Showing posts with label health. Show all posts
Showing posts with label health. Show all posts

Tuesday, 17 July 2018

Cannabis Research - Things To Consider

I generally don't discuss cannabis use too heavily, as a professional. Partially as to not begin a debate with anyone who disagrees with my views, but also because it's not my place to be recommending pharmaceuticals to clients anyway. However, objectively, there's a lot of stock to be placed in cannabis' use for health and medicinal purposes, and with October 17 quickly approaching, I expect to be receiving many questions on the topic in my practice.


You may have heard, though, the recent story about the major Australian study that found no beneficial use of marijuana for the treatment of chronic pain. This study is making headlines and many are considering this to be a big blow to the validity of cannabis.

However, if we read further than the first paragraph, the study is admitted as being inconclusive. Rather than being a controlled experiment, this study was purely observational. True, the findings were that chronic pain patients who used marijuana in addition to opioids  (as opposed to those who used opioids alone), the marijuana users reported higher pain rates. But, what this study did not control for was the possibility that those cannabis users may have been in higher pain to begin with and could have simply been self-medicating with marijuana due to that fact.


Nor did this study look at the variety of cannabis strains that these individuals were using and the vast number of others that are out there. For those who aren't in the know, this number is closing in on a thousand, with the effects of each type having it's own unique set of effects on the human body.


Let's also remember that opioids, themselves, can have a pain-sensitizing effect in the long-term, and so the dosage of their medications, other treatments they were receiving, and overall lifestyle need to be taken into account.

In fact, there are still many more studies supporting cannibinoids and pain relief, and even some findings that opioids and cannabis together are an even more effective combination. This seems contradictory to the recent story, though, doesn't it?

Overall, we need to keep in mind how restricted cannabis research has been up until this point. Studies and experimentation using marijuana was so difficult to attain approval for that virtually ANY research on the topic is severely lacking. So while, yes, a lot of research is supporting cannabis for medical use, our overall knowledge is FAR from complete.

This being said, there were definitely limitations on the study that seemed to quash cannabis as a pain treatment. At the same time, the research that DOES support marijuana for medicinal use is still in the early stages. No matter which way you lean on the subject, we need to take any findings with a grain of salt for the next foreseeable future. I have no doubt of many of the benefits being reported, but at the same time, I'm sure there are HEAVY placebo effects regarding the creams and ointments hitting the market.

Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!

Click Here!

Tuesday, 30 January 2018

Life Doesn't Mirror Gym Movements (And Doesn't Have To)

No, I'm not telling you that the gym is bad and that you should stop going. There are many fantastic reasons why the gym is awesome.



However, there's a certain phenomenon among many of my clients that I'm noticing. Fear of movement.

The best example is the rounded-spine position. On one hand, many individuals who experience back pain are told by doctors, therapists, and more to absolutely avoid bending down and rounding their backs; that doing so will result in more pain. Having this fear of that movement instilled, however, does little to remove their pain, as these positions are, to say the least, inevitable. As a result, the nervous system, essentially, becomes primed and ready to guard against those movements, causing pain in those ranges and positions when pain wouldn't normally be a necessary response in that case. 

We call this kinesiophobia, the fear of movement due to pain which actually works to prolong pain and disability.



Here's the surprising thing. Active and healthy individuals experience this too! I've also seen this in very disciplined gym-goers who, for all intents and purposes, have nothing mechanical going on to suggest that they should be in pain. However, due to the immense emphasis on "good form" that active and athletic individuals may be bombarded with, I've been witness to the exact same avoidance-triggered pain. These are clients who are under the impression that it's necessary to square-up and keep a neutral spine curve every time that they so much as bend down to tie their shoes. And again, this belief that any other type of position is harmful is so strong that, just the same, they experience guarding and pain. Even so-called functional training isn't devoid of instilling these messages.

The takeaway from this is that the body has very natural movement patterns that it likes to use that don't necessarily reflect the strict and controlled form of the gym. Absolutely, if you're at the squat rack, moving in a single-plane only, and are loaded up with multiple plates per side, then you should definitely be observing "proper form". However, whether you're an active or inactive individual with or without formal training, the body is built for free and fluid movement. Don't let anyone, including Instagram personalities, magazines, or even doctors to tell you that dropping form as you live your life is a dangerous thing.

