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Tuesday 11am - 7pm Thursday 11am - 7pm Friday 3pm - 6pm

Dr. Sundeep Sandher, 1332 Khalsa Drive, Mississauga, ON (2026)

03/03/2022

Spinal Adjustment Thoracic Spine

😩Mid back pain is a very common patient complaint, that can stem from several issues like lack of movement and prolonged postures.

👐🏽A mid back adjustment can help temporary alleviate the pain by

👉🏽Reducing muscle tension and tone

👉🏽Desensitizing the nervous system

👉🏽Leading to improved mobility.

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03/01/2022

🤚🏾Mobilizations

👉🏽Joint mobilizations are an effective manual therapy technique used by practitioners to help restore motion into the joint, function, and reduce pain.

👐🏽It is done by applying passive movement to the joint with varying degrees of amplitude.

💆🏽‍♂️This helps create a gliding or traction of the joint which is therapeutic.

⚡️An important manual therapy tool that helps improve ranges of motion.

⚡️It can be done on facial, extremity and spinal joints.

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02/23/2022

What do Chiropractors do?

💪🏽Chiropractors don’t just do adjustments as social media shows.

🙌🏽Chiropractors provide a hands-on approach after completing a thorough exam, using various treatments depending on your needs from soft tissue therapy to adjustment techniques to help you feel better and moving pain free.

👊🏽We use a variety of tools from mobilizations, adjustments, stretching, exercises and much more, that helps you get moving better.

🔹Chiropractors don’t just treat the back.

🤕Chiropractors treat anyone from children to seniors to pregnant women, and athletes, dealing with issues stemming your muscles, tendons, ligaments, joints and nerves.

🔸Our next series of posts will go through some of the tools we use!

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Source: Canadian Chiropractic Association

02/19/2022

Midfoot Sprain injury 🚨

🔹AD rolled his ankle in the game against Utah this week and we had suspected it would be a inversion sprain.

🔸MRI confirmed it to be a mid foot sprain.

🔹Mid foot region is the middle region of the foot, and it forms the arch of the foot.

🔺This area is defined as the Lisfranc joint complex. There are cluster of bones an ligaments in this area. If there is significant ligament damage that can further increase the recovery timeline for AD.

🔻The average game time loss from a mid foot sprain is 12 games , and approximately 28 days.

↪️The mid foot has minimal motion and is critical in stabilizing the arch for push off during walking.

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02/17/2022

MCL Injury for Joe Burrow 🚨

🥶Joe Burrow is currently being evaluated after suffering a knee injury in the Super Bowl. Important to remember this is the right knee, and he had suffered an ACL tear in his left knee.

🦵🏼MCL injury commonly results from lateral trauma to the knee, resulting in a valgus stress. This causes the knee to bend in as it did for Burrow in the game. MCL is the prime static stabilizer of the medial/inside side of the knee joint.

🦿The patient is initially placed in a brace to help the ligament reduce stress and improve the healing process for the first 1-2 week intervals. The patient also commences rehabilitation to help strengthen the knee joint and surrounding knee structures.

🏈In football players, the return to play time for grade 1 and 2 injuries of the MCL is an average time of 20 days.

1️⃣In grade 1 injuries, it may average 10-11 days post injury, and 20 days for grade 2 injuries.

3️⃣Grade 3 injuries which are complete tears are more complicated and often co-exist with other ligament or meniscus injuries.

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02/14/2022

ACL injuries occur 70% of the time as a non contact injury.

As seen in the video, Odell attempts to catch the ball and as he begins to turn his knee on the left side buckles.

Odell injured the same side in October 2020 while playing for the Browns.

Recall, statistics indicate only 65% of athletes return to playing their sport at their pre-injury level, as Odell did.

Also, returning to cutting sports increases the athletes odds of injury to the same knee by 3.9x.

At this time it is feared by the Rams training staff, that Odell suffered an ACL injury, here’s hoping to a speedy recovery to the newly minted Super Bowl champion.

02/18/2021

🚨Joe Thornton Rib Fracture

🔹Joe Thornton left in 3rd period in a game against the Edmonton Oilers, after taking an awkward hit along the boards on Jan 21. It was revealed the next day the veteran forward would be out for 4 weeks with a rib fracture.

🔹Joe returned to the line up on Feb 15, and had a goal and assist in his return, showing he recovered really well from his rib fracture.

👉🏽A rib fracture can occur like in this case from direct trauma to the chest, and causing a break of the bone.

🚨Symptoms: painful with touch, deep breathing, sneezing, coughing.

🔹Patients tend to splint when they breathe, taking shallow breathes reduces movement of the rib cage.

🚑Diagnosis: chest x-ray is utilized to diagnose a rib fracture.

❌Need to rule out: internal bleeding + bruising, collapse of the lung (pneumothorax), and a flail chest which occurs with 2 or more consecutive ribs being broken in at least 2 places.

🩹Treatment: reducing pain with medication, controlled breathing exercises, and therapy (laser therapy, soft tissue release, spinal mobilizations, stretching and exercise).

☺️Prognosis: rib fractures can heal from 4-6 weeks without any further complications

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Source:Baiu I, Spain D. Rib Fractures. JAMA. 2019;321(18):1836. doi:10.1001/jama.2019.2313

02/16/2021

🔵Neymar Adductor Strain

🔹Neymar limped off injured in PSG last game against Caen in the round of 64 French Cup with an adductor strain after sprinting for a loose ball. His team was set to begin their clash with Barcelona for the first leg in the Champions League round of 16 the following game, a big blow the French league champions.

