Blog Archives

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 5 Comments ↓

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

Posted in Blog, Necks, Pain 1 Comment ↓

A step by step guide to addressing your pain and creating long term change in your body

Step by step against the sky

Pain can come in many forms and for a variety of reasons, but most of the time there is something that you can and should do about it other than take medications.  Suffering from chronic pain can be a defeating place to find yourself, but if you become part of the solution by assertively educating yourself, seeking the right help and being open to change, you can usually win the battle.  This post outlines the steps I recommend you follow to take control of your health both physically and mentally and get the help you need.

Step 1: Don’t Panic
Step 2: Learn
Step 3: Network & Ask for Help
Step 4: Treatment
Step 5: Maintenance & Prevention

Step 1: Don’t Panic

It is really hard to think logically and objectively when you have been in pain for an extended period of time.  Irrational fears can cloud your judgement and Googling your symptoms can create fear and confusion.  Try to become mindful of the fact that you may be getting pulled down a rabbit hole of misleading information and mind fogging medications.  As best you can, try to zoom out from the pain and try to look at yourself in the context of where you are and where you want to be.  Create a physical and mental goal to anchor your purpose and then start learning what it will take to get you there.

You are the only person that has to live with your pain on a moment to moment basis and you are the only person that has the control to change it.  You will likely have to change some of your behaviors, step outside of your comfort zone and ask for help from people you don’t know.  It is journey that may take longer than you expect and won’t be a linear path, but is something you need to assertively embark on to control your future.  Read More

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Stomach Pain: A mechanical explanation & a pill-free treatment

day two hundred and one.
Back pain is the number one complaint that brings people into my office for physiotherapy treatment, but rarely do people have just one issue.  Many times people have a handful of symptoms, but either don’t think they are related, or don’t think it is necessary to mention it to their physiotherapist.  Most people see stomach pain as an issue for their doctor and/or something they just have to live with, but in my experience doctors just prescribe symptom treating pills that don’t get at the crux of the problem.  Stomach pain very much can be an acid balance problem, but it also can very commonly be a mechanical issue related to your mid back and the physical mobility of your stomach.

After learning the osteopathic approach of visceral manipulation, I started considering the physical toll people’s organs can have on their alignment and their pain.  I started noticing and feeling the tension in people’s abdomens and ribcages in a different way because I had a better understanding of how the anatomy is attached to the inside of their ribcage and spine.  More often than not, a client would come to see me complaining of mid to lower back pain, but I started asking “are you having any stomach problems,” because I started to pick up on a particular pattern of restriction in their mid-back and upper stomach.  Enough clients started saying “how did you know?” that I started sensing that I was on to something.

Your stomach is a muscular bag that sits in the upper left quadrant of your abdomen and is squished up against your liver and under your diaphragm.  To do its job properly it needs to be able to muscularly churn your food which requires mobility relative to its neighboring organs and surrounding structure.  The mobility in the upper abdomen can and does get affected by the nerves that originate from your lower thoracic spine or mid back area.  Read More

Posted in Blog, Case Studies, Mid Backs Tagged with: , , , , , , , ,
4 Comments ↓

My Book is Almost Here!!

I am excited to announce that my goal of writing and publishing a BOOK is becoming a reality this year!

Over the past five years I have written numerous articles and created over fifty videos as resources for my clients and the general public to help give them a context for how their bodies work.  Until recently I have kept those videos in the members section of this site and held off promoting anything about WhyThingsHurt.com because I wanted to focus on quality content.

In the past year I haven’t posted much new content to this site because I have been working hard to organize and expand the information into a book to help my followers learn things in a more appropriate order.  I have used client and personal stories to tie together relevant information about how your body and mind function and ultimately to explain Why Things Hurt.

My new book will be titled:

Why Things Hurt: Life lessons from an injury prone physical therapist

(available Spring/Summer 2016)
In the lead up to my book launch, I will be completely redesigning the structure and function of this website.  I will be eliminating the members section and have already loaded all of the videos onto my YouTube Channel.  I am working on creating a variety of playlists to help provide direction of what order to watch the videos and to do the exercise progressions.  The new site (March/April) will have the YouTube videos integrated into the written blog posts and a gallery of playlists specific to different issues.

Reading my book will make the new website infinitely more useful because you will develop a big picture understanding of how your body and mind work and then can use this site to help you work on the specifics that are important to you.

Read More
Posted in Blog, Brent on Business Tagged with:
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My meeting with the College of Physiotherapists of BC

Last night from 5:30-9pm with Dieter and Yvette by my side, we met with Brenda, Phil and Heather from the College to discuss the issues surrounding the RCA exam.  We created objectives, wrote them down then talked our way through all of them until we agreed it was time to go home. 

