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About Hoong Phang

Hoong Phang is a registered physiotherapist at Propel Physiotherapy. He believes that every person is capable of improving their current physical situation and is passionate about developing unique strategies through critical analysis and assessment to help his clients achieve their personal goals. Hoong is currently published in the academic journals “Disability and Rehabilitation” and “Spinal Cord.”

Physiotherapy Supports Healthy Aging

May is National Physiotherapy Month. This year, we are celebrating by highlighting some commonly asked questions and the many ways our profession can enable and support healthy aging. “From helping Canadians recover from illness to helping improve the flexibility, strength, and balance older adults need to remain independent and mobile, physiotherapy plays a key role in healthy aging.”[i]

What is the Role of a Physiotherapist?

The role of a physiotherapist is to assist patients and clients recover and rehabilitate from an injury to the musculoskeletal, neurological, or cardiorespiratory systems. Physiotherapists are also able to provide guidance, education, and instruction for community health as well. The role of a physiotherapist can vary slightly, depending on your situation and the responsibilities of the physiotherapist in that particular setting.

You might also enjoy reading: The Essential Role of Physiotherapy

What is a Physiotherapist vs Physical Therapist?

In Ontario, there are no differences between the term physiotherapist and physical therapist; and they can be used interchangeably. The terms Physiotherapist, Physicial Therapist, and Physiotherapy and short forms of these terms (e.g., “PT”) are deemed protected terms, according to the College of Physiotherapists of Ontario. It is illegal to use these titles without being registered with the college.

How Does Physiotherapy Work? 

A physiotherapist will perform a comprehensive initial assessment, according to your main concerns and injury or limitations you present with. After the assessment, your physiotherapist will develop meaningful goals with you and apply techniques such as manual therapy, exercise or movement prescription, education, modalities (e.g., such as acupuncture, shockwave therapy, electrical modalities) to get your body moving better functionally, and with reduced discomfort or pain. Your physiotherapist may have additional training in specific techniques.

You might also enjoy reading: How Acupuncture Works

How Effective is Physiotherapy?

Physiotherapy and elements of physiotherapy are applicable to a large variety of conditions that affect the musculoskeletal, neurological, or cardiorespiratory system. The effectiveness of physiotherapy in the recovery and rehabilitation for people living with acute and systemic conditions has been well documented and studied. There is a large proportion of evidence to suggest that physiotherapy will assist in a person’s recovery and overall quality of life.

How Does Physiotherapy Support Healthy Aging?

Physiotherapy can reduce the incidence and likelihood of falls at older ages, particularly for people living with chronic conditions that make them more frail. Frailty can increase the risk of fragility fractures due to falling. At Propel Physiotherapy, we can tailor a falls prevention program that helps to improve balance and posture with the goal of reducing falls and fragility fractures.

Physiotherapy can also promote the health of the joints and the major muscle groups that surround the joints, especially of weight bearing parts of the body like the hips and knees. Active physiotherapy guidance also plays a major part in pre-habilitation and the rehabilitation of joints, due to natural aging processes. Across the one’s lifespan, physiotherapy can play a vital role in improving quality of life for people living with chronic or systemic disorders.

You might also enjoy reading: Strength Training for Women Over 50

How Can Physiotherapy Reduce Pain?

Physiotherapy can reduce pain in a number of ways. By improving mobility, muscular strength, and daily physical function, a physiotherapist can assist in reducing pain. In addition, depending on the type of pain and chronicity, techniques such as manual therapy, education, modalities, and physiotherapy guidance can greatly reduce the pain experience.

You might also enjoy reading: 3 Easy Ways to Reduce Pain & Improve Comfort

Can I Do Physiotherapy at Home?

Yes! It is encouraged by many, if not most, physiotherapists to continue with a home movement or exercise program to assist in your physiotherapy recovery. Doing physiotherapy outside of the clinic is a great way to improve your progress. In addition, during the pandemic, physiotherapists have increased their abilities to deliver homecare, in addition to virtual physiotherapy care to assist with barriers getting into a clinic.

You might also enjoy reading: How Virtual Yoga Therapy & Mindfulness Can Benefit You More Than In-Person Sessions 

Is Physiotherapy Right for Me?

Your physiotherapist will provide a comprehensive assessment and screening to determine if physiotherapy is right for you. In addition, they are trained in healing timelines to help you determine when you can return to activities. Your physiotherapist can also communicate with your primary health care provider to see if you are a candidate for physiotherapy. Most clients who come through our doors are ready to reap the benefits of physiotherapy treatment and guidance.

