Services

Why an injury prevention program?

Many ACL injuries result from improper landing and mechanical faults. In the majority of cases, the non-contact ACL injury occurs during landing from a jump or stopping to change directions. Female athletes are several times more prone to non-contact ACL injuries than male athletes.

Athletes must be taught the proper techniques of how to run, jump, land, and move before they execute endless amounts of drills and exercises in team practices.

What is the purpose of the program?

The main purpose is to reduce the risk of knee, ankle, and leg injuries through the proper execution of change-of-direction and landing techniques.

What is the basis of the program?

The Sport Injury Prevention Program incorporates the basic principles of acceleration, deceleration, and change-of-direction of the Sport Specific Speed program.

The program goes further by emphasizing landing technique, balance, and specific strength development. Strength is improved through bodyweight activities specific to skills such as deceleration, change-of-direction, and landing.

The program is delivered with a low instructor-athlete ratio.

Patients preparing for joint replacement surgery may be referred by the surgeon for pre-operative rehabilitation (Prehab).

The goal of Prehab is to help you be as well-conditioned as possible prior to surgery to enhance your post-operative recovery, and to understand the therapy routine that you will need to be involved in after surgery.

Prehab is accomplished in the few weeks before surgery:

Patients meet with a physical therapist for an assessment of their current mobility status and home set-up.

They learn a home exercise program at the first Prehab visit.

Two to three follow-up visits allow the patient a chance to show the therapist their progress with movement and strengthening.

Patients learn how to move safely with the new joint when completing daily activities such as stairs, bathing and dressing.

Patients learn how to utilize the devices used with their recovery, such as a walker, crutches or cane.

If you are planning on a joint replacement surgery, plan to do everything you can to guarantee a successful outcome!  Contact our professionals today to see how we can work with you to ensure that your surgery is a resounding success. 

At In Motion, our team will take time to thoroughly assess your functional status following your surgery. This will involve analyzing your gait and range of joint motion, strength and levels of pain. As well as a thorough physical examination, our individual therapists will take into consideration your previous level of function, sporting abilities and activities so that we can tailor an individualized program to help you meet your rehabilitation goals.

Our personalized approach to care is designed to help achieve excellent outcomes. We know that each person’s rehabilitation after surgery is a different experience and everybody has different goals to strive for.

The frequency of outpatient physiotherapy following your surgery depends on the type of surgery you have had and your functional status. Often our team would strive to see you on a regular basis, several times weekly in the earlier stages to ensure that your rehabilitation is progressing well and that the program is meeting your needs.  As always at In Motion, our goal is to ensure you return to doing the things you love to do as soon as possible.

Whether on the job, on the field or around the house an injury can slow you down and keep you from doing the things you love.  And you know that the first place to go following an injury is to the trusted professionals at In Motion.  But even once you have resolved the pain of that injury, certain injuries will leave you with persistent instabilities or weakness that must be addressed through structured rehabilitation. 

At In Motion we provide one-on-one rehabilitation sessions with our certified Kinesiologists that will help you restore full strength, flexibility and function.  In most instances these sessions will be covered by your extended health insurance, either through direct coverage for kinesiology or through your referring health care provider.  With the option for 30 or 60 minute sessions, we will ensure that you receive the rehab that you need to get you back doing the things you love to do!  Don’t wonder if your injury is healed up.  Prove to yourself that it is!  This is your Life.  Live it!  Get In Motion!

Exercise is the key to a healthy life. It strengthens the heart and lungs, lowers blood pressure, and protects against many degenerative condition. It gives you more energy, improves sleep and helps lessen stress.

The benefits of a Fitness Training Program developed by In Motion can include: weight loss, decreased body fat, recovery from injury, improved athletic performance, and reduction of health risks. Exercise can strengthen bones, slowing down the progress of osteoporosis and other degenerative conditions. 

