All Posts tagged spine pain

Motion is lotion

Motion is lotion

Understanding the “Why” behind Movement & Exercise

How do our mindset and beliefs around exercise affect the decisions we make? This blog explores the nitty-gritty of the “why” movement and exercise are beneficial to you in order to help you make the change you are seeking.

As Physiotherapists, one part of our job is to provide evidence-based education to our patients about the importance of movement and exercise. Movement can be active (something you do) or passive (something that is done to you such as joint mobilisation or muscle/nerve/fascia release as common examples). Saanich Physiotherapy  and Sports Clinic prides itself in providing an engaging holistic approach to your health & wellbeing. Movement and exercise are but one part of that approach.

We are each of us unique. We come with complexities and intricacies that make us who we are. In order to delve deeper to understand the “why”, it is important to highlight that all injuries are not the same, even if they are the same injury. Equally so, all pain is not the same, despite the pain seeming to originate from a particular region. Confused? It’s ok, it’s a little bit complex, but I promise to break it down for you so it’s easy to digest. No-one likes pain and our brains are wired to take short cut’s. It’s part of being human. We all want a quick fix. We don’t have time for this pain or injury. It’s stressing us out. Sometimes a quick fix can work to provide some temporary relief, and that’s ok. However, there is usually more to the story and so I will tell you about what we’ve learnt from the many 1000’s of patients we have had the pleasure of helping by getting to know their stories around exercise and movement.

If you’ve tried quick fixes and you haven’t solved the issue your internal voice may speak up and tell you to “do exercises to fix the issue”. That seems logical. Then you probably google it.

Movement and exercise to fix an issue

If logic has taken you on a bypass route straight to a Dr Google search or an Instagram video providing a generic or formulaic approach to exercise as a “fix”, the bypass route will not provide all the answers you need and may even steer you in the wrong direction. There is nothing wrong with information however, which information is critical. Which exercises? When to do them? How many to do? How often to do? When to increase? When to decrease? When to change? What if I get worse? Do I persist? Do I modify? How should I modify? These and many more questions will not be answered by trying to skip the longer scenic route with your physiotherapist as your co-driver and guide to improving your skill. Heading straight to the bypass route either solo or with only partial information that applies to you specifically will often lead to an aggravation of your pain and a delay in the healing process.

Please don’t stop reading here as there is so much more to share with you. Your Physiotherapists job is to know people and people are like complex ecosystems. Bodies – brains, hormones, muscles, bones, tendons, ligaments, nerves, fascia, neural networks, chemicals transmitting signals everywhere, emotions, expectations, histories, unconscious and conscious biases and everything that makes you tick, it’s all interacting with your environment, with other people, constantly re-evaluating. How amazing is that? People are awesome. You are awesome and that is why you need a multifaceted and complex problem-solving approach to your treatment. That is what we do. There are no exceptions. None of us can say we are exempt, we don’t get to opt-out, as we are all made up of the same pieces, it’s just that our jigsaw puzzle, once completed, like our neural networks and their interconnectedness, looks different to anyone else’s. And that is the beauty of people and everything each of us brings with us.

Mindset and Beliefs

Before we look at the “why” exercise is important, it is imperative to understand the mindset and beliefs we each carry within us in relation to movement and exercise. Simply hearing the word “exercise” can invoke a range of varying emotions and responses in each of us. These responses are based on our subconscious and conscious biases, our way of thinking, our past and recent experiences.

We all know exercise is supposed to be good for us – but “knowing” is simply often not enough to make the leap to effect a change in our behaviour, specifically around learning and developing new patterns of behaviour. In order to learn and lay down new habits, we must “do”, we need to act and we must “repeat”. Another vital link to laying down new patterns of behaviour is attributing a positive meaning to our new “doing”, in this case, exercise. Here we explore a range of common responses to exercise prescription or even the thought of doing exercises and the likely mindset linked to each.

