Wednesday, 16 January 2019

Treadmill Running and Overuse Injury

Myself, I was never a huge fan of treadmill running. Mostly because I like nature and am a sucker for a nice waterfront view. But I digress...

Treadmill running isn't going anywhere. It's a staple in our gyms and a handy tool for being able to measure and control for our physical activity.


However, there have been some claims that treadmill running may pose an increased risk for overuse injuries.

The idea is based on the fact that overuse injuries stem from repetitive stress to a particular tissue, and this stress is greater when the variance in the movement is decreased. By this, we're referring to the fact that treadmill running strides will typically always be the same length, at the same speed, and with the same impact force. In contrast, running outside will have a much greater variability in the types of strides being taken, with the body needing to learn to adjust and adapt to the subtlest change in terrain.


While this claim is cited by several sources, few of them use hard, researched evidence. We do, however, have evidence supporting the general principle of low variance resulting in increased tissue stress. As well, while treadmill running has been shown to lower the rate of stress fractures, specifically, the same study found it to be less beneficial to bone strengthening than outdoor running. This might translate to decreased overall beneficial training adaptations from treadmill running and, thus, and overall increased injury risk.

I feel I must apologize for the inconclusiveness here, but hopefully it's good food for thought. Don't let this change your training regiment if treadmill running is currently working for you, but if you suffer from running injuries, it may be worth trying a modification in surfaces. And of course, if you're training specifically for running a race, the best training for you will be found outside.

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Tuesday, 25 December 2018

Top Blog Posts From 2018

It's been a big year at our clinic, and I thank all of those who have been with us during the way and following our progress. Between growing Cain Exercise Rehab, adding on additional practitioners to our team, and finally making the move to our new office, it's been a full 2018! We look forward to another great year.



With that in mind, let's look back at our top five most-popular blog posts from 2018. You chose them! If you haven't given them a read, please take a look and share the information with those who may need it.

5: The Nocebo Effect - Why Belief In Treatment Is Vital

We spoke about the nocebo effect, which is the opposite of the placebo. It's very possible and common for the belief of harm being done (or simply just the belief in a treatment being ineffective) to turn into reality. This is important in highlighting the need to find a therapist who can productively educate you, as the client, so that trust in the treatment and therapist is there.

4: Get Out Of Pain - 3 Steps For Maintaining Motivation

Everyone tells us that something should be easy to do as long as we want it enough. This disregards the complex, messy, and irrational way our brains work, however. That being said, there are other steps that we can take to make sure that we stay on the right track when it comes to exercise or other lifestyle changes.

3: Cannabis Research - Things To Consider

With the legalization of recreational cannabis in Canada this year, a increase questions and speculation have started cropping up when it comes to the use of marijuana for pain treatment.

Not to rain on the parade, but I just need to remind everyone that our understanding and study into cannabis is still very fresh. While I won't discredit the use of cannabis for medicinal purposes, it's important to take anecdotes and news updates with a grain of salt until we know more.

2: The Stressful Effect Of Stress On Pain

One of our first posts from 2018; stress is EVERYWHERE in our lives, and it absolutely can have an effect on the way our bodies physically feel. When pain is present, stress can exacerbate and prolong it, contributing to the development of countless chronic pain conditions.

This shouldn't be an article to worry you, however; rather, it's a reminder that we can help ourselves by treating our emotional and mental health when we're in pain, as well as the physical.

1: Making Rehab Fun

Our most-read post from 2018, and I'm happy this is the one that took! Rehab, or any exercise for that matter, can often be grueling and unenjoyable. For that reason, it's important to incorporate fun movements and the client's preferred activities into the recovery plan. Having fun during recovery is going to both benefit your mental health as well as ensure that adherence to that physical activity will be maintained.


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Wednesday, 19 December 2018

Don't Be A Hero - Use Crutches

I sprained my foot pretty good, this past weekend. There was a crunch. It hurt. Ruled out a fracture and went on with my next few days. Thankfully, it started feeling better quite quickly, but I definitely needed crutches to walk without a limp.


Bringing me to my point; I have athletes, very commonly, be too stubborn to use crutches when they sustain minor lower limb injuries.

True enough, the pain isn't so severe that walking isn't impossible, albeit with a limp (as was the case for me.) But, despite the fact that you might feel "soft" for using the assistance, the fact of the matter is that you're prolonging your recovery time by limping around.

