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Physiotherapy Rehabilitation and neuroplasticity

Neuroplasticity is the ability for the brain to make changes.  It is what allows us to grow and to learn: intellectually, physically, and emotionally. 
In physiotherapy rehabilitation, the goal is to help you recover as much function as possible.

What is neuroplasticity?

With respect to injury and disease, neuroplasticity is often used with stroke and dementia.  From a Physiotherapy perspective, there are two ways to heal from stroke and to slow the progress of the effects of dementia.  They are through remediation and compensation.  In remediation, parts of the brain can heal.  In compensation parts of the brain that previously did not do a task can be trained to take on a new task that they previously didn’t do.  This is accomplished by building new synapses: connections in the brain, somewhat like new railway lines.  It is important to provide rehabilitation opportunities that target both remediation and compensation during Physiotherapy appointments.

Treatment techniques require practice and repetition.  From a movement perspective, it is important to consider open kinetic chain activities as well as closed kinetic chain activities as they stimulate joints and their neural receptors differently.  Another treatment technique is to ask a person to perform a task that is currently too hard for them but that is a related, higher level task to what they want to achieve.

How Does It Work?

In sport, we tend to use the term neuromuscular training.  It is not possible to train just the nervous system or just the muscular system in isolation.  When physiotherapists say that they focus on neuromuscular training they usually mean that they are considering the most functional and optimal movement patterns that the body needs to use to accomplish a task.  The more patterns that a person can develop, the more choice they have.  In sport, this often translates to the subconscious, natural movement selection.  When you see a highly skilled athlete perform an amazing catch, or leap, or defensive dodge, it is because stored somewhere in their brain, they have practiced some type of task related to it.

Physiotherapy Rehabilitation Exercises

Let us take the hamstrings.  People will ask, can I do a prone leg curl to strengthen my hamstrings (laying on your tummy and pulling your knees toward your bum against resistance)?  The answer is, you can.  And it will strengthen your hamstrings.  However, I would encourage you to consider if your hamstrings ever act that way in function.  In function (weight bearing positions & natural movement positions), the hamstrings control hip flexion and knee extension.  If you wanted to practice a movement that will both strengthen your hamstring, but also teach your brain how to use that strength in natural movement patterns consider using a squat or a lunge.  These specific exercises look more like what the hamstring does in a functional task like getting on and off the toilet, or like walking and running.

Another example is crawling.  Did you know that crawling is the fundamental building block of throwing?  That’s right, one needs to be able to reciprocal crawl (monkey crawl) in order to develop the cross pattern for throwing a ball.

3-D Movement Patterns

We typically think of jumping jacks in the frontal plane (side to side), but consider doing them in the sagittal and in the transverse planes.  Furthermore, consider dissociating the upper extremity from the lower extremity and mixing and matching the planes that they are moving in.  When you think of it this way, you have just created an exponential number of combinations and permutations as compared to just the typical jumping jack.  The creation of these diverse movement patterns will add to your brain’s “library” of movement patterns when it comes to activity selection.  To bring this back to pathology and disease, or even to ageing, these patterns can also be applied to something like a slip and fall.  For those of us who live in Alberta, we know how icy roads and parking lots can sometimes call for a unique pattern of reaction to stabilize us from a fall.

To learn more about remediation, compensation, crawling, squatting, lunging, and jumping please join Zenia at Prairie Therapy for an assessment and treatment plan.

How to Protect Your Knees for Skiing This Season

Protect Your Knees Skiing

As ski and snowboard season is now in full effect, it’s important to make sure you’re properly protected on the hill. Of course wearing a helmet for head safety is key; however there is one area of your body that you may be overlooking, your knees.

Knee stability is critical for all activities, but it becomes far more prevalent for skiing and snowboarding. Your knees act as your shock absorbers. They allow you to adjust to changes that occur on the hill from an unexpected mogul to changes in snow from hard packed to slush. Being able to compensate for these changes is necessary for anyone on the hill; but what happens when your body can’t compensate? In most cases you will fall and depending on the speed and obstacles around you, it can lead to injuries.

This is where the Donjoy Defiance 3 knee brace comes in. The Donjoy Defiance 3 is Donjoy’s premier custom product for all ligament instabilities in the knee. It can also be configured to provide off-loading for individuals with osteoarthritis who are looking to stay active. The brace contains stainless steel hinges with a light-weight, high-strength carbon fiber framework. Its unique design and strapping method keep the brace in position to handle any activity.

Defiance Custom Don Joy Knee Brace

The Donjoy Defiance 3 has been popular amongst skiers, snowboarders for a variety of reasons. The first is that it can be easily adjusted to allow a thermal layer to be worn under the brace. The second is the fourcepoint hinge that creates a dampening effect on the knee and helps to stop hyperextension. The third reason is the biggest; the Donjoy Defiance 3 can be measured with a short-calf option greater than other braces on the market. This way there will be no impact between the brace and the top of your ski or snowboard boot.

Protect Your Knees Skiing

Canada’s top alpine skiers are using Donjoy and so are our clients. Of all the custom defiance braces sold at Prairie Therapy, over 70% of clients mentioned that their primary use was to return to skiing or snowboarding.

Whether you need the brace for support or are looking for injury prevention the Defiance 3 is a great option. It has numerous accessories and colour options to make it your own. Custom Donjoy Defiance braces can be manufactured in one week so you don’t miss any time on the slopes this winter.


Matt de Gooijer BKin, CAT(C), Certified Athletic Therapist.  Click here to see Matt’s bio.