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FAQ's Physiotherapy

Do I need a doctor's referral to attend physiotherapy?

No. Since 1995 physiotherapists were granted direct access. It means that you do not need a doctor's referral to attend physiotherapy. Physiotherapists are highly skilled professionals who have expertise in assessment and treatment of soft tissue injuries and biomechanical dysfunction. If you have a doctor's referral, please bring it with you on your first visit. Some insurance companies may require and doctor's referral.

Does Alberta Health Care cover physiotherapy?

No, it is Alberta Health Services Community Rehabilitation Program that may cover up to three visits of physiotherapy. The rules are constantly evolving so please check with us for the current status.

How soon after an injury should I start physiotherapy?

Research has shown that early intervention means quicker recovery. We can help you through all stages of healing. Prompt and proper care means optimum recovery in a shorter amount of time.

Is there a wait list to get an appointment?

Since our inception, we have a motto of providing prompt professional care. For MVA (Motor Vehicle Accidents) and WCB (Work related injuries) there is no waiting list. However due to limited Alberta Health Services funding, there can be a short waiting periods for Government funded physiotherapy.

How long will my first appointment take?

We suggest to allow at least one hour for the first visit. It is also recommended to come at least ten minutes prior to your appointment time. This allows you time to complete medical history forms and other necessary paper work.

What should I expect during my first appointment?

First, the receptionist will explain the registration process. You will complete a medical history form and other forms to release your information to the necessary authorities. Eg. Your doctor, Alberta Health Services etc. Your physiotherapist will do an in depth medical history and examination. He/she will explain the findings of your examination. He/she will explain to you, your role in recovery and the things you should do or things to avoid. Remember, you are an active partner in your recovery. When applicable your therapist may give you treatment and a home exercise program as well.

What should I bring with me?

Please bring your Alberta Health Care card with you. If you are a WCB or MVA (motor vehicle accident) injury client, please bring your claim number, your adjuster's name and phone number, your MVA insurance company and/or your employer's information. You may want to bring loose fitting clothes so that we can examine your affected area properly. Should you need shorts or a gown, we will be happy to provide you.

Should I bring someone with me?

It is up to you. If you have restricted mobility or communication difficulty, we highly recommend you to bring someone with you to help you. If you are under 16, your parent's/guardian need to come to sign the necessary papers. If you need or feel comfortable with someone's presence, please feel free to do so.

How many visits will I need?

That will depend on the type and severity of your injury, as well as if it is acute or chronic condition. Everyone heals at a different rate. For example younger people heal much faster. On average people may require 6 to 8 sessions. However, many WCB and MVA client's may need more sessions.

Do you have a child care facility available?

In our building, there is A and D Daycare. You may contact them directly for child care. We also have a child friendly environment. We have some children's toys and books on site.

Can you please explain about my funding options?

Physiotherapy treatment may be covered by your MVA insurance company in the event you are involved in a motor vehicle accident. This is applicable if you attend physiotherapy within 90 days from the date of your accident and have filled out and submitted your AB-1 form within 10 days from the date of your accident. If your injury occurred at work, WCB will cover the cost of your physiotherapy treatment once your claim is approved. If you are covered under RCMP, DVA or Alberta School Employee Benefit Plan, physiotherapy treatment will be covered. Many people have group plans through work, which may cover physiotherapy. Alberta Health Services can cover up to 3 visits per year. For people who underwent surgery or suffered a fracture Alberta Health Services may cover up to 4 more additional visits. People with low income, or who have coverage under AISH (Assured Income for Severely Handicapped) may get an additional 4 treatments covered as well. Please call us and we will be happy to answer your questions.

FAQ:  Frequently Asked Questions about Massage Therapy

What kind of conditions and injuries does massage therapy treat?

Massage Therapy can be used for a wide variety of illness and injuries. In general whenever there is any issue with pain, muscle spasm, stiffness or stress, massage therapy can be used.

 What can I expect when I go for a massage appointment?

