At this time, pelvic floor services at Evolution are focused on female incontinence with a plan to expand our services offered soon.

What Is the Pelvic Floor?

The pelvic floor is a group of muscles that sit at the bottom of the pelvis, forming a supportive “sling.” These muscles support organs such as the bladder, bowel, and (in people with a uterus) the uterus.

The pelvic floor also works closely with the abdominal muscles, back muscles, and diaphragm to help with:

• Bladder and bowel control
• Posture and balance
• Core strength
• Breathing and movement

Like any muscle group, the pelvic floor can become too weak, too tight, or poorly coordinated, which can lead to symptoms.

What Is Incontinence?

Incontinence is the unintentional leakage of urine or stool. It can happen during activities like coughing, laughing, running, or lifting, or it may occur with a strong, sudden urge to go to the bathroom.

Common types of incontinence include:

• Stress incontinence: leakage with physical effort or pressure
• Urge incontinence: leakage associated with a strong urge to urinate
• Mixed incontinence: a combination of both

Pelvic floor physiotherapy is often a first-line, non-surgical treatment for incontinence and can be very effective when done consistently.

What Does a Pelvic Floor Physiotherapist Do?

A pelvic floor physiotherapist is a licensed physiotherapist with extra training in assessing and treating pelvic health conditions. Their goal is to help the pelvic floor muscles work properly—whether that means strengthening, relaxing, or improving coordination.

Treatment may include:

• Education about pelvic floor function
• Exercises tailored to your specific needs
• Breathing and posture work
• Movement and lifestyle strategies to reduce symptoms
• Manual therapy

What to Expect at a Pelvic Floor Physiotherapy Visit

Your first appointment usually begins with a detailed conversation about your symptoms, medical history, daily activities, and goals. This helps the physiotherapist understand what may be contributing to your concerns.

A physical assessment may follow, which can include checking posture, breathing, and how your core and pelvic muscles work together. This may include an internal assessment of the vagina and/or rectum, but this is always at your discretion. The physiotherapist will always explain what they are doing, ask for consent, and make sure you feel comfortable. You are encouraged to ask questions and share any concerns.

After the assessment, you’ll receive a personalized treatment plan. This often includes exercises or strategies to practice at home, as progress typically happens over time with regular practice

Frequently Asked Questions

What should I wear to my appointment?
You should wear comfortable clothes that you are able to move around in.

Can I still come to my appointment if I’m menstruating?
Yes, you can still come for your appointment and all the same assessment/treatment techniques can be used. We can modify the session as needed for your comfort.

How long are appointments?
The initial assessment is approximately 1 hour. The length of follow up visits may vary depending on your physiotherapist’s recommendations, but will likely be about 45 minutes.

Isn’t urinary incontinence normal after childbirth or with aging?
No! While it may be common, urinary leakage is a sign of dysfunction and is treatable!

Do I need to have an internal assessment?
It is completely your decision if you would like to have an internal exam and you always have the right to change your mind both within a session, or from session to session. The benefit of the internal exam is it allows for direct palpation of the pelvic floor muscles to assess for tone and tenderness, strength, and coordination for more accurate treatment. It is possible to do exclusively external assessment and treatment, but it may be less specific.

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Rapid Access Clinics (RACs) are part of a province-wide initiative that improves access to high-quality care for joint and spine issues. These clinics connect people with the right professionals at the right time—cutting down on waitlists and reducing uncertainty. They also help ensure your care is based on what will actually help—not guesswork.

Hip & Knee Rapid Access Clinic

The Hip and Knee Rapid Access Clinic (formerly known as the Total Joint Assessment Clinic) is designed to provide timely, high-quality care for people with hip or knee osteoarthritis. If you’re experiencing persistent joint pain or mobility issues, this clinic connects you with an Advanced Practice Provider (APP)—a specially trained physiotherapist or chiropractor—who performs a focused assessment and helps determine the best next steps.

While no hands-on treatment is provided, and exercise prescription is limited, these assessments identify whether you may benefit from surgery, rehab, or both. If surgery is needed, the clinic fast-tracks your referral to an orthopedic surgeon. If not, the APP will guide you toward evidence-based self-management strategies or refer you to a rehab professional who can help.

Interprofessional Spine Assessment & Education Clinic (ISAEC)

For low back or sciatic pain that’s lasted more than six weeks (but less than a year), the ISAEC—also known as the Rapid Access Clinic for Low Back Pain (RAC-LBP) —offers a focused path forward.

