Does my health plan cover your sports medicine services?

If you are a Canadian resident, your provincial health plan covers consultations with our sports medicine doctors and orthopedic surgeons. All of our other services are private, and may be covered by your workplace extended health care plan. Please see Our Services for more information.

Do I need a referral to see a sports medicine doctor?

No, you do not need a referral to see a sport medicine doctor here at SEMI but if you would like the doctor to correspond with your family doctor, we would require a referral from them to do so.

Do I need a referral to see a physiotherapist?

No. All of our physiotherapists, are trained to be the first point of contact. Some insurance companies may require a doctor’s referral for reimbursement from your extended health benefits.

Is PRP covered by OHIP?

The consultation with one of our Injection physicians regarding PRP is covered by OHIP, however all fees for these procedures itself are private and paid out of pocket.

Is there parking available?

Our parking entrance is located off Doris Avenue, one block east of Yonge, just north of Sheppard, UNDERNEATH THE SHEPPARD CENTRE. Our office is located in the South Tower of the Sheppard Centre on the 6th floor. Please bring your parking stub to our office for 90 minutes of FREE validation.

What’s GeneRx?

Ever wonder why your friend’s low carb diet has them looking fit and feeling mentally well, but the exact same diet makes you feel sluggish, sore and depressed?

Unless you have an identical twin, we are all unique, with genetic profiles that make us individuals like no other. GeneRx is an analysis and interpretation of your 23andMe genetic test. Not too little, and not too much, is a great way to describe GeneRx, distilling pages of 23andMe reporting into the most important information for you personally. GeneRx also combines information gained from multiple genes that affect the same metabolic pathway, and summarizes this information into your report. You get a more comprehensive summary of your genetic profile, enabling you to easily understand what it is exactly you need to know for your own health and well being. Finally, GeneRx provides easy to follow advice regarding diet, exercise and supplements to optimize your health based on your own personal genetic profile. It’s a big leap forward from one size fits all medicine and diet, unfortunately all too common in medicine today.

What’s in the GeneRx Report?

Metabolic

This section looks at the production of and sensitivity to the 3 main hormones: adiponectin, leptin ghrelin, which control your rate of metabolism, satiety, hunger and food cravings. It also looks at how the central nervous system impacts lipogenesis, the formation of fat from food, as well as examining the genetic influence on burning calories. Finally it identifies which individuals have a metabolism that functions best with intermittent fasting or 3 meals a day. It creates an individualized protocol to maximize metabolic function helping to prevent and treat weight gain and obesity, diabetes and unstable blood sugar levels.

Carbohydrates

This section looks at how the body responds to carbohydrates in several ways. Would a low carbohydrate diet, like a ketogenic diet, actually help you, or hinder you? Through various genes we can discover who produces more than the normal amount of insulin in response to carbohydrate intake, or who has impaired beta-cell activity in the pancreas, thus underproducing the same hormone. It shows who has impaired glucose transport and uptake leading to elevated blood sugar levels following carbohydrate consumption (glucose intolerance). The report identifies those who have altered cellular growth and differentiation pathways in response to carbohydrates and those that have a greater inflammatory reaction to carbohydrates. This section will provide the suggested level of carbohydrate consumption, meal frequency and timing to minimize the potential negative effects of carbohydrates.

Fats

This section looks at how saturated fats can affect the production and response to the 3 metabolic hormones leptin, adiponectin and ghrelin. It explains how fats can not only influence weight gain but can alter satiety and food-seeking behavior. It shows who has a decreased ability to break down stored fat in the body, who increases LDL production (“bad cholesterol”) and who produces more inflammatory substrates when consuming saturated fats, potentially contributing to more inflammation and pain in the body. This section will then provide the exact gram content of recommended saturated fats per day to help prevent high cholesterol and obesity. A table of saturated fat content in foods to help guide better dietary choices will also be provided.

Protein

This section will show the exact gram content of protein per meal that is ideal for each person by considering how protein affects the production of their metabolic hormones, their ability to use fatty acids readily as a fuel source, and the level at which protein will increase general inflammation in the body. Finally it identifies which individuals have a metabolism that functions best with intermittent fasting or 3 meals a day to maximize metabolic function and prevent acidosis and inflammation.

Dairy-lactose

This section looks at one’s response to the sugar lactose found in dairy products. It will determine the ability of the small intestines to breakdown dairy via the production of the enzyme lactase regulating symptoms such as gas and bloating.

Serotonin & Dopamine

These 2 sections look at the production, transportation, binding and clearance of serotonin and dopamine through a combination of several genes. It generates treatment protocols that optimize these hormone levels and function to moderate depression, motivation, low mood, learning and memory, addictive behaviours. bowel irregularities sleep and response to stress.

