PhysioWorks @physioworksbc - Tumblr Blog

Welcome to the Team!

We're happy to announce that our Wesbrook Village Clinic is now officially open! Located right in Wesbrook Village, close to the Wesbrook Community Centre and right above the Shopper's Drug Mart we're excited to become a part of the community and offer our services to UBC and the surrounding areas.

In addition to our new location, we are excited to introduce our newest team members, Charlotte Reiher and Renee Tong.

Charlotte (MPT, BKin, CAFCI) is a registered physiotherapist and has received her Masters in Physiotherapy and her Bachelors in Kinesiology from University of British Columbia. She is also certified in acupuncture through the Acupuncture Foundation of Canada Institute and trigger point dry needling and intramuscular therapy through the Functional Integrative Rehabilitation Education. Charlotte has experience with sports injuries, pre and post-operative rehabilitation, neck and back pain, and motor vehicle accident related injuries.

Charlotte’s treatment approach includes manual therapy, needling techniques, exercise prescription, and patient education. Using a patient-centered care model, she collaborates with her clients to form appropriate treatment goals and to make a plan on how to achieve them. Charlotte remains up to date with current evidence in physiotherapy research to support her treatment approach.

Outside of the clinic, Charlotte spends most of her time being active; you can either find her at the gym or at the local yoga studio. She is a weightlifter competing both provincially and nationally. With 7 years experience as a former CrossFit athlete, Charlotte has a special interest in helping this community and athletes alike to achieve high performance while remaining pain-free.

You can book in to see Charlotte at both our West 4th and Wesbrook Village locations

Renee (RMT, BKin) graduated with her Kinesiology degree from the University of Ontario and is a BC registered Massage Therapist. Her training at the Sutherland-Chan School of Massage Therapy included clinical placements in sports, palliative, seniors, pregnancy, and stroke recovery settings.

Not one to rely solely on deep pressure, Renee uses a range of assessments and massage techniques to help patients feel thoroughly cared for and to help them achieve their goals. Her motivation to help others comes from growing up immersed in sports and understanding the frustration of injuries and setbacks.

As a therapist, Renee takes interest in helping people return to their daily activities and maintain their ability to move well.

Want to come check us out? Join us on March 11th from 1 to 4pm for our grand opening party! There is free 2 hour parking in the lot in front of our building and underground as well as free 1 hour parking along the street.

You can book in to see Renee at our West 4th location

#physio #rmt #massage #team #ubc

Travel tips

Many of my clients travel this time of year, for both business and pleasure, so I love to give them tips on how relax while they’re away. You may think going on vacation would automatically allow the body to relax, and this is true in some respect as you are no longer putting your body through the “daily grind”. What if however, you are travelling for work? Pulling long hours on a laptop is actually worse - please don’t use it regularly. And long plane rides, bus rides, car trips all have their own negative effects on our bodies. Lack of regular exercise can stiffen you up but prolonged walking as you explore a new city can really tighten up the lower body.

So what to do? How can I keep my body from stiffening up while I’m away?

Stretching: Yes! This can be done in any country so please don’t forget all the homecare you’ve been given by your health practitioner. You can even do some dynamic stretching prior to going on that long ride.

Exercise bands:If your muscles are sore and fatigue quickly you may need some strengthening. Best to talk to your physiotherapist but doing a few key strengthening exercises can stop hypertension of other muscles. You can also use them to stretch.

Rolling:foam rollers are not the most portable thing to bring but you can use alternatives like “tiger tails” or massage sticks as some are called. A wonderful and very cheap roller to bring is a tennis ball or lacrosse ball - very easy to carry and because they are smaller I get clients to use them on their feet. Just stand and roll under one foot at a time.

Heat: Many hotels have hot tubs but if you can’t find one there are small things like bags filled with grains or beans that can be heated in a microwave or a pot of hot water. If you don’t have access to a kitchen you can bring a good old fashioned hot water bottle, cheap and sold at most drug stores. Most hotel rooms have kettles you can borrow to fill it up. Remember to wrap it in a moist towel so you can get a deep moist heat which is more effective. And please don’t buy the cheap one - my neighbours leaked and left a burn!

Neck pillow : Great on a long ride, just make sure it’s not so big that it pushes your head forward a lot - this will just give you a different kind of pain. There are even inflatable versions so you can fill it to your desired size. Use it instead of those terrible large hotel pillows. Supposed to be plush and luxurious but really bad for your neck.

I know you don’t want to bring a lot of extra stuff on your trip, so my suggestions for minimal weight with maximum benefits are: a tennis ball, inflatable neck pillow and a hot water bottle. Throw in the exercise band if you’re keen! If you carry just these few little things it might make your trip much more enjoyable!

About twice a month our therapists will be posting answers to commonly asked questions. So, if you have a burning question that you want answered let us know in the comments below or tweet us @PhysioWorksBC.

We can cover anything ranging from active rehabilitation, to injury prevention. From performance training to day to day biomechanics.

This week our featured therapist is Caroline. To learn more about Caroline check out our PhysioWorks team.

