Frequently Asked Questions — Brookswood Plus Physiotherapy
Your Complete Guide to Physiotherapy Care in Brookswood, Langley, BC
Whether you’re a new patient searching for physiotherapy in Langley, managing a long-standing injury, recovering through ICBC or WorkSafeBC, or just trying to figure out if your extended health plan covers your visits — you’re in the right place. We’ve put together this FAQ to answer everything honestly, clearly, and without the medical jargon. If you still have questions after reading, give us a call. We’re always happy to chat.
General Questions About Our Clinic
Q: Where is Brookswood Plus Physiotherapy located, and what areas do you serve?
We’re located in the Brookswood neighbourhood of Langley, BC — right in the heart of South Langley. We see patients from all over the Fraser Valley, including Langley City, Walnut Grove, Aldergrove, Cloverdale, and South Surrey. If you’re looking for a physiotherapy clinic in Brookswood or Langley that offers a wide range of specialized treatments under one roof, you’ve found it.
Q: Do I need a doctor’s referral to book a physiotherapy appointment?
No, you don’t. In British Columbia, physiotherapists are primary healthcare providers, which means you can book directly with us without seeing your doctor first. That said, some extended health insurance plans may require a physician’s referral before they’ll reimburse your visits — so it’s always worth calling your insurer to check before your first appointment. ICBC and WorkSafeBC claims do not require a referral.
Q: What makes Brookswood Plus Physiotherapy different from other clinics in Langley?
Honestly? A few things. First, we offer a broader range of treatment modalities than most clinics — from IMS and dry needling to shockwave therapy, laser therapy, vestibular rehab, neurological rehab, and medical acupuncture. Second, our team takes the time to actually listen. Your initial assessment isn’t rushed. We want to understand not just where it hurts, but why it hurts and what’s been making it worse. Third, we specialize in conditions that many general clinics refer out — things like BPPV, post-concussion syndrome, Parkinson’s, and complex chronic pain. We’re built to handle the tough stuff.
Q: How long is a typical physiotherapy session at your Langley clinic?
Initial assessments are usually 45 to 60 minutes. We need that time to get the full picture — your health history, how your body moves, where the restrictions are, and what your goals look like. Follow-up treatment sessions are typically 30 to 45 minutes depending on your treatment plan and what’s being done. We never double-book our physiotherapists, so you’re getting their undivided attention for your entire appointment.
Q: What should I wear or bring to my first appointment?
Wear something comfortable and easy to move in. If you’re coming in for a knee, hip, or lower limb issue, loose shorts are helpful. For shoulder or upper back problems, a tank top or loose-fitting top works well. Bring a list of any medications you’re taking, any relevant imaging (X-rays, MRI reports), and your extended health card or insurance information if applicable. For ICBC claims, bring your claim number and the date of your accident.
Q: Can I book online, or do I have to call?
You can do both. Our online booking system is available 24/7 on our website, or you can call us directly during clinic hours. If you have a complex situation — like an ICBC claim, a WorkSafeBC referral, or a new neurological diagnosis — we’d recommend calling first so we can match you with the right therapist from the start.
Q: Do you see children and seniors?
Absolutely. We treat patients of all ages. For younger patients, we work on sports injuries, growing pains, and postural issues. For our senior patients in Langley and the surrounding Brookswood area, we specialize in fall prevention, balance training, arthritis management, and post-surgical rehab. Age is never a barrier to getting better.
ICBC Coverage — Motor Vehicle Accident Physiotherapy
Q: Does ICBC cover physiotherapy after a car accident in BC?
Yes. If you’ve been in a motor vehicle accident (MVA) in British Columbia and have an active ICBC claim, you are entitled to physiotherapy treatments as part of your recovery. Under ICBC’s Enhanced Care model, most injury claims allow for direct access to physiotherapy without needing to pay out of pocket upfront. Coverage limits, approved visit numbers, and specific entitlements will depend on the nature of your injuries and your claim type.
Q: Do I need to wait for ICBC to approve my claim before starting physiotherapy?
No — and this is really important. You should start physiotherapy as soon as possible after your accident. Early treatment leads to better outcomes. ICBC generally covers physiotherapy when you have a valid claim number. You don’t need to wait for a formal approval letter to begin. Call us with your claim number and the date of your accident, and we’ll handle the billing directly with ICBC on your behalf.
Q: What ICBC injuries does your Langley physiotherapy clinic commonly treat?
We see a wide range of motor vehicle accident injuries including whiplash and neck pain, lower back injuries, shoulder injuries, knee injuries, headaches and post-concussion symptoms, soft tissue strains, rib injuries, and nerve-related pain. If you were in an accident and you’re feeling pain, stiffness, dizziness, or anything “off,” it’s worth getting assessed — even if symptoms didn’t show up immediately after the crash.
Q: How many physiotherapy sessions will ICBC cover for my accident injury?
This varies based on your specific claim and injury severity. Under ICBC’s Enhanced Care model, you may be entitled to a set number of pre-approved sessions, with the ability to request more if your recovery requires it. Our physiotherapists will document your progress and communicate with ICBC on your behalf when additional treatments are needed. We’ll always be transparent with you about where you stand with your coverage.
Q: I was in an accident a few weeks ago and didn’t start treatment right away. Is it too late to use my ICBC benefits?
It’s not too late, but don’t wait any longer. You have a window to initiate your claim and begin treatment. The longer soft tissue and nerve injuries go without care, the more they can become entrenched. Please call us and we’ll help you understand your options based on your specific situation and claim timeline.
Q: Will I have to pay anything out of pocket for ICBC physiotherapy at your Brookswood clinic?
Under the Enhanced Care model for eligible claims, most patients pay nothing out of pocket for ICBC-covered services. We bill ICBC directly. There may be situations where specific treatments aren’t fully covered under your claim type — we’ll always let you know ahead of time if that applies to your case.
Q: Do I need a doctor’s referral for ICBC physiotherapy?
No. Under Enhanced Care, you can go directly to a physiotherapy clinic without a physician referral. Just bring your ICBC claim number and we’ll take care of the paperwork.
WorkSafeBC (WSBC) Coverage — Workplace Injury Physiotherapy
Q: Does WorkSafeBC cover physiotherapy for workplace injuries?
Yes. WorkSafeBC (also known as WSBC or WCB) covers physiotherapy treatment for accepted workplace injury claims in British Columbia. If you’ve been injured on the job — whether it’s a sudden incident or a gradual strain from repetitive work — you may be entitled to funded physiotherapy through WorkSafeBC. Brookswood Plus Physiotherapy is a recognized provider for WorkSafeBC claims.
Q: What kinds of workplace injuries does your Langley physiotherapy clinic treat under WorkSafeBC?
We treat a broad range of occupational injuries including back and neck strains from lifting or awkward postures, repetitive strain injuries (RSI) like tendonitis and bursitis, shoulder injuries from overhead work, knee injuries from kneeling, squatting, or falls, hand and wrist injuries, post-fracture rehabilitation after a work-related accident, and nerve injuries. Whether you work in construction, warehousing, healthcare, hospitality, or an office setting, we’ve treated it.
Q: How do I start physiotherapy through WorkSafeBC?
Once WorkSafeBC accepts your claim, you’ll receive a claim number. Call our clinic with that number and we’ll get you booked. In many cases, you can begin treatment while your claim is being processed — our team can help guide you through the process so there’s no delay in your care.
Q: Does WorkSafeBC pay the clinic directly, or do I pay and get reimbursed?
WorkSafeBC pays us directly. You shouldn’t have to pay out of pocket for treatments that are covered under your accepted claim. If there’s ever a question about coverage for a specific service, we’ll let you know before proceeding.
Q: What if my WorkSafeBC claim is denied — can I still come to your clinic?
Absolutely. If your claim is denied or still under review, you can still come in as a private-pay patient or use your extended health insurance in the meantime. We’d also encourage you to speak with WorkSafeBC about appealing the decision if you believe your injury is genuinely work-related. Our clinical documentation can support your case.
Q: Can physiotherapy at your Brookswood clinic help me return to work faster?
That’s often one of our primary goals for WorkSafeBC patients — getting you functional, pain-managed, and back on the job safely. We work closely with return-to-work timelines, modified duty recommendations, and functional capacity goals. We can provide written progress reports to WorkSafeBC when required and coordinate with your employer and case manager if needed.
Extended Health Plan Coverage
Q: Does my extended health insurance cover physiotherapy at your Langley clinic?
Most extended health benefit plans through employers, group benefits, or private insurance in Canada include physiotherapy coverage. This applies to plans through major providers like Sun Life, Great-West Life (Canada Life), Manulife, Green Shield, Blue Cross, Desjardins, and others. Coverage amounts, annual limits, and per-visit caps vary significantly from plan to plan — so we always recommend calling your insurer or logging into your benefits portal to confirm before your first visit.
Q: Do I need a doctor’s referral for my extended health plan to cover physiotherapy?
Some plans do require a physician’s referral, and some don’t. It really depends on your specific plan. We recommend checking your benefits booklet or calling your insurer directly. If a referral is required and you don’t have one, your family doctor, walk-in clinic, or even a nurse practitioner can typically provide it.
Q: How much of my physiotherapy cost does extended health typically cover?
This varies widely. Some plans cover 80–100% of the cost per visit up to an annual dollar limit (e.g., $500 or $1,000 per year). Others cover a set number of visits per year. We’ll provide you with a receipt after every visit that you can submit to your insurer for reimbursement. If your plan allows direct billing, we’ll do that for you so you don’t have to pay upfront.
