Vestibular Screening Clinic with Dr. Nahla Goma

We are very pleased to announce our involvement in a monthly vestibular screening clinic in conjunction with otolaryngologist (ENT) Dr. Nahla Gomaa, MBBCH, MSc, MD. PhD. Dave Benterud works out of Dr. Gomaa’s office in south Edmonton monthly with her and her patients to determine if vestibular rehabilitation techniques or exercises would be beneficial.


Dr. Gomaa is an Associate Cl. Professor of Otolaryngology-Head & Neck Surgery, a Clinician-Educator in the Department of Surgery, and the Lead of Surgery in the Faculty Development Committee at the Faculty of Medicine & Dentistry, University of Alberta.

After her graduation, she received her Clinical Masters in Otolaryngology, then Doctorate Degree from Cairo University. Parallel to this, she pursued her fellowship at the University of Iowa, U.S.A, to complete her MD. PhD., In addition, she earned a Quality Improvement in Education training through a European Commission grant in the United Kingdom [UK], after which she held the position of Director of QI at the Faculty of Medicine. She received a number of international and local educational and clinical research grants. 

She has been on faculty at the Division of Otolaryngology-Head & Neck Surgery, at the University of Alberta since 2012. Since then, she has committed to the clinical, classroom, multi-disciplinary teaching, research, and administrative roles. She served on different committees including strategic planning of Competency-Based Medical Education [CBME], Human Research Ethics Board, [HREB], and is still currently an active member of the Faculty Development Committee [FDC], in which she has helped to spearhead a number of initiatives along with other committee members, such as faculty peer review, collaboration of the FoMD with international institutes and medical schools, development of the online annual report [ARO] for FoMD, and development of the Vision & Mission of the Faculty Development Committee.

She has also been an OSCE examiner, MMI panellist, STIR program supervisor, and Alberta innovates grant reviewer. 

In 2019, she earned her Degree in “Patients’ Safety & Quality Improvement”; from the University of Calgary and has been the Director of quality improvement at the Division of Otolaryngology-Head & Neck Surgery.

Her academic interest featured quality improvement in medical education, Feedback & assessment in medical education, innovative educational tools including simulation, blended courses, and using different technology in medical education. 

Her clinical research interests funded by a number in the domains of hearing, balance, and inner ear research including Auditory Evoked Potentials,  fMRI role in central auditory defects,  Tinnitus diagnosis and intervention, Vertigo Diagnosis and treatment,  Knowledge translation in hearing and balance research and research of the inner ear, Qualitative studies. 

She has also supervised students’ projects as a scholarship on quality improvement in the healthcare system and CanMEDS roles. Quality Improvement in clinical as well as educational settings of Competency-based medical education [CBME]. She has mentored a number of multi-disciplinary students in these domains. In addition, she has collaborative work with Peter S. Allen Research Centre, Neuroscience Institute and Surgical Simulation Research Lab [SSRL] at the University of Alberta. 

In addition to her work at the University of Alberta, Dr. Gomaa also consults with patients at her clinic, the Trust Hearing & Balance Medical Centre, in south Edmonton.

What exercises are used in vestibular rehabilitation therapy

Title Card with text that reads: what exercises are used in vestibular rehabiliation therapy

Vestibular rehabilitation therapy (VRT) is a specialized program designed to help individuals overcome balance and dizziness issues caused by problems with the vestibular system. This system, located in the inner ear, plays a crucial role in maintaining balance and spatial orientation. Through a series of exercises and techniques, VRT aims to retrain the brain and strengthen the vestibular system, allowing patients to regain their balance, reduce dizziness, and improve overall quality of life.

Gaze Stabilization Exercises: Enhancing Visual Focus

One of the primary exercises in VRT is gaze stabilization. It involves fixing the eyes on a specific target while the head is in motion. This exercise helps improve the coordination between the vestibular and visual systems, reducing dizziness and improving balance during activities like walking or driving.

Balance Training: Steady on Your Feet

Balance training exercises focus on improving stability and reducing the risk of falls. These exercises may involve standing on one leg, walking on uneven surfaces, or using stability balls to challenge the balance system. Over time, patients become more confident and sure-footed in their daily activities.