Credit: Greg Lehman


Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!

Click Here!

Tuesday, 16 January 2018

Get Out Of Pain - 3 Steps For Maintaining Motivation


I tend to harp on New Year's resolutions a lot, mostly because of how well-documented it is that they don't work.

That's not to say that it's not possible to make changes at this time of year. However, "because it's January" is a reason for change with a rather abysmal success rate. I see many clients at this time of year who have looked at the calendar, groaned, and decided that it's time to deal with their back pain, and it often becomes my challenge to make sure that they take advantage of that temporary drive and turn it into a permanent one. Here are a few things to think about when you're considering taking the first step.

1) Determine Your Reasons Why

A lot of people will walk into a therapist's office saying that they want to get out of pain, but without much more reason in mind other than "knowing they should" or "have to". Especially in chronic pain cases, this attitude is very detrimental to the recovery process, as it reflects a kind of "going through the motions" approach.

If you've had severe back pain for years, it's easy to default to this attitude, but if you want to make an earnest attempt at progress, then you need earnest reasons for it. Try to find intrinsic, rewarding factors to motivate you such as family, quality of life, return to activity, or longevity to keep you adherent to the healing process.

2) Start Small And Create Goals

Next, those reasons you've determined are important, but going all in with only that end-goal in mind often leads to failure as well. Long-term plans are tough to keep to when the going gets tough and the end barely seems any closer.

If your long-term goal is to run a marathon in two years, remember that you need something to keep your motivation during all 24 of those months. Have a one-week goal, a one-month; two, half-a-year, and so on. Those steps are vital in order to maintain a sense of realism and attainability with the entire process.


3) Expect Speed Bumps (And Prepare For Them)

Clients can often be dismayed by the fact that they've been doing incredibly well in their rehab and feeling fantastic, then hitting a hump and experiencing a relapse in pain. They can often feel like this is an indicator of the treatment not working or that their condition is, in truth, there to stay with no hope of permanent recovery.

This is wrong, however, and it's important that clients know that these are only speed humps, not complete road blocks. Even in drug addiction rehab, a relapse is not considered to be a failed recovery; rather, it's a delayed one with a lesson learned.

If a perfectly healthy person can't expect to never experience an injury, then recovering pain clients don't need to expect to never experience reirritation. Just know that it's coming, have tools to help cope with that temporary increase in pain, and then be prepared to hop right back on the train.

One step back, but always two steps forward.


Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!

Click Here!

Tuesday, 2 January 2018

The Nocebo Effect - Why Belief In A Treatment Is Vital

We all know what the placebo effect is. It's the very real-world phenomenon of the body responding positively to an otherwise ineffective treatment or stimulus caused by the belief that there will be a positive outcome. The placebo effect is, in reality, a large reason for many success stories in the therapeutic world, believe it or not. In fact, some modalities actually rely on a patient's belief that it will decrease their pain.

Source
BUT.. did you ever stop to consider the opposite effect being a possibility as well?

The "nocebo" effect is classified as when a negative expectation results in a negative outcome, whether it's to do with movement, nutrition, a clinical treatment, or virtually anything else. Truly, it's the other far-side of the spectrum from the placebo.

This ties directly in with my past topics about how language selection and expectations of pain can propagate and cause more pain. Like I've said before, mental state has a huge effect on driving the body's outputs, whether it be pain, inflammation, or more.

This being said, the nocebo has a massive influence on the effectiveness of a therapy treatment. If a client does not believe in a certain type of treatment or modality or they think that it will cause them harm, then it absolutely can interfere with the treatment outcome!

For this reason, I do my best to thoroughly educate my clients in exactly what kind of processes are occurring in their body before, during, and after any treatment I provide in order to help them understand the targeted effect and increase the probability of success.



If a client simply doesn't believe in a modality at all, then that's ok! Therapists work for the client, not the other way around, and the client does not HAVE to subscribe to every philosophy. However, in absence of that belief, gears need to be switched with either a new approach or a new therapist, otherwise we're charging that client continually for treatments with no outcome. And that's where responsibility on the clinician's side comes in.