Q: Do you offer direct billing to extended health insurance?
Yes, we offer direct billing to many major insurance providers in Canada. This means we submit the claim on your behalf and you only pay whatever your plan doesn’t cover (if anything). Ask our front desk team about your specific insurer when you book — we’ll confirm whether direct billing is available for your plan.
Q: What if my extended health plan runs out mid-treatment — what are my options?
It happens, and it’s more common than people expect. We’ll work with you on a plan. Options include continuing at our private-pay rates, spacing out appointments to match your budget, or focusing remaining sessions on home exercise programs so you can continue improving independently. We never want your recovery to stop just because benefits run out.
Q: Does extended health coverage apply to all the treatments your clinic offers, like shockwave or laser therapy?
Not always. Physiotherapy assessments and manual therapy are typically covered. Modalities like shockwave therapy, laser therapy, and IMS/dry needling may or may not be included depending on your plan. Some insurers categorize them under physiotherapy, while others require specific codes or don’t cover them at all. We recommend confirming with your plan before your appointment if you’re specifically seeking one of these treatments.
Q: Can I use both ICBC and my extended health benefits at the same time?
Generally, no — not for the same service. ICBC typically covers your physiotherapy related to the accident, while your extended health plan covers non-accident-related care. However, your extended health may cover services that ICBC doesn’t fully fund. Our billing team can help sort out the coordination of benefits in your specific situation.
Musculoskeletal & Joint Pain Treatment
Back & Neck Pain
Q: Is physiotherapy effective for back and neck pain?
Yes — and it’s one of the most evidence-based treatments available for musculoskeletal pain. Physiotherapy for back and neck pain addresses the root cause of the problem, not just the symptoms. Whether your pain is from a disc issue, a muscle strain, poor posture, or a joint problem, our physiotherapists in Langley will assess exactly what’s happening and build a targeted treatment plan. Most patients notice meaningful improvement within a few sessions.
Q: How do I know if my back pain needs physiotherapy or just rest?
If your back pain has lasted more than a few days, is getting worse instead of better, is accompanied by numbness or tingling down your legs, or is affecting your daily life — physiotherapy is the right call. Rest alone rarely fixes the underlying issue. In fact, prolonged rest can sometimes make things worse by allowing muscles to weaken and stiffen further. Movement, done correctly and guided by a physio, is almost always part of the solution.
Q: Can physiotherapy help with a herniated or bulging disc?
Absolutely. Disc injuries are one of the most common things we treat at our Brookswood clinic. Through a combination of manual therapy, targeted exercises, education about posture and movement, and modalities like IMS or shockwave therapy, most people with disc herniations improve significantly without surgery. We work closely with the relevant anatomy to reduce nerve pressure, improve disc health, and rebuild the supporting muscle structures.
Q: I’ve had chronic neck pain for years. Is it too late for physiotherapy to help?
It’s never too late. Chronic neck pain — even when it’s been around for years — often responds well to physiotherapy, especially when treatments like manual therapy, dry needling, and postural correction are combined. We see patients regularly who have tried everything else and found real relief through a structured physiotherapy program. The key is proper assessment to understand the specific drivers of your pain.
Q: What’s causing my back pain to shoot down my leg?
That pattern — back pain radiating down the leg — is often called sciatica and is usually related to nerve irritation in the lumbar spine. It can come from a disc bulge, stenosis (narrowing of the spinal canal), piriformis syndrome, or other structures compressing the sciatic nerve. Our physiotherapists will assess which structure is involved and create a treatment plan accordingly. This is very treatable with the right approach.
Sprains & Strains
Q: How long does a sprain take to heal with physiotherapy?
It depends on the severity of the sprain. A Grade 1 sprain (minor ligament stretching) might feel substantially better within 1–3 weeks with proper care. A Grade 2 (partial tear) may take 4–8 weeks. A Grade 3 (complete rupture) can take 3–6 months, sometimes requiring more intensive rehab or surgical consultation. Physiotherapy speeds up this timeline by managing swelling, restoring joint movement, rebuilding strength, and — critically — addressing the proprioception (balance and coordination) deficits that make re-injury so common.
Q: I sprained my ankle months ago and it still doesn’t feel right. Can physio help?
Yes — this is actually a very common presentation we see. Many people “walk off” a sprain, only to find months later that the ankle still swells, feels unstable, or gives way. This often means there are residual mobility deficits, weakness in the surrounding muscles, or poor proprioception from the injury. Physiotherapy can address all of these and significantly reduce your risk of re-injury.
Q: What’s the difference between a sprain and a strain, and do you treat both?
A sprain involves a ligament (connecting bone to bone), while a strain involves a muscle or tendon (connecting muscle to bone). They feel similar — pain, swelling, bruising, reduced movement — but the treatment approach differs slightly based on the tissue involved. We treat both at our Langley clinic, and we treat them properly by targeting the specific injured structure.
Q: Can I exercise while recovering from a muscle strain?
In most cases, yes — but the right exercise matters enormously. Loading a strained muscle too aggressively too soon can cause re-injury or delay healing. Our physiotherapists will prescribe exercises that are appropriate for your stage of healing — gentle movement and activation in the early phase, progressive loading as tissue repairs, and return-to-sport or return-to-activity protocols once you’re ready.
Q: Are there any at-home things I can do right after a sprain or strain before my physio appointment?
The classic RICE approach (Rest, Ice, Compression, Elevation) remains a reasonable short-term strategy for the first 24–48 hours to manage swelling and pain. However, prolonged rest and icing are no longer universally recommended as they can slow healing. Get in for an assessment as soon as possible. In the meantime, gentle pain-free movement is usually better than complete immobilization.
Arthritis Management
Q: Can physiotherapy actually help arthritis, or do I just have to live with it?
Physiotherapy is one of the most effective non-surgical treatments for arthritis — both osteoarthritis and rheumatoid arthritis. While physiotherapy can’t reverse the structural changes in a joint, it can dramatically reduce pain, improve function, slow progression, and increase your quality of life. Exercise, movement, joint protection strategies, manual therapy, and the right modalities can make a genuine difference. Many of our Langley patients with arthritis report that consistent physiotherapy has transformed their day-to-day life.
Q: What joints do you treat for arthritis at your Brookswood clinic?
All of them. We most commonly treat hip, knee, shoulder, and hand/wrist arthritis, but we also see patients with arthritis in the spine, ankle, and other joints. The approach differs by joint, but the goals are consistent: reduce pain, restore movement, strengthen surrounding muscles, and help you stay active.
Q: I have knee arthritis and my doctor mentioned surgery. Should I try physiotherapy first?
Yes — and most orthopedic surgeons would agree. Pre-surgical physiotherapy (called “prehab”) improves outcomes significantly if you do end up having surgery. But many patients who commit to a proper physiotherapy program find that surgery can be delayed or avoided altogether. Strengthening the muscles around the knee reduces load on the arthritic joint and can meaningfully reduce pain. It’s absolutely worth trying.
Q: Does physiotherapy help with the stiffness that comes with arthritis in the morning?
Morning stiffness is one of the most common complaints from our arthritic patients, and yes, physiotherapy helps. Regular gentle exercise, joint mobilization, and movement routines taught by your physiotherapist can dramatically reduce the duration and severity of morning stiffness. We’ll also give you a morning routine that takes only a few minutes and makes a noticeable difference.
Q: Is it safe to exercise when my arthritic joints are inflamed and painful?
This requires some nuance. During a significant flare-up with active inflammation, very gentle, low-load movement is generally preferred over aggressive exercise. Your physiotherapist will help you understand the difference between harmful pain (stop, rest, modify) and productive discomfort (okay to work through). Long term, appropriate exercise is one of the best things you can do for arthritic joints — it improves joint lubrication, strengthens supportive structures, and reduces inflammation over time.
Tendonitis & Bursitis
Q: What’s the difference between tendonitis and bursitis, and how do you treat them?
Tendonitis (or tendinopathy) is irritation or degeneration of a tendon — the tough cord connecting muscle to bone. Common examples include Achilles tendinopathy, rotator cuff tendinitis, and patellar tendinitis. Bursitis is inflammation of a bursa — a small fluid-filled sac that cushions between tendons, bones, and muscles. Both cause localized pain, stiffness, and pain with specific movements. Treatment overlaps significantly: load management, targeted strengthening, manual therapy, and modalities like shockwave therapy or laser therapy are effective for both conditions.
Q: I’ve had shoulder pain from rotator cuff tendinitis for months. Why isn’t it getting better on its own?
Tendons have a relatively poor blood supply compared to muscles, which means they heal slowly — and they often don’t fully recover without targeted intervention. If you’ve had ongoing tendon pain for more than 6–8 weeks, it’s likely shifted from an acute inflammatory phase to a more chronic degenerative state called a tendinopathy, which requires a different approach. Passive rest doesn’t fix tendinopathy — progressive, structured loading under a physiotherapist’s guidance does.
Q: Can shockwave therapy help my chronic tendinopathy?
Yes — shockwave therapy is one of our most effective tools for stubborn tendon problems, and it’s something we offer right here at our Brookswood Langley clinic. It works by stimulating the body’s natural healing response in degenerated tendon tissue. Research consistently shows strong results for Achilles, patellar, plantar fascia, rotator cuff, and other tendinopathies, particularly when other treatments have plateaued.
