Can You Treat A Labral Tear?

Labral tears of the hip or shoulder are generally regarded as very detrimental injuries. A result of significant trauma to the joint, such as from a car accident or sport impact, these tears to the joint cartilage are considered to be structurally limiting and requiring surgery in nearly all cases.

With that being said, many people tend to assume that there is little to be done in terms of rehab before (or unless) the operation has been done.

It's good to point out, however, how often labral tears are completely asymptomatic in individuals. For perspective, one study found 43% of tested subjects without symptoms to have a labral tear in their hips while another recorded that rate as high as 69%! As far as the shoulder goes, we found results of up to 72%.

So what does that imply?

It means that, while conservative therapy can't repair a torn labrum, that there is a possibility of relieving the symptoms as if it they weren't there. After all, look at those numbers of people walking with damaged labrums and had no idea!

Manual therapies such as massage in combination with active rehab and exercise can recondition the joint, in many cases, to perform its functions with minimal or no discomfort. True, other cases will certainly require surgery, but it goes to show that it's well-worth exploring the conservative options first.

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!

Remember, Scar Tissue Doesn't Break Down

Scar tissue is a natural product that comes out of a tissue injury. Skin, muscle, tendon; most of the body's bits and pieces will scar over when an injury occurs.

Realistically, the song, "Scar Tissue", probably also resulted from some type of past deep-hurt.

A lot of therapy claims center around the ability of a technique to break down scar tissue.

However, let us remind everyone of the deep, dark secret of the therapy world: Scar tissue does not "break down".

And it doesn't have to! (Just putting that out there before you lose hope and close your screen.)

To be quick and make things simple to understand, consider when you have a large cut on your skin which then scars over. Do you think any amount of aggressive massage would make that scar go away? Does manual pressure cause either that scar OR the skin to "break apart"?

No? Then you can imagine how counter-intuitive it is to think that those same forces can break down a scar inches beneath the skin.

However, this doesn't need to mean that all hope is lost in the recovery process, as we mentioned. Consider this; does the scar on your skin continue to be tender and cause pain years later, even when it remains visible? Does it do a poor job replacing the skin that was damaged?

No, that scar is an effective bridge between the gaps in healthy tissue. And the same goes for scarring that occurs within muscle, tendons, and ligaments.

Yes, muscles and ligaments are more complex in their functions to hold the joints securely together and will typically cause more pain at the onset of injury. But that's where the manual therapies come into play. While they do not physically break down any of that scarring, what these techniques do do is decrease the sensitivity and pain in the area to allow the healthy tissue to learn to carry on its function despite the presence of that scar.

(Remember, these therapies have a more direct effect on your nervous system rather than the tissue itself.)

In the end, none of this really changes the way that treatments work except for providing a better explanation behind them. That knowledge comes in very handy, however, in order to have the confidence to accelerate in your own recovery and to avoid false claims and money-grabs.

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!

Willingness To Change

In essence, a willingness to change is mandatory when seeking any expected new outcome.

But is it mandatory right from the start?

A client once came to us with absolutely no expectation that she could ever get better and vocalized her adversity to any type of exercise. Essentially, she let us know to not expect her to follow an exercise routine for treating her pain at all.

Ok, pressure was on.

Like we discussed previously, we're not proponents of the, "Just do it" approach with clients. We can guarantee that this client would have walked out of our door at the end of the session and we would have never seen her again after that.

Props to her, however. She was willing to discuss her unwillingness to exercise and the reasons behind her pain prognosis.

And as the professionals, it was our job to work with her from her starting point. Wherever that starting point was.

That starting point revolved mostly around pain and body education coupled with some gentle movements to do when getting out of bed to limber up the joints. Nothing that we would normally consider exercise.

From there, it was a building process. As results started to trickle in, no matter how minor, it became apparent to the client that success was based upon her own input. After starting with the most minor of homework requests, we slowly developed a willingness to change.

Today, this client is still on her road to recovery, but feeling much better than she did on day-one and feeling proud that she is adhering to an exercise routine for the first time in her entire life. In fact, she's close to perfect when it comes to sticking to her rehab plan every day!

