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Latest Blogs
Tips to help you clear up brain fogTips to help you clear up brain fog
December 11, 2024Occupational TherapyHave you ever felt like your mind is clouded and not as sharp as it used to be? You might be experiencing brain fog. Brain fog is a common term used to describe how people feel when their thinking is sluggish and unclear. What is brain fog? Brain fog affects your ability to think. You might find it more difficult to focus, remember things, plan, or solve problems in everyday life. When our thinking is not clear, simple tasks can become challenging. For example, you might have a hard time planning a trip to the grocery store, remembering the ingredients to add to your meal, or keeping track of all the appointments on your calendar. People can experience brain fog for many reasons. It can be from stress, tiredness, or a lack of sleep. Certain health conditions, such as cancer, diabetes, migraine, menopause, and viral infections (e.g. cold, flu, COVID-19) are also possible causes of brain fog. Brain fog affects many people. Research shows that over 80% of people who tested positive for COVID-19 experience brain fog. And it continues to affect up to 20% of these individuals even after they have recovered from physical symptoms like cough and fever.     How to clear up brain fog? Taking charge of improving one’s health is known as self-management. It is also considered as the best way to manage brain fog in patients with long COVID-19 symptoms. Here are some small positive changes to your body, mind, and lifestyle that may help to clear up brain fog: Your body Strengthen your body: tiredness and fatigue can lead to brain fog. Boost your energy with regular physical activities, such as walking, running, and yoga. Save energy: energy conservation is an effective way to reduce tiredness and fatigue. Here are its four key principles: Pace yourself: keep the activities short. Take breaks and give yourself more time to complete tasks. Prioritize your tasks: focus on activities that need to be done on that day. Think about positioning: choose sitting instead of standing for longer tasks, such as cooking and showering. Plan ahead: break down bigger tasks into smaller ones, and slowly increase its length and intensity. Set aside time in your schedule to rest. Learn more about the four principles of energy conservation. Your mind Exercise your brain: working your brain is an important step in keeping it healthy. Puzzles, memory games, reading, and even household chores are all beneficial for your brain. Start with simple tasks before moving on to more complex ones. Use reminders: reminders also help with your memory. Write important information down or take a picture. Make a checklist for your errands. Use the reminder or alarm function on your phone to remind yourself of medications and break times. Your lifestyle Adjust your environment: reduce the noise in your environment. Use natural light as much as you can for your room and workstation. Add lamps or ceiling lights for extra lighting. Better sleep, less stress: your ability to think can be affected by sleep quality and stress level. Have a regular sleep schedule and a good bedtime routine. Relieve your stress through activities such as mindfulness, progressive muscle relaxation, and breathing exercises. Build support and connection: many people with brain fog have a hard time reaching out, just because its symptoms are less visible compared to a physical injury. However, it is important to share your experience with your family and friends, so that they can better understand and support you. Our ability to think is important for everyday tasks, and brain fog can greatly affect our quality of life. Remember that you are not alone. Many online communities now offer peer support groups for people who are experiencing brain fog. To schedule an appointment, contact a pt Health clinic near you or book an appointment online. This blog originally appeared on Lifemark.ca and was written by Rona Guo, an occupational therapy student from McMaster University. [...]
