Testimonial – Paul Toffoli

My name is Paul Toffoli  and I just wanted to give a big thank you to the team at Insync Physiotherapy. I've been seeing one of the physios due to really chronic tennis elbow caused by playing too much golf. And I've received IMS and massage and lots of take-home exercises so I can work on it on my own.

I've seen a vast improvement. The pain has really minimized and my golf game has improved. So thank you so much.

Shoulder Injury Recovery – Rotator Cuff Ball Release

Do you have a chronically sore or stiff shoulder? Do you use your shoulder repetitively or exert it intensely in sports like throwing, hitting, lifting or rock climbing? If yes, then this recovery exercise might just be one of the right exercises for you.

Start with a release ball, either a very soft one to start or a stiffer one like a lacrosse type of density) and place it under the back part of your shoulder blade lying down on top of it.

Take a big breath in then slowly exhale as you relax your body and the back of your shoulder into the ball. Then using the ball as a pressure point release gently and slowly roll over the ball while trying to keep the body relaxed. Do this for a few minutes and find 2 to 3 other areas in the muscle to repeat this on.

If you have any abnormal pain or discomfort or are unsure about what you are doing consult a local physiotherapist before continuing.

Lateral Elbow Pain – Heather Camenzind

Mark: Hi, it's Mark from TLR. I'm here with Heather Camenzind and of Insync Physio in Vancouver. We're going to talk about lateral elbow pain or tennis elbow. How are you doing Heather?

Heather: I'm good thank you. So yeah, I've been getting some clients in with lateral elbow pain. So there's two in particular, one's a mountain biker that he is getting elbow pain just on like the outside of the elbow, more below the elbow joint. But he's getting at when he's gripping his handlebars and just absorbing like the force is going through his arm as he's going down the mountain.

And then another one is an office worker. That's getting it just with computer work. And they're very similar in that they're two different mechanisms that are causing their pain. But the reason why they're getting a pain is actually quite similar. So it can relate to a lot of people. 

Mark: So what's the cause? 

Heather: So, the main is a breakdown, is an overuse injury of the muscle and the tendon. So there's the tendon at the elbow and the muscles come up the arm and they attach into the arm. So it can break down in three different places. So it varies from person to person. Sometimes it's a breakdown of where the muscle meets the tendon. Sometimes it can be mid tendon or sometimes it can be where the tendon meets the bone.

It's all treated the same. We figure out where it is. But as physiotherapists, we just have to know that there could be potential breakdown and disruption in any of those three places. So it's overused, those muscles or tendons are getting overused. They're overworking and they're not able to recover in time before we stress them again.

Mark: And what does it feel, what is it presenting? Where they came in and say, my elbow is sore and it goes away sometimes or comes back or how does it present? And then what's the treatment protocol? 

Heather: It presents is something that often, it's painful with use. So like for the mountain biker, when he's mountain biking in particular. With the office worker it's painful with using mainly the mouse or with typing, but it's also things that it hurts them when they lift, like if they're cooking and they're lifting the kettle and they're rotating or cooking and moving a pot, or sometimes even opening like a doorknob or something, just the twisting action can be painful on the arm.

Mark: Toothbrush?

Heather: Toothbrush, sometimes driving. So it's mainly something that you're gripping and then having to move your arm. Typically people are okay at rest and normally when they're just resting their arm, the pain goes away. So it has a very mechanical nature in that when you're using it, it hurts. When you're resting the pain goes away.

The interesting thing about this injury is that it is a breakdown of the muscles and the tendon in the area, but it can often be something contributing from the neck, actually. So, this is where it kind of gets a little bit complicated and that sometimes we treat tennis elbow or lateral elbow pain, and we're just treating the elbow and it's just not going away.

And what has to happen then is we have to look higher up in the chain. So in your neck, you have all your vertebrae and then you have your nerves that come out of each vertebrae at the holes. And the ones that innovate the elbow are mainly, we labeled them C5, C6. And so often there's something going on at that level that is compressing those nerves a little bit or irritating them and contributing to the breakdown that you're getting lower down in the limb. 