Phil ran the flow of the meeting and I voiced our concerns throughout the process in an open and constructive manner.  Phil’s focus was on establishing the history of how we got to where we are today with the Quality Assurance Program (QAP) and my focus was on helping him understand how I/we didn’t like where we are today and why.  I better understand their position from the process, but in no way was convinced or swayed that the Registrant Competency Assessment (RCA) portion of the QAP as it stands today is a good idea.  I believe that they heard my arguments against the RCA and although they didn’t concede that there is a better option, I think I created some openness in their position, which is a good start.

Brenda said very little, but listened and took notes as Phil and I debated the details of the QAP point by point.  He had Heather write out on the board the aspects that were required of the QAP taken from this document on their website.  Please take a moment to open this pdf file and scroll to page 4, there are fourteen points that they feel are very important to the development of the QAP.  I actively challenged them that they currently weren’t achieving the first six points in their current iteration of the QAP with the RCA in it. Read More

Posted in Blog, Brent on Business Tagged with: ,
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BC Physiotherapists RCA Updates

I have created this page in preparation for my meeting with Brenda Hudson (Registrar), Phil Sweeney (Chair of Board), and Heather Leslie (Vice Chair of Board) of the College of Physical Therapists of BC on January 27, 2016.  We will be discussing the Registrant Competence Assessment (RCA) exam that all physiotherapists in BC are currently required to write.

For background on this on going matter please read my November 2015 post titled BC Physiotherapists Rally Together to Have a Voice

Since writing the above post I have learned a lot about the history of this exam and have had phone calls, emails and in person thank yous from all over the province for speaking up.  Apparently I am not alone in my feelings about the principle of this test just being way off the mark.  We have tried to challenge it from its inception but the College has marched forward despite our concerns.

The PABC has spent a lot of hours over the years trying to help resolve this issue to no avail so the challenge falls on our shoulders if we want to challenge what the College thinks is a good idea.  My challenge is to create a platform that will reach all 3000 physios in the province because the PABC is protective of its email list and I’m guessing the College will be the same.

My original post had a much further reach than I expected, but this time I am shooting for ALL of you (3000+).  Together with the small advisory team I have built, we will be emailing out a short questionnaire to get a sense of everybody’s stance on this subject and depending on the outcome of our January 27th meeting a petition to change the RCA exam to something more appropriate.

If you are a registered physiotherapist in BC, PLEASE sign up for the email list below so I can build the platform for us all to talk about this and have a powerful voice in dealing with the College.  Read More

Posted in Blog, Brent on Business Tagged with: ,
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BC Physiotherapists Rally Together to Have a Voice

Head in Hands

UPDATE 2018: It Happened AGAIN!

After all I/we went through to voice our concern about the RCA exam in 2015, they stuck to their guns and made a new group of BC physios write the exam three years later with the same result of technology failure causing the whole thing to be canceled.  I received countless emails, phone calls and even hand written letters from all over the province thanking me for trying to stand up for us in 2015 and now it is starting all over again.  Physios are mad about the inconvenience, but still madder at the underlying principle that this test is not a valid or appropriate measure of our competency.  I hope the College of Physiotherapists of BC starts taking the feedback of its members more seriously…lets see what happens!

Original Article Below

I am writing this article tonight because I am mad, I am offended and I  want to help create change and I know that I am not alone.  I have been a physiotherapist in British Columbia for twelve years, a path that required me to attain two university degrees and pass a written and practical certification exam.  I have taken over twenty five post-graduate courses, run a private clinic and work closely with countless other healthcare professionals and was just recently required to write a three hour exam to prove my ‘competency’ as part of our college’s Quality Assurance Program.

Physiotherapy is a regulated profession in British Columbia, meaning that we have a regulatory body called the College of Physical Therapists of BC (CPTBC) that creates standards and provides licenses for therapists to work as certified health care professionals in the province.  Apparently in 2007 the BC government passed a law called the Health Professions Amendment Act that requires regulatory bodies to monitor our ‘continuing competency’ defined as: the ongoing ability of a practitioner to integrate and apply the knowledge, skills, judgments and interpersonal attributes required to practice safely and ethically in a designated role and setting. 

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Posted in Blog, Brent on Business Tagged with: , , ,
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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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Posted in Blog, Case Studies, Education, Pain Tagged with: ,
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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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Posted in Blog, Education, Fitness, Sports Tagged with: ,
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