Physiotherapist helping man to balance

What is Vestibular Rehabilitation Therapy?

Feeling Dizzy? That’s your Vestibular System at work!

Although we all rely on it extensively, most people have never heard of the vestibular system..

The Vestibular system

In simple words, the vestibular system is a sensory system. It consists of the inner ear organ that detects motion and the parts of the brain that process this information. In addition, this system plays a role in motor activities such as balance, head and body stabilization during movement, and maintaining our posture. As a result, the vestibular system is crucial for proper movement and balance and to see clearly when the head is in motion.

Vestibular disorders

Man suffering with vestibular disorder

The vestibular system consists of parts of the inner ear and the brain components that interpret sensory information for balance and eye movement control. If these processing parts get damaged by disease or an injury, dizziness and balance problems might occur.

Vestibular disorders can also be caused by or made worse by genetic or environmental factors, or they might happen for no apparent reason.

Common Vestibular Disorders include:

  • Vestibular Migraine
  • Benign Paroxysmal Positional Vertigo (BPPV)
  • Mal de Debarquement (MDD)
  • Labyrinthitis or vestibular neuritis
  • Cervicogenic Dizziness
  • Recurrent Vestibulopathy
  • Unilateral Vestibular Hypofunction (UVH)
  • Head injury concussion or TBI
  • Persistent Postural Perceptual Dizziness (PPPD)
  • Post Concussion Syndrome (PCS)
  • Age-related dizziness and imbalance

The best way to resolve issues with the vestibular system is through Vestibular Rehabilitation.

Vestibular Rehab Therapy

When the vestibular system is injured, the brain can compensate for the loss of inner ear function. It learns to depend on alternate signals from other systems in the body to cope with the disorienting signals coming from the vestibular system. This can be achieved through Vestibular rehabilitation therapy.

Vestibular rehabilitation therapy (VRT) is a research-based therapy that uses customized approaches to help the brain adjust for vestibular system abnormalities. It is an exercise-based programme to reduce visual disturbance, vertigo and dizziness, imbalance, and falls.

There are many possible causes for dizziness, vertigo, and balance issues, and VRT is an effective treatment for many of them. It is a non-invasive and painless solution, as it usually involves a custom exercise program to retrain your body’s balance systems.

VRT can treat dizziness and balance issues caused by:

  • Ageing
  • Neck dysfunction
  • Head injury
  • Central nervous system issues
  • Neuropathy (numbness in feet)
  • Vestibular hypofunction or loss
  • Benign Paroxysmal Positional Vertigo (BPPV)

A physiotherapist creates a treatment plan for vestibular rehabilitation therapy. It includes balance training exercises, gait training, head movement sequences, gaze stabilization exercises, functional training, and more.

Physiotherapist helping man to balance

Otoconia or Bio-crystals, which are a natural element of your balancing system, can sometimes create balance issues. For example, these crystals might throw off your balance if they land in the incorrect part of your inner ear. A physiotherapist can help you dislodge the crystals by guiding you through head movement sequences.

A complete vestibular rehabilitation examination is lengthy. You can expect the following at your visit to the physiotherapist:

  • A discussion of the history and nature of your symptoms.
  • Checking for more severe reasons of vertigo or unsteadiness
  • Balance assessment (both stationary and moving)
  • Checking for sensitivity to motion or changes in position
  • Infrared video analysis aids in the evaluation of eye movements
  • Checking for other issues that might be causing problems, such as neck pain or high blood pressure.

Following the evaluation, the healthcare practitioner may recommend several therapies. Eye exercise, sensitivity training, balance challenges, and techniques for dealing with cognitive and psychological effects are a few examples.

Canalith repositioning techniques are most effective in treating Benign Paroxysmal Positional Vertigo (BPPV) (the most frequent cause of vertigo).

Apart from patients suffering from vestibular problems, vestibular rehab can also help patients with orthopedic, sensory, or other brain-related diseases that impair balance.

How long does treatment take?