So we often have to treat the elbow itself, but also looking higher up the chain to figure out what the true source of, why are those muscles overworking on one side of the body manly versus the other side? That's often a common question I get is why is it this side? Not the other side. And it's due to something higher up in the chain. 

Mark: So, I guess with mountain biking, could it also be that you're using one hand, the rear brake, if you're going downhill a lot more.  

Heather: Absolutely. So it can just be that you're using it more. Maybe it's the position of your neck a little bit. Some people when they look up, if you're mountain biking, you're looking up, you might have a little bit loss of range in your neck. And so you're looking a wee bit tilted. You might just not realize it. And you're compressing the nerve roots there a little bit and contributing to the discomfort that you're getting down in the neck or down in the elbow, sorry. 

Mark: Okay. How do you make it better? 

 Heather: Million dollar question right? So like I said, you have to treat the elbow. So there's different things that we treat or we teach the patient to do, is some stretches. So those are simply just kind of stretching out your arm, stretching out the muscles, as long as it's pain-free to stretch, it's safe to do.

The other thing that we get people doing is some strengthening exercises specifically for those muscles. And so we want to restrengthen them and why we want to do that is we want to put some loading and some force through those muscles. So then they start to heal in a proper way. So that's what the elbow treatment, then the physiotherapist will often feel your neck and do some manual therapy to try to maybe facilitate some movement through those joints a little bit more and to open things up a little bit.

So just create a little bit more space for those nerve roots. And often that can just be some like massage in the area to help to decrease the muscle tone at those segments. So it's not like you're cracking your neck or anything like that. It's just that you're releasing the discomfort at that local level.

Mark: What about EMS or heat or any kind of the massage hammering types of guns, Theragun, that sort of stuff. Any usefulness there? 

Heather: It definitely can. Heat is often just more of a pain, if it's painful, you can put heat, you can put ice on it. It doesn't necessarily make it heal any faster, but it's more for pain. So you use it just, if it's painful and it's bothering you and you want it to go away. Then you can put some heat or some ice on no problem there, and you could put it on your elbow or put it on your neck. Either is fine. 

In terms of like the Theragun, lots of people are starting to have those. The neck is like, I've never tried one on my neck, so I don't know what it feels like. I think it might be a little bit too much, too strong for it, but if it feels good and it's not hurting, it doesn't feel like it's hurting you. Maybe you could try. But often just getting in there with like yourself massaging with your hands, or even like a tennis ball or a lacrosse ball or something like that. And you just sort of lay on it and just can gently kind of massage your neck there, would be good. 

Mark: And what about electro muscle stimulation? 

 Heather: Not as useful in this case for this injury.

Mark: And the kind of exercises that you would prescribe anything specific?

Heather: Yeah, so we're looking at trying to do what we call is eccentric contraction. So we think the breakdown is happening in a tendon in particular. eccentric contractions have been proven to be more useful in helping the tendon to heal.

And so what an eccentric contraction is, is it's actually a contraction when the muscle is lengthening? So if you can see my arm, so a concentric contraction is one where the muscle is shortening. So these muscles are getting shorter to pull my wrist up. That, and then an eccentric contraction is when you're lowering the wrist and these muscles are lengthening out.

So we get people to do, what's called an eccentric contraction. So you basically have your arms supported on a desk or something like that. And then you pull your wrist up and you're holding a little weight in your hand, and then you slowly lower it down. And then you raise it up and then you can slowly lower it down.

And you build up the amount of weight that you're holding in your hand and try it also in different positions. Not just kind of with your elbow 90, but maybe straight out, depending on where you're getting your pain. Everybody's a little bit different. 

Mark: And it's going to take what kind of timeframe to get better? I imagine first is you got to lay off a little bit of what's making it hurt, but then what's the recovery protocol.?