Canalith Repositioning Maneuvers: Treating Benign Paroxysmal Vertigo (BPPV)

BPPV is a common vestibular disorder that causes brief episodes of intense vertigo triggered by changes in head position. Canalith repositioning maneuvers, such as the Epley maneuver, are effective in treating BPPV by relocating displaced calcium crystals in the inner ear.

Brandt-Daroff Exercises: Alleviating Vertigo Symptoms

Brandt-Daroff exercises are helpful for individuals experiencing vertigo due to conditions like Meniere’s disease or labyrinthitis. These exercises involve a series of head movements performed in a sitting position, gradually desensitizing the vestibular system and reducing the severity and frequency of vertigo attacks.

Vestibular Ocular Reflex (VOR) Exercises: Improving Eye-Head Coordination

Vestibular Ocular Reflex exercises aim to enhance the coordination between eye movements and head movements. By focusing on a moving target while moving the head side to side or up and down, patients can improve their ability to maintain clear vision during motion and red

Habituation Exercises

A therapist can determine which specific movements or environments cause a moderate level of symptoms. Then, through a progressive program of repetitive exposure, the patient habituates to the sensation and as a result minimizes the symptoms.

Vestibular rehabilitation therapy offers a tailored approach to address balance and vestibular issues, helping patients regain their equilibrium, confidence, and independence. With regular practice and guidance from qualified physiotherapists, individuals can make significant strides in their journey to better balance and overall well-being.

Hit the Ground Running: How Physiotherapy Helps with Common Running Injuries

Running is a popular and accessible form of exercise that provides numerous physical and mental benefits. However, the repetitive nature and impact involved in running can sometimes lead to common running injuries, affecting athletes and fitness enthusiasts alike. From runner’s knee to Achilles tendinitis, these injuries can be painful and hinder progress. Fortunately, physiotherapy plays a critical role in addressing and preventing common running injuries. In this article, we explore how physiotherapy can be a game-changer for runners, promoting recovery and supporting optimal performance.

1. Runner’s Knee (Patellofemoral Pain Syndrome):
Runner’s knee is a prevalent injury characterized by pain around the kneecap. Physiotherapy interventions focus on correcting biomechanical issues, such as poor tracking of the kneecap, and strengthening the muscles around the knee to reduce strain and improve stability.

2. Shin Splints (Medial Tibial Stress Syndrome):
Shin splints cause pain along the shinbone, often resulting from overuse or improper training techniques. Physiotherapists use a combination of rest, stretching exercises, and gradual return-to-running programs to help runners recover from shin splints and prevent recurrence.

3. Achilles Tendinitis:
Achilles tendinitis is inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. Physiotherapy involves a range of treatments, such as eccentric strengthening exercises, soft tissue techniques, and footwear modifications, to promote healing and prevent further strain on the tendon.

4. Plantar Fasciitis:
Plantar fasciitis causes pain in the heel and arch of the foot. Physiotherapy addresses this injury through stretching exercises, foot taping, and the use of orthotics to relieve pain and improve foot mechanics.

5. IT Band Syndrome:
Iliotibial (IT) band syndrome leads to pain on the outer side of the knee and/or hip due to inflammation of the IT band. Physiotherapy interventions aim to reduce inflammation, strengthen the hip muscles, and correct any underlying biomechanical issues contributing to the syndrome.

6. Stress Fractures:
Stress fractures are tiny cracks in the bones often caused by overtraining or improper footwear. Physiotherapists provide guidance on gradual return-to-running programs and recommend strengthening exercises to aid recovery and prevent further fractures.

7. Ankle Sprains:
Ankle sprains can occur during running, leading to pain and reduced mobility. Physiotherapy involves exercises to improve ankle stability and proprioception, promoting full recovery and reducing the risk of future sprains.

Prevention and Performance Enhancement:
Beyond injury recovery, physiotherapy plays a crucial role in injury prevention and performance enhancement for runners. Physiotherapists assess running biomechanics, muscle imbalances, and gait patterns to identify potential issues and develop personalized training programs. By focusing on strength, flexibility, and proper running mechanics, physiotherapy helps runners optimize their performance and reduce the likelihood of future injuries.

One of our tools that we often use to help our patients to return to running is the use of our clinic’s LiteSpeed Lift LSX500, a body weight support treadmill system. Get in touch with us if you would like to know if this is a good fit for your recovery plan.

