Blog Archives

How Your Body Actually Works: Explained Like You’re 65

Tennis 2014

Reality is that you are now armed with the wisdom of time, but equipped with an actively degenerating body. You likely now have the time to pay attention to your body, but may have less to work with than you had hoped. Your joints are probably stiffer, your spine has shrunk half an inch and your toes look like a bunch of mashed up, gnarly tree roots. Getting Old Sucks was the title of section one in my book for a reason: our bodies progressively require more and more maintenance over time just to keep them feeling okay. After sixty-five years of abusing your body, you may have resigned yourself to the idea that you can’t change now and that your aches and pains are simply a product of your age. I hope that the next few paragraphs will change your mind.

Thirty years is a long time. If you are sixty-five now, there is a reasonable chance that you will live for three more full decades with a body that is continuing to breakdown over time. Think about how much you have done since you were thirty-five, now visualize what you see yourself doing until you are ninety-five. I promise you that you will enjoy your third lap around more if don’t blame things on your age and instead work at improving things that you didn’t have time for in your second lap. You may not be able to go back and fix your gnarly toes or your rounded shoulders, but you can prevent them from getting worse and likely improve them more than you had ever thought possible. Your enjoyment in life for the next thirty years will most likely be closely correlated with your physical strength, mobility and balance in a way you have not experienced in the past sixty years. Read More

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How Your Body Actually Works: Explained Like You’re 35

Your body is comprised of a series sensory feedback loops that help you interact, engage and react to the world around you; you are aware of some of them, but there is a lot going on under the surface that you likely don’t appreciate.  Your brain is constantly barraged by information from your eyes, ears, skin, muscles, joints, ligaments and organs, and it subconsciously decides which information you should really be paying attention to.  Your subconscious usually makes good decisions, but it is very influenced by emotional factors like stress and anxiety.  Your body is always creating new data for your brain, but your mood and personality will strongly impact what you do or don’t attend to mentally.  Pain is a good example of this phenomenon, but it takes a bit more groundwork to explain why this doesn’t just mean that pain is “all in your head.”

Your ability to experience pain is an important evolutionary trait that helps your brain determine what is or isn’t safe for your body.  You can sense when something is too hot and may risk damaging your skin, when something is too sharp that it may cut you or if an object is putting too much pressure on you that it could injure tissues.  You live in a busy environment that requires you to sense, react and move in response to the forces around you and within you.  Your body will create a homeostatic resting state that becomes what you experience as your ‘normal,’ and you need to be able to sense when things fall outside of that normal so you can take action to help keep yourself healthy.  Pain is one of the signals that something is not normal, just like fever, altered heart rate, pins and needles, blurry vision, or a change in your balance.  Read More

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How Your Body Actually Works: Explained Like You’re 5

tomorrow. five.

Your body is part of who you are; it belongs to you.  You are responsible for it.  Your mother helped you build it, but it’s your job to grow it.  You get to grow your body by moving, seeing, eating, breathing, talking, laughing, touching, smelling, crying, running and jumping.  You get to experience it for about ninety years, that’s almost 33,000 days of doing stuff.  Every time you do something, your body learns.  Every time you try, your body remembers. The more you try, the more you learn.  The more you learn, the more fun your body becomes.  It can learn to run faster, sing better and think deeper when given time and practice.

Play

Some people’s bodies’ will learn faster than others and some people’s bodies’ will be bigger than others.  Some will seem smarter and some will seem stronger, but your body is yours and you are responsible to help it learn.  You can learn from watching, and listening, and reading, but nothing is better than actually doing.  You can learn anything you want, you just have to try and try and try, most of the time you won’t be very good at it, but each time you try your body will get a little bit better because it loves to learn.

