Call Us 450-934-0701 or Email us
Our address: 3230 Curé-Labelle boulevard, Suite 204, Laval (Quebec) H7P 0H9


  • Headaches
  • Orofacial Pain/TMJ
  • Pelvic Floor Rehabilition
  • Manual Therapy
  • Dry needling

There are three basic classifications of primary headaches: migraines, tension type headaches (TTH) and cervicogenic headaches (CGH).


Migraine headaches are usually unilateral (affecting one side of the head) although sometimes it can be on both sides. The severity can be mild to severe, often rendering people non-functional, having to lie down in a dark room. Symptoms are usually described as pulsatile or throbbing. Premonitory symptoms, meaning some kind of sign such as fatigue, neck stiffness or decreased concentration prior to the onset of the headache are common but the type varies from person to person. A visual aura only occurs in 20% of the population. Sometimes treating head and neck muscle tension or treating neck stiffness can lessen the severity of a migraine or decrease its frequency.

Tension Type Headaches (TTH)

A tension type headache may either be primary or it may be secondary to another sort of headache such as being associated with a migraine. This type of headache can either be on one side or both sides of the head and is often described by patients as a feeling of pressure, squeezing, tension and aching. These headaches are usually mild to moderate in intensity and often involve muscle trigger points which are tender spots in a muscle which when pressed may cause local pain or may refer pain to other areas.

Cervicogenic Headache (CGH)

The definition of a CGH as per the International Association for Study of Pain (IASP) is moderate to severe unilateral headache without change of side. Usually starts in neck or occipital area, eventually involving forehead & temporal areas. Episodes of varying duration in early phases, frequently becomes more continuous, with exacerbations & remissions. A physiotherapist may use manual therapy techniques to help relieve neck joint stiffness to treat this type of headache. Educating patients on proper posture and proper ways to do daily activities as well as using exercise therapy can also be used to treat this type of headache.

What is TMD?

TMD stands for temporomandibular joint disorder and is a term often used for many associated disorders. The TMJ or temporomandibular joint is the jaw joint found just in front of each ear. TMD is difficult to diagnose as the symptoms can be numerous and appear in different areas, particularly the head, face and neck. Some common symptoms are pain, clicking, limited mouth opening, headaches and neck stiffness.

Two common examples of TMDs are myofascial pain and internal disc derangement.

Myofascial Pain

Myofascial pain (“Myo” meaning muscle and “Fascial” meaning fascia, or the fibrous membrane covering the muscles) is characterized by a dull regional ache and tender points in a muscle called “trigger points” and in the case of TMD, it may also limit mouth opening. Pain may be referred to other areas. A dentist may find a tooth to be normal in a patient who has a toothache because the true origin of the pain may be myofascial. This type of TMD is most often associated with the tension type headache.

Internal Disc Derangement

Within the TMJ there is a meniscus or fibrocartilagenous disc. Following years of micro-trauma or after major trauma the disc can become displaced, usually forward. This changes its position at rest as well as altering the movement or biomechanics of the joint. Local joint pain may be felt due to swelling. A clicking or cracking sound is often heard while eating, opening and/or closing the mouth and it may even lock open or closed.

What is orofacial pain?

TMD is just one form of orofacial pain. Orofacial pain is pain in the areas of the head, face and/or neck. The causes can be muscular, articular, neurological and/or psychogenic. A good differential diagnosis is a must so patients can receive good treatment from the right health care professional or group of professionals.

Why physiotherapy for TMD?

Physiotherapy is proven to help joint and muscle problems. A specially trained physiotherapist can do a thorough examination including a clinical neurological exam, assessing the range of motion of the jaw and neck, extensive muscle palpation and testing, joint assessment and postural evaluation. This enables the physiotherapist to establish the main causes of a patient’s signs and symptoms as well as to develop an effective treatment plan to help make the patient feel better.

How important is posture?

Ask a musician, a dancer, or a physiotherapist and they will all say it is very important! Poor posture has a direct impact on joint position as well as the surrounding muscle work. Proper posture is the position in which the structures of the body, including joints and muscles are under the least amount of stress. It is a key component to improving the symptoms of TMD.