How to get ready for ski seasonHow to get ready for ski season
December 9, 2024Physiotherapy / Sports PhysiotherapyIf you love skiing or snowboarding, you’re probably ecstatic to see snow show up in the weather forecast. Snow sports are a great way to stay fit during the winter months, stave off the seasonal blues and enjoy the great outdoors. However, like any sport, skiing and snowboarding come with a risk of injury. Here are five simple tips to help reduce your risk of injury and keep you on the slopes all winter. Make sure everything is tuned up As you are tuning your equipment and repairing any dings and dents it may have received last season, consider “tuning up” your body as well. Are you still battling nagging injuries from golf season or climbing season? A physiotherapist can assess your condition, diagnose any problems and develop for you an exercise or rehabilitation program that can allow you to meet your goals. If nagging injuries are holding you back, make sure to schedule an appointment. Have a solid base Just as your ski or board should start the season with a solid base, your body should also have a solid base level of fitness. Prior to ski season, add to your routine a cardiovascular activity, such as walking, running, cycling or cross-country skiing, that you perform 3-5 days per week. Group fitness classes are another way to get your heart pumping! Don’t skip leg day Exercises that use your leg muscles, such as going for a long run, can cause a burning sensation, though this sensation doesn’t always mean the muscle is injured. Moreover, strengthening your quads and gluteal muscles using squats and squat variations can help limit the fatigue you may feel after your first day on the slopes. Examples of exercises you can do include squats with or without weights, wall sits, walking lunges and monster walks. Aim for a lot of repetitions without a lot of added load, but make sure that you are increasing your workload gradually. Adding too many repetitions or too much weight too fast can have the opposite effect of what you are looking to accomplish! Prepped for monster- and crab-walks Rock hard abs People tend to think about strengthening their core for summer weather, but it’s just as important to be strong in the back and core in the winter, even if we hide our body with layers of clothes. Body weight exercises that can be helpful include planks, side planks and bird-dog variations. Some core exercises can irritate an existing back injury, so make sure to see a physiotherapist prior to starting a new exercise program to make sure it’s safe for you. Basic bird-dog exercise Become arm-strong Tumbles, brushes with branches and using the T-bar all require a strong shoulder in order to avoid getting hurt. Banded exercises for the rotator cuff are easy to do almost anywhere! Banded external rotation That’s it. Have a fun and safe ski season! If you’d like to schedule an appointment, contact a pt Health clinic near you or book an appointment online. This blog originally appeared on Lifemark.ca. [...]
Toilet habits to protect your pelvic floorToilet habits to protect your pelvic floor
November 27, 2024PhysiotherapyChances are, you don’t think too much about using the bathroom! More than likely, you’ve just gone when you need to, without much thought, unless a bladder or bowel issue comes up. Your pelvic floor plays a crucial role in your overall health and well-being. From supporting your organs to aiding in bladder and bowel control, these muscles have very important roles behind the scenes. One of the most important yet often overlooked aspects of supporting a healthy pelvic floor is how you use the bathroom. Here are some essential habits to adopt to ensure your pelvic floor stays healthy. 1. Foster a good bathroom routine Your body, and especially bowels, thrive on routine. By taking steps to optimize your bladder and bowel habits, you can help your body get into a healthy routine to promote regular bowel movements. What does this look like? Ideally, you should be able to void your bowels within the first 30 minutes of waking up. If this is not the norm for you, drinking a cup of warm liquid, ideally water or tea, will help to stimulate your bowels. Consider using a small step stool to elevate your feet, so that your knees are slightly above hip level while sitting on the toilet. This will help to place your body into an optimal position for passing stool without straining. Relax! Your pelvic floor needs to relax to void, so make sure you are not tensing as this will make it more challenging to pass your urine or stool. Some find it helpful to complete some deep breathing exercises or to distract themselves with a phone or device. Just be mindful not to spend too much time sitting on the toilet if you are not passing anything (nothing over 10 minutes). 2. Avoid straining Straining during bowel movements can put excessive pressure on your pelvic floor muscles which may have unfavourable consequences over time, including increased risk for hemorrhoids and anal fissures. How can you avoid straining? Stay hydrated. Drink plenty of water to keep stools soft and easy to pass. Prioritize a fibre-rich diet. Make sure to incorporate fruits, vegetables, whole grains and legumes into your diet to optimize fibre intake and promote regular bowel movements. Perfect your positioning. As mentioned above, using a small step stool to elevate your feet so that your knees are slightly above hip level while sitting on the toilet will place your body in an optimal position to pass your stool.  If you experience incomplete emptying of your bladder, stand up from the toilet, complete a few pelvic tilts in standing (round your low back and tuck your tailbone under to tilt your pelvis forward , then complete the opposite to tilt your pelvis back and repeat!) 3. Take your time Rushing through your bathroom routine can result in incomplete emptying of the bowel or bladder. Instead, give yourself enough time to pass your urine or stool. Waiting 10 minutes to see if you are able to pass stool is a reasonable amount of time. If it takes any longer than this, stand up and try again later. Avoid spending long periods sitting on the toilet. 4. Listen to your body When your body gives you the urge to go to the bathroom, make sure you pay attention. Ignoring your body’s signal to pass a bowel movement may result in symptoms such as gas, bloating and cramping. These are all signs that you missed your body’s call to void. Your pelvic floor health is vital to your overall well-being and it’s important to adopt healthy bathroom habits to support these essential muscles. By creating a healthy bathroom routine, avoiding straining, taking your time in the bathroom and listening to your body, you can promote a strong and healthy pelvic floor. Remember, small changes can make a big difference. If you experience any challenges with your bladder or bowel, pelvic health physiotherapy may be helpful in addressing your symptoms and improving your quality of life. To schedule an appointment, contact a pt Health clinic near you or book an appointment online. This blog originally appeared on Lifemark.ca and was written by Emily Gunning, a physiotherapy student at the University of Toronto.   [...]