The brain is a funny thing, but it's the boss. We gotta work with it.


Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!

Click Here!

Monday, 18 December 2017

Removing Pain - An Example Of Pain Expectation

I had an awesome experience regarding pain psychology and coaching this week. I've already written before about how pain can be amplified purely due to expectations of pain, but it's always great to have some real-world examples rather than only scientific studies.


I had a chronic-pain client come and see me in the past week after a particularly-stressful time period. As a result, her pain sensitivity through her neck and upper traps was through the roof, and she recoiled from only very light pressure from my hands.

Knowing that it wouldn't be productive to simply try and force my way into her muscle tissue and use physical means to get my client to relax, I instead did some education on pain.

I used this great example from Dr. Jarod Hall, on Facebook where he talked about how he experienced a splinter poking him in the back in a sauna. However, due to being in the hot sauna, his nervous system interpreted the "poke" sensation as "burning" due to the expectation of what kind of a sauna would typically cause. Yep, the body can be that easy to trick!


With that being said, I was able to use that experience to teach my client on how it's unnecessary to expect pain, especially when the oncoming stimulus isn't an appropriate one. By coaching her through self-talk to convince her that the pressure from my hands, while perhaps not being the most comfortable, wouldn't cause her any physical harm or damage, her pain sensitivity decreased dramatically. And just like that, without any other physical intervention, I was immediately able to apply more pressure to those sensitized area than ever before!

Remember, pain isn't all in your head! But the head sure can affect things!

Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!

Click Here!

Tuesday, 12 December 2017

Sleep and Pain

In the big picture, Canadians don't seem to do too bad in terms of sleep. Two thirds of adult Canadians are getting the recommended 7-9 hours of sleep. A third is still a very large number, though, and overall sleep quality may still be an issue. We all know the typical effects of sleep deprivation; the decreased mental function, the irritability, the mood swings. However, can sleep affect pain as well?

If I just never wake up, I'll never feel the pain.

The short answer is yes. It's been well-documented that poor sleep and increased pain have a strong correlation. Testing responses to specific stimuli before and after sleep deprivation in subjects has definitely shown an increased output of pain to all types of different pain sources. Heat, cold, pinprick, deep pressure, and other types of provocations all show these results.

However, when looking at sleep deprivation and the cascade of other symptoms it provides, it brings up another questions. Could these related conditions be the true cause for pain sensitivity? Indeed, some studies are finding that sleep disturbances are do have a more indirect link to pain, suggesting that increased pain perception is more-related to those depressive symptoms and how much attention to pain that these individuals may have.

So, perhaps we're looking at is a type of central nervous system fatigue. As I've discussed before, both physical and mental illnesses can propagate these chemical changes in the brain and contribute to pain.

No matter the cause, it's clear that poor sleep and pain ARE related, and unfortunately, this relationship is cyclical. Poor sleep heightens pain levels, and it doesn't take much thought to understand that chronic pain results in even more sleep disturbances.



Treating this, obviously, is a complex thing, and could very well require a comprehensive medical team, rather than one therapist, including sleep specialists, psychologists, and more. On my own, as an Athletic Therapist, what I can do is try to begin breaking that pain-sleep cycle, just like the pain-spasm cycle, and provide a bit of relief at a time in order to slowly improve sleep quality as the client and I go.

Sleep on that.

Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!

Click Here!

Wednesday, 29 November 2017

Breaking Down the Buzzwords - 6 Blog Topics to Read

Buzzwords are every media-mogul's bread and butter. Need proof? Just look at how quickly everyone and their grandma eats up any news article with "Trump" in the headline.

Ok, enough about politics. I'm supposed to be writing about things that are healthy for you. (Ok, last one, I'm sorry!)

I came so close to posting a Trump meme as well, but I
stopped myself and went with a funny cat photo instead!
Your welcome.

Just like the nutrition and diet enterprises thrive off buzzwords such as "gluten", "cleanse", and "clean-eating", so does the healthcare and fitness realm have its own shortlist, at any given time, of words and phrases meant to strike a chord and turn the population into click-hungry internet trolls.