Q: I was diagnosed with hip bursitis. Do I need surgery?
Rarely. The vast majority of hip bursitis cases respond well to physiotherapy. We address the mechanical factors that are creating excess load on the bursa (often weakness in the hip abductors and gluteal muscles), reduce inflammation through manual therapy and modalities, and gradually rehabilitate the area. Surgery is typically a last resort after conservative treatment has been thoroughly tried.
Q: Can I keep playing sports with tendonitis?
This depends on how severe the tendinopathy is and which tendon is involved. In some cases, continuing activity with load modification is appropriate and even beneficial for tendon healing. In others, a short period of activity reduction is needed to allow the tendon to settle. Your physiotherapist will assess the tendon’s irritability level and help you understand what you can safely do — and how to train smarter so this doesn’t keep recurring.
Post-Fracture Rehabilitation
Q: When should I start physiotherapy after a fracture?
Ideally, as soon as your fracture is stable enough — which your doctor or orthopedic specialist will confirm. In many cases, physiotherapy can begin while you’re still in a cast or brace, focusing on the joints and muscles around the fracture site to minimize atrophy and stiffness. Once the fracture is healed, the real work of restoring range of motion, strength, and function begins. Don’t wait until everything feels completely normal on its own — by then, significant stiffness and weakness have often set in.
Q: I had a wrist fracture and now I can barely bend it. Is physiotherapy going to help?
Stiffness after a wrist fracture is extremely common, especially after an extended period in a cast. The surrounding joints, tendons, and tissues stiffen significantly with immobilization. Physiotherapy — through joint mobilizations, stretching, strengthening, and gradual functional exercises — is highly effective at restoring wrist motion and grip strength. Most patients see significant progress within 4–8 weeks of consistent treatment.
Q: My ankle fracture healed, but I’m still limping. What’s going on?
After a fracture, the brain and body “forget” how to load and move the limb normally. This is called altered movement patterns or movement avoidance, and it’s completely normal — but it needs to be addressed. Your physiotherapist will work on gait retraining, balance, strength, and confidence in loading the ankle so that your limp gradually resolves and your function returns fully.
Q: Can physiotherapy help with the bone after a stress fracture, or is rest the only option?
Rest from the aggravating activity is essential in the early stages of a stress fracture — but physiotherapy plays a huge role in the recovery. We identify why the stress fracture happened (often training errors, biomechanical issues, or nutritional factors), keep you active in low-impact ways during healing, and then build a structured return-to-activity program that reduces the risk of it happening again.
Q: Will I get back to full function after my fracture?
In the vast majority of cases, yes — especially with proper physiotherapy. The timeline depends on the bone involved, how complex the fracture was, your age, overall health, and how consistently you engage with your rehabilitation. Our goal is always full return to function, whether that means playing recreational sports, doing manual labor, or keeping up with your grandchildren.
Vestibular Rehab: Dizziness & Balance Treatment
Vestibular physiotherapy is one of our specialty services at Brookswood Plus Physiotherapy. Many people in Langley and the Fraser Valley suffer from dizziness, vertigo, and balance problems without realizing that these conditions are often very treatable with the right kind of physiotherapy. Here’s what you need to know.
Vertigo & Spinning (BPPV)
Q: What is BPPV and can physiotherapy really fix it?
BPPV stands for Benign Paroxysmal Positional Vertigo — a mouthful of a name for a very common and very treatable condition. It happens when tiny calcium crystals (called otoconia or “ear rocks”) in your inner ear get displaced into one of the fluid-filled canals, causing brief but intense spinning sensations triggered by head movement. Yes, physiotherapy can absolutely fix it. A trained vestibular physiotherapist performs specific repositioning maneuvers (like the Epley Maneuver) that guide the crystals back to where they belong. Many patients feel dramatically better after just one or two sessions.
Q: How do I know if my vertigo is BPPV or something else?
BPPV typically presents as brief spinning episodes (less than a minute) triggered by specific head movements — rolling over in bed, looking up, bending down, or getting up quickly. If your vertigo is prolonged, constant, or accompanied by hearing loss, ringing in the ears, or neurological symptoms like double vision or weakness, it may be a different condition that requires different assessment. Our vestibular physiotherapist will conduct a thorough examination, including specific tests like the Dix-Hallpike and Roll Test, to identify exactly which type of BPPV you have (which canal is affected) and choose the right treatment.
Q: I’ve been dizzy for weeks and my doctor says it might be BPPV. How soon can I get in?
Please call us as soon as possible. BPPV is debilitating and significantly affects quality of life — but it responds very quickly to treatment. We prioritize vestibular patients because the sooner treatment begins, the sooner you feel human again. Weeks of dizziness don’t have to be your new normal.
Q: Are there any exercises I can do at home for BPPV?
Yes — the Brandt-Daroff exercises are commonly recommended for home management. However, doing the wrong exercises for the wrong type of BPPV (or the wrong canal) can sometimes make things worse. We strongly recommend getting assessed first so we can identify your exact BPPV variant and give you the appropriate home exercise program. Generic YouTube exercises are often unhelpful and occasionally counterproductive.
Q: Will BPPV come back after treatment?
It can. BPPV has a recurrence rate of around 15–20% per year in some studies. If it comes back, the good news is that it’s treated just as effectively the second time around. We’ll also teach you how to recognize early symptoms and what to do — and what not to do — if it returns. Some patients benefit from ongoing vestibular exercises to reduce the likelihood of recurrence.
Inner Ear Infections & Dizziness (Labyrinthitis / Vestibular Neuritis)
Q: What is vestibular neuritis and how is it different from labyrinthitis?
Both are conditions where the vestibular nerve (which carries balance information from the inner ear to the brain) becomes inflamed, usually after a viral infection. Vestibular neuritis affects the nerve only, causing dizziness and balance problems without hearing changes. Labyrinthitis involves inflammation of both the vestibular and auditory parts of the inner ear, so it also causes hearing symptoms. Both are extremely disorienting in the acute phase but typically respond very well to vestibular physiotherapy once the inflammation settles.
Q: I had a bad viral infection and now I’m dizzy all the time. Should I see a physiotherapist?
Yes — this is a classic presentation of post-viral vestibular dysfunction. The initial viral phase is typically managed medically, but once the acute illness resolves, many people are left with residual dizziness, imbalance, and sensitivity to movement. This is because the brain hasn’t fully compensated for the change in balance signals from the damaged inner ear. Vestibular physiotherapy at our Brookswood clinic helps retrain the brain to compensate correctly, dramatically speeding up recovery.
Q: How long does recovery from vestibular neuritis typically take?
Without physiotherapy, recovery from vestibular neuritis can take 6 months to over a year, and some people never fully recover. With targeted vestibular rehabilitation — including gaze stabilization exercises, habituation training, and balance retraining — most patients achieve significant improvement within 6–12 weeks. Early intervention produces faster and more complete recovery.
Q: Can vestibular physiotherapy help if it’s been months since my inner ear infection?
Absolutely. Even if you’ve been struggling for many months, the brain retains its ability to compensate (called central compensation) with the right exercises. Later-stage vestibular rehab may take a bit longer, but it’s still highly effective. Don’t let the passage of time discourage you from seeking help.
Q: Will I ever feel completely normal again after labyrinthitis?
Many people do recover fully. Recovery depends on the severity of the initial damage, your age, how quickly you started vestibular rehab, and your consistency with the exercises. Some people are left with mild residual sensitivity to head motion or large visual environments, which can be further managed with ongoing vestibular exercises and exposure therapy. Our goal is always maximum recovery — we don’t put a ceiling on what’s possible.
Dizziness Related to Migraines (Vestibular Migraine)
Q: Can migraines cause dizziness even without a headache?
Yes — and this surprises many people. Vestibular migraine is one of the most underdiagnosed causes of recurrent dizziness. Patients experience episodes of vertigo, dizziness, motion intolerance, or visual disturbances that may or may not accompany a headache. It’s believed to be related to the same neurological process as classic migraines but manifesting in the vestibular system. It’s more common in women and often has a family history of migraines.
Q: How does physiotherapy help with vestibular migraine?
Vestibular physiotherapy for migraine-related dizziness focuses on reducing the sensitivity of the vestibular system and visual motion sensitivity, improving habituation to triggers, and building tolerance to movement. We also work on lifestyle factors (sleep, stress, screen time) and collaborate with your physician or neurologist regarding medication management. It’s a multimodal condition that requires a multimodal approach.
Q: What triggers vestibular migraines and can I learn to manage them?
Common triggers include bright or flickering lights, busy visual environments, strong smells, stress, sleep disruption, certain foods, and hormonal changes. Your physiotherapist will help you identify your personal trigger profile and develop a graduated exposure program — so that instead of avoiding triggers (which increases sensitivity over time), you desensitize to them systematically.
Q: Is vestibular migraine the same as a regular migraine?
They share the same neurological foundation, but vestibular migraine predominantly features vestibular symptoms (dizziness, vertigo, motion sensitivity) rather than just head pain. Many people with vestibular migraine have a history of classic migraines, though not always. Diagnosis is based on a clinical pattern and typically involves ruling out other vestibular causes — a process our vestibular physio can help with alongside your physician.
Q: My dizziness gets worse when I look at screens or bright lights. What’s causing that?
