Shoulder Bursitis Explained

With the fall season already upon us, many of us are starting back up our recreational/competitive sports, finishing up yard work before the winter season, or completing home renovations while the weather is still warm(ish). Often times, many of these activities require repetitive overhead motion of our shoulders. Over time, these repetitive movements can lead to over-use injuries of the shoulder, where eventually simply reaching up to put your purse in the closet or performing a movement you have done hundreds of times becomes painful. One of the reasons for your pain in your shoulder may be due to an inflamed bursa, called bursitis.

So you may be thinking, I’ve recently been diagnosed, but what is it and how did I develop it? To understand what bursitis is, we first have to discuss what a bursa is. A bursa is a sack of fluid found in different parts of the body that help reduce friction between tendons, muscles, skin and bones. Bursitis is the term used if the bursa has become inflamed due to irritation. Common areas where bursitis is found in the body are in the shoulder, hip, elbow, and feet.

There are a variety of reasons that an individual may develop bursitis, and although over-use injuries are often the most common, there may be other reasons as to why you may have developed pain in your shoulder. Some of those issues include:

  • Direct trauma to the bursa
  • Muscular imbalances including weakness or motor control dysfunctions causing shoulder impingement
  • Decreased muscle flexibility or joint mobility
  • Anatomical/structural variations
  • Joint disorders such as osteoarthritis, rheumatoid arthritis or psoriasis

If you have recently been diagnosed with shoulder (subacromial, subdeltoid, subcoracoid) bursitis, contact us at EQ Physio, where we have developed a specialized program (Freedom to Move Bursitis Program) to help you recover from your bursitis and get you back to moving pain-free.

Judy Wu

Simon Janik, Registered Physiotherapist, is a graduate of Western University. He has taken post-graduate courses in manual therapy acupuncture and has a special interest in working with athletes, having been a former NCAA tennis player.


Figure 1:

Running Cycle

Have you ever wondered if you are running “correctly”? Is pain limiting your distance, time, or affecting your long term goals when you run? If so, it may be important to look at the different phases in your running cycle to help address these issues.

Contrary to popular belief, there is no one way to run correctly, but there may be one that is more efficient or safer for you based on factors such as age, previous injuries, and goals that you have set out for yourself. For example, if you suffer from hip pain when you run, or have osteoarthritis in your knee, it may be beneficial to look at your initial contact to toe-off (absorption phase) to help with load management of these joints. Performing a biomechanical assessment can help determine what changes in the running cycle, temporary or permanent, may be necessary to help manage these acute or chronic conditions in order to keep you moving without causing further harm.

Running can be broken down into stance phase, when the foot is on the ground, and swing phase, when the foot is in the air. Stride length is measured from initial contact of the foot, through the stance and swing phase, until initial contact of the same foot. Step length is the length between initial contact of the one foot to initial contact of the other foot. Cadence is the number of steps you take per minute. Understanding these terms is important to know when you are running, as modifying parts of the running cycle may help improve efficiency or reduce risk of injury. For example, by increasing a runner’s cadence, you can help decrease their stride and step length, which may be beneficial for runners who don’t have sufficient hip extension (see figure 1, take off and swing phase). This in turn can help prevent irritation to the hip joint.

  • Exercises for hip mobility

Figure 1- Running cycle, stages are in relation to right foot

Because running is a complex movement that involves many different muscles in your body working in unison, often times it can be tricky to determine what is causing your pain when you run. At EQ Physio, we look at your technique through all stages to help tease out what part of the running cycle may need to be addressed.

If you experience pain while running, come in and see one of our health professionals here at EQ Physio to help get you back to running pain free and back on track to whatever you running goals may be.

Simon Janik is a registered Physiotherapist at EQ Physio. He has given multiple talks to running groups regarding biomechanics, injury prevention, and strength training in runners. He is an avid runner himself, having completed 10k’s and half-marathons. He is currently training for his first marathon in 2020.

Judy Wu

Simon Janik, Registered Physiotherapist, is a graduate of Western University. He has taken post-graduate courses in manual therapy acupuncture and has a special interest in working with athletes, having been a former NCAA tennis player.


The Importance of Mobility and Flexibility in Tennis

With the U.S. Open Tennis Championships starting up this week, it's only fitting to discuss the importance of having good flexibility and mobility as a tennis player in order to play the game at an effective and injury-free level. Below I will discuss a few areas that you might want to focus on to help with your game as well as a few exercises to help increase your mobility.

When looking at the tennis swing from a ground stroke perspective, a great deal of rotation is required through your thoracic spine (mid back). In order to generate the necessary swing speed as well as desired topspin to help keep the ball in the court, here is a great exercise to help increase your thoracic spine mobility.

  • Exercises for thoracic spine (mid-back) mobility
  • Exercises for thoracic spine (mid-back) mobility

To create an efficient swing that is also consistent, one of the most important aspects of the game is to be properly set up for a shot with good balance and stability prior to swinging. When that happens, you are able to create power in your shots through a strong base of support. With that base of support comes good mobility in the hips to help with rotation. Here is a great exercise to help increase your hip internal and external rotation.

  • Exercises for hip mobility
  • Exercises for hip mobility

The swerve in tennis is one of the most challenging shots to execute consistently and effectively, combing a unique blend of overhead movement such as spiking a ball in volleyball and throwing a baseball. This complex motion requires significant range of motion of the shoulder, particularly into external and internal rotation.  Here is a good stretch to make sure you have the adequate amount of mobility in your shoulder to perform the service motion (diagram below is for the left shoulder).