#health #travel #tips #selfcare #explore

Common running myths

Running increases your risk of knee osteoarthritis

Many people believe that running causes arthritis and ruins their knees. But studies have shown that the opposite is actually true. These studies have shown there is no increased occurrences of knee and hip OA in runners when compared to non-runners. Some have shown more knee and hip replacements occurring in non-runner populations.

The ‘Perfect’ running form exists

While there are many schools of thought that promote a specific running technique, the truth of the matter is that there is no ‘perfect’ form. Consider the vast differences in body types, limb lengths, and proportions. It would not make sense to have a uniform running style. Focus on maximizing your running economy rather than changing minor details of your gait.

Barefoot running is the best

I do agree barefoot or minimalistic running is beneficial. However, a blanket statement that barefoot running is optimal for all runners is unsubstantiated. Studies are rather split on this hot topic. There seems to be a good amount of agreement that running barefoot can help correct running mechanics in a runner but there is a relatively high risk of injury. It must be used with great caution or under the guidance of an experienced clinician or coach.

Many studies can agree that running in a lighter or minimalistic shoe is more economical in terms of oxygen consumption. Some state that for every 100g increase in shoe weight, your O2 consumption increases by 1% per leg. So, for every 100g increase in shoe weight, you will have to work harder by 1% per shoe.

You should stretch before your run

Studies are showing static type stretching does not have performance benefits nor do they help reduce injuries in general. The recent consensus is to use dynamic type stretches and exercises to warm up the body before your activity. These movements should be related to your activity.

Examples: high knees, leg swings, butt kicks, skipping.

Now there are times as a clinician, I will recommend clients to stretch certain muscles before an activity for reasons specific to their injury or conditions.

Running causes back degeneration

It’s easy to blame running for potential negative effects on the body. We all have heard someone report that running has ruined their backs. Seems plausible considering all the ‘jarring’ that happens during a run. But a study has shown that the MRI imaging of discs in the runners group were healthier than the non-running group.

Running with flat feet will cause injury

The evidence is rather split on this topic. Simply stating or prescribing a motion control shoe or orthotics for all individual who pronate would be incorrect. There is no standardized measure of how ‘flat’ these feet are in the studies. That is why we would address each injury individually and consider several other factors such as ankle mobility, hip and core stability before recommending an orthotic or motion control shoe.

You must run at 180 steps per minute cadence

Recently the buzz in the running community is the cadence of your running gait. 180 is the optimal number according to many articles. It is true that elite runners do have a higher cadence than that of the recreational and intermediate runners. But the fact is that your cadence should be 180 +/- 10 steps per minute. That means anywhere from 170 to 190 steps per minute.

Dehydration and electrolyte loss causes cramping

We have been bombarded with statements that a dehydrated body with electrolyte loss will make us prone to cramping. But it seems that it might be false despite all the sports drinks, gels, and tablets on the market.

Studies have shown that after an event such as marathons and Iron Man races, those who cramped did not show any deviations in body electrolyte concentration compared to non-crampers. It even went on to show that the non-crampers had more water loss and lost more weight during their races.

We can cover anything ranging from active rehabilitation, to injury prevention. From performance training to day to day biomechanics.

This week our featured therapist is Rob. To learn more about Rob check out our PhysioWorks team.

#running #myths #vancouver

Top 5 Exercise Fails

New year and a new you? While we might not all hop on the resolution bandwagon, it is the time of year that many people tend to kickstart an exercise program. We thought it would be fun and informative to give you our list of the top 5 exercise fails that we see around the clinic. People often come in with neck and shoulder tension, shoulder impingement, pain and grinding in the kneecap area after doing these exercises incorrectly. We’ve given you a few tips to help you avoid injury.

1. The Plank

Bad

Fail: Hips too high or too low. Too high and you are overloading your neck and shoulders. Too low can lead to an arched back which can strain your lower back muscles.

Good:

Tip: Keep your hips in line with shoulders so that you can draw a straight line from your shoulders, hips, to ankle. It should look like you are standing up but just horizontally.

2. The Squat

Bad:

Fail: Knees coming forward over toes which overloads the knees and does not allow for strong recruitment of the core and gluteal muscles.

Good:

Tip: Sit deep into your hips keeping your weight in your heels. As your knees bend, you should still be able to see your toes. Plant your feet firmly into the ground, activate your core and squeeze your butt when you rise.

3. The Lunge

Bad:

Fail: Lunging forwards instead of downwards which overloads front knee.

Good:

Tip: Have equal weight distribution between your front and back leg. Focus on bending the back knee and lowering it towards the ground.

4. The Push Up

Bad:

Fail: Head diving down before your torso. This can cause strain on your neck and shoulder muscles.

Good:

Tip: Keep your head in line with your shoulders by imagining your head is being suspended by a hook on the ceiling.

5. Using free weights

Bad:

Fail: Shoulders rising up to your ears as you lift the weights. This puts a lot of strain on your neck muscles and muscles in the front of the shoulder.

Good:

Tip: Have a small arch in your lower back and mid back relatively flat. Anchor your feet into the ground, keep your stomach muscles pulled in, and chest open. You should maintain this position as you lift the weights.