This is a phenomenon called visual-vestibular mismatch or visual dependency, and it’s very common in vestibular migraine, post-concussion syndrome, and other vestibular disorders. The brain is receiving conflicting signals between the visual and vestibular systems, and it becomes oversensitive to visual motion or contrast. Vestibular rehabilitation includes specific exercises to retrain the brain’s integration of these signals.
Post-Concussion Balance Issues
Q: How long after a concussion should I wait before starting vestibular physiotherapy?
The old advice of total rest for weeks is largely outdated. Current evidence supports gentle, symptom-monitored physiotherapy beginning within the first few days to weeks post-concussion — as long as we’re staying within your symptom tolerance. Starting vestibular rehab early leads to faster recovery and reduces the risk of persistent post-concussion syndrome. Our Langley concussion physio team will meet you wherever you are in your recovery.
Q: My balance has been off since my concussion. Is this normal and will it improve?
Yes, balance disturbances and dizziness are very common after a concussion. They occur because the concussion affects the brain’s ability to integrate information from the inner ear, eyes, and body. The good news is that this generally improves significantly with proper vestibular physiotherapy. Most patients see measurable improvement in balance and reduction in dizziness within 6–12 weeks of starting treatment.
Q: Can physiotherapy help with post-concussion dizziness that’s been going on for months?
Yes. Post-concussion syndrome — where symptoms persist beyond the expected recovery window — is something we specialize in at Brookswood Plus Physiotherapy. Even months or years after a concussion, the right vestibular and cognitive-physical rehabilitation can produce meaningful improvement. You don’t just have to live with it.
Q: What’s involved in vestibular physiotherapy for post-concussion balance issues?
Treatment typically includes gaze stabilization exercises (training the eyes and inner ear to work together), balance retraining on progressively challenging surfaces, habituation exercises to reduce motion sensitivity, cervicogenic dizziness treatment (addressing the neck, which is almost always affected in concussions), and gradual return-to-activity protocols. We also coordinate with your physician, neuropsychologist, or other members of your concussion care team.
Q: My child had a concussion playing sports. How soon should they see a vestibular physiotherapist?
As soon as possible — especially if they’re experiencing dizziness, balance problems, headaches with movement, or visual disturbances. Pediatric and adolescent brains are both more vulnerable to concussion and more responsive to rehabilitation. Early, appropriate intervention dramatically improves outcomes and facilitates a safe return to school and sports. We have experience working with young athletes in the Langley and Fraser Valley area.
Ringing & Vertigo (Meniere’s Disease)
Q: Can physiotherapy help with Meniere’s disease?
Meniere’s disease — characterized by episodes of intense vertigo, hearing loss, tinnitus (ringing), and a feeling of fullness in the ear — is a complex condition that requires a team approach. Physiotherapy won’t cure Meniere’s, but vestibular rehabilitation between episodes can significantly improve your balance, reduce the functional impact of dizziness, and help the brain compensate more effectively. We work alongside your ENT (ear, nose, and throat) specialist and audiologist to provide complementary care.
Q: I have Meniere’s and my balance is terrible between attacks. Will physio help?
Yes. Even between acute Meniere’s attacks, many patients have ongoing balance problems and dizziness because the inner ear has been damaged over time. Vestibular physio targets this inter-episode instability directly through balance exercises, compensation training, and fall prevention strategies. Many of our Meniere’s patients report feeling significantly more stable and confident in between attacks.
Q: How does Meniere’s disease affect my daily life, and how can physiotherapy address that?
Meniere’s disease can be profoundly disabling — the unpredictability of attacks causes anxiety, avoidance of activities, and reduced independence. Physiotherapy helps in two key ways: physically, by improving your balance and compensation so daily life is more manageable; and functionally, by gradually reintroducing activities you’ve avoided. We also work on fall prevention so that if an attack does happen, your risk of injury is minimized.
Q: Can I make Meniere’s attacks worse by doing vestibular exercises?
This is a valid concern. Vestibular exercises should be timed and paced appropriately — during an acute attack, rest is appropriate. Between attacks, graduated vestibular exercises are safe and beneficial. Your physiotherapist will design a program that’s appropriate for your specific pattern of Meniere’s symptoms and respects your attack frequency.
Q: What lifestyle factors should I be managing alongside physio for Meniere’s?
Salt restriction (to reduce endolymphatic fluid pressure), adequate hydration, stress management, sleep, and caffeine and alcohol reduction are all well-supported strategies for reducing Meniere’s attack frequency. Your physiotherapist will discuss these in the context of your overall management plan, alongside your medical team’s recommendations.
Balance Training & Fall Prevention
Q: I’m not dizzy, but my balance isn’t great. Can physiotherapy help?
Absolutely. Balance can deteriorate for many reasons — aging, inactivity, neurological changes, previous injuries, or sensory deficits. You don’t have to have a vestibular disorder to benefit from balance training. A physiotherapy assessment will identify which of your balance systems (vestibular, visual, somatosensory) are contributing to the problem, and we’ll build a progressive training program that challenges and improves your balance safely.
Q: Who benefits most from fall prevention physiotherapy?
Falls are the leading cause of injury-related death and disability in older adults in Canada. Our fall prevention programs are most often sought by adults over 65, people with neurological conditions like Parkinson’s or MS, those recovering from lower limb injuries or surgeries, individuals on multiple medications, and anyone who has already fallen and is afraid of falling again. If you or a loved one in the Langley area is concerned about falls, please don’t wait for an incident — prevention is always better than treatment.
Q: How is a fall risk assessed at your Brookswood clinic?
We use validated clinical tools like the Berg Balance Scale, Timed Up and Go (TUG) test, 4-Stage Balance Test, and dynamic gait assessments to objectively measure fall risk. This gives us a clear baseline and allows us to track measurable progress over time.
Q: How often should I come for balance training?
Initially, most balance training programs involve 1–2 sessions per week for 4–8 weeks, combined with a daily home exercise program. As you progress, sessions may taper to maintenance frequency. The home program is crucial — the exercises you do at home between sessions are where most of the gains happen.
Q: Can balance problems be completely fixed, or will they always be an issue?
It depends on the cause. If balance problems are due to a reversible condition (like BPPV, a healed ankle injury, or deconditioning), full resolution is often possible. If they’re related to a progressive neurological condition or significant sensory loss, the goal shifts to optimization and compensation rather than cure — but meaningful improvement is almost always achievable. We’ll be realistic with you about expectations from the start.
Motion Sickness & Visual Sensitivity
Q: Can physiotherapy help with chronic motion sickness?
Yes — and this surprises many people. Chronic motion sickness (especially when it occurs during everyday activities rather than just boats or cars) is often related to a vestibular or visual-vestibular mismatch. Vestibular rehabilitation that includes habituation exercises and visual motion desensitization can significantly reduce motion sensitivity over time.
Q: I feel dizzy and nauseous in busy visual environments like grocery stores or scrolling on my phone. Is that a vestibular problem?
This is extremely common in vestibular disorders and post-concussion syndrome. It’s called visual vertigo or supermarket syndrome. The brain is overly reliant on visual input for balance (visual dependency) and becomes overwhelmed in high-motion visual environments. Vestibular rehab specifically addresses this with optic flow exercises and progressive visual desensitization.
Q: Will my screen sensitivity get better with vestibular physiotherapy?
Yes, with the right exercises. We typically use a progressive approach — starting with gentle visual exercises and gradually increasing screen time, visual complexity, and motion. Most patients see significant improvement within 8–12 weeks, though the timeline varies based on the severity and underlying cause.
Neurological Rehabilitation & Stroke Recovery
Stroke Recovery
Q: How soon after a stroke should physiotherapy begin?
The sooner the better. Neuroplasticity — the brain’s ability to rewire itself after injury — is highest in the weeks and months immediately following a stroke. Early mobilization and physiotherapy, starting in hospital and continuing through outpatient settings like our Brookswood clinic, has been shown to significantly improve functional outcomes. If you or a family member in the Langley area has recently had a stroke, contact us as soon as possible about outpatient stroke rehabilitation.
Q: What does stroke physiotherapy involve at your Langley clinic?
Stroke rehabilitation is highly individualized because no two strokes are the same. Treatment may include gait retraining and walking rehabilitation, balance and fall prevention, upper and lower limb strengthening, coordination and fine motor exercises, spasticity management, and functional task training. We also work on compensatory strategies to help you manage daily activities more independently while your strength and coordination continue to improve.
Q: Can you still improve years after a stroke, or does most recovery happen in the first few months?
The most rapid neuroplastic recovery does occur in the first weeks to months, but the brain’s capacity to adapt and improve continues for years — potentially indefinitely with the right stimulus. Many patients who haven’t received adequate rehabilitation or who plateau at one level respond significantly to renewed, intensive therapy. We believe in every patient’s potential for continued improvement, regardless of how long it’s been since their stroke.
Q: My father had a stroke and now has difficulty walking. Can physiotherapy help him get back on his feet?
Walking rehabilitation is one of the most important and rewarding aspects of post-stroke physiotherapy. Depending on the extent of the stroke, many patients progress from needing significant support to walking independently or with a cane or walker. The key is intensive, task-specific training combined with a structured home exercise program. We work with both the patient and the family to maximize progress.
Q: Can physiotherapy help with the emotional and cognitive effects of stroke?