And so we digress: A willingness to change isn't necessary from the start, but a willingness to discuss it is.

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!

Learning To Move

It's the understanding that your therapist is going to be the expert in teaching you how to exercise.

But there's a step further that's vital when recovering from an injury.

After you learn how to exercise, you must learn how to move.

We wrote before on how exercises in the gym tend to not practically mimic our day-to-day movement habits.

It's one thing to know how to deadlift weight. But it's also necessary to learn how to drop form and allow the body to comfortably and naturally move outside of an exercise setting.

For instance, it's common at our clinic to have to teach even very fit and strong individuals how to comfortably round their spines.

The answer is, "No".

This hesitancy (and sometimes inability) for even healthy individuals to be unable to attain these textbook-IMperfect positions doesn't boil down to either a strength or a flexibility deficit. It's simply a trained response that we've taught our bodies.

Oftentimes, a conditioned fear of movement develops, whether it's appropriate or not. It's regardless of whether we teach it to ourselves or it's a doctor or fitness professional that instilled it; telling the brain that rounding the spine, lifting overhead, or jumping is going to be harmful enough times will result in your body having a poor reaction when those movements are attempted. And it doesn't matter if the raw strength or flexibility to perform those actions is present or not.

So while we therapists are the experts in how to exercise, the right one will also be the expert in how to move. It goes beyond strengthening and stretching muscles; it's about teaching the body how to be tolerant of movement beyond what we see in the weight room.

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!

Am I Feeling Better?

It's funny how often that my clients, when asked how they're feeling, answer that they feel roughly the same as the last treatment.

I then proceed to interrogate question them on their symptoms, and they suddenly realize what improvements that they've made!

Sometimes, the changes are simply just gradual, so the improvement isn't as apparent. Other times, a person's symptoms had become so day-in-the-life that the client noticed neither the symptom anymore nor the progress.

Here are a few questions to ask yourself when you're unsure if your rehab is working.

Is my pain less severe, less frequent, or both?

Many people, habitually, focus on only severity or frequency of their pain, but not always both. It sometimes is worth taking a moment to simply question both of those factors next to each other to remind you that things are getting better.

Is my pain the same but while I'm doing increased work/activities?

This one is humerous. A client will tell me that their pain is still a 7/10....however, they did an hour hike instead of a half hour walk. I think we can put the math together on this one.

Is the pain the same but require more activity to trigger it?

Similar to the last point, but a bit different. Sometimes, people have pain that isn't a gradual buildup, but rather a quick trigger for a flare up. But often, it's easy to miss that the trigger is getting harder to pull, with more work or activity being required before that flare up occurs.

Is my life being affected less by pain?

And finally, pain is sometimes directly affecting very specific aspects of our lives, such as sleep, energy, and even diet. It's good to evaluate all of these sorts of areas to see if there's any improvement and indication that pain is dictating your life even a little bit less.

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!

Trust Your Body - The Bridge Between Recovery And Comfort

I had a client who I helped to rehab a dislocated shoulder. We got their shoulder strong again and returned its range of motion, and thereafter we went several months without seeing each other again.

Fast forward, and the client returned for a visit after reaggravating the old injury. Upon an update on the past few months, I found out that this client was still having a lot of hesitation, before that point, when it came to supporting weight through the shoulder with a hand on the floor.

To me, this highlighted the importance of making sure that rehab was carried forward beyond simply removing the pain and getting strength in each range of motion back.

Rehab is essentially relationship counselling between the brain and body.

This comes back to what I've talked about before regarding helping clients through avoidance habits. When the hesitation and lack of trust regarding certain movements is too great, it's easy to avoid anything resembling that movement to the point that we see a weakening in that joint's function again.

And with that lack of specific activity, the more likely it becomes to re-injure that joint as soon as you do anything resembling that activity again.

For this reason, as a client, we always recommend perseverance in the rehab program beyond the point where there's simply no more pain. As we return the strength and range of a joint, we then turn the exercise plan into something practical and reflecting the demands of your life and any physical activities that you do.