This program provides timely access to expert assessment, education, and self-management strategies, along with expedited referrals for imaging or specialists if needed. Referrals can be submitted by a family doctor or nurse practitioner. Once accepted, you’ll meet with an APP who specializes in low back pain. Their job is to assess your condition, explain your options, and offer a plan that may include movement strategies, home exercises, or referrals for additional care if necessary.

So Where Does Physiotherapy Fit the RAC Programs?

If rehab is the best approach, that’s where clinics like ours come in. While the RAC programs are an excellent way to get clarity, they don’t replace ongoing, hands-on treatment. If you’re referred for rehab, the goal is to connect you with a professional who has the right training and experience for your specific issue.

At Evolution Physiotherapy, we often support clients after they’ve gone through RAC—or we help them access it if we think it could benefit their care. We offer personalized rehab that picks up where RAC leaves off—focused on building strength, easing pain, providing post-surgical rehabilitation and helping you return to the activities that matter most. Allen Hicks, the Clinic Owner at Evolution Physiotherapy, worked as an APP in the Rapid Access Clinic for Low Back Pain for the last 2 years.

Not sure if you’re a candidate for one of these programs? Book a consultation with one of our therapists today—we’ll help you figure out the best next step for your recovery.

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One of the most important aspects in all these cases is improving the tolerance of the tissue in and around the painful region. If the therapy is incorrect or incomplete, it will not improve tissue tolerance.

Appropriate physiotherapy (rehabilitation) involves a comprehensive assessment of the local region of pain, as well as the other areas of the body that can impact the painful area. For example, we often see teenage athletes with knee pain. In addition to addressing the tissues around the knee, it is often necessary to strengthen the foot/ankle, hip and core/pelvic stabilizing muscles to reduce the stress on the knee.

Many of our clients have chronic neck and/or low back pain, but they have never been provided with a comprehensive program to improve the tissue tolerance of their neck and/or back.

Selecting the best exercises and progressing the exercises to make them more challenging as things improve will allow the tissue to become stronger and more tolerant. The process can take some time, and requires some persistence. The benefits are a long-term solution that actively involves the client in their rehabilitation, promoting self efficacy and independence.

Your physiotherapist (or other rehabilitation professional) should have hundreds of exercise options to improve your tissue tolerance. Selecting the most appropriate exercises and progressing them as you get stronger is essential to improve your tissue tolerance. If the exercises temporarily increase your pain, a skilled physiotherapist with expertise in exercise selection can regress the exercise to make it easier, allowing you to perform the exercise with less pain. Once the regressed exercise gets easier, it can be progressed to a more challenging exercise.

The physiotherapists at Evolution Physiotherapy in the Kanata/Stittsville area have strong expertise in exercise selection and appropriate progressions and regressions to reduce your pain and improve your tissue tolerance, strength, and function.

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We are fortunate to live in a digital age where communication is available to us on many platforms. Physiotherapists have been using video conferencing to provide physiotherapy services to clients/patients who either cannot make it into a clinic or who simply find it more convenient. As many of you have already experienced with in person sessions we spend a great deal of time talking with you to understand your pain and or your therapy goals. These discussions are paramount to our diagnosis and treatment plans. A great physio and one of the founders of hands on manual therapy, James Cyriax MD, said “If you listen to a patient they will tell you what’s wrong and if you listen to a patient long enough they will tell you how to fix it.” Telehealth allows us the opportunity to listen and provides you a platform to be heard. The use of video allows us as therapists to be able to access your movement quality and performance providing us more information to match what you are telling us and allowing us to assist you in your goals and recovery.

Exercise and education are the cornerstones of physiotherapy treatment, it is where our profession started and it is still what the research supports as best practice. There is no reason why you cannot continue to improve on your current condition while in the confines of your home. We can guide you through rehabilitative exercises that are appropriate and tailored to your situation. Having access to video in your home is actually a great benefit as we can see you perform the exercises with the equipment you have available to ensure it works for you. Based on your symptoms we can modify or progress your rehab program. We can instruct you on pain relief and how to self treat. We can still answer your questions and help you reach your goals.

The current state of affairs in our city is a necessity to protect the vulnerable and allow our healthcare system to best manage this COVID-19 pandemic. Don’t let the fact that our physical doors are currently closed be the reason you push off your rehab or live with your pain. Open the digital doors and let’s use this time to continue your path forward.