On your first visit you will complete a confidential health history form. Your therapist will assess and create a treatment plan for you. At this time it is important to inform your therapist if you have any medical conditions or are taking any medications. To fully understand your position your Massage Therapist listens to your concerns and your individual needs as well as other factors that may be contributing to your situation. With your health history information your therapist will develop a treatment plan with you so you receive the appropriate treatment that will help you a return, as much as possible, to your normal activities.

Do I have to disclose all my health conditions on the Health History form for my Massage Therapist?

It is best if you can give an accurate picture of your health and injuries on your health history form. This enables your therapist to design the most appropriate and effective treatment for you

Should I eat before I come for a massage?

It is best to not eat for at least 90 minutes before your massage treatment and only a light meal at that time. The body needs time to digest your food. This is the same caution you would take when you go swimming or exercising.  The digestion process directs the blood flow away from your peripheral tissues and concentrates it on digestive tract.  Massage draws the blood flow to the area tissues being worked on therefore draws the blood away from the digestive tract causing poor digestion and possible discomfort.

Do Massage Therapists have Cancellation Policies?

Yes. To be fair to your massage therapist and other patients awaiting massage therapy, we have a cancellation policy. If you are unable to make your appointment, please provide us with at least 24 hours notice or as soon as possible. The cancellation fee is posted at the clinic.

Do I need a doctors' referral? 

There is no requirement to have a referral to see a Registered Massage Therapist.  Extended health care plans, and insurers may require a referral before you will be covered. You need to check with your policy to see if you need one to be reimbursed for the treatments.

Does Alberta Health Care cover massage therapy?"

Currently there are no Provincial Health plans that cover Therapeutic Massage but many work place or private Extended Health Care Insurance programs have full or partial coverage.

What if I am uncomfortable with my body? Do I have to undress?

Let your therapist know your comfort level. It is possible to work on a client who is dressed.  Direct skin contact is best with an application of oil or lotion. However your Massage Therapist is required to cover/drape you so only to expose the area which they are working on.  So opting wear your clothes is fine, bring clothes that you can get oil on like a bathing suit or shorts and a tank top.

Does the gender of the massage therapist make a difference?

This is an issue of personal preference. Massage therapists are professionals who provide professional service just like medical doctor or nurses.

I bruise easily, can I still get a massage?

It is important to let your massage therapist know (this will be one of the questions on the health history form you will be asked to fill out on your first visit). Massage therapy is not recommended for people who suffer from haemophilia.

Am I expected to talk during the massage?

If you wish to have silence, you should say so at the beginning of the treatment. The therapist may, however, require verbal information pertinent to health findings during the treatment.

After my appointment, is there anything I need to have on hand or anything specific I should do?

Plan for 30 minutes of quiet time right after your treatment. An Epsom salt bath is recommended to soothe and to calm muscles, and enhance the benefits of the massage. It will help alleviate stiffness you may feel the next day, and it is also recommended for use after workouts for the same reason.  Make sure to drink water to keep your tissues hydrated.

Are there any ailments or conditions Massage Therapy is not a recommended treatment?

Yes, you can ask your massage therapist if you have any questions. At the initial assessment, your massage therapist will discuss with you any contra indications or cautions.

How often should I have massage treatments?

A mutual consultation with your Massage Therapist can help you establish a treatment program which fits your lifestyle and physical requirements. Your massage therapist is on your team and is involved with your repair, rejuvenation and in the maintenance of your health. Your choice of RMT assures you that your recommendation for further treatment is being made by a qualified health professional and is made with your preeminent care in mind.

Is one massage therapy treatment enough?

Yes, if you just want to experience massage therapy to relax. However, to have a longer term therapeutic affect one treatment may not be enough.

Take note: massage therapy is most beneficial in both acute and chronic conditions, when used over a series of treatments and then followed up with maintenance or preventive treatments. (Acute conditions are recent, occurring within a week to a month, and can be severe to mild but are sudden in onset. This could describe anything from car accident to a muscular sprain. Chronic conditions are present for several months or years.)