Physiotherapy directly addresses the physical effects of stroke — mobility, strength, balance, coordination. However, exercise itself has a powerful positive effect on mood, cognitive function, and fatigue following a stroke. We work closely with your broader healthcare team (physicians, occupational therapists, speech therapists) to ensure your care is coordinated across all aspects of recovery.
Parkinson’s Disease
Q: Can physiotherapy slow the progression of Parkinson’s disease?
While physiotherapy can’t stop the underlying neurodegeneration of Parkinson’s, there is strong evidence that regular, targeted exercise and physiotherapy can slow functional decline, improve motor symptoms, and maintain quality of life for significantly longer. Exercise is genuinely neuroprotective in Parkinson’s — it’s one of the most powerful tools available. Our approach emphasizes vigorous, intensive movement to counteract the tendency toward slowness and rigidity that Parkinson’s creates.
Q: What specific issues does physiotherapy address in Parkinson’s patients?
We work on gait problems (shuffling, freezing of gait), balance and fall prevention, posture (the stooped forward posture that commonly develops), arm swing reduction, turning difficulties, getting up from chairs and bed, fine motor coordination, voice projection (in combination with speech therapy), and overall stamina and strength. We also use strategies specific to Parkinson’s, such as external cueing (rhythmic cues to improve walking pattern).
Q: How often should someone with Parkinson’s come for physiotherapy?
Research suggests that higher-intensity, more frequent exercise produces better outcomes in Parkinson’s. Many of our patients come 2–3 times per week, and we build a robust home exercise program for the days in between. The key is consistent, long-term engagement with exercise — not just a short course of treatment.
Q: My parent with Parkinson’s is afraid of falling. How can physiotherapy help?
Falls are one of the most serious risks in Parkinson’s disease. We assess fall risk thoroughly and implement a combination of balance training, gait retraining, home safety strategies, and education on fall prevention techniques. We also work on the specific Parkinson’s-related gait features that increase fall risk, like shuffling, festination (involuntary acceleration), and freezing episodes.
Q: Is there a specific type of physiotherapy that’s best for Parkinson’s?
The LSVT BIG program (Lee Silverman Voice Treatment — BIG) is a specialized, evidence-based physiotherapy protocol for Parkinson’s that focuses on large amplitude, vigorous movements to counteract the small, slow movements that characterize the disease. Our physiotherapists are trained in these specialized approaches. Exercise that’s challenging, intensive, and varied produces the best outcomes.
Multiple Sclerosis (MS)
Q: Is physiotherapy safe and beneficial for people with MS?
Yes — and this is increasingly well-supported by research. Exercise and physiotherapy are now recognized as essential components of MS management. Contrary to older concerns that activity might worsen MS symptoms, appropriately paced exercise improves strength, fatigue, balance, walking ability, mood, and cognitive function in most people with MS. The key is tailoring the program to your current level of function and managing heat sensitivity (Uhthoff’s phenomenon) if relevant.
Q: MS affects people so differently. How do you individualize physiotherapy for MS?
This is the key to MS rehabilitation. Your presentation — whether it’s primarily spasticity, weakness, fatigue, balance problems, pain, or cognitive symptoms — shapes every aspect of your treatment plan. We begin with a comprehensive assessment and build a program that targets your specific challenges while respecting the fluctuating nature of the condition. We also teach you how to self-manage during relapses.
Q: Can physiotherapy help with MS fatigue, which is my biggest problem?
MS fatigue — which is different from ordinary tiredness — can be profoundly disabling. Physiotherapy helps by improving cardiovascular fitness (which reduces the metabolic cost of daily activities), teaching energy conservation strategies, and optimizing the muscle patterns you use for walking and daily tasks. It feels counterintuitive, but more activity — done right — often leads to less fatigue.
Q: What can I expect from physiotherapy during an MS relapse?
During an active relapse with new neurological symptoms, we typically focus on gentle, adaptive strategies rather than intensive exercise. Rest, symptom management, and maintaining basic mobility are the priorities. Once the relapse has stabilized (with your neurologist’s guidance), we begin active rehabilitation to recover as much function as possible.
Q: I’ve had MS for many years and my walking has deteriorated. Is it too late for physiotherapy?
It’s not too late. While longer-standing MS can create more permanent neurological changes, physiotherapy can still meaningfully improve function, reduce fall risk, and improve quality of life at any stage. We focus on maximizing what you can do — not on what the disease has taken.
Concussion & Head Injury
Q: What is post-concussion syndrome, and how do you treat it?
Post-concussion syndrome (PCS) refers to concussion symptoms that persist beyond the expected recovery window — typically beyond 3–4 weeks in adults or 1–2 weeks in children. Symptoms include headaches, dizziness, brain fog, light and noise sensitivity, fatigue, mood changes, and memory difficulties. Treatment at our Brookswood clinic involves a combination of vestibular rehab (for dizziness and balance), cervical physiotherapy (for headaches and neck pain), gradual return-to-activity protocols, and education on symptom management. We take a systematic, evidence-based approach to concussion recovery.
Q: My concussion happened a year ago and I still have symptoms. Can you help?
Yes. Late-stage post-concussion syndrome is something we have specific experience with. Even months or years after the initial injury, the right rehabilitation can produce meaningful improvement. The brain’s neuroplasticity doesn’t have an off-switch — it can continue to learn, compensate, and recover with the right stimulus.
Q: How do you decide what treatment to use for a concussion?
Our approach depends entirely on your symptom profile. Dizziness and balance issues → vestibular rehabilitation. Headaches from the neck → cervical physiotherapy. Exertion intolerance → graded aerobic exercise protocols. Visual disturbances → oculomotor exercises and visual rehab. Most patients need a combination of approaches. We identify your primary symptom drivers and target those first.
Q: Can I exercise if I have a concussion?
Yes — with guidance. The days of “complete rest until all symptoms resolve” are behind us. Current evidence supports sub-symptom-threshold aerobic exercise beginning early in concussion recovery. This means exercising at a level that doesn’t significantly worsen symptoms. Your physiotherapist will help you identify your current threshold, gradually increase it, and track your progress toward full return to activity.
Q: Do you work with sports organizations or schools for concussion management in Langley?
Yes. We support athletes, youth sports programs, and schools in the Brookswood and Langley area with concussion education, acute assessment, rehabilitation, and structured return-to-sport and return-to-learn protocols. If you’re a coach, parent, athletic therapist, or school counselor looking for a concussion physiotherapy resource in Langley BC, we’re here to help.
Spinal Cord Injury
Q: Can physiotherapy help after a spinal cord injury?
Yes — and it’s one of the most critical components of spinal cord injury rehabilitation. Whether the injury is complete or incomplete, physiotherapy aims to maximize remaining function, prevent secondary complications (pressure sores, contractures, respiratory problems, muscle atrophy), improve upper body strength for wheelchair users, facilitate any neurological recovery that occurs, and optimize independence. The breadth and intensity of physiotherapy significantly affects long-term outcomes after spinal cord injury.
Q: What kinds of goals can I expect from physiotherapy after a spinal cord injury?
Goals depend entirely on the level and completeness of your injury. For incomplete injuries, goals may include improved walking, balance, and hand function as the nervous system recovers. For complete injuries, goals focus on maximizing upper body function, transfers, wheelchair skills, pain management, and community reintegration. Every patient’s goals are individually set and regularly reassessed.
Q: How does physiotherapy change over time after a spinal cord injury?
Rehabilitation evolves through phases: acute inpatient rehab focuses on basic mobility, sitting tolerance, and preventing complications. Community-based outpatient physiotherapy (which we provide here in Langley) focuses on functional strengthening, independence, pain management, and quality of life. Long-term maintenance physiotherapy supports ongoing health, prevents deterioration, and addresses emerging complications.
Q: I had a spinal cord injury years ago and I’m experiencing new problems. Should I see a physiotherapist?
Yes — this is called late-onset or aging-with-disability and it’s a very real concern for long-term spinal cord injury survivors. Issues like overuse injuries (especially shoulder pain from wheeling), pain, spasticity, fatigue, and declining function can emerge years after the injury. Physiotherapy can address these proactively.
Q: Will physiotherapy at your Brookswood clinic be accessible for someone who uses a wheelchair?
Absolutely. Our clinic is accessible and designed to accommodate patients who use wheelchairs, walkers, or other assistive devices. Please let us know when booking so we can ensure the right space and equipment are prepared for your visit.
Neuropathy
Q: Can physiotherapy help with neuropathy (nerve damage)?
Yes, significantly. Peripheral neuropathy — nerve damage that causes numbness, tingling, burning, weakness, or balance problems in the hands and feet — can result from diabetes, chemotherapy, alcohol use, compression, or unknown causes. Physiotherapy can’t reverse the underlying nerve damage but can address its functional consequences: improving balance, strengthening muscles weakened by neuropathy, reducing fall risk, desensitizing hypersensitive areas, and teaching protective strategies.
Q: My diabetic neuropathy is affecting my balance and I’ve nearly fallen. What can physiotherapy do?
Balance training for diabetic neuropathy is something we do regularly at our Langley clinic. When sensation in the feet is reduced, the vestibular system and eyes have to work harder to maintain balance. We train these systems specifically, along with strengthening the leg and core muscles that help compensate for the sensory deficit. Most patients see measurable improvement in their balance test scores.
Q: Can physiotherapy reduce the pain from neuropathy?
