Shoulder Impingement

Is your shoulder pain caused by impingement syndrome? Read more to find out and learn how physiotherapy can help.


Designed for mobility rather than stability, the shoulder joint is prone to pain. One of the most common conditions of the shoulder is impingement syndrome. Shoulder impingement syndrome is the result of the compression of the soft tissue structures by the bony structures of the shoulder. This compression usually involves the rotator cuff tendons and/or the bursa, the fluid filled sacs within the joint. Therefore, impingement syndrome is often seen in combination with rotator cuff tendinitis or bursitis.


While the exact cause of the condition is not known, generally shoulder impingement is associated with repetitive overhead movements. For this reason, impingement syndrome is common in those whose sports (e.g. swimming) or jobs (e.g. painting) require overhead movements. Because impingement syndrome is an overuse condition, it usually comes on slowly over time, worsening with increased use. Most frequently the pain is felt in the front of the shoulder joint, possibly radiating down the upper arm. Overhead movements, backwards reaching or lying on the affected side triggers the pain, which is often described as “sharp” with a “catching” sensation when lifting the arm.


What can you do at home?

  1. Prone Ys: Lie face down with your arms up and at a 45-degree angle and thumbs pointed up towards the ceiling. Slowly lift your arms upward, squeezing your shoulder blades down and together. Repeat for 10 reps and 3 sets.


  1. Pizza Carry: With your back against the wall, bend both elbows to 90-degrees with your palms up. Rotate your arms outward as far as you can while keeping your elbows tucked into your side. You should feel your shoulder blades squeeze down and together. Hold for 5 seconds, for 10 reps and 3 sets.

Why should you see a physiotherapist?

The first thing I can do for you is determine if your shoulder pain is, in fact, caused by impingement syndrome. I will do this by taking a thorough history of your shoulder pain, and then examining your shoulder movements and strength, as well as performing additional tests. Should I confirm a diagnosis of impingement syndrome, I will create a personalized treatment plan tailored to your exact symptoms. The treatment plan will likely including stretches and strengthening exercises to help restore full, pain-free shoulder movement. Additionally, I will use manual therapy techniques and modalities during treatment sessions to further promote the return of pain-free shoulder functioning.

If you are experiencing shoulder pain and want relief book an initial physiotherapy assessment at The Massage Clinic Health Centres today


Alyson Schwichtenburg

Registered Physiotherapist



What is Plantar Fasciitis? What can a Physiotherapist do for Plantar Fasciitis?

The plantar fascia is a thick connective tissue that supports the inside arch of the foot, and is important for weight bearing. Plantar Fasciitis is one of the most common foot conditions we physiotherapists see. Originally thought of as an inflammatory condition, new research suggests plantar fasciitis is actually a degenerative condition. This new way of classifying the condition has altered how plantar fasciitis is treated.


Plantar fasciitis is common in runners or those who stand for long periods of time for work. Other factors that can make you more susceptible to plantar fasciitis include: incorrect knee, ankle and/or foot alignment; calf tightness or weakness; weight gain; fast increase in training, and/or inadequate footwear.


Sharp heel pain is the most common symptom of plantar fasciitis. This heel pain is often worse when walking first thing in the morning or after prolonged rest. The pain can also occur while standing, walking or running, forcing you to stop activity.


What can you do at home?

  1. Lunging Calf Stretch: Step your non-painful foot forward, bend your front leg forward, keep your back leg straight and your heel on the ground. You can lean forward and place your hands on a wall in front of you for balance if necessary. Hold the stretch for 30 seconds, relax, and repeat 3 times.
  2. Plantar Fascia Stretch: Sit upright with your leg crossed so that your painful foot is resting on your other knee. Keep your foot relaxed, use your hand to pull your foot and toes up towards your shin. Massage the bottom of your foot and heel while holding the stretch. Hold for 30 seconds, relax and repeat 3 times.


Why should you see a physiotherapist?

You may choose to see a physiotherapist if your heel pain restricts your work, physical activities or everyday life. I will perform a thorough assessment of your heel pain, and create a more comprehensive treatment plan. This personalized treatment plan will help prevent disruption to the healing process, quickening in your recovery. The treatment plan may include a set of home physiotherapy exercises, the use of electrophysical agents, myofascial release, education for activity modification, and/or recommendations for orthotic devices.