Heather: Yeah, So it can always vary from person to person. The longer something's been there, unfortunately the longer it takes to go away. So typical timeline would probably be about like six to 12 weeks can be a typical timeline. Sometimes it can be a little bit quicker if people kind of catch it really early and it's maybe not too, too bad. Then it can go away a little bit sooner, but you have to do a little bit of a rest period. And then rebuilding the strength, rebuilding the muscle. 

Mark: So the underlying message is don't tough it out.

Heather: No a lot of clients ask, like when should I come in? Like when do I know to come in for physiotherapy? And so if someone's injured themselves and if they've trying to do something about it, maybe they're, they're trying to rest, or they're trying to stretch and they're taking measures to help it recover. And there's still no change or it's still getting worse after about seven to 10 days. It's definitely time to come and seek some help and see a physiotherapist for some additional advice.

Cool. So don't tough it out. Go see Heather at Insync Physio, you can book your appointment online, insyncphysio.com. Lots of opportunities there. So they have two locations as well. If you're in North Burnaby, they have a location there. Or you can call them. The Cambie office is (604) 566-9716. They'll book your appointment for you. Thanks, Heather.

Hip Injury Management – Butterfly Hip Mobility

Do you have hip pain or stiffness? Do you play any running, cutting or lunging type of sports? If yes, then this might be a great exercise to help you improve your hip mobility.

Start by sitting down with the soles of your feet together drawing your heels as close to your body as possible. Make sure your lower back is nice and straight. Hold on to your ankles and feet with both hands and bend forward with your hips keeping the low back straight and push the knees to the floor with your elbows. Hold this for 30 seconds doing 3 sets 2x/day.

If you have pain that doesn’t feel like a stretch, or are unsure about what you’re doing consult a local physiotherapist before continuing. 

Hip Injury Management – Adductor Longus Muscle Mobility

This is a great mobility exercise for the hips to help improve what we call the motion of abduction so that you can move the lower extremities more into the outward direction.

Start by securing a belt or a solid strap around something solid and unmovable like the leg of a couch. Check your position by starting with your knees open wide in a “V” and bent. Make sure your lower back is nice and straight.

Next, hold on to the strap and gently pull yourself forward to take up the slack of the belt to reach the barrier of your hip flexion while you maintain a straight low back. Then begin to straighten the knees to the floor and gently pull yourself forward on the strap by flexing at the hips even more until you feel a more moderate but comfortable pulling on the inside muscles, or the Adductor Longus Muscles, of your thighs.

Hold this for 30 seconds doing 3 sets 2x/day. If you have pain that doesn’t feel like a stretch, or are unsure about what you are doing consult a local physiotherapist before continuing.

Low Back Pain Testimonial – Justin Booth

Hi, my name's Justin Booth. I am a patient at Insync Physiotherapy. I first went there because I had some really bad, lower back pain. And it was getting to the point where after a round of golf, or sometimes in the morning after some physical activity the day before, I was having trouble standing up straight. And I went to see Wil and some of his people at the clinic and they helped me diagnose what the issue was.

And then they administered IMS. Intramuscular stimulation, on that part of my back. And I had almost instantaneous relief, for weeks and months afterwards. This was a problem that had plagued me for a long time. And when I finally went and saw Wil and his people at Insync Physio, they were nothing but professional.

And really found out very quickly what my problem was and found a way to help me rectify it. So thank you. The result now is I can golf and do all my physical activities with almost no pain. And if I ever do have pain in my back afterwards, I now know what to do to fix it. So thank you Wil, and your whole team at Insync Physio for always being so great and helping all of us stay active and live our best life.

Concussion and Whiplash with Wil Seto

Mark: Hi, it's Mark from TLR. I'm here with Wil Seto. He's the owner, the chief physiotherapist at Insync Physiotherapy, sports physiotherapy in Vancouver, BC on Cambie Street. And we're going to talk about concussion and whiplash. Are you doing Wil? 