Running is a rewarding activity that can transform lives, but it’s essential to address and prevent common running injuries to stay on track with your fitness goals. Physiotherapy offers a comprehensive approach to injury recovery, injury prevention, and performance enhancement for runners. Whether you’re a seasoned marathoner or a novice jogger, seeking physiotherapy support can keep you on the path to success, helping you hit the ground running with confidence and achieve your running aspirations.

The Power of Touch: The Top 8 Benefits of Therapeutic Massage

Person lying face down on a massage table getting a massage

Therapeutic massage has been practiced for centuries and is renowned for its profound impact on physical, mental, and emotional well-being. The power of touch goes beyond relaxation, as therapeutic massage offers multiple benefits that can enhance your overall quality of life. At Tawa Physical Therapy, we believe in the physiological effects of therapeutic massage and the value it brings to our patients’ rehabilitation journey. In this article, we uncover the top 8 benefits of therapeutic massage and explore the additional advantages of integrating massage into a clinical setting.

1. Stress Relief and Relaxation

One of the most immediate benefits of therapeutic massage is stress relief and relaxation. The gentle kneading and manipulation of muscles induce a relaxation response, calming the nervous system and reducing stress hormones. This relaxation not only promotes a sense of well-being but also improves sleep quality.

2. Pain Reduction and Muscle Tension Relief

Therapeutic massage is highly effective in reducing pain and relieving muscle tension. The application of targeted pressure and techniques helps release tight muscles, reduce knots, and alleviate chronic pain conditions. It is particularly beneficial for individuals dealing with injuries, repetitive strain, or postural imbalances.

3. Improved Blood Circulation

Massage enhances blood circulation, improving the flow of oxygen and nutrients throughout the body. Better circulation supports tissue healing, reduces inflammation, and boosts the immune system’s functionality.

4. Enhanced Flexibility and Range of Motion

By addressing muscle tension and tightness, therapeutic massage helps improve flexibility and range of motion. Athletes and individuals recovering from injuries can benefit from enhanced joint mobility and increased flexibility, which aids in injury prevention and performance optimization.

5. Stress and Anxiety Reduction

Beyond physical benefits, therapeutic massage has a positive impact on mental and emotional well-being. It helps reduce anxiety, promote relaxation, and improve mood by triggering the release of endorphins, the body’s natural feel-good hormones.

6. Boosted Immune Function

Regular therapeutic massage sessions have been linked to improved immune function. As massage supports lymphatic drainage and the removal of toxins, it contributes to a stronger immune system, making the body more resilient to illnesses.

7. Injury Rehabilitation and Recovery

Integrating massage into a clinical setting, such as Tawa Physical Therapy, amplifies the benefits of traditional physical therapy. Massage complements the rehabilitation process by promoting faster injury recovery, reducing scar tissue formation, and improving tissue healing.

8. Holistic Approach to Wellness

Therapeutic massage embodies a holistic approach to wellness, considering the interconnectedness of the body, mind, and spirit. By addressing physical and emotional aspects, massage therapy fosters overall health and harmony.

Massage and Your Health Benefit Plan

In Alberta, many health benefit plans cover therapeutic massage as part of their extended health coverage. At Tawa Physical Therapy, we understand the importance of accessibility to massage treatments. Our reception team is dedicated to helping you determine if your health benefit plan covers therapeutic massage, making it easier for you to incorporate this invaluable therapy into your wellness routine.

If you are seeking the powerful effects of therapeutic massage and wish to explore its integration into your wellness plan, get in touch with us! Our skilled therapists are ready to support you on your path to optimal health and vitality.

The Road to Recovery: How Long Does Physical Therapy Treatment for Motor Vehicle Accidents Last?

Title Card with the Text: The Road to Recovery: How Long Does Physical Therapy Treatment for Motor Vehicle Accidents Last?

Motor vehicle accidents (MVAs) can have far-reaching physical consequences, leaving individuals with a range of injuries that require specialized care. One of the most effective ways to address these injuries and support recovery is through physical therapy. However, the duration of physical therapy treatment for MVAs can vary based on the severity and type of injuries. In this blog, we’ll explore the typical course of physical therapy treatment for different kinds of injuries sustained in motor vehicle accidents.

