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Back Works is now an official Complete Concussion Management™ clinic.

As concussions have become the focus for both professional and amateur athletes around the world, we wanted to be at the forefront of concussion diagnosis, management, and rehabilitation. With our collaboration and education through Complete Concussion Management we now offer the research-driven concussion treatments and rehabilitation.


What is a concussion?
A concussion can be simply defined as a disruption in neurological functioning following a significant impact to the head or elsewhere on the body. This causes a biochemical imbalance within brain cells as well as decreased blood flow and temporary energy deficits within the brain.
Following a suspected concussion, a player should be immediately removed from play, assessed and placed on complete rest in order to recover from the energy deficit. Studies have shown that any activity, both mental and physical, in the immediate days following concussion can delay the process of recovery and should be avoided until the athlete is completely symptom free.


What is baseline testing?

The biggest concern surrounding concussions comes from the energy deficit that occurs in the brain following injury. When the brain is in this low energy state, it has been well established that the brain is extremely vulnerable to additional trauma, where even smaller impacts can lead to another concussion; and these second concussions can cause severe brain injuries with potentially permanent or fatal outcomes.

The problem is that symptoms (meaning how someone feels) do not coincide with brain recovery. The only way to know when the brain has fully recovered and out of this “vulnerable period” is to compare current brain function to when the individual was healthy; this is what is known as a “baseline test”. A baseline test is a battery of tests that measures every area of brain function that could potentially become affected following a concussion (you need more than computer tests!!). The reason that the test is termed a “baseline” is because it is done BEFORE the athlete gets injured. In order to know when an athlete has fully recovered, we first have to know where they were when they were healthy. Without having this information, there is no way to truly know when an athlete has fully recovered and is safe to return to their sport.
Baseline testing is the most important thing to get done prior to beginning your sports season on a yearly basis.


Complete Concussion Management™:
Complete Concussion Management™ is a concussion research company that educates healthcare practitioners on cutting-edge concussion therapies and management strategies based on the most current medical research so that they may provide high quality concussion treatment and follow-up. Certified Complete Concussion Management™ practitioners are continuously updated on current research and treatments in order to manage these injuries properly and safely to ensure adequate recovery, thereby limiting the risk of further injury and long-term brain damage.

• Comprehensive baseline testing
• Post-injury diagnosis and injury management
• Concussion rehabilitation for chronic symptoms (Post-Concussion Syndrome)
• Coach & trainer education and certification programs


The CCMI Network:
Complete Concussion Management™ is the largest network of clinics that treat concussions in all of Canada. As part of being involved with this network we contribute to ongoing research in concussion management. Athletes tested through our program can have access to any CCMI certified clinic across the country. All of these clinics have received the same training, are conducting the same tests, and using the exact same equipment. This means that if you are baseline tested in your town and you are out of town for a tournament and you get a possible concussion, you can walk into that clinic and be tested and compared against YOUR OWN baseline!




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Congratulations Lisa!

Back Works is proud to announce we now have 4 physiotherapists certified in Intramuscular Stimulation (IMS). Lisa successfully completed the course at the University of British Columbia in Vancouver.


IMS is a treatment technique used to help people with ongoing or chronic myofascial pain syndromes. For more information on UBC Gunn IMS give us a call, visit our page or go to the University of British Columbia's website (UBC Gunn IMS).



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Congratulations Rabi!

Rabi Guha has completed his certification course in Gunn Intramuscular Stimulation from the University of British Columbia.


For more information on Gunn IMS just click on the title above or visit the "How We Can Help You" page for more information on our other services.