Wil: Yeah, I'm doing great. Thanks Mark. Yeah, so quite often when people get a concussion, like whether it's like from a sports injuries, you know it's quite common with contact sports, and you get a neck injury related with that. And quite often that concussion can be missed. Or, you know, it could be so mild. 

Another area that right now that we're seeing sort of the combo of concussions and whiplash is motor vehicle accidents. And so I guess really to look at a concussion is essentially a brain injury. And what that means is that you've had like a force that's imparted in the skull, or, you know, your brain gets rattled. And you're essentially you have a injury to your brain. It's really hard to classify and it's hard to classify because a lot of the times you can have these symptoms and you do all these different tests like you know, an MRI or scans and all that stuff, and it can be negative. Because the brain is so complex. 

But the fact of the matter is that, you know, quite often when you have a concussion, you don't want to rule out a neck injury or whiplash. And in fact, quite often when you're able to treat the symptoms related to whiplash, because sometimes they can sort of overlap. Then you can actually also be helping the concussion type of stuff too.

Mark: So someone comes in and they think they've had a concussion or they have some symptoms. How do you go about diagnosing? 

Wil: Yeah. The biggest thing is you know, when I'm working with a sports team or with athletes and if it happens like in the moment or on the field of whatever at the time, then we run through a concussion screen test. And then there's all these things that we take them through. And then also in terms of subjectively, they tell us what's going on and we can sort of ascertain that we think that they might've sustained a concussion. 

And then when they come into the clinic and they're still feeling certain symptoms, you know, that they're having and we can do certain tests too, as well and to help measure that as well objectively. But ultimately those tests are definitely a good screening tool. So there's definitely a battery of tests from questions that we ask specifically. So the subjective exam is really important. And then also looking at a few objective tests and exams that we go through.

Mark: And how does that tie in with whiplash? What's different about diagnosing that? 

Wil: Well, so this is where there's a lot of similarity. Like for example, one of the biggest complaints with concussion that people get is that they may feel headachy, or they may feel like just the biggest one, you know, they're sensitive to light, sound you know, all that kind of stuff.

And those are sort of the more common types of head injuries that you can get where the symptoms overlap with a whiplash. So with whiplash, there's also different degrees of it, obviously. But like when you're looking at sort of where it starts to kind of overlap in terms of the symptoms, definitely those are the biggest ones.

And a large part of that too, if you also just think of the nervous system and the nerves that come out from the brain to the spinal cord, out to the neck, they are interconnected. And then also with the specific areas of the neck, with the muscles, and if you injure the muscles and the joints and then you have the nerves firing around those areas, and then they go back up into the spinal cord and the brainstem, then sometimes can be very confusing.

And you're not really sure what's causing what, because like a headache could be something related to the concussion. Or something related to your whiplash or your sprained neck or whatever that you've had going on. Cause you can get like also the muscle type of what we call a cervicogenic type of headache where it's coming from your neck.

Mark: So what kind of treatment protocols would be typical? 

Wil: Yeah. So there's specific stuff that is related to concussion treatment. But then when we're looking at treating the neck and if it's whiplash related, we're looking at specific things that are related with the mobility and the movement and function. So when I say function of the neck what we're we're talking about is how the muscles are moving and the way that they help the joints move. So you want to restore that joint mobility. But also that functional mobility that joint or joints, you're in respect to how the musculature are working together.

So if you have a whiplash injury where your joints are sprained, then quite often you get a lot of muscle spasming along with that. And so you get all this sort of a sequela things going on. So you want to try and normalize that. So you want to try and get some more normalized mobility.

And one of the biggest important things to do is that you're not increasing the bad symptoms that you're getting, where it stays even longer. Like you want to be gentle with it. So in an acute situation, you probably do want to let it rest a little bit. Because if it's an acute injury, you got to give that time to allow that acute aspect of it to settle right down.

And then once that part settled down a little more, then you can start to work on the mobility. And there's actually some research to show that there is actually some good results when you activate and you start to get things mobilized and moving to the neck to get it better, faster, and also in the long-term. And then also some correlation with working on whiplash and the whiplash symptoms in relation to the concussion. 