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Tendinopathy is the general term that is now used to describe most tendon problems.  The reason for the use of the term is that is remains uncertain what the exact mechanism is that creates the clinical presentation that includes tenderness on palpation and pain, often when exercising or with movement.  Common conditions, including tennis elbow, golfer’s elbow, achilles tendinitis, rotator cuff tendinitis, DeQuervin’s tenosynovitis, and others, would fall under the umbrella term of tendinopathy.

Three terms have evolved in the medical terminology to refer to injuries that cause tendon pain.  Initially, starting in the 1970’s, the term tendinitis was used.  Tendinitis describes a condition in which the substance of the tendon exhibits a primarily inflammatory response.  In the late 1990’s, the term tendinosis started to appear.  Tendinosis describes a chronic tendon injury with degeneration at the cellular level and no inflammation.  Finally, in recent years, tendinopathy has become the most appropriate term again.  Tendinopathy describes a chronic tendon injury with no implication about etiology (cause).

There is another tendon term that also exists – paratenonitis – which occurs where a tendon rubs over a bony protruberance.  The term has been proposed as an umbrella term for the separate entities of peritendinitis and tenosynovitis (single layer of areolar tissue covering the tendon).  Paratenonitis describes inflammation of the outer layer of the tendon (paratenon) alone, whether or not the paratenon is lined by synovium.

The leading scientists in the field of tendon research have been using the term tendinopathy in recent years.  While the term may still be open to debate, there is strong research to support the best methods to treat these problems.

There are several key factors your healthcare provider needs to understand to provide the appropriate treatment.  These include:

• Understanding the different stages of tendinopathy
• Understanding the role of compression in tendinopathy
• Understanding the concepts of tolerance and capacity

Their clinical examination will help them develop an appropriate, individualized treatment plan by identifying:

• What aggravates the tendon symptoms
• What is happening throughout the rest of the kinetic chain (mobility, stability, motor control)
• How much load can the tendon tolerate
• How much rest the tendon requires (tendons can adapt to load given adequate rest time…sometimes 1 to 3 days, depending on the activities)

This advanced understanding of tendinopathy will allow them to provide appropriate treatment, including:

• Education regarding appropriate cross training activities that won’t aggravate the tendon
• Advice on how to reduce tensile and compressive loads
• Recommendations on stretching. It is important to realize that stretching is not always a good thing. For example, sometimes stretching will cause increased tensile and compressive loads on the tendon.
• Advice on prognosis and timelines (it might not respond by 6 weeks. We give bone and ligaments time to heal, but we expect the tendon to be better in a few days.)
• Education and advice regarding load management (where to start, and how to progress the exercises)
• Education regarding graded increase in use (e.g. mileage for runners)or training intensity – in order to allow the tendon to adapt to load, changes to training need to be done gradually while monitoring symptoms. Change one thing at a time and plan enough rest after!

What you should not do:

• Don’t continue to ignore the pain and train or work through the problem. It will likely get much worse, and take longer to recover.

We recommend assessment from a qualified health care professional to help you manage what can be a persistent and difficult injury.

The post What is the Difference Between Tendinitis, Tendinosis and Tendinopathy? appeared first on Evolution Physiotherapy.

Most clients with osteoarthritis are not receiving the best care from the healthcare system. Recent guidelines for osteoarthritis treatment include:

Engaging the patient/client regarding their goals and help them on a behavioral change journey that will include the following strategies:

• Exercise (including skilled exercise prescription and coaching; individual exercise is the best; providing exercise sheets without proper coaching and training is not effective)
• Self management strategies
• Weight loss (if appropriate)

A thorough physical examination will help identify what types of exercise and movement training will be most appropriate, and help target modifiable risk factors:

• Biomechanical assessment, including their trunk control and lower extremity/kinetic chain, in addition to their most painful joint (knee, hip, etc). Some examples of common findings may include:
• Poor Foot posture (stability motor control dysfunction – SMCD)
• Difficulty controlling femoral internal rotation (stability motor control dysfunction – SMCD)
• Decreased strength and function of their quadriceps muscles, gluteal muscles, etc
• Poor alignment/dysfunction somewhere along the kinetic chain (mobility, stability, or motor control)

These are the types of physical examinations that are performed everyday by skilled, engaged physiotherapists/physical therapists (such as those at Evolution Physiotherapy).