When an acute injury occurs, we know that consistent movement and range of motion are crucial in those early stages in order to promote proper tissue healing. In the event of soft tissue damage, scarring will start to form. Taking the joint through its regular range of motion means that that scar tissue, as it forms, will align itself in those directions of pull, developing as closely-resembling the healthy tissue as possible.

When limping and protecting that joint, you're preventing proper movement and avoiding stressing that healing tissue, resulting in irregularities in the scar formation. This is likely to prolong the pain and potentially result in mechanical dysfunction later on in time. Conversely, using that walking assistance allows you to deload the limb while maintaining regular (or as close to) movement of that joint and increases the speed and effectiveness of healing.



So, I know that you may not expressly feel the need to use a cane or a crutch when in minor pain from an ankle sprain, hamstring tear, or other lower limb injury. However, buck up and use the assistance until you can walk without a limp; you'll recover faster and stronger for it.

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Tuesday, 11 December 2018

4 Explanations For Common Pain Conditions

Nearing the end of 2018, I've compiled a short list of go-to explanations and busted myths about some of the most common pain conditions that walk in my door. These can hopefully summarize many of the questions that individuals have about their afflictions.


Back Pain

May as well start with the most common! Back pain clients will often have no specific diagnosis and generalized symptoms. It can be a hard thing to wrap one's head around, so here are three major points that I educate my clients with.


Osteoarthritis

A LOT of misconceptions revolve around the reasons for the development of osteoarthritis and the most effective ways to treat it. Does too much activity really deserve the blame? Does movement help or hurt more after diagnosis? Is surgery always necessary?


Shin Splints

"Shin splints" tends to be used as a catch-all term for any shin pain, from muscular tears to stress fractures. However, in true cases of medial tibial stress syndrome, there is a mechanism occurring right down to the level of the bone structure itself. And yes, muscular conditioning will still help or hinder the situation.


Tendinitis

Another heavily-misunderstood condition. What is physically occurring within the tissue during a tendinopathy? And hat are the best ways to treat it?

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Tuesday, 4 December 2018

The Reverse Domino Effect Of Health

"I sprained my ankle. Limping caused my hip to go out. Then I started getting back pain and it's traveled all the way up to my neck."

This is the domino effect occurring. We know for a fact that a dysfunction or injury left unattended long enough can lead to another. It's often small occurrences that begin individuals down a path toward long-term, wider-spread pain.



It's an unfortunate trend, but as we know, it's not necessarily a permanent one. Therapy and rehab, especially those involving movement and exercise, are proven to be able to address these dysfunctions and alleviate the symptoms.

However, it's also a trend for individuals who have experienced this sort of domino-collapse of their joints and muscular system that have a difficult time motivating themselves to begin making those changes for the better again. It can be easy to feel like the time and energy to address such a large number of different (albeit related) problems could be fruitless.

I like to remind clients, though, that it's not necessarily a matter of address every single ache and pain separately, though.

As a biological organism, the human body is good at organizing. In this I mean that this domino effect that we're considering can occur back in the OTHER direction!



I always start with broader corrective exercise when I first treat my clients, only narrowing the specificity down as needed. More often than not, broader changes with how the body moves are enough to begin making the mechanics that we want to see start clicking together. Addressing one area of dysfunction (not even necessarily in reverse of what order it occurred in) can lead to the body further correcting and managing other areas along the chain.

Not acknowledging this reverse domino effect is to not acknowledge the body's own ability to run operations on the most efficient manner that it can. We're a sophisticated system that is excellent at making do with what it has. Small changes CAN make a big difference, and only when those small changes hit a plateau in effect do we need to begin nitpicking for further progress.

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Tuesday, 27 November 2018

5 Neck and Shoulder Things

I'm often asked what the most common injury that I get in my practice is. As it turns out, I'm a shoulder and neck guy. A large part of my practice involves treating body builders, rock climbers, trades workers, hairstylists, and elderly who experience pain in this area.

(Funny enough, I always thought that I'd be a knee-guy while in college, due to my running background. What's more, the shoulder was the most difficult joint to get my head around in school. I guess studying actually pays off?)