Neuropathic pain is notoriously difficult to treat, but physiotherapy is part of the evidence-based approach. Desensitization techniques, graded exposure, manual therapy for any compression components, and exercise (which has neurological anti-inflammatory effects) can all reduce neuropathic pain. We’ll be honest with you about realistic expectations and work as part of your broader care team.
Chronic Pain Management & Relief
Persistent & Long-Term Pain
Q: I’ve been in pain for years and tried everything. Can physiotherapy actually help?
We hear this a lot, and we never dismiss it. Chronic pain is genuinely complex — it’s not just about damaged tissue. It involves changes in how the nervous system processes pain signals, psychological factors, sleep, stress, and movement habits. At Brookswood Plus Physiotherapy, we approach chronic pain with an understanding of pain science alongside targeted physical treatment. Many patients who felt hopeless have found meaningful, lasting relief with the right approach. We don’t give up easily.
Q: Why does chronic pain sometimes keep hurting even when the original injury has healed?
This is the core question of chronic pain, and the answer lies in the nervous system. After prolonged pain, the central nervous system can become sensitized — meaning it produces pain signals that are out of proportion to any actual tissue damage. This is called central sensitization, and it explains why chronic pain often spreads, fluctuates unpredictably, and responds differently to treatment than acute pain. Understanding this doesn’t mean your pain isn’t real — it absolutely is. It just means the treatment approach needs to be different.
Q: What does physiotherapy for chronic pain actually look like? Is it just exercises?
No — it’s much more than that. Our approach includes pain science education (understanding how pain works changes pain), graded activity and movement (carefully paced to gradually expand what you can do), manual therapy, therapeutic modalities like laser or dry needling, stress and sleep coaching, and collaborative goal setting. We treat you as a whole person, not just a painful body part.
Q: How long will it take to see improvement in my chronic pain?
This is genuinely variable and we’ll always be honest with you. For some people, understanding their pain better leads to quick early improvements. For others, progress is gradual over weeks to months. Chronic pain typically took a long time to develop, and it takes consistent, sustained effort to shift. We’ll set realistic milestones and celebrate every step of progress.
Q: Do you work with other healthcare providers for chronic pain management?
Absolutely. Chronic pain is best managed with a multidisciplinary approach. We frequently communicate with your family physician, pain specialists, psychologists, and other team members to ensure your care is coordinated. If you don’t have all the members of your care team in place, we can also point you toward appropriate resources in the Langley and Fraser Valley area.
Sciatica / Shooting Pain
Q: What exactly is sciatica and how does physiotherapy treat it?
Sciatica refers to pain, numbness, or tingling that travels from the lower back or buttock down the leg, following the path of the sciatic nerve. It’s caused by compression or irritation of the sciatic nerve, most often from a disc herniation, bone spur, or tight piriformis muscle. Physiotherapy is highly effective — we use a combination of specific exercises (often extension-based or nerve mobilization techniques), manual therapy, posture education, and activity modification to reduce nerve irritation and restore normal movement.
Q: My sciatica has been present for months. At what point should I consider surgery?
Most people with sciatica improve without surgery when they receive proper conservative treatment — including physiotherapy. Surgery is typically considered when there’s progressive neurological deficit (worsening foot drop, significant muscle weakness), loss of bowel or bladder control (seek emergency care immediately), or failure to improve with at least 6–12 weeks of active, appropriate physiotherapy. If you haven’t yet had a course of physiotherapy, please start there first.
Q: Can I make sciatica worse by exercising?
The wrong exercises can temporarily aggravate sciatica, which is why we don’t recommend generic YouTube routines for nerve-related pain. Some movement patterns that help disc herniations can make piriformis-related sciatica worse, and vice versa. A proper physiotherapy assessment identifies the exact source and directs the treatment appropriately. Once you know the right exercises for your specific cause, consistent movement is one of the best things you can do.
Q: I wake up with severe sciatica pain. Does that mean my mattress is the problem?
It might be a contributing factor, but it’s usually not the whole story. Morning pain that’s severe with sciatica often relates to disc pathology — discs can become more hydrated overnight, increasing nerve pressure. Sleeping position also matters significantly. Your physiotherapist will discuss these factors with you and can make specific recommendations for sleeping positions, pillow placement, and mattress firmness.
Q: Can sciatica resolve permanently, or will it keep coming back?
Many people experience complete resolution of sciatica with proper treatment, especially if the underlying cause is addressed. If the problem is a disc herniation, most herniations resorb naturally over time. If it’s related to muscle tightness or postural habits, those can be corrected with exercise and education. The key to preventing recurrence is the home exercise program and lifestyle habits your physiotherapist teaches you — sciatica that comes back is often related to those same predisposing factors not being fully addressed.
Widespread Body Pain (Fibromyalgia)
Q: Can physiotherapy help with fibromyalgia?
Yes — and it’s one of the most evidence-supported non-pharmacological treatments for fibromyalgia. Exercise (particularly aerobic exercise), movement, and graded activity have been shown to reduce fibromyalgia pain, improve fatigue, and enhance quality of life. Physiotherapy also helps address the secondary effects of fibromyalgia — postural problems, weakened muscles from inactivity, sleep disruption, and deconditioned cardiovascular fitness — all of which can worsen pain.
Q: Exercise sounds impossible when everything hurts. How do you start?
Very, very gently. The paradox of fibromyalgia is that rest makes it worse, but jumping into too much activity also causes flare-ups. The answer is graded exercise — starting at a level well below what causes a flare, and increasing in tiny, systematic increments over weeks and months. Your physiotherapist will calculate your starting threshold and guide the progression. It often starts with just walking a few minutes per day or gentle pool exercise.
Q: Is fibromyalgia just anxiety or is it a real physical condition?
Fibromyalgia is absolutely a real, physical condition. It’s now well-understood as a central sensitization syndrome — where the central nervous system amplifies pain signals across the body. This is measurable and physiological. The fact that it has psychological contributors (as most chronic pain conditions do) doesn’t make it any less real. Our approach treats the whole person without minimizing or dismissing your experience.
Q: What other treatments alongside physiotherapy help with fibromyalgia?
Fibromyalgia is best managed with a combination of physiotherapy, proper sleep management, stress reduction (including cognitive behavioural therapy or mindfulness), medication management through your physician, pacing strategies for daily activities, and social support. We’ll work within your broader care team and can discuss which complementary approaches have the best evidence base.
Q: My fibromyalgia symptoms fluctuate a lot. How do we plan around that?
This is one of the defining challenges of fibromyalgia and it’s something we plan for explicitly. We don’t set a rigid treatment schedule that ignores how you’re feeling on a given day. We teach you pacing principles so you can adapt your activity level to your current state without either overdoing it on good days or completely resting on bad ones. Predictable moderation beats extreme variation.
Burning, Tingling & Nerve Pain / CRPS
Q: What is CRPS and can physiotherapy help?
CRPS (Complex Regional Pain Syndrome) is a chronic pain condition characterized by severe, burning pain — often in a limb — along with skin colour changes, temperature changes, swelling, and extreme sensitivity to touch. It typically develops after an injury or surgery. CRPS is one of the most challenging pain conditions to treat, but physiotherapy is one of the primary treatments. Graded motor imagery, mirror therapy, desensitization, and graded exposure to movement and touch are core physiotherapy techniques that have strong evidence for CRPS.
Q: The burning nerve pain in my arm or leg is unbearable. What can physiotherapy do?
Burning neuropathic pain is agonizing, and we take it seriously. Treatment depends on the cause — whether it’s CRPS, peripheral neuropathy, nerve entrapment, post-surgical nerve damage, or central sensitization. Desensitization programs (gradual normalization of sensation in the affected area), pain neuroscience education, graded exposure, and manual therapy to release any nerve entrapment can all make a meaningful difference. Modalities like laser therapy and IMS may also help.
Q: My skin is so sensitive I can barely tolerate light touch. Is there any treatment for this?
This hyperalgesia (exaggerated pain response) and allodynia (pain from normally non-painful stimuli) are hallmarks of sensitized pain conditions. Desensitization therapy — gradually exposing the area to different textures, temperatures, and pressures in a systematic, tolerable way — helps retrain the nervous system to normalize its response to sensory input. It takes patience, but it works.
Q: How does graded motor imagery work for CRPS?
Graded Motor Imagery (GMI) is a brain-based treatment that works in three stages: limb laterality recognition (training the brain to correctly identify images of your affected limb), imagined movements (mentally rehearsing movements before attempting them), and mirror therapy (using a mirror to create the visual illusion of normal movement in the affected limb). GMI progressively rewires the pain pathways in the brain without triggering intense pain responses, and has the strongest evidence base of any intervention for CRPS.
Q: Is it normal to feel tingling or burning sensations during nerve recovery?
Yes — and this is often actually a positive sign. When a compressed or damaged nerve begins to recover, it can produce tingling, buzzing, or electric-shock sensations as it regenerates. This is sometimes called “pins and needles” or dysesthesia during nerve recovery. Your physiotherapist will help you distinguish between recovery sensations (generally good) and signs that the nerve is still being irritated (requiring further treatment).
TMJ & Jaw Pain
Q: Can physiotherapy treat TMJ pain and jaw clicking?
Yes — physiotherapy is one of the most effective treatments for temporomandibular joint (TMJ) dysfunction. TMJ issues often involve a combination of joint problems, muscle tension (especially the masseter, pterygoids, and temporalis muscles), postural issues in the neck and head, and stress-related clenching or bruxism. Our physiotherapists use manual therapy to the jaw and neck, postural correction, exercises to normalize jaw mechanics, and patient education about habits that aggravate the joint.