If you are experiencing foot or heel pain, book an initial physiotherapy assessment at The Massage Clinic Health Centres today.

Alyson Schwichtenberg

Registered Physiotherapist 


Physiotherapy Acupuncture FAQ

Physiotherapy Acupuncture FAQ

Physiotherapy, Acupuncture

Would I benefit from acupuncture?

Currently, there is good scientific evidence supporting the use of acupuncture for the following conditions: lower back pain, elbow pain, neck pain, osteoarthritis, fibromyalgia, headaches, and chronic pain. Research is ongoing for many other conditions, though the results are promising for pains in the hip, foot, and shoulder. 


What is the science behind acupuncture?

The science behind acupuncture is complicated and, frankly, not well understood. Simply put, acupuncture provokes multiple biological responses, both locally (at the site of insertion) and systemically (in the whole body). One such biological response is the release of endogenous opioids (opioid peptides) that induce pain relief. 


Do you incorporate Traditional Chinese Medicine into your acupuncture practice? 

Yes, my acupuncture training included elements of Traditional Chinese Medicine. In addition to the Theory of Ying and Yang, the Theory of Qi, and the Theory of Five Elements, my training emphasized the use of the Theory of the Channels and Collaterals (Meridians). This theory forms the basis for acupuncture, and can influence which points I select for treatment. 


What should I feel during an acupuncture treatment?

Contrary to popular belief, acupuncture is not meant to hurt. Though you may feel some mild pain, most people report minimal sensation upon insertion. Once a needle is fully inserted, you may feel a mild, dull ache or a light tingling sensation. Some also report feeling a general heaviness in the treatment area. 

How many acupuncture treatment sessions do I need?

While the results vary from person to person, one systematic review found that six or more treatment sessions were required for significant improvements. Treatments were typically performed two to three times per week, and lasted fifteen minutes. 


Are you a Registered Acupuncturist / Can you bill the treatment as acupuncture?

No, I am not a Registered Acupuncturist, and cannot bill as such. I am a Registered Physiotherapist with additional training in acupuncture, which allows me to perform acupuncture as part of a physiotherapy treatment session. Therefore, all treatments, even those that include acupuncture, will be billed as physiotherapy. 


How do you choose the acupuncture points?

There are not set rules as to how many needles to use for each condition, or exactly which points to use. Generally, a combination of points local to the injury/pain and distal to the affected area is used. Local points are good for activating the release of neurotransmitters, while distal points help when pain is too acute to allow local points. Following an initial assessment, I will determine which combination of points would work best for you. 


If you believe you may benefit from physiotherapy with the use of acupuncture, book an initial physiotherapy assessment at The Massage Clinic Health Centres today. 

Alyson Schwichtenberg

Registered Physiotherapist


Do you know when to seek a physiotherapist?

Do you know when to seek a physiotherapist?

Alyson Schwichtenberg, BSc. KIN (Hons), MScPT, Registered Physiotherapist

Do you know when to seek a physiotherapist?

When experiencing pain or discomfort many people wait weeks or months before booking an appointment with a physiotherapist. Many people hope that the pain will eventually diminish with time or rest. However, this does not usually happen. Seeing a physiotherapist when the pain first starts can help ensure a more timely recovery and return to your everyday activities.


Pain is the body’s way of telling you something is not as it should be; therefore, listening to this warning is important. You may cause your condition to worsen by postponing physiotherapy, further delaying your return to pain free activities.


To prevent you from waiting too long to book a physiotherapy assessment, here is a list of signs that you would benefit from an appointment:

– If your pain is constant

– If your pain has not improved since the initial onset

– If your pain is brought on by a specific action or activity

– If your pain is affecting your ability to function


Though pain is often the reason people seek physiotherapy, pain is not the only thing a physiotherapist can help with. Physiotherapists can also help prevent injuries, increase mobility, and restore proper functioning.


What to expect during your physiotherapy assessment and treatments


At The Massage Clinic Health Centres, your initial physiotherapy assessment is a 45-minute appointment. During this time I will take a verbal history of your symptoms, then conduct a thorough physical exam. The session will likely conclude with a discussion about your diagnosis, prognosis and treatment plan, and demonstration of your home exercises.