Heat or ice, which should you use?Heat or ice, which should you use?
November 26, 2024PhysiotherapyIf you’ve ever wondered whether you should apply heat or ice to alleviate muscle soreness, check out this heat vs ice reference guide. It demonstrates how ice and heat work to ease discomfort, how they can be applied safely and when to use them. Click on the image below to access the downloadable guide! Additional tips for using heat and ice packs  Don’t apply cold for longer than 15 – 20 minutes because after that timeline the blood vessels actually stop constricting and start to dilate  There is no research to support “fancier” cooling systems than just a good old fashioned bag of frozen peas…although we don’t suggest eating the peas after using them as an ice pack;)  While inflammation causes pain and swelling, it is also your body’s natural repair process.  In the early stages of an injury it is perfectly normal to have inflammation as it will result in tissue healing.  Intermittent use of cold therapy, however, will improve your level of comfort during this period of tissue repair   Topical agents (gels and creams) can still help with pain by having a numbing effect but may have less of an effect on circulation and should not be used in conjunction with ice or heat  Light physical activity such as walking, jogging, dynamic stretching also help to increase blood flow and warm the muscles and joints  Note: The information listed is intended as a general guideline. If you have questions or concerns related to your own injury or condition, please speak to your healthcare professional. Please exercise caution when using heat and / or cold applications, especially if you experience decreased sensation in certain areas of your body. To schedule an appointment, contact a pt Health clinic near you or book an appointment online. This blog originally appeared on Lifemark.ca and was written by Meg Smith, MSc, FCAMPT, Physiotherapist [...]
What are orthotics and how can they help?What are orthotics and how can they help?
November 23, 2024PhysiotherapyHave you ever wondered what orthotics are or how they can help? Paul Mäkinen, a Lifemark Certified Pedorthist, recently joined me and interested members of the community for a webinar about foot orthotics. From the basics of foot orthotics, to how they can help address and treat various types of pain and foot conditions, the webinar provided an excellent opportunity for participants to get their questions answered. The points below are a summary of my conversation with Paul. You can also watch the full recording of the webinar on YouTube. What is a Pedorthist? A Pedorthist is a foot orthotic and orthopedic specialist who is trained to assist in alleviating pain and abnormalities of the feet. They are also able to assess if orthotics or a footwear recommendation is right for you. What is a foot orthotic? A foot orthotic is a device insert for your footwear to correct alignment concerns with your feet as well as all the joints above your feet. Orthotics are similar to glasses, when you are wearing them they correct the alignment but as soon as you remove them, they stop working. What kinds of conditions can be treated with foot orthotics? Orthotics can be helpful and help treat a multitude of conditions, including: Lower extremity pain (heel, arch, shin, knee, hip, back etc.) Strain, tension and/or pressure in the foot Arthritis and Diabetes Bunions We recommend that you are assessed by a Physiotherapist as well as a Pedorthist to determine the best solution for you. Do orthotics help with back pain? Yes. Back pain can be mechanical in nature or can be the result of another part of your body – if the foot or walking pattern (gait) are contributing factors to an individual’s pain/condition then orthotics can be of benefit. A thorough and individualized assessment is always valuable to determine what your best options are. Do Can orthotics help those struggling with diabetes or arthritis related foot pain? Yes. There are factors to consider if someone is dealing with foot pain resulting from diabetes or arthritis. Usually a treatment plan for pain associated with these conditions involves providing orthotic support that is as soft or shock absorbing as possible. What is the difference between a custom or off the shelf orthotic? Custom orthotics are built from scratch and designed with a specific body in mind. A 3D image and/or cast/impression of the foot is used by the lab to make a 3D model which the orthotic is then built from. This provides the specific support required. In contrast, off the shelf orthotics are not designed for specific conditions or people. Those with good mechanics and alignment that are experiencing general discomfort, might be candidates for an off the shelf insole for additional support, but they might also just need a new pair of shoes. How do I know which specialists are following best practices? Before you schedule an appointment, check if they are a Canadian Certified Pedorthist and make sure they provide a thorough assessment including full range of motion, medical history, and a 3D cast of the foot (digital scan or cast). How long do custom orthotics last? There are a few factors to consider; how much time do you spend on them? What material is it made of? What are we addressing? Typically when your symptoms start to show again, it’s a good sign that it is time to get a replacement. But general rule of thumb is approximately every 2 years. Pronation and Supination – what are they? Pronation – the tipping inward of the foot when you walk. A degree of pronation is normal and needed. Supination – the tipping outward of the foot often causing knee and lateral hip stress. To schedule an appointment, contact a pt Health clinic near you or book an appointment online. This blog originally appeared on Lifemark.ca and was written by Krista McIntyre, Reg. PT., M.Sc.PT., H.B.K. [...]
