Blog Archives

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

Posted in Blog, Education, Healthcare, Mindfulness Tagged with: , , ,
2 Comments ↓

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

Posted in Blog, Education 3 Comments ↓

My Eye Injury: One Year Later

Double
photo: Andrew Kovalev
Imagine walking down the sidewalk on a nice summer day, enjoying the scenery and the sunshine all around you.  Now imagine taking a visual picture of what you see in front of you and copying it.  Take that copy and paste it diagonally up and to the right so that it overlaps half of the nice beautiful scene you are looking at.  Now take that second copy and strip all the detail out of it and cover it with a thin layer of milky water.  While you are at it, put a big smudge on anything that ends up in the centre of the picture and add distortion to anything that might be a straight line.  I have this milky, distorted, hologram version of the world superimposed over my proper vision now and it sucks.  And that’s not even the worst part, when I walk or drive I get the sense that the shitty hologram world is moving at me faster than the clear real world.  For example, every morning when I walk from my parking spot to my office there are a series of tree shadows across the sidewalk and a set of two manholes that I walk over.  As I approach the shadows and the manholes, I see double of everything, but as I get closer and closer to the real objects, the amount of the displacement of the second blurry pictures gets less and less to the point that they almost become one object as I pass over them.  The fact that my double vision gets worse the further an object is away creates the illusion that the world on the right of me is coming at me twice as fast as the world on the left of me even though they are actually distorted pictures of the same thing. 
Read More
Posted in Blog, Case Studies, Education, Pain Tagged with: ,
No Comments ↓

How sports affect your body throughout life

Untitled
photo: jeff_whiteside
“We are what we repeatedly do.  Excellence, then, is not an act, but a habit.” -Aristole

Sports become a part of who you are, both mentally and physically.  For children, sports become a means of socialization, but they also play a prominent factor in the development of movement.  For adults, sports become a means of fitness, stress relief, competition and commonly injury.  No matter where you find yourself on the spectrum of young to old, or novice to professional, sports have likely impacted your body in some way.  Appreciating how and to what extent may help you address chronic problems, prevent future ones and likely maximize your performance.

Each sport comes with its own particular set of movement patterns required of its’ athletes.  Dancers have chest up, shoulders down, butt clenched, toes out drilled into them.  Tennis players and golfers spend hours twisting one way and not the other.  Bikers ride hundreds of kilometers with their bodies tucked into a tight aerodynamic position with their head poking up, and runners get used to just going straight forward all the time.  How much these movement experiences will affect you really depends on what stage of your life you do them, how much you do them, and if you also have a variety of other sports you do, or have chosen to specialize and commit to the performance of just one.

Early movement experiences will really mold a child’s posture and coordination later in life, which is why I encourage physical play with my kids.  Activities like chase, wrestling, rolling, jumping, throwing and catching really help kids build an awareness of how to use their bodies.  They get some bumps and bruises along the way, but it helps them learn that pain is temporary and that their bodies are really amazing at healing themselves if they give them a chance.  As a physiotherapist, I can quickly tell the difference between adults that have a physical, athletic history and ones that have lead a fairly sedentary lifestyle, both in their body awareness and their outlook on their current pain or dysfunction.  Past athletes tend to have a more optimistic and in-control attitude about their rehabilitation because they have relationships with their bodies due to past experience.  Conversely, adults that haven’t competed in sports in their youth tend to be much less assertive in their healing and much more dependent on health professionals because they are less in tune with their bodies.

Read More
Posted in Blog, Education, Fitness, Sports Tagged with: ,
No Comments ↓

Your Invincible Years are Over: how to stay strong, fit and pain free as you age

Old Superman #famousoldies

I used to beat the hell out of my body when I was in high school.  I played soccer, basketball, rugby and a variety of other sports on almost a daily basis.  I would bang and crash and hurt myself, but it never really slowed me down because I just took it for granted that within a few days or a few weeks my body would heal up and be ready for more.  In University I tested my body with little sleep, more sports and a lot more alcohol, but I still always bounced back and kept going.  Around my mid-twenties to early thirties a few things happened that started changing my perspective on life.