 Mark: And what would the typical healing protocol timeframe be? 

Wil: Oh, that's kind of a loaded question because, you know, with a concussion it's difficult. And then also it's hard to classify. Like there's just so many iterations of how the sports physiotherapy and the sports medicine and the medical community I've been trying to classify acute concussions. There was one point where the classified as mild and complex, well, you know, they don't really do that anymore.

And a lot of it is based on after the fact than the symptomology. And like what they're experiencing and how well they're recovering, like, Oh, okay well that was a complex concussion is what they classified it before, when they used to use that kind of a grading system. So it's really difficult.

And I think with whiplash, I think it's a little bit easier, you know, like if it's just an isolated whiplash, but then when you have whiplash and concussion it really depends on how they're presenting with those concussion and brain injury symptoms and dysfunctions.

So it can be really debilitating where they can't even like go out daylight. And stare at a screen for more than five minutes kind of thing. And those are cognitive processes. Like those are a lot of things that really affect you know, especially present day function, like we're on a screen. People are working on a computer a lot these days.

And so that's huge. And so then when you're looking at those factors and then also, there's this sort of research done on the visual aspect and the visual cortex and how that's been affected. So it's a really difficult question to answer. And I think that what we need to do is look at some of the things that we can address, like the dysfunctions in the neck. And because there can be relationships where there's, you know pain and stiffness and mobility in certain parts. That I have a direct connection with symptoms similar to concussions. 

So the headaches, like I was saying, for example and that can be sometimes mediated by working on mobility and restoring that functional mobility. So not just at the joint level, but the muscle level, and then even just doing some specific concussion rehab stuff as well. And I think this is an area that's just so rich to really you know, still continue to explore on the rehab level. But I think it's been shown that it's good to work on both and make sure that you address both the whiplash and the concussion.

Mark: So if you've had a concussion or you suspect you've had a concussion or you've got some neck pain, you suspect maybe you've had a whiplash, a car accident, you've been playing soccer, you've been playing football, hockey, et cetera. Something happened where you bonked the old coconut. Get ahold of Wil. Book online at insyncphysio.com or call the office at (604) 566-9716. You have to call and book ahead. He's booked up, but he can get you feeling better, fast. Or any of the other physiotherapists that Insync Physio. Get in there. Get after it. Get feeling better as soon as possible. Thanks Wil. 

Wil: Thanks Mark.

Ergonomics at Home

After one year since going into a state of emergency, many British Columbians are still found to be working from home. Although this yields to be beneficial for the health and safety of employees, working from home may actually be a slippery slope when ill-prepared. Giving in to the temptation of sitting on your couch or melting into your chair will only feel good for a short amount of time, despite how comfortable it may seem. These natural tendencies can potentially be detrimental to your body, possibly resulting in some tension and pain. Ergonomics can be defined as “an applied science concerned with designing and arranging things people use so that the people and things interact most efficiently and safely.” Creating a workspace that is ergonomic is an easy and productive way to take care of your body on a day-to-day basis.

Here are some ways you can make your workspace at home ergonomic: 

  • Adjust your chair accordingly so that your arms sit at a 90-degree angle along the top of your table.
  • When sitting on your chair, make sure that your feet are flat on the floor, and that your back is against your chair so that it promotes your spine’s natural S-shape. Use our video on sitting posture retraining as a guideline for how to properly sit on a chair and prevent back and neck pain.
  • Keep your monitor an arm’s length away from you. By adding a few textbooks underneath it, raise your monitor high enough so that the top of the screen is at eye level. 
  • Position your accessories and office supplies close at hand to help you avoid reaching for them when you need it, thus, preventing tension and pain.

Following these tips are crucial for creating an ergonomic workspace. Making these changes while working from home will be beneficial in caring for your body while working efficiently.

