What are the opening hours?

Monday 9:30am - 7:30pm Tuesday 9:30am - 8pm Wednesday 9:30am - 7:30pm Thursday 9:30am - 8pm Friday 9:30am - 4pm Saturday 9am - 3pm

St Vital Physiotherapy & Sports Injury Centre

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Winnipeg, MB
St Vital Physiotherapy & Sports Injury Centre

St. Vital Physiotherapy has been providing physiotherapy services to the citizens of Southeast Winnipeg since 1986. Mary’s Road, just south of Meadowood Drive.

Our clinic is easily accessible in the Meadowood Professional Building, at 1555 St.

11/03/2025

Moving With Ease: Smart Ways to Manage Osteoarthritis - https://www.facebook.com/profile.php?id=100063579188622

11/02/2025

Conclusion: Towards Equitable Musculoskeletal Practice.
Rethinking musculoskeletal pain in women is not about introducing new protocols. It is about refining clinical reasoning, expanding our lens, and acknowledging the systemic biases that shape our practice.
Pain is a multidimensional, lived experience. When we fail to consider the role of sex hormones, immune profiles, trauma history, and social context, we fail half the population. Bridging the gender pain gap requires intentionality, education, and the development of outcome measures that reflect women's realities.
As clinicians, educators, and researchers, we must lead the charge in transforming musculoskeletal care from a one-size-fits-all model to one that recognizes and responds to the unique needs of women. Ultimately, integrating female-specific perspectives into musculoskeletal care is not a "niche interest"; it is essential for equitable, effective, and evidence-informed practice.
Reference: Blog by Sonam Jethwa, Australian Physiotherapist
For full article:
https://dralisongrimaldi.com/blog/women-in-pain/?mc_cid=1eee471acd&mc_eid=30ceffc272

10/31/2025

What are the Clinical Implications for Physiotherapy Practice?
To address these disparities, MSK clinicians must integrate female-specific considerations into assessment and management. This includes:
• Taking a detailed hormonal history (such as age at menarche, menstrual patterns, menopause – natural/ surgical, contraceptive use, endometriosis/ adenomyosis).
• Early menarche (typically between ages 9 and 11) has been associated with an increased risk of chronic pain conditions involving the neck, abdomen, upper limbs, and chronic widespread pain (CWP).23
• Screening for trauma and psychosocial risk factors.
• Identifying patients at risk using tools like the Örebro Musculoskeletal Pain Screening Questionnaire (OREBRO-SF) and the Central Sensitization Inventory (CSI).
• Adapting exercise interventions to account for or adapt to hormonal phases, immune system profile and psychosocial situation.
• Advanced frameworks like the Pain and Movement Reasoning Model24 offer valuable structure, which can be enhanced with a female-centred lens to integrate sex-specific factors into clinical reasoning.
• Call for researchers to develop outcome measures that identify females at risk of persistent pain by incorporating female-specific variables such as hormonal status, trauma history, and psychosocial factors.
Furthermore, integrating exercise as a therapeutic tool must be done with caution in women with conditions like RED-S or autoimmune, where overtraining may exacerbate painful condition.25
Clinicians should also embrace person-centred care approaches, validating the patient’s lived experience, and offering shared decision-making.26 This involves explaining why certain symptoms may be hormonally modulated or psychosocially influenced without attributing pain solely to mood or stress.
Educational reform is also essential. Clinicians must be trained in sex- and gender-based medicine and taught to critically appraise literature for sex bias. The Sex and Gender Health Education Summit 2020 recommends that healthcare professionals develop competencies in sex-based pain management, critical appraisal, and advocacy.
Reference: Blog by Sonam Jethwa, Australian Physiotherapist
For full article:
https://dralisongrimaldi.com/blog/women-in-pain/?mc_cid=1eee471acd&mc_eid=30ceffc272