Whiplash Injuries

Whiplash is a common injury that occurs when the head jerks forward and backward suddenly during a collision. Physical therapy plays a crucial role in treating whiplash, and a typical course of treatment may last between 8 to 16 weeks. Therapists focus on reducing pain and stiffness, improving neck mobility, and strengthening the neck and shoulder muscles.

Fractures and Dislocations

Fractures and dislocations can vary in severity, and the duration of physical therapy will depend on factors such as the type of fracture and the individual’s healing progress. For instance, a minor fracture may require 8 to 12 weeks of physical therapy to regain strength and function, while more complex fractures may require longer treatment periods. Typically, the physiotherapy treatment is begun once the fractures have stabilized after a 3-8 week immobilization period.

Soft Tissue Injuries

Soft tissue injuries, such as sprains and strains, can cause pain and reduced mobility. Physical therapy for these injuries generally lasts around 4 to 16 weeks. Therapists use manual techniques, exercises, and modalities to promote healing, reduce inflammation, and restore function.

Spinal Cord Injuries

Severe motor vehicle accidents can lead to spinal cord injuries that result in partial or complete paralysis. The duration of physical therapy for spinal cord injuries varies greatly, as it involves long-term rehabilitation. Treatment can span several months or even years, focusing on maximizing functional independence and mobility.

Head Injuries and Concussions

Head injuries and concussions require a cautious and gradual approach to physical therapy. Depending on the severity of the injury, treatment may last for several weeks or months. Therapists prioritize rest and gradual re-introduction of physical activities to allow the brain to heal properly.

Physical therapy is an invaluable resource in the recovery process after motor vehicle accidents. The duration of treatment varies based on the type and severity of injuries sustained. By working closely with skilled physiotherapists, individuals can embark on a personalized journey to regain function, reduce pain, and improve their quality of life.

What is it like to receive a shockwave therapy session

Featured Image with the text "What is it like to receive a Shockwave Therapy Session

Shockwave therapy is an effective and non-invasive treatment for a variety of musculoskeletal conditions. It is usually performed in a clinical setting and takes about 20 to 30 minutes to complete. Patients may experience some discomfort during the procedure, but no anesthesia is required.

As the sound waves penetrate through the skin, it can cause a feeling of warmth or a strong tapping sensation.  Depending on the intensity of the therapy, these pulses can range from feeling like gentle tapping to more intense pulsing.  Most patients describe it as a mild to moderate discomfort during treatment that usually subsides quickly. During the session, the patient will be monitored closely by the clinician and adjust the intensity in accordance with the patient’s tolerance.

The results of shockwave therapy will vary depending on the condition being treated, but typically take 4-6 weeks to show improvement. The clinician will provide instructions for aftercare activities such as stretching and strengthening exercises that should be done at home following each session to promote healing and improve mobility and strength.

Shockwave therapy is an effective treatment option for many types of chronic pain conditions affecting tendons and muscles. It is quick and relatively painless with minimal side effects.

How Long Does it take for Shockwave Therapy to Work

Shockwave therapy is a non-surgical treatment that has been used to treat chronic tendinitis and other musculoskeletal conditions. It uses high-energy acoustic sound waves to stimulate the healing of injured tissue, relieve pain, and improve mobility. This type of therapy has been found to be effective in treating conditions such as lateral epicondylitis (tennis elbow), Achilles tendinitis, plantar fasciitis, rotator cuff tendinopathy, patellar tendinopathy, calcific tendinopathy and bursitis.

The timing of the results with shockwave therapy will vary depending on the severity of the condition being treated. Generally speaking, it can take anywhere from four to six weeks for someone to experience noticeable improvements in their condition after just 3-6 sessions. There are also certain factors that can influence how long it takes for shockwave therapy to work; these include age and overall health status, as well as how compliant a patient is with their post-treatment rehabilitation program.

Overall, shockwave therapy is an effective treatment for many types of chronic soft tissue injuries.

SI Joint Pain and Treatment

Sacroiliac Joint Dysfunction

What are and where are the Sacroiliac Joints?

The sacroiliac joints are 2 large joints in the pelvis that connect the pelvis to the bottom of the spine, or sacrum. These joints are named for their position: sacro (like sacrum) + iliac, or the ilium, which is part of the pelvis. You can find these joints on yourself by finding the dimples at the back and top of your pelvis. Just to the midline and slightly below this are each of your sacroiliac joints. 