FAQs Acupuncture

What is acupuncture?

Acupuncture is an ancient form of Chinese medicine involving the insertion of solid filiform acupuncture needles into the skin at specific points on the body to achieve a therapeutic effect. No drug is injected. The needles alone create the beneficial effects of acupuncture.

Acupuncture is used to encourage natural healing, improve mood and energy, reduce or relieve pain and improve function of affected areas of the body. It is safe and effective and is often successfully used as an alternative to medications or even surgery. Relief is often obtained with acupuncture when traditional medical therapy has failed.

Acupuncture points (also referred to as "acupoints‟) are places on the skin that have a lower resistance to the passage of electricity than the surrounding skin and are part of a network of points that were mapped centuries ago by the Chinese. Most are found along "meridians‟ or "channels‟ that are believed to be the pathways by which energy or Qi (pronounced "Chee‟) flows through the body. Acupoints are located either by identifying anatomical landmarks or by the classical method (for example: "the point where the middle finger touches the thigh when standing at attention").

A dull, heavy, or aching feeling often occurs when the needle is correctly placed. This is referred to as "de Qi‟ and is considered by some traditional acupuncturists to be necessary for acupuncture to be effective. The experience of AFCI is that relief of pain can often be obtained without provoking the de Qi response. Recent fMRI studies indicate that there is a difference in the response of the brain to needling with and without the de Qi sensation1.

The needles are left in place for 15-30 minutes, and the practitioner may manipulate the needles to strengthen or reduce the flow of Qi. Lifting, twisting, and rotating are some of the needling techniques a practitioner may use.

Question- How does acupuncture work?

Traditional Concepts
Traditional Chinese Medicine is, fortunately, not based on science. It is based on a paradigm of balance in nature, a concept that has existed for millennia, originating in Taoism. The heart of the paradigm is the belief that there exists in nature and in the human body, energy, referred to as Qi (pronounced "chee‟). In order to be healthy one must have sufficient Qi, it must be balanced and it must be free-flowing within the body in a pattern that is specific to the Qi related to each of several identified organs. Blood and body fluids ground and nourish Qi to create balance so Qi can move freely in the meridians.

Traditionally, acupuncture‟s effects are explained by how it influences Qi. Qi is believed to flow through "meridians‟ or "channels‟ along with blood and body fluids. These meridians make up a conceptual network of pathways through the entire body. The word "meridian‟ comes from the French translation of the Chinese term jing-luo, which means "to go through" and "something that connects or attaches". According to TCM theory, Qi forms at conception and is maintained throughout life by the intake of food, water and air. Everything in nature is classified as being either yin (cold, female, dark, inside, etc) or yang (hot, male, light, outside. etc). Under healthy circumstances, the body maintains a state of balance (i.e. between yin and yang) when Qi is moving smoothly through the meridians.

If there is an imbalance in yin and yang or if the movement of Qi is deficient, obstructed, moving in the wrong direction, or in excess, the body may be in a diseased state or more susceptible to illness. In traditional approaches, acupuncture is used to stimulate points either along meridians or points that lie outside these pathways that may connect two meridians, to correct the imbalance. A traditional acupuncturist will diagnose and treat the "root‟ and "branches‟ or the underlying imbalance and symptoms of the disease or disorder. In this way, traditional acupuncture treats not only the symptoms, but addresses the root cause of the underlying problem and may also prevent further illness. For more detailed information on traditional acupuncture from a traditional Chinese Medicine perspective, please see the Traditional Chinese Medicine therapy review on CAMline. http://www.camline.ca

The reason for stating at the outset that it is fortunate that TCM is not based on science is to acknowledge its value in solving health-related problems that confound modern medicine. Often modern medical knowledge with its emphasis on studying the minute details about a condition misses the big picture one sees when symptoms are viewed through the eyes of an individual with training in TCM concepts. Using that knowledge often leads to a successful outcome for an ill person that was impossible with western medicine

Is acupuncture safe?