Some balance issues can be addressed in a single session or only a few days after beginning therapy, while others can take longer. Keep in mind, however, that the longer you wait to seek therapy, the more your brain adapts to the unfavourable changes in your balance. This makes retraining your body much more difficult.

How to get started

Numerous studies have proved VRT to effectively treat symptoms, including unilateral vestibular hypofunction, chronic dizziness, concussion, vestibular migraine, and other vestibular disorders.

With over 20 years of service in helping patients become pain-free, Activa Clinics is dedicated to providing excellence in vestibular rehabilitation. Visit our services page for more information, if you or someone you love is in need of vestibular rehab therapy, and find an Activa Clinics location in Toronto near you!

Doctor examining focus of young female patient

Traumatic Brain Injury and Concussion Rehab

Each year, nearly 150,000 Ontarians suffer a concussion, according to the Ontario Neurotrauma Foundation. However, despite the rising frequency of concussions, only 15% of Canadians can accurately identify the best ways to manage them. In addition, slow-recovering individuals are at risk for secondary concerns such as physical deconditioning and mental health difficulties. A concussion can put your life on a hold.

Infographic on concussion

About concussion

A mild traumatic brain injury is known as a concussion (also known as mild TBI). It occurs when a bump, blow, or jolt to the head or by a hit to the body causes the head and brain to move violently back and forth. The brain might bounce about or twist in the skull due to this rapid movement, causing chemical changes in the brain and, in some cases, straining and destroying brain cells.

Signs and symptoms of a concussion

The following are some of the signs and symptoms of a concussion:

  • headache
  • memory problems
  • double or blurred vision
  • balance problems or trouble walking
  • dizziness
  • nausea or vomiting
  • confusion
  • being slow responding to questions
  • light sensitivity
  • slurred speech
  • drowsiness
  • slowed response to stimuli

Children and concussion

If you’re wondering if children can suffer concussions, then the answer is yes. The majority of concussions in children and teenagers occur when they are participating in sports. Especially, young people playing sports like football, ice hockey, lacrosse, soccer, and field hockey are at the most risk. It can also be caused by accidents involving motor vehicles or bicycles, falls, or a brawl.

A child who has suffered a concussion may show the following symptoms:

  • have issues with memory or learning
  • have a headache that gets worse
  • feel depressed, quickly irritated or enraged, or anxious
  • be unable to concentrate
  • have problem sleeping

Concussion treatment

If you have sustained a concussion, it is essential to rest for the first 24-48 hours after the concussion and limit physical and other activities that require a lot of focus before you can resume participating in these activities. You don’t have to wait until your symptoms are completely gone to start participating in activities. However, if symptoms prevent you, you should stop for a few minutes before participating in an activity and attempt it again after some time or try a less extreme version of the exercise.

Concussion rehab

If your symptoms haven’t improved in 7 days, physical therapy can assist with balance, stability, attention, gait, and mood. In addition, studies suggest that early intervention of various treatments and supervised physical exercise can also help in concussion recovery to enhance brain function, resolve blood flow problems, and heal wounded tissue. So, the goal of your therapy will be to reduce symptoms while also figuring out what’s causing them.

Doctor checking focus of patient

Concussion rehab involves both assessment and treatment of concussion patients. The healthcare practitioners will start by assessing you and your injury and the symptoms. Then they may conduct neurological and cognitive tests to check your vision, memory, concentration, reflexes, and coordination. As concussions do not appear on MRI or CAT scans, a brain scan may not be necessary for mild concussions. But the healthcare practitioner may order those scans to investigate additional issues if someone was knocked unconscious, keeps vomiting, has a severe headache that gets worse, or was wounded in a serious accident.

Based on the tests and diagnostics, the healthcare practitioners will develop a personalized concussion management strategy for you which will include a wide range of therapies and treatments, such as:

Looking forward

If you’ve had a concussion previously, you’re very much likely to have one again. Therefore, you must avoid concussions after a head injury. To prevent another concussion, you need to make sure to decrease the risk of concussion by avoiding sports activities such as tackling or heading the ball in soccer.

