Movability - Wellness & Sport Sciences

Movability - Wellness & Sport Sciences Chiropractic, pelvic floor physiotherapy, acupuncture, massage, orthotics, naturopathic care, and rehab all under one roof.

We treat complex conditions through full-body assessment, root-cause care, and a collaborative, patient-first approach.

11/19/2025

Your migraines are not random. They are threshold. When load crosses your line, the attack fires. When the line sits higher, the same day does not take you out.

If light and sound feel hostile, if nausea, brain fog, and canceled plans steal days, you are not imagining it.

Migraine is a clinical label, not a single cause. It describes a brain state, not a culprit. For many, roots cluster across systems, which is why one food swap or one pill rarely changes the story.

Threshold moves with sleep and circadian rhythm, stress chemistry, hormone shifts, hydration and glucose, gut immune signals, sensory load from light, weather, medication patterns. And the part most people miss, mechanics: upper neck and jaw, tongue and diaphragm, eyes and vestibular system. If grocery aisles, scrolling, or car rides set you off, that pathway is involved.

Science you can feel. Migraine brains are more excitable and can show reduced habituation to repeated input between attacks. CGRP is a key messenger in the trigeminovascular network. Tiny nitric oxide challenges in controlled studies can provoke the premonitory state before pain. The cortical wave tied to aura can also switch on protective programs, a proposed safety net. Wearables flag pre attack shifts in heart rhythm, skin conductance, temperature, movement, sleep.

This is not about one diet or one drug. Patterns higher in omega-3 and lower in excess omega-6 helped in trials for some, not all. CGRP targeted preventives reduced monthly migraine days for many, not everyone. Neither is a one size answer. Both are examples of raising tolerance while we hunt true drivers. Frequent quick relief can quietly keep the line low. Not your fault; the biology is tricky.

My lane is threshold centered, systems first. I read and sequence change: rhythm and regulation, fuel and inflammation, mechanics and environment, hormone rhythm across the lifespan, medication ecology. I have applied this map in thousands of encounters over more than a decade, across continents.

The shift is simple to say and powerful to live. Move from trigger chasing to threshold rising while we map and treat true drivers.

— Dr. Sina

11/17/2025

Ankylosing spondylitis, simplified and research backed. This is more than pain and stiffness.

We reviewed the best evidence across genetics, microbiome and virome, mechanics and imaging, to explain why every system matters.

Here is what a flare does under the microscope. At the enthesis, the tiny anchor where ligament meets bone, the immune system fires an alarm. TNF, IL 17, and IL 23 rise. White cells flood the area. Osteoclasts dissolve the bone edge and leave pits. Then repair overshoots. A soft scaffold is laid down, mineralizes, and becomes thin vertical ridges called syndesmophytes. Layer by layer they can bridge one vertebra to the next. That is how flexible joints become a bamboo spine.

Why it happens, according to the best evidence. Genes matter, especially HLA B27, ERAP1, and IL23R. The gut microbiome and virome are often altered. Viral hits and other infections can tip the system on. Repeated micro stress at the anchors adds fuel. Smoking accelerates damage. Men tend to form bridges faster. Women often present differently and are diagnosed later.

How it gets missed. Onset is usually before 45. Early X rays can be normal. HLA B27 can be negative. MRI of the sacroiliac joints often shows inflammation first. Look for extra clues like uveitis, psoriasis, or bowel inflammation.

Treatment and timing. Modern medicine can drive inflammation toward remission. TNF and IL 17 blockers, and sometimes JAK inhibitors, reduce inflammatory signals. Starting earlier is linked with less structural progression.

Our approach. We work with your doctor, and with our naturopathic doctor, to use the remission window well. While medicine cools the fire, we help regulate the systems that influence it, gut, immune, hormones, bone, connective tissue, lungs and chest wall, heart and vessels, nervous system, sleep and stress, nutrition and metabolism, movement and load. The goal is simple, raise the odds of staying in remission, reduce flare risk, and protect mobility over time.

