Specialties at our downtown Vancouver physiotherapy clinic include orthopaedics, repetitive strain injuries, ergonomics, and sports injury management. In all instances, the goal is to design an appropriate rehabilitation program for the particular injury, constantly reassessing as healing progresses.
Manual therapy, electrical muscle stimulation, laser and ultrasound can be used by the physiotherapist. If appropriate, massage therapy and a rehabilitation program, specifically designed by the exercise therapist in consultation with the physiotherapist, may be recommended as well.
Physiotherapists treat the whole body. We believe in an interdisciplinary approach to rehabilitation including physiotherapy, registered massage therapy, and injury or sport specific exercise programs. Our focus is on orthopaedic medicine: the treatment of muscles, joints, and soft tissue problems of the spine and limbs.
When should I consider your Clinic?
- If you are a high level athlete or have a specialized need (such as rehabilitation after anterior cruciate ligament reconstruction), we have physiotherapists with high levels of expertise in this area.
- If you have a complex musculoskeletal problem, perhaps unimproved after previous attempts at treatment, we have physiotherapists who are Fellows of Canadian Academy of Manipulative Physiotherapy, and are highly skilled practitioners in these fields.
- If you are a dancer, and require physiotherapy secondary to any acute or chronic injuries, we can help. Physiotherapy is also an excellent choice for a dancer interested in injury prevention and strength and conditioning with an emphasis on core strength and feet/ankles.
- If you require acupuncture or similar physiotherapy treatments, Boyd Glyn-Williams is certified to provide this type of service.
- If you complain of a general physical problems including low back pain, shoulder pain or neck pain, the high level of expertise available to you at this Clinic will secure accurate and focused treatment.
Typically we treat problems such as:
Physiotherapy treatment for joint inflammation
Evaluation and resolution of postural problems and work-related injuries, including carpal tunnel syndrome, low back, and neck pain
Treatment of muscles, joints and soft tissues problems of the spine and limbs including the use of manual therapy and electrotherapy
Physical therapy gait and postural assessment and prescription or orthotics
Physiotherapy exercise prescription to strengthen bones and prevent falls and fractures
- Overuse syndromes
Physiotherapy treatment for tendonitis
Physiotherapy treatment of children under 16 who have orthopedic and neurological conditions
- Post-surgical issues
Physiotherapy for spinal discectomy and fusion, hip and knee replacement
- Post Motor-Vehicle Accident
Physiotherapy for conditions related to car accidents
- Pre and Postnatal care
Physical therapy treatment for pre and post pregnancy conditions
Physiotherapy treatment of acute and chronic conditions characterized by inflammation, soreness, and stiffness of muscles, and joint pain due to degenerative joint disease
- Spinal Manipulation
Physiotherapy treatment strictly reserved for physiotherapists who completed advanced physiotherapy training and exams in Spinal Manipulation Therapy and who became Fellow of the Canadian Academy of Manipulative Therapists (FCAMT)
- Sports Injury
Physiotherapy treatment of sprains, strains, ligament tears and other athletic injuries using techniques such as sport specific exercises, taping, bracing, laser, ultrasound and electrotherapy
- Temporomandibular Joint Dysfunction (TMJ)
Physiotherapy treatment of discomfort, pain or degenerative joint disease in the jaw muscle function and neck and shoulder muscles such as osteoarthritis, as well as rheumatoid arthritis in the jaw joint
- General Exercise Therapy
Individualized progressive exercise programmes appropriate and specific to the Client’s needs, supervised by a certified exercise therapist
Some of the modalities used by physiotherapists include
- Orthopedic Manual Therapy
- Soft Tissue Mobilization
- Shockwave Therapy
- Functional Dry Needling
- Gunn IMS
IMS AND FUNCTIONAL DRY NEEDLING
Trigger point dry needling, also referred to as intramuscular stimulation (IMS) and/or intramuscular therapy (IMT) is an invasive procedure in which an acupuncture needle is inserted into the skin and muscle.
It’s part of physiotherapy and is not acupuncture.
What is Trigger Point Dry Needling?