Go figure.
The neck and shoulder are closely related, with dysfunction or symptoms in one often causing symptoms in the other. With that being said, here are some go-to thoughts regarding the health of these joints.

Your Posture Probably Isn't The Problem

I speak a lot on the fact that there is poor correlation between bad posture and future incidents of pain. There are too many individuals out there walking with forward heads and shoulders but no discomfort and vice versa.

Instead, we've linked lack of variety in posture closer to pain. Good or bad, spending too much time in a single position is not what the body craves, and this often is the route to muscular tension and discomfort. This is why it's recommended to take regular movement breaks while at work. It doesn't take much.

Stretching Does Not Make Unstable Joints Happy

Thank goodness, the fitness industry seems to be tapering off a bit from the whole mobility craze that it went through. But I digress, I still see numerous individuals trying to stretch and traction their shoulders to proper health.


No, I'm not saying that joint mobility isn't important. But fairly enough, we went through a bit of an epidemic of fitness buffs non-specifically stretching their joints to the point of laxity with bands. Shoulders often hurt because they're, in simple terms, too loose. And stretching something in this condition will not improve the situation.

Warm Up, But Not Just Your Rotator Cuffs

So we turn to strengthening and warming up. Many individuals think that the rotator cuff muscles are the end-all for shoulder health. After all, their function is to stabilize the head of the humerus (the ball) in the socket.

However, what we don't always realize is that rotator cuff muscles are often simply overworked. Proper strength to control the movement of the shoulder blade is vital to shoulder health, so warming up and exercising the ability to protract, retract, and glide the scapula is key.


Your Upper Traps Are Not Your Only Traps

The upper traps seem to be the bane of many people's existence. The stress tension collects there, they take over other muscles' jobs, and the pain can be excruciating. And stretching often doesn't seem to have an effect.

Well, we know that muscle tightness is neurological. Sometimes, a muscle will present as tight because its opposing muscle is weak. The lower traps oppose the upper in part of their function, with the middle traps assisting the two. I frequently find these middle and lower traps weak in clients who complain of upper shoulder tightness, and so this is an important area to keep in mind.


Keep That Neck Strong

The muscles at the front of your neck are important for maintaining stability and control of that area of the spine. These are also one of the muscle groups that commonly become weak throughout our sedentary lifestyles.

I had to insert this somewhere.
Drawing your chin in like a drawer (or the double chin position) contracts those deep neck flexors at the front. Having these guys strong will prevent the neck muscles in the back or others from the shoulder from tensing up to try and create that stability on their own.




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Tuesday, 20 November 2018

The Memory Of Pain

Remember that time, years ago, when you hurt your back while bending over?

Well, your back remembers it too.

You may have heard of the term "muscle memory" in the past. It's a loose term defining the body's ability to remember past motor patterns, often triggered subconsciously as soon as the right environment presents itself. For instance, someone may not have ridden  bike in 30 years, but as soon as they feel the seat, pedals, and handlebar, all the balance and coordination comes rushing back to them and off they go.



Now imagine if, instead of that feeling of the bike seat and pedals, the trigger you felt was bending forward. And instead of the ability to ride the bike, the signal that your brain digs out of storage is pain.

This is one of our BIG contributors to chronic pain. Very often, our past experiences of what caused pain in the first place, no matter how long ago, can amplify pain we feel in the future as a conditioned response. In the same way that Pavlov trained dogs to salivate at the ring of a bell, regardless of food actually being present, the nervous system can be trained to pump out pain signals, regardless of an appropriate trigger.


This concept is closely integrated with the one showing expectations of pain causing increased pain. In this example, your back is conditioned to have an exaggerated guarding response to bending forward. What's more, this bad habit is further encouraged by the fact that you've explicitly been avoiding flexion, essentially confirming your nervous system's irrational fear of the movement.


Hopefully, this helps to create an understanding of why pain can be persistent long after tissue has healed and appropriate triggers are no longer present. There are definitely subconscious and conscious factors at play here. (Along with the physical side, which, I'm not ignoring. Don't worry!)

With this being said, this is the reason why a lot of the rehab that I do with clients doesn't necessarily involve strengthening, but instead reteaching and reassuring them of movement and ranges that has been, inappropriately, acting as triggers. This goes for active and nonactive populations as well; it's incredible how many gym rats I need to teach how to round their backs again.


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