Acupuncture is a safe technique, provided that practitioners are properly trained and follow appropriate techniques. AFCI-trained practitioners of acupuncture use single-use, sterile disposable needles and have been trained regarding precautions and contraindications to acupuncture.

It is important to notify the practitioner if you are pregnant or could possibly be pregnant, as acupuncture treatment may have to be modified or may not be appropriate.

How does acupuncture work?

Acupuncture is the stimulation, by insertion of needles, of specific points on the body which have the ability to alter various biochemical and physiological conditions. Acupuncture stimulates the release of endorphins, which are the body‟s natural pain-relieving neuro transmitter chemicals. Acupuncture affects the functioning of the hormonal system, promotes a decrease in inflammation, increased circulation and relief from pain.

How many sessions of treatment will I need?

Many people see a significant difference within one to two treatments but some take longer to respond, perhaps 5 or 6 sessions, depending on the condition being treated. If no difference is felt by the end of the fifth or sixth treatment, the diagnosis of the condition should be reconsidered and further medical investigations may be needed.

Chronic conditions may need repeat maintenance treatments to maintain the momentum after an initial period of frequent treatments. Post treatment exercise and discipline in diet is extremely important for continued improvement and recovery.

Generally treatments every second day (Mon, Wed and Fri) would be considered frequent treatment. Maintenance treatments could range from weekly to monthly or when symptoms begin to recur.

What conditions can be helped with acupuncture?

There have been many studies on the usefulness and efficacy of acupuncture in the scientific literature. Study design and size have sometimes resulted in complexities in the measurement of outcomes with treatment, however promising results with acupuncture treatment have been shown in the treatment of many conditions.

Acupuncture is used to treat a vast number of painful conditions such as sciatica, low back pain, sprains and strains, whiplash, headaches, as well as neurological, and other medical conditions or problems.

Post-operative and chemotherapy-related nausea can also be helped with acupuncture.

Recent studies have shown that acupuncture provides pain relief, and improves function for people with osteoarthritis of the knee and is an effective complement to standard care.

Other conditions which may be helped with acupuncture include: (This list is by no means a complete list of conditions which can be helped with acupuncture)

Ear, Eye, Nose and Throat Disorders:

Sinusitis

Hay fever

Dizziness



Gastrointestinal Disorders:

Irritable Bowel Syndrome

Colitis

Constipation

Diarrhea

Abdominal bloating



Gynecological/ Genitourinary

PMS

Menstrual problems

Prostatitis



Neurological Disorders:

Multiple Sclerosis

Neuralgias

Cerebral Palsy

Stroke



Respiratory Disorders

Asthma

Brochitis

Colds and Flus

For more detailed information go to About Acupuncture/Conditions it Can Help.

Is acupuncture painful? What does it feel like?

Acupuncture is usually a comfortable treatment. Needles are very fine, metallic and as thin as a hair, making them quite painless upon insertion. Everyone experiences acupuncture differently, but most feel no pain or very minimal pain as the needles are inserted. You may experience a mild aching sensation or warmth around the needle site.

How much exercise should I do?

Exercise helps to improve blood circulation and recovery from illness depends on a good supply of nutrients and oxygen. Exercise as frequently as possible but never to the point of exhaustion. Rest between exercises and replenish the body with nutritious food and drinks.

What activities are to be avoided after acupuncture treatment?

Strenuous physical activities including vigorous exercise should be avoided for at least 2 hours after treatment.

A good feeling after acupuncture must not be taken as full recovery and patients must avoid over-engaging in any activities they were unable to perform previously due to their condition until they regain their strength and stamina.

What should I do before and after an acupuncture treatment?

You should make sure that you have eaten a light meal prior to having acupuncture. You should avoid consuming caffeine or nicotine for 90 minutes before and after treatment. Continue with all medications as prescribed.

Is acupuncture covered by insurance?