Short Term Stress and Long Term Stress

These two sections look at the production of hypothalamic and adrenal stress hormones and the strength with which they bind to receptors. The overall function and feedback within the Hypothalamic Pituitary Axis (HPA) is evaluated along with its response and ability to exaggerate the stress reaction emotionally and physically. The impact of dysfunction within the HPA axis is reported along with an analysis of its impact on various problems including anxiety, sleep disorders, depression, hyperactivity, panic attacks, ADD, ADHD and PTSD.

Cardiovascular Exercise

This section analyses muscle fibre type, which dictates whether an individual is more suited to high intensity (e.g. sprinting) or endurance (e.g. distance running) type exercise. It examines blood perfusion and electrolyte delivery to muscles, blood vessel reactivity, muscle injury and healing response following exercise. It also considers the ability of the lung bronchi to dilate during specific types of exercise and thus optimally oxygenate tissues. Variables are combined to produce specific exercise recommendations that suit your body best.

Resistance Training

This section looks at how an individual responds to resistance training such as weight lifting. gene analysis will identify those that tend to accumulate subcutaneous fat with the wrong type of exercise. It also looks at the production of inflammatory mediators, the degree of muscle breakdown and the flow of blood within muscles during weight training. Variables are combined to produce specific exercise recommendations.

Injury Susceptibility and Prevention

This section looks at the production of enzymes that break down collagen in tendons, ligaments and joints as well as the ability of the body to increase production of collagen in order to repair and strengthen those tissues. These processes play a big role in the acquisition and repair of injuries. It also examines the production of inflammatory cytokines that further breakdown and degrade joints and collagenous tissue, contributing to common injuries like osteoarthritis and tendinopathies. Treatment recommendations are aimed at boosting collagen production, inhibiting damaging enzymes and reducing inflammation.

Immunity

This section looks at genes that affect cytokine production, virally-mediated activation of interferon, macrophage function and the major histocompatibility complex. These genes have a significant influence over immunity-related conditions such as allergies, asthma, eczema, auto-immune disorders and infection. They also affect the incidence and severity of inflammatory conditions such as arthritis. As inflammation and immunity are so closely intertwined, analyzing the combination of these genes is extremely important in order to balance the immune response.

Inflammation

This section looks at the production of two of the most important and potent inflammatory cytokines, IL6 and TNF. Individuals with certain genes produce far more than the normal amount of these cytokines in response to injury or infection. This has a direct effect on inflammation and causes excessive stimulation of the inflammatory cascade. Increased inflammation has a profoundly deleterious effect on disease risk and leads to the adverse expression of many genes. Treatment is directed at reducing inflammatory cytokine production and stabilizing the inflammatory response.

Phase 1 and 2 detoxification

These 2 sections look at a series of genes involved in the molecular alteration of toxins (phase 1) and their chemical binding and elimination from the body (phase 2). Such toxins include caffeine, several herbs, medications such acetaminophen and ciprofloxacin, cigarette smoke and steroid hormones found in the enviroment (such as ‘xenoestrogens’). Balancing these two pathways plays key roles in the prevention of inflammation, cellular toxicity and the harmful effects these have on gene expression.

Vitamins, minerals and methylation

This section looks at the absorption, transportation and binding of several vitamins including A, C, D and those involved in methylation like B12, folic acid and B6. It also examines transportation of the mineral Zinc, which plays a vital role as a co-factor in numerous metabolic processes and gene expression. Treatment combines single nutrients or a combination of vitamin products to maximize vitamin and mineral activity with the fewest supplements possible.

Reproductive Hormone: Estrogen

This section initially looks at baseline levels of estrogen production from the adrenals and gonads (ovaries and testes). It then further considers conversion rates of estrogen into 2-hydroxy-estrogen or 4-hydroxy-estrogen, which has a profound effect on the activity and safety of estrogen itself. This impacts PMS, menopause, polycystic ovary syndrome (PCOS) and estrogen-receptored tissues like breasts in females. Treatment is aimed at increasing the 2-OH form while reducing the 4-OH form creating a healthy estrogen profile and having a positive impact on the several estrogen related problems mentioned above.

Reproductive Hormone: Testosterone

This section looks at the degree to which an individual converts inactive testosterone into its active form, dihydro-testosterone, and how quickly that hormone is cleared from the body. The balance between these two factors affects prostate health, libido, PCOS and bone health. Treatment is aimed at creating an optimum balance that promotes the beneficial effects of testosterone over its harmful ones.