Tuesday, 19 February 2019

The Best Time Of Day To Rehab

At the end of appointments, my clients always ask me when the best time of day to do their exercises would be.
The start of the day? In the evening? Before working out? Afterward?

Firstly, let me make it clear that any time of the day is better than never. So if you find yourself unable to set time for your rehab exercises when it might be the most ideal, you're still reaping the benefits by doing them whenever else you can.

As for when the most ideal time is, my opinion is that performing them as closely before the most physically-active time (or times) of your day is the best. Whether you're doing it as part of your warm up before working out or before leaving for work at a labour-intensive (or even a low-intensity) job, rehabbing prior to other activity will likely see the most benefit.

After all, the point of rehab is to create a change in the way that you're moving to eliminate and prevent pain. Practicing those new ways of movement before other activity or tasks is going to provide an opportunity to let those exercises carry forward in the day. Essentially, you get to practice using those new mechanics throughout your daily/workout routine.

In contrast, simply going through your entire day or workout first and saving your exercises until the end might mean you've just spent all that time reaffirming your old ways of movement.

As I said, if early doesn't work for you, I understand. It's not realistic for every client who works at 6:00AM to set aside an additional 20 minutes in the morning to exercise before leaving for the job site. (Although I always do expect my athletic or gym-going clients to incorporate it into their warm ups for best effect.) But all in all, as long as you do them at all, I'm happy.


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Tuesday, 12 February 2019

Pain, Health, And Rehab: Our Favourite Unit Of Measure

During the rehab process, therapists, their clients, and their doctors and lawyers often like to see objective measures of the injury's extent and its progress of improvement.

But how do we measure the impact of pain and the rate of recovery? We know that pain tolerance is too individual and subjective to rely on pain scales and descriptions. Muscular strength and flexibility don't correlate well to dysfunction. And you can't exactly hold a measuring tape to pain.


Although, while scientists are trying to find new ways to measure pain, there's one method that I prefer over any other to determine a client's state. It's also the unit that will nearly always be the most meaningful to the client: the activities that they can do.

My most successful clients are usually those that come into the clinic concerned about a loss of ability, not simply those who are in pain. A lot of individuals feel pain, but it is the motivation to regain a certain lifestyle that drives them into a rehab program.


That being said, using lifestyle and activities as our unit of measure helps both the client and the clinician. The therapist is able to accurately gauge the client's physical improvement (or their readiness to improve) while the client is able to truly feel and see that improvement while using those lifestyle activities as goal-setting and motivation. A client going from being able to barely walk to walking 30 minutes per day and then finally back to hiking is a much more important observation than her MRI findings or the angles I find her pelvis to be sitting in.

At the end of the day, it's not simply how strong you are. It's not whether or not you can touch your toes. It's not what shows on an x-ray. It's how you feel, physically and mentally, and what you're able to do leave the clinic and do.

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Tuesday, 5 February 2019

3 Reasons To See An Athletic Therapist In The Most Acute Phase Of Injury

I see a lot of very long-term, persistent types of pain cases in my practice. Often, individuals come to see me to recover from complications of an injury that occurred weeks, months, or even years ago.

Oftentimes, these cases are complicated even further due to the time lapse between the initial injury and the point of first contact with a medical professional. As time passes, secondary conditions often develop, and the time for recovery will increase proportionately.

In contrast, individuals who see Athletic Therapists during the most acute phase of injury - and we're talking as early as within 24 hours of the incident - will benefit the most quickly and efficiently from treatment. Here's why.

1) Optimizing Inflammation

Contrary to popular belief, inflammation does not need to be completely eliminated. Being the active mechanism for initiating healing, an inflammation response should be allowed to occur during an injury, to an extent. What does need to be prevented is excessive swelling around the injury site, but outside of controlling that, there are always mild-level techniques and movements that can be done to maximize the bloodflow and metabolic activity that accompanies inflammation itself.


2) Maintaining Range of Motion

As many people try to "rest away" an injury and wait for it to "settle down" before initiating treatment, the joint is often kept immobilized in order to protect it from further injury and pain. We need to remember the body's strict use-it-or-lose-it policy, however.

By immobilizing an injured joint, the joint becomes conditioned to that state of low-movement. As a result, it creates an extra step in the rehab process where range needs to be reattained. By seeing a therapist in the acute phase, however, we can eliminate this step by making sure the range is maintained in as tolerable a volume as possible.


3) Activity-Specific Treatment from Day One

Every individual has their own unique life demands. As such, why would we treat every injury - even if it's a similar or identical type of injury - the same? 

Athletic Therapists gain a lot of experience working on-site with competitive athletes in order to fast-track them back to play as quickly as it is humanely possible by making the rehab as applicable and practical to their exact sport from the first day of treatment. This concept jumps immediately from sport to any other type of activity, occupation, and lifestyle. If a 30 year old construction worker and a middle-aged client who enjoys gardening have the same shoulder injury, the rehab processes still aren't going to look alike.


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