— Dr. Sina

🪝 When patients ask me what’s causing their POTS, this is my quick checklist:• Idiopathic when no clear driver is found....
11/16/2025

🪝 When patients ask me what’s causing their POTS, this is my quick checklist:

• Idiopathic when no clear driver is found.
• Autoimmune: systemic autoimmune disease, autonomic receptor autoantibodies, small fiber autonomic neuropathy. Mast cell activation overlap in some.
• Post infectious: EBV mono, influenza, GI viruses, COVID-19. Lyme in some. Rare post vaccine onset without proven causality.
• Genetic: familial clustering. Rare NET (SLC6A2) mutation. Possible sodium channel variants.
• Connective tissue: hypermobile Ehlers-Danlos or joint hypermobility causing venous pooling.
• Neuropathic secondary: diabetes, amyloidosis, sarcoidosis, chemo-related, Sjögren small fiber neuropathy.
• Hyperadrenergic: high standing norepinephrine, NET dysfunction or drug induced NET inhibition (atomoxetine, reboxetine, some SNRIs or TCAs).
• Hypovolemia with impaired renin-aldosterone responses.
• Deconditioning: prolonged bed rest or illness, microgravity analogs.
• Hormonal and life stage: puberty or growth spurts, menstrual shifts, pregnancy and postpartum.
• Physical stressors: concussion or head or neck trauma, surgery, major illness.
• Structural contributors in select cases: Chiari I or craniocervical instability.
• Medications and other triggers: diuretics, potent vasodilators, anticholinergics, some antipsychotics, drospirenone OCPs.
• Endocrine mimics to rule out: hyperthyroidism, adrenal disorders.

Save to discuss with your clinician, then personalize testing and treatment.

Why this matters: POTS is heterogeneous. Many people have several drivers at once, for example small fiber neuropathy plus venous pooling plus hyperadrenergic physiology. When I meet someone with POTS I look at the whole picture, not one label: onset trigger, comorbidities, hypermobility signs, immune and infectious clues, hormones, sleep and nutrition, medications, volume status, conditioning, and goals. Then I tailor testing and treatment to the dominant pathways. I’ve talk about POTS a lot on my page and will continue to do so. Hope this helps!

— Dr. Sina

🧠 A common virus may be fanning the flames of autoimmune disease. Epstein Barr virus infects most of us by adulthood, wh...
11/15/2025

🧠 A common virus may be fanning the flames of autoimmune disease. Epstein Barr virus infects most of us by adulthood, which means a positive EBV panel is expected, not destiny.

What matters is behavior. A new study mapped what EBV is doing inside lupus. The virus hides in memory B cells and in lupus it appears far more often, about 1 in 400 cells compared to fewer than 1 in 10,000 in healthy people. EBV flips genetic switches with a protein called EBNA2. Those infected B cells start acting like turbo antigen presenting cells, showing pieces of your own tissue to T cells. T cells push more B cells to make autoantibodies. The fire spreads through the body. That is fatigue, brain fog, rashes, joint pain, organ flares.

EBV is a s**t disturber. Not because everyone with it gets sick, but because in vulnerable people it tilts the whole immune orchestra off key. EBV biology has also been linked to multiple sclerosis, rheumatoid arthritis, Sjögren’s, autoimmune thyroid disease, systemic sclerosis, and some inflammatory myopathies. Different organs, different symptoms, but a similar spark. Molecular mimicry, confused immune brakes, and tired regulatory cells that cannot calm the response.

Why some get hit harder: genes that amplify inflammation, female hormonal shifts, chronic stress, smoking, low vitamin D, co infections, and the unlucky spot where the virus settles.

What this means for real people:
• Stop burning money on repeated EBV tests. A positive result confirms exposure only.
• Ask better questions. Are B cells overactive. Are T cells being overhelpful. What is driving flares today.
• Use real levers. Improve sleep, support hormones and metabolic health, manage stress, treat true infections, nourish your body, and use evidence based therapies.
• Watch the horizon. EBV vaccines, precision antivirals, and smarter B cell strategies are being built. Not cures yet, but real targets finally in sight.