What's more, the sooner we can start the rehab process, the fewer avoidance habits you'll develop and the more easily we can transition to your life-specific reconditioning.

Rehab is essentially relationship counselling between the brain and body. Being strong is great, but if you can't build trust that your body can perform again, the chances are that it will struggle to ever do so.

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!

3 Ways To Incorporate Your Rehab Into Your Day

We all live busy lives, which can sometimes make following a recovery plan difficult. With that said, it can be very frustrating to be handed a list of exercises by a therapist with orders to do them every day, unconditionally.

As we know, it's just not realistic for many people to simply create a block of time during the day. As well, motivation and energy, fairly enough, may not be in great supply first thing in the morning or at the end of the night.

Some kind of commitment and regularity is needed when it comes to exercise rehab, however, and simply planning to exercise in front of the TV just never seems to work.

So what are some ways that we can work our exercise routines into our daily life without having to feel like we're punishing ourselves or sacrificing other aspects of our day?

1) Pick A Consistently-Free Time

Maybe you find yourself with 15 minutes to relax between finishing breakfast and leaving for work. Maybe it's directly after getting home, before cooking dinner. Perhaps you have a second wind after dinner, and can set aside a moment before hitting the couch and catching up on Big Bang Theory.

It's a common fact that regularity with a time of day to exercise is the best method of making it a long-term habit. IF you have the time during your day or evening that you know you'll always (or nearly-enough) have available, then it becomes easier to make it a rule to yourself to do your exercises then.

2) Warm Up Before Activity

This is an easy one if you're someone who has a workout routine or sport that you stick to on a regular basis. However, it can apply to you if you have a dog that you take to the park, like to go for bike rides, or enjoy any other physical work and activity, such as gardening.

Using your rehab plan as a warm up before any other physical activity that you do, whether it's a traditional workout or simply a walk in the park, is not only a great way to make your exercise a habit. It's also excellent for getting your body accustomed to new ways of moving that the rehab plan is meant to achieve.

Now it's a treat for both of you!

3) Breaks

We all (hopefully) have breaks during our work days that allow us to decompress and take a moment to ourselves. If so, this provides one more opportunity to create an exercise habit.

It stands to reason that work tasks are a common cause of individuals' pain, and so taking routine breaks from those duties to relax and move around is both efficient and a great way to relieve some pain or discomfort while on shift. While not realistic for every single type of workplace, if there's a chance for you to take a corner, or even just stand up at your desk, to perform even part of your rehab plan, then take 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!

Don't Ignore Your Finger Health

They may not be the most common joints to injure, but when it happens, it becomes quickly apparent how nagging and debilitating finger pain can be.

Finger injuries occur both acutely and gradually from sudden incident or overuse. From sport to occupation, from rock climbing to typing, from judo to construction.

While the injury itself isn't as common as others, what is common is the tendency for individuals to ignore the pain and wait it out until the pain subsides on its own.

I suppose the thinking is, since the joints are so small and seemingly-less complex than the larger shoulder or hip joints, that there is less to be done except to let time take its course when pain onsets.

However, we know that resting and waiting out any injury can be a detriment, whether it's due to the loss of strength and range in the meantime or simply due to the development of irregular movement habits to work around the pain.

Furthermore, neglecting rehab and failing to effectively restrengthen the joint can result in a predisposition to further conditions down the road, such as osteoarthritis.

Like any other joint, a finger injury shouldn't come with the guarantee of long-term complications, but we need to treat it like those other joints and properly address and rehab it. Reattaining range of motion in the early stages will be vital to curb restrictions later down the road, and further strengthening to both the flexors and extensors of the wrist and fingers will keep the joints conditioned to be durable against the constant activity stress that work and life demand.

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!

How Non-Athletes Can Still Benefit From Athletic Therapy

The “I’m not an athlete” explanation is still a barrier when it comes to members of the public seeing an Athletic Therapist for the first time.

The assumption is that Athletic Therapy will either be too intense or simply non-applicable to individuals who aren’t involved in sports or fitness. Allow us to help you understand why this isn’t true.