Trigger point dry needling is physical intervention that uses dry needles to stimulate trigger points, diagnose and treat neuromuscular pain and functional movement deficits. 1
As the name implies, dry needling is primarily directed at myofascial trigger points.
Physical therapists around the world practice trigger point dry needling as part of their clinical practice and use the technique in combination with other physical therapy interventions. A high degree of kinaesthetic perception allows a physical therapist to use the needle as a palpation tool and appreciate differences in the density of those tissues pierced by the needle.
Although some people refer to trigger point dry needling as a form of acupuncture, it did not originate as part of the practice of traditional Chinese acupuncture. The difference being that there are distinct anatomical locations of myofascial trigger points within muscle tissue, whereas acupuncture points have point specificity on the body.
There is substantial medical literature on IMS and dry needling that has been subjected to peer review.
Many common diagnoses, such as Achilles tendonitis, lateral epicondylitis, frozen shoulder, chondromalacia patellae, headaches, plantar fasciitis, temporomandibular joint (TMJ) dysfunction, myofascial pain syndrome (MPS), and others, might, in fact, be the result of neuropathy, and associated myofascial trigger points.
Intramuscular therapy has been very successful for patients with chronic low back pain and sciatica symptoms. Shortening of the paraspinal muscles, particularly the multifidi muscles, can lead to disc compression, narrowing of the intervertebral foramina, and/or cause direct pressure on the nerve root, which subsequently would result in peripheral neuropathy and compression of super sensitive pain receptors, resulting in pain and dysfunction.
In layman’s terms, the treatment uses acupuncture needles, to target specific muscles that have contracted and become shortened. These shortened muscles compress and irritate the nerves. This treatment can greatly reduce tightness and pain while increasing flexibility and range of motion.
The treatment involves dry needling of affected areas of the body without injecting any substance. The needle sites can be targeted at the site of taut, painful muscle bands, and/or can be near the spine where the nerve root may have become irritated and super-sensitive.
An important note is needling of a normal muscle is painless. In contrast, a shortened muscle will ‘grasp’ the needle and produces a cramping sensation. Intramuscular dry needling can reduce pain and soften these trigger points while increasing flexibility and range of motion.
IMS AND FUNCTIONAL DRY NEEDLING VISIT FEES
Initial visit is $95. Consecutive visits are $90. Premium assistance user fee is $35, and ICBC user fee is $45.
Who has access?
Everyone in BC has direct access to physiotherapy services. As a result, a doctor’s referral is not necessary. However, we recommend you consult your physician. In most cases, this will promote a team approach to your rehabilitation. When a private insurance group such as ICBC is involved, an initial referral is useful.
Those on Premium Assistance and with an active Medical Services Plan are entitled to 10 visits per year. A user fee of $30 ($35 with Boyd Glyn-Williams, who combines acupuncture with physiotherapy) per visit is payable at the time of the visit. Patients with active ICBC coverage pay a $10 fee at the time of each visit. Registered First Nations’ members are charged a $30 user fee ($35 with Boyd) each visit. The private fee is $90 for the first session and $85 for each consecutive one. The length of the session varies depending on the complexity of the problem being treated, the number of necessary modalities, and the duration of educational sessions specific to the injury. Please note that in most cases treatments rendered at this Clinic exceed the standard clinical time.
The initial visit will begin with the subjective examination in the form of questions and answers focusing on your reasons for seeking help from a physiotherapist. This is followed by the objective examination where your therapist will look at the part of your body appropriate to your problem. For most conditions, you will need to remove at least some of your clothes. If you have a neck problem you will need to remove your upper body clothing and for a low back pain problem, you will need to remove lower body clothing also. The Clinic will provide you with shorts or gowns to wear (or you could bring your own). You should feel very comfortable during this process. If you would prefer a female or male therapist, you need to make it clear when you book in. After the examination is completed, your physiotherapist should give you a working diagnosis and the kind of treatment he/she has in mind, with some idea of how long that should go on for. Once you consent, the treatment will commence during your first visit. It is important you clearly understand what is being aimed for and why various techniques are being performed. All previous medical records pertinent to your condition could be faxed or e-mailed to the Clinic prior to the initial session.