You are not broken. Your immune system is responding to signals. Science is getting closer to understanding those signals and how to quiet them before they burn the house down.

— Dr. Sina

11/14/2025

If your spine MRI says “disc osteophyte complex,” do not chalk it up to “just aging.” This is a targeted repair response to microinstability. As discs lose proteoglycans they dehydrate, lose height, and develop annular fissures; load shifts to the vertebral rim, endplates, uncovertebral joints, and facets. The spine tries to stabilize by laying down fibrocartilage that ossifies into marginal bone spurs (endochondral ossification). Paired with a bulging or herniated disc, those osteophytes can narrow the central canal or the neural foramina, producing spinal stenosis or foraminal stenosis and nerve root compression. This pattern is typical in cervical spondylosis and degenerative disc disease.

Mechanisms to know: reduced disc hydration and height; annular tears; endplate microfracture and sclerosis; facet and uncovertebral hypertrophy; ligamentum flavum infolding; osteophyte growth along Sharpey fiber attachments. At the molecular level, loss of proteoglycans, a shift toward type I collagen, upregulated MMPs, and inflammatory cytokines like IL‑1 and TNF sustain the cascade. Adaptation comes first; crowding and symptoms come later.

Who is more prone: people with hypermobile Ehlers‑Danlos syndrome or generalized joint hypermobility (segmental laxity increases shear); prior whiplash or disc injury; heavy repetitive loading at work or in sport; smoking; metabolic and hormonal factors that impair disc nutrition and repair; and conditions like DISH that create large anterior osteophytes.

Complications to watch: radiculopathy with dermatomal pain, numbness, or weakness; degenerative cervical myelopathy, also called cervical spondylotic myelopathy, with hand clumsiness, imbalance, and hyperreflexia; dysphagia from large anterior cervical spurs; rare cerebrospinal fluid leaks from ventral dural tears caused by calcified disc or osteophyte, often presenting with orthostatic headache and MRI signs of intracranial hypotension.

My approach is root cause. When I see this on imaging, I always ask why. I review the entire history and the whole body, inside and out, plus the environment you live and train in, to find what drove it so we can stop it from progressing.
—Dr. Sina

11/12/2025

Deep sleep in a glass. This cold and sparkly bedtime drink uses tart cherry, chamomile, lavender, a teaspoon of raw honey, and a pinch of cinnamon to help you wind down and support deep, restful sleep.

I used what I had at home. Ideally, steep high quality organic tea (I used tea bags).

Why it works
• Tart cherry provides natural melatonin and sleep supporting anthocyanins
• Chamomile contains apigenin that interacts with GABA receptors to promote calm
• Lavender aroma is associated with improved sleep quality
• Raw honey gives a gentle glucose nudge that may aid tryptophan availability and soothes the throat
• Cinnamon provides polyphenols that support a steady glucose response and a cozy flavor

Ingredients
• 1 chamomile tea bag
• 1 lavender tea bag
• 2 to 3 oz organic tart cherry juice
• 4 to 6 oz sparkling mineral water
• 1 tsp raw honey
• A light pinch of cinnamon
• Ice optional

Instructions
1. Steep both tea bags in 1/2 cup hot water for 5 to 7 minutes. Remove the bags.
2. Let the tea cool completely. Refrigerate to speed it up.
3. Stir in the honey, then a light pinch of cinnamon. If the tea is slightly warm it will dissolve honey faster. If fully cool, just stir longer.
4. In a clean glass add the tart cherry juice.
5. Pour the cooled tea over the cherry juice.
6. Top with sparkling mineral water and give a gentle stir so you keep the bubbles.
7. Sip and enjoy.

Care so you do not ruin the good stuff
• Do not make this piping hot. Higher heat can dull chamomile and lavender aroma, and it can degrade cherry anthocyanins and the delicate enzymes in raw honey.
• Keep it cold and sparkly. Cool the tea first and add sparkling water last to preserve fizz.
• Sweetness is flexible. Start with one teaspoon of honey and adjust.

Sleep well after you enjoy the Dr. Sina Sleep Tonic.