You May Not Lift Weights, But You Do Lift Boxes

I think that we can all agree that lifting is universal. Whether it’s boxes at work, furniture at home, or your newborn baby, lifting can be strenuous and be complicated by pain.

So while your Athletic Therapist isn’t going to try to convince you to start going to the gym to desdlift, if that’s not your jam, they will help to keep your back and hip muscles relaxed and pain-free and teach you proper technique to start picking up those heavier loads. (After all, your baby won’t wait for you before growing heavier.)

You Might Not Run Down A Track, But You Do Run After Your Kids

Like lifting, running tends to be a basic necessity of life. Running after your kids as they become more active, chasing after your dog, or simply sprinting for a bus; it’s good to know your body is up for the task for when the situations arise.

An Athletic Therapist can help you if you experience difficulties with your hips or knees that make running more of a challenge. Osteoarthritis, tendinosis, or other afflictions shouldn’t hold you back from these aspects of life.

You’re Not Reaching Up With A Racquet, But You Are Reaching For That Top Shelf

Athletes aren’t the only ones who work overhead. While you might not be hitting a badminton birdie or throwing a baseball, your shoulders still need to be healthy enough to reach for high objects, wash a window, or anything else at home or work involving working up high.

Your Athletic Therapist will help condition your shoulders to be strong with overhead and repetitive tasks. Learning proper use with your shoulders will also spare the smaller elbow and wrist joints from repetitive strain, allowing you to continue with your daily routine.


As you can see, all athletic movements are just higher-intensity versions of simpler activities involved in our daily lives. We don't expect to teach someone how to pitch a baseball or sprint down a track if they have no need. However, the same principles that we DO use with athletes for those purposes easily apply to each unique need of the non-athletic individual.

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!

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.

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!

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.

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!

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.

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!

Mental Illness Awareness Week - Blog Posts To Read

We're mid-way through the Canadian Mental Illness Awareness Week. I'm a big advocate for mental health and try to constantly remind others as well as myself to remain mindful of these hidden diseases and the way that they might be affecting a person's life.

As an Athletic Therapist, it's not my place to treat mental illness, but it is my job to recognize when it's present and how it might be affecting a client's physical health and recovery. Here are a few posts from this past year regarding how an individual's psychology may be altering someone's pain.

Exercise And Why You Aren't Lazy

Many people assume the "Just Do It" approach to exercise and berate others as "lazy" should they not be following through with an active lifestyle or rehab plan. As one psychologist broke down, though, an inability to adhere to change may be a result of anxiety.

Guilt And Recovery

As an Athletic Therapist, with a lot of focus on exercise and lifestyle for the purpose of rehab, it stands to reason that I encounter clients who may have difficulty adhering to behaviour changes I attempt to help them make. It's important for clients to know, however, that they do not need to feel guilt or shame, as these emotions might derail our progress even further!

The Stressful Effect Of Stress On Pain

We've known, for a long time, the biological effects that the stress-response can have on our bodies. It stands to reason that the chemical and hormone mechanisms at play during high-stress periods can have an effect on the pain that we feel.

When Loved Ones Are In Chronic Pain

When you have a parent, child, partner, or friend living in a great deal of pain, the situation quickly transcends a purely physical one. The individual in pain can experience a complete 360-turn in their lives, and so it's important to know, as their loved one, what to consider as they go through and try to manage the way they feel.

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!

Can Injury Be A Blessing In Disguise?

It's autumn! The weather is cooling down and the leaves are falling. Time to get out there to rake them up, but, oh wait! You got halfway through and wrenched your back!

Agony ensues, so you check in with your therapist, get your rub down, do the rehab, and feel better. That's all and good, but man, what a waste of time and money that was! It's great that the rehab worked, but don't you just wish that you had never had all of that happen in the first place?

Well, maybe not. Perhaps there was some good that came out this mess.

Consider this; in most cases, there's an underlying condition that contributed to injury or there was a method of prevention had the body been in a different physical shape. There was an existing dysfunction present or there was a healthier state that you could have been in to avoid incident.

