Blog Archives

Intramuscular Stimulation (IMS): Your case studies & testimonials

The University of British Columbia has recently taken over Dr. Chan Gunn’s body of work researching the effects of Intramuscular Stimulation or IMS.  As a clinician that has been using it since 2008, I have no doubt of its efficacy, but the medical community has been slow to acknowledge it because of studies showing that acupuncture yields no benefit.  I find it unfortunate that the two forms of treatment get lumped together because they are fundamentally different treatment modalities.
 
I am not a researcher, but I am confident the research will eventually catch up to the clinical practice regarding IMS.  What I can help with, is to help gather case studies of peoples’ experience with IMS and give patients some information to go to their doctor with to help educate the medical community.

If you have had IMS as a treatment by your physiotherapist and care to share your experience (positive or negative) please share your story in the comments below in the following format:

A brief history of you and your pain:
e.g. I am a 46 year old runner with a 6 month history of knee pain when I run…

A brief history of what you may have tried prior to IMS:
e.g. “normal physio” with electrical machines, chiropractor, massage therapy, acupuncture, ice, heat

Who you saw for IMS and what your doctor’s thoughts were (if applicable):
Feel free to give your physio a plug or simply share how you heard about it

Your experience with IMS (short term and long term)
You may have found it uncomfortable, but felt looser afterward.  Totally open ended….tell us what happened for better or worse.

Click here to read my article explaining how IMS works and how it is different than acupuncture

Please leave your case study and/or testimonials below.  I will be providing a variety of interesting case studies involving IMS in the coming months.

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Posted in Blog, Case Studies, Healthcare Tagged with: , , , , ,
2 Comments ↓

Why Shoulders Hurt

01.12.2011O
Your shoulder is brilliantly designed to allow your arm to reach, grab, throw, push, pull, etc., etc., etc., but I’m sure if you have experienced shoulder pain in your lifetime you might argue that there are some flaws in the blueprints.  I have seen shoulder pain bring some of the toughest guys to their knees and frozen shoulders put women’s lives on hold for 1-2 years.  I personally, have dislocated my shoulder multiple times and eventually had surgery on it in 2001.  My shoulders and I are not friends, but I have learned how to keep my enemies close and under control.

Knowing what I know about biomechanics and anatomy, I would still have to support the idea that the shoulder is extraordinarily designed, but I would make the case that it should come with a detailed instruction manual of how to actually use it properly.  Your shoulder is a complex ball-in-socket joint that’s function is intimately tied to the posture and alignment of your ribcage and thoracic spine.  ‘Normal’ movement in your shoulder requires the ball to spin in the socket, the shoulder blade to slide over your ribcage and your torso to remain in a relatively stable position; a problem in any or all of these factors will lead to dysfunction and eventually pain in your shoulder.

It is not hard to determine what structure in your shoulder may be damaged and hurting, but it can be harder to understand why you damaged anything in the first place.  Sometimes why is easy.  You may have tried tackling a two hundred pound Kiwi rugby player determined to run through you and your shoulder lost the battle like mine did, but most of the time ‘why’ is more complex than you would like.  Shoulder pain usually involves a combination of factors that over time lead to the insidious onset of pain.

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Posted in Blog, Pain, Shoulders Tagged with: , , , , , , , , ,
5 Comments ↓

Why Backs Hurt

Waking up with back pain

If you have ever had your back ‘go out’ on you, you will appreciate the following post and may just learn something about how to fix your nagging back issue.  Back pain can take many forms and is hands down the most common issue that brings people in to physiotherapy.

“It hurts when I bend over to brush my teeth”
“I can only sit for 10 minutes before I have to move”
“Walking triggers a pain deep in my butt”
“I bent forward and couldn’t get back up”

It happens to the best of us.  I have seen lazy, overweight people with back pain; insanely fit personal trainers with back pain, elite athletes, new moms, desk jockeys and I have personally suffered from it on occasion.  You can have the strongest core in the world and still be susceptible to hurting yourself or experiencing pain in or around your back.  In this article I have outlined the most important factors as to WHY backs hurt because back pain requires an explanation of what is going wrong as opposed to a diagnosis of a condition.  You can also watch the video Why Low Backs Hurt.

Step 1 to Understanding:

Things happen for a reason.  You don’t just catch back pain like you can catch a cold.  It usually is related to something that you have done or are continuing to do poorly, like stand, sit, walk, breathe, bend or lift.  An accident or acute injury can set pain into motion, but how you deal with the injury, pain and mobility after the fact is the important part.  You are a product of everything you have done or been through up to this point and if that product has left you with chronic back pain then something has to change.  You may need someone to loosen something for you, you may need to learn to move more efficiently, you may need to lose weight, or may even need surgery. 

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Posted in Blog, Low Backs, Mid Backs, Pain Tagged with: , , , , , , ,
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Dealing with Injuries as an Aging Tennis Player

Tennis
I treat a lot of the top Seniors level (35+) tennis players in British Columbia, many of whom compete in the national and world championships every year.  These are not professional athletes, but very active adults with full time jobs that work hard and play harder.  The combination of work + age + sport inevitably results in aches, pains and unfortunately injuries.

