Blog Archives

My Eye Injury: A physical and emotional battle

This article is a detailed account of the past 90 days of my life.  A big part of me wants to forget everything that happened to me over the past three months, but something inside of me wants to tell the story.  I warn you, that every time I go into detail about what I actually went through, people squirm and shy away, so this is my forum to get it all out.  It was the darkest, lowest part of my life to date and I am still only just collecting myself to re-establish some normalcy for my family and business.  I returned to work just a few weeks ago, under three weeks after my fourth eye surgery in two months after I was struck in the right eye with a hard orange floor hockey ball on August 19th, 2014.

My wife and three children were away at our family cabin.  I had returned to work for the week after an amazing almost 3 week holiday, but I only made it to Tuesday before my world changed.  Earlier in the summer a client had told me about a regular pick up floor hockey game at a nearby community centre.  I went a few times before my vacation, but I was the new guy amongst a group that had been playing together for a while.  The only guy I somewhat knew was my client who had told me about the game.

The game was social, but competitive.  Every guy had a different level of protective gear, but most did not have any form of eye protection.  I happened to have my squash goggles with me, but forget them in the car because I was running late.  I had never worn eye protection playing floor hockey before, but was definitely considering it with this group; unfortunately I never got the chance.  I decided to jump right into the game and was having a great time.  I scored five goals in the first two games before it happened.  I ended up in the corner just off to the side of net.  I turned back to follow the ball when I saw a split second of an orange ball flying right at my face. Read More

Posted in Blog, Case Studies, Healthcare, Miscellaneous, Pain Tagged with: , , , , , , , ,
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Beth’s Story: an ex-runner turned mother rediscovers her body

pep talk from Mom...

Beth (as we will call her) was an energetic nurse in her mid-thirties with two young boys to chase around.  She was an elite runner in her early twenties, but these days walking a few blocks was a painful chore and picking up her kids was nearly impossible.  Pregnancy had done a number on Beth…twice.  She had endured the slow nine months of body changes.  She had powered through the labours and deliveries and ended up with two lovely little boys to watch grow and thrive, but her body as a result decided to stop cooperating with her desired lifestyle.  She went from competitive running, to running a few times a week with discomfort, to just chasing her kids around in pain, to simply walking being a painful task in a period of just a few years.

When Beth first walked into my office she had “tried physio, massage, chiro, core training, prolotherapy and IMS” for her back problems with mixed success.  IMS (intramuscular stimulation) had provided her with the most relief, but she still sat in front of me with a dysfunctional body so she obviously needed something more or different to help her get her body back.  Her goals were simple: walk without pain, play with her toddlers and generally live an active lifestyle.  I had to push her to include running on that list because she had resigned herself to the idea that she would never run again at the age of 37.

To look at her, Beth was a thin, lean looking runner with a big smile on her face and a positive attitude, even though her body had crapped out on her.  She appeared to have all the pieces, so why was she still having so much trouble?  Therapists had massaged her, needled her, stretched her, cracked her and strengthened her but she still couldn’t even walk without significant discomfort in her back.  Read More

Posted in Blog, Case Studies, Low Backs, New Moms Tagged with: , , , , , , ,
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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

Posted in Blog, Education, Fitness, Healthcare Tagged with: , , , , , , ,
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Allied Healthcare: your options outside of the medical model

Physiotherapist
photo: Beta Klinik
The medical model is one that most people are familiar with.  You get hurt or sick and you go check in with your family doctor, walk in clinic or even hospital to see what a doctor thinks about what you have done.  When it comes to illness and major trauma a physician is definitely the one you want looking after you, but when it comes to pain, injury and preventive health, both physical and cognitive, doctors are not your best choice.  The fact that you even have a choice comes as a surprise to many people; most are under the assumption that their doctors know best.  If you live in a moderate sized city, the chances are you have a choice of a variety of allied health workers that have exceedingly more specialized training in physical health and rehabilitation than any doctor you will visit.