This could be anything from:
*a closed mindset response – I am not doing that
*a negative mindset response- I don’t want to do that
*a stress response – I don’t have time
*a fear response – I can’t do that
*an avoidance response – that doesn’t apply to me
*an unsure response – I didn’t know that could help
*an angry response – I don’t want exercises. I just want someone to fix me
*a curious mindset response– how will that help me, can you tell me more so I can understand?
*an open mindset response – I will do my best to execute that
*an eager response – what can I do to help myself
*an overeager response – If I just do a lot of these this should fix my issue
*an honest response – I may not have the time, nor energy, but I understand that this can help me so I’ll give it a try
* a mindful response ­ I will tell myself I’ve done a good job when I do my exercises, even if it’s not as often as it could be, I am doing the best I can at this moment.
*a non-judgemental response – I will not tell myself off if I don’t do my exercises as this is not helpful to me learning new patterns of movement and exercises.

Exercise prescription – Finally the nitty-gritty of why exercise and movement are good for us

Exercise prescription can be given for a range of reasons too. The majority of the physiotherapy patient population are prescribed exercises for improving the functionality of a muscle – it may be weak, lacking endurance capacity or overactive and tight. A muscle can also be slow at responding to input from our immediate surroundings which can affect our sense of balance and lead to issues such as falling over.

However, exercise can be given for other reasons too, such as pain modulation, down-regulating an overactive and sensitized nervous system, improvement in bone density, decreasing stress hormones (ie cortisol ) and substance p ( a neurotransmitter & neuromodulating chemical responsible for providing information back to our central nervous system about pain sensations in the body), to minimise and manage the inflammatory chemical response to acute injury or chronic stress on the immune system ( there are many inflammatory mediating chemicals that are produced inside our bodies such as histamines, prostaglandins and bradykinin – this one increases the bodies sensitivity to pain).

Exercise and diet may also assist in the management of overproduction of pro-inflammatory hormones (such as insulin and eicosanoids). An overproduction of these hormones can lead to chronic hyperactivity of our immune system and the development of immune system disorders (including but not limited to rheumatoid arthritis, Crohns’s disease, asthma, ulcers, cancer, atherosclerosis {heart disease}, sinusitis and more ).

Exercise decreases the levels of TNF (tumour necrosis factor) and CRP (C-reactive protein), which are both involved in systemic inflammation. In order to maximise the benefits of exercise and avoid chronic inflammation, we need to ensure we allow sufficient time for your body to recover after each strenuous exercise session.

Foods that increase the inflammatory response in our body are sugars, refined carbohydrates, saturated fats, trans fats, omega 6 fatty acids, MSG, gluten and casein (arthritis.org ).

Exercise can help us to get to sleep (when we get into a regular morning exercise routine our brain produces a sleep chemical called melatonin and exercise also stimulate the brain to produce a chemical called adenosine which makes us feel sleepy). Your circadian rhythm (your natural sleep/wake cycle) is maintained with regular exercise and therefore your sleep patterns are maintained consistently. This is very important in the management of pain and mental health stability.
Exercise regulates our mental health by reducing the body’s arousal, anxiety and depressive symptoms (after exercise our brain produces endorphins, dopamine, norepinephrine, and serotonin and these chemicals make us feel happy and improves our sense of wellbeing ).

Exercise helps our brains remain engaged. As we age, our brain needs to keep learning new things to keep it active and exercise can play a major role in keeping neural circuits in our brain open or creating new neural circuits. By engaging in exercise, we effectively slow down the process of ageing. Working on proprioception, which is your brains understanding of where you are in the world, you can improve your balance reactions, allowing you to do more for yourself and prevent falls.

So that is my condensed version of the nitty-gritty of why exercise is good for us. For me, I enjoyed sharing with you my passion for moving and I hope you learned a few new things too; and now both you, who has most likely sat for a length of time to read this article and me, as I have sat for a lengthier time to write this article, need to get up and move.

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Treating Chronic Pain

Treating Chronic Pain

Breaking the cycle of chronic pain. What is chronic pain?