We can cover anything ranging from active rehabilitation, to injury prevention. From performance training to day to day biomechanics.

This week our featured therapist is Jessie. To learn more about Jessie check out our PhysioWorks team.

#physiotherapy #exercise #exercise fails #proper form

Phases of Healing Post-Injury

Timing is key with management of injuries. As physiotherapists we are constantly assessing what stage of healing our clients are in to determine how to progress treatment, exercise and deciding when you are ready to return back to activity. The speed at which one moves through these phases depends on a number of factors including extent of injury, age, health status, as well as recurrent injury to an area. Often there is overlap of these phases and sometimes regression particularly if the injury is mismanaged. Early rehabilitation with physiotherapy helps facilitate quicker and proper healing through these stages and prevents risk of re-injury.

Acute/ Inflammatory Phase: Days 1-7

Higher levels of pain, redness, swelling and often warmth to the area are present- a sign of inflammation. We commonly associate inflammation as being a 'bad' thing, however this increase in blood flow, cells and chemicals to the area are necessary to start the healing process. In this stage "P.R.I.C.E" or Protect, Rest, Ice, Compress, and Elevate the area is recommended to prevent further irritation. At this point physiotherapy is typically focused on education, minimizing pain and keeping the area moving within a pain-free range of motion.

Fibroblastic (Repair) Phase: 4 days - up to 6 weeks

Pain levels decrease, inflammation is minimal and often movement starts to become easier. During this phase collagen fibers are set down in the damaged area in the form of scar tissue. This type of tissue is less tensile and weaker making it susceptible to damage if overloaded. This is a VERY common phase for people to get re-injured as you start to feel better and return to regular activity too quickly only to find that same ankle or shoulder injury has flared up again. The focus at this point is regaining range of motion and working on light to moderate pain-free strengthening of surrounding muscles. Your physio may work on mobilizing joint or scar tissue as well as provide guidance on specific exercises to prepare you to return to activity.

Remodelling Phase: as early as 2-3 weeks, up to months or years

At this stage there is typically minimal pain and no inflammation present. The quality and strength of the collagen fibers within the tissue have progressed. This is where proper loading through the tissues is crucial to help further strengthen and realign the collagen fibers so that the tissue can tolerate various stresses placed on it.

Typically physio will be focused on pushing range of motion, increasing resistance, and re-introducing higher impact movements such as running and jumping. If rehabilitated properly, this is the stage where most people will be ready to return to sport. Remember that tissue healing takes time so be patient! Getting guidance from a physiotherapist early on can help speed up your recovery and prevent lingering aches and pains.

We can cover anything ranging from active rehabilitation, to injury prevention. From performance training to day to day biomechanics.

This week our featured therapist is Charlene. To learn more about Charlene check out our PhysioWorks team.

#injury #rehabilitation #healing #physiotherapy

Anxiety

Unfortunately, such a common word now and we hear it all the time. At least I do, as a mother I hear it at my kids school, as a therapist I hear it at work. Stress, nervousness, fear, worry - all common emotions and anxiety is too a primal emotion. It drives us and keeps us in check, kind of like that inner voice we were always told to listen too. Before a big test or significant life event we all feel it. So, a certain amount of anxiety is actually a good thing. When it is constant and you start getting nervous about the “average” or daily life events it becomes a disorder. Anxiety disorders are diagnosed when one experiences excessive anxiety about a number of events or activities, occurring more days than not, for at least 6 months.

Now, I am not educated in mental health so I’ll speak to you about the physical effects seen from such disorders. Rapid heartbeat, sweating, stomach aches, headaches, tense muscles... these can all come into play when your nervous system is firing all the time. So an excessive or prolonged amount of this can be debilitating. From what I’ve been reading this is what a lot of people finally go to the doctor for the physical effects, which usually means this has been going on for far too long.

We do have a lot of stress these days but hopefully a lot more education in the importance of mental health, which is maybe why we hear more about it now? Who knows, I don’t but again I am not educated in mental health. I do know that the mind/body connection is very strong and I’m hoping that if our country gets a better system in place for educating everyone in mental health we can keep plugging away at PREVENTION..from the mental and physical aspects.So here’s a link to check out if you need anymore info on this important topic.I hear it is tremendous and has an award winning app you can download too.

Keep calm..come to PhysioWorks!

We can cover anything ranging from active rehabilitation, to injury prevention. From performance training to day to day biomechanics.

This week our featured therapist is Caroline. To learn more about Caroline check out our PhysioWorks team.

#anxiety #mental health #physical health

The key to a good massage

Communication is key to receiving a good massage. A simple definition of communication is the process in which information is relayed. This can happen verbally or nonverbally.

In order to give as effective a massage as possible, two-way communication is key. If your therapist could read your mind, they would know what your expectations with massage in general were, what short and long-term goals you have for your treatment session, what areas are painful and what pressure you are comfortable with. Unfortunately, mind reading is not among our skills. We can do our part by asking more relevant and specific questions to yield better answers from you. But we can’t communicate effectively without information.

So what can you do to help the two-way communication?