In addition, if you’re riding a bike, or involved in any other sports activity, make sure to wear a helmet where possible. So, even if you have a concussion while wearing a helmet, it will protect you from a skull fracture or significant brain harm. A child who has sustained a second concussion should not ignore the symptoms or attempt to wait it out. Instead, they must immediately stop participating in activities or sports and should seek medical attention.

If you or someone you know has suffered a concussion and is looking for a rehabilitation clinic in Toronto, book an appointment now to get evidence-based treatment. At Activa Clinics, our team is up to speed on the most recent concussion research and rehabilitation procedures to provide the finest possible care for concussion and post-concussion syndrome.


What is Osteopathy Treatment

What is Osteopathy Treatment?

Osteopathy treatment is a non-invasive therapy that aims to improve the patient’s overall health instead of treating a specific illness or group of symptoms. This is because symptoms occurring in one area of your body can be linked to a problem occurring elsewhere. It is based on the principle that your physical and mental well-being relies on your nervous, circulatory, and lymphatic systems working well together.

Osteopaths use manual therapy such as massaging, stretching, and manipulating the musculoskeletal system to diagnose, treat, and prevent injury or illness. It can also be used to complement traditional medicine.


Whether you’re injured, have unexplained pains and stiffness, or suffer from health conditions associated with aging – our osteopaths can help to restore your overall health so you can feel like yourself again.

When it comes to your wellbeing a one-size-fits-all approach will not work. Our osteopaths will assess your condition and provide a personalized treatment plan after determining the health of your joints, ligaments, and tissues. This is often done by examining your body’s structure, mobility, and the areas you are experiencing pain or stiffness.

Osteopathy helps to reduce pain, improve mobility and blood circulation as well as increase lymphatic fluid drainage.

Osteopathy is often used to treat chronic pains (neck, back, and shoulder), headaches, migraines, arthritis, digestive issues, sports injuries, and other musculoskeletal conditions.

 Some other ways Osteopathy can help you improve your health are:

  • Reducing muscle tension
  • Correcting poor posture
  • Relieving stress
  • Promoting better sleep
  • Managing hormonal changes during pregnancy

Most patients start seeing results from our treatment after the first session. However, depending on the severity of your condition, it can take 3 to 4 sessions to feel the benefits of the therapy. Osteopathy treatment isn’t an instant cure but a gradual process where your symptoms are reduced over time until you return to full health.

At Activa Clinics our team of multidisciplinary health care providers collaborate together to provide our patients with the better outcomes through physical care as well as availability of mental health solutions.

Our osteopaths are also trained to check for signs of serious health conditions and will advise you if you need to see your physician.

Some work place health plans cover Osteopathic treatment. Call us to book your appointment.

Wall squat for Knee Strength

Knee strengthening exercises

If you’ve suffered a knee injury, or are just trying to prevent one before it happens, knee strengthening exercises can help.

By strengthening the muscles around your knee, you can ensure the joint is properly supported. This will reduce strain on the joint, which relieves knee pain and lowers your risk for injuries.

Here are some simple exercises knee strengthening exercises that you can use right away:

Hamstring Curls

This exercise strengthens muscles in the back of your thighs and buttocks.

  1. Find a countertop, chair, or another object to hold on to for balance.
  2. Stand with your knees close together, only about 1-2 inches apart.
  3. Slowly bend one knee, lifting your foot behind your body until your shin is parallel with the ground.
  4. Avoid locking your other knee by keeping it slightly bent.
  5. Hold the knee bend for up to 5 seconds.

Seated Leg Raises

This exercise will strengthen the muscles in the front of your thighs.

  1. Sit in a chair and adjust its height or put pillows on the seat until your feet dangle just above the ground.
  2. Hold onto the sides of the chair to stabilize yourself.
  3. Slowly extend one leg until it’s almost parallel to the ground, and try to keep it as straight as possible without locking your knee.
  4. Pause briefly before lowering your leg.