Massage Therapy helps to rehabilitate physical injuries and improve health by acting directly upon the muscular, nervous and circulatory systems. It prevents or lessens some physical problems, whether they are a result of injury, disease, repetitive strain, long periods of inactivity or other causes. Massage Therapy positively affects circulation, pain perception, muscular and nervous systems, psychological state and respiratory function, thus enabling people to remain active.
Conditions treated by the Registered Massage Therapists at the Clinic include: whiplash, headaches, back and neck pain, sprains and strains, muscle spasm, arthritis, tendonitis, fibrositis, carpal tunnel syndrome, bursitis, sciatica, neuritis, neuralgia, insomnia, asthma, emphysema, chronic bronchitis, acute reaction to stress and other physical complaints. Also, massage therapy may be combined with physiotherapy and/or a rehabilitation program specifically designed by the exercise therapist in consultation with the therapist.
- As rehabilitative sciences evolve and new information becomes available, the Clinic’s therapists make every effort to keep up-to-date. All of the therapists are actively involved in post-graduate education.
- All massage therapists in British Columbia are registered and licensed by the College of Massage Therapists of BC. The educational requirements for licensing in BC are the highest in North America, according to the Massage Therapists’ Association of British Columbia.
- All Registered Massage Therapists participate in continuing education to maintain their license and improve their skills.
- All courses are interlinked to provide a thorough understanding of the mechanics of injuries as well as treatment techniques available to therapists.
- This Clinic is proud of its continuous effort to reach and maintain the highest treatment skills available in Canada. Our massage therapists are skilled in various techniques such as neuromuscular therapy, myofacial/craniosacral therapy, lymphatic drainage, muscle energy technique and therapeutic exercise.
- By concentrating on an integrated approach to physical rehabilitation, all therapists associated with the Clinic constantly share their experience, knowledge and understanding of both typical and complex treatment routines.
Some of the treatments techniques used by our Registered Massage Therapists include: Swedish Massage, which rehabilitates tissues by increasing blood and lymph circulation, reducing muscle spasm, improving muscle flexibility and tone, and improving range of motion. The Five major Swedish Massage techniques are listed below:
Directs blood and lymph towards the heart using the entire surface of one or both hands
A technique where the therapist applies pressure and releases the soft tissues by kneading, compressing, wringing, lifting and rolling
Light or deep pressure applied in one direction at a time
Using fingertips to move tissue against the underlying structure or across fibers of a tendon, muscle, scar and other tissue
Tapping a body part to stimulate muscles and nerves and to help dislodge fluids from the chest cavity
There are many other effective forms of massage therapy:
- Deep Friction Massage
The movement of tissue against the underlying structure or across tendons, muscles, scar or soft tissue, disrupting adhesions that can lead to more serious problems
- Connective Tissue Massage
A series of strokes that pull on reflex zones, loosening and relaxing tissues
- Trigger Point
Uses fingertip pressure to release trigger points, allowing nerve activity to regain its normal function
According to The Massage Therapist’s Association of British Columbia, registered massage therapists practicing in this province are the most highly qualified practitioners in North America (In Touch, The Practice of Massage Therapy in British Columbia, 1998, pp. 2-3).
A doctor’s referral, although not necessary in some cases, should prove useful, especially for patients relying on extended health coverage. We recommend you consult your physician. In most cases, this will promote a team approach to your rehabilitation. Patients on premium assistance are entitled to 10 visits per year. A user fee of $27 is charged for a full 1/2 hour visit. Patients with valid ICBC claims pay a private rate and arrange to be reimbursed by ICBC. We do not accept WCB claims for registered massage therapy. Workers Compensation Board will allow only 20 min of registered massage therapy and we believe very little can be accomplished in this time The private fee is $60 for 1/2 hour. $88 for 45 min., $108 for one hour, $130 for 75 minutes, and $157 for 1 and 1/2 hours. Special arrangements are made if longer treatments are required.
