What makes the best exercise program?

April 1, 2024 Sian Owen

Developing some key points on exercise you can find in my older blogs.

The most effective exercise programs will result in improved muscle and bone strength, cardiorespiratory fitness, flexibility and balance. Correct posture while exercising is important in the prevention of injury. I think of it as an eternity symbol, each exercise type contributing to the next and to overall wellbeing.

Developing a multi-faceted program takes time, effort and commitment, but it’s so worth it! Exercise becomes part of your life because it makes you feel good and live more fully. Exercise is for everybody; whatever level of fitness and ability you have, there’s an exercise program waiting for you.

Here’s what has worked for me:

Before you start, listen to your body. If an exercise causes you a new or worse pain, stop it immediately. If you’re feeling unwell, give yourself a rest, or modify your program accordingly. Exercise is a life-long engagement, so missing a day or two is ok. (Chronic pain and fatigue bring special challenges here, and medical/professional advice on the correct program for you is well worth exploring.)
Another essential pre-workout check: posture. Correct posture means head is aligned, chin and bottom tucked in. Use a mirror or work with a knowledgeable friend/professional to get it right. It will help you avoid injury.
Stretch muscles after your workout. This prevents tightness and ultimately enables you to carry on exercising another day.
If you can, get a second pair of eyes, preferably an experienced professional. They can help you develop your program, including correct stretches, give you feedback on your posture, and on how you’re performing the exercise.
If you’re living with a new injury or illness, ask your doctor’s advice before you start. A Physiotherapist will also be able to guide you.
Build up gradually and vary your program.
Wear the correct clothing and footwear. Clothing should allow you to move freely and shoes should be supportive and fit well. No high heels!
Balance is a big one, because many factors are at play. See my next blog for more on this. But here are some ways to start working on balance, always within the limits of your safety, and with hand support as needed:

I’ve written in more detail about some of the components of exercise in these blogs.

Happy exercising!

R. Sian Owen

Registered Physiotherapist

How to improve sitting posture in a work chair.

February 1, 2024 Sian Owen

If your job involves a lot of sitting check these key posture points throughout your day to banish muscle strain and pain. I’d recommend setting an hourly alarm to do a quick check. You’ll feel so much better at the end of your workday!

Ask yourself:

1. Can you sit upright in your chair? If not, time to make some serious adjustments or even get new chair! Sit up tall and look at your posture. Specifically:

· Where are your knees relative to your hips? They should be slightly below your hips. This encourages the normal curve in your lumbar spine.

· If you have a lumbar support, is it in the right place for your lumbar curve? It should be in the apex of the curve in your lower back. Is it a good fit for your body? It shouldn’t make you over-arch your lower back; it should prompt you to sit up straight and feel supported and comfortable, not strained in any way. Try different supports until you get the right fit, for example use a small rolled towel or scarf.

· Where are your shoulders? Are they being pushed up by the arms of the chair or the table you are working at? Are they pushed up by your own work-related focus or tension? Your shoulders should be in a relaxed position and not pushed up.

· Last, but not least, how is your head position? Are you looking forwards or down? Your eyes should be looking straight ahead at a screen. Ask someone to look at the side of your head. Is your ear forwards from your shoulder? If it is, tuck your chin in and lengthen the back of your neck a little until your ear is in line with your shoulder. Note, we are not able to achieve this without good lower back posture.

2. Can you reduce the time you sit? Take as many standing breaks as you can. Explore adjustable sit/stand desks so that you can vary your posture throughout the day.

3. Are you introducing brief exercise /postural improvement breaks on a regular basis? Exercise, particularly for the postural muscles is key. If you practice good alignment and work your muscles in this position, they will help to keep you there through the day and reduce injury. See below for 2 exercises you can try.

Note, these exercises may need to be modified if you have arthritis or other pathology in your neck/spine. A registerd physiotherapist or rehab professional can modify these exercises to suit you.

Chin tuck exercise: Sit or stand tall.

· Keeping your eyes level, gradually lengthen your neck upwards as you tuck your chin in gently.

· Bring your shoulder blades down and back towards your spine.

· Hold for 5 secs. Repeat often.

Do not push through pain and stop if you have any.

Upper back strengthening exercise-resisted shoulder blade squeeze: Sit or stand tall.

· Make sure your chin is tucked as in the exercise above.

· Then relax your shoulders down and squeeze your shoulder blades together slightly.