Wall Squats

This exercise strengthens muscles in the front of your thighs and buttocks.

  1. Stand with your back flat against a wall.
  2. While keeping your back and shoulders against the wall. Step your feet forward. about 24 inches away from the wall, no wider than hip-width apart.
  3. By bending your knees slowly, slide your back down the wall, until you are just above normal seated position.
  4. Hold that position for 5 seconds, extend your knees to slide back up the wall.

Step Exercises

This exercise will strengthen muscles in your hips, buttocks, and the front and back of your thighs.

  1. Use an exercise platform or stool that’s no taller than 6 inches.
  2. Step up on the platform with one foot and keep your other foot slightly behind you so it’s hanging in mid-air.
  3. Hold that position for up to five seconds.
  4. Slowly lower the hanging foot back to the floor, and then step off the platform.
    Alternate to the other leg.

Exercising With a Knee Injury

You may find knee injuries make it difficult to get exercise since you rely on your knees whenever you walk, run, jump, or climb. However, there are a few things that can help you be more active despite a knee injury—and can help you heal faster.

One example is physiotherapy. Physiotherapists can analyze your injury and create a personalized exercise plan that will speed your recovery safely. 

Another example is a functional knee brace. These braces can provide some added support and prevent the knee from making unnatural movements while allowing you to be active. That means there’s less risk of aggravating your injury through exercise.

To learn more about how exercise can help with knee injuries and pain, speak with your doctor.


How to Avoid the Most Common Sports Injuries

From Shin Splints to ACL Injuries, Here are Some of The Most Common Sports Injuries and What to Do About Them

When you get injured playing sports, it can be a very discouraging experience. Not only does it sideline you from the game, but it may get in the way of your regular daily activities. If the injury is bad enough, you might be unable to work or even walk until the injury heals.

But you shouldn’t let the possibility of an injury get in the way of staying active. Sports are a great choice when it comes to fitting more physical activity into your life, and can help you stay motivated about improving your fitness.

To help you stay on the field and avoid injuries, let’s go over some of the most common sports injuries, how to spot them, and how to prevent them before they happen.

Common Sports Injuries

Tennis Elbow or Golfer’s Elbow

Both tennis elbow and golfer’s elbow are overuse injuries. They occur when the tendons in your arm get over stressed and tiny tears form in the tissue causing pain, weakness, and stiffness. 

Despite the names of these injuries, they can be caused by any activity that involves repeated use of the arm and wrist. Where they differ is that tennis elbow causes pain on the outside of the elbow, and golfer’s elbow causes pain on the inside of the elbow.

ACL Tear or Strain

The ACL is one of the major ligaments in your knee, and can sometimes get injured by excessive stress such as in sports that involve sudden changes in direction, jumping, and landing.

If you experience an ACL injury, you may hear or feel a “pop” in the knee followed by severe pain, rapid swelling, and loss of range of motion. You may also feel the knee giving way when you try to put weight on it.

Shin Splints

Shin splints are caused by repetitive stress on the connective tissues around your shinbone. It can result when you start playing a new sport, or intensify your training too quickly. This injury causes pain along the shinbone and may cause some mild leg swelling.

Runner’s Knee

Runner’s knee can describe a number of conditions that cause pain around your kneecap. It typically involves irritation of the soft tissues or worn cartilage in the knee. As the name suggests, it is common among runners, but can also be caused by any activity that puts repetitive stress on the knee. 

Hamstring Strain

The hamstring is made up of three muscles behind the knee. Hamstring injuries can range from a mild strain to a complete tear of the muscle. These injuries can be caused by fatigue, lack of a warmup, or improper running technique. It causes sudden pain in the back of the thigh and lower buttock and may cause some bruising.

How to Prevent Injuries

Now that you know some of the basics about what injuries to look out for and how to spot them, here are some tips on how to prevent those injuries before they happen. These preventative measures also apply to many other types of sports injuries.