Pictured: A troll

Obviously, these trending topics make for easy game when it comes to looking for new blogging jumping points, so here's a collection of posts from the past couple years that break down each buzzword, both for better and for worse.

Fascia


"Myofascial release" is the new thing to do to get your body feeling great! Right? Well, it seems like many fitness enthusiasts are treating fascia like it's an evil entity that needs to be utterly destroyed. (Spoiler: It's not!)

Functional Training


Functional training is where "fitness is headed", by the sounds of it. Enough of isolated movements! Give me more squats on a BOSU! Let's stop and ask ourselves, though, where does "functional" begin and where does it end?

K-Tape


Ok, so maybe Kinesio tape isn't quite in the headlines the same way as it was for the couple years after London 2012. However, it still seemed worth it to revisit my own, quick, review on the application.

Mobility


The fitness industry seems to be preaching about proper joint mobility these days. Is there a benefit behind greater mobility? Is any amount too much? Is a conservative approach better? Lastly, what else, besides mobility, needs to be considered?

Posture


Forward heads and rounded shoulders are being demonized more and more in mainstream media. Is there really anything to be concerned about, though?

Trigger Points


Get that lacrosse ball and grind out those trigger points. Find that painful spot in your shoulder and press into it until it basically dies! Wait, is that right? Is every painful nodule a trigger point, or are our bodies more complicated than that?

Subscribe to the Weekly Updates

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Tuesday, 14 November 2017

Brain-Body Trust

Here's another scenario:

You're an avid weightlifter who hits the gym five times per week. You regularly do squats, deadlifts, and many others of those exercises that gym rats know and love.

Gains.
However, despite your ability to deadlift twice your bodyweight, one morning, you simply bend down to tie your shoe and you completely put out your back. You're in excruciating pain for the rest of the week which lingers to a lesser extent for the next month or so before you go and get it treated. All the while, you've been doing what you can at the gym but have been avoiding deadlifts and have been extra cautious when bending over to pick anything up on a daily basis in order to protect your back. Every time you try to bend down, you recreate that most-painful sensation and it needs to be avoided. Finally, you decide to go get treated. (Perhaps even by an Athletic Therapist!)

Promotionpromotionpromotion.
Treatment goes great. After one or two sessions, the constant pain is no longer a bother. You have your homework to condition and strengthen your core and protect your spine. You go on your way out of pain - except when it occurs the next time you go to deadlift again. Although your therapist told you that the tissue is all healed and the inflammation is gone, that bending motion, alone, still elicits tension and pain through your back as soon as you square up to lift heavy.

So here's the question: Even after receiving treatment and home exercises, after the tissue is healed and the inflammation is gone, once you've gotten strong enough that you core should be stabilizing your back without a problem, this one movement still causes you pain. Why could that be?

Pain science is a fascinating field and I'm not about to go into the neurobiology and in-depth psychology of pain today. However, I will quote the Pain Science Podcast that I listen to in this.

"Pain is a conditioned response," and "Pain is an output, not an input".

If you know of the Pavlov experiment, this is like how he was able to trigger salivation in dogs every time he rung a bell. Essentially, all physiological responses, pain included, can be conditioned to occur whether the stimulus is appropriate or not. This is related to when I talked about pain avoidance habits and how they can propagate pain rather than prevent them. After such a prolonged period of time of an individual telling their nervous system that bending down is going to cause pain, the nervous system is now trained and hyper-reactive, sending out pain signals every time that movement is performed even after healing has occurred.

Not kidding. This picture is how pain can work.
This is actually a common occurrence. Clients who should be out of pain are still experiencing it due to their nervous systems, basically, working against them. In a way, although there is not actually anything wrong with those tissues anymore, the brain no longer trusts that particular movement pattern and will have a sympathetic response every time that it's attempted.

Stupid nervous system!
This case I'm discussing is, in reality, actually one of the more simple ones. In severe chronic pain cases, those inappropriate pain triggers can extend to nearly every movement and even light touch to the body!

In any of these cases, careful rehab considerations to both the physical and psychological side of the recovery are required. It's the responsibility of the therapist to guide the client through those movements - or other stimuli - very carefully to progressively allow the nervous system to adapt and trust the pattern again. At the same time, coaching a client away from expecting pain is important, otherwise it may leave a barrier that the individual might never overcome. 