The top five things that tend to bring tennis players into the physio for servicing are:

1.  Tennis Elbow
2.  Rotator Cuff Impingement
3.  Knee Pain
4.  Torn Calf/Achilles
5.  Low Back Pain

Below I will briefly touch on some of the principles you should follow in dealing with these injuries as they relate to tennis, age and work.

Tennis Elbow

Lateral elbow pain does not necessarily follow the “if it hurts, ice it” rule.  Nine times out of ten the root cause of lateral elbow pain stems from your neck and the back of your shoulder.  It is usually an irritation of your C6 nerve root in your neck and the radial nerve in your arm…that being said, if your elbow is hot, red and swollen, go ahead and ice it, but don’t expect just ice and rest to fix the problem.  Hands down the best way to fix tennis elbow is to go for IMS acupuncture to calm down the nerve irritation.  Once the arm feels better have a physio teach you how to move more efficiently so your swing doesn’t create too much strain on your neck and shoulder.  You may also need a tennis pro to adjust your technique and/or your racquet.
Suggested articles:
Elbow Pain: why it can last so long & how to fix it properly
Why Elbows Hurt

Rotator Cuff Impingement

Most shoulder pains are some form of an impingement (which implies a pinching of one or more of the tendons of your rotator cuff). 

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Posted in Blog, Elbow, Knees, Low Backs, Pain, Shoulders Tagged with: , , , , , , , , , , ,
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Physiotherapists vs. Chiropractors: which one should you choose?

Batman
I get asked at least twice a week what I think about chiropractors.  Some people have this belief that there is an ongoing rivalry between the two professions, but it is just not true.  There is room in the allied health field for practitioners with different approaches; in fact we are all better off for it.   As a physiotherapist, I am obviously biased, but I think for some people, chiropractic treatment may be the best thing for them and for others it may be the worst thing they could do for their pain and that is where the big difference between the two professions is the most evident to me.

Physiotherapy has a much broader scope of practice than chiropractic treatment does.  A well trained physiotherapist should have the ability to manipulate the spine, perform muscle release techniques, use acupuncture or IMS needling treatments, teach core stability exercises, help work on your posture and balance or build a sport specific training program for you.  Most chiropractors focus purely on joint manipulation with a smaller percentage also using muscle release techniques like Active Release (A.R.T.) or Trigenics.  Chiropractors may be the best at using manipulation as a treatment technique by virtue of pure experience and practice, but I would prefer a clinician that has the ability to manipulate me (if need be), needle me (if need be), use myofascial release (if need be) and spend the time with me to help me prevent the problem from arising again.  A good physiotherapist should be able to do everything a good chiropractor can do and more.

The problem is that not every physiotherapist is well trained and just like any profession there are ‘good’ ones and ‘bad’ ones.  The same holds true for chiropractors.  Some physiotherapists will bring their clients in hook them up to three different machines over the course of an hour and barely pay any attention to them. 

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Posted in Blog, Healthcare Tagged with: , , , , , , , , , ,
63 Comments ↓

Canucks limp into 2011/12 season: what Kessler, Nolan & Raymond should be doing

Blackhawks
(photo: hockeybroad)

The Vancouver Canucks had an amazing season and playoff run last year.  They did everything they could short of winning the Stanley Cup and they did it being one of the most injured teams in the league all season long.  That speaks to the depth the organization, the heart of the players and the support of the medical and training staff to get players back on the ice.  But why were we one of the most injured teams in the league?  Hockey is a tough sport and injuries are part of the game, but some injuries are preventable and some don’t have to be recurrent.  I believe the Canucks have a great medical team behind them, but I think they are missing out on a hidden gem that the Vancouver medical and physiotherapy community has brought to the world….and that is IMS acupuncture.

I have been a physiotherapist in Vancouver for eight years and a Canucks fan for thirty two.  I write this article to educate the public on the nature of pain and injury as it relates to hockey injuries like groin pulls, back pain and labrum tears.  I am not affiliated with the Canucks in any way, but I do have interest in seeing them win the Stanley Cup this year and hope to see the players get the best possible care available.  I do not have access to their rehab programs, but if the following information is new to the athletic therapists and doctors in the organization, I suggest they pursue the help of a physiotherapist that can provide IMS to the players.