Q: My jaw locks sometimes, and it’s terrifying. Is this a physiotherapy problem?
Jaw locking (where the mouth won’t fully open or gets stuck) can be related to disc displacement within the TMJ — where the cartilage disc between the joint surfaces shifts out of position. This is absolutely something a physiotherapy assessment can identify. We use manual therapy techniques to help normalize disc position and improve jaw mechanics. In some cases, we coordinate with your dentist or oral maxillofacial specialist for a comprehensive approach.
Q: Does neck posture affect TMJ pain?
Significantly. Forward head posture — extremely common in people who work at desks, use phones extensively, or drive long hours — puts the neck and jaw in a mechanically disadvantaged position that increases tension in the jaw muscles and alters TMJ mechanics. Addressing the cervical spine is a core part of effective TMJ physiotherapy.
Q: I grind my teeth at night and wake up with headaches and jaw pain. How can a physiotherapist help?
This is a very common presentation, and physiotherapy can help in several ways: releasing the tension in the jaw and neck muscles through manual therapy and dry needling, correcting the postural factors that contribute to clenching patterns, and providing exercises to normalize the resting position of the jaw. A night guard from your dentist is often part of the puzzle too — we work alongside your dental team.
Q: How many physiotherapy sessions does TMJ treatment usually take?
Many patients notice significant improvement within 4–6 sessions. Like most musculoskeletal conditions, the timeline depends on how long the problem has been present and how committed you are to the home exercise program. Chronic, long-standing TMJ dysfunction may take longer to fully address than a more recent onset.
Post-Surgical Pain
Q: When should I start physiotherapy after surgery?
As soon as your surgeon clears you — and often earlier than people expect. For many surgeries (joint replacements, ACL reconstructions, rotator cuff repairs), physiotherapy begins within the first week or two post-operatively. Early movement, within safe parameters, is crucial for preventing excessive scar tissue formation, maintaining circulation, and beginning the strengthening process. We work closely with surgical guidelines and your surgeon’s specific protocol.
Q: I had surgery months ago but I’m still in pain. Is it too late for physiotherapy?
No. Post-surgical pain that persists beyond normal healing timelines is unfortunately common and has multiple potential causes — scar tissue formation, nerve irritation, ongoing muscle imbalances, or central sensitization. Physiotherapy can address all of these. It’s never too late to optimize your surgical outcome.
Q: What surgeries do you commonly rehabilitate at your Brookswood clinic?
We see patients recovering from knee replacements (TKR), hip replacements (THR), ACL reconstructions, rotator cuff repairs, shoulder replacements, spinal surgeries (discectomy, laminectomy, fusion), ankle reconstructions, wrist surgeries, and abdominal surgeries. We tailor the rehab protocol to your specific surgical procedure and surgeon’s guidelines.
Q: My scar from surgery is tight and pulling. Can physiotherapy help with scar tissue?
Yes. Scar tissue management is an important part of post-surgical physiotherapy. Techniques include scar mobilization (direct massage of the scar to prevent adhesion), fascial release of surrounding tissue, and education on home scar massage. When scars are addressed early, they typically heal with less restriction. Even older scars can be softened and mobilized.
Q: How do I know if my post-surgical pain is normal or something that needs to be addressed?
Some pain and discomfort after surgery is expected and part of the normal healing process. Pain that is getting progressively worse rather than gradually better, sudden significant increases in pain, signs of infection (increasing redness, warmth, swelling, discharge), or the return of symptoms that were supposed to be fixed by the surgery are all reasons to contact your surgeon and your physiotherapist. When in doubt, don’t wait — get it checked.
Ergonomic & Desk-Related Pain
Q: I work at a desk all day and I’m in constant pain. Can a Langley physiotherapist help with this?
Without question. Desk-related pain — neck tension, headaches, upper back tightness, shoulder aching, wrist pain, and lower back discomfort — is one of the most common things we treat. The problem is almost never the desk itself — it’s the way you’re set up at your desk, the positions you hold, and how long you stay in them without moving. We address all of these through physiotherapy treatment and practical ergonomic advice.
Q: Do you offer ergonomic assessments, and are they covered by insurance?
We provide ergonomic education and advice as part of your physiotherapy treatment. Whether a formal ergonomic assessment is covered depends on your insurer and plan. For WorkSafeBC claims related to workplace injuries, ergonomic assessment and workplace accommodation recommendations are often covered. Ask us when you call.
Q: What’s the most common mistake people make at their desks that causes pain?
Honestly? It’s not any single position — it’s staying in any position for too long without moving. Sitting is not inherently bad for you. Sitting for 6 hours without getting up is. We teach the 30-20-2 principle as a starting point: every 30 minutes, take a 20-second posture break and move at least 2 minutes per hour. Combined with proper setup, this makes an enormous difference.
Q: My wrists hurt from typing. Is this carpal tunnel, and can physiotherapy fix it?
Wrist pain from typing can be carpal tunnel syndrome (compression of the median nerve), tendinopathy of the wrist extensors, or general forearm and wrist tension — among other things. A proper physiotherapy assessment will differentiate between these. True carpal tunnel syndrome responds well to physiotherapy through neural mobilization, wrist and forearm strengthening, ergonomic modification, and sometimes night splinting. More severe cases may eventually require surgical consultation.
Q: Can physiotherapy help prevent work-related injuries from getting worse over time?
Absolutely — and this is one of the most underutilized aspects of physiotherapy. You don’t need to wait until pain becomes severe or disabling before seeking help. Early intervention when you first notice discomfort or stiffness is almost always more effective and requires fewer visits. If your employer offers extended health benefits that include physiotherapy, using them proactively is some of the best healthcare value you can get.
The Plus Treatments
Manual Therapy (Hands-on Joint & Muscle Care)
Q: What is manual therapy and how is it different from a massage?
Manual therapy is a hands-on clinical treatment performed by a trained physiotherapist that uses specific techniques to restore movement in joints and soft tissues. It’s different from massage in that it’s diagnostically guided and therapeutically specific — we target the exact joint or tissue that’s restricted and apply precise mobilization or manipulation techniques to restore normal movement. Techniques include joint mobilizations, HVLA (high-velocity low-amplitude) spinal manipulation, soft tissue release, and myofascial techniques. It’s typically one component of a broader physiotherapy program.
Q: Does manual therapy hurt?
Most techniques should not cause significant pain. You may feel pressure, stretching, or mild discomfort during treatment — and sometimes areas that are restricted will be tender when worked on — but we always communicate with you throughout and work within your comfort level. Post-treatment soreness, similar to what you might feel after a good workout, can occur for 24–48 hours and is normal.
Q: What conditions benefit most from manual therapy?
Manual therapy is effective for a wide range of conditions: neck and back pain, joint stiffness and restricted range of motion, headaches (especially cervicogenic headaches from the neck), shoulder impingement, hip and knee stiffness, post-fracture rehabilitation, and many others. Your physiotherapist will assess whether your specific condition and presentation is suited to manual therapy techniques.
Q: How many manual therapy sessions will I need before I notice a difference?
Many patients notice significant improvement in mobility and pain levels after just 1–3 sessions of manual therapy, particularly when the issue involves joint restriction. The gains from manual therapy are most lasting when combined with corrective exercises that maintain the restored movement — otherwise the restriction tends to return.
Q: Is spinal manipulation (cracking the back or neck) safe?
Yes — when performed by a trained physiotherapist who has thoroughly assessed you. HVLA spinal manipulation carries a very small risk profile in appropriate patients. Your physiotherapist will screen you for any contraindications before performing any manipulation technique, and will always explain what they’re planning and why before doing it. You can always request gentler mobilization techniques if you prefer.
IMS & Dry Needling (Deep Tissue Release)
Q: What is IMS (Intramuscular Stimulation) and how does it work?
IMS — Intramuscular Stimulation — is a dry needling technique developed by Dr. Chan Gunn that uses acupuncture-sized needles to target tight, hypersensitive muscle bands (trigger points) that are causing pain. The needle causes a reflex muscle twitch and relaxation response that releases the tension, restores normal muscle function, and reduces pain. It works through both mechanical and neurological mechanisms, and is particularly effective for chronic musculoskeletal pain that has a neuropathic component.
Q: What’s the difference between IMS, dry needling, and acupuncture?
These terms are often used interchangeably but have nuances. IMS and dry needling both use solid filiform needles (no injection involved) targeting muscles and trigger points, guided by musculoskeletal anatomy and pain science. Traditional acupuncture uses the same needles but is guided by traditional Chinese medicine meridian theory. Medical acupuncture bridges both. Our physiotherapists are trained in IMS/dry needling from a Western physiotherapy perspective and use it as one tool within a broader treatment plan.
Q: Does dry needling hurt?
The needle itself is very thin (much thinner than a hypodermic needle) and insertion typically produces little to no sensation. When the needle reaches a trigger point, you’ll often feel a characteristic twitch response — a brief muscle cramping or aching sensation that tells us we’ve found the right spot. It can feel intense for a second or two but typically dissipates quickly. Most patients are surprised at how tolerable it is.
Q: What conditions is IMS/dry needling most helpful for?
IMS is particularly effective for chronic myofascial pain, tension headaches, neck and back pain with a muscular component, post-whiplash injuries, plantar fasciitis, hip flexor and gluteal tightness, rotator cuff pain, IT band syndrome, and any pain condition with significant muscle tension and trigger points. It’s often a game-changer for patients whose pain has been resistant to other treatments.