Pain is a funny thing and pain patients are kind of like the Murphy's Law of healthcare: Expecting the worst can cause the worst to happen. However, responsible therapists can recognize these barriers; no person should be trapped by their pain.

Subscribe to the Weekly Updates

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Tuesday, 7 November 2017

The Advantage Of Active Rehab

In the wake of hiked ICBC rates due to an uncontrollable flood of payouts as well as an audit into unethical professional fees to do with claims, it has been a thought of mine recently that there is something not quite working with an insurance system that should be easily covering its costs due to the nature of what it is.

Now, there are many directions to point the blame. One of the articles above discusses how much autobody shops are milking the insurance company with hiked rates, and I'm sure there are therapy clinics who aren't much better in terms of ethics. There's the increase in legal fees as well, due to ICBC's fight against offering higher and fairer initial settlements. We won't even get into the political discussion of what role certain provincial parties may have played in creating this mess.


Whatever the reason, I'm mostly concerned with solutions to the problem. One way that I can see it - one that would save much in terms of time and money on the side of both the insurance companies, the legal teams, and the clients - is the shift towards more active approaches to injury rehab.

I don't often feel the need to talk about the importance of exercise for recovery since, to myself, it's a no-brainer. However, I remind myself that the world we live in isn't necessarily one that's focused on exercise and movement the same way that an Athletic Therapist is. But I digress...

It's easy to find evidence for my case. Studies are easily comparing the difference between active rehab (which includes movement and exercise prescription) to passive rehab (which is treatment-centered only) and consistently shows an improvement in client-condition and function when you get people moving.



The implications of this are easy to figure out. With more control of recovery being given to clients - by way of prescribed home exercises - the result is more-optimal recovery through means of fewer appointments and thus, less money! 

So while saving ICBC from paying a few less $70 appointments isn't quite comparable to the thousands of dollars that car shops might be milking, if the trend catches on, it can make a difference. And obviously, this doesn't solely apply for motor vehicle injury claims; individuals paying out of pocket for their recovery would of course appreciate paying a little less.

The advantage is clear. Exercise rehabilitation is the way to go!

Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!

Click Here!

Tuesday, 10 October 2017

Random Thought On Exercise Adherence

As an Athletic Therapist, I'm obviously always concerned with how to keep my clients adherent to their exercise plans in order to accelerate their recovery. It's not always easy, especially when that client's motivation was low enough that they barely made it to my office in the first place.

It's funny, though, some of the methods we employ to try and keep ourselves motivated. One common thing I've noticed that people attempt to do to keep themselves true to healthy habits is bargaining the use of passive habits in order to achieve them. Allow me to explain..

Once in a while, I see a client who floats the idea of adhering to their rehab plan by doing their exercises during "down-time" to make it easy, such as while watching television. Unfortunately, not a single client who has said this has been able to maintain their routine. Where is the disconnect here?

I'm too snuggly-wuggly comfy to exercise right now!

Well, it could simply be the fact that using those passive activities is only going to motivate our psychology toward more passive habits, rather than the other way around. When it comes to exercise in general, our brain is going to activate these exercise-related habits when it experiences related stimuli that normally goes along with them. (ie: When the "switch is flipped" when you walk into a gym or get up early for your run.) Since your brain is going to have trouble associating passive activities, such as television, with activity, the chances of developing those habits are slimmer.

As well, this is speculation, but perhaps trying to bargain passive methods in order to stay healthy is a sign of poor self-efficacy. Maybe someone who attempts to use these tricks, in reality, has poor confidence in the first place that they will adhere. And as we know, self-efficacy is vital when it comes to lifestyle changes and without that sense of control, success rates are low.


In short, the clients of mine that are the most successful are the ones who are intrinsically motivated enough to set aside time to, well, get'er'done!

Does this mean that a person is a lost cause if they're not one of these go-getters who's ready to go guns-out and balls-to-the-wall with their recovery, however? OF COURSE NOT!