— Dr. Sina

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) research update and path forward, 2025You are not invisible....
11/11/2025

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) research update and path forward, 2025

You are not invisible. Your symptoms are real. Many were told to push through. That was harmful. Modern guidance centers post exertional malaise, respects energy limits, and treats this as a biomedical condition.

What the best evidence says now (
• ME/CFS is a neuroimmune and energy disorder.
• Post exertional malaise is core. There is no single lab test. Diagnosis is clinical and person centered.
• Autonomic dysfunction is common. Orthostatic intolerance and POTS often respond to fluids, salt, compression, and selected medications.
• The crash after exertion can be measured. On a two day CPET many show a reproducible day two drop that is not seen in simple deconditioning.
• Brain studies at ultra high field show elevated lactate in some regions, consistent with energetic stress.
• Immune profiling shows dysregulation and features of immune exhaustion, with overlap seen in long COVID. A subset has autoantibodies to β2 adrenergic or muscarinic receptors. Early studies in carefully selected post COVID cases suggest antibody removal may help, this remains investigational.
• A large randomized trial found that coenzyme Q10 plus NADH improved fatigue and some sleep measures. Not a cure, a useful add on for some.

Care today
Pacing first. Use heart rate informed activity to prevent crashes. Treat orthostatic intolerance. Optimize sleep and pain. Consider low risk adjuncts with evidence. Build a plan that protects limited energy and supports daily function.

Guidance, up to date
NICE NG206 (UK) remains current as of January 2025 and advises against fixed graded exercise. CBT can support coping, it is not curative. A 2024 D A CH consensus (Germany, Austria, Switzerland) reached similar conclusions.

Hope
Research is accelerating across the UK, Europe, Australia, and worldwide. We are mapping subtypes, testing targeted therapies, and building better biomarkers. You deserve validation, careful management, and partnership. You are not alone.

Educational content only. Talk with a clinician experienced in ME/CFS for personal care.

— Dr. Sina

11/10/2025

Your body is a planet seeking balance. Homeostasis is its climate control, the quiet work of keeping temperature, blood sugar, hormones, and the nervous system steady. When you stack detox plans, IVs, new supplements, an elimination diet, and a fresh workout all in the same week, you create weather, not healing. Too many variables become storms. Signals blur. Progress stalls.

Start with stability. Reduce variables. Pick one lever. Define intent. Set a metric and a timeline. Examples that move the needle without chaos: protect 7 to 9 hours of sleep, front load protein and fiber, morning light for circadian rhythm, ten minute walks after meals, hydrate with minerals, one consistent bedtime, five minutes of breath work. Track simple markers, energy, mood, digestion, skin, cycle, resting pulse, cravings, performance.

Honor sensitive seasons when homeostasis is easier to disturb. Puberty. College or first job stress. Pregnancy. Postpartum and breastfeeding. Perimenopause. Menopause. Andropause. Starting or stopping birth control. Fertility treatments. Thyroid shifts. Coming off stimulants or SSRIs. Post viral recovery. After concussion or surgery. Big travel and jet lag. Shift work. High volume training or weight cuts. Grief and major life transitions.

Before any protocol, ask three questions. What is my physiology telling me. What is the single target. How will I measure change over two to four weeks. If you cannot answer, you are not ready to add more. Pull back to foundations until the signal is clear. Your body is the master. You are the steward.

This is the work I do with patients, we reduce variables and trickle in targeted strategies so the system can regulate and repair. If you have been trying ten things at once, take a reset week, stabilize the routine, then introduce one precise intervention. Comment with the one lever you will test next, save this for the next sensitive season, and share with a friend who needs fewer storms. Slow is smooth. Smooth is fast. Strong foundations steady insulin, calm inflammation, support the microbiome, and build metabolic health. When you change less, you learn more, and what you keep actually works.

— Dr. Sina

11/09/2025

Collecting diagnoses like Pokémon but still not getting better? You are not alone. Many people leave visits with a new label, a thicker chart, and more confusion. I see patients with 10, 15, even 20 diagnoses and a binder full of tests. They feel stuck, not knowing where to start. Some clinicians avoid these cases as too complicated.