Therapeutic touch: how different forms of massage therapy can helpTherapeutic touch: how different forms of massage therapy can help
October 29, 2024Massage TherapyMassage therapy promotes healing by acting on the muscular, nervous, and circulatory systems in the body. It offers many therapeutic physical, mental, and emotional benefits including improving circulation and reducing swelling, decreasing muscle stiffness to promote relaxation and stress relief while reducing pain. It is often used as a valuable component of treatment for various health conditions such as back pain, carpal tunnel syndrome, fibromyalgia, sciatica, and more.  Whether it’s deep tissue massage for a specific issue or restorative massage to help reduce stress and improve sleep, massage therapy offers a multifaceted approach to supporting your overall quality of life and ability to keep doing or getting back to what you love.   Below you will find a description of several types of massage therapy, each of which offers unique benefits to manage pain, injuries or other health issues.  Deep tissue massage  A deep, targeted pressure approach to help break down bands of hard, painful tissue, or “knots”, in your muscles and fascia. The concentrated pressure helps to reduce inflammation in the area which may be contributing to pain.  Deep tissue massage therapy can benefit those suffering from stress, tension headaches, whiplash, sciatica, fibromyalgia, and even those recovering from surgery or an injury.  Relaxation massage  Though gentler than deep tissue massage, relaxation massage contributes to loosening tight muscles while helping to promote a sense of calm and wellbeing.  Sports massage  This type of massage is usually focused based on the demands of a particular sport and used with athletes before, during and/or after training or competition. Performed before an activity, this form of massage can enhance flexibility which may optimize performance and help reduce risk of injury. Post exercise or sport, it can help relax targeted muscles, decrease muscle soreness and reduce recovery time.  Myofacial release massage  This form of massage focuses specifically on the connective tissue (fascia), or the “skin” surrounding the muscle, to help relieve tightness which may be contributing to pain and muscle restrictions. Myofascial release uses stretching and sustained pressure to loosen and lengthen the fascia which can improve mobility and reduce pain.   Trigger point massage  Many individuals will experience what are commonly referred to as “knots” in their muscles, known as trigger points. These points may contribute to pain in the location of the knot or refer pain to associated areas of the body.     This type of massage may not be as comfortable, but it can relax your muscles and release tension, often after just one session. Your massage therapist will always work within your comfort level.  Massage therapy can be used as a stand-alone therapy or part of multidisciplinary care along with physiotherapy, chiropractic, occupational therapy and more.   To schedule an appointment, contact a pt Health clinic near you or book an appointment online. This blog originally appeared on Lifemark.ca and was written by Krista McIntyre, Reg. PT., M.Sc.PT., H.B.K.  [...]
Can you get injured raking leaves?Can you get injured raking leaves?