Many of us suffer from ailments, which affect our health. Among these ailments are Stress, High Blood Pressure, Diabetes, Arthritis, and Osteoporosis. A regular Fitness Training Program will relieve and in some cases, eliminate these conditions. A proper diet combined with regular physical activity will provide a longer, happier and healthier life.

All individuals and athletes are different, so to is their training. In Motion customizes and periodizes each training program to ensure optimal performance and progression. 

Your program begins with a complete fitness assessment, which includes body composition, circumference measurements and blood pressure. It also includes a movement assessment to assess posture, flexibility, and to uncover dysfunctional movement patterns and muscle imbalances.  Whether your goal is weight loss or improved sport performance the Performance Team at In Motion work with you to create S.M.A.R.T. goals and provide and path and the support you need to achieve your dreams.

- Specific
- Measurable
- Attainable
- Realistic
- Time Frame

In Motion provides comprehensive conditioning and sports specific training programs and nutritional packages geared towards developing the physical tools and individual skills necessary for improving physical and athletic performance.  Our goal is to develop the athlete within you.

In Motion specializes in off-season and in-season functional sport-specific training focusing on:

- Footwork, Coordination, Proprioception
- Acceleration and Deceleration
- Core Stability and Dynamic Balance
- Strength and Power
- Energy Training- Anaerobic and Aerobic

Because athletic performance relies heavily upon adeptness of various "movement skills", each program is initiated with a biomechanical analysis of your sport and an identification of key parameters to target for improvement. Training programs are then developed to challenge current abilities with focus on balance, body position, foot-ground relations as well as angles of force. Emphasis on specificity ensures that exercise and drill selection are "functional" and promote sports specific strength, power and speed with the ultimate result of an enhanced ability to react, respond and move.

Whiplash usually occurs as a result of a car accident and involves pain, stiffness and other symptoms which typically start within the first 2 days after the accident.   Other symptoms include headache, dizziness and anxiety. Active treatment and exercise help with return to normal activity.  Physical activity releases body chemicals that help reduce pain in a natural way. To prevent chronic pain it is important to start moving as soon as possible.  An assessment from one of our chiropractors will give you a specific diagnosis and discuss treatment options, pain control and possible referrals with you.

If you have whiplash…

A spine care specialist can help relieve the pain of whiplash and regain range of motion. Follow your health care professional's instructions carefully. Remain active and do the exercises that you are taught to improve your posture and reduce the strain on your neck. Remember that, with proper care and patience, you are likely to recover from whiplash.

It is estimated that eighty to ninety percent of the Canadian population experiences headaches at least once or more per year. There are two general types of headaches, primary and secondary. Primary headaches account for 95% of all headaches which include muscle tension headaches, migraines, and cluster headaches. Secondary headaches account for about 5% of headaches and are the result of physiological problems such as tumor, sinusitis, and meningitis.

Recently, at the Baltimore College of Dental Surgery at the University of Maryland, a new anatomical discovery has provided an anatomical basis for the effectiveness of manual therapy in the treatment of tension headaches. It is called, the Muscle Dural Connection. They discovered a tissue bridge between a muscle at the base of the skull and the membranous covering of the brain and spinal cord called dura. It is this evidence that supports the anatomical basis for the rationale behind the long-standing success of chiropractic treatment that decreases muscle tension and thereby reduces or eliminates pain by reducing the potential forces exerted on the dura via the muscle-dura connection.

There are many ways that chiropractic treatment can help relieve and prevent headaches. This is accomplished by determining the causative factors such as stress (muscle tension), allergies, diet, eye strain, and biochemical changes, which can all affect the vascular and neurological systems leading to headaches. Once this is determined the proper treatment and patient education can be given to allow the headache sufferer to live a more functional and emotional lifestyle without depending on medications.

If you or someone you know suffers from headaches call and make an appointment and see what In Motion can do for you?