“The pandemic has made the benefits of physiotherapy even more obvious – not just for older adults. Physiotherapy can help Canadians maintain and improve their physical wellbeing and manage and prevent injury and illness in all of us as we age.”[ii]

Written by

Hoong Phang
Hoong PhangClinic Manager & Physiotherapist
Hoong holds a Bachelor Honours Health Sciences from the University of Western Ontario (2008). He has also completed a Master of Science in Health and Exercise Psychology (2010) from McMaster University, and Master of Physiotherapy (2012) from McMaster University. Hoong is currently published in the academic journals “Disability and Rehabilitation” and “Spinal Cord.”

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    Types of Headaches: Proper Diagnosis & Management Without Medication

    Did you know that there are six types of headaches with different characteristics, aggravating factors and symptoms? Many people are diagnosed incorrectly. This can leave people with recurrent headaches with little management strategies, poor personal and societal burdens of pain, decreased quality of life, and financial implications across industries.

    As anyone who has suffered from headaches can tell you, they can be disabling and lead to unwanted time off work, leisure activities, sports, and other activities of daily living.  According to the World Health Organization[i] , headache disorders are the most common disorders of the nervous system. In this article, we examine the six types of headaches, proper diagnosis, and management solutions without medication.

    Types of Headaches

    Headaches can be separated into two broad categories: primary and secondary. Let’s examine each broad category a little closer.

    Headaches are categorized as primary when the headache is the main issue at hand.  Primary headaches can be very painful and disabling, but despite their qualities, they are not ultimately dangerous. Their onset is also mainly predictable and has a consistent pattern. Examples of primary headaches are tension-type headaches, migraines, and cluster headaches.

    Headaches are categorized as secondary when the headache is not the main issue at hand; and is a secondary symptom to another underlying condition. Secondary headaches maybe a warning sign to other deleterious conditions. These types of headaches may have a sudden and unpredictable onset. [ii]

    Examples of secondary headaches are cervicogenic headaches, post-traumatic headaches, and headaches related to central nervous system injuries (e.g., brain injury, stroke, concussion).

    Getting the Right Headache Diagnosis

    In order to address the headache appropriately, an appropriate diagnosis must occur and next steps or strategies can be formulated.

    Registered physiotherapists can assess and diagnose certain types of headaches, including tension headaches and cervicogenic headaches. A registered physiotherapist can help to rule out other serious pathology that may require further medical investigation.

    Although a registered physiotherapist cannot diagnose a concussion, they will be able to help you along with the intensity and frequency of the headaches you experience from the concussion, which would be considered a secondary headache.

    With any type of headache, if the symptoms are severe and unrelenting, the registered physiotherapist may suggest you return to your family physician to obtain a referral for a neurologist or another specialist.

    The video below illustrates the variety and severity of headache types [iii], which includes:

    • Tension Type Headaches
    • Migraines
    • Cluster
    • Cervicogenic
    • Central Nervous System
    • Trigeminal Neuralgia

    Headache Management Without Medications

    Physiotherapy, massage therapy, exercise guidance, and mindfulness practice can assist in symptom management of many of the types of headaches listed above and are a non-pharmacological approaches to headache management.

    Through various hands-on techniques such as massage, manipulation, mobilization and soft tissue techniques, therapists can help release the neuromuscular causes of tension and headaches.

    Exercises focusing on stretching, postural correction and optimizing range of motion will also contribute to the overall prevention of many types of headache.  Modalities such as acupuncture, TENs, taping and shock wave therapy may also be utilized to manage pain.

    In addition, physiotherapy and ergonomic guidelines can also assist in optimizing posture and limit unnecessary strain on smaller muscles that contribute to tension in the cervical spine and head.

    Physiotherapy for Headaches: Tension and Cervicogenic

    Tension type headaches and cervicogenic headaches are often treated conservatively with physiotherapy.

    Tension type headaches are one of the most common types of headaches and are often the reason many people seek a management solution without medications to address the symptomology associated with it.

    Tension type headaches tend to respond to pain modulating modalities (e.g., thermotherapy, acupuncture, shockwave therapy) and exercises that assist in stretching or lengthening any shortened or dysfunctional musculature associated with the head and neck.

    Cervicogenic headaches are often treated with proprioceptive exercises, postural correction, and manual therapy to help mobilize the cervical spine. Interestingly, the use of over-the-counter medications may serve as a very short-term solution. However, if the root of the problem is not addressed, it is almost certain that the headache will return.

    At Propel Physiotherapy, our experienced and knowledgeable therapists can help assess and treat various types of headaches. Contact us for a complimentary consultation to learn more about our assessments and treatment solutions.