What type of massage are you expecting? Do you just want to relax or do you have some long-term issues to work through? Before booking a massage, take a look at the therapist profiles that are on our website. We try to describe our treatment style and what we have experience in. You may be able to choose a therapist that fits your expectations just by reading the bios.

Before an initial treatment, everyone fills in an intake form that outlines your current condition and areas of concern. Please be as truthful and detailed as you can. There may be some information that you may deem unrelated but may actually directly impact your current area of concern. Some problems may not be as simple as: “I need my arm worked on because that is where it hurts.” Maybe that previous neck surgery ten years ago may have impacted the nerve responsible for the sensory input for your arm. It may not be relevant but that may be a connection to explore.

Some people expect no pain during massage. Some others expect a lot of pain during massage. The truth is somewhere in between. Conveying your preferences referring to pressure during the massage is great. We love the feedback. Since your treatment is not a competition between you and your therapist, it is best to tell us when your discomfort is too high to be working on a particular area at that pressure. Holding your breath to protect yourself from the pain is not a good idea. Trust me, breathing is good!

Are you getting any referred pain, numbness or tingling? There can be times that you may experience these during a massage. It is not necessarily something to worry about but it is important for us to know that that is occurring so we can modify treatment.

Be honest about how you feel after the massage. Your feedback here would impact if and how much remedial exercises or stretches you should be prescribed. If you have an unexpected reaction afterwards, or if there is something that we can improve, please let us know. There may be times when it would be better for you if we referred you to one of our colleagues that would suit your current condition better.

Our goal is to customize your treatment to you. With more communication, we can achieve that together!

We can cover anything ranging from active rehabilitation, to injury prevention.

This week our featured therapist is Brian. To learn more about Brian check out our PhysioWorks team.

#rmt #community #communication

Does Pronation Cause Running Injuries?

I thought it would be helpful to address a few questions that we get a lot in clinic when helping recreational and high level runners a like. A lot of us can get too caught up with the ideal posture and the ideal movement patterns when doing activities. The abundance of information in this day and age can make things very hard for runners and athletes to figure out what is good and what is not. In this post, we will look into pronation and its possible contributions to injury.

Does pronation cause running injuries?

I get asked about pronation almost every single time I treat a runner for knee pain. Pronation is a combination of movements during a walking or running cycle where the contact points roll from the heel to the toes. Pronation is necessary for several things like shock absorption and distributing our weight properly during the standing phase of the running cycle.

So… Pronation is not too bad?

It is in fact necessary for things like walking and running. Labeling pronation as the cause of all knee pain for example might be doing more harm than good. That’s not to say that over-pronation is never the culprit because that would be throwing out the baby with the bathwater. Some running injuries can be caused by over-pronation, but not all. The cause of running injuries often require an assessment of the training loads, muscle strength and length, and running assessment among other things.

Most of the time, injury stems from an issue of inadequate cross-training, poor load management and gradation of training volumes than a single movement flaw. Instead of pointing the finger at pronation, we might be better placed to ask why the over-pronation is taking place in the first place. For example, inadequate hip musculature strength and control can lead to increased pronation in the stance phases of running as much as a weak foot arch.

We are lucky to work with several runners from the Kitsilano community with a variety of problems. If you are dealing a running injury, want to start or take up running again, consult with one of our physiotherapists for a thorough assessment of your running style, strength and flexibility, and design a program to suit your lifestyle and goals.

We can cover anything ranging from active rehabilitation, to injury prevention.

This week our featured therapist is Iyad. To learn more about Iyad check out our PhysioWorks team.

#running #running injuries #pronation #physiotherapy

10 Things Your Registered Massage Therapist Wants You to Know

It really doesn’t matter that you haven’t shaved. Seriously. We truthfully don’t even notice, up until you mention it. It has no effect on our treatment. If it does, that’s what the oil and lotion is for.

Do your stretches. And your exercises, and your home care. Although it would be fun to follow you around, give you treatment and remind you of your therapeutic exercises all day long, we can’t. In the grand scheme of things, our time together is very short, only minutes a day, a week, a month, or even longer. The homework your Registered Massage Therapist (RMT) gives you is designed along with your treatment plan to help you resolve your pain and dysfunction. Your health is in your hands the rest of those minutes, days, weeks, and months. If you want to get better, you need to do your homework.

Your body is beautiful, too. RMTs treat hundreds of patients. That means seeing, and touching, various body types. Guess what? They are all different. Out of all of them, not even one looks like what you see airbrushed in the media. There is only one condition your body should be in, male or female, young or old: Healthy. And that looks a little different for everyone. Your RMT is here as a vessel for your health. We are not here to judge. And we want to tell you: Your body is beautiful, just how it is, as long as you are on your journey to health.

When you “re-make” the table, I smile inside. After the treatment, when we come in for reassessment, check ins, clean ups, etc., and we see that all of the linens have been attempted to be put back, tidied and re-made, it warms our hearts. I mean, it’s silly really, they all get washed after every treatment. It’s completely unnecessary, but it’s also really sweet for some funny reason.