The following post is a brief summary of some of your healthcare choices and the treatment options they can provide that don’t involve medications or surgeries (scroll down to read details about each bullet).

–    Physiotherapist
–    Massage Therapist
–    Chiropractor
–    Naturopath
–    Osteopath
–    Kinesiologist/Personal Trainer
–    Yoga/Pilates instructors
–    Counselor/psychologist
–    Occupational Therapist
–    Traditional Chinese Medicine/Acupuncturist

Full disclosure: if you were not already aware, I am a physiotherapist and am moderately biased towards my own profession, but I do work closely and share clients with almost all of the different disciplines listed above.

Physiotherapy aka Physical Therapy

Physiotherapists (in Canada) are considered primary care givers, which means you don’t require a doctor’s referral to see them.  They now have a minimum of 6 years of university education and typically extensive post graduate training in various specialties.  Physiotherapy is a profession with a broad scope of practice which allows its’ therapists to take the best techniques from many other healthcare disciplines and make them their own. 

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Posted in Blog, Healthcare Tagged with: , , , , , , , , , , , ,
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Diagnostic Tests: a static snapshot in time of a moving being

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X-Rays, CT scans and MRIs are useful tools when your doctor is trying to determine what is physically damaged or degenerated inside your body.  They can give you tangible evidence of something physical that you can blame your pain on, but they often detract from the process of trying to determine why that structure is damaged.  A significant finding on a diagnostic test can tend to stop the clinician’s critical thinking process required to push past what is injured and instead figure out why it got injured.  This concept is particularly relevant in chronic pain issues that don’t stem from a traumatic accident, but is also important in cases that started with a trauma, but the person didn’t heal or improve along the expected time line.

An over reliance on hands off diagnostic tests is a fundamental reason why the medical model doesn’t deal very well with people with persistent pain issues and why experienced manual therapists like physios and osteopaths simply speak a different language than doctors.  Doctors will look at the pictures of inside of you, or commonly just read the report that another doctor wrote about the pictures of inside of you and then tell you what they believe to be wrong.  A good manual therapist will feel, watch and experience your movements with you to try and understand the movie that is happening in your body instead of the pictures of the aftermath.  A significant finding on an MRI or EMG study can be a red herring and distract you from what the underlying problem really is.

A healthy body is one that has good physiological movement in the joints, muscles, nerves and organs.  Tests that don’t assess the body in vertical or during functional movements shouldn’t be relied on too heavily to conclude what is or isn’t wrong with a person. 

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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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Posted in Blog, Education, Healthcare, Posture Tagged with: , , , ,
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Case Study #1: How a 34-year-old physiotherapist overcame his foot, back, hip & knee issues

I get asked by my clients all the time: ‘what made you want to be a physio?’ So I figured I would make myself Case Study #1 in a series that I am writing to help you relate to pain, injury and rehabilitation in a realistic and practical way.  My short answer to clients is usually ‘I’ve been an active athlete my whole life and have always been very good at hurting myself so I spent my fair share of time in physio.  I was quite familiar with it and always had a fascination with the human body so it was a natural progression for me after my Human Kinetics degree to go into Physiotherapy.

This article will summarize the lessons I have learned from both hurting myself repeatedly and working with people in pain every day.  I will outline the path I took to overcome some chronic issues that are very common to people of all ages and the things I try to teach to both my parents and my kids.