By the age of twenty four, I had completed two university degrees and was officially a registered physiotherapist.  I’d like to think I was a lot smarter after six years of university, but I learned much more in the following six to ten years than I ever did in school.  It was a time when my body seemed to start getting less and less invincible and I started gaining more and more perspective on the importance of physical health.  I still played soccer, hockey and squash, but my body started taking longer and longer to recover; things that used to take days to feel better, starting taking weeks and I was forced to consider the physical consequences of my activity choices more than ever.

As a physiotherapist, working with clients from nine to ninety years old, I started recognizing that I was not alone in the weakening of my invincibility around age thirty.  I would hear an average of ten ‘getting old sucks’ complaints a week, equally spread amongst the thirty, forty and fifty year-olds.  The sixty and seventy year-olds tended to phrase it more around ‘this old body is falling apart,’ and the eighty to ninety year-olds just seemed to be happy if something actually didn’t hurt.  Read More

Posted in Blog, Education, Fitness, Healthcare Tagged with: , , , , , , ,
No Comments ↓

Getting Old Sucks: the march towards stenosis

Old
photo: susafri
My favourite part of being a physiotherapist is the perspective I gain by working with a broad array of people: young people, old people, active people, sedentary people, successful people and those just starting out.  I find it fascinating to try and see the world through these people’s eyes as I get little glimpses into their lives during our thirty minute appointments each week.  The relationships people have with their own bodies are a very curious thing to me.

Some people literally behave like their bodies are simply vehicles to walk their heads around; they have little to no awareness of how or what they are doing physically and are blinded by cognitive factors like stress and anxiety.  Others treat their body like a temple and seek help when they detect even the slightest change from their normal, homeostatic state.  Many people’s relationships with their bodies are a product of to their early childhood sports combined with their recent fitness endeavors.  Your early sport and movement experiences are responsible for molding your general postures while your more recent fitness endeavors will create the lens that you see your physical self through.

Some people choose personal trainers, others choose Yoga classes and some are determined to work out at home with programs like Foundation, or P90X.  Your choice of activity will affect your perception of what physical health means to you.  You may get focused on strength or flexibility or endurance or speed.  I see many people in my practice that were active teenagers, but are now in their early 40s with two kids and are trying to rediscover their bodies; unfortunately many people get hurt during this phase because their bodies are 10-20 years older than they physically remember and their choice of activity was based more on familiarity than need.

Read More
Posted in Blog, Education, Healthcare, Posture Tagged with: , , , ,
2 Comments ↓

Movement: Your body is the car and you are the driver

2010

Imagine handing the keys of a finely tuned, bright red Porsche 911 to a 16 year old boy, first time driver and saying have fun!  Now imagine telling him 15 years later, after he has been in a few accidents, scratched the paint and  destroyed the clutch that he should have driven more carefully because this is the only car he will ever own for the rest of his life, that he will now have to go for regular tune ups and will probably have to get an artificial clutch and a titanium tire sometime in the next 30 years.  Oh yeah and your shocks will get worse and worse every year.  I hope you had enough fun driving in the first 15 years to make the next 40 years worthwhile!  Sorry I didn’t teach you to drive better!

We watch our kids struggle to reach the gas pedal for years then blindly let them grind the gears of their own bodies through their adolescence.  We put them into sports in key developmental years that unknowingly teach them how to move a particular way and may mold their posture for the rest of their lives.  We tell them to stand up straight with little context of what that means and we start binding their feet with stiff little shoes before they can even walk.

Children are resilient, moldable little sponges that should be given some direction and opportunity to become good drivers in their own bodies.  The trouble is that most parents aren’t particularly good drivers and their kids think that they are invincible until they reach their mid twenties.