Do you experience a clicking or popping of the jaw, frequent headaches, ringing in the ears, dizziness, or difficulty smiling or swallowing?

You may be suffering from Temporomandibular Disorder, sometimes called TMD or TMJ. The experts at In Motion can help. 

TMD can be the result of stress, tooth-grinding, jaw-clenching, or something more serious like misalignment of the teeth or a sports or accident-related injury. In Motion understands the pain and discomfort of TMD. We’re here to help. At In Motion, our multidisciplinary team of healthcare professionals will diagnose the cause of your TMD and provide personalized care and attention. Our chiropractors, physical therapists and physicians work together to relieve your pain and solve the underlying problem. 

At In Motion, you’ll visit with our healthcare providers in a relaxed and comfortable setting. Our offices are exquisitely appointed and offer the latest in integrated, multi-disciplinary care. The staff at In Motion is warm and inviting. Our healthcare team includes board-certified chiropractors, physical therapists, and physicians, who have extensive experience in the treatment of TMD. At In Motion, you will receive comprehensive treatment that may include specialized manual therapy, physical therapy, personalized jaw exercises and, if necessary, medication. The team at In Motion also specializes in lifestyle modification and emotional stress therapy.

The mid-back is the middle region of the spine and contains the spinal bones called thoracic vertebrae.

Each of these bones is connected to two opposing ribs.  The mid-section of the spine is also connected to a variety of muscles and connective tissue that make up the middle portion of your back.  The thoracic vertebrae, like the rest of the spinal column, also provide protection for the nerves of your spine and your spinal cord.  Due to a smaller range of motion, the mid-back is less susceptible to the injury, wear and tear that affects the upper and lower back.  However, active lifestyles, posture, office environments and other influences can cause pain and discomfort in the mid-back.  If you are experiencing pain in the mid-back, you should contact the healthcare experts at In Motion today. 

Pain in the mid-back is most commonly caused by injury or irritation to the muscles and connective tissues.  This can happen because of improper rehabilitation from a prior injury, poor posture, stress, exercise, and long hours spent sitting at computers.  A more serious mid-back condition can occur when the spinal bones become misaligned, leading to muscle strain, spasm and nerve dysfunction.  Mid-back pain can be the result of extraordinary circumstances or something as simple as the way you sit at your desk.  If you are experiencing pain or discomfort in your mid-back, the experts at In Motion can help.

In Motion applies multi-disciplinary team therapy to ease your pain and cure the disorder.  Our chiropractors are specialists in hands-on manipulation of mid-back muscles, ligaments and spinal bones.  With our expert physical therapists and massage therapists working together, In Motion will apply the latest techniques and use the most advanced technology to diagnose and treat your condition.
 

What is acute low back pain?

Acute low back pain (LBP) is defined as low back pain present for up to six weeks. It may be experienced as aching, burning, stabbing, sharp or dull, well-defined, or vague. The intensity may range from mild to severe and may fluctuate. The pain may radiate into one or both buttocks or even into the thigh/hip area. Low back pain may begin following a strenuous activity or jarring trauma, but often is seemingly unrelated to a specific activity. The pain may begin suddenly or develop gradually.

What causes low back pain?

The exact source of acute LBP is often difficult to identify. In fact, there are numerous possible pain producers including muscles, soft connective tissue, ligaments, joint capsules and cartilage, and blood vessels. These tissues may be pulled, strained, stretched or sprained. Additionally, annular tears (small tears that occur in the outer layer of the intervertebral disc) can initiate severe pain. Even if the actual tissue damage is minor, and likely to repair quickly, the pain experienced may be quite severe.

No matter which tissue is initially irritated, a cascade of events occurs which contributes to the pain experience. Numerous chemical substances are released in response to tissue irritation. These substances “stimulate” the surrounding pain sensitive nerve fibers, resulting in the sensation of pain. Some of these chemicals trigger the process of inflammation, or swelling, which also contributes to pain. The chemicals associated with this inflammatory process feed back more signals which perpetuate the process of swelling. The inflammation attributable to this cycle of events may persist for days to weeks. 