Brief Background …

I tend to refer to your teens and twenties as your invincible years.  You can punish your body without experiencing that much consequence because the pain, stiffness and soreness doesn’t last long enough to deter you from doing the activity again, or to change your behaviour significantly.  I was a long, lanky kid that played a lot of soccer, rugby, baseball, track & field, water-skiing, wake-boarding, basketball and volleyball.  I sprained ankles, broke my wrist, and dislocated my shoulder many times, but I kept on going.  Now at 34, after being a physiotherapist for ten years, starting a business and having three kids in three years, I have come to realize that I am the cumulative product of everything I have done up to this point and that I better take care of my body because it’s the only one I’ve got for the next 60 years (Click here for related article). Read More

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Plantar Fasciitis: an illustrated explanation of why your foot hurts

171/365:
photo: who am i today

Plantar fasciitis is a very common form of foot pain and one that I find really interesting because it manifests in both really active runners and relatively sedentary people.  How can a person that is training for their third marathon develop the same pain as someone that doesn’t exercise much more than walking from their desk to their car?  You can’t purely blame it on over or under-use if the desk jockey and the super athlete are getting the same thing.  So what is causing the bottom of people’s feet to hurt so much and for so long?

The short answer: (a combination of the following factors)

  1. The shoes you wear all day (not just while running)
  2. Your posture & movement patterns (how you sit, stand, walk and breathe all day)
  3. A nerve irritation in your low back
  4. Weakness in your feet and tightness in your calves
  5. Fascial restrictions in your visceral system affecting the blood and nerve flow to your feet

The long answer:
It is typically a series of on-going events that leads to you developing that burning, pulling, aching pain on the bottom of your foot.  You may have one or all five of the above issues.  If your pain has lasted a long time, it is worth exploring all of them.  Read on for details…

1. The shoes you wear all day…

It is hard to talk about foot pain and not mention shoes.  I have written a number of articles on this blog already about feet.  If you are convinced that your shoes are the culprit please read these articles too:

All too often, plantar fasciitis gets blamed on a ‘lack of support’ and this bothers me. 

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Posted in Blog, Feet, Pain, Shoes Tagged with: , , , , , , ,
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IT Band and Patellofemoral Syndrome: how did your knee pain turn into a ‘syndrome’?

Jogging
photo: Ed Yourdon

Over the years, the medical community has created a need to give everything that can go wrong in your body a name; e.g. lateral epicondylitis (‘tennis elbow’),  patellar tendonitis (‘jumpers knee’).  A lot of the pain related conditions were defaulted to something ending in ‘itis’ implying an inflammation of a particular tendon or bursa, but these diagnoses only really apply to people in the acute phase of pain or injury.  Quite often people continue to experience pain or dysfunction for months in the complete absence of swelling or inflammation.  Labeling a five month old elbow or knee problem a tendonitis is just not accurate or helpful to the person in pain.  The solution became to call them a tendonosis which acknowledges the tendon is not actively inflamed, but there is ‘disorder in the tendon.’

People tend to seek a diagnosis, but what they are really after is an explanation of why.  When it comes to persistent pain, a diagnosis just gives you something to tell your family or employer ‘what you have,’ but typically does very little to help you get rid of it and can even hinder your progress.  Most persistent pains in your body develop from a combination of mechanical, cognitive and emotional reasons and where it actually hurts is just the symptom at the end of a chain of events.  Unfortunately most doctors’ knowledge level on musculoskeletal pain is limited to the area where it hurts and not the chain of events that made it hurt.

I try my best to not tell you ‘what you have’, but instead explain to you ‘what is going on.’  It is usually way more information than you were anticipating, but makes all the difference when it comes time to convince you that you may have to change some of your habits. 

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Posted in Blog, Feet, Hips, Knees, Pain Tagged with: , , , , , , ,
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Mindfulness: The skill of living in the present

Below is a great talk on the topic of mindfulness, or the ability to step back from your emotions and look at your thoughts and feelings in a more objective way.  The way we perceive the world is hugely affected by our past experiences and future expectations as is our perception of pain and sensation in our bodies.  Developing the skill of mindfulness is commonly the path out of chronic pain for many people.

Watch this 10 minute video below for an introduction to the concept.

See below the video for a link to a great book on the topic that dives deeper into the idea and the science behind it.

Mindsight: The new science of personal transformation

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Click Picture for details
Please feel free to leave questions or comments in the space below and I’d be happy to try my best to answer them.

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