Please don’t call us “masseuses.” We are Registered Massage Therapists. With years of training, education then certification, experience and legal responsibilities. The word masseuse is…ugh. Shudder-worthy. It’s associated with less than desirable connotations and a very unprofessional type of “massage”. And that is not what we do. RMT’s provide well thought out, research based treatment plans to assist our patients return-to or maintenance-of health. We appreciate being called by our hard earned titles. Registered Massage Therapist, Massage Therapist, or simply, RMT.

Being quiet is ok. You have no obligation to talk to us during a massage. If talking helps you relax, by all means go ahead. Otherwise, go to your happy place, fall asleep, meditate. It’s your hour, so do what you feel is right to relax

Feedback is important. Tell us if you want more or less pressure. We are happy to oblige, and won't take offense. In fact, we love it if you tell us what you like and don't like as we go along. It helps us to individualize your massage to what you want and need.

Don’t be shy about your butt. In our world, it’s a large muscle. Actually it’s three. We call your bum gluteals or glutes. It’s not a booty or ass and we don’t see it as fat, tiny, jiggly or bony. We observe your bodies in a clinical sense, and if you have pain associated with your low back, legs, hips or glutes, don’t be shy. We’re here to help, let us know!

Bodily functions are normal. Most massage therapy treatments have some component of relaxation. Your parasympathetic nervous system starts to shine, meaning the rest-and-digest functions are in full swing. And yes, that means stomach grumbling and growling, snoring, even passing gas is normal. It doesn’t happen all the time, but when it does, that’s a good sign you are relaxed. As healthcare professionals, it doesn’t faze us. We don’t judge you, we’re here to help you.

We care. Yes, we actually care if you do your home care. Yes, it really matters what you tell us and how you are feeling. And yes, we worry about you when you’re struggling. We really want you to get better.

We hope we can make your pain and dysfunction better, that’s the goal, that’s why we do what we do. That’s also why RMTs refer you to other practitioners, because we truly think they could help and their tools could be of use to your recovery. Because your recovery is our priority and you matter to us. And most importantly, because we really care about you and your health.

Know that we love what we do, helping people is the best job in the world. We truly feel just as good as you do after a successful treatment! We are genuinely grateful when you consider trusting us with your health, and we consider it a privilege to share that time with you!

We can cover anything ranging from active rehabilitation, to injury prevention.

This week our featured therapist is Karen. To learn more about Karen check out our PhysioWorks team.

#registered massage therapy #rmt #massagetherapy #massagetherapist

Video Gait Analysis

Ever wonder what you look like when you’re running? As a physiotherapist, my eyes have become trained to look at body mechanics and it’s amazing to see how there is such variation on how people run. No one teaches us how to run. It’s a natural movement pattern that develops naturally as a child. Babies grow and develop their bodies and brains; without any instruction, they get up one day and just start to walk. This requires a complex pattern of coordinating hundreds of muscles and ligaments with a huge network of nerves. So as children grow, they move with what seems to be most natural for their bodies and brains. Our bodies are amazing machines!

Unfortunately, we see our fair share of running related injuries here at PhysioWorks. While there is no perfect way to run, there are definitely ways to make our running gait more efficient. Often this relates to a form of an overuse injury. It isn’t always as simple as running too much. How we strike the ground, what our posture looks like, which muscles are weak and/or tight all affect the efficiency of our running gait. Running is really repetitive. One will take about 10,000 steps in a 10 km run. Optimizing this complex system will help decrease your chances of injury and help with accomplishing your running goals.

We offer video gait analysis at PhysioWorks to help runners (and walkers) improve their efficiency and identify causes for their injuries. This includes a full biomechanical analysis performed by a registered physiotherapist followed by a video analysis on our treadmill. Our software helps to identify mechanics like alignment, foot striking, posture and other factors. It’s fun experience to see yourself run on video. Much like listening to your own voice on a recording, it’s usually not what you expect! After the analysis, we build a program that includes recommendations on your running form, a running program and an exercise program to improve your mechanics. We see a range of runners, from those who are just starting to run to seasoned marathoners. If you have any questions about our video gait analysis, feel free to contact us here at PhysioWorks.

We can cover anything ranging from active rehabilitation, to injury prevention. From performance training to day to day biomechanics.

This week our featured therapist is Byron. To learn more about Byron check out our PhysioWorks team.

#video #gait #run #physio

Massage 102

Last time I blogged I wrote about the four basic principles of massage strokes:

General to specific to general

Superficial to deep to superficial

Periphery to center to periphery

Proximal to distal to proximal

This time I want to introduce to you some basic massage application techniques. Effleurage, Petrissage, Tapotement, Friction, and Vibration are the 5 basic techniques of Swedish massage. Swedish massage is the type of massage most people think of when you tell your friends “I have a massage at the spa later.” Usually your friends will get a little jealous and wish they were you for a quick second. For myself as an RMT, Swedish massage is done for 4 reasons: To improve circulation, to introduce the client to your touch, to start to move the soft tissue so I can start my deeper and more therapeutic techniques, and then when the deeper techniques are complete to flush out the tissue. When starting to apply Swedish massage always refer back to the four basic principles of massage and this will help you give a successful relaxing massage that your client will remember for weeks.