    References

    [i] Headache Disorders Fact Sheet, World Health Organization

    [ii] Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. (2018). Cephalalgia38(1), 1–211. https://doi.org/10.1177/0333102417738202

    [iii] The Complete Headache Chart, National Headache Foundation/

    Written by

    Hoong Phang
    Hoong PhangClinic Manager & Physiotherapist
    Hoong holds a Bachelor Honours Health Sciences from the University of Western Ontario (2008). He has also completed a Master of Science in Health and Exercise Psychology (2010) from McMaster University, and Master of Physiotherapy (2012) from McMaster University. Hoong is currently published in the academic journals “Disability and Rehabilitation” and “Spinal Cord.”

    FOLLOW US!

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      CONNECT WITH A PHYSIOTHERAPIST!

      Let us help you maximize your mobility and improve your performance in daily activities.


      Traumatic Brain Injury and the Mental Health Effects of Covid-19

      As a physiotherapist working in one of the province’s leading neurological rehabilitation centres, I have witnessed the mental health effects of COVID-19 on some of my clients with traumatic brain injury. In the spirit of Bell Let’s Talk Day, I wanted to share the perspectives of some of my clients (with their permission) with our readers in the hopes that it might help someone.

      Since the first pandemic lockdown in Canada last March, many of my clients who were previously suffering from a mild to moderate traumatic brain injury have reported an increase in issues regarding psychosocial health, mental health, stress, anxiety, and just overall not feeling well. They also shared that the unpredictability and uncertainty of the pandemic situation is the root cause.

      A year into the pandemic, we now have access to research that links the associated lockdowns, physical distancing, and other containment strategies; and the resulting economic breakdown with an increased risk of mental health problems and exacerbated health inequalities. In one study, preliminary findings suggest increased adverse mental health effects in previously healthy people and especially in people with pre-existing mental health disorders.[i]

      Traumatic Brain Injury and Mental Health

      People who sustain a brain injury are at an increased risk of experiencing mental illness. Some of the short- and long-term effects of brain injury are related to mental health, and can include anxiety, depression, aggression, and impulsivity.[ii]

      The psychiatric consequences of brain injury are influenced by pre-injury status, co-occurring disorders, injury-related factors, and pre- and post-injury environmental factors, among other potential influences.[iii]

      It is not difficult to imagine how social isolation, loss of income, loneliness, inactivity, limited access to basic services, decreased family and social support, food insecurity, or increased access to online gambling, alcohol and other substances might be contributing factors to an increase in mental health issues in this population.

      What we also see as physiotherapists is that as our clients’ symptomology becomes further exacerbated, it reveals itself in physical manners as well. In other words, the client is reporting decreased quality of sleep, increased self reported pain, decreased muscular endurance or cardiovascular endurance, with no physical change or explanation.

      That is because mental health and physical health are fundamentally linked. In fact, people with mental health issues are at higher risk of developing chronic physical conditions and vice versa.[iv] For this reason, physiotherapists have an important role to play in mental health care for our clients.

      You may also enjoy reading: Brain Injury: Prevention & Treatment

      The Physiotherapists Role in Mental Health Care

      As physiotherapists, it is important to recognize that we are not mental health experts. However, due to the nature of our job, specifically in working with clients who have had traumatic brain injuries or other life altering injuries, we often treat clients who are experiencing mental health issues. It is therefore essential that we understand how to recognize the signs, show support and point them towards experts or resources that can help.

      One of the more common messages I’m hearing from my clients with TBI is they’re not feeling mentally well. More specifically, not being able to see their family and friends or get back to the things they used to love doing is really having a real impact on their life. And, although they can be making some good physical gains in physical therapy sessions in clinic, it does, in effect, dampen a portion of physical health goal setting.

      For instance, one of my client’s goals for the winter was to get back to playing winter sports such as snowboarding or cross-country skiing. With lockdown orders in effect and many winter sports facilities temporarily closed and/or operating at a reduced capacity, these goals are suddenly harder if not impossible to achieve. This lack of tangible goals outside the clinic can limit the client’s perception of how well they’re doing in clinic.

      The first thing any physiotherapist working with someone who has had previous traumatic brain injury needs to understand is that the client is at an even higher risk of developing mental health issues during this time. The second thing need to know is how we can help our clients and stay within our scope of practice.

      As a physiotherapist, I think one of the most important things we can do is just talk to our clients, and have that regular touchpoint to make ourselves more aware of their situation. For this at-risk population, finding areas where they require additional support in clinic and in the community is critical.