Muscular tension (spasm) in the surrounding tissues may occur resulting in a “trunk shift” (the body tilts to one side more than the other) due to muscular imbalance. Additionally, a relative inhibition or lack of the usual blood supply to the affected area may occur so that nutrients and oxygen are not optimally delivered and removal of irritating byproducts of inflammation is impaired.

How long will an episode of low back pain last?

The good news is that even if the exact source of pain is not determined, usually the acute pain subsides spontaneously over time. The originally irritated tissue heals. Fifty percent of episodes nearly completely resolve within two weeks, and 80% by six weeks. 

Unfortunately, the duration and severity of a single episode cannot be predicted based on the onset, location of pain, or even the initial severity. Excruciating initial pain may resolve within several days, while moderate or mild symptom may persist for weeks. However, up to 30% of individuals will experience recurrent pain or develop persistent pain in the future.

How should acute LBP be managed?

Some of the best advice for treatment for acute LBP is to continue to remain active “as tolerated”. Continuing to perform everyday activities may seem counterintuitive, and the natural inclination may be to stay in bed or “freeze”, to guard and avoid activity. Yet, activity keeps blood and nutrients flowing to the affected area, inhibiting inflammation and reducing muscular tension. Many individuals with LBP find that they can perform their usual, but more controlled cardiovascular activities, such as walking, in spite of the pain and often feel better after the activity. More vigorous or uncontrolled activities such as weight lifting or competitive or contact sports are inadvisable while pain is severe. 
Local application of heat or ice can temporarily reduce pain and heat may facilitate stretching, but does not necessarily speed long term recovery.

The multi-disciplinary Health Team at In Motion is ideally suited to help you manage your low back pain.  The chiropractors at In Motion will perform a detailed history and physical examination to determine the specific pain generator in your condition.  As specialists in manual therapy, Doctors of Chiropractic will provide you with a plan to get you out of pain, and stay that way.  When appropriate you will be referred to the other members of the Health Team, providing you with an unmatched array of professional services under one roof.  We will get you back in motion, and help you stay that way.

Chronic Low Back Pain

Low back pain is considered to be chronic if it has been present for greater than three months. Chronic low back pain may originate from an injury, disease or stresses on different structures of the body. The type of pain may vary greatly and may be felt as bone pain, nerve pain or muscle pain. The sensation of pain may also vary. For instance, pain may be achy, burning, stabbing or tingling, sharp or dull, and well-defined or vague. The intensity may range from mild to severe. 

Many times, the source of the pain is not known or cannot be specifically identified. In fact, in many instances, the condition or injury that triggered the pain may be completely healed and undetectable, but the pain may still continue to bother the patient. Nevertheless, even if the original cause of the pain is healed or unclear, the pain felt by the patient is real and the treating physician knows this.

Chronic low back pain may be the result by many different conditions. It may start from diseases, injuries or stresses to a number of different anatomic structures including bones, muscles, ligaments, joints, nerves or the spinal cord. The affected structure sends a signal through nerve endings, up the spinal cord and into the brain where it registers as pain. 

A number of different theories have developed to try to explain chronic pain but the exact mechanism is not completely understood. In general, it is believed that the nerve pathways that carry the pain signals from the nerve endings through the spinal cord and to the brain may become sensitized. Sensitization of these pathways may increase the frequency or intensity with which pain is perceived. A stimulus that is usually not painful, such as light touch, can be amplified or changed by these sensitized pathways and experienced as pain. Sometimes, even after the original injury or disease process has healed, sensitized pathways continue to send signals to the brain. These signals feel just as real and sometimes worse than the pain caused by the original injury or disease process.

What treatments are available?