This article was written based on topics collaborated on with of Sasha Tanoushka, owner of Verus Systems Therapy. Sasha is a member of the BC AMFT and AAMFT  ( American Association of Marriage n Family Therapists  ). She's completing her MA in Marriage And Family Therapy through Northcentral University. She's worked extensively with families and individuals over the years in both community sports, martial arts, kids' clubs and ladies' community groups.

She has a particular interest on neuropathy and works with several therapeutic modalities but has a particular leaning towards Satir, Bowen and Gestalt.

Follow her on Facebook!


Subscribe to the Weekly Updates

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!


Tuesday, 12 September 2017

Plantar Fasciitis (And The Nerves That Imitate It)

I thought that this would be a good post to make, as I've now encountered a handful of clients with this issue. Individuals have come to see me with complaints about plantar fasciitis that has been persistent to any amount of stretching or foot massage.



In these instances, my typical process was to assess the injury but have difficulty replicating their pain using any ranges of motion or muscle testing at the foot, ankle, or knee. Pain with pressure was common, however.

After attempting to treat the plantar fascia with no benefit, I had to flip switches and try something different. Having some experience with this before (and with the wonderful handiness of the internet) I zoned in on testing a couple nerves instead.


Most people assume that nerve pains follows the trend of always beginning centrally near the spine and extending down the length of the limb. However, it is only a trend, not a rule. If entrapment of the nerve occurs further than the spine or in several, less severe areas separately, then the symptoms can absolutely manifest at only the end of the limb, like in these "plantar fasciitis" cases.



Both the sciatic and the saphenous nerves have the potential to cause plantar pain that many people may think to be fascial. (Both can be dull, diffuse, or burning pain.) However, upon proper testing where we put the nerve itself on stretch, we were able to determine the root of the cause. Without fail, after treating these clients up at their hips or back instead, we were able to relieve the pain.



Just a good example that therapy and rehab isn't as easy as chasing the pain. Often, you have to go quite a ways up the chain in order to find the cause. In these cases, finding that cause can be a hard thing for clinicians to do, considering that protocol wouldn't normally involve having to rule out joints as high as the spine in cases of foot pain. However, therapist or client, it's important to keep in mind that the body works as whole.

Subscribe to the Weekly Updates

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Tuesday, 8 August 2017

7 Athletic Therapy and Rehab Myths

Athletic Therapy is still a growing field, and one that the majority of the public is still not entirely aware or educated about. I can't act like we AT's are martyrs, though; I'm well aware that Physiotherapists and Massage Therapists are also fighting their own battle in trying to raise public awareness on the importance and benefits of their practices.

That being said, here are my top seven myths and misconceptions debunked, not only on Athletic Therapy, but also on rehab and recovery as a whole!

1) Athletic Therapy is only for athletes

It's obvious why this belief exists. Athletic Therapy has its roots in the world of athletic training (akin to the job title in the US) that works primarily with sports-teams. Since those early days, however, Athletic Therapy has branched and spread itself out to being able to address and care for any demographic. "Athletic" Therapy speaks more on the modality of exercise that we specialize in and use to help clients recover rather than on any misconceived exclusivity of target demographic.


2) My insurance won't cover Athletic Therapy

This one may have been more true even as recently as 5-10 years ago. As it stands now, however, Athletic Therapy is receiving more and more widespread coverage with major insurance providers. Great West Life, Manulife, Sunlife, and more are all now known to cover AT; if not all the time, then at least under the right circumstances or based on request.

3) You need a referral to see an Athletic Therapist

I'm going to say that this one is probably untrue. Granted, if your particular extended health plan requires you to attain a doctor's note in order to receive coverage to see an Athletic Therapist, then that's that. However, when it comes to simply seeing an AT on your own accord, any AT will welcome you into their clinic, referral note or not.

4) Athletic Therapy is only for accidents and acute injuries

Indeed, Athletic Therapy is excellent for treating acute injuries resulting from specific accidents. In fact, the sooner and more acute the injury is when we first see a client, the quicker the recovery will be! However, AT's are trained and experienced to work with clients experience chronic and overuse conditions that aren't necessarily labeled as "sports injuries", including long-term low back pain, arthritis, and tendinitis.