Effleurage: These are the sliding Swedish massage techniques that cover different areas of the body. They are long sweeping strokes that alternate between firm and light pressure which can be performed using the palm of the hand or the fingertips. Used at the start of my massage to apply the lotion evenly and to introduce your pressure along with improve circulation in a more general way.

Petrissage: This is the technique of kneading the muscles of the body to attain deeper massage. The palms fingertips and knuckles are used to knead the muscles of the body and to squeeze them to prepare them for the other even deeper techniques

Tapotement or Rhythmic Tapping: This technique of Swedish massage, as the name suggests consists of rhythmic tapping that uses a fist, a cupped hand, ulnar board of the hand, or your fingertips. This helps to loosen and relax the muscles being manipulated but also helps stimulate them neurologically.

Friction: This is used to bring more blood and heat to the muscles and skin. This technique can be used as a warm up for the muscles of the body to be treated with more therapeutic techniques.

Vibration or Shaking: This is the one among Swedish massage techniques that helps to loosen up the muscles by using a back and forth action of the fingertips or the heel of the hand over the skin. The muscles of the body are shaken up to loosen and relax the muscles. The sides of the hand, and any part of the hand such as the finger tips or heel can be used to increase circulation and separate muscles from the underlying tissue.

Of course practice of these techniques needs to happen to be able to use them appropriately, utilization of the 4 basic principles of massage in combination with the techniques of Swedish massage you will give a successful relaxing massage. Next blog, Massage 200, I will take you into some more complex therapeutic applications of massage: Myofascial Release, Trigger Point Release, and Stretching. Thanks for reading!

We can cover anything ranging from active rehabilitation, to injury prevention.

This week our featured therapist is Adam. To learn more about Adam check out our PhysioWorks team.

#rmt #massage #therapy

Spotlight On Clinical Pilates

Did you know that we are one of the largest Clinical Pilates clinics in the Westside of Vancouver? The majority of our therapists are trained through STOTT Pilates as rehabilitative instructors. We can integrate Pilates exercises into your regular rehab treatment or carry out one-on-one customized Pilates sessions for you. We have had a lot of success with clients that struggle with the typical gym exercises like squats or planks. It is also a great starting point for clients who are just looking into getting their physical fitness going.

What is Pilates? Pilates is a system of exercises originally created by Joseph Pilates over 50 years ago to develop strength, flexibility, and endurance in the muscles of the spine and limbs. It emphasizes initiating movement from the core while maintaining correct spinal and pelvic alignment, and using breathe as a focal point to connect the mind and body.

STOTT pilates was developed by physiotherapists, sports medicine experts, and fitness professionals and is a contemporary approach to the original exercise system. It integrates modern principles of exercise and rehabilitation, and includes modifications and preparatory exercises that allow for this technique to be appropriate for people with varying abilities and body types.

Who can benefit from pilates? Pilates is particularly beneficial for people suffering from:

back or neck pain

poor posture

sports injuries

repetitive stress injuries

muscles strains and imbalances

arthritis

pre- or post-natal weakness

What are the benefits of pilates? There are many benefits to pilates. Some of them include:

restoring pain-free movement of the spine and limbs

increasing strength and endurance of the core muscles

improving balance and coordination of the muscles within the body

improving posture and alignment

What is Clinical pilates? Clinical pilates is a pilates-based exercise program designed by a physiotherapist to meet your rehabilitative goals. It is widely used in Australia and New Zealand and is a proven treatment method. Research has shown that the quality of results from physiotherapy improve when Pilates is integrated into the treatment plan.

PhysioWorks is currently set up for mat and reformer pilates. Pilates sessions may be covered under your extended health plan. Please contact the front desk, 604.366.8125, if you have any other questions about booking or our rates.

We can cover anything ranging from active rehabilitation, to injury prevention. From performance training to day to day biomechanics.

#clinicalpilates #stottpilates #pilates #physiotherapy

Perfect Posture, a Myth?

I know it sounds contradictory coming from a physiotherapist who repeatedly nags you about your posture and probably assessed your posture on your first visit but I can explain. First let’s start with a definition of posture. Posture is the static alignment of the total body at a given moment where each body part or joint affects others. Ideal Posture would be the position at a given moment that places minimal mechanical stress and strain on body parts or joints as a whole

So, ‘ideal’ posture is related to the task at hand and the amount of time spent doing that task. When performing a high force or intense task, one should be very mindful of posture vs a low load task - think lifting 25 kg vs 2 kg box off the floor. But a low load task of long duration will also require postural awareness - sitting at your desk for 8 hours vs 10 min.

In recent years sitting has been taking a beating due to its negative effects, not only your musculoskeletal system but on your body. Heath care professionals have been advocating standing desks to reduce long term risks of sitting. The rational was standing promotes a more ‘ideally’ aligned posture and is more active than sitting. Yes, posturally speaking your hips will be extended/straightened compared to sitting but I would argue that the rest of your body from head to hips would not significantly differ. I would estimate that a ‘hunched’ position in standing is just as prevalent compared to sitting postures.