Treatments for chronic back pain can vary greatly depending on the type and source of the pain. If a treatable source of the pain is found, then the underlying process can be addressed. When the underlying cause is either not specifically identifiable or not amenable to treatment, then the symptoms are treated. The goals of the treatment are to reduce pain, improve quality of life and increase function. 

There are several different general categories of treatment that are usually recommended for chronic back pain. These categories include chiropractic, physical therapy, medications, coping skills and acupuncture. In Motion will tailor a program involving a combination of these options to address your needs.

How is chronic low back pain diagnosed?

As mentioned earlier, chronic low back pain is defined as back pain that lasts greater than three months. During the evaluation of chronic back pain, the goal is to rule out any injuries or disease processes that place the patient at risk of further injury if not treated or addressed. In addition, a specialist will consider diagnoses that can be treated in order to reduce the pain. A good patient history and a thorough physical examination by a member of the In Motion Health Team are the most important aspects of the evaluation. Serious injuries and illnesses can often be diagnosed or ruled out based on the history and physical exam alone. Lack of a definite diagnosis does not necessarily mean more testing is needed. Needless tests do not add anything to what the doctor has already discovered in his or her physical examination and review of previously performed studies and treatments. In fact, unnecessary testing is not only expensive to the patient, but can expose the patient to unnecessary risks or radiation. 

Combining manual therapy and exercise is one of the best things that can be done to relieve the expectant mother's pain without the use of drugs which can be harmful to her unborn child and thus contraindicated during pregnancy. Pregnant women suffer from low back pain during pregnancy due to the physical changes their bodies are undergoing which are further complicated by the hormonal changes that are taking place during the pregnancy. As a result of the great weight in the front of the body, the center of gravity shifts more toward the back of the body, causing the normal spinal curve to increase and also the hip joints to rotate outward and the arches of the feet to flatten. Affected joints are supported by ligaments which are softened during the pregnancy by a hormone known as Relaxin. Relaxin, which is produced by the woman's ovaries primarily affect the joints in the pelvis, softening them and preparing them for stretching during childbirth.

In Motion understands the changes in your body and will generate a plan tailored to your needs. Our Doctors of Chiropractic can check the spine to insure that the pelvis and vertebra are functioning together as a unit and are properly balanced. All this is extremely important for the pregnant woman who needs to have her body as healthy and strong as possible in order to handle the rigors of pregnancy and childbirth.

A comprehensive rehabilitation program with our Physiotherapist can provide the pre-natal or post-natal patient with a means to manage the pain and discomfort often associated with pregnancy.

Pregnancy massage is provided by using a variety of techniques while focusing on the therapeutic needs of the client as she goes through physical and emotional changes.

Benefits of Massage Therapy for Pregnancy:

- Relieves stress and promotes relaxation
- Relieves muscle spasms, cramping, and myofascial pain
- Relieves headache discomfort
- Increases circulation of blood and lymph
- Relieves stress on weight-bearing joints
- Provides emotional support and nurturing touch
- Includes an ongoing educational exchange about the process of relaxation, breathing, and visualization which helps facilitate the clients' response during the labor process.

Our registered massage therapists utilize a pregnancy pillow to allow clients the option to receive a massage in a more comfortable position.

The shoulder is the most mobile joint in the human body and shoulder pain is a common experience.

The shoulder has four tendons, which are connective tissues that join muscle to bone.  These four tendons, called the “rotator cuff,” are subject to injury and discomfort due to a wide range of causes.  If you experience shoulder pain, the multidisciplinary team of chiropractors, physicians and physical therapists at In Motion can help.