Upto one in five Canadian adults suffer from chronic pain. It affects one in five people globally and is the primary reason people seek medical treatment. In most cases, chronic pain starts with an acute injury or illness. Sometimes, what can happen, is that even after you’ve healed from an injury, surgery or other conditions, the pain continues. If the pain lasts longer than 3 months it’s then considered chronic pain.

Chronic pain syndrome can then be considered short term pain, or acute pain, that doesn’t go away and has a physical and psychological impact on a person’s life. Chronic pain syndrome often creates secondary complications such as sleep deprivation, depression, irritability and fatigue, affecting a person’s personal and social relationships.

What is Pain?

Pain functions as a warning signal. The nervous system senses danger and responds to it with actions called guarding responses, designed to protect and defend us from further injury or harm.

Muscle tension, decreased range of motion, anxiety, fear of movement, increased sympathetic responses (raised heart rate, increased blood pressure, change in respiration) and a mechanism called low pain threshold (becoming excessively sensitive to pain and minor impulse or stress to the body region cause pain) are all consequences of the guarding response. This is the way the body protects itself from future painful incidents.
In chronic pain, even after the injury has healed, this mechanism remains and continues to affect the body creating a vicious cycle of real pain.

Your Brain and Pain

When we adopt this instinct to guard ourselves against future pain, it actually does the opposite and keeps feeding your pain cycle and increasing symptoms including pain (scientific research “Pain Processing in the Human Nervous System: A Selective Review of Nociceptive and behavioral Pathways). This guarding mechanism is most likely to occur to those people that view their pain or condition as a threat, rather than something that just is and that in all likelihood can be overcome or at worst worked through towards acceptance and continuing on with life in as normal or your new normal way as possible.
Being extremely apprehensive about your injury and symptoms, avoiding activities believing that that may be harmful, stress and negative emotions are coupled with autonomic, endocrine, and immune responses which may amplify pain through a number of psychophysiological pathways prolonging your “fight or flight” response to the original injury. This will lead to a downward cycle of deconditioning, weakness, muscle spasms and/or tension, increased anxiety and depression.

What can Saanich Physiotherapy and Sports Clinic do to help reverse pain?

Part of our job as physiotherapists and massage therapists is to help you and guide you, our patients, to overcome any fear avoidance behaviour (learned fear), such as fear of movement, by using not only hands-on treatment, dry needling or exercises, to target your injury or pain, but to talk to, explain and assist you in understanding the way that pain and our brain works. We can help you to overcome or negate some of these non-helpful brain responses. By doing this we help you to down-regulate your brains protective response in order to minimise your pain experience.

Working with you in this 1:1 way, taps into your brain and nervous system. Your brain and nervous system is complex. We can work with you to change your neural pathways and learned patterns of thinking and beliefs that in turn produces more of your own natural brain chemicals like endorphins. This resetting and rebalancing, forming positive neural/brain connections, plays a large part in you overcoming your injury or pain experience.

Of course, each individual person is unique and we all come with our own history and life story that also plays a major part in how we experience pain and how we as therapists target your particular treatment. The way we think about our pain and ourselves, how we act and what kind of self-talk we undertake can all play a major role in the way that our Physiotherapists work with you, our patients who suffer from injury, pain, chronic pain, pain sensitivity, learned fear, anxiety, and depression.

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Dry Needling, IMS Saanich Peninsula

What is Dry Needling?

Dry Needling is a specialised form of treatment that we use for reducing your pain and inflammation. Your trigger points are targeted with acupuncture needles to treat your pain, muscle tension, injury, and dysfunction. Dry Needling treatment is highly effective and you will often feel immediate pain relief as your muscles relax.

Common injuries treated with Dry Needling

Sports Injuries
Headaches & Migraine
Tennis Elbow
Carpal Tunnel Syndrome
Achilles Tendonitis
TMJ Pain
Muscle Tears/Strains/Tightness
Bursitis
Plantar Fasciitis
Arthritis
Hip & Knee Pain

 

How does Dry Needling work?