· Bend your elbows to 90 degrees and keep them into your sides, palms up.

· Keeping your elbows by your side, separate your hands whilst squeezing your shoulder blades together. Note, don’t allow your chin to come forwards.

· Use a band held in your hands to add resistance when you are ready.

Repeat 5-10 times, starting every other day. Do not push through pain and stop if you have any.

This you tube link has a great video of how to do this exercise:

https://www.youtube.com/watch?v=CrT3XfuINnk

There are many more exercises that can help with posture. Consult a physiotherapist or rehab professional for a program tailor-made for you.

Click HERE to see my previous blog on this subject: text neck.

R. Sian Owen

Registered Physiotherapist

Safety Is Key When Using Walkers

January 1, 2024 Sian Owen

Walkers vary in size, design and detail. There is evidence that while walkers do encourage mobility and independence, walker users are at higher risk of falls than non-walker users (Physiopedia), so safety is key.

The references below contain excellent information about walkers, which I won’t repeat here. The Physiopedia article is particularly thorough, with information on walker types, factors involved in walker prescription, usage and correct maintenance.

I will make two strong recommendations.

No matter what your reason for buying a walker, it is crucial to get properly assessed by a PT or OT with experience in this area. There are many factors involved in choosing the right walker for your needs, and PTs and OTs have the skills to help you decide. In addition, the Government of Ontario’s Assistive Devices Program (ADP) helps fund the purchase of medical assistive devices, including walkers. To apply for this assistance you must work with an ADP-registered PT or OT. The Government of Ontario ADP website below provides a list of ADP registered therapists in your area. You can also ask your vendor if they have links with ADP registered therapists.

And finally, try the walker out before you buy. If you’re buying online make sure you can return the walker easily and free of charge.

R. Sian Owen

Registered Physiotherapist

References/Further Reading

1. Physiopedia- excellent article on different walker types. Includes important information about paradoxical increased risk of falls in walker users, and reported benefits of increased mobility and independence.

https://www.physio-pedia.com/Walkers#:~:text=A%20walker%20is%20a%20walking,mobility%20or%20lower%20extremity%20impairment.

2. ADP -Government of Ontario program to help finance medical equipment including aids to mobility. Must apply and be assessed by an ADP-certified therapist (PT or OT).

https://www.ontario.ca/page/mobility-aids

3. Mayo Clinic – good detail on different walker types and safe use.

https://www.mayoclinic.org/healthy-lifestyle/healthy-aging/multimedia/walker/sls-20076469

4. Medline (National Library of Medicine USA) – focus is on safe use. Links to other helpful articles.

https://medlineplus.gov/ency/patientinstructions/000342.htm

Vendors

This is as incomplete list of vendors in the Toronto area. (Vendors included in this list are for your convenience, and do not represent a recommendation by Sian Owen Physiotherapy.)

LifeCare Mobility (authorized ADP vendor)

https://www.lifecaremobility.ca/wheeled-walkers-rollators-toronto/

HME (Home Medical Equipment)

https://www.hmemobility.com/walkers/

Vital Mobility - Bariatric Walkers

https://www.vitalmobility.ca/Products/Walkers/Bariatric-Walkers.php

InMotion Services

https://inmotionservices.ca/collections/walkers

Silver Cross

https://silvercrossstores.com/walkers-rollators/

Wellwise (Shoppers)

https://shop.wellwise.ca/search?type=product&options%5Bprefix%5D=last&options%5Bunavailable_products%5D=last&q=walkers&pf_t_category=category%3ARollators+%26+Walkers

Starkmans

https://starkmans.com/catalogsearch/result/?q=walkers

Med + Medical Equipment Distribution

https://www.medplushealth.ca/product-category/walkers-rollators/

Sources of additional financial help

Wellwise (Shoppers) Sources of additional financial help for assistive devices, mobility devices and home modifications.

https://shop.wellwise.ca/pages/funding-assistance

Exercise for healthy bones.

December 1, 2023 Sian Owen

Exercise is an important part of keeping our bones healthy. There are 4 main components:

1. Weight-bearing exercise. Any activity where you take weight through your bones is a weight-bearing exercise. If you already have osteoporosis you need to follow your MD/rehab professional recommendations but would likely need to stick to the lower impact group. This type of exercise strengthens your cardio-respiratory system as well as your bones. Canada’s 24 hour Movement Guidelines(1) recommend 150 mins per week, or around 20-30 mins per day. Make sure you pick an exercise that is right for you.