Babies can move, but very little of it is intentional.  Most of their movement is created by a series of reflexes that move an entire limb as one unit.  The back extensor muscles develop before the abdominals as the baby figures out how to lift its head up and arch its back. Read More

Posted in Blog, Education, New Moms, Posture Tagged with: , , , , , , , , ,
No Comments ↓

Mind over matter: The power of perception

I am a physical therapist by training, but have become a psychologist by experience.  Working with people from 9 to 90 years old and from the peak of athletic performance to the lows of neural rehab, I have come to see pain, emotion, attitude and perception in a new light.  I have seen 250 pound rugby players squirm at the thought of a needle and polite 70 year old English ladies drop F-bombs while I loosen their hip.  I have seen confident CEOs get lost in pain and happy go lucky blue collar workers shift into deep depressions after car accidents and battles with insurance companies.  Chronic pain can have many sources and only some of them are physical; unfortunately it is usually only the physical issues that get addressed and the people that could use some help cognitively are the least likely ones to pursue that type of care. 

This website is geared toward helping you with the physical side of pain, posture, prevention and performance, but to get the most out of it you will need to be mentally open to change in your body.  I have created a page on the right side bar called Books to Read that recommends books that I have found particularly helpful.  Here they are again for you:

The following are books that I have read and found very useful in my life.  To understand your body and your pain you first need to understand yourself and make sense of your life; this is a missing element in many people that suffer from chronic pain.  Most people are open to seeking physical therapy for their pain issues, but much more reluctant to seek any cognitive therapy.  I recommend the following books to help you:

  • Understand why you think the way you think
  • The basics of how your brain works
  • The roots of your relationship with your family
  • The role of work in your life
  • The role of money in your life
  • What motivates you
  • How pain can affect you
  • How to get the most out of life without sacrificing a piece of yourself

Mindsight: The New Science of Personal Transformationstyle=border:none

  • A fascinating book written for the lay person about how your brain works as it relates to your personality, your relationships and your pain.  Highly recommend it.  Click on the picture to learn more about it.
Read More
Posted in Blog, Brent on Business, Education, Pain Tagged with: , , , , , , , , , ,
No Comments ↓

Six Degrees of Movement: Life as a workout

Please review each level below then read the explanation that follows.

 

 

 

 

 


 

Level 1: Personal Control

  • Emotion/Attitude
  • Awareness
  • Persistence
  • Pain

Level 2: Gravity

  • Standing
  • Sitting
  • Breathing
  • Moving

Level 3: Mobility

  • Bending
  • Lifting
  • Walking
  • Climbing stairs

Level 4: Function & Prevention

  • Carrying
  • Running
  • Jumping
  • Twisting

Level 5: Athleticism

  • Pushing/Pulling
  • Cutting/Pivoting
  • Accelerating
  • Decelerating

Level 6: Pushing Physical Limits

  • Cardio Training
  • Weight Training
  • Motherhood
  • Sports

The Six Degrees of Movement Framework is a categorization of day to day movement challenges that people face throughout life.  The first two categories are the most important as well as the most mentally challenging.  You learn how to move at a very young age when you can, and do, take everything in life for granted.  Who you are, both physically and emotionally, develops before you are old enough to have any control over it.  Your parents play a big role and so does gravity.  As you get older, you progressively take back most of your emotional/personal control from your parents, but unfortunately most people don’t learn to take back their movement control from gravity.  Just because you can sit, stand, walk and breathe doesn’t mean you are doing any of it correctly.  Movement and posture are skills that some people learn well and others do not; those who do not, tend to suffer from far more pain and health concerns throughout life than those who move well.

The six levels are not a linear progression of how we learn to move as humans; instead, they are a categorization of the complexities of each movement skill.  Day to day life provides us with ample opportunity to be strong, mobile creatures, but poor Level 1 skills tend to make people move very inefficiently and in an inherently lazy way.  There is nothing more persistent on Earth than gravity so one of the best things you can do for yourself physically is to learn how to be persistently aware of how it affects your day to day life.  Read More

Posted in Blog, Education, Fitness, Posture Tagged with: , , , ,
No Comments ↓

Follow Me!

Instagram125
Facebook1k
Facebook
YouTube406
YouTube
RSS

Subscribe to the Movement School

Update Me! Get notified when Brent writes a new post

*No Junk! I promise! Boo Junk!