While the fact that the injury, well, sucked, the saving grace in the matter is that it has now highlighted areas for improvement. As long as the rehab is taken beyond the realms of getting rid of pain and we can continue to condition the body past recovery and toward prevention, it's possible to come out of the fray being better off than you were even pre-injury.

It's not uncommon for clients to come in for a visit for pain, but after a longer period of discomfort of inability to perform specific movements or functions. After fully rehabbing these individuals and addressing mechanical habits that they had that contributed to their state, they often come back exclaiming how their squat at the gym has gone up in weight, that they no longer wake up in the morning feeling stiff, or how amazing it is that they're now touching their toes for the first time in 30 years!

So yes, injury sucks. Take the silver lining, though, and treat it as an opportunity to improve. We learn from our mistakes and what doesn't kill you gives you a chance to make yourself stronger.

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!

If It Hurts, Don't Do It (Except Do It A Little)

Traditionally, we healthcare practitioners get used to telling clients that if something hurts, then don't do it. Seems pretty obvious.

Exhibit A

However, wait! We've talked about how avoidance of movement out of fear of pain may actually make the problem worse! Let's say that you're wishing to squat, but squatting hurts your hip. Telling you to not squat at all is likely to decondition you even further and prime the nervous system to expect pain when you do attempt the movement again. And thus, the movement does continue to hurt more and more when performed.

As we know, pain and the treatment for pain are primarily nervous system-driven. When certain movements hurt, yes, the tissue may be damaged in the case of acute injury, but the area has also become accustomed to having a lower load tolerance.

With that being said, if you've had long-term wrist pain when squeezing a fist, then retraining both strength and load tolerance will probably see you...squeezing your fist as an exercise. But maybe at 50% rather than 100%.

This is the basis of exercise rehab. The last thing that we therapists want to see is the complete cessation of any particular movements or exercises. Obviously, our job comes in when those movements need to be modified in order to reintroduce load within pain tolerance, and Athletic Therapists are the experts for recognizing when, where, and how those adjustments need to occur to get you better.

So no, when a movement hurts, it's not necessarily a call to stop that movement completely (unless it's absolutely something that the body isn't supposed to do, of course), but adjusting the method and volume of that movement is likely necessary. It's all about re-accustoming the body to the performance that we want it to do.

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!

The Secret In Simplicity

We’ve all witnessed the unfortunate reality of therapists who don’t look toward progressing an individual’s rehab program enough for it to be effective. You the know stories I’m talking about; the person who’s done clamshells for their hips or the one performing forward band flexions for the shoulders for the past eight months and for some reason still isn’t feeling better.

Has anyone not been given these?

On the flipside, I’m also privy to those practitioners who are overcomplicating what they prescribe to clients to the point that they’re either unable to perform their exercise effectively or just left totally confused and unclear as to what the goals of the plan are.

There are big hypes around new and fancy fitness and exercise methodologies, (such as DNS or Ido Portal’s training, for those of you in the know) and they are absolutely fantastic philosophies! I won’t argue against the scientific basis and benefits of any of these schools of thought and I’m eager to continue to study and learn from them more.

BUT, should a new client have all of that content thrown at them in the first few appointments?

I'll let your imagination run wild here.

I was listening to the Adam Meakins’ NAF Physio podcast and heard a great quote when they were discussing tendon health and exercise simplicity. “When treating an organism, let the organism organize.”

What this refers to is that the human body is an extremely sophisticated system. It works within itself incredibly well to perform its functions and adjust to its environment. Note that I never call the body a machine. It neither has a single manual on how to fix it, but neither does it need every single gear and function specifically programmed by us to work properly. Often, as soon as we make one or two adjustments to the faults that it’s experiencing, the body is intelligent enough to do the reprogramming and reorganizing on its own.

Going back to the quote, why it resonated is because it correctly suggests that the body has the potential to recover on its own accord with very simple changes or exercises. What’s more, simplicity translates to a better understanding for the client on how everything works, allowing them a better feeling of control for better treatment success.