Examples of high impact are:

· fast running,

· basketball

· volleyball

Examples of moderate impact are:

· slow jogging

· doubles tennis

· skipping and hopping

· pickle ball

Examples of lower impact are:

· brisk walking

· marching

· stair climbing

· gentle heel raises and drops

2. Progressive resistance strengthening. Resistance may be from weights, exercise bands, moving your body against gravity, or with resistance equipment. Note: you should always stretch the muscle groups used following strengthening.

‘Bone-fit’, produced by Osteoporosis Canada (2) recommends 2X week or more. Muscles targeted should include major muscle groups in our core, hips, shoulders arms and legs. Check out this guide for examples of some of the exercises that could be right for you.

3. Posture. A poor posture often results in weak muscles, as the bones/joints are not biomechanically aligned. In osteoporosis, poor posture can cause fractures.

Bone-fit recommends working on posture daily for 5-10 mins, then working on it as you go through your day. (2) See my blog on Text Neck (July 16, 2021) for information on neck posture and how to improve it. Click HERE.

4. Balance. This can be done with specific exercises which challenge your balance (safely -so you don’t fall), or you could try an activity such as Tai Chi or line dancing which makes you move outside of your base of support in a safe way.

Bone-fit recommends trying to challenge your balance daily, perhaps by incorporating it into your daily routine.

If you’re new to exercise, or shy of it, this probably seems like a lot to take on. So, do it in bite-sized pieces. Its usually easier to start with exercise that you enjoy and know how to do, then build out from there.

Build it slowly, making exercise a life habit. And remember, don’t do it if it hurts! All exercises can be customized to meet your particular needs and preferences – ask a physiotherapist with expertise in osteoporosis to help you get started, or to increase your challenge in a safe and sustainable way.

R. Sian Owen PT

(1) https://csepguidelines.ca/

(2) https://osteoporosis.ca/wp-content/uploads/OC-Too-Fit-To-Fracture-Osteo-Exercise-Book.pdf

Is the perfect pillow just a dream?

November 1, 2023 Sian Owen

Getting a pillow that works for your body shape and sleep position can seem like an impossible dream, but by following the steps below you can, at least, prevent it from becoming a nightmare.

Pillow preference is very personal; there is no one-size fits all. The best way to decide if a pillow is right for you is to try it. Mattress shops will often let you try a pillow on their mattresses, and some even have a return policy, which is the best way to ensure you have the right pillow. Before testing in a store there are a few things to think about:

· Are you a front, side or back sleeper? Front sleepers need a thinner pillow than a back sleeper. Side sleepers need a thicker pillow to provide enough neck support. If you sleep in more than one position, get the pillow that will support you wherever you lay your head. (For example, people who sleep on their backs and their sides need a pillow that combines thin and thick.)

· What type of material do you want? Many pillows are made from hypoallergenic material now. Memory Foam can give good support, but as it is hotter than other materials, you might want one with a cooling gel. Feather pillows can be great for people who dislike synthetics and like to “bunch up” their pillow.

· The amount and type of fill you have in your pillow will affect its firmness. Some pillows allow you to adjust the amount of fill, e.g. feathers, foam pieces. Store the pieces you remove to allow continued adjustment as needed.

· Pillows do lose body over time, so it’s a good idea to replace your pillows every couple of years.

· Here are some simple ways to prolong your pillow’s life: wash the pillow-cases regularly, *fluff up your pillows regularly by hand, massage the lumpy bits to break them down, put the pillow in a dryer (check manufacturer’s guidelines first), along with a clean tennis ball or clean soft toy (dryer-safe), air your pillow outside in dry weather. Washing your pillow is also a good way to prolong its life, but follow manufacturer’s guidelines carefully. *(These apply to fill that is not one solid piece).

When trying out the pillow in the store:

· Make sure you lie on a mattress that is similar in firmness to yours. If it’s a lot firmer or softer than yours the trial won’t be effective. In fact, you may come home and find the pillow that was so comfortable in the store gives you a neck ache as soon as you lie down.

· Make sure the pillow allows you to lie with your head in line with your body. It shouldn’t be pushed up (pillow is too thick or firm) or allowed to drop out of alignment with your spine in any way. It is helpful to have someone with you to look at your posture and alignment.