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Inactivity in Older Adults

Older adults are living longer than ever before. The current life expectancy in Canada is 80.93 years,  10 years more than Canadians living 50 years ago (1). Unfortunately increased life expectancy does not necessarily translate into more years of healthy independent living (2).  Although the majority of older adults expect to travel, be active around the home, take up a new hobby or spend more time with their grandchildren, in reality most will spend their last 10 years living in sickness, disability and immobility (3). Lifestyle is largely to blame. A recent study identified the five most important contributors to life expectancy and good health in later years as smoking, alcohol consumption, stress, diet and physical activity (2). Improving these behaviours was estimated to increase life expectancy by  7.5 years, but more importantly has the potential to increase the number of years living in good health by 9.8 years (2). Being physically active alone was shown to increase life expectancy by 2.4 years (2). Unfortunately inactivity is commonplace for Canadian adults with only 15% meeting the recommended 150 minutes of moderate to vigorous activity every week in bouts of 10 minutes or more (4,5).

Physical activity in any form including walking, swimming, cycling or tasks around the house is vitally important to maintain good health, especially in older adults.  Active older adults report greater independence, less depression, and are at less risk for the development and progression of many diseases such as high blood pressure, high cholesterol, heart disease, stroke, diabetes and colon and breast cancer (6,7). Active older adults are also at significantly decreased risk for becoming disabled and have a lower mortality rate than their inactive peers.  The physical effects of inactivity extend to the brain as well. Recent reports suggest that exercise has a protective role, lessening the risk of developing various kinds of dementia with age (8).

Starting or progressing an activity program can be a difficult task at any age. Our busy lives and schedules make it difficult to find time for many things especially exercise. However, given the importance of staying active for our health at any age, incorporating exercise in to our daily lives should be a priority. A registered Physiotherapist can help. Physiotherapists have extensive knowledge of muscle and exercise physiology and can provide guidance and education to clients of any age, including older adults, about how to start, maintain or progress an activity programme.  Physical activity has so many important benefits. Give yourself the best gift of all and get active today.



1.  Statistics Canada. Life expectancy at birth, by sex, by province. 2012. Available at: Accessed October 10, 2013.
2.  Manuel DG, Manson H. SEVEN MORE YEARS?: The impact of smoking , alcohol , diet , physical activity and stress on health and life expectancy in Ontario.; 2012.
3.  Heart and Stroke Foundation. Reality check?: Boomer dreams for later life may not Changes Now , Many Baby Boomers Face a Decade of Sickness and Disability. 2013.
4.  Janssen I. Health care costs of physical inactivity in Canadian adults. 2012;806(February):803-806. doi:10.1139/H2012-061.
5.  Colley RC, Garriguet D, Janssen I, Craig CL, Clarke J, Tremblay MS. Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey. Health Rep. 2011;22(1):7-14. Available at:
6.  Katzmarzyk PT, Janssen I. The economic costs associated with physical inactivity and obesity in Canada: an update. Can J Appl Physiol. 2004;29(1):90-115. Available at:
7.  Simonsick EM, Lafferty ME, Philips CL, et al. Risk Due to Inactivity in Physically Capable Older Adults. 1993:1443-1450.
8.  Larson EB, Wang L, Bowen JD, Mccormick WC, Teri L, Crane P. Annals of Internal Medicine Article Exercise Is Associated with Reduced Risk for Incident Dementia among Persons 65 Years of Age and Older. 2006:73-82.

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The Gold Award!


Thank you to our clients who voted for us in the Waterloo Chronicle Readers Choice Awards. We work hard to provide individualized, effective care to our clients and it is humbling to have people go out of their way to recognize it.

We have exciting changes happening around the clinic. New skill acquisition through ongoing continuing education courses is our priority in order to continue to strive for the most updated treatment options.

Once again we thank you for your loyalty and votes.




The Staff at Back Works

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Welcome Dr. Davenport!


Back Works is pleased to announce that Dr. Anna Davenport has joined our team to provide sports medicine services.  Sport Medicine physicians have specialized training and skills to provide care for active  patients of all ages.  Dr. Davenport has an advanced skill set in evaluating  movement patterns in the injured athlete that helps her to form effective treatment approaches aimed at regaining optimal movement patterns.  For many years she has been involved in triathlons, as well as competing in rowing and cross country skiing. 