Needles are usually used to target painful trigger points in muscles. The penetration of the needle causes a micro-trauma that increases blood flow and alters the chemical balance in the muscle, assisting with muscle relaxation and healing.
The stimulation of pain receptors also causes the body to release opioids (e.g. endorphins). These are natural pain relievers in your brain. Their release provides further pain relief to you.

Your muscle may respond with a twitch response to the needle stimulation. This is a highly effective form of dry needling treatment and you often feel immediate benefits from this form of release. Your muscle releases tension and lengthens. Substance p, a pain chemical in your body, as well as inflammatory chemicals are eliminated around your trigger point. Flushing out these nasty chemicals can provide a longer lasting pain relief.

How is Dry Needling different to Acupuncture?

Acupuncture generally refers to the traditional Chinese medicine which is based on stimulating the flow of Chi (energy) through the meridians of the body, whereas Dry Needling is based on anatomical and neurophysiological principles. While the dry needles are the same and many of the ideas behind acupuncture are still applicable, the principles behind the use of Needling are very different.
Often people may use the term acupuncture when referring to Dry Needling so if you have had acupuncture in the past it could have been Dry Needles.

Is Dry Needling Physiotherapy safe?

Dry Needling Physio is very safe. There are certain factors that may make you unsuitable for Needling or that require extra care to be taken (e.g. Diabetes) but your Physio will consider these. All dry needles are sterile and used once before being disposed of safely in a sharps container.

Will Dry Needling Hurt?

One of the great advantages of Dry Needles over deep tissue massage for muscle release is that there is generally less pain both during and after treatment.
Most people don’t feel the insertion of the dry needle. When the needle penetrates the trigger point, you may feel an initial twitch or deep ache that quickly settles to become a light dull ache, warmth, heaviness or nothing at all. This is far better than the constant feeling associated with a firm massage that would be required to achieve an equal effect.

After Dry Needling Physio treatment there is often no or little soreness. Sometimes you may feel slightly tight, sore or an ache for a short time (up to 1-2 days). This again is invariably much less that than felt after massage and soft tissues techniques.

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How Can I Prevent Back Pain?

How Can I Prevent Back Pain?

How Can I Prevent Back Pain?

The latest research tells us that often people have never had a physical trauma to cause back pain like a car accident, falling, or lifting something heavy. There are usually a combination of factors that cause back pain which could include overuse, poor posture or other stressors.

Keeping in mind everyone is different, here are some expert tips:

Exercise! you can’t escape it, exercise is important for so many reasons, but a big one is preventing back pain. Muscles are meant to move. If you aren’t in good shape, you’re more likely to hurt your back and feel pain when you do even simple movements, such as getting out of the car. Exercise helps keep your joints fluid and your muscles strong.

Core & glute strength a regular strength-training routine that focuses on training your muscles to work together can help support your spine. Core muscles include your pelvis, lower back, hips and abdomen. Strong, activated glute muscles help protect your back from activities such as lifting a heavy object.

Eat well healthy eating habits can keep your weight down. Being overweight can put added strain on all of your joints, especially your spine.

Posture awareness be aware of how often you slouch over your laptop and iphone when texting. Take the time to take a break from long periods in front of the computer with a simple walk around the block or some hip-flexor stretches.

Reduce stress stress can impact your level of pain. Stress causes you to tense your muscles and constant tension can cause back pain. Take up a hobby or regular activity that helps you relax.

Sleep style for most, sleeping on your back can put pressure on your spine, pop a pillow under your knees to reduce this. If you’re a tummy sleeper, put a pillow under your pelvis. Side sleeping is generally the best way to go (but everyone is different!)

Lower back pain can be debilitating and can have a major effect on your daily life and work activities. Don’t let that happen to you, put in place some positive things today.

Physiotherapists are experts in the assessment of musculoskeletal injuries, especially spinal related pain, that’s why we can help you. We can help you with a strengthening home/gym-program for whole-body awareness, strength and posture improvements.

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