Clinically, I have been treating similar reports of pain and issues from those who have changed to standing desks from sitting. Many do report improvements after changing to standing but rarely does it eradicate the issues. The underlying issue for both cases is the duration spent in a static posture. We are mostly dealing with tasks that could require being stationary for hours at a time. Standing or sitting, being static for that long is unhealthy for your musculoskeletal system even if you are positioned in ‘perfect’ alignment. I have always told my clients, ‘perfect’ posture becomes poor posture if held long enough.

What’s the answer? MOVEMENT = less time spent static. I’m not advocating treadmill desks but here are some simple items you can incorporate in your static day.

hange from sit to standing every 2 hours

Move items that use intermittently further away on your desk and alternate left to right side of working surface. Ex. stapler, water bottle just far enough away so that you lean slightly

< Set of 10 squats or lunges every 2 hours when you change from sit to stand

There are a various repertoire of exercises or movements that can be catered to your problems you can incorporate.

I believe standing promotes more movement naturally but it is not a remedy from prolonged sitting. As a side note, recent research has shown that occupations that require standing all day showed greater cardiovascular health risks than sitting.

In short, MOVE more.

We can cover anything ranging from active rehabilitation, to injury prevention. From performance training to day to day biomechanics.

This week our featured therapist is Rob. To learn more about Rob check out our PhysioWorks team.

#posture #physio #health

5 Common Sources of Knee Pain

I'm sure that many of you have heard of various knee dysfunctions from patella femoral pain syndrome, IT band friction syndrome,and patellar tendonitis to name a few. What many people don't know however, is that the cause of knee pain almost always is coming from dysfunctions in other parts of the body. In today's blog I'm going to discuss some of the most common culprits of knee pain that I see in the clinic.

Weak Glutes: This is an entire topic on it's own, but not having enough power and endurance in your hips when running, squatting, walking and playing sports can cause havoc on your knees. Your butt muscles are important for proper knee alignment as well as propelling your body forward. Therefore inefficient glutes can lead to overloading of the knee joint as well as the surrounding knee musculature.

Weak Core: Similar to having weak glutes, not having a strong enough core can lead to poor control of the torso, pelvis and hips. Naturally, being unstable through these areas can lead to excessive motion and poor tracking of the knee joint upon loading.

Unstable Ankles and Collapsed Foot Arches Looking further down the chain, individuals with pronated feet (collapsed arches) have a tendency for their knees to point inward and collapse in during impact. This goes as well for those with old ankle injuries that perhaps weren't properly rehabilitated. Training on wobbly or weak ankles makes it extremely challenging to control your knee alignment. Supportive footwear, balance training and ankle strength can go a long way

Tight IT band and Outer Quads:An imbalance of excessively tight outer quads and weak inner quads can lead to the knee cap being pulled slightly out of the groove that it sits in, often leading to patellar femoral pain syndrome. Tightness through the TFL muscle and IT band on the other hand (typically due to weak glutes) can lead to friction and sometimes inflammation on the outer portion of the knee where the IT band attaches.

Training-Error: This seems like an obvious one, but we see it all the time in the clinic. Progressing speed, weight training, increasing training distance, or changing training surfaces too quickly can lead to injury. The muscles, tendons and joints surrounding your knee need time to adapt to new load. Gradual progression (only progressing if there is no pain, and you can keep good form!!) and rest days are important here to ensure that repetitive strain injuries don't set you back.

We can cover anything ranging from active rehabilitation, to injury prevention. From performance training to day to day biomechanics.

This week our featured therapist is Charlene. To learn more about Charlene check out our PhysioWorks team.

#knee #pain #prevention #physio

Does pain = injury?

So you just woke up and your neck was hurting for some reason. You go to see your favourite therapist or doctor for some relief. You are in pain and not happy about it. Your practitioner treats you and advises you to move your neck around every so often even if it hurts.

Wait a second… did he just say I should do range of motion exercises when he knows that it triggers my pain?

Well, yes. Yes, I did. Let’s pretend you burned the tip of your finger one day while cooking. That finger became very red, swollen and painful over the next hour. Now every time you move your finger or touch anything with it, you feel that same burning pain. This is often no different than most sprains or strains. Because every time you feel that burning pain, you are not actually burning that finger again, the nerves in that area are just more sensitive.

Let’s describe what pain is. Pain is considered a warning system in your body. It is essential for us to experience life. This alarm system warns us when we do something our body does not like such as burning our finger. We need this system at the time of the injury to take our hand off the stove so it clearly has some use and we should listen to it sometimes. So when you remove your hand off the stove, that alarm system should gradually go down. You will still feel your finger for a while as you get more desensitized to it and as you naturally heal. So long-story short: are you making your injury worse every time you feel that same pain? Probably not.

Any new pain can be intimidating at first. Our role as your therapist is to provide you with the necessary education, treatment and empowerment to help you get back to your normal activities. If you have a new injury, consult with your practitioner for the right advice, coping strategies and reassurance.

A resource I found very helpful for anyone in pain and for every therapist can be found here here.

We can cover anything ranging from active rehabilitation, to injury prevention.

This week our featured therapist is Iyad. To learn more about Iyad check out our PhysioWorks team.

