Upper Canada Sports Medicine

About Us

Why are we different at Upper Canada Sports Medicine?

Our method of assessing your body’s biomechanics or how you move is different than all the centers in the Upper York Region. My work with hockey players for over 20 years has given me insight as to how easily the pelvis can be knocked out of alignment. Seemingly minor mishaps can lead to the pelvis being misaligned. This misalignment can lead to changes in muscular recruitment patterns in less than twelve (12) hours. (It may be even sooner but in the clinical situation we cannot monitor these changes, we must rely on feedback from our patients as to when they start to notice little changes in how their body feels or moves.)The misalignment in the athletic person is not dramatically different than that of the office worker or the gardener.  The athlete puts their body through greater demands in a shorter time period and the altered recruitment pattern becomes problematic much sooner. Many of our non athletic patients are surprised that they have a similar biomechanical problem as an elite athlete on the table beside them but have a significantly different set of signs and symptoms.

The Sports Medicine model that we follow dovetails with this approach because we have superior manual muscle testing skills so that we can identify the muscles or muscle groups that are exhibiting the altered movement patterns. Our treatment program then becomes one that is centered on correcting the pelvic biomechanics using Muscle Energy Techniques and then correcting the altered muscle patterns, whether they have shortened, lengthened, or have an improper recruitment pattern. We place very little emphasis on treating pain unless it is absolutely necessary to allow us to correct the preceding issues. Most of the time, correcting the recruitment patterns leads to reduction in pain.

Bold comments, yes, but after 18 years of clinical experience our success speaks for itself.

Disc Bulges and Herniations

Every back patient that we have treated over the years has had this pelvic malalignment. To treat the disc alone without correcting the improper recruitment patterns and bony alignment is the most logical explanation of failed conservative treatment of disc patients. Traction and McKenzie extension exercises are important in treating disc injuries but if the biomechanics of the pelvis are not corrected, all the reasons the disc became injured are not corrected. Of course, there are discs that are so badly damaged that the only recourse is to have a surgical intervention and remove the offending disc contents. We have enough experience to make the decision with input from the patient to make the call to seek further medical intervention. We prefer to coordinate with your family doctor with such a decision as they are your primary health care provider.

I will admit, I do not equivocally know if it is the pelvic issues that cause the disc to break down or the disc breaking down contributes to the pelvic movement issues, but I do know that failure to correct the pelvis will limit the ability of the disc bulge to reduce or the herniation inflammatory process to settle down. The great Canadian research done by Stuart McGill at the University of Waterloo, gives clinical research support to our approach. His web site, www.backfitpro.com  will lead you to books about his research on disc injuries and the need to correct movement patterns around the pelvis. If you wish to immerse yourself into his books, you will truly understand disc injuries and what you can do to control and in most cases, eliminate your back pain. We have adopted many of his exercises into our rehabilitation routines.

The work by Shirley Sahrmann, a physiotherapist that popularized correcting improper movement patterns around the pelvis as a method of controlling back pain has been a core pillar of our back treatment protocols at Upper Canada Sports Medicine.

Our aggressive release of trigger points (TrP’s) around the pelvis has been influenced by the outstanding work of Dr. Janet Travell and Dr David Simons and their seminal work on Myofascial Pain and Dysfunction.  Below is an excerpt from an article by John M. McPartland, DO, MS., reviewing Travell and Simons work.

Proposed Etiology of TrPs

The 1999 edition of Travell and Simons ‘Myofascial Pain and Dysfunction: the Trigger Point Manual5 proposes an "integrated hypothesis" regarding the etiology of TrPs. Such an integrated hypothesis involves local myofascial tissues, the central nervous system (CNS), and biomechanical factors. 

A biopsy of local myofascial tissue in the vicinity of TrPs revealed that the tissues contained "contraction knots," described as "large, rounded, darkly staining muscle fibers and a statistically significant increase in the average diameter of muscle fibers."9 Electromyographic (EMG) studies of TrPs have indicated spontaneous electrical activity (SEA) in TrPs, while adjacent muscle tissues are electrically silent.10 These intersecting discoveries led Travell and Simons to implicate dysfunctional motor end plates as the underlying etiology of TrPs. The terms motor end plates and neuromuscular junction are interchangeable, although the first term describes structure and the latter reflects function. Both terms refer to the point where  -motor neurons contact their target muscle fibers. (See Figure 2 for a schematic drawing of a motor end plate.) The correlation between motor end plates and TrPs ("myalgic spots") was first elucidated in a study conducted by Gunn and Milbrandt in 1977.11 

 

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  • Rogers Centre
  • Toronto FC
  • Toronto Argonauts
  • Town of Newmarket, Ontario