  • Exercises for shoulder mobility
  • Exercises for shoulder mobility

If you are unsure whether these exercises are right for you, we would encourage you to come in for an assessment prior to trying these. One of our registered physiotherapists will perform an assessment and help diagnose any potential areas that you may need to work on. Our clinic is conveniently located at the corner of Dundas and Trafalgar in Oakville.

Judy Wu

Simon Janik, Registered Physiotherapist, is a graduate of Western University. He has taken post-graduate courses in manual therapy acupuncture and has a special interest in working with athletes, having been a former NCAA tennis player.


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Acupuncture helps Neck Pain!

Acupuncture has been practised for centuries in China and surrounding countries for treatment and management of pain. Over the last few decades, there has been a growing amount of research conducted in Asia, North America and Europe in the area of dry needling and acupuncture which involves the use of thin filiform needles applied to various areas of the body.

In the case of chronic neck pain, nerve signals that were active during initial acute injury continue to send signals to the body that it is in pain long after the initial injury has healed - lasting anywhere from weeks to years. New research has suggested that it may be due to a malfunction in the way the brain maps sensory information. Not only can acupuncture modulate the signals to the brain through neuropathways, but it can improve blood circulation, reduce muscle tension and trigger points, decrease inflammation as well as increase body's own opioid production. Its ability to regulate sympathetic and parasympathetic nervous systems explains why acupuncture can also be effective for stress or anxiety related neck tension.

In a 2015 randomized control trial comparing 12 acupuncture sessions performed within 3-4 months plus usual care (prescribed medications and visits to GPs, physiotherapists and other healthcare professionals) vs. usual care alone for individuals with an average of 6 years of neck pain, found that the acupuncture group showed a significant reduction in pain and improved function at 12 months. It was also found that at 6 and 12 months, self efficacy was greater with the acupuncture plus usual care group compared to usual care alone.

Your therapist at EQ Physio can use acupuncture to treat your chronic neck pain. A detailed assessment carried out will determine if you are a good candidate for acupuncture. Typically, you will experience significant changes after the first two weeks (4 sessions) of acupuncture. This would follow with two more weeks of bi-weekly sessions and a gradual decrease in frequency with frequent re-evaluation of your condition.

If you are having problems with your neck, contact the clinic today so we can get you on a path to recovery as soon as possible. We're conveniently located at the corner of Dundas and Trafalgar in Oakville.

Judy Wu

Juny Wu is a Registered Physiotherapist. She has an advanced certification in neuroanatomical acupuncture and is involved with teaching at a Neuro-meridian Acupuncture program.

Achilles tendon pain

What is it the Achilles tendon?

The Achilles tendon is the large cord-like structure at the back of the ankle. It is responsible for transferring the muscle forces generated by the calf, which in turn allows you to roll onto the ball of your foot during walking and running. This tendon can withstand tremendous stress – it can tolerate forces of greater than 1000 pounds. However, it is also a tendon that can become inflamed and injured. Most tendon injuries are the result of gradual wear and tear from overuse or aging. Anyone can have a tendon injury but people who make repetitive movements in their jobs, sports, or daily activities are more likely to damage a tendon.

Signs you are having a problem with your Achilles?

Symptoms include pain (in the tendon or where it attaches to the heel bone), swelling, weakness in the leg, and morning stiffness. Discomfort that resolves as the day progresses, is common.

What can we do?

At EQ Physio we often see clients that experience chronic Achilles pain. Recent studies have shown that a certain Achilles condition called tendinosis, responds very well to a specific program of eccentric loading to stretch and strengthen the tendons. Given enough time and proper technique, we can help these patients recover from a problem that may have been bothersome for several months.

Who do you know that is experiencing Achilles or some other type of foot pain? There is a good chance that we can help – contact us today! Our clinic is conveniently located at the corner of Dundas and Trafalgar in Oakville.

Aquatic exercise benefits

Aquatic exercise is one of the best ways to take the load off your joints while enjoying a cardio and strength-building workout. Here are some fun facts: did you know that you weigh 50% less when you stand in waist deep water? Did you know you weigh 90% less when you are submerged in water up to your neck?

Here are some great reasons to try water-based exercise:

  • Increase muscle strength– a recent study found that after 12 weeks of regular aquatic aerobic exercise, participants had made significant gains in strength, flexibility and agility.
  • Build endurance – Unlike traditional weights, which require the human body to push and pull against the weight plus gravity, water resistance is a more natural resistance which requires the body to strain through the water rather than against it.
  • Increase flexibility – As the body is subject to water resistance during water aerobic exercise – which requires movement in various directions while adjusting to the push and pull of water – the joints naturally increase their range of motion and your flexibility improves.
  • Low-impact exercise – the impact on your joints during weight-bearing exercise can be hard on your joints. The buoyancy that happens during water exercise lessens the impact on joints. This is very beneficial to people with arthritis or anyone undergoing physical rehabilitation.
  • Relieve stress and decrease anxiety – engaging in water-related activities is great for reducing stress, and can help alleviate anxiety and depression.
  • Burn calories – your body gets a full workout in water as it combines strength training and cardio, with the bonus of water resistance, it’s possible to burn between 400 to 500 calories an hour.
  • Reduce blood pressure – the water resistance works with your blood and enables it to flow and circulate more effectively throughout the body, effectively decreasing blood pressure and decreasing your heart rate – so your heart is being productive with less stress.
  • Cooling exercise – water aerobics are a cool activity no matter what time of year it is.
  • Social fun – since they aren’t limited to any age group or skill level, water aerobics are a great activity for anyone!

If you have aching, arthritic joints, do yourself a favour, and book an assessment with us to see if an aquatic exercise program is right for you. It could be one of the best things you ever do for yourself! Contact our clinic today – we’re conveniently located at the corner of Dundas and Trafalgar in Oakville.