Ryan Kessler is the best two way player in the NHL right now, but he has torn his labrum in both hips in the past few years.  Your labrum is a rubbery piece of cartilage that surrounds the socket of your hip to effectively make it deeper and create stability.  Tearing it is similar to tearing your meniscus in your knee.  It can screw up the mechanics of the joint and lead to pain in the groin, hip and leg.  The labrum doesn’t have a very good blood supply to it, so if you tear it, the body is unable to heal it properly and surgery is usually required to get players functioning properly again.  Kessler has had both hips operated on and is training to get back into form for November as far as I know. Read More

Posted in Blog, Hips Tagged with: , , , , , , , , ,
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Elbow Pain: Why it can last so long & how to fix it properly

In-Line Chiropractic Cypress, TX (281) 894-5020

Tennis elbow and golfer’s elbow are the typical names given to elbow pain; tennis being pain on the outside of the elbow and golf being pain on the inside of the elbow.  The more technical term is lateral epicondylitis which simply indicates tendonitis in a specific location.  Putting a name to elbow pain doesn’t really help you get rid of it, but understanding why it happens and where it comes from will.
Tendons are the tough bit of tissue that attaches muscle to bones, and tendonitis literally means inflammation of the tendon.  This term can be misleading when it comes to elbow pain because many people have pain that persists for months in the complete absence of swelling and inflammation.  That is because elbow pain is not just an overuse injury.  It happens when the muscles being used are in an irritable state due to a nerve irritation stemming from your neck and shoulder.  Nerves are the electrical wiring of muscles and when they are irritated, it doesn’t take much to overuse the muscles and tendons that they innervate, resulting in inflammation and pain.  If you rest the joint, the body will heal the inflammation, but the nerve irritation may persist and thus the inflammation and pain will return as soon as you attempt to use your arm again.

Radial nerve extends from base of neck, through shoulder, down to elbow

Muscles are comprised of a whole bunch of stringy tissue that can stretch and contract.  The muscle should have a certain amount of resting tone in it, i.e. at rest it is slightly contracted, not flaccid or extremely tense; this is dictated by the input of the nerve.  If the nerve is irritated as it extends from the spine, or anywhere in the periphery it will result in an altered signal getting to the muscle.  Read More

Posted in Blog, Elbow, Pain Tagged with: , , , , , , , , ,
3 Comments ↓

What is IMS Acupuncture? Intramuscular Stimulation vs. Traditional Acupuncture

IMS stands for intramuscular stimulation and is an anatomy specific form of acupuncture performed by specially trained physiotherapists and some doctors.  It has its roots in traditional Chinese acupuncture, but is fundamentally different in many ways.  IMS uses Western medicine’s understanding of the neurophysiology of pain and Dr Chan Gunn’s assessment techniques of identifying underlying nerve irritations to treat chronic pain issues.  The technique does use acupuncture needles, but not in the way someone practicing traditional acupuncture would.  Traditional acupuncture focuses on pre-mapped out points in the body that relate to different organs and meridians of energy running through the body.  Fine acupuncture needles are then inserted into a number of these points and the person rests with them in for 10-20 minutes.  It can be very useful for the right condition, but it is not as specific or as purposeful as IMS.

To understand why IMS is performed the way it is you should have a basic understanding of how your body experiences pain.  If you haven’t already, please read the article titled Why Things Hurt: Explain Pain.

When a physiotherapist performs IMS he will first assess your basic posture and movement patterns to look for some common signs of underlying nerve irritation.  The most common one is to palpate for tender bands or knots in particular muscle groups.  He will look for restriction of movement in major joints such as your hips and shoulders and note the appearance of the skin and muscle tissue on either side of your spine.  When there is an underlying nerve irritation in an area, the skin can start to look like the rind of an orange peel, feel thickened and respond differently to light touch.  A person may develop goose bumps easily and/or have areas of coolness or hair loss.  The therapist will take all these things into account when determining where to treat you. Read More

Posted in Blog, Elbow, Healthcare, Low Backs, Necks, Pain, Shoulders Tagged with: , , , , , , ,
78 Comments ↓

Why Things Hurt: Explain Pain

This article has an accompanying video titled Why Things Hurt and a follow up article about the use of IMS dry needling

Reference: Dr Chan Gunn,  istop.org

If you experience an acute accident or injury, like spraining your ankle, it is easy to understand why your ankle may hurt.  You likely tore some of the ligaments and or muscles around the joint and experienced subsequent swelling, bruising and inflammation.  Over a four to six week period your body typically fills in the torn tissue with scar tissue and then slowly remodels it back to its original state.  Sometimes though the pain persists beyond six weeks even though all the swelling and bruising have long disappeared.  Other times pain appears for no apparent reason in the complete absence of an injury and you can’t understand why or what you did wrong.

Nerves are the electrical wiring of your body.  They supply the energy for all your muscles and organs to do their jobs.  Your brain and spinal cord are like the electrical fuse box of your body and your spine and skull are their protective coverings.  Peripheral nerves extend out from your spine at every level on both the left and right sides.  The nerves that extend from your neck are responsible for most of the muscles in your shoulders, arms and hands, while the nerves that come from your low back enervate all of the muscles in your hips, legs and feet.  The nerves in the middle are responsible for your trunk and a lot of your organs.

Muscles are comprised of a whole bunch of stringy tissue that can stretch and contract.  The muscle should have a certain amount of resting tone in it, i.e. at rest it is slightly contracted, not flaccid or extremely tense; this is dictated by the input of the nerve.  Read More

Posted in Ankles, Blog, Elbow, Feet, Knees, Low Backs, Mid Backs, Necks, New Moms, Pain, Shoulders Tagged with: , , , , , ,
1 Comment ↓

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