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My Name is Lance- Remember Me…

st pauls

Today I find myself sitting in a coffee shop across the street from St Paul’s Hospital in Vancouver, Canada waiting for my mother to have a procedure on her heart.  I just admitted her through the emergency room that has the insurmountable challenge of helping the people of our downtown Eastside caught in the epidemic of our opioid crisis.  It was an eye opening experience that inspired me to write this post and think further on the topic that I know is plaguing my city.  I am a healthcare professional that deals with people in various levels of pain all day.  I am also a person that due to a freak accident has found himself in the emergency room, in the operating room, given OxyContin, morphine and other drugs to try and help my immediate pain on a cycle of over three months.  My experience talking to Lance today in the St Paul’s ER has made me reflect on my experience and realize how slippery of a slope it can be for a person to go from a normal life, to an injury, to being a homeless drug addict living among throngs of others living out their own journeys on the street.

We arrived at the ER at 8:45am on a Saturday morning to a relatively quiet waiting room for downtown Vancouver’s only hospital.  There was one very talkative man being processed by the nurse.  He was seemingly a drug addict in withdraw and his father was quietly waiting in the chair looking like he had been through this before.  The dad was about my mother’s age and the talkative man was about my age.  I made sure my mom was taken care of at the admitting desk and then I was told to wait for about twenty minutes while the nurses processed her.  Read More

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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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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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Posted in Blog, Healthcare, Pain Tagged with: , , , , ,
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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: , , , , , , , , ,
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The experience of pain is all in your head: an entertaining explanation

Here is a great TED talk by neuroscientist Lorimer Moseley about how our bodies’ experience pain.  He is a funny and engaging speaker as he demonstrates how your brain can create, perceive and amplify pain.  Notice the title of his talk!

Lorimer Moseley teamed up with David Butler a number of years ago to create this book called explain pain.  It is a great resource for understanding your body as it relates to pain.
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Pregnancy, Pain & Posture: a video