In children and adults of childbearing age (<50 years of age), the SI joints naturally rotate as we walk and move. The SI joints also need to be flexible enough to allow for giving birth. However, as we age, the SI joints become stiffer. In one study, 37% of SI joints in men over the age of 50 were so stiff that they had become completely fused. (Brooke R: The sacroiliac joint. J Anat 58:299-305, 1924)

Am I suffering from Sacroiliac (SI) Joint Pain? What are the Symptoms of Sacroiliac Joint Dysfunction?

Sacroiliac joint pain, low back pain, and hip pain can be very similar in nature and may be very hard to differentiate from one another. It is thought that SI joint pain can account for 25% of lower back pain cases. (Simopoulos TT, Manchikanti L, Gupta S, Aydin SM, Kim CH, Solanki D, Nampiaparampil DE, Singh V, Staats PS, Hirsch JA. Systematic Review of the Diagnostic Accuracy and Therapeutic Effectiveness of Sacroiliac Joint Interventions. Pain Physician. 2015 Sep-Oct;18(5):E713-56. [PubMed]). 

Typically, sacroiliac joint pain can be pinpointed to one side of the bottom of the spine just to the midline and below the dimples in your pelvis. In fact, the ability to point a finger to this precise area, if painful, is called the Fortin finger test, a fairly reliable indicator of SI joint pain as a pain source. Pain from the SI joints can radiate into the buttock and the upper thigh, but pain typically does not radiate pain below the knee. Demographically, the majority of SI joint problems occur in younger adults, although a smaller proportion of older adults can suffer from SI joint pain as well.

In people suffering from SI joint pain, rolling in bed, lying on the affected side, weight bearing on the affected leg, sitting down on the affected side, and climbing stairs can all be very uncomfortable activities. Sometimes SI joint pain can cause a clunking or clicking feeling to occur in the pelvic region at the bottom of the spine.

What causes Sacroiliac joint Dysfunction? What are the Types of Sacroiliac Joint Dysfunction?

Most commonly sacroiliac joint dysfunction is seen in younger adults as a problem of hypermobility, or where the joints move too much and cause pain. This is very common after childbirth when the joints of the pelvis are traumatized and stretched to make way for the baby. When the SI joint moves too much, this can cause pain. 

The sacroiliac joints can also move too little and also cause pain. These joints can either be stiff and move less than normal (termed hypomobility), or they can lock out of their normal position and  not be able to move at all (termed subluxed). 

Sometimes muscle imbalance, where certain muscles that attach to the pelvis are too stiff and other muscles that are too weak, can cause the pelvis to be misaligned, function incorrectly and create SI joint pain.

How is Sacroiliac Joint Dysfunction treated?

Your physiotherapist will assess your lower back, pelvis and hip region to properly diagnose the source of your pain. Once it is determined that your SI joint is problematic, there are several physiotherapy approaches available to give you relief, depending on the type of problem found:

  • Stretching exercises for the lower back, pelvis and hip region
  • Core stability and strengthening exercises
  • Joint mobilization or manipulation
  • Ergonomic or postural advice
  • Use of a sacroiliac joint brace
  • Frictions to trigger points found in tight muscles
  • Acupuncture or dry needling techniques for pain control or to resolve trigger points
  • Electrophysical agents for pain control such as interferential current or ultrasound

COVID-19 Policies and Procedures

Covid-19 Physiotherapy Policy

With respect to the need for our community to observe social distancing and minimize the risk of spreading COVID-19, we initially closed our doors March 27th to in-person physiotherapy services, and implemented a plan for Tele-rehabilitation services. This is a method of virtual care, also known as Telehealth or Teletherapy, allowing our valued clients to connect with their physiotherapist from the safety of their own home using teleconferencing technology. We’ve had much success supporting our valued clients through tele-rehabilitation since April 6th, and as of May 4th, we have transitioned to a hybrid model of care. This includes a combination of in-person physio and tele-rehabilitation based on client screening, prioritization and appropriateness. Massage therapy appointments available starting June 15th. You are welcome to contact us for an appointment.