There are many causes of shoulder pain including swelling, inflammation, changes in the bone, and tearing of the tendons.  Arthritis and degenerative conditions, as well as the natural aging process, also cause shoulder pain.  Normal wear and tear may result in shoulder tendonitis, an inflammation of the tendons.  This occurs due to the shoulder’s wide range of motion and can be worsened by sports like baseball and tennis, in which the shoulder is extensively used.  Other shoulder conditions include bursitis - an inflammatory disorder, shoulder dislocation, shoulder separation, fracture, inflamed tendons near the shoulder, and “frozen shoulder syndrome,” which occurs when the shoulder is not moved due to a prior injury.  If you are experiencing any kind of shoulder pain, In Motion offers a comprehensive team approach to diagnosis and treatment.  We will help you return to a pain-free and active lifestyle with the finest healthcare expertise and state-of-the-art manual therapies. 

At In Motion, we know how to treat shoulder pain and injury.  Our multidisciplinary approach incorporates comprehensive physical therapy with recuperative exercise for total wellness of being.  Our chiropractors, physical therapists and massage therapists specialize in treating pain and the disorders that cause pain. Our physical therapists are experts in rehabilitation and will help you learn how you can help yourself recover from shoulder injury.  When necessary, we will prescribe medication or provide corticosteroid injections to lessen pain and quicken recovery.  Whatever the cause of your shoulder pain, the professionals at In Motion will diagnose and treat it using cutting-edge technology and the finest medical attention.

The elbow is a source of frequent pain and discomfort, especially in physically active people. 
 

Elbow pain is often the result of injury, overuse, strain, or can occur due to a more serious injury.  If you are experiencing elbow pain, contact the healthcare professionals at In Motion.  Our upscale offices are located on Lambton Mall Rd, beside the Bank of Montreal.  Our multidisciplinary team of chiropractors, physicians and physical therapists will help you return to an active and pain-free life.

Elbow pain can be caused by a variety of conditions.  Some disorders may be serious; most are not.  Pain in the elbow can be caused by an inflammatory condition like tendonitis, arthritis or bursitis, or may be a tendinosis, a chronic injury resulting from repetitive movements at work, playing racquet sports or golf.  Discomfort of the elbow can also be caused by overuse of the wrist, manual work such as using a screwdriver, or by a small fracture or irritation of the nerve.  If you are experiencing pain in your elbow, contact In Motion today.  We can help.

The experts at In Motion specialize in pain management, physical therapy and rehabilitation.  For elbow pain, we use sophisticated manual therapies and rehabilitation to correct the cause of your condition.  Our chiropractors, physicians, and physical therapists will work together to ensure your return to a pain-free, active life.  The healthcare specialists at In Motion know that an active lifestyle is a healthy lifestyle.  If your pain is the result of a sports injury, we’ll have you back on the tennis court or golf course in no time.

Knee pain is common and may be experienced due to many different reasons. 

The knee bears the weight of the upper body and is often stretched and strained in many directions.  Knee injury is frequent among athletes, including professionals and “weekend warriors.”  Conditions involving the knee can be minor disorders or bigger problems requiring serious medical attention.  If you are experiencing knee pain, don’t hesitate to contact the experts at In Motion.  Our team of chiropractors, physical therapists and sports rehabilitation experts is here to serve you with expert medical attention and exquisite personal care. 

Knee pain can come from an inflammatory condition such as arthritis, bursitis, or tendonitis.  It can also be the result of a sprain or strain, dislocated kneecap, injury to the cartilage tissue in the knee - called the meniscus, or any number of conditions particular to the knee.  Knee pain can even be a symptom of gout or may be caused by disorders of other parts of the body such as the hip.  In Motion offers a comprehensive team approach to knee care.  Our beautifully appointed offices are the best place to attend for a diagnosis of knee pain and injury.  Our multidisciplinary team of chiropractors, physicians, physical therapists and massage therapists will identify the cause of your pain and provide personalized treatment options.

The team at In Motion knows that physical therapy is important treatment for knee pain.  Our physiotherapists are licensed experts in their field and will treat you with soothing care and attention you won’t find anywhere else.  The In Motion chiropractors are experts in orthopedic diagnosis and manual therapyensuring that you receive a comprehensive diagnosis and treatment for your knee condition. Whether your pain comes from simple wear and tear, overuse or misuse, or is more serious and requires prescription medication or surgery, the professionals at In Motion possess the knowledge and expertise to help you recover your health and return to an active, healthy lifestyle.

