Blog Archives

How Cannabis Can Help with Your Pain, Stress & Anxiety

cannabis dosage

I have been wanting to write an article about cannabis for a while now but didn’t know exactly how I wanted to present my opinion on the topic.  I am a physiotherapist in Vancouver, Canada, a place that has long embraced the use of cannabis, but up until recently it carried the stigma of technically being illegal.  I say technically because we have had weed shops on every other corner for years in this city that law enforcement had chosen to let function in a grey area due to public opinion.  On October 17, 2018 the federal government of Canada officially made marijuana legal and countless companies have been jockeying for position at all levels of the industry.

As a physiotherapist, that works with many people with resistant and chronic pain problems, I have definitely noticed an increase in people’s openness to talking about their use of cannabis or their new interest in trying it as an option for their pain.  Healthcare professionals have always had to walk a fine line in their discussions about marijuana with patients both due to legal implications and the lack of strong research on the topic.  My goal with this article is to help decrease the residual stigma of cannabis by talking about its effects on pain, stress and anxiety from my perspective and to introduce a leading physician in the cannabis space named Dr Caroline MacCallum .

Pain can simply overwhelm people. It can be sharp and acute or dull, aching and chronic.  It is not a tangible, physical thing, but more of a perception, or an experience.  It is hard to explain this concept to someone in pain and not have them think that you are calling them crazy and suggesting that it is ‘all in their head.’  We are programmed to think that pain is related to a physical structure in our body being damaged, and if we can somehow fix that structure all of our problems will just go away, but unfortunately that is not the case.  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

Posted in Blog, Education, Mindfulness Tagged with: , , ,
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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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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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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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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. 
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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.

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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

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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.

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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

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