· Probably most important: let yourself lie there for at least 20 minutes, going into your favourite sleeping positions, and really feel what’s happening in your neck and shoulders. Ask yourself, does your head feel supported? Are your neck muscles working to support your head, or do they feel relaxed? If after 20-30 minutes you can say your neck and shoulders feel soft and relaxed and your head feels supported, buy the pillow!

For more detailed information take a look at https://www.wikihow.com/Choose-a-Pillow

Good luck pillow hunting!

R. Sian Owen PT,

Registered Physiotherapist.

The Story of a Physio Who Broke Her Wrist, (and learned not to self-diagnose).

October 1, 2023 Sian Owen

Day 1

I was in England. The suddenness of the fall was a shock. One minute I was walking into a washroom, the next I was on the floor, not knowing what had happened. I didn’t lose consciousness. In a fall the body’s automatic response is to protect your head. It’s quite amazing. I have no memory of the fall, but I know I will have landed on an outstretched hand, my left (dominant) hand. My wrist hurt, a lot.

Still feeling a bit shaken, I sat down and wondered how much damage I’d done: the pain showed no sign of diminishing, and now I had swelling. My physio brain kicked in: no skin broken, no bones at an odd angle (thank goodness!) and I was able to gently move my hand, wrist, elbow and shoulder joints. It could be worse, I thought, but it still hurt. It must be one of the small carpal bones, I thought. My scaphoid, probably, judging by the location of the pain and swelling. Scaphoids can be tough to heal, I remembered, because the blood supply isn’t great. No point in dwelling on the negatives, I told myself. Just be grateful you didn’t hit your head, or fracture something so badly that the bones displaced.

I was heading home to Toronto in a few days, and wearing a cast can be problematic if you’re flying, so I opted not to seek medical care yet. I took anti-inflammatories, applied ice and wore a wrist brace that night. It helped a bit, but discomfort and anxiety prodded me awake every time I dozed off. My physio brain was definitely not engaged, and those negative thoughts I’d resolutely pushed away earlier came flooding back: what if my scaphoid is broken and doesn’t heal properly? Will I need surgery? What if I have to stop work?

I mean, really!

Day 4

Still in my brace I got back to Toronto, on the Sunday of a long weekend. Despite my panic, I was pleased to note that my hand was still attached to my arm, and the pain had subsided. I decided not to clog up Emergency. I could wait a couple of days to talk to someone at my doctor’s office.

Day 6

I obtained an X Ray requisition from my doctor.

Day 8

The X ray showed a possible crack in one of the carpal bones, but not where the pain and swelling was. I was confused, and getting alarmed. I was so sure it was my scaphoid.

Day 14

I continued to experience pain and swelling at the base of my thumb and decided to go back to my family MD. She recommended a further X-Ray, made an Orthopaedic referral and also told me about an Emergency Minor Injury Clinic at a different hospital. I continued to wear the wrist brace. It was cumbersome and I had to adapt some of my clients’ treatments to accommodate it, but it protected my wrist and kept the bones in place. I just wished I knew for sure what was damaged, and how badly.

Day 15

The second X-Ray gave no more information.

Opening jars, lifting things, washing dishes were all off limits. I was worried something was being missed.

Day 18

My doctor’s surgery called me to ask if I had a date for my Ortho referral, which I didn’t. They said they would do what they could.

Day 21

Still no news about my Ortho referral. I went to that Emergency Minor Injury Clinic. I was immediately aware of how truly minor my injury was, compared to many of the folks I saw there. And how patient and professional the staff were.

7 hours and a CT scan later I finally had a diagnosis – not my scaphoid at all, but a non-displaced fracture of the distal radius. It’s not always easy to see a break on X-Ray if it hasn’t been displaced. Because I had been very cautious and was wearing a brace for activities and work, it was healing well, but to be safe they decided I should still have a cast. My wrist immediately felt safe.

I relaxed, got better at using my right hand, and waited for my follow-up appointment with the Orthopaedic surgeon from this other hospital.

Day 29

Appointment with the Orthopaedic Surgeon and out of the cast. Phew! He told me that the pain at the base of my thumb was likely arthritis, which had flared up with the fall. He clarified that I should continue with the brace for a total of 6 weeks (now at 4 weeks post injury) to allow the radial fracture to heal, then start to wean myself off it. He advised me to start range of motion exercises.

What have I learned?