Foot Pain – Heather Camenzind

Heather: So we had a warm stretch here in Vancouver, and it pretty much felt like summer. And the client came in the week after just saying, Oh, the bottom of their foot, like along the arch was really sore. And after talking to them about like what had changed, a very common question that I asked with foot pain is, have you changed your footwear recently or any changes there?

And it turns out that with the warm weather they had transitioned from wearing like more of like a running shoe or more supportive shoe to just a basic flip-flop, like the ones with the foam. Very very standard kind of flip flops that you see. And that can contribute to their pain that they're having. So that's what we're here to talk about today. 

Mark: So is that a function of just kind of transitioning too quickly into changing the footwear? 

Heather: Yeah, exactly. It can be a shock to the foot. If you think about what your foot is doing when it's in a running shoe, there is actually a little bit of a heel lift. So your heel is elevated within the shoe. So your foot gets used to that position. And also just the forces and the pressures that are going through your foot get used to that. And then when you transitioned to something like a flip-flop or just being in your bare feet more outside, your feet aren't strong enough.

They're used to being in this very compressive shoe, this very supportive shoe, and then you walk around and your foot can splay more with the flip-flop or even just in your bare feet and your feet aren't ready for it. As well as then the heel is no longer elevated, it's quite flat. So that puts a lot more strain on your calf and in through the bottom of your foot. 

Mark: So I have some other questions about that, but let's talk about how do you diagnose what's going on? And then what's the treatment protocol.

Heather: Yeah, so it always starts with a detailed history. So like I said, with this person, we found out kind of that something had recently changed in their life. And then you go into more of the, we call it an ergonomic assessment. So we watch how they walk and we watch how they stand, and then we do like a manual assessment. So we get our hands on the foot and we test out muscle length, some muscle strength, and then also just the joint mobility. So in the foot there's so many little bones and how are they all moving and how do they move within one another?

And sometimes there's something stiff, but often it's something that's a little bit tight. And one of the common things we see is calf tightness. And that's what this person presented with, this calf tightness. 

Mark: So is that just then prescribing some stretching exercises or is there more, do you pull out the needles?

Heather: Yes, we can pull up the needles and we can do something called IMS. And so that can be very useful in releasing that tension, especially something in this case where it was something very acute. We can often mitigate that pain in one or two sessions quite quickly for the person, with something like IMS. But also then we can just do some manual release like massage in through the foot and stretching, and then following up with some home exercises for this person. 

Mark: So foot pain, I'm sure it's something not just switching from winter footwear to summer footwear, but what about shoes breaking down?

Heather: Absolutely. So shoes can become, they do, they break down. The rubber, especially in running shoes, they break down, you can see that maybe you flip your shoe over and you look at the bottom and you look at the wear pattern on it that you've worn down more, maybe more, a part of a heel or more part of, one part of the shoe than the other, or just the rigidity within the shoe.

You take the shoe and you kind of like bend it and you should have, not all shoes, but some shoes, most shoes have some rigidity to them a little bit. And some of you can just kind of like fold up. And if we're used to going from a more rigid shoe or your shoes and slowly breaking down, sometimes you can detect that.

I myself know when it's a new time I run a lot. I know it's time for a new pair of running shoes. My knees start to hurt. When I run, I get new running shoes and the pain goes away. It's one of those like telltale signs for myself. That I know it's time that my shoes and the cushioning and my shoes are broken down.

Mark: Yeah. I've learned for myself now with how much I walk, that it's three months. I got to change them every three months. They're toast. 

Heather: Yep. Yeah. Yeah. It depends on everybody. They kind of people, they kind of figure it out. They know yep, it's that time. They walk that certain distance in that time. Or they run that certain distance or something and it's time for the new pair. And it's unfortunate sometimes the shoe looks really good still. Like it still looks, it still looks brand new, but it's just, it's lost that cushion. 

Mark: Yeah, my wife was complaining about how her feet were sore. We went for a walk the other day and her shoes are a year old, only oh they're only a year old, they still, there was nothing there. Tissue paper. What about barefoot running? Barefoot shoes, all that kind of stuff. What's your experience with that? 