Many insurance plans offer coverage for acupuncture treatment. To find out if your plan covers acupuncture, and any limits to the number of treatments covered, you should contact your insurance company directly. Acupuncture may also be covered if you sustained a workplace injury or were injured in a motor vehicle accident.

FAQs IMS

What is IMS?

Intrasmuscular Stimulation (IMS) is a total system for the diagnosis and treatment of myofascial pain syndromes (chronic pain conditions that occur in the musculoskeletal system when there is no obvious sign of injury or inflammation).  IMS is grounded in Western Medical Science, and has a solid foundation in its radiculopathic model of pain, which is now supported by many experts in the field.  It was developed by Dr. Gunn while he was a physician at the Worker's Compensation Board of British Columbia in the 70's, where he investigated the large number of mysteriously stubborn cases after frustration with the ineffective modalities at his disposal. The treatment, which utilizes acupuncture needles because they are the thinnest implements available that are designed to penetrate deep within muscle tissue, specifically targets injured muscles that have contracted and become shortened from distress. .

IMS relies heavily on a thorough physical examination of the patient by a competent practitioner, trained to recognize the physical signs of neuropathic pain.  This physical examination is indispensable since chronic pain is often neurological as opposed to structural, and therefore, invisible to expensive X-rays, MRI Tests, Bone and CT Scans. Failure to recognize these signs will result in an inaccurate diagnosis, and thus, a poor starting point for physical therapy.

The treatment involves dry needling of affected areas of the body without injecting any substance.  The needle sites can be at the epicenter of taut, tender muscle bands, or they can be near the spine where the nerve root may have become irritated and supersensitive.  Penetration of a normal muscle is painless; however, a shortened, supersensitive muscle will 'grasp' the needle in what can be described as a cramping sensation.  The result is threefold.  One, a stretch receptor in the muscle is stimulated, producing a reflex relaxation (lengthening).  Two, the needle also causes a small injury that draws blood to the area, initiating the natural healing process.  Three, the treatment creates an electrical potential in the muscle to make the nerve function normally again.  The needle used in IMS, by stimulating muscle spindles, essentially becomes a specific and unique tool for the diagnosis of Neuropathic Muscle Pain.

The goal of treatment is to release muscle shortening, which presses on and irritates the nerve.  Supersensitive areas can be desensitized, and the persistent pull of shortened muscles can be released.  IMS is very effective for releasing shortened muscles under contracture, thereby causing mechanical pain from muscle pull.  IMS, in effect, treats the underlying neuropathic condition that causes the pain.  When competently performed, IMS has a remarkable success rate, as proven by the alleviation of symptoms and signs, even for chronic back pain with root signs.

IMS is comparable in some ways to acupuncture; however, there are a number of important differences. IMS requires a medical examination and diagnosis by a practitioner knowledgable in anatomy, needles insertions are indicated by physical signs and not according to predefined, non-scientific meridians, while subjective and objective effects are usually experienced immediately.

Information supplied by istop. For more information, please visit www.istop.org

Who may treat patient with IMS?

Only physicians and physiotherapists who have attended an GunnIMS course, are allowed to treat patients with IMS. 

I have been in many clinics to treat my back and leg.  I have had many medical investigations including X-rays.  I have tried physiotherapy, manipulations, and pills without any lasting relief.  My doctors tell me they have found nothing wrong, but why are my 'aches and pains' still with me and so difficult to treat?  Is surgery necessary?  

Pain is not one entity but three.  Type One is well known and easily understood. There is an obvious painful cause from injury. Think of a burn on the skin, or a cut from a knife. Type Two pain is the pain of inflammation, such as a sprained ankle when there is obvious swelling, redness, and the ankle is hot to touch.  These two types of pain and their treatment are well understood by the medical profession.