This is the most important thing you can do to prevent sports injuries. Taking the time to stretch and warm-up before athletics helps prepare your body for the stresses it’s about to face. It increases blood flow to your muscles, loosens your joints, and improves flexibility. In addition to preventing injuries, it can also help with your athletic performance. 

Wear Proper Shoes

Having the right footwear is another important part of preventing injuries. During athletics, your shoes provide cushioning and support that helps you move more efficiently and take some of the stress off your joints.

Ensure you replace your athletic shoes before they get too worn out.

For added support, consider using orthotic inserts or orthotic shoes. They can be custom designed to provide the perfect amount of support and correct imperfections in the way you move. 

Gradually Increase Intensity

Whenever you start playing a new sport or up the intensity of an exercise, it brings some risk of injury. That’s because you put your body under stress that it’s not properly prepared for. 

Take it slow when you’re trying something new. For example, a rule of thumb for distance running is to gradually increase your distance by no more than 10 percent a week.


neck pain from computer

Avoiding Repetitive Strain Injuries

When you hear the term “workplace injury”, what probably comes to mind is a job that involves some obvious safety hazards like working with heavy equipment. It’s easy to forget that simply using a computer can put you at a real risk of injury.

Repetitive strain injuries (RSI) such as carpal tunnel syndrome are common among workers who use computers. These injuries typically involve pain in your hands, wrists, arms, shoulders, or neck. 

They’re the result of repetitive motions and overuse that gradually damage your muscles, nerves, and tendons. Once you get an RSI, it can be very painful to perform even simple actions like clicking a mouse.

One way to prevent an RSI is to avoid repetitive tasks. But when you have to use a computer to perform your job, avoiding those tasks is not an option. So here are some ways you can reduce your risk of injury:

Take Regular Breaks

A man running.
We help our patients achieve healthier and more active lifestyles.

Taking regular breaks is one of the simplest and easiest ways to reduce your risk of suffering an injury from repetitive strain. Frequent short breaks are better than one long one, so you may be able to split up your existing breaks into smaller chunks. That means you won’t have to reduce your workflow.

If possible, you should stand up and walk around during your breaks. Remember that the important part is taking a break from using your computer, so there’s nothing stopping you from performing other tasks. For example, getting up to go to the printer or photocopier can count as a break.

Improve Your Posture

Remember the advice your parents gave you about not slouching? They were right. Having proper posture will reduce your risk and make you more comfortable as you work.

Besides avoiding slouching, you should avoid bending the wrists. So adjust your chair so you can use your keyboard while keeping your arms and wrists straight and level with the floor.

To avoid straining your neck, ensure your computer screen is straight in front of you and the top of the screen is at eye-level. Your keyboard should also be directly in front of you with enough space at the front (about six inches) to rest your wrists when you’re not typing.

Another tip is to keep your mouse as close to you as possible. This will help you avoid leaning forward and reaching as you work.

Use Ergonomic Equipment

a man having wrist pain

There is a range of ergonomically-designed equipment that can reduce your risk when using a computer. That includes keyboard and mouse wrist mats that help you keep your wrists straight. Headsets can also be a big help if you need to talk on the phone while typing, as they eliminate the need to squeeze a phone between your head and shoulder.

There is also software to help you work more comfortably. For example, speech-to-text software can help by minimizing the need to type. And there’s free software that allows you to use your mouse without clicking. It works by automatically clicking for you when you hover the cursor for a set amount of time.

Get Help From a Physiotherapist

Physiotherapists are experts at preventing these types of injuries. They can use manual therapy, exercise programs, and other treatments that will improve your flexibility, endurance, and resilience to RSI. 

With their understanding of biomechanics, physiotherapists can also analyze your posture and the way you perform repetitive tasks to make recommendations on how to improve. And if you are suffering from an RSI, physiotherapy is one of the best ways to relieve pain, restore your range of motion, and speed up the healing process.