Once the treatment plan has been designed, the biggest challenge in making changes to improve osteoarthritis symptoms are behavioral changes. The adherence to these behavioral changes will be the toughest challenge! Good clinicians can help you with this by measuring monitoring, and motivating their clients.

If you are interested in reducing your pain and improving your function, we are here to help you.

The following blog post includes recommendations by David Hunter, an internationally recognized researcher and rheumatologist. For a full overview of his recommendations, listen to his February, 2017 British Journal of Sports Medicine podcast (BJSM) at http://feeds.bmj.com/bjsm/podcasts.

The post What is the Best Treatment for Osteoarthritis? Physiotherapist Allen Hicks Explains appeared first on Evolution Physiotherapy.

Just as there are different physiotherapy clinics, different physiotherapists, and different rehabilitation providers, there are different definitions for the term Leadership.  Since we are a physiotherapy clinic, we will use the five themes of leadership emphasized in the Ontario Physiotherapy Association’s Leadership Project.  These include:

• Mentorship
• Trailblazing
• Communication
• Collaboration
• Executing the Plan

Our staff includes physiotherapists who have been teaching post-graduate physiotherapy courses for over 20 years. We have educated and mentored hundreds of physiotherapists in the Ottawa region. We have been invited to conduct presentations and workshops for physicians at the Canadian Academy of Sport and Exercise Medicine (CASEM) conferences, in addition to local Sport Medicine Rounds. We have held executive positions with the Canadian Physiotherapy Orthopaedic Division, Sport Physiotherapy Canada, and the Canadian Physiotherapy Association National Student Assembly. All 11 physiotherapists at our clinic also provide mentorship to each another, sharing our unique knowledge, expertise, and perspectives.

Twenty to thirty years ago, in most physiotherapy clinics, whether they were in a hospital or in private practice, the treatment emphasis was on passive modalities (heat/cold, ultrasound, electrotherapy, etc.).  There were probably a few stretches, and some basic strength exercises, but most of the treatment was very passive in nature.  Since then, there became a stronger emphasis on manual therapy treatment (joint mobilization, manipulation, and soft tissue techniques such as ART).  While these remain a fundamental part of our profession, there is compelling evidence to suggest that, on their own, they will not solve many of the problems our clients present with.  We need to include better education (particularly regarding pain), and a strong emphasis on active, functional rehabilitation (our clients won’t improve their stability and strength by lying down receiving manipulations, or having therapeutic ultrasound done to their shoulder 2 or 3 times a week).

We have always and will always continue to evolve our practice to ensure that are clients receive physiotherapy services based on current best practice principles. To do this, we identify leaders in musculoskeletal research, such as Jill Cook (tendinopathy), Stuart McGill (biomechanics of the low back), Kathryn Schneider (concussion rehabilitation), David Hunter (osteoarthritis rehabilitation), Karim Khan (tendinopathy, mechanotherapy) and leaders in pain research, such as Adriaan Louw, Peter O’Sullivan, Lorimer Moseley, and Dave Walton. We take a leadership role in rehabilitation because we invest the time to read their research papers, and then incorporate the relevant findings into the way we practice and care for our clients.

We identify clinical leaders in pain rehabilitation, such as David Butler, Adriaan Louw, and Neil Pearson; clinical leaders in low back rehabilitation, such as Stuart McGill; clinical leaders in movement assessment and rehabilitation such as Gray Cook and Gary Gray; clinical leaders in concussion assessment and rehabilitation, such as Jacquie van Ierssel, clinical leaders in Exercise is Medicine, such as Karim Khan. We take a leadership role in physiotherapy and rehabilitation because we invest the time and money to take their clinical courses, and more importantly, invest further time implementing the course material (assessment techniques, treatment techniques, equipment, and technology) into our practice.

We are leaders because we have invested tens of thousands of dollars into the rehabilitation equipment we have at our clinic.  We feel it is essential to have the appropriate equipment to educate, instruct, and observe the clients carrying out exercises along the entire rehabilitation spectrum. For many conditions, including tendinopathies, post-surgery (ACL, THA, etc.), and low back pain, a 4 or 5 stage approach is recommended. We can progress our clients through the full rehabilitation process, if that is their goal. In many cases, it is not possible to help individuals return to their desired level of function if you can’t load and strengthen them sufficiently.