The foot is composed of 26 bones, 4 arches, and countless muscles, veins, arteries, nerves, joints, and fascia. Beyond that, we rely on the foot repeatedly throughout the day to walk, run and stand. The feet take a lot of abuse; it's easy to understand why they're so prone to injury. We've outlined some of the most common injuries we see and treat in our clinic.

Achilles Tendonitis/Tendonosis: The Achilles tendon is made up of the tendons from two muscles in the lower leg, the gastrocnemius and the soleus. It attaches onto the top/back portion of the calcaneus (heel bone) and is the largest tendon in the body, being able to withstand over 1,000 lbs. of pressure. Although it is strong, it is also the most commonly ruptured tendon. Micro tears occur in the tendon causing inflammation in the area. The patient feels pain at the back of the heel, typically after periods of rest or during jumping, and starting/stopping activities. Inflexible lower leg muscles, over pronation of the feet, and changes in footwear and training schedules are all causes of this condition.

Bunions: Bunions are seen at the side of the base of the big toe. It looks like an enlargement of the joint. They form when the big toe bends laterally towards the other toes, a condition also known as Hallux Abducto Valgus. Bunions can result from abnormal bone formation in the first metatarsalphalangeal joint. Poor foot mechanics are often genetic and can lead to this problem. Other things such as injuries to the foot and 1st toe, flat/pronated feet, and poor footwear can also be a cause. People with bunions complain of pain from the pressure of their footwear, redness and swelling in and around the joint, the motion of the first toe is very restricted, and their other toes are affected either by hammer toes, calluses or corns.

Acute Compartment Syndrome:

- Can take several hours to develop
- When the pressure exceeds the blood pressure within the compartment, the blood vessels collapse
- Without nutrients the tissues can die within hours
- Common causes of ACS include badly bruised muscles, complications after surgery, circulation blockage, crushed foot, and major changes in activity level

Chronic Compartment Syndrome:

- Pain and swelling typically due to exercise
- Improves with rest
- Numbness and difficulty moving foot
- Muscles feel "tight" or "full"
- The pain stops relatively quickly after ending activity but the pressure can remain elevated for some time

Corns: The formation of dead skin cells that develop on the top, sides and tips of the toes. The core of the corn is usually cone shaped with the point facing down. With pressure, the tip can press onto a nerve, making it even more painful. Corns may also become inflamed due to friction from footwear.

Gout: Gout occurs most often in the big toe but can affect any joint of t he body. It usually occurs overnight (within 12-24 hours). It involves painful swelling of one joint at a time, sometimes two. After the first attack a person may go anywhere from one week to years without having another, growing more frequent and more severe with every attack. Without treatment, gout may cause chronic or continuous joint problems and damage.

Uric acid is a natural chemical produced by the kidneys and is key in breaking down and building up food and body tissues. It is normally dissolved in the blood, but in the case of gout, crystal deposits form in the joint causing an inflammatory response.

Genetics play a role in this disease as well as obesity, sudden weight gain, abnormal kidney function, excessive alcohol consumption, and some cancers. The relationship between uric acid levels in the blood stream and gout is unclear. People with high levels of uric acid in their blood do not always have gout and visa versa.

Hammer Toes: Hammertoes can affect any of the toes except the big toe and is most commonly seen in the second toe. It happens when the ligaments and tendons tighten and pull the toe downwards. The bend occurs in the proximal inter phalangeal joint (PIP) with the base of the toe pointing up and the bottom of the toe pointing down. Most people will not notice the initial signs of a hammertoe until a corn appears on the top of the bend in the toe. The corn develops due to the pressure and friction on the joint, typically from footwear. It will be noticeably painful while wearing tight fitting shoes.