Q: How many IMS sessions will I need?
Many patients feel a difference after 1–3 sessions. Chronic conditions may require 6–8+ sessions for lasting change. IMS is most effective when combined with corrective exercise and the other aspects of your physiotherapy program. The effects are typically cumulative — each session building on the last.
Medical Acupuncture (Traditional Healing)
Q: What is medical acupuncture and how is it different from traditional Chinese acupuncture?
Medical acupuncture uses the same needles as traditional acupuncture but is guided by Western anatomical and neuroscientific understanding. Our physiotherapists who perform acupuncture integrate both traditional meridian-based points and specific anatomical target points, and use it as a tool within a comprehensive physiotherapy treatment plan. It’s evidence-informed and grounded in current understanding of how acupuncture affects the nervous system, inflammation, and pain modulation.
Q: Is acupuncture covered by extended health insurance?
This depends on your specific plan. Some plans cover acupuncture only when performed by a registered acupuncturist (R.Ac or Dr.TCM), while others cover acupuncture performed as part of physiotherapy. If you have separate acupuncture benefits and physiotherapy benefits, you may be able to use both. Check with your insurer or ask our front desk — we navigate this regularly.
Q: What conditions does medical acupuncture at your Langley clinic treat?
Acupuncture is most commonly used for chronic and acute pain (back pain, neck pain, osteoarthritis, headaches and migraines, shoulder and knee pain), as well as sciatica, tendinopathies, and post-surgical pain. It’s also used adjunctively for neurological conditions and chronic pain syndromes. The evidence base for acupuncture is strongest for musculoskeletal pain and headaches.
Q: How does acupuncture actually reduce pain?
Acupuncture stimulates specific points in the body that influence the nervous system in several ways: triggering the release of endorphins and other natural pain-modulating chemicals, modulating pain signals in the spinal cord, reducing local muscle tension and improving circulation, and downregulating the sensitized pain pathways involved in chronic pain. It’s not just placebo — neuroimaging studies have shown measurable changes in brain activity in response to acupuncture.
Q: Are there any side effects from medical acupuncture?
Side effects are generally minor and temporary. Mild bruising, local soreness, or a light-headed feeling after treatment can occasionally occur. Serious adverse events are extremely rare when performed by a properly trained clinician. Your physiotherapist will take a complete health history and screen for any contraindications (such as blood thinners, certain skin conditions, or pregnancy) before treating.
Shockwave Therapy (Advanced Chronic Pain Relief)
Q: What is shockwave therapy and how does it work?
Shockwave therapy (also called extracorporeal shockwave therapy, or ESWT) uses high-energy sound waves delivered to painful areas through a handheld device. It stimulates the body’s natural healing response in chronically damaged tissue — particularly tendons and fascia — by promoting blood vessel formation, reducing calcification, stimulating collagen production, and breaking up scar tissue. It’s one of the most powerful non-invasive treatments available for chronic musculoskeletal conditions that have failed to improve with other therapies.
Q: What conditions does shockwave therapy treat at your Brookswood physiotherapy clinic?
Shockwave therapy is most commonly used for plantar fasciitis (heel pain), Achilles tendinopathy, patellar tendinopathy (jumper’s knee), rotator cuff tendinopathy, calcific tendinitis of the shoulder, lateral epicondylitis (tennis elbow), medial epicondylitis (golfer’s elbow), trochanteric bursitis (hip pain), and myofascial trigger points. If you’ve had one of these conditions for months without improvement, shockwave therapy may be the breakthrough you’ve been looking for.
Q: Does shockwave therapy hurt?
Shockwave therapy can be uncomfortable, particularly over very sensitive areas. The intensity is adjustable and we start lower, increasing as tolerated. Most patients describe it as a deep, intense pressure. The discomfort during treatment is temporary, and most people experience meaningful pain relief in the days following a session as the biological healing response kicks in.
Q: How many shockwave therapy sessions will I need?
Most conditions require 3–6 sessions spaced 1 week apart. Some patients notice significant improvement after just 2–3 sessions; others take the full course. Shockwave therapy is typically done as a series — the cumulative effect of multiple sessions is greater than a single session. Research shows success rates of 70–80% for appropriate conditions.
Q: Is shockwave therapy covered by insurance?
Coverage varies by plan. Some extended health insurers cover shockwave therapy when performed by a physiotherapist as part of a physiotherapy treatment. ICBC coverage may apply for accident-related conditions. WorkSafeBC may also cover it in some cases. We’ll help you understand your specific coverage situation before you commit to a course of treatment.
Laser Therapy (Cellular Repair & Healing)
Q: What is laser therapy and how does it accelerate healing?
Therapeutic (low-level) laser therapy — also called photobiomodulation (PBM) — uses specific wavelengths of light to stimulate cellular energy production (ATP synthesis in the mitochondria), reduce inflammation, and accelerate tissue repair. It works at a cellular level, enhancing the natural healing processes in damaged tissue. It’s painless, non-invasive, and supported by a growing body of research for a range of musculoskeletal, neurological, and pain conditions.
Q: What conditions is laser therapy used for at your Langley clinic?
Laser therapy is used for acute and chronic soft tissue injuries, tendinopathies, wound healing, scar tissue reduction, arthritis pain, neuropathic pain, post-surgical recovery, and inflammatory conditions. It’s particularly useful as an adjunct in conditions where tissue healing is slow or incomplete, and for patients who can’t tolerate more aggressive hands-on treatments.
Q: Is laser therapy safe? I’ve heard lasers can be dangerous.
Therapeutic laser therapy uses very different parameters than surgical or cutting lasers — the power levels are far below what would cause tissue damage. It is safe when used by a trained clinician with appropriate protective eyewear (which we provide). There are some contraindications — including over active cancer sites, over the eyes, and during pregnancy — which your physiotherapist will screen for before treatment.
Q: Does laser therapy hurt?
No. Laser therapy is painless. You may feel a gentle warmth over the treatment area, but there’s no discomfort. It’s one of the most comfortable treatment modalities we offer.
Q: How does laser therapy compare to shockwave therapy for tendon problems?
Both are effective for tendinopathies, but through different mechanisms. Shockwave is more mechanical — it stimulates healing through acoustic energy and is generally more intensive. Laser is gentler and works at a cellular energy level. For very irritable or acute presentations, laser may be preferred first. For chronic, stubborn tendinopathies, shockwave often produces more dramatic results. They can also be combined for synergistic effect. Your physiotherapist will discuss which is most appropriate for your specific situation.
Concussion Rehab (Brain & Vestibular Recovery)
Q: What makes your concussion rehabilitation program different from just resting and waiting?
Rest was once the universal prescription for concussion — we now know it leads to worse outcomes than active, guided rehabilitation. Our concussion rehab program at Brookswood Plus Physiotherapy addresses every system that concussion affects: the vestibular system (dizziness, balance), the cervical spine (neck pain, headaches), the visual system (eye tracking, convergence), and the autonomic nervous system (exercise intolerance, fatigue). We use a structured, symptom-monitored approach to gradually expand your capacity in each of these domains.
Q: How do you assess a concussion at your Brookswood clinic?
Our concussion assessment is thorough and multi-system. It includes a detailed symptom history, cervical spine assessment, vestibular testing (including the Head Impulse Test, Dix-Hallpike, and balance testing), visual and oculomotor assessment (saccades, smooth pursuit, convergence), and sub-threshold aerobic testing to identify exercise intolerance. This gives us a clear map of which systems are involved and guides a targeted treatment plan.
Q: Do I need imaging (MRI or CT scan) before starting concussion physiotherapy?
Standard concussions typically don’t show up on CT or MRI because they’re a functional, not structural, injury. Imaging is primarily used to rule out more serious injuries (bleeds, fractures) in the acute setting. For physiotherapy purposes, we don’t require imaging — our assessment is clinical and functional. However, if you’ve had imaging done, please bring those reports as they provide useful context.
Q: Can I return to sports during concussion rehabilitation?
Return to sport is a stepwise, gradual process governed by established protocols (like the Concussion in Sport Group graduated return-to-sport protocol). You progress through stages — from rest to light aerobic exercise, sport-specific exercise, non-contact training, full-contact practice, and finally full game play — only advancing when you’re symptom-free at each stage. Your physiotherapist manages this progression carefully and communicates with coaches, trainers, or team physicians when needed.
Q: My child’s school is asking for clearance to return to learn after a concussion. Can you provide that?
Yes. Return-to-learn is as important as return-to-sport, and we have protocols for both. We can provide documentation and guidance for schools regarding appropriate academic accommodations during recovery (reduced workload, screen time limits, quiet environments) and when your child is ready to return to full academic activities. We take pediatric concussion recovery very seriously.
Still Have Questions?
We hope this FAQ has answered most of what’s on your mind — but we know that every person’s situation is unique, and reading a FAQ can only go so far. If you have a question that isn’t covered here, please reach out directly.
We serve patients from throughout the Fraser Valley including Langley, Aldergrove, Cloverdale, South Surrey, and the surrounding Brookswood community. Whether you’re dealing with a new injury, a chronic condition, an ICBC or WorkSafeBC claim, or you’re looking for specialized vestibular or neurological rehabilitation — we’re here, and we’re ready to help you feel like yourself again