October 28, 2024Occupational Therapy / Physiotherapy / Sports PhysiotherapyFall means beautiful foliage, but it also means we have to clean up those leaves as they cover our gardens and lawns. Raking leaves is a great way to get outside and do some light exercise. However, it can also mean tired, aching muscles or even a back injury that could put you out of commission for days. Avoid injuring yourself by stretching first The easiest way to avoid injuring yourself while raking leaves is to make sure you warm-up before you start. Walk around your yard/garden a few times to loosen up your muscles, and do some stretches. Here are a few that will stretch out the muscles you’ll use while raking: Clasp your hands over your head and lean slowly to each side. Put your hands on your hips and slowly rotate your body side-to-side, stretching out your upper body.  Put your heel on a step and with your leg straight, slowly lean forward from the hips to feel the stretch in the back of your leg. Make sure you keep your back straight.   Hold onto a tree or wall and grab your ankle behind your body and slowly pull your heel toward your buttock. Hold all of these stretches for 15-20 seconds and repeat 2-3 times. Do not stretch into pain. The ergonomics of raking A thorough warm-up is only half the battle when it comes to avoiding injuries while raking. You’ve got to keep ergonomics in mind too. Make sure your rake fits you. There are many ergonomic rakes, shovels, and other tools available at your local hardware store.  Change your position as you work – alternate the forward foot and reverse hand positions when raking.  Make sure to take frequent rest breaks – stand up, put your hands on your low back, and briefly bend backwards.  Cool down – walk around your yard/garden a few times to admire your work.  Repeat the warm-up stretches. To schedule an appointment, contact a pt Health clinic near you or book an appointment online. This blog originally appeared on Lifemark.ca [...]
Running to the Bathroom and Not the Finish Line?Running to the Bathroom and Not the Finish Line?
October 25, 2024Physiotherapy / Sports PhysiotherapyDid you know that more than 40% of female runners report leaking during running or other high-impact activities? As common as it is to suffer from incontinence while running, it shouldn’t be happening. Many suffer in silence, or try to hide the embarrassing wetness, but it can be resolved! Stress urinary incontinence (SUI) is an involuntary loss of urine associated with an increase of pressure exerted on the abdominal muscles. If you have SUI you may experience leakage when you cough, sneeze, laugh, or during high-impact activities like running and jumping. Although stress urinary incontinence affects both men and women, the percentage is greater in the female population. Pregnancy and childbirth rank high on the list of causes for SUI, but other risk factors include: prostate surgery, obesity, chronic coughing due to smoking/lung disease, loss of pelvic muscle tone, repeated heavy lifting, or high-impact sports. Imagine your pelvic floor muscles like a sling. They attach at the pubic bone in front and run all the way to the tailbone in the back. These muscles support your pelvic organs; bowel, bladder, uterus, vagina and rectum. SUI occurs when pelvic floor muscles and other supportive tissues weaken. Now imagine exerting force on weak abdominal and pelvic muscles; it is going to put pressure on your pelvic organs. Hold on! Don’t rush off to do Kegels just yet. There are two reasons for a weak pelvic floor: hypotonic muscles (relaxed and there’s a strength deficit) and hypertonic muscles (too tight). For those who have too much tension in their pelvic floor, this will cause the muscles to fatigue, leading to the same lack of support as those with a weak pelvic floor. Whether you need to strengthen or relax, a pelvic health therapist can work with you to develop a plan to ensure you’re on the right track. To schedule an appointment, contact a pt Health clinic near you or book an appointment online. This blog was written by Nadine Martin and originally appeared on Lifemark.ca. [...]
Choosing the right shoe for youChoosing the right shoe for you
August 26, 2024PhysiotherapyShoes today come in many different shapes, sizes, styles and functions. For many people, the task of selecting the proper shoe for their needs can be a frustrating and sometimes painful process. This article is designed to give you some general tips to keep in mind when you go shopping for new shoes. Every shoe has a purpose. Start by determining what activity will be done in the shoe and select the proper shoe accordingly. For example, if you were planning to go for a hike on rugged, rocky terrain, a running shoe may not be appropriate. A cross-trainer with sturdier soles might be a better choice. Almost all activities have specific shoes designed for that purpose. Just because you were a size 6 ten years ago, doesn’t mean you are now. As we get older our feet continue to get longer due to lowering arches. The lowering of the arches results in longer and wider feet. Be sure to have your feet measured every time you try on new shoes. Every shoe fits differently There are thousands of shoe manufacturers out there today and there is no standardized fitting system. For this reason, two shoes that are both a size 8 could fit very differently from one brand to another. Keep in mind that there are many brands today that have both length and width sizing available. If you have a wider foot, it is better to find a shoe in a wider width than it is to get a longer shoe. The rule of thumb, literally, is to have approximately a thumb’s width between your toes and the end of the shoe when you are standing. Hard to fit feet? Seek advice. If the structure of your foot makes it difficult for you to find proper footwear, you should get advice from a professional who can recommend brands and styles that may work better for you. A certified pedorthist can make recommendations based on foot mechanics and structure. Shopping at independent shoe retailers rather than large chains is often better as they tend to focus on fit and selection. A good shoe retailer will take the time to measure your feet, help select the best shoe for your foot type/activity, and ensure the proper fit. To schedule an appointment, contact a pt Health clinic near you or book an appointment online. This blog originally appeared on Lifemark.ca. [...]