Reading

What you do with your body will affect how it feels, inside and out.  On the outside you have skin, a big waterproof suit that keeps all your guts and muscles and nerves on the inside while allowing you to feel everything on the outside.  Skin lets you feel what’s sharp and what’s dull, what’s hot and what’s cold; it is your body’s connection to the world.  When you are young your skin is tight and smooth, but as you get older it gets stretched out and wrinkly. Read More

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Pressing Pause on 7+ healthcare businesses in Vancouver during COVID-19

My name is Brent Stevenson, I am the founder and co-owner of Envision Physiotherapy in Vancouver, Canada.  I, like everyone else in the world right now, am hiding out at home watching society shut down around me while we all try to endure the impacts of a novel virus on an overly connected world.  Some of my friends are front line workers in the hospitals, others are simply working from home on their laptops until further notice, but I am in the complicated position of running a small business that functions as the umbrella for over seven other health related small businesses in Vancouver.  People in Canada don’t naturally think of healthcare and business in the same framework, but most of our allied health services are private businesses with leases and employees to pay.

The business owner in me is worried about our bottom line, the healthcare professional in me just wants to help, the entrepreneur in me twirls with the current strange opportunity of time, and the father in me just wants to protect my family.  It is a strange time, but I am determined to make the most out of it and hopefully help as many people as I can by providing something interesting to read or watch other than COVID-19 related news stories.  I will start with the story of Envision Physiotherapy, but I will transition to Why Things Hurt, mental health, posture and the stories that have filled my days as a physiotherapist for the past twenty years.  My goal is to post a new story or video each day and start an active conversation in the comments below to give readers the opportunity to Ask Me Anything.

The Story of Envision Physiotherapy:

March 1st, 2020 was a big day for Envision Physiotherapy, we had officially acquired Dayan Physiotherapy & Pelvic Floor Clinic and initiated the process of merging the business and its five physiotherapists into our existing clinics.  Read More

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IMS Dry Needling: an expanded explanation of how & why

IMS dry needling is an increasingly popular form of treatment used by physiotherapists in Vancouver, Canada due primarily to the strong influence of local retired physician Dr Chan Gunn. He studied and refined the use of acupuncture needles specifically for treating persistent pain and ran a training and research center in Vancouver over the past thirty years. He engaged physiotherapists that had experience with manual therapy and taught them how to feel and treat inside the muscles instead of just pushing and prodding from the outside. It was a new modality that strayed from traditional acupuncture and pushed physiotherapy outside of its’ customary box. More physiotherapists in Vancouver adopted the new technique than elsewhere due to the local availability of training and the allowance of our regulatory body in British Columbia that permitted physios to puncture the skin.

Early adopters of IMS learned from Dr Gunn in the ‘90s, but relatively more and more have adopted dry needling as a staple of physiotherapy practice in the past ten years. I learned from Dr Gunn in 2008, after being exposed to the technique at Diane Lee’s physiotherapy clinic in 2006. In hindsight I am glad that I had some exposure to the dry needling technique in the hands of physios before I learned it directly from Dr Gunn because it helped me put the model that Dr Gunn was teaching in perspective. His model of intramuscular stimulation (IMS) is very valuable and the underlying principle that I apply when needling, but it is too simplistic and limited in its explanation and application. I wrote this article a few years after taking the IMS course to help explain to clients what I was doing and how IMS was different than acupuncture. If you want a history lesson about acupuncture and to see how many people have different views about needling, please scroll through all the comments at the end of that article. Read More

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

picture grid for empathy article

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 low back pain can become both less useful and less empathetic.  Read More

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My Name is Lance- Remember Me…

st pauls

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 the nurses processed her.  Read More

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Resistant Pain: A 3-Dimensional Moving Puzzle

Supernova Remnant Cassiopeia A (NASA, Chandra, 1/6/09)

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 helped people, but not the way I am able to today. Read More

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IMS Dry Needling: Stories from an Outspoken Physiotherapist

blog pic just Brent with needle from cover

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 of IMS that drew me to iSTOP, it was working in a renowned physiotherapy clinic alongside experienced therapists that were using IMS every day with great results that made me sign up as soon as I met iSTOP’s prerequisites. Read More

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

Cranial Nerves

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- Glossopharyngeal- swallowing, speech, taste

X- Vagus- control heart, lungs & digestion

XI- Accessory- neck muscles

XII- Hypoglossal- tongue muscles

Don’t bother trying to remember them all, but just consider that every movement, sensation and process that happens in your body is somehow connected to your brain and nervous system.  Read More

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