So, absolutely, I will begin by showing a person a simple chamshell or forward shoulder flexion exercise to get them started, and sometimes that has actually been enough to get them feeling better! In the event that those simple measures are unsuccessful, then that’s our cue to compound and layer on top of the plan with more complexity. But, by having those simple changes first, we’re building a foundation for both the conditioning and the knowledge in order to most-effectively progress the plan.

You don’t teach a person to multiply without first showing them how to add. Remember the K.I.S.S. principal: Keep it simple, stupid!

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!

Exercise And Why You Aren't Lazy

I found a great article regarding how laziness does not exist, and it applies beautifully to rehab and exercise.

"But I don't wannaaaa...."

Clients often come to their follow-up appointments with tails tucked after not doing their exercises. (And I'm speaking on doing them at all. The people who feel bad for only doing them every second day need to chin-up.)

A lot of therapists will put their hands on their hips and immediately scold their clients, citing their predicted inability to get better if they don't exercise and pushing them to just do it. But we know, but now, that this is an ineffective method, don't we?

I think I just heard Nike call their lawyers.

The psychologist who researched and wrote the above article boiled "laziness" down to two causes. One was anxiety regarding the task and a perception that the person's attempts would not be "good enough". (Fear of failure.) The other was confusion or lack of clarity on the first steps of the process.

Understanding this now, can you see why a stern "just do it" is the last thing you want to tell someone with either of these struggles? Instead, I find it to be a crucial exercise in empathy in order to help clients past their hurdles.

If a client can't foresee a positive outcome and doesn't believe that they can get better, regardless of their homeplan, then it takes a great deal of coaching in order to teach them how to perceive control over their condition. They need to know, deep down, that recovery is possible; not simply go through the motions of an appointment.

And as for the lack of clarity, any half-decent therapist should have the ability to educate and break down the pieces for their clients as needed.

Everyone has their own background. We prefer to see things as simple and black and white, but have you put yourself in someone else's shoes lately?

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!

The Rehab Schedule and Exercise Frequency

How often did your last therapist tell you to do your rehab exercises? Twice a week? Three times? Every day?

If you answered 'every day', then you're likely of the majority of individuals. There's a trend among health professionals to make this rule absolute. If you want to get better, then the more you adhere to your exercise plan, the fast the recovery will be. Makes sense!

However, how often do you see someone make a seven-day-per-week behaviour change in a snap simply because a medical professional told them to do so one time?

Sorry, what?

A lot of my clients are self-motivated fitness enthusiasts, so if I tell them to do their rehab exercises every single day, adherence is high! However, expecting perfect compliance is rare among most demographics. I'm not talking about unhealthy shlobs who are unused to taking care of their bodies at all. I'm talking about recreational athletes, weekend warriors, avid gardeners, blue-collar labourers, and more. Telling just about anyone to add a 20-minute routine to every single one of their days might not sound like a lot, but it can be quite the feat.

A lot of therapists are aware of this and will still stick to the "daily dose" model, however, figuring that clients will still do a lesser amount of exercise when prescribed the more. But is this an effective measure? Or does the higher expectation lead to a greater rate of failure? If a client feels guilty because they did less work then they were instructed to, this could lead to a quicker loss of motivation and eventual overall noncompliance.

For this reason, I find it important to get a thorough understanding of each of my clients' lifestyles, schedule, and inherent motivation. If I feel like someone is going to be perfectly happy to exercise as told every single day, then great! For most, however, setting high standards is an easy way to make clients feel disappointed. Instead, I tailor each plan to each individual, whether it's alternating exercises on each day, having them exercise every other day, or simply doing their rehab plans just as warm-ups for their activities and sports.

We're not sacrificing quality of the program by decreasing the frequency. We're ensuring overall success by helping to create gradual habits. Besides, just a couple days of exercise per week is enough to start providing beneficial effects for just a wide variety of physical ailments.

I'll say this again before Nike sues me: "Just do it" doesn't work.

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!

Joint Insecurity?

Disclaimer: This is purely a personal opinion post, not an accepted fact or opinion of the medical community.