We are leaders because we practice using a clinical reasoning approach that follows accepted principles.  We do not treat using recipes and methods. We continually reflect on how we practice, and re-assess our clients continually to evaluate the effectiveness of our treatments. We are leaders because we have moved beyond outdated diagnoses (e.g. tendinitis, trochanteric bursitis for any lateral hip pain, disc derangement for any lumbar flexion related problem, ligament sprain in the absence of any trauma).  We recognize the lack of correlation between pain and structural tissue changes in many individuals. We have educated our clients for many years regarding the prevalence of many asymptomatic findings on diagnostic imaging (e.g. disc protrusions, degenerative disc findings, joint space narrowing, rotator cuff degenerative changes, hip labral tears, etc.).

We embrace a functional, active rehabilitation approach.  We educate our clients on tissue homeostasis, tissue tolerance, and tissue capacity.  In a recent podcast with Jill Cook, she stated that tissue capacity should be considered a core concept for all rehabilitation professionals – which, presently, it certainly is not.  We have organized our exercises into a 4 by 4 matrix approach, which allows the exercises to be classified into at least 16 distinct categories, facilitating appropriate regressions and progressions of the exercises.  Some clinics have not moved beyond the outdated model of treatment that emphasizes placing numerous modalities on tissue 2 or 3 times a week for 4 to 6 weeks.

We provide and promote free educational material on our website for the pubic and for other health professionals, on different topics, including pain, concussion, anterior knee pain, etc. We will continue to add further content on a regular basis.

Evolution Physiotherapy is proud to have been one of the first facilities in Canada to join the American College of Sports Medicine’s (ACSM) Exercise is Medicine® network.  A few years later, Exercise is Medicine Canada (EIMC) was created.  We are a proud to be a member of the EIMC Professional Network, as an EIMC Provider.  Our team supports its guiding principles, and we believe that:

• Exercise and physical activity are important to health and the prevention and treatment of many chronic diseases;
• More should be done to address physical activity and exercise in health care settings; and
• We should encourage a greater focus on physical activity and exercise in health care settings

Leadership involves communicating with many diverse groups (clients, other health professionals, administrators, insurance companies, etc.). The most important group for us to communicate with effectively is our clients. At Evolution Physiotherapy, we feel that developing a partnership approach with our clients is critical to improving client outcomes. Active, engaged listening to the clients’ story, concerns, and beliefs is critical to this. Understanding the clients’ goals and expectations is necessary before we discuss any treatment options. Prior to starting treatment, we educate our clients regarding their current problem and our recommendations for treatment to help them achieve their goals (often eliminating pain and restoring their function).

Current research and recommendations in chronic pain indicates that how we communicate with our clients can have a critical impact on whether we can help prevent – or in cases where chronic pain exists, help eliminate chronic pain. We need to be thoughtful about the words we choose, how we explain the results of a diagnostic test that might reveal some degenerative changes, lumbar disc findings, etc. At Evolution Physiotherapy, we are aware of this research evidence, we discuss it with each other, and we incorporate the recommendations into our practice. This helps us facilitate improved knowledge translation within our clinic. We also communicate and collaborate with other health professions (physicians, chiropractors, massage therapists, etc.), administrators, and insurance adjusters, to facilitate improved care for our clients. In some cases, trying to collaborate with other health professionals can be challenging. Despite these challenges, our goal is to improve inter-professional communication and collaboration.

We are proud to be leaders in physiotherapy and rehabilitation, and will continue to evolve, plan new initiatives, and execute these plans to improve the services we deliver.

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May is both National Physiotherapy month and Exercise is Medicine® month. This makes May the ideal month to highlight the importance of increased physical activity in our everyday lives!

If there was a drug that could reduce your risk for heart disease, cancer, diabetes, osteoporosis, and many other chronic illnesses, would you take it?

The answer is probably YES – and you would probably want to take it for the rest of your life!

What is this wonder drug? It’s exercise. In addition to preventing and/or managing chronic disease, including depression, regular exercise increases your energy levels and improves the quality of your sleep.

Evolution Physiotherapy is proud to be one of the first facilities in Canada to join the American College of Sports Medicine’s (ACSM) Exercise is Medicine® network. Our team supports its guiding principles, and we believe that:

• Exercise and physical activity are important to health and the prevention and treatment of many chronic diseases;
• More should be done to address physical activity and exercise in health care settings; and
• We should encourage a greater focus on physical activity and exercise in health care settings

If exercise can improve our health so significantly, with few negative side effects, why don’t more people exercise regularly?