10/26/2025

Psychosocial Determinants and Gender-Based Vulnerabilities
Pain in women is shaped not only by biology but also by lived experiences. A history of trauma, especially in childhood or in the context of intimate partner violence, significantly increases the risk of developing persistent pain states.20
Moreover, socioeconomic disadvantage, caregiving roles, low educational attainment, and poor access to healthcare have all been associated with pain persistence.6 Women with persistent pain are more likely to experience depression, anxiety, and social withdrawal, further compounding the biopsychosocial complexity.21
The burden of pain is not evenly distributed, and these disparities are rarely captured in traditional outcome measures or rehabilitation plans. This highlights a critical need for trauma-informed care and social determinants to be explicitly considered within clinical reasoning.
Additionally, societal expectations may influence how women report or interpret pain. Women are often socialized to endure discomfort and prioritize caregiving, which can delay help-seeking or minimize their perceived need for rest or recovery.22 Understanding these dynamics is essential for clinicians to provide validation and contextualized support.
Reference: Blog by Sonam Jethwa, Australian Physiotherapist
For full article:
https://dralisongrimaldi.com/blog/women-in-pain/?mc_cid=1eee471acd&mc_eid=30ceffc272

10/24/2025

Immune and Neuroendocrine Contributions to Sex Differences in Pain
Emerging evidence suggests distinct immune mechanisms underpin persistent pain in males and females. In male patients, microglial activation and BDNF expression are central, whereas in females, adaptive immune responses involving infiltrating T cells predominate.19 These biological sex differences necessitate a nuanced understanding of inflammatory pain mechanisms. For example, women in low-oestrogen states (e.g., post-menopause) often demonstrate a proinflammatory cytokine profile, contributing to systemic and musculoskeletal inflammation.1
Additionally, hormonal withdrawal states (e.g., menopause, postpartum) are increasingly being recognised as risk periods for the emergence or exacerbation of musculoskeletal symptoms. Inflammatory arthropathies such as rheumatoid arthritis and lupus also demonstrate higher prevalence and severity in women, with symptom onset often linked to reproductive transitions.5
Furthermore, immune-hormonal interactions may underpin sex-specific differences in autoimmune risk. Oestradiol influences immune cells such as T-lymphocytes and macrophages, shifting the immune balance between proinflammatory and anti-inflammatory states depending on concentration.1 This may help explain the observed higher prevalence of autoimmune and inflammatory musculoskeletal conditions among women.
Reference: Blog by Sonam Jethwa, Australian Physiotherapist
For full article:
https://dralisongrimaldi.com/blog/women-in-pain/?mc_cid=1eee471acd&mc_eid=30ceffc272

10/19/2025

Exploring female sex-specific biological and psychosocial determinants of pain
The literature reports numerous sex-specific biological mechanisms that underlie pain at both physiological and pathological levels, and these insights underscore the necessity for sex-specific management of musculoskeletal conditions.
The Influence of Sex Hormones on Pain
Sex hormones significantly modulate pain perception and inflammation. Oestradiol, in particular, demonstrates complex dual roles. At high concentrations, it enhances descending inhibitory pain pathways (anti-nociceptive), while at low concentrations, it facilitates sensitisation (pro-nociceptive).1 These modulatory effects are especially evident during hormonally dynamic periods such as menstruation, perimenopause, and post-menopause.
Progesterone and testosterone also exhibit antinociceptive properties. Progesterone has been linked to pregnancy-induced analgesia, while testosterone is associated with a lower risk of developing persistent widespread pain.18
Hormonal fluctuations, whether natural or iatrogenic could influence pain thresholds, inflammatory cytokine profiles, and pain sensitivity.5 These mechanisms may help explain why many female patients present with pain that is cyclical, migratory, or resistant to standard musculoskeletal interventions.
Further, hormonal fluctuations are likely to influence not only pain perception but also tissue structure and function. For instance, variations in oestradiol levels may affect collagen synthesis, joint laxity, and tendon health.1
It is important for clinicians to assess whether pain intensifies during specific hormonal phases. Tracking symptoms across the cycle may help identify hormone-sensitive pain presentations and tailor treatment accordingly. For instance, some patients may benefit from modifying exercise loads or incorporating pacing strategies during ovulation or menstruation when symptoms are worse.
Reference: Blog by Sonam Jethwa, Australian Physiotherapist
For full article:
Women in Pain: Sex-Based Gaps in Musculoskeletal Clinical Practice | Find out more