There are two separate types of Hammer Toes;

a) Flexible - can move actively and straighten passively (with help from fingers) and
b) Rigid - movement in this case would be limited and painful. Hammer Toes can be hereditary but tight shoes are mostly the cause. Weak muscles in the foot and ankle can also be a factor.

Morton's Neuroma: A condition where nerve(s) are being "squeezed" by the toes and surrounding tissues of the foot, typically between the 3rd and 4th toe. Symptoms of this condition include sharp pain, burning, and even a lack of feeling in the affected area. Morton's Neuroma may also cause numbness, tingling, or cramping in the forefoot. You may experience this after prolonged walking or standing.

Metatarsalgia: A painful condition in the metatarsal area of the foot (the ball of the foot). Pain is typically located under the 2nd, 3rd and 4th toes and is most prominent under the 1st toe (big toe). One or more of the metatarsal heads become inflamed due to extended pressure on the forefoot. Improper fitting shoes are a common cause.

Plantar Fasciitis: The plantar fascia is a band of connective tissue running from the heel into the toes and serves to support the bottom of the foot. It takes a bulk of the load when you are weight bearing. When the fascia and surrounding tissues aren't stretched/used regularly there are allowed to shorten. A shortened plantar fascia is more likely to tear when asked to stretch past its capacity (sometimes all it takes is weight bearing). The most common symptom of this condition is pain in the heel on 1st step, in the morning or after a period of rest.

The calcaneus is the largest bone in your foot and takes the most pressure when weight bearing. A heel spur can develop at the lower frontal area of the calcaneus, where the plantar fascia attaches. When under stress, the plantar fascia pulls away from the bone causing your body to lay down calcium (building block for bone) in an attempt to strengthen the area.

Many people have a spur and don't know it because a spur alone does not cause pain. Rarely are there cases of the spur "poking" into tissue resulting in pain. A spur is mainly just evidence that you may have plantar fasciitis.

Shin Splints: Characterized by inflammation of the sheath of the periosteum (bone) of the tibia (shin bone). This may happen on the outer side (lateral) or the inside/back of the tibia. Most describe the onset of pain as gradual, starting as a dull ache after walking or running. The area of pain is typically localized, being 4-6 inches in length on the mid region of the bone. The muscles that attach to the tibia (soleus, flexor digitorum longus, tibialis anterior, tibialis posterior) often feel sore as well. Causes may include overuse, running on hard surfaces, tip toe running, high arches, and bad shoes and arch support. There is an increased risk of stress fractures occurring if this condition is left untreated.

Sprains: An overstretching or tearing of a ligament. The most commonly damaged ligament is the anterior talo-fibular ligament of the ankle. Risks of injury include poor rehabilitation of a previous sprain, poor proprioception of a previously sprained ankle, and weak ankle muscles. There are three different types of sprains:

1. 1st Degree Sprain: There is some overstretching and tearing of the ligament and little or no functional loss of the ankle. There is mild pain on weight bearing and some swelling and stiffness.
2. 2nd Degree Sprain: There is more tearing than a first degree sprain, moderate instability, moderate to severe pain on rest and severe pain on weight bearing. Swelling and stiffness are also present.
3. 3rd Degree Sprain: The ligament is completely ruptured; there is functional loss and gross instability. Many times there is severe pain right after the injury followed by no pain at all. Swelling is typically severe. 

Tarsal Tunnel Syndrome: Signified by the entrapment of the tibial nerve inside the ankle. Patient has tingling and numbness in the sole of the foot that worsens throughout the day. Rest and elevation lessen the symptoms. The tibial nerve bends around behind the medial malleolus, making it more prone to injury. Surrounding structures can also impinge the nerve if they are swollen or inflamed. Things like flat pronated feet, a cyst or lesion in the area, Rheumatoid Arthritis, fractures or other misalignments to a joint can cause this condition.