Cooldown movements for post-cycling blissCooldown movements for post-cycling bliss
August 22, 2024PhysiotherapyNote: The exercises and/or stretches in this blog are not intended to replace the advice of your clinician. Starting a new exercise, stretch, movement, or activity may result in some expected stiffness and soreness. If you are unsure, please speak to your clinician before attempting any of the suggestions below.    Cycling is a wonderful form of exercise as well as a means of transportation. The fun of generating your own power on two wheels, exploring, going fast or slow, long distances or short, leaving the car behind for an errand, or cycling just for exercise, the benefits are many!  Bicycles are built differently for purpose and cost.  There are bikes that are more upright, allowing a better view of the surrounding area and offer perhaps a bit more comfort and stability.  For long distances, you will see cyclists on drop bars, bent over for less wind resistance and more power.    Whichever style of bike you are on, you are in a similar position of bent hips, weight on the arms, a flexed spine, arms forward and palms down, and extended neck position. A person who is in an aerodynamic position on a road bike may look uncomfortable, but those who are used to long-distance cycling can ride many hours this way. Alternatively, a period of time on an upright bike may cause you to feel a bit sore and tight afterwards.   How can you reduce soreness after bike riding? Doing movements that are opposite to cycling positions can help the body overcome stiffness. Check out these 6 movements you can use to loosen up your body and reduce discomfort from the stresses of cycling. 1. Lengthen your neck The small muscles at the base of your head and top of the neck are placed in a shortened position while cycling. To restore length and reduce tension in these muscles try the following movement. Stand tall and look straight ahead. Use your hand to guide your head straight backwards. Your chin should tuck in, and your ears should come back over your shoulders as far as comfortable. Keep your eyes level, you should not be looking up or downwards. Hold for 3 seconds and repeat 3- 5 times.  2. Open up and straighten out your arms, chest, and mid-back While cycling the muscles of your chest are in a shortened position, while your upper back is rounded. To reverse this, reach both arms back as if you are getting ready to give someone a big hug. You should feel a gentle pulling in your chest. Hold for 1 to 2 seconds, then bring your arms forward to give yourself a hug. Repeat 3- 5 times.  Next, stand with your back and arms against a wall.  Bring both of your arms up to make the letter W. Pull your forearms back a little further and squeeze your shoulder blades together. Keep your chin tucked in and ears over your shoulders. Then, reach your arms all the way up to the sky as high as you can, lengthening your torso and extending your arms. Hold as high as you can for 3 seconds, then bring your elbows down through the W position, staying tall through your spine. Repeat 3-5 times.  3. Move your low back Often while cycling, the low back is in a rounded position. Counteract this by standing with your palms on the back of your hips. Keeping your eyes straight ahead, lean backwards, arching your low back. Move in and out of this position 5 times.  4. Stretch your hips Hip flexors are in a shortened position while cycling and this can lead to hip stiffness and back pain. To stretch your hip flexors, put one foot up on a bench and lunge forward onto that leg by bending your knee. Hold this position for 30 seconds before returning to a standing position. Repeat this twice for each leg. This will lengthen the hip flexors and calf of the leg on the floor, and the upper hamstrings of the elevated leg.  5. Finish with a cool down walk A cool down walk will continue to help loosen muscles and bring your heart rate down after cycling. Walking 5-10 minutes after cycling while taking deep breaths can be key to helping you feel refreshed while you recover.    Let’s keep you cycling! To learn more about post-cycling exercises, see one of our physiotherapists. Following an assessment, they can help you create a plan that fits your activity and body’s needs so that you can perform your best.  To schedule an appointment, contact a pt Health clinic near you or book an appointment online. This blog originally appeared on Lifemark.ca and was written by Marjolein Groenevelt, Clinic Director, Physiotherapist. [...]