One barrier is that many people don’t know how to begin a safe, effective exercise program. Sometimes, they try an activity that is not appropriate for their current fitness levels and it doesn’t feel good. Even worse, it could lead to physical injury. A second barrier is that it can be challenging to get motivated to exercise. Any change or new routine needs motivation to get started and to stick with it until new habits are formed.

The team at Evolution Physiotherapy understands these barriers to exercise– and we have strategies and solutions to help address them. The first step is deciding to make a change and setting your fitness goals. And that’s where we can help.

Have you ever heard the saying “A goal without a plan is just a wish”?

Evolution Physiotherapy can help you reach your health and fitness goals through exercise. Our experienced, educated staff of physiotherapists can design an exercise program specific to your unique needs and fitness levels. We then work with you so you know how to follow the program and start to see the benefits of exercise while preventing injury. When you see real results towards your health and fitness goals, you’re more likely to stick with it!

All Evolution Physiotherapy’s exercise programs are designed to meet your individual goals for:

• Health objectives: to address pain, injury, muscle imbalances, faulty movement patterns
• Fitness objectives: weight loss, strength and conditioning, sport specific training

Every client is unique –so all our exercise programs start with an initial evaluation to determine what types of exercises are appropriate for you. We discuss and assess your specific goals, health history, injury history, exercise history, and functional movement limitations. This input is used to design a personalized exercise program.

Then, we educate and coach you through the exercises in the program. The program can be performed at home, at a gym, or under various levels of supervision at Evolution Physiotherapy – based on your needs and personal preferences. We can also work with you to identify and overcome the barriers to motivating yourself to be physically active.

So, if you’re ready to see what a commitment to exercise can do for your overall health and fitness, we’re here to help. Contact us to learn more about how Evolution Physiotherapy can be part of your plan towards meeting your goals!

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The majority of people who consider a physiotherapy consultation do so because they have pain. Pain will affect the way you move. The way you move will affect your pain. It can be a vicious cycle.

To effectively deal with the causes of your pain, it is essential that a detailed musculoskeletal examination is performed. This will often include a patho-anatomical assessment, to determine the extent of any tissue damage that is causing the pain. If you recently sprained your knee or ankle, it may be easy to determine the cause and extent of the injury. But what if your pain has existed for a longer period of time (weeks or months)? In these cases, it will also be necessary to perform a functional evaluation of your movement.

The functional evaluation of your movement is an area that many physiotherapists have specialized training in. This is very important to perform in cases of long term low back pain, knee pain, shoulder pain, neck pain, etc. Why? Low back pain may be a result of be of stiffness or decreased mobility in your hip or in your upper back (thoracic spine). Chronic or long term knee pain is often related to weakness in some of the hip muscles. Unless these muscles are strengthened, the pain may continue. And if these connections between your pain and the root causes are missed, your treatment program may not achieve the results you need.

A question many people in pain ask is: “Should I see a physiotherapist, a chiropractor, a massage therapist, a physician, an osteopath, an athletic therapist?”

Regardless of who you see to seek a solution for your pain, it will be important that you understand what needs to be done. How severe is the tissue injury? Will you require surgery for a torn ligament or tendon? If the tissue injury is not severe, what needs to be done to help the area heal? Sometimes the tissue has healed, but pain persists.  Do you need to improve your mobility which could involve addressing your flexibility and range of motion? Do you need to improve your stability or your strength?

The treatment you receive should be focused on addressing the key contributing factors of your pain. If the treatment you receive is for mobility (i.e., manipulation, mobilization, massage, etc.) – but you actually need to improve your stability and strength to correct the root cause of your pain, the problem will probably be persistent or recurrent. In many cases of chronic pain, the brain and central nervous system needs to be addressed with therapeutic neuroscience education and graded motor imagery.

Choose a health care provider who can properly assess the extent of the pain, tissue damage, your mobility, stability, motor control, and strength. A thorough and detailed assessment will allow them to design an appropriate treatment plan to help you overcome the root cause of your pain.  The longer the problem exists, the more complicated it often becomes. If you aren’t satisfied with previous answers or treatment, keep looking for another opinion.

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