Here is the truth. A diagnosis is often a description in another language, not an explanation. It can sound technical, yet it rarely tells you the root cause.

How labels usually break down:
• Purely descriptive: low back pain, fatigue, chondromalacia patella. They say where or what, not why.
• Syndromes: IBS, PCOS, fibromyalgia, chronic migraine. Shorthand for a pattern with multiple possible endotypes.
• Eponyms: Graves, Parkinson, Addison. Names, not mechanisms.
• Mechanistic when luck and science align: group A strep pharyngitis, DVT from factor V Leiden, TSH receptor antibody mediated hyperthyroidism. Helpful, but these are the minority in everyday care.

Here is how I think about chronic pain and complex cases. You can begin recovery without waiting for the perfect diagnosis. We always rule out red flags first. Then we sit down and actually listen, to the story and to the body. We map the systems that could drive the root cause or causes: tissue load and capacity, sleep and stress, hormones and thyroid, iron status and glucose control, nutrition and meds, nervous system sensitivity, environment and habits etc… Then we build a testable plan, not a forever plan. Misdiagnosis happens. That is why we test and pivot.

Use this framing at your next visit:
Label, so we can communicate.
Root cause, the mechanism that explains the symptoms.
Testable plan, one or two actions with a metric and a timeline.

Three questions to bring with you:
What do you think is driving this?
What should change if we are right, and by when?
What is plan B if it does not?

You are not too complicated. You do not have to collect more labels to recover. Put the information together, look across systems, and take the first testable step. Save this for the next appointment. Share it with someone who feels stuck.

— Dr. Sina

11/07/2025

Certainty feels safe. It also shuts the door. The moment you decide you have the answer, you stop looking for better ones. That is why I am careful with absolutes. Real life is layered. It is messy, alive, and always teaching if you keep listening.

No one holds the whole map. We all carry pieces. The danger is treating your piece like the world. That is the Dunning-Kruger effect at work, a classic cognitive bias: a little knowledge can feel like mastery. Confidence shoots up while competence has barely left the runway. The fix is simple and powerful. Treat your opinions as drafts. Add “for now” to your strongest takes. Ask who sees it differently. Learn out loud.

This mindset is mental freedom. When you stop needing one perfect system, you stop defending a fixed identity. You are no longer the “X method” person or the “Y school” person. You become a student of outcomes and reality. This is critical thinking for real life, a practice of open mindedness and self improvement. This is the growth mindset in practice. Labels can be tempting because they offer belonging and status. They also become cages. Once you pick a team, you stop noticing what the other teams can teach you. Curiosity is louder than identity. Let it lead.

Collaboration turns this into momentum. Your piece plus mine creates a truer picture. We compare notes. We test ideas against facts. We keep what survives and release what does not. It leads to better decisions. Changing your mind starts to feel good, not threatening, because it is proof you learned something today that you did not know yesterday. The more you learn, the more you realize how much there is to learn, and that realization creates an honest hunger that sustains growth.

If you want a practical rule: replace always and never with for now. Seek one credible viewpoint that challenges you before you decide. Ask better questions than statements. Share credit. Keep the curiosity switch on. Be wary of absolutists. Be generous with learners. Refuse to live inside a label. Carry your piece of the map and some tape. Together we can assemble something closer to the truth, and the journey will keep you sharp, adaptable, and free.

— Dr. Sina

11/05/2025

The secret about chronic tendon pain. It is a wiring problem, not just wear and tear. Healthy tendon cores are almost nerve free. After overload, sensory nerves grow inward from the sheath into the tendon proper. That is maladaptive reinnervation, the wrong wires in the wrong place, carrying chemistry that turns pain up.

If your MRI looks normal but you still hurt, you are not imagining it. If your scan looks messy but the pain does not match, you are not broken. Pain persists because the wiring and the chemistry changed, not only the tissue.