TMD – A patient’s history

Patients who have been hit in the face or had a whiplash injury can more easily understand their TMD symptoms; however, TMD does not have to start with one major trauma. In fact, it is very often precipitated by several smaller factors such as a minor fall, keeping the mouth open for prolonged periods of time during dental work, grinding the teeth or having periods of stress. TMD is also more prevalent in females and those who have very flexible joints.

Only physiotherapists who have taken courses given by qualified instructors may evaluate and treat patients in need of pelvic floor rehabilitation. Erin Cox started taking courses in 1998 and she has continued to treat the following problems:

Female Urinary Incontinence

Stress urinary incontinence is a sign of weakness of the pelvic floor muscles. The pelvic floor is made up of several layers of muscle spanning the area between the pubic bone and the coccyx. When women leak urine following coughing or sneezing or with physical activity such as jumping or running, this is a sign of weak pelvic floor muscles. Physiotherapy treatment may consist of Kegel exercises to strengthen the pelvic floor muscles as well as internal manual therapy techniques to help stimulate or relax the muscles. Biofeedback and neuromuscular stimulation may also aid in regaining pelvic floor muscle control.


The International Society for the Study of Vulvovaginal Diseases (ISSVD) has defined vulvodynia as vulvar discomfort, most often described as a burning pain, occurring in the absence of relevant visible findings or a specific, clinically identifiable, neurological disorder. Patients can be further classified by the anatomical site of the pain (e.g. generalized vulvodynia, hemivulvodynia, clitorodynia) and also by whether pain is provoked or unprovoked.

Vulvar Vestibulitis Syndrome or Vestibulodynia

VVS is a subset of vulvodynia that is characterized by severe pain in the posterior area of the vaginal opening during attempted vaginal entry (ie. intercourse or tampons insertion), tenderness to pressure localized to the vulvar vestibule and redness of the vulvar vestibule. Woman affected with this condition are less likely to have constant pain but have pain with contact.


Dyspareunia is vaginal pain during penetration. Vaginismus is a condition involving involuntary tightness of the pelvic floor muscles during intercourse. A woman may not even be aware of the muscle response causing the tightness or penetration problem and because there may be associated burning or pain during intercourse, a woman may have protective contractions of the pelvic floor making intercourse even more difficult or even impossible.

Physiotherapy treatment can help pelvic floor pain or difficult penetration by teaching a woman how to regain control of her pelvic floor muscles by doing kegel exercises and using biofeedback if necessary. Providing massage and stretches of the pelvic floor using internal manual techniques attains relaxation of the pelvic floor muscles and sometimes a home program is given to stretch the pelvic floor using dilators.

The FCAMPT designation is given only once a physiotherapist has passed several levels of both written and practical exams. “FCAMPT” is the acronym for “Fellow of the Canadian Academy of Manipulative Physical Therapy”. CAMPT is Canada’s member organization of the International Federation of Manipulative Physical Therapists (IFOMPT), part of the World Confederation of Physical Therapy and the World Health Organization. IFOMPT was formed in 1974 to pull together the skill and knowledge of physiotherapists practicing advanced manual therapy techniques.

Orthopaedic Manual Physical Therapy is a specialized area of physiotherapy for the management of neuro-musculo-skeletal conditions, based on clinical reasoning, using highly specific treatment approaches including manual techniques such as joint mobilization, soft tissue techniques, joint manipulation and therapeutic exercise. IFOMPT put in place internationally accepted standards for teaching Orthopaedic Manual Therapy.

Dry needling is a treatment first developed in Europe and in the United States. It is called “dry needling” because no medication is injected. Dry needling, in conjunction with manual therapy, is a very effective treatment for Myofascial Pain or muscle pain and tightness. In Dry Needling, we use sterile, one use acupuncture needles, to insert into trigger points (tender muscle points which can cause unwanted muscle shortening, dysfunction and local and/or referred pain). Needling trigger points can help increase blood and oxygen flow as well as decrease local neurogenic inflammation to help decrease local and referred pain thereby helping to increase function. We can also use Dry Needling to help with ligament healing and scar tissue. Dry Needling is excellent for either acute or chronic cases. This type of treatment can only be administered by therapists certified by the Ordre professional de la physiothérapie du Québec (OPPQ).

This is a unique website which will require a more modern browser to work!

Please upgrade today!