Heather: There's definitely a time and a place for them. They're not for everybody. But the thing with barefoot shoes and barefoot running is that we have to transition to it slowly. So we can't just go from wearing our traditional running shoe to something that's very minimalist with like a zero drop or something like that. You have to ease yourself into it. So it's kind of like any training program. I encourage people, say, okay, you have to train yourself up. So you start with maybe 10 minutes of running in your minimalist shoe. And then you could even increase that distance or the time, and you have to train your foot and your body. It's not just your foot, but it's actually training the whole way up the chain that your body needs to adjust to that. There's nothing wrong with them. People just often transition to them way too fast. And that's where we see breakdown or injuries happen. 

Mark: So you mentioned how, you know, when it's time to change your shoes, cause you get knee pain running. How much do your feet being properly supported, affect the rest of your body and how can that show up? How have you seen that show up for people? 

Heather: It's very common. You think about our feet support us. We're often kind of abuse our feet. We don't really pay much attention to them, but they're what hold us up all day. Our feet are working so hard and they're brilliant in how they're designed to support us.

But there's lots of things that can go wrong in the foot. Often we get weaker in the foot. And a lot of people see these flat feet, that means their arch has collapsed. And then you see that transition up the chain in that you see then there's more pressure on the inside of their foot, which then puts more pressure on the inside of their knees. And then up into the hips and into the low back, you see these shifts that people do within their bodies to compensate for those changes within their foot. 

Mark: Any quick exercises that you would recommend that people use to maybe strengthen their feet a little bit.

Heather: Yeah, so strengthening and stretching. Common stretches I give for any foot person, any foot injury is a calf stretch. So most people know it's like the good lunge stretch, stretching with your knees straight, and then also bending your knee a little bit in that position. And the other stretching or soft tissue release that I often recommend is just ball rolling on the bottom of your foot.

And the way you recommend people do that is thinking about rolling from your heel and then roll the ball along, kind of pretend this is your foot, you roll from your heel along the line to your big toe. And then you go back and then roll along the line to your second toe and go back and then to your third toe and go back. And it gets all the different muscles and lines along your foot. Rather than just kind of, most people just kind of roll in the middle and we want to get all these different lines. 

In terms of strengthening, there's many different ways you can strengthen the foot. One is just doing a really gentle calf raise and focusing on coming up square on your foot. A lot of times we curl our foot or our ankles turn out and learning how to come up. Where on the foot. So you're across the whole, all the toes are equal. All the way to cross your toes as equal is really important. And that's actually quite hard when you get people to control it slowly on the way up. And then that get them to control it slowly on the way down. Is really nice functional strengthening for the ankle and the whole foot. 

Mark: If you've got some foot pain and you want relief. Go see Heather at Insync Physio, you can book online at insyncphysio.com. She's in the Cambie Street office. Or you can call them (604) 566-9716. Get in there. Get ready for summer. It's gonna happen. It will. Thanks Heather.

Heather: Bye.

Entee – Runner Testimonial

Hey, what's up, what's up everybody. Just want to give a quick shout out over to the Insync Physio team. I've been seeing them for the past three weeks and goodness gracious have they ever helped me with my mobility work on my run guys. You know, I've been looking to improve my runs and for the longest time I was not using the full function of the, actually the tripod.

So when they went to explain that I was able to increase my efficiency and my effectiveness on the run. I be able to last long. And on top of that, I did the IMS, which is dry needling for anybody that hasn't tried dry needling, go see these guys, they're experts. They really know what they're doing.

And it's, I did my traps and my lats, and it's really opened up my traps and lats. I have really, really tight traps and lats for the longest time. And once they've done it, man does it ever like, number one it kills, but it's so good. It's really opened it up for me to be able to actually do proper workouts at the gym.

So anyways, what I'd say, give a quick shout out to the Insync Physio team. Thank you so much guys. Professional, clean. You guys are great and you guys are friendly too. So thanks again guys.