The Initial Consultation
If you can, please arrive 10 to 15 minutes before your first scheduled appointment to fill out a medical history form. The initial visit will begin with the subjective examination in the form of questions and answers focusing on your reasons for seeking help from a registered massage therapist. This is followed by an assessment through palpation of the part of your body causing the problem. For most conditions you will need to remove at least some of your clothes. If you have a neck problem you will need to remove your upper body clothing and for a low back pain problem you will need to remove lower body clothing also. The Clinic will provide you with shorts or gowns to wear (or you could bring your own). You should feel very comfortable during this process. If you would prefer a female or male therapist you need to make it clear when you book in. After the assessment is completed, your registered massage therapist should give you a working diagnosis and the kind of treatment they have in mind, with some idea of how long that should go on for. Once you consent, the treatment will commence during your first visit. It is important you clearly understand what is being aimed for and why various techniques are being performed. At the end of treatment, the therapists will review prescribed home exercises.
The suggested time for the first visit is 45 minutes. All aspects of the treatment, as mentioned above, will be performed within the limits of the time booked. All previous medical records pertinent to your condition could be faxed or e-mailed to the Clinic prior to the initial session.
Our exercise therapy programs aim at injury rehabilitation, injury prevention, back conditioning & care, flexibility & strength, cardiovascular improvement, recovery and regeneration, chronic pain management, weight management, stress management & relaxation, and sports-specific training.
The physiotherapist and exercise therapist together design a progressive exercise program specific to the type of injury in order to maintain the correction achieved during the physiotherapy treatment. This program is progressive and continually assessed to reflect the current stage of healing.
In all cases, our main objective is the patient’s early return to normal activity as well as education aimed at making the patient familiar with exercise routines to pursue in order to make the final recovery lasting. Monitored exercises, followed by a physiotherapist’s reassessment, are the best way of ensuring that the patient does not put any adverse stress through the already aggravated joints/soft tissue, thus facilitating permanent improvement.
Private insurance groups, including ICBC, may cover exercise therapy for patients with a valid claim. With this exception, exercise therapy sessions in our gym are billed at private rates. A one-on-one, 1 hour exercise session costs $80 per hour.
What is telehealth?
Tele-rehabilitation is an online method to deliver physiotherapy services. It requires a laptop computer with a camera or a smart phone.
How effective are telehealth sessions?
Although these sessions are not an ideal replacement for hands-on treatments, they can be used for sessions supervised by a physiotherapist present through a virtual link. Tele-rehabilitation may be particularly helpful when you require an expert opinion for acute injury management, to answer questions regarding your current treatment plan, to modify a program you’re having issues with, or to progress exercises. A substantial part of a physiotherapist’s role in injury management is education and exercise prescription, both of which can be covered during a tele-rehabilitation session.
What can be achieved with telehealth?
- Range of motion and strength exercises
- Functional exercises for sport and activity
- Postural correction and education
- At home or office ergonomics
- Pain management
- Acute injury management to avoid hospitals and urgent care units
- Prevent flare-ups of existing injuries
- Post-surgical progression
- Return to sport
- Current evidenced based educational advice for physical injuries
What does telehealth treatment look like?
- Self mobilization techniques for joint stiffness
- Active release techniques for tight/short muscles
- ROM and strength exercises
- Postural Exercises
- Education for ergonomics, sleep positions, driving positions
- Pain management advice
Are telehealth sessions secure?
Jane’s telehealth feature is HIPAA compliant! Each online appointment is encrypted, anonymous, and never recorded or stored.
What do I need to participate?
- A quiet space, free of distractions
- A laptop computer with a camera or a smart phone
- Space to move
How do I prepare for the telehealth session?
- Make sure your camera shows you
- Make sure there is enough space to move freely and the camera can be adjusted if needed
- Make sure there are no distractions impeding the flow of the session
- Test your microphone, for the best audio quality
- Wear suitable clothing
- You will be reminded to join the session 10 min in advance.
Who is covered for telehealth physiotherapy sessions?
Many 3rd party insurance companies cover telehealth rehabilitation sessions. Some allow for direct billing from a physiotherapy clinic and others require you to submit the invoice online. When in doubt, please contact your plan administration directly.
Currently the confirmed companies that allow direct billing are:
- Great West Life (Canada Life)
- Patients referred for post-op rehabilitation by UBC Hospital