Physiotherapy follow-up appointments at The Massage Clinic Health Centres are likely different than what you may have experienced at other clinics. Most treatment sessions are 30 minutes, and that entire time is spent with myself, the physiotherapist. This is unlike many other clinics, where you see the physiotherapist for a short amount of time and then are treated by an assistant or hooked-up to machines. This style of treatment allows me to change my course of treatment during a session depending on how you are responding, which helps promote better outcomes.


If you are interested in learning more on how a physiotherapist can help get you back to pain-free living, book an initial physiotherapy assessment at The Massage Clinic Health Centres today.


Alyson Schwichtenberg, BSc. KIN (Hons), MScPT, Registered Physiotherapist



Time to Get Back on Track!


To help get you back on track, for the month of June, Dr Lisa Vecchi, is offering 10% off of your supplements when you book a 30 minute or longer Naturopathic visit.


Tick Bite?

These are seriously nasty bugs carrying even worse bacteria and viruses.  It’s not only Lyme Disease!  Please do tick checks everyday.  I am happy to go over how to do a check and how to properly remove a tick at your next visit.  Just ask and I will even put together a kit so you have what you need if you get bit.


Love this Sunscreen

This is one of my favorites! Natural Sunscreen that is easy to apply, all natural and reef friendly and scores a 1 on the Environmental Working Group Safety Report.  Remaining stock is on sale in the clinic for only $10.



Registered Acupuncture

Did you know that I am also a Registered Acupuncturist?  That means that if you have separate coverage for this service in your extended health benefits, I could be administering your Acupuncture.  Of course, as always, I am able to administer Acupuncture under my Naturopathic Doctor License as well.




Dr. Lisa Vecchi


Spring Detox


Hello Spring Time!

Are you feeling sluggish from the dreary weather? Ready to give your body a healthy break to start spring? Let’s do a 2 week reset to get you started.

It’s Cold and Flu Season!!

Sick couple catch cold. Man and woman sneezing, coughing. People got flu, having runny nose.; Shutterstock ID 511263940; PO: 316197243; Client: 030a93a7-9fad-4f35-864f-171c1887a9af

Help boost your immunity this cold and flu season with natural remedies!

Choose from 2 days (or call us to book another time)

Friday, October 19th 3-4 pm

Saturday, October 20th 9-10 am 

More about the remedies…

  • activates and supports the defense mechanisms of your body to better defend you from viruses
  • oral administration
  • safe for anyone 2 years and older including pregnant and breast feeding mothers
  • the effectiveness of the remedies is not reduced if you have had the conventional flu shot
  • most effective if administered once in October and once in January (more often for those with increased exposure)
  • cost is $50 per treatment including the taxes
  • covered by most extended health benefits as a Naturopathic Visit



Dr. Lisa Vecchi


Compression Garments 101

Compression socks. compression garments, compressions, medical compression socks,

A great article from our compression garment company Juzo;
Lymphedema Compression Garments 101
Author: Cindy Anderson, Return/Product Training Manager
September 2018

Has a medical professional recently told you that you need compression therapy? You likely have tons of questions, but no worries! Here are the basics you should know about the various lymphedema compression garments available and some key benefits – with the help of your medical team you can find the best medical compression garment for you.

Lymphedema compression garments help to manage re-accumulation of fluid by providing external pressure to tissue where lymphatic failure (or swelling due to fluid build up) has occurred. For best results, you should start wearing a compression garment as soon as possible after completing decongestive phase of treatment.

Not sure which compression garment is best for you? That’s okay. A trained or certified compression fitter can evaluate your condition and help you decide what is the best therapeutic compression garment to help manage your lymphedema. In addition to measuring and providing the best fit possible for your compression garment, they also will explain how certain variables will influence which product you should wear, such as the shape and size of your limb, your mobility, age and volume of swelling.

Types of Compression Garments
You’re probably wondering what different types of garments are available and even why there are different types. We’ll explain.