#physio #pain #injury

Foam Rolling

What is it?

You have probably seen or tried it at your gym or exercise class. It looks like a pool noodle but a bit thicker and firmer than it. That is a foam roller. It is a self-massage tool used to release muscle knots and enhance recovery after a workout. How does it do that? By applying pressure to the tissue, it can break up the knots, improve blood flow and flush out toxins in the muscle.

How much and often should I do it?

If you have tried foam rolling before, you will know that it hurts. There are different “intensities” of foam rollers which I will discuss later, so you can start with a lighter version first. In general, start with 30 seconds and build up to 3-5 minutes per muscle. Ideally, you should feel the muscle release or soften under the roller. Try to be consistent with it, around 3x/week and it is best after a workout when your muscles are already warm.

The different types of rollers

There are many variations of foam rollers out there, but I will try to simplify them into four main types:

The lightest intensity would be the stick. You only use as much pressure as your hands generate so it is relatively mild. This can be effective for sensitive tissue and I find it handy for muscles in the calf and hamstrings.

Next up would be a high-density foam roller. This is what we use at the clinic and I find it a good entry point if you have an injury or a very tight muscle.

The next level up would be rollers with spikes or bumps on the outside of the roller. These are meant to be more aggressive and get deeper into trigger points. Many people like these for big muscles like the quads.

And finally the most aggressive would be a hard ball like a lacrosse ball. This is great for getting into those tough to access muscles and ones that are quite deep.

Words of caution

Never roll tissue that is inflamed - red, hot, or swollen. This will just make things worse. Also, avoid rolling over joints or bones. I do not recommend rolling the lower back or neck. And although foam rolling is meant to be a bit painful, it shouldn’t be so painful that you aren’t able to relax your muscles while rolling. If that is the case, try to use a gentler method and work your way up. Firmer is not necessarily better. You just need to find a tool that works for your level of tension.

If you have any more questions on how to use a foam roller or want to know which muscles to roll for your injury or activity, please consult a physiotherapist.

We can cover anything ranging from active rehabilitation, to injury prevention. From performance training to day to day biomechanics.

This week our featured therapist is Jessie. To learn more about Jessie check out our PhysioWorks team.

#foamrolling #physio #therapy

Running Principles

A slew of running injuries have been arriving at the clinic recently and I have found myself educating clients on efficient running mechanics. So, I thought it would be a good time to revisit a blog on running.

Is there an optimal running technique?

Should we all run the same way considering there are vast differences in the level of runners, the distance of running and our own biomechanical and physiological properties. I believe and promote economical running by educating clients on a few simple principles and letting individuals LEARN to run naturally.

Economical running principles:

Foot Strike Type: Are you a forefoot, midfoot or heel striker? Essentially, what part of your shoe contacts the ground first is how you would answer this question. Research shows that there is increased in forces applied to your joints for heel strikers. Think of landing on your heels after you jump up. To soften the impact, you would naturally land on your midfoot or forefoot. But excessive forefoot impact increases the load on your achilles tendon and calf system which could lead to achilles tendon and calf injuries. So, a midfoot strike somewhere between the heel and the ball of your foot is the preferred point of contact in my opinion. I know its not very specific but it allows for natural tendency to prevail.

Foot Strike location: Another component of your foot strike that impacts your running is the location of contact. WHERE your foot strikes rather than HOW. The further your foot strikes in front of your center of gravity (COG), the more likely your heel strikes first. This forward placed impact will create a braking force that opposes your forward motion, regardless of the type of foot strike. Your goal in running is to maximize the forward motion of your COG safely and efficiently. Learning to place your foot contact beneath your COG will not only increase your efficiency but also promotes a mid-foot strike.

Cadence (steps you take per minute): Your cadence or how often your feet contact the ground should be around 180 foot-strikes per minute. Studies consistently show that majority of elite long distance runners run at this rate. A low cadence will promote over striding/reaching as the runner attempts to cover as much ground as they can per step. As mentioned before, over reaching will increase the braking force applied to your forward motion and promote heel-striking. I also see a higher vertical displacement in runners with low cadence resulting in a bounding or bouncing type running style. Your goal is to move forward, not up and down.

You can calculate your cadence by counting the number of times one foot contacts the ground for a specific interval. So, your right (or left) foot should hit the ground 90 times in a 60 second interval or 45 times in 30 seconds. For those individuals who are accustomed to over-striding, this will feel like you are shuffling your feet at this cadence because you will need to shorten your stride length. Don’t worry, you will get used to it. Those who run to music, do a quick internet search ‘180 BPM running music’ to find a playlist of appropriate songs to run to.

I hope these simple principles can help you establish efficient and safe running mechanics. Of course there are many more variables that affect your running mechanics and can lead to injuries. If you are having issues reaching your running goals, a health care practitioner at PhysioWorks would love to help you achieve your goals. Book in for a running gait analysis with a comprehensive physiotherapy assessment to start your recovery.

We can cover anything ranging from active rehabilitation, to injury prevention. From performance training to day to day biomechanics.

This week our featured therapist is Rob. To learn more about Rob check out our PhysioWorks team.

#running #prevention #vancouver

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