Physiotherapy
The heart of the physiotherapy profession is understanding how and why movement and function take place in the body. Physiotherapists are highly skilled, autonomous health professionals who provide safe, quality, client-centered care through a commitment to service availability, accessibility and excellence. At Flow, our dedicated physiotherapist provides manual lymphatic drainage massage, exercise prescription and coaching sessions, as well as cancer rehabilitation (education, exercise prescription for different stages of your treatment, and lymphatic massage).
MANUAL LYMPHATIC DRAINAGE
Manual lymphatic drainage (MLD) massage uses a light and rhythmic stretching of the skin in a specific pattern that is designed to stimulate lymph flow and drain tissues of waste products such as excess fluid, bacteria, viruses, toxins and unwanted substances. This can help accelerate the healing process from injury and surgery and prevent post-operative complications. MLD can help with treating and managing lymphedema, swelling, inflammation, congestion and bloating in the body.
Our physiotherapist provides the same Vodder lymphatic massage as the RMTs, but with a physiotherapy lens. Focus is on using MLD to help improve overall tissue health and function to promote functional strength, mobility and independence. MLD is also an effective tool in preventative care by decreasing load on other systems of the body and accelerating recovery from musculoskeletal related dysfunction.
We offer 30, 45, 60, 75, 90 and 120 minute treatment sessions. Prices vary according to length of appointment. A minimum appointment of 60 minutes is recommended for your initial appointment to ensure a comprehensive assessment and treatment time.
INDIVIDUALIZED EXERCISE PROGRAMMING
Exercise not only supplements but enhances the benefits you receive from MLD. It is one of the best ways you can be actively involved in promoting lymphatic health.
Research has shown that exercise is a vital tool in managing almost all mental and physical health conditions. Sometimes it can be daunting and overwhelming to know where to start. The goal of individualized exercise programming is to identify barriers and overcome them by finding a routine and type of exercise that is safe, easy to follow, and maintain in order to reach your functional goals. Our physiotherapist can do regular check ins in order to progress or modify your program as needed.
For musculoskeletal injuries and those pre or post surgery, stretching and strengthening is essential in promoting recovery and minimizing post-op complications. Our physiotherapist can work within the functional parameters outlined by your medical team to provide an individualized program that helps decrease pain, promote functional mobility, strength and range of motion to accelerate recovery in a safe and timely manner.
We offer 30, 45, 60 minute exercise prescription sessions. These sessions can also include MLD. Prices vary according to length of appointment.
CANCER REHABILITATION
Physiotherapists are an essential member of your cancer care team. The earlier they are involved in your care the better. They focus on helping patients physically and mentally prepare for upcoming treatment. A preventative care approach is used to provide education and tools to prevent and/or address many of the common side effects related to cancer and its treatment. The goal is to set you up for the best possible outcomes throughout your cancer journey and survivorship.
Prehabilitation
Prehabilitation is the process of raising physical, functional, and mental reserves/capacity to prepare for a significant stressor. Research has shown that engaging in regular exercise before cancer treatment can improve treatment tolerance, coping ability, reduce emotional distress and treatment related side effects.
Our physiotherapist can give you the tools, strategies and resources to help you engage in a personalized exercise program that is easy to comply to prior to and throughout your cancer treatment. If you are someone who is already quite physically active, our physiotherapist can provide education on how to maintain and/or modify your current routine based on your treatment plan and schedule.
Prehabilitation research our physiotherapist has been involved in:
Brahmbhatt, P., Look Hong, N. J., Sriskandarajah, A., Alavi, N., Selvadurai, S., Berger-Richardson, D., Lemon-Wong, S., Mascarenhas, J., Gibson, L., Rapier, T., Isenberg-Grzeda, E., Bernstein, L. J., Santa Mina, D., & Wright, F. C. (2024). A Feasibility Randomized Controlled Trial of Prehabilitation During Neoadjuvant Chemotherapy for Women with Breast Cancer: A Mixed Methods Study. Annals of surgical oncology, 10.1245/s10434-023-14851-z. Advance online publication. https://doi.org/10.1245/s10434-023-14851-z
Chemotherapy
One of the biggest side effects of chemotherapy is chemotherapy related fatigue. Exercise is one of the best ways to manage this. When you are exercising at a moderate intensity, your body releases chemicals called endorphins that give you more energy and improve your mood. Exercising during the day allows your body to get better quality, restorative sleep at night, setting you up for success the following day. Exercise throughout chemotherapy treatment can help with the management of peripheral neuropathies (commonly experienced as weakness, numbness and pain usually in the hands and feet), and improves tolerance of higher dose, more effective forms of chemotherapy.
Surgery
Our physiotherapist is experienced working post-operatively with cancer patients from all disease sites including head and neck, breast, abdominal surgeries involving the organs, and blood cancers that require a bone marrow transplant.
For the breast cancer population, our physiotherapist works closely both pre and post operatively with patients who undergo sentinel lymph node biopsies, axillary lymph node dissections, lumpectomies, mastectomies, both immediate and delayed breast reconstruction involving immediate implants, tissue expander insertions and exchanges, latissimus dorsi, DIEP and TRAM flaps. Each of these surgeries have specific post-operative activity restrictions and exercises to help with recovery. Education regarding post-operative drain care, managing activities of daily living (dressing, clothing, bathing, diet, sleeping and driving) and identifying potential post-op complications (axillary web syndrome/cording, seromas) is also provided. It is recommended to book an appointment with our physiotherapist prior to surgery to review this information and your exercise program, which is safe and encouraged to start on post-operative day one in most cases.
For individuals whose cancer surgery requires reconstruction with skin flaps on their legs, you may have post-operative weight bearing restrictions that you must follow. It is recommended to make an appointment prior to surgery in order to discuss these post-operative activity restrictions and strategies. This could include transfers, gait and stairs assessments, recommendations for gait aids or assistive equipment/devices to help with your functional independence and managing activities of daily living. Post-operative exercises will also be provided to help accelerate recovery and minimize risk for certain post-operative complications.
Radiation
A common side effect of radiation treatment is radiation induced fibrosis (RIF), which is the hardening or stiffening of the soft tissue within the radiation field. This affects the elastic properties of your skin, connective tissue, muscles, nerves and blood vessels causing them to become less stretchy. This can result in postural changes, decreased range of motion, muscle imbalances, pain as well as lymphatic dysfunction.
Prior to beginning radiation treatment, our physiotherapist can provide you with a home exercise program with stretches focused on minimizing the impact of RIF. It is recommended that you perform these exercises daily before and after radiation treatment as well as for a few weeks upon completion of treatment.
Lymphedema Management
If your cancer treatment involves the surgical removal of lymph nodes or radiation to remaining lymph nodes, you are at an increased risk of developing secondary lymphedema. Lymphedema is a chronic condition, but is fortunately manageable with appropriate and early intervention from a combined decongestive therapist (CDT). Our physiotherapist can provide education, manual lymphatic drainage massage, exercises and organize a compression consultation to help with the management of lymphedema and keep it well controlled.
We offer 30, 45, 60, 75, 90 and 120 minute cancer rehabilitation sessions, where any of the above interventions can be provided as clinically indicated based on where you are in your cancer journey. If you are unsure of the length of appointment time, we recommend a free consult with our physiotherapist by e-mailing her at jmascarenhas88@gmail.com. Prices vary according to length of appointment.
Meet our Registered Physiotherapist, Joanna.