Circular knit garments are seamless and not as dense and stiff as flat knit. They come in standard sizes or Juzo can custom make them for you. The elasticity of the circular knit material is great for early to mild stages of lymphedema, when swelling is moderate. Other features include:

  • Comfort
  • Moderate containment
  • Maximum aesthetics – available in a variety of colors and prints
  • Not made with natural rubber (Latex free)

Juzo Lymphedema products with circular knit include Juzo Soft or Juzo Dynamic in the following styles arm sleevesgauntlets/gloves and lower extremity.

Flat knit garments have a seam and offer excellent therapeutic results. Only available as custom-made, they can accommodate a variety of shapes and sizes. The fabric is stiffer and certain fabrics have a micro massage weave, which is preferred for areas with severe swelling. Combined with an optimal level of compression, flat knit garments offer the maximum containment in an elastic compression garment. Other features include:

  • Improved aesthetics – now available in a variety of colors
  • The density of the knit remains consistent throughout the garment (even at areas of larger circumferences, which is important for managing swelling)
  • Durable for extreme wear and use
  • Not made with natural rubber (Latex free)

Juzo products with flat knit include Juzo Expert and Juzo Strong garments which are custom to any body part with swelling issues. Most areas of lymphatic failure are arm sleevesgauntlets/gloves and lower extremity..

Inelastic wraps are the most stiff and help reduce swelling or provide maintenance. These garments are Can be used as alternative to short stretch bandaging or for anyone who may have issues putting the garment on and taking it off. Features include:

  • Reversible –can be worn beige or black
  • Special notches and minimal overlying straps resist gapping and bulk
  • Provides increase in pressure during activity and reduced pressure during resting
  • Adjustable to increase pressure during the day

Juzo’s inelastic garment is the Juzo Compression Wrap and is available for lower and upper extremity.

Please remember to work with a trained compression professional at an authorized Juzo dealer to help select the best product, provide the best fit and give you proper instructions. We hope this helps answer some of your questions. Be sure to read other blog posts to learn more, including how to care for your garment and Juzo full product line of Lymphedema aids. Also, visit juzousa.com and register for our quarterly newsletter for more information.


Tavia Wilson RMT, Combined Decongestive Therapist, Certified Fitter.


Concussions PART 4: The Importance of a Team

The Importance of a Team

health care team, concussion, recovery, physiotherapy, chiropractic care


In all cases it is important to have a healthcare team working together to get you back on the field safely with an eye on your long-term health.

A physician can provide a concussion diagnosis and manage and evaluate your condition in order to provide medical clearance.

Health care practitioners such as chiropractors can help you manage headaches or back and muscle pain you may have as a result of your concussion. It’s important to remember that your injury may have also injured your neck, shoulder or back. While you’re resting and recovering, these injuries might resolve on their own. If not, a chiropractor or a physiotherapist can help you recover and return to play. A full evaluation of your strength and physical function will help you know when your body is ready to get back into sports.

Concussion symptoms can vary widely from person to person: while one person might suffer from pain, another may have depression and trouble sleeping. Education, encouragement, and a commitment to getting you back to your daily activities as soon as it is safe and appropriate are some of the best known strategies to help overcome many of the negative outcomes of concussion. That takes a committed approach from the right health care team alongside family and friends.

Dr. Alexandra Tarkowski



Concussion, return to play, concussion management, headaches, therapy, chiropractic


Most people recover within a few days to three months. The Zurich Consensus statement on concussion recovery recommends the following five stages of rehabilitation:

  1. No activity: Focus on recovery. Rest your body and your mind.
  2. Light aerobic exercise: Get your heart rate up with light activities like walking and swimming, but don’t go past 70% of your maximum heart rate. Your goal is to increase your heart rate without risk of re-injury. Do not do any resistance training yet.
  3. Sport-specific exercise: Add movement by re-introducing sport-specific movement like skating or running drills. Do not do anything that might risk a head impact.
  4. Non-contact training drills: Add more complex forms of training to improve your exercise, coordination and cognitive load. This could include passing drills in football and hockey. You may start resistance training again.
  5. Full-contact practice: Once your doctor says it’s okay, you can participate in normal training again. This will build your confidence and skills before returning to play.

At any stage, if you experience any recurring symptoms, restart the process and remain inactive until the symptoms stop.

Returning to play after concussion should occur only with medical clearance from a licensed health care provider trained in the evaluation and management of concussions.


Dr. Alexandra Tarkowski