      You may also enjoy reading: My Traumatic Brain Injury Road to Recovery

      A couple of simple ways that I make this a priority is by scheduling my sessions in a way that gives me the first five to seven minutes in a session just to talk with clients that I know are at risk, or have conveyed to me that their mental health is not good. Giving us that buffer time really helps with how the remainder of the session unfolds, but also it helps me take notes in case I need to take further action.

      In addition to having that dialogue, we need to familiarize ourselves with the signs of anxiety, stress or depression. While listening to the client talk about their fears about their own health or the health of their loved ones, pay specific attention to language around any physical changes in their sleeping, nutritional intake, or if they’ve shared that they have increased use of any substances. These are all things to take note of and consider whether additional support from mental health experts or resources need to be part of the overall approach to a client’s treatment plan.

      Access to Mental Health Services & Resources

      A lot of our clients who do rely on publicly funded services for peer support, or emotional or psychological support, have had access to these services limited or disrupted during this time. We try to help our clients connect with others services, including virtual mental health supports or our online mindfulness training and resources, and free or very low-cost resources that the government has developed like these below:

      Tips for managing mental health:

      WELLNESS TOGETHER CANADA MENTAL HEALTH PORTAL– Government of Canada

      RESOURCE HUB: MENTAL HEALTH AND WELLNESS DURING THE COVID-19 PANDEMIC– Mental Health Commission of Canada

      TIPS TO SUPPORT MENTAL HEALTH DURING THE COVID-19 PANDEMIC– The Canadian Mental Health Association

      HOW TO LOOK OUT FOR OUR MENTAL HEALTH DURING COVID-19– Jack.org

      MENTAL HEALTH AND COVID-19– The Centre for Addiction and Mental Health

      TAKING CARE OF MENTAL HEALTH DURING COVID-19– Canadian Red Cross

      MENTAL HEALTH AND CULTURAL SUPPORTS FOR INDIGENOUS CANADIANS– First Nations Health Authority (British Columbia focused)

      MULTICULTURAL MENTAL HEALTH RESOURCES RELATED TO COVID-19– Multicultural Mental Health Resource Centre

      WELLCAN DIGITAL RESOURCE HUB– Morneau Shepell

      Managing anxiety, stress and panic:

      COPING WITH STRESS AND ANXIETY– The Centre for Addiction and Mental Health

      MANAGING ANXIETY THAT TURNS TO PANIC (VIDEO)– Dr. Joti Samra (MyWorkplace Health)

      7 TIPS FOR MANAGING ANXIETY AND WORRY ABOUT CORONAVIRUS (VIDEO)– Dr. Joti Samra (MyWorkplace Health)

      CORONAVIRUS: MANAGING STRESS AND ANXIETY– The Canadian Mental Health Association Kelowna

      COPING WITH ANXIETY DURING STRESSFUL TIMES– Calgary Counselling Centre (Alberta focused)

      End the Stigma Around Mental Health & Brain Injury

      Sadly, there still exists a stigma around mental health and brain injury. Internal or invisible symptoms are often misunderstood and disregarded by others. That is why it is so important for us to be a part of the discussion and try to make a difference in the mental health care and outcomes of people with traumatic brain injuries.

      Some tips for physiotherapists and other healthcare providers in treating people with brain injury include:

      • Make sure that the language we use is not judgmental.
      • Try to educate yourself as much as we can.
      • Give the client time to respond and not rush them through their responses.
      • Build in that time to talk about mental health and illness, and even by providing empathetic and supportive listening can go a long way.

      I hope this article gives you a glimpse of how a physiotherapist, or even your massage therapist or exercise professionals can help people with mental health, while working specifically on your physical health and physical goals.

      References

      [i] How mental health care should change as a consequence of the COVID-19 pandemic

      [ii] J. R. Fann, A. Leonetti, K. Jaffe, W. J. Katon, P. Cummings, and R. S. Thompson, “Psychiatric illness and subsequent traumatic brain injury: A case control study,” J. Neurol. Neurosurg. Psychiatry, vol. 72, no. 5, pp. 615–620, 2002.

      [iii] Understanding the link between mental health and brain injury, ABI Research Lab

      [iv] Connection Between Mental and Physical Health, CMHA

      Written by

      Hoong Phang
      Hoong PhangClinic Manager & Physiotherapist
      Hoong holds a Bachelor Honours Health Sciences from the University of Western Ontario (2008). He has also completed a Master of Science in Health and Exercise Psychology (2010) from McMaster University, and Master of Physiotherapy (2012) from McMaster University. Hoong is currently published in the academic journals “Disability and Rehabilitation” and “Spinal Cord.”

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        Health for the Holidays: 4 Healthy Holiday Gift Ideas

        With restrictions on gatherings, travel, and indoor dining, shopping and other activities across the country, this holiday season will undoubtedly feel a lot different than seasons past.