10/17/2025

Sex-Based Disparities in Pain Experiences
Persistent pain affects approximately 30.8% of women compared to 26.8% of men2. Research also indicates that women are five times more likely to experience osteoporosis and 1.4 times more likely to have arthritis compared to men.4 Moreover, women represent 85% of autoimmune diagnoses.5
Compounding this burden is the phenomenon of Chronic Overlapping Pain Conditions (COPCs). These include fibromyalgia, endometriosis, temporomandibular disorders, vulvodynia, chronic fatigue syndrome, and migraines. COPCs are more common in female and are associated with heightened pain sensitivity, poorer functional outcomes, and increased healthcare utilisation6,7.
The Victorian Gender Pain Gap report,8,9 further highlighted that nearly one in three women experienced negative healthcare interactions related to pain. Many women reported that their concerns were dismissed, their symptoms attributed to psychological causes, or they were inappropriately referred to mental health services. These outcomes underscore the pervasive sex-based bias that persists across both clinical research and practice—manifesting through the ongoing under recognition of their pain experiences in healthcare settings.
These issues are further exacerbated in culturally and linguistically diverse populations, where communication barriers and cultural assumptions can mask legitimate pain experiences.10 Clinicians should be aware of these layered vulnerabilities when assessing and treating pain in women
Reference: Blog by Sonam Jethwa, Australian Physiotherapist
For full article:
https://dralisongrimaldi.com/blog/women-in-pain/?mc_cid=1eee471acd&mc_eid=30ceffc272

10/15/2025

Musculoskeletal pain remains one of the leading causes of disability worldwide, disproportionately affecting women across the lifespan. Yet, for decades, the medical and research communities have failed to adequately address the unique biological, hormonal, and psychosocial determinants of pain in women.1,2 Despite a higher prevalence of pain conditions such as fibromyalgia, migraines, osteoarthritis, and autoimmune disorders among women, clinical encounters often leave their pain dismissed, psychologised, or inadequately managed.3
We now understand that musculoskeletal pain is neither purely mechanical nor solely the result of tissue damage. Rather, it is a complex, multidimensional experience shaped by biological, psychological, and social processes—including life transitions, healthcare interactions, and societal influences. When it comes to women, these layers reveal one undeniable truth: we are missing something big.
In this blog, I share key insights from my recent presentation and essay, arguing for a paradigm shift in how we understand and treat musculoskeletal pain in females. This shift demands that clinicians integrate female-specific biological, hormonal, and psychosocial factors into every layer of assessment, reasoning, and care.
Reference: Blog by Sonam Jethwa, Australian Physiotherapist
For full article:
https://dralisongrimaldi.com/blog/women-in-pain/?mc_cid=1eee471acd&mc_eid=30ceffc272

10/10/2025

Over the next few posts we'll explore sex-based differences in pain and musculoskeletal injuries that we find relevant to our practice.
For years women have been essentially treated as "small men", but there is more and more evidence to suggest we have failed to adequately address the unique biological, hormonal, and psychosocial determinants of pain in women.
Please join us in learning more about how we can do better!
Reference: Blog by Sonam Jethwa, Women in Pain
For full article:
https://dralisongrimaldi.com/blog/women-in-pain/?mc_cid=1eee471acd&mc_eid=30ceffc272

09/10/2025

Angela Hazlewood has been offering exceptional patient care at St. Vital Physiotherapy and Sports Injury Centre since 2006. Here's and example of what her clients are saying:
"Thank you for your expert care while I was your patient at the clinic. I want to let you know that I have made a full recovery and my injuries did not interfere with nor limit my activities on my trip.
I really valued receiving treatment which incorporated multiple modalities accompanied by your friendliness and genuine interest in my recovery and well-being. Each of these contributed to my healing process.
You are an excellent example of a professional and I will refer others to you.
Thank you again for a wonderful physiotherapy experience!"

To book an appointment with Ang, or learn more about our clinic, visit our website stvitalphysio.ca or call 204-255-0597.

09/02/2025

St. Vital Physiotherapy Newsletter - The Powerful Benefits of Walking Poles
To learn more: https://stvitalphysio.ca/the-powerful-benefits-of-walking-poles/

Address

1555 St. Mary's Road
Winnipeg, MB
R2M5L9

Opening Hours

Monday	9:30am - 7:30pm
Tuesday	9:30am - 8pm
Wednesday	9:30am - 7:30pm
Thursday	9:30am - 8pm
Friday	9:30am - 4pm
Saturday	9am - 3pm

Telephone

+12042550597

Website

http://www.stvitalphysio.ca/

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