Dr. Davenport will be available on a part time basis at Back Works and referrals can be made directly to Back Works at (519) 746-8172 or by e-mail at  Patients are welcome to call themselves for an appointment.

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Tips for Maintaining a Healthy Body and Garden

As the snow melts and we can finally start to see our yards again, the prospect of gardening begins to approach. 

Gardening and yard work can be a part of maintaining a healthy lifestyle.   It provides the benefits of improving endurance, strength, and flexibility, in addition to the benefits of enjoying the outdoors. 

The tips below will help minimize the risk of injury and pain to allow you to enjoy the benefits of this upcoming gardening season.

1. Warm up and cool down.


Gardening, like any other exercise, requires a proper warm up and cool down.  Start with an easy walk and exercises consisting of similar motions you would use while gardening.  Work from small to large ranges of motion, and target the muscles and joints required to complete you gardening tasks.  After putting away your shovel, perform stretching exercises to target your back, legs, arms, hands and neck. 

2. Never work through pain.


If you feel pain before, during or after gardening don’t push through it.  It will be worse to have to cut your gardening season short due to an injury rather than resting and seeking help early. 

3. Use proper tools.


There are ergonomic tools available that can help those with mobility restrictions, or to simply help make gardening tasks easier and reduce the stress and strain on your body.  When buying tools, make sure to choose those with proper handles for your height.  Ensure you tools are sharp and well maintained to reduce the workload on your body and prevent injury.  Raised garden beds are also available to help reduce bending over while gardening. 
It is not only important to consider the use of proper gardening tools.  Ensure you are wearing the proper footwear to help you navigate the uneven ground, slippery surfaces, and obstacles present while gardening. 

4. Plan, pace, and stay hydrated.


Gardening can be hard work.  Plan the tasks that you need to accomplish, and spread the work out over several weeks so you don’t get overwhelmed or over do it.  Make sure you start slowly and take frequent breaks, as well as change positions or alternate tasks to avoid overuse injuries.  In addition, staying hydrated throughout the day and while you work is important during any physical activity, especially as the temperatures outside begin to rise.


5. Use proper movement and form.


When bending or lifting, hold the objects close to your body, squat to use the large muscles in your legs instead of you back, and keep you feet wider apart to give yourself a large base of support.  When raking or reaching, move your feet to avoid twisting your trunk and to get body closer to the task.
Don’t wait to seek help if you’re suffering from a gardening related injury.  Physiotherapy can help prevent and treat injuries to keep you and your garden healthy.

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Fit Fore Golf

Finally, after a long winter, golf season is almost here!


Many golfers find putting to be one of the most challenging parts of their game.  In most sports, an athlete looks at the target when either shooting or passing a ball.  For example, when a basketball player shoots a 3 pointer, their focus is on the basket; when a pitcher throws the baseball they are focused on the catcher's glove. Why then does a golfer look at the ball when they are putting? Try this has worked for me! When you are on the putting green practicing your 4 foot putts, look at the hole during your practice strokes (try 3 or 4). When you are ready to putt, place the putter behind the ball and look at the hole again while you make the putt. It will feel strange at first, but I think many people will find they start making more short putts! It should be noted that for longer putts, requiring a larger backswing, this technique may not work as well, so try it out on the practice green first, before it counts on the course!


Golfers, like any other athletes, have injuries that either affect their performance.  The first few rounds can be particularly challenging on the body as your muscles and joints may not be as flexible as they were pre-winter.  Back Works is pleased to offer assessments and treatments focused on golf specific rehabilitation from a FitForeGolf trained therapist.  Call today to set up an appointment with Dave Gilman to have your golf swing assessed and get some pointers on preventing injury this golf season. 

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Steph DaSilva
October 16, 2018
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Lisa Streib
November 30, 2014
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