🔹The adductors of the hip joint include 6 muscles: the adductor longus, magnus, and brevis and the gracilis, obturator externus, and pectineus.

👉🏽It is a common injury to occur in soccer and hockey due to the requirement of using the hips to adduct and push off in the opposite direction. Thus, it is important for these group of athletes to focus on hip adduction strength.

👇🏽Lets look into the stats bit more in detail :

👊🏽Tyler et al found that preseason hip adduction strength was 18% lower in NHL players who subsequently sustained groin strains, compared with the uninjured players. The hip adduction:abduction strength ratio was also significantly different between the 2 groups.

👊🏽Arnason et al also found the importance of soccer players who had increased incidence of adductor strains had decreased range of motion in abduction, and history of adductor strains.

👊🏽Hagglund et al found players who sustained a previous hamstring, groin, or knee injury were 2 to 3 times more likely to incur a recurrence in the following season.

👊🏽Tyler et al also found out that placing players on an adductor strain strengthening program can help reduce the risk of injury drastically.

🔹Strengthening program example by Tyler et al:
bicycling/swimming, stretching adductors and hip musculature
sumo squats, side lunges, ball squeezes between the legs, and bilateral adduction on sliding board

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Source:Tyler TF, Silvers HJ, Gerhardt MB, Nicholas SJ. Groin injuries in sports medicine. Sports Health. 2010;2(3):231-236. doi:10.1177/1941738110366820

02/15/2021

🔵Kevin Durant Hamstring Injury

🔹KD made his long awaited return to the Bay Area on Saturday, and helped his team to a victory on Saturday. The next day the team disclosed he will be out for the next 2 games with a mild hamstring strain.

🔹KD has been on outstanding this year, returning after a horrific achilles rupture in the 2019 NBA Finals, he has been averaging 29 pts, 7.3 rebounds, and 5.3 assists.

🔹Hamstring injury commonly occurs during running. The hamstring muscle group consists of the semimembranosus, semitendinosus, and biceps femoris muscles, with the biceps femoris long head being injured most often in high-speed running.

🔹Hamstring strain injuries are also classified according to the amount of pain, weakness, and loss of motion. The grading system is used to identify the type of strain: grade 1 mild, grade 2 moderate, grade 3 severe.

🔹In the case of KD, it is being reported to be a grade 1 strain of the muscle. The biggest concern with this type of injury is to avoid re-aggravation and reinjury of the tissue.

🔥3 phase approach to rehabilitation for hamstring strain for KD
1️⃣Reducing swelling and pain, complete low intensity exercises (stationary biking, single leg balance drills , lateral lunges, side body
2️⃣Eccentric actions of the hamstring muscle, running at 50% maximum speed
3️⃣Sport specific movements and agility drills

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Source:Heiderscheit BC, Sherry MA, Silder A, Chumanov ES, Thelen DG. Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. J Orthop Sports Phys Ther. 2010;40(2):67-81. doi:10.2519/jospt.2010.3047

02/13/2021

🔵Wayne Simmonds Broken Wrist Anatomy

🔹Wayne Simmonds broke his wrist against the Vancouver Canucks during a play which the defensemen was passing out the puck from his blue line, the pass unfortunately made contact with Simmonds wrist resulting in him suffering a fracture in his wrist.

🔥Simmonds was on an absolute tear and seemed to be the right piece to the puzzle. It has been reported that he will now will be out 6 weeks due to this injury.

🔹In terms of the anatomy, the bone structures are the radius which is the bone going towards the thumb, and the ulna which is the bone going along the pinky. It is thought in terms of the region where the puck may have hit him, he may have suffered a fractured ulna. This would require him to be in a cast for 6 weeks to allow the bone to heal.

🔹Additonally, there are 8 carpal bones which meet with the radius and ulna. These bones are situated in 2 rows of 4 bones. These bones are important for the controlled rotational movement the wrist can do.

🔹Simmonds will have to go through extensive rehabilitation after the cast removal to maintain strength into his forearm musculature and to have the ability to shoot.

👌🏽Important rehab exercises
👏🏼Controlled wrist movements in all directions
👏🏼Wrist curls in flexion and extension (light weight to begin)
👏🏼Grip strength exercises using a stress ball/ gripper
👏🏼Wrist movements and snatching into a rice bucket

02/11/2021

🔵What is a turf toe injury and why is Mahomes getting surgery?

🔹Turf toe is an injury that occurs to the big toe, and it typically occurs in football, when the player places their weight/load on to the foot causing hyper extension of the big toe. This then causes increased load on the ligament structures of the big toe, which can cause separation or a complete tear. It is an important injury to take care of because all our loading, running /walking/ sprinting mechanics and movement is dictated using the big toe for lift off.

🔹In this case, Mahomes suffered a grade 3 tear which requires surgery, and a recovery time of 10-16 weeks before he begins to ramp up his off season training. He will be in a long term immobilization boot or cast post surgery.

🔹A grade 2 partial tear requires 2 weeks of recovery and a walking boot and crutches are used to take the load off the big toe.

🔹A grade 1 injury is stretching of the structures causing acute pain into the area, the athlete can use a stiff soles shoes with a toe plate insert (or custom orthotics) to help reduce pain and limit motion in the big toe. This is what Mahomes had used in the Super Bowl to help reduce pain during play.

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Source:McCormick JJ, Anderson RB. Turf toe: anatomy, diagnosis, and treatment. Sports Health. 2010;2(6):487-494. doi:10.1177/1941738110386681

Dr. Sundeep Sandher

03/03/2022

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