5) My x-rays showed that I have something that won't go away, even with rehab

This one is a message that I'm passionate about, but one that's tough to get out there as much as I'd like. As I've written before, x-rays and MRI results are very likely to reveal injuries and conditions that a doctor may be quick to label as a problem. The thing to remember is that, in almost every adult, there are going to be some natural aging changes in your joints that are overdiagnosed as arthritis or degeneration.

Numerous studies consistently show completely asymptomatic patients testing positive for disc bulges or other degenerative changes on imaging. It just goes to show that an Athletic Therapist can definitely return you to pain-free function, even with these occurrences.


6) I need surgery first

When it's been determined that surgery is a necessary intervention, many prospective clients assume that they have nothing to do but wait for the date. However, it's been shown that patients awaiting hip surgery are able to reduce their pain with rehab in the meantime and may be able to improve their post-surgical outcomes. This may have something to do with getting the nervous system trained early for the rehab that will come post-operation or by getting accessory muscles away from the surgical site stronger to support the area. 

On the flip side, perhaps you've been told you need a surgery that's statistically unsuccessful or unnecessary. Oftentimes, conservative rehab is more effective and successful than operating on the area. Granted, Athletic Therapists will always respect the recommendations of medical doctors, but it may still be worth receiving an additional opinion or trying out a few sessions first in order to help assist you in your decision-making.

7) I'm not quite ready to start exercising

Finally, too many individuals who are in a large amount of pain have a misconception that they need to wait until their pain, somehow, settles down on its own before commencing a rehab program. Unfortunately, this often results in further pain and dysfunction as they become less and less active.

Inversely, even if a great deal of pain is present, there is always something that an Athletic Therapist can prescribe a client to do, even if it's the tiniest movement with the neck, hip, or even eyes that will improve that client's condition and outcome.




Subscribe

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Click Here!

Book Now

In the Victoria area and interested in booking an appointment with Cain Exercise Rehab? Follow the link below to book online!

Click Here!

Tuesday, 1 August 2017

Overcoming Pain - Perception of Control

There are many psychological facets that result from or contribute to pain, one such as I described in last week's post. It's important to remember, though, that no trait is independent of one another; they'll occur concurrently and are interrelated. That being said, I'll continue to break it down to help both my readers and myself understand the psychology of pain better in order to overcome it.


After a large sample of patients were interviewed, another of one the biggest predictors of chronic pain that was found was poor perception of control.

In a nutshell, when individuals are in pain, (even if it's only acute pain) and they don't have high self-confidence in their ability to recover from it, the result can be that those misconceptions may come true. Why is this?

To quote the above study, perception of low personal control can "lead to passivity, inactivity, reduction or cessation of coping attempts, avoidance of specific behaviours and poor adherence with advice". It may sound like a deplorable attitude toward one's own body and wellbeing, but if you think about it, it makes sense. If you were a mechanic and were told by your boss to do everything you could to repair a car while every inherent ounce of your gut told you that it couldn't be done, would you still put in the same amount of effort in the attempt?

This fact isn't helped by the fact that so many individuals go through the rungs of  other medical professionals who use language that enforces these beliefs!
  • "You'll have this for the rest of your life."
  • "It's only going to get worse with time."
  • "You have the knees of a 70 year old."
  • "You need to see me every week if you want to keep walking."
"My elbow hurts."
"We'll have to cut it off."
No wonder why so many people plateau in their rehab! Everyone is telling them they can't do it and bringing them down!

As an Athletic Therapist, specializing in exercise rehab, I can provide one of the best methods to help my clients boost their confidence in their recovery. What better way is there to increase their perception of control over their health than by giving them the tools that allow them to do the work themselves? (In contrast, if an individual only sees a clinician that massages or adjusts them without any other intervention, that puts all the control of their recovery into that clinicians hands.)


To help the matter, I make very sure to educate my clients on what every single exercise that I prescribe is doing; which muscle it's helping, what this stretch will do, how it replicates their daily activities. Clients need to know exactly how much power they have in propelling their own recovery. They want to know how their bodies are working. They need to hear less about what their therapist can do for them and more what THEY can do for them.


