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I’m Brent – a Vancouver based physiotherapist.

Why Things Hurt is a site I’ve created to share my articles and videos. They’ll help you understand your aches and pains, and give you concrete and simple strategies to help!

  • GETTING STARTED
    An Instructional manual to let you navigate WTH and your body

 

  • TREATMENT TECHNIQUES
    Powerful options that you likely haven’t tried

 

  • MOVEMENT SCHOOL
    An email guided program to improve your posture

 


Empathy Over Ego: the art of active listening as a health professional

Sincere empathy can be a challenge for many healthcare professionals because we are confronted with an endless stream of people that have encountered horrible life events and we can’t possibly begin to understand the psychological stressors that they are now facing, either real or perceived.  Many of us work in healthcare models that give us very limited time with a client due to the volume of people we are trying to help and/or the financial constraints of who is paying for our time.  The combination of these two factors doesn’t usually result in a positive experience for patients trying to navigate through their medical system armed with only a very superficial knowledge of their bodies. Our medical systems are typically very good at keeping people alive, but after that they can become a series of very stressful life events that cause just as much harm as good to a person’s psyche. People that find themselves caught in a cycle of chronic pain are the prime example of how someone can do everything right in their search for help, but end up having the process actually cause more harm than their original injury.  Chronic pain is a combination of entangled physical and psychological stressors that shifts more and more towards the cognitive side as time passes.  Every new professional that a patient sees and has to tell his story to without receiving some form of empathy and/or meaningful explanation further feeds the fire of fear, stress and anxiety related to his pain. Healthcare professionals are trained to first and foremost screen for ‘red flags,’ or signs of something more sinister than a simple muscle strain.  Physicians have the most knowledge and experience of the various sinister conditions and because of that fact their approach to dealing with less threatening issues like ...
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My Name is Lance- Remember Me…

Today I find myself sitting in a coffee shop across the street from St Paul’s Hospital in Vancouver, Canada waiting for my mother to have a procedure on her heart.  I just admitted her through the emergency room that has the insurmountable challenge of helping the people of our downtown Eastside caught in the epidemic of our opioid crisis.  It was an eye opening experience that inspired me to write this post and think further on the topic that I know is plaguing my city.  I am a healthcare professional that deals with people in various levels of pain all day.  I am also a person that due to a freak accident has found himself in the emergency room, in the operating room, given OxyContin, morphine and other drugs to try and help my immediate pain on a cycle of over three months.  My experience talking to Lance today in the St Paul’s ER has made me reflect on my experience and realize how slippery of a slope it can be for a person to go from a normal life, to an injury, to being a homeless drug addict living among throngs of others living out their own journeys on the street. We arrived at the ER at 8:45am on a Saturday morning to a relatively quiet waiting room for downtown Vancouver’s only hospital.  There was one very talkative man being processed by the nurse.  He was seemingly a drug addict in withdraw and his father was quietly waiting in the chair looking like he had been through this before.  The dad was about my mother’s age and the talkative man was about my age.  I made sure my mom was taken care of at the admitting desk and then I was told to wait for about twenty minutes while ...
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Resistant Pain: A 3-Dimensional Moving Puzzle

The following is a copy of an article I recently wrote for BC Physio Magazine: After fourteen years of literally poking and prodding other people’s bodies all day, I have learned a few things about pain, anatomy and human nature.  I have done more than my share of market research in the hurting yourself category and have managed to work with or train under some of the world gurus in the pain and rehab space.  My name is Brent Stevenson.  I am the co-owner of Envision Physiotherapy in Vancouver and the author of the new book Why Things Hurt: Life Lessons from and Injury Prone Physical Therapist.  It is a collection of stories and lessons, written in a humorous, conversational tone, that I have found to be the most meaningful and helpful for my clients as they navigate their journeys down the path of resistant pain problems. I refer to pain as a 3-dimensional moving puzzle due to the entanglement of physical and emotional factors that contribute to the end perception of a person’s pain.  When I started my training as a physiotherapist I learned about anatomy and the different systems of the body, like the boney framework of the skeleton and all the muscles that attach to it.  I learned about the nervous system and the basic electrical wiring of the body followed by a superficial look at some of the organs that the skeleton was protecting.  I was then released into the healthcare world to try and help people with my new found knowledge, but quickly realized how superficial my understanding of the body and my ability to help people really was.  I knew about most of the pieces but didn’t really grasp how most of them integrated together as layers of systems within the body.  I ...
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IMS Dry Needling: Stories from an Outspoken Physiotherapist

A few years ago I posted this article (What is IMS acupuncture? Intramuscular Stimulation vs Traditional Acupuncture) on my blog largely as a resource for my clients, because inevitably, about three needles into treatment, clients would ask “how is this different from acupuncture again?”  What started as a patient education piece turned into a learning experience for me, in that I discovered how different groups of people had strong and differing opinions about the technique I was using and how I chose to explain it.  I had entered the turf war of dry needling.  Some acupuncturists were telling me that IMS simply was acupuncture, while others were telling me that my explanation was ‘just bollocks,’ and I should stop misleading people.  Meanwhile a retired physician and an aging physiotherapist were telling me that dry needling had been ‘debunked years ago,’ but local physicians and hundreds of previous clients were actively referring patients and friends to me specifically for IMS treatment.  It is an interesting time in the world of treating people’s pain! I learned to perform IMS (intramuscular stimulation) from its’ originator and guru in his field, retired physician, Dr. Chan Gunn in 2008.  At the time, I did not know the history of dry needling or the fact that Dr. Gunn had been praised for his work by some and criticized by others, but in my mind, the innovators that stir the pot of the status quo are the ones worth following.  I happened to live and work in Vancouver, the city that Dr. Gunn ran his training center called iSTOP (Institute for the Study & Treatment of Pain) which resulted in Vancouver having the most IMS practitioners than anywhere in the world simply due to the ease of access of training.  It wasn’t research articles validating the effects ...
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/ Blog, Education

Is your head twisted? Cranial Nerves: A missing link for head, face and body pain

Hello from down a rabbit hole!  I have now officially taken ten post-graduate courses in a manual therapy approach to assessing and treating the body called osteopathy.  Specifically, I have focussed on two techniques called visceral and neuromeningeal manipulation (NM).  Visceral manipulation (VM) refers to the use of my hands to treat fascial restrictions around organs that may be causing physical restrictions to blood flow, movement, alignment and posture, while Neuromeningeal manipulation is the act of treating the nerves, membranes and brain itself by means of light touch. I recently just completed a course called NM4 where I learned all about the role of the cranial nerves and how to affect them with my hands to help my clients.  Your cranial nerves extend out of the base of your brain and branch to provide the electrical wiring to your face, eyes, head and organs.  They are kind of important to your daily life, but largely fly under the radar until they get annoyed for one reason or another.  They can be responsible for headaches, eye pain, ringing in the ears and even referred sensitization and irritation into the body due to their connection to numerous organs through the vagus nerve. As a person who has woken up with a headache every day for two years since my eye injury, I found this class fascinating.  My empathy for people with head and face pain is substantial so I tried to learn as much as I could from this class to help my clients and hopefully myself. There are twelve cranial nerves: I- Olfactory-smell II- Optic-vision III- Oculomotor- eye movement IV- Trochlear- eye movement V- Trigeminal- movement & sensation to your face, tongue, nose, ear VI- Abducent- eye movement VII- Facial- facial expressions & taste VIII- Vestibulocochlear- sound & balance IX- ...
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/ Blog, Necks, Pain
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