversified Health Clinic today at (250) 382-0018 to book with Angelina Schaaf, our kinesiologist and personal trainer in Victoria, BC., or book an appointment online.

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Are Winter Blues + Holiday Stress Making You Feel Grinchy? 

Are Winter Blues + Holiday Stress Making You Feel Grinchy? 

It’s the time of the year that is supposed to be very merry and bright. Still, for many of us, winter blues and holiday preparations add extra tasks to our never-ending to-do lists, resulting in compounding holiday stress that leaves us feeling more tense than jolly. Luckily, there are things you can do to salvage your energy and save your spirits this holiday season.

Beating The Winter Blues (Hello, Darkness My Old Friend)

Using light therapy to help offset holiday stress and tension.

When Simon & Garfunkel sang this lyric in their famous song The Sound of Silence, they weren’t referring to west coast winters marked by dark skies before your 5 o’clock drive home from work, but they could have been. Shorter daylight hours can put a damper on anyone’s mood and energy, leaving little left in the proverbial tank for holiday socials, decorating, baking, shopping and more. To help offset dark weather doldrums, some people find relief from investing in light therapy lamps that replicate daylight. The trick is to sit within 12 to 15 inches of your lamp for at least 20 to 30 minutes per day — ideally in the morning after rising. When shopping for the best light therapy lamp, look for one that:

  • Radiates a brightness level of at least 10,000 lux of white light;
  • Is 100% UV Free;
  • Has a design that will make it easy to place where you’ll remember to use it each day (at least on days when you’re starved of natural sunlight). 

Offsetting Barometric Pressure + Hibernation Mode

Does winter chill and rain make you wish you could just stay home? Obligatory social engagements and ugly sweater parties can add enough pressure and holiday stress when all you want to do is hibernate. In addition, barometric pressure changes and decreased physical activity can trigger headaches, joint pain and fluid retention. If you’re noticing more general achiness than usual, a light walk or warm Epsom salt bath can help. If your joint pain is isolated to one or two areas, you can also try these simple, at-home ways to help reduce winter aches and joint pain. If joint pain becomes persistent or interferes with your favourite activities, booking a consultation and treatment with a trusted physiotherapist can help relieve pain and encourage healing without delay.

Preventing and Treating Holiday Tension and Burnout

The holidays can be an incredibly stressful time, especially if you’re planning on doing some holiday hosting at your home. It can be hard to turn down social invitations and give engagements a miss, but sometimes, bowing out or saying no to that baking swap opportunity is the best gift you can give yourself to prevent burnout. It’s also a great time to practice delegating, which can be especially challenging for traditionalists and perfectionists. Finally, it helps to remember what the holidays are all about — being with the people you love and having fun. If turkey feasts with all the trimmings result in more work than pleasure, it may be time to tweak traditions by dining out or ordering pizza — who doesn’t love pizza?

Even if you’re brimming with the holiday spirit, the hustle and bustle of holiday preparations (and even happy stress) can create muscle tension and tightness that can interfere with relaxation and fun. In this case, booking a massage therapy treatment or two (or more) can be the perfect proactive measure to prevent and treat holiday muscle tension and tightness. Besides, a therapeutic massage can feel incredibly good — it’s the easiest thing to prioritize once you realize how great you feel afterwards.

Get Ahead of Holiday Stress and Tension

Give our team of practitioners a call at Diversified Health Clinic today at (250) 382-0018 or book an appointment online. If you need help deciding 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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