        The pandemic has created increased stress and anxiety levels for many people. In addition, it has created barriers to accessing important services that can help people take care of their mental and physical health.

        Your physical and mental well-being are always our top priority at Propel Physiotherapy. But this year, in particular, we have been reminded of the importance of self-care, and how educating our clients and empowering them to be more active in their own recovery is perhaps the single most important service we can provide.

        We are fortunate to be able to continue offering services in-clinic and in the community throughout the holiday season. We are also offering some wellness-focused and pandemic-friendly, healthy holiday gift ideas for the 2020 winter season to help you take care of yourselves and your loved ones.

        This holiday season, avoid the malls and Amazon. Give the gift of health.

        1. Get That Home Exercise Routine Started with the Get-Fit-Kit 

        If you’re thinking of an incorporating exercise into your routine but don’t know where to start, this kit is for you. Propel Physiotherapy’s Get-Fit-Kit includes resistance bands, myofascial release instruments, a stretching strap, a water bottle, and a personalized exercise script, designed to get you started on movement, mobility, and strengthening.

        get fit kit healthy holiday gift ideas Propel Physiotherapy

        The Get-Fit-Kit also includes a 15-minute virtual consultation with an exercise expert to get you started on your journey to physical wellness!

        At only $95 +HST, the “Get-Fit-Kit” is your jumpstart to a physically active future!

        *Quantities are limited and will be sold on a first come first serve basis.

        2. Lose the “Covid Weight” with Virtual Personal Training Sessions

        Know someone who is feeling a little sluggish after being cooped up indoors and not having the appropriate physical activity outlets to keep our blood pumping? Not a problem. Our Registered Kinesiologists and Exercise Physiologists are able to craft personalized exercise programs geared towards your goals to get you back into shape!

        Whether you have a home-gym or just a small space in your condo, we’ll be able to work with what you have . In addition, we can set you up with the necessary equipment to make sure your progress is always moving in the right direction.  Our exercise pros will be able to provide services and support to you, virtually.

        Get a Package of 5 Exercise sessions for $380 +HST or 10 exercise sessions for $690+ HST.

        3. Stress Be Gone with Registered Massage Therapy Sessions

        If you can think of someone who isn’t feeling stressed this year, let us know. For everyone else, the gift of massage therapy would be a welcomed treat. Registered Massage Therapists (RMTs) are able to decrease muscular tension, improve blood flow, decrease stress, and improve your well being with their skillset in manual therapy-based treatment.  These skilled practitioners will be able to melt away muscular pain, lingering soreness, tension headaches, and the wear and tear of the daily grind.

        Our Registered Massage Therapists continue to safely practice their craft to a strict level of clinical standards. Better yet- give a loved one the gift of a massage therapy session with a gift card.

        Registered Massage Therapy Sessions begin at $95 + HST for a one-hour session.

        4. Build Your Mental Fortitude with Private Virtual Yoga Sessions

        Imagine having your very own yoga therapist or instructor working with you on a 1:1 basis.  With the help of virtual therapy sessions, you can benefit from Yoga practices that target your mobility, breathing, mental clarity, dynamic balance, and mindfulness. Depending on your abilities and goals, your yoga therapist or instructor can customize what your sessions look like!

        healthy holiday gift ideas Propel Physiotherapy

        Research indicates that virtual yoga therapy and mindfulness are just as beneficial to clients as in person sessions. In one study, patients reported a reduction in stress and anxiety levels after participating in virtual yoga and mindfulness sessions.

        One-hour private yoga sessions start at $75 +HST.  Call into the clinic for more details on pricing for different types of yoga services.

        Orders, Payment & Scheduling Process

        To book sessions for yourself or a loved one or to purchase a gift box, call our clinic main line at 416-621-2506. Our front office staff can assist you with payment for a gift, schedule appointments or arrange for pick-up or delivery of gift boxes .

        These are just a few healthy holiday gift ideas that can help you or your loved ones take more control of their physical and mental well-being. Follow-us on social media or sign up for our monthly newsletter to get more health info, tips and inspiration for developing healthy habits!

        This holiday season give the gift of health!

        Written by

        Hoong Phang
        Hoong PhangClinic Manager & Physiotherapist
        Hoong holds a Bachelor Honours Health Sciences from the University of Western Ontario (2008). He has also completed a Master of Science in Health and Exercise Psychology (2010) from McMaster University, and Master of Physiotherapy (2012) from McMaster University. Hoong is currently published in the academic journals “Disability and Rehabilitation” and “Spinal Cord.”

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