"Your shoulder is unstable."

We've heard this one before. I've used it before, myself. When speaking on the "stability" of a joint, we're referring to the muscles, passive structures (ligaments) and neural systems that surround the joint to maintain its structure and integrity.

Stability can become compromised for a number of reasons, with muscular weakness, lack of proprioception, and physical tissue damage among them. In many cases, the instability is real. A previously-dislocated shoulder pops out again very easily with very little force. A post-ACL reconstruction patient experiences buckling and failure of the supporting muscles. A rolled ankle that has a much easier time of rolling again after the first injury.

But what about when this severe lack of integrity isn't present. What about the person who simply has an achey shoulder? "Multi-angular instability!" The client with low back pain? "Core instability!" Neck pain? "...Neck instability?"

It may seem like a trivial thing, but words have a lot of power, especially when used on individuals who may be in pain and coming to professionals for help. Using terminology that instills more fear about one's own condition can increase pain expectation and potentiate avoidance habits. This is why many clinicians are being more selective of their language. We're not being hopeless optimists about a problem; we're simply preventing psychology from making it worse! If the back isn't at risk of dislocating, then why are we telling people that their cores are unstable?

That being said, when a joint isn't truly at risk of injury, especially when it comes to chronic pain clients and those who might not be in situations that put their joint in danger, then should "instability" be one of the terms that's vaulted and reserved for those truly-unstable situations that I spoke about above? Lately, I've found myself naturally gravitating to the word "insecurity". Yes, just like when we were awkward teenagers in high school.

It does make sense. A lot of times, in chronic pain, muscular tone is high and pain outputs are driven due to the conditioned state of the body to think that the joint is at risk and to respond as such in order to protect the area. My metaphor for clients, often, is that the muscles are angry and on strike, not allowing the joint to function as needed. To treat, we simply provide sensations to the tissue to get it to relax and exercise it to create a better sense of security, removing the reason for the body to think that those negative responses were necessary.

I'm open to discussion from clients and colleagues. In the meantime, I'll continue to play around with this word and see what kind of feedback and success I can garner.

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!

Making Rehab Fun

Pain isn't fun. For many people who aren't accustomed to sport or fitness, exercise might not immediately be a fun thing either.

I find that many individuals struggle to adhere to their recovery plans due to the fact that the rehab process is perceived to be grueling and unenjoyable. Perhaps, even to the same extent as the pain itself!

Maybe the exercise is causing a different type of discomfort that the client is adverse to. Perhaps the rewards aren't immediate enough. Maybe the exercises being provided are just "lame". A lot of factors can play into the reasons why a client doesn't enjoy exercise, regardless of knowing the benefit behind it.

The difference between pain and the mental blocks of rehab is this: clients are often accustomed to the pain! That being said, it's sometimes easiest to simply deal with the pain rather than persevere through the work, as coping mechanisms for the former have already been developed.

So let's make the recovery process fun! Many therapists think that the fun factor is only applicable to making young children adhere to their pains, but why is it so absurd to think that adults might like a bit more enjoyment as well? People of all ages benefit from using fun to motivate their health behaviours.

Disclaimer: If you hate fun, don't book with me.

I'm not suggesting that every rehab exercises needs to be turned into a game. Regimented exercise has its necessary place and making fun out of everything is unrealistic. However, tedious sets and reps have a limit to holding interest and attention.

But how about using the activities that the clients are trying to get back to? Whether it's a sport, going for hikes, or gardening, there's bound to be an active activity that those individuals would like to get back to. Using a soccer ball as a piece of rehab equipment, walking or trails, or even simply incorporating light activities in the yard into the plan is going to go a long way to keep clients motivated. They'll enjoy the work, it will apply to their desired lifestyles, and it will act as a constant reminder of progress.

Many clients will thrive off of strict exercise plans and regular routines, but, like fitness, some people will need other alternatives to enjoy the process. As a therapist, it's my job to recognize which methods are going to be the most effective for each individual. At the end of the day, whatever works to get you feeling better.

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!