We are committed to keeping our valued clients and staff safe through the following methods in our clinic:

  • Waiting room seating capacity reduced, with visits by appointment only. Staff and clients to wear masks and adhere to social distancing recommendations
  • Facilitating the completion of paperwork & intake forms that can be completed before (rather than during) appointments
  • Reducing therapists’ client caseloads to 50% of normal (or less)
  • Physical distancing: Our clinic configuration has been changed to increase physical distancing between clients
  • Non-contact thermometers and COVID-19 screening questionnaires are done daily for all staff and clients
  • Personal Protective Equipment: A cough screen has been installed at our reception desk, and we require continuous masking by all clients and staff, along with the use of gloves and face shields by staff when appropriate
  • Diligent Hygienic and Cleaning Practices: All staff and patients are required to use hand sanitizer/wash hands upon entering the clinic as well as before and after using treatment/exercise equipment. Therapists continue to wash hands frequently, with extra diligence. Exercise equipment is sanitized between each use. Our cleaning staff regularly wipe down all points of contact between clients and therapists in our clinic with an AHS-recommended disinfectant solution. 
Using technology for tele-rehabilitation.

Our massage therapy services resumed on June 15th, 2020, following the Alberta provincial strategy for re-opening, as directed by the Chief Medical Officer of Health.

We are closely following developments and health authority recommendations regarding the global COVID-19 pandemic. We are acutely aware of our responsibility to minimize the risk to our clients and employees and we are following guidelines set by the Government of Alberta and Alberta Health Services (https://www.albertahealthservices.ca/topics/Page16947.aspx).

For more information on coverage and funding for physiotherapy, including physiotherapy through tele-rehab, check out our Announcement Page.

Tele-Rehabilitation Announcement and Coverage

Edmonton Tele-Rehabilitation Direct Billing through Tawa Physiotherapy

Great news, Tawa Physical Therapy is approved for direct billing for Tele-Rehabilitation sessions through our secure video Tele-Rehabilitation platform. Just let us know who your provider is and your plan number, and we can do the rest for you.

Will my insurance pay for Tele-Rehabilitation physiotherapy?

Yes! Workers Compensation Board (WCB) is paying for Tele-Rehabilitation physiotherapy treatment. All personal/group/extended health benefits insurance companies that bill through the Telus Health Portal accept Tele-Rehabilitation services. Here are the specific insurance companies that are included under Telus Health as well as their contact phone numbers:

BPA – Benefit Plan Administrators 1-800-867-5615

Canada Life 1-800-957-9777

Canadian Construction Workers Union 416-240-0047

Chamber of Commerce Group Insurance 1-800-665-3365

CINUP 1-800-665-1234

ClaimSecure 1-888-513-4464

Cowan 1-888-509-7797

Desjardins Insurance 1-800-463-7843

First Canadian 1-866-212-5644

GMS Carrier 49 1-800-667-3699

GMS Carrier 50 1-800-667-3699

GroupHEALTH 1-833-344-6944

GroupSource 1-888-547-6947

Industrial Alliance 1-877-422-6487

Johnson Inc. 1-866-773-5467

Johnston Group Inc. 1-800-893-7587

LiUNA Local 183 416-240-2103

LiUNA Local 506 416-506-8841

Manion 1-866-532-8999

Manulife Financial 1-866-407-7878

Maximum Benefit 1-800-893-7587

Sun Life Financial 1-855-301-4786

TELUS AdjudiCare 1-877-944-7100

In addition, Blue Cross 780-498-8000 , Green Shield 1-888-711-1119, SSQ 1-888-651-8181, and Empire Life 1-800-561-1268 also cover Tele-Rehabilitation. 

Most MVA insurers are paying for Tele-Rehabilitation. With respect to motor vehicle injuries, we recommend you call your insurance adjustor directly to confirm that they will cover physiotherapy fees for Tele-Rehabilitation sessions. 

Alberta Health Services (AHS) recently announced their support for funding Tele-Rehabilitation through contracted clinics. As of April 24th, we are able to provide AHS funded Physiotherapy Virtual Services for those that meet the criteria set out by AHS.

Does Tawa Physical Therapy direct bill to my insurance provider? 

Yes! We will direct bill all insurance companies that are serviced through the Telus Health Portal. As various plans differ even within specific insurance companies, please call your insurance provider directly to check on your specific plan details.