Expert Physiotherapy, Chiropractic, and Orthotics Services for Optimal Health

Sports Medicine

Physiomed is proud to offer a specialized Sports Medicine program for professional, amateur and recreational athletes in need of a comprehensive recovery management plan and specialized care for orthopaedic conditions, including:

  • ACL/MCL Injuries
  • Achilles Tendonitis
  • Chronic Joint Pain
  • Muscle Tears
  • Sprains and Strains
  • Stress Fractures
  • Rotator Cuff Tears
  • Other sports-related injuries to the hand, wrist, shoulder, hip, knee, or foot

The program is offered under the guidance of Sports Medicine Physician, Dr. Guru Kandasamy, a licensed Sports Medicine Specialist and one of the top integrative health practitioners in Toronto with extensive training in Medicine, Acupuncture, Chiropractic & Kinesiology.

Some of the services we offer include medication management, surgical referrals, and non-surgical interventions such as Ultrasound-Guided procedures, Platelet-Rich Plasma treatments, and hyaluronic acid joint injections.

Ultrasound Guided Injections

The use of Ultrasound in medical practice has greatly enhanced the ability to diagnose and treat musculoskeletal conditions including:

  • Torn vs Ruptured Tendons
  • Joint/Tendon Inflammation
  • Avulsions Injuries
  • Inflamed Bursae
  • Fluid in the Joints
  • Haematoma in Muscles
  • Other sports-related injuries to the hand, wrist, shoulder, hip, knee, or foot

Ultrasound is extremely useful when guiding injections into injured muscles, tendons, bursa and joints. It helps to improve accuracy and studies show superior results in patients returning to their baseline strength and performance. Using direct ultrasound vision, Physiomed offers same day in-house interventional injections for small and large joints/tendon, and conditions can be re-assessed and monitored periodically using the technology.

Treatments performed under ultrasound into tendons and joints include:

  • Hyaluronic Acid Gel
  • Cortisone
  • Platelet Rich Plasma
  • Prolotherapy
  • Hydrodilatation for Frozen Shoulder

Hyaluronic Acid Injections

Hyaluronic acid injections are a treatment for osteoarthritis and improving joint health. It is a clear gel that is delivered by a small injection into a joint, most commonly used in knees, hips, shoulders, ankles, and fingers.

Hyaluronic Acid is made from a natural substance that lubricates the joint and may provide up to 12 months of joint pain relief with a single injection. Although there is no cure for osteoarthritis, a number of treatments and pain management programs are available to lessen the pain, improve mobility and improve quality of life.

Treatment with hyaluronic acid offers a safe and effective option for joint related pain. It temporarily supplements the deteriorated synovial fluid in your joints with a naturally derived lubricant closely resembling the fluid in healthy joints.


A corticosteroid, or steroid, injection is used to reduce inflammation in tendons or joints. It’s often used to treat conditions such as arthritis, tendinitis, and bursitis.

Steroids can be injected directly into a painful, inflamed joint. It cushions and lubricates areas where tendons, ligaments, skin, muscles, or bones rub against each other. They can also help reduce inflammation of a bursa, which is a sac of fluid.

A steroid injection using ultrasound guidance can provide short-term pain relief when other treatments haven’t worked. If steroid treatments help, pain may improve for weeks to months.

Platelet Rich Plasma Injections

Platelet rich plasma (PRP) injections were first used in the 1980’s in the operating room to treat cardiac pathologies. Today, PRP injections have been safely used in a number of fields including sports medicine, orthopaedics, cosmetics, and dentistry.

Blood contains plasma, red blood cells, white blood cells and platelets. Platelets are tiny cells with a life span of approximately 7-10 days and contain granules with powerful growth factors. During the healing process, platelets are activated and aggregate together at the site of injury. They then release the granules which stimulate the inflammatory cascade and healing process.

Typically, platelets make up approximately 1% of our whole blood, whereas PRP has a significantly increased supra-physiological platelet concentration. Although this level can vary depending on the method of extraction and equipment, studies have shown that there can be a clinical benefit to injuries if the PRP used has a platelet concentration greater than normal blood.

PRP injections can be used in the treatment of many musculoskeletal injuries including those related to tendons, muscles and joints. Depending on the severity of the injury, 2 to 3 injections several weeks apart may be indicated for full recovery.


Prolotherapy, short for “proliferation therapy”, is a treatment that involves injections of a solution into specific sites and trigger point areas in the body to help with pain and dysfunction. Following an injury, ligaments and tendons surrounding joints can become stretched out or even torn. This destabilizes the joint, causing inflammation and pain.

With prolotherapy, an injection is made into the area near a joint, ligament, or tendon, and the irritation of the injected solution stimulates new collagen production, which helps stabilize the joint and regenerate the site. Prolotherapy helps resolve pain and can stimulate permanent healing in many patients.

Typically, a dextrose (sugar) solution, saline solution, and an anesthetic like lidocaine are used for the injections. Effective prolotherapy typically involves several periodic treatments — from weekly to monthly injections, depending on the condition.

Hydrodilatation for Frozen Shoulder

Hydrodilatation, also called hydrodistension, is a special type of ultrasound-guided high-volume solution injection used to treat pain and the restriction of movement caused by Adhesive Capsulitis, also known as Frozen Shoulder.

Frozen Shoulder is a condition causing pain and stiffness in the ball and socket joint of the shoulder. It can develop over time and lead to a loss of functional arm use. Most cases of frozen shoulder improve without treatment. However, waiting for this condition to improve spontaneously can take several years. Experts recommend seeking early treatment rather than waiting for it to improve.

A common treatment used historically is a simple cortisone injection. However, this is only moderately helpful in the early stages to reduce pain and stop the progression. Hydrodilatation, on the other hand, is a more impactful treatment that involves injecting a high-volume solution directly into the shoulder joint, causing distension of the capsule and rupture of the capsular adhesions. This ultimately results in increased range of motion and pain reduction.

Frozen shoulder is common in middle-aged people and most cases do not have a triggering factor. Hydrodilatation works well to stop the progression of this disease, and treating your frozen shoulder early is essential to getting the best results.

Currently, our Physiomed Sports Medicine program is only offered at our Physiomed Medical Walk-In Clinic, located at 1176 St. Clair Avenue West in Toronto. To request an appointment or to learn more, please call us at 416.270.6789.


Sports Medicine Physician

Before earning his medical degree, Dr. Kandasamy obtained his Honours Bachelor of Science degree in Kinesiology from the University of Waterloo, graduated from the Canadian Memorial Chiropractic College, and became certified in Medical Acupuncture through McMaster University’s Department of Anesthesia. He completed his Family Medicine residency at Michigan State University with focused PGY-III Sports Medicine training.

Following his post-graduate training, Dr. Kandasamy earned his Diploma in Sports Medicine from the Canadian Academy of Sport & Exercise Medicine (CASEM) and received his GP Focused Practice Designation in Sports Medicine granted by the Ontario Medical Association & Ministry of Health.

Dr. Kandasamy is a board-certified physician in both Canada & the United States and has served on the medical staff of several professional sports organizations, caring for athletes in the NHL, OHL, MLB, NFL, CFL and on various Canadian and NCAA collegiate teams. His clinical expertise includes multidisciplinary management of sport-specific injuries, musculoskeletal procedural ultrasonography, and regenerative medicine with Platelet-Rich Plasma and Viscosupplementation injections. Dr. Kandasamy is a Lecturer at the University of Toronto, and holds a Clinical Academic Appointment in its Faculty of Medicine, where he continues to teach Integrative Sports Medicine to aspiring medical students and residents.

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