Since an obvious cause of pain from injury or inflammation has not been found, it is very likely that there is no actual source of pain.  This is not unusual; the pain you feel is caused by abnormal and excessive sensitivity of your body's nervous system.  This is medically known as 'supersensitivity.'  Unfortunately, supersensitivity has received little attention in medical circles.  Since there is no pain source, surgery will not help, and is definitely not indicated.  .

If my pain is Type Three, what makes my nerves supersensitive? 

The basic problem is that the nerves going to your painful area are unwell.  Doctors call it neuropathy.  Unwell nerves behave abnormally - they are too sensitive; they tend to magnify ordinary inputs, and change them into painful sensations.  Supersensitivity usually occurs when there is some irritation to the nerve roots that come from your spinal cord.  Probably your nerves were already weakened (through wear and tear, or aging), and only a minor accident can trigger them into supersensitivity.

How can my supersensitive nerves be treated?

Supersensitivity cannot be operated on and "cut away," but it can be desensitized. "Pain killers" and other pills only mask pain briefly.  What your nerves need is energy to heal themselves.  That is why we instinctively massage a painful part to provide mechanical energy and to revitalize it.  Heat - or thermal energy - is another commonly used form of treatment.  In fact, all effective treatments for Type Three pain are different forms of energy.

But I've tried massage and heat.  They only give me temporary relief.  Why?

All types of local treatment have their limitations.  They cannot penetrate deeply into the body, and the duration of their energy input is temporary.  For instance, the energy of a massage does not last much longer than the massage itself.  That is why I prefer to use a needle treatment that is a modification of traditional acupuncture.  A needle causes a minute local injury, and the injury does two important things.  Firstly, the injury generates electrical energy (as proven by Galvani over 300 years ago), and muscle spasm is released.  The injury also releases fresh blood into the painful site and blood platelets have a healing effect.  The needle's main purpose is not to block pain (although it does this too), but to stimulate the body to heal itself.  It's as close to a "cure" as you can get.

I've heard of acupuncture and that it can help pain.  How is IMS different?

Acupuncture is an ancient philosophy, and its diagnosis and practice in Traditional Chinese or Oriental Medicine are not based on modern science.  What was a great approach four thousand years ago can be improved with today's medical knowledge. Intramuscular Stimulation or IMS relies on neurology and a Western understanding of anatomy for diagnosis and treatment.

Why did some of my friends, who have had acupuncture, not feel the cramping sensation? 

Many doctors perform traditional acupuncture by inserting needles into locations according to acupuncture "maps."  They are not seeking the epicenter of the painful muscle.  Sometimes they may add electrical stimulation to the inserted needles.  This type of acupuncture is not so painful, but the results are unlikely to be as good as IMS.

How long will the benefits last?

The effects of IMS are cumulative.  Each needle injury stimulates a certain amount of healing until, eventually, the condition is healed, and the pain disappears. Blood also brings a healing factor known as the Platelet Derived Growth Factor to injured tissues. IMS is like pruning a plant: you produce small injuries to stimulate new growth to replace injured tissues, but once healing has occurred, you are back to where you were before the pain occurred.

How often are treatments necessary?

Treatments are usually once a week because time is needed between treatments for the body to heal itself.  Also, stimulation for healing remains for several days, lasting for as long as the injuries caused by the needle are present.  Treatment can be spaced out over two weeks.

How many treatments will I need?

The number of treatments required depends on several factors: your general health, the duration and extent of your condition, how much scar tissue there is (previous surgery is bad news), and how quickly your body can heal.  The rate of healing also depends on the condition of your nerves; young people usually heal quicker, but older is not necessarily slower.  If the pain is of recent origin, one treatment may be all that is necessary.  In published study of patients with low back pain, the average number of treatments required was 8.2.

Does IMS always succeed?

There is no absolute guarantee, but if the diagnosis of nerve supersensitivity pain is correct, and the part of the body requiring treatment is capable of healing, then the probability of healing should be the same as that for a cut on your finger.  Treatment fails if the diagnosis is wrong, or if the treatment is improperly applied.  For more information, please visit www.istop.org , the official site of GunnIMS

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