At the same time, I'm careful with my language. Essentially, it's important to put an optimistic spin on things in order to maintain a positive outlook and efficacy.
  • "This muscle could be stronger," instead of, "This muscle is weak."
  • "We need to get your hip moving better," instead of, "Your hip keeps getting stuck.
  • "You'll feel better the more you do your exercises," instead of, "If you don't do your exercises, you'll be in more pain."
See what I did there?







This topic was written with consult and collaboration with Alison Quinlan, a Sports Behavioural Consultant in Victoria, BC who is also pursuing continued education in dietetics. Follow her on Twitter and visit her website and blog to see some of her own authored articles. 












Subscribe to the Weekly Updates

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!

Tuesday, 18 July 2017

Specific Adaptations to Imposed Demands

There was one principle that was commonly reiterated to us all throughout school. 

SAID: Specific Adaptations to Imposed Demands

Whether it's for rehabilitation or for fitness, this is a very important thing to note about the body's reactions and adaptations to the stresses we place upon it. Beneficial changes cannot and will not occur if we don't give them a reason to happen.

So, in the same way that you won't gain muscular size if you don't work out, you also can't expect tissue to properly heal following injury if we don't exercise it in the manner that we need it to function.

Why aren't I in shape?
Essentially, you use it or lose it. I can't tell you how many times I've heard potential clients decline starting rehab in their acute phase of injury because they think that they need to rest and wait first for partial healing to occur on its own. This is especially rampant among elderly demographics who simply feel unsafe attempting any sort of exercise too close to their injury.

It doesn't always have to come to this!

Unfortunately, young or old, too much rest is more detrimental than anything. Immobilizing injured tissue results in it healing in a way that typically doesn't allow for optimal return to activity, as the tissue was not stressed with any of the demands that replicate it's intended function.

I cringe every time someone tells me that their doctor recommended nothing but bedrest; something that is still painfully common. Inversely, when an injury occurs on an athlete whose team I work with, I get to witness the increased speed that they bounce back completely from injury. Just by jumping on top of exercise and range of motion immediately during the acute phase, we're able to seriously cut down on their recovery time.

I'm being real; I'm not expecting you to box jump and power clean directly after blowing your ACL. There's always some sort of movement that is possible, though, and something is always better than nothing.


Subscribe to the Weekly Updates

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!


Tuesday, 11 July 2017

Cross Syndrome Is Not A Disease

I've spoken to several people lately who have been very concerned with their "cross syndrome" and have sought my advice in correcting it.

For those not in the know, cross syndrome is a term coined by Vladimir Janda in the 80s for a series of muscular and postural imbalances. It signifies the criss-cross pattern of shortening and lengthening of muscles that results in postural imperfections, such as the classic forward shoulder position from tight upper traps and pecs combined with weak neck flexors and lower traps.


These cross patterns occur through both the upper and lower body as termed by Janda. Similar principles exist through the entire kinetic chain overall, not being isolated with just the aforementioned saggital (front and back) planes.

I take issue with the name "cross syndrome", though, as I find that it's regarded with more fear than it should. The term "syndrome" is mistaken by many individuals (usually ones that are self-researching for their own health or working in fitness) to be synonymous with "disease". This is absolutely not the case.

I wrote before about how textbook posture is an unrealistic achievement and a largely-unnecessary goal. These cross patterns (as I prefer to call them) are often correlated to injury, yes, but not causative to them.



Many, many people will walk around with forward heads and rounded T-spines their entire lives and never experience shoulder pain. Anterior pelvic tilt does not automatically signify lower back pain. We need to not fear these postural imperfections and think that they always need to be corrected for.

Obviously, these patterns are something that we pay attention to if there is pain, because they provide the rehab practitioner a good place to start in terms of relieving the symptoms and the mechanics that caused the injury. In absence of a symptomatic dysfunction, though, there's very little to gain by trying to address the "imbalance".

All in all, there's no real problem with wanting to train yourself to stand taller, but we shouldn't be concerned when we look sideways in a mirror and notice "upper cross syndrome". If it ain't broke, don't fix it. If it doesn't hurt, if it doesn't impede your performance or day-to-day activity, it's probably functional.



Subscribe to the Weekly Updates

Do you like the content that you're reading? Sign up to receive the weekly blog update from Cain Exercise Rehab directly to your email!