Here is the loop. New nerves release substance P and glutamate. Tenocytes release them too. Their docking stations multiply, so everyday loads feel like threats. Mast cells sit beside those nerves like amplifiers. When triggered, they release histamine, tryptase, and nerve growth factor. NGF tells nerves to sprout. More nerves means more transmitters. The loop closes, the gain stays high, and pain outlives the original injury. That is neurogenic inflammation.

If you have mast cell activation syndrome, MCAS, this explains why flares can spike tendon pain across the body. Mast cells live in connective tissues, including tendons. When mast cells degranulate, they bathe nearby nerves in mediators that sensitize them and invite more nerve growth. Result, louder pain from normal motion. Calming mast cell activity can lower that noise.

What helps. Smart loading remodels tissue and signaling. Eccentric and isometric exercises teach the tendon to tolerate force while dialing down the chemical alarm. Image guided procedures that target neurovascular ingrowth can prune the wrong wiring when rehab needs a boost. Education matters, because understanding the loop reduces fear and makes every rep more effective.

If this clicked, save it, share it, and tell me where you feel tendon pain most. If you live with chronic pain or MCAS, you deserve answers grounded in biology and delivered with clarity. Your pain has a map we can follow toward relief. Start here.

— Dr. Sina

Seatbelts on, class. Dr. Sina is driving the Magic School Bus through the latissimus dorsi.First stop, the back wall of ...
11/03/2025

Seatbelts on, class. Dr. Sina is driving the Magic School Bus through the latissimus dorsi.

First stop, the back wall of the torso. The lat springs off T7 to T12, thoracolumbar fascia, iliac crest, and lower ribs, sometimes the scapular inferior angle. It wraps under the arm to the bicipital groove. Job list, extend, adduct, internally rotate the humerus, assist a deep inhale. Through the thoracolumbar fascia it speaks to the pelvis and lumbar spine.

Chaos tour. A short, overactive lat drags the shoulder down, fixes the scapula in depression and downward rotation, steals overhead reach, narrows the subacromial space, flares ribs, and makes the neck lift for it. Thoracic extension gets stingy. The low back arches to fake shoulder flexion.

How do people end up here. One sided sports like golf or hockey. Swim or climb seasons with lots of pulling. Heavy pulldowns with rib flare. Long desk hours with the same mouse reach. Baby carrying on one side. Couch and TV that face one way. Shallow breathing or a long cough. All of these bias the lat to win too often.

Nerve tour. Thoracodorsal nerve C6 to C8 leaves neck roots, joins the posterior cord, then slips through the axilla into the lat. If those neural tissues get sticky at the scalenes or under the clavicle, the nerve can feel tethered. Tethering alters motor output, so the lat gets tight and quick to guard, with ache toward the posterior arm and ulnar forearm.

What I check on the bus. Lagging scapulohumeral rhythm, early shoulder hike, rib flare on elevation, depressed scapulae, limited thoracic extension, tender points at the posterior axillary fold and along the lateral ribs. Breathing that lives in the neck instead of the diaphragm.

How we fix the traffic jam. Free the lat and teres major, mobilize the thorax, restore scapular posterior tilt and upward rotation, coach rib control and diaphragmatic breath, reload the lat with slow eccentrics in a clean range, balance with serratus anterior and lower trap. Then adjust life inputs, carry both sides, tweak desk reach, set neutral ribs in golf.

Take the ride, do not chase symptoms. Find the driver, correct the links, and the map gets simple fast. Start curious.

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2 Hunters Point Drive
Richmond Hill, ON
L4C9Y4

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Monday 10am - 7pm
Tuesday 10am - 7pm
Wednesday 10am - 7pm
Thursday 10am - 7pm
Friday 10am - 7pm
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Sunday 10am - 4pm

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+19057634000

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What Makes Us Unique

Movability was created to fill a void in the healthcare world. We noticed a lack of truly custom and comprehensive care, we knew we had to be different to provide the best possible treatment. We set out to create a unique therapeutic experience built on empathy, trust, and unparalleled attention to detail. We spend the time to get to know the real you, your goals, dreams and expectations because you are much more than just a diagnosis. We work with you to create custom treatments that meet those expectations. At Movability there’s no such thing as one size fits all. Experience the difference for yourself.