A bit more about me: how my mind goes into overdrive when I can’t get a concrete answer to my body’s problems. How unhelpful that is. How misleading self-diagnosis can be. How important it is to have faith in the careful process of medical diagnosis and treatment. How right I was to listen to my body and protect it. How much energy it sometimes takes to remain calm and be persistent when dealing with the medical system. How grateful I am to the professionals who helped me in this process. How grateful I am that their expertise was available to me, free of charge.

R. Sian Owen

Registered Physiotherapist.

The Story of a Physio Who Broke Her Wrist, (and learned not to self-diagnose).

October 1, 2023 Sian Owen

Day 1

I mean, really!

Day 4

Day 6

I obtained an X Ray requisition from my doctor.

Day 8

The X ray showed a possible crack in one of the carpal bones, but not where the pain and swelling was. I was confused, and getting alarmed. I was so sure it was my scaphoid.

Day 14

Day 15

The second X-Ray gave no more information.

Opening jars, lifting things, washing dishes were all off limits. I was worried something was being missed.

Day 18

My doctor’s surgery called me to ask if I had a date for my Ortho referral, which I didn’t. They said they would do what they could.

Day 21

I relaxed, got better at using my right hand, and waited for my follow-up appointment with the Orthopaedic surgeon from this other hospital.

Day 29

What have I learned?

R. Sian Owen

Registered Physiotherapist.

Peripheral Neuropathy: what is it and how can physiotherapy help?

September 1, 2023 Sian Owen

What is it?

Peripheral neuropathy is a condition that damages the peripheral nerves. These are nerves that carry messages to and from the brain and spinal cord. Peripheral nerves exist throughout our bodies, connecting the brain and spinal cord to our muscles and internal organs. There are 3 types:

· sensory - allowing us to feel through our skin

· motor-allowing us to initiate and control movement

· autonomic -allowing normal internal function, for example heart rate, blood pressure, digestion.

Peripheral neuropathy disrupts the nerves’ ability to send and/or receive the signals our bodies require: they may send pain signals when they’re not needed, or they may be unable to send a signal that is needed.

What are the symptoms?

Symptoms include pain, tingling and/or numbness, often starting in the hands and feet, but this may spread into your limbs. Some people describe the pain as sharp, freezing or burning, and they may be unable to cope with even the slightest touch in the affected area. People may drop things, or find it difficult to move as easily; balance may be affected. If the autonomic system is involved, people may feel unwell; they may have low blood pressure or digestive problems, for example.

What are the causes?

Diabetes is a major cause of peripheral neuropathy, but it can also result from infection, trauma, metabolic disorders (such as hypothyroidism or kidney disease) alcoholism and long term exposure to toxins. The condition can also be inherited, for example in Charcot-Marie-Tooth disease. If you are experiencing any symptoms, you should see a doctor immediately. As the causes vary considerably, the doctor will want to know your full medical history and a complete list of your symptoms.

Is there a treatment?

If the underlying cause of the neuropathy can be treated the nerve function should also improve; for example if the neuropathy was caused by trauma, from which the limb is expected to recover, then the neuropathy should also diminish in time. Pain medication and non-pharmaceutical pain management treatments also offer relief, as do splinting for hands and feet that are painful or have diminished motor control.

What can physiotherapy do to help?

A physiotherapist will assess your physical function, liaise with your doctor regarding the cause, and then provide a treatment program that will target areas of weakness and risk. For example you may have poor balance, reduced mobility,stiff limbs, weak muscles and/or low heart fitness. The physiotherapist can also provide you with appropriate walking aids, braces and splints, as well as non-pharmaceutical pain relief such as Transcutaneous Electrical Nerve Stimulation (TENS) or acupuncture.

R. Sian Owen

Registered Physiotherapist

Links

The Mayo Clinic has some good information at http://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/home/ovc-20204944

Recent research on the effectiveness of TENS can be found at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2746624/

Text Neck. What is it and what can I do to reduce the problem?

August 1, 2023 Sian Owen

What is it?

Text Neck is a recent term used to describe a repeated head forwards posture, such as when texting/ using a mobile phone.

Postures that contribute to a head forwards posture are:

· hunching your back and poking out your chin, such as when using a smart phone or a computer/laptop that is not positioned correctly for you.

· cradling your phone with your head and shoulder

· sitting slouched in a chair

· rounding your shoulders

See PICTURES by clicking HERE

(photo: handsonseminars.com/bad-posture-big-problems)

What are the symptoms?

If the forwards head posture is repeated, eventually there will be:

· Neck pain, shoulder pain, and possibly headaches.

· Neck stiffness

· Muscle weakness around the neck and shoulders.

· Tight chest muscles

Other issues can also occur, such as

· Numbness/tingling in arms and/or legs

· Stiff upper back

What can I do?

Try and improve your head posture whether you are sitting, standing or walking.

· Gradually lengthen your neck upwards as you tuck your chin in

· Bring your shoulder blades down and back towards your spine

Be sure to talk to your doctor/physiotherapist if you have had an accident and/or you have a neck condition such as arthritis as you will need a modified program

You can also

· Adjust your seating to help you maintain this posture

· Strengthen your neck and upper back.

· Reduce your use of smart phones and take frequent breaks.

A physiotherapist can provide you with postural re-education and an appropriate exercise program tailored specifically for you.

For more information visit: https://www.physio-pedia.com/Text_Neck

R. Sian Owen PT

Registered Physiotherapist

A feat of biological engineering.

June 30, 2023 Sian Owen

“These feet were made for walking, and that’s just what they’ll do….”

Nancy Sinatra was, in fact, singing about boots, but she wasn’t wrong when she said that those appendages at the bottom of our legs were meant for walking. Then there’s standing, tip-toeing, running, jumping, dancing, skating, skipping, swimming; keeping us hooked to a bike or a horse; tight rope walking. Feet can even do the work of hands for some people. Our feet do an incredible job for us; here are some of their amazing every-day achievements.

1. Our feet keep us grounded.

Our large, oval shaped feet are what keep us connected to the ground. Together with our magnificent brains, they give us the ability to balance on different surfaces, or in different conditions (ice, wet, high wind, for example). Multiple bones and joints form two arches (longitudinal and transverse) that react to different stimuli, such as sandy or rough ground, and help keep us upright. Our feet have thousands of nerve endings that detect information about the surface they’re on. This information travels at high speed to our brain, which relays urgent messages back to the foot muscles to get working. End result – we don’t fall over.

2. They’re at the centre of things.

We all have an invisible base of support, a no-falls safe zone. When we’re upright, with feet shoulder width apart, it’s a rough circle around the feet, about as wide as our shoulders. The closer together our feet are, the narrower the base of support. If we’re standing our body needs to be perpendicular to this circle, but if we’re running it will move a little beyond the circle as we gather momentum. If we move too far beyond our base of support we’ll start to fall. Our feet are key to helping us stay within this safe zone, informing our brain when we move too far beyond it, and activating the right muscles to bring us back in.

3. They’re team players.

Our feet work with muscles in our legs to enable us to move. Strong calf muscles (plantar flexors) push the front of the foot into the ground. The heel rises, and bingo, you’re off walking! Next we swing our leg through space, preparing to land the heel. Shin muscles (dorsiflexors) automatically pull up the foot, so that our toes don’t get caught on the ground. Muscle work is all about sharing the load: some muscles work as prime movers such as the dorsiflexors to lift the foot, others work as stabilisers such as the muscles in the other leg to hold us up.

4. They are super-adaptable.

Some people use their feet to draw and write. Take a look at these beautiful pictures drawn by an artist using his right foot. https://www.youtube.com/watch?v=8Mtxh

All this work is pretty hard on your feet. Here’s how you can help keep them healthy and rested.

1. Wear shoes that support but that aren’t too tight. Beware of shoes that pinch, especially those that squish your toes together. The shoes may look cool, but damaged toes and bunions don’t.

2. Include a foot and ankle strengthening routine in your work-out. You can get information on specific strengthening exercises from a physiotherapist.

3. Don’t over-do any activity, including the above-mentioned strengthening exercises. Over-use of tendons or muscles that move the foot, for example, can cause peroneal tendinitis or shin slints.

4. See a foot specialist if you have problems with your feet (corns, bunions, pain, swelling). Regular care by the right professional will keep your feet strong and healthy and ready to work wonders for you.

5. Pamper your feet occasionally with a home foot-spa. Even a basin of warm water and some soft towels will make them feel loved.

For more information about feet and foot care visit the College of Chiropodists of Ontario. You can search for a licensed chiropodist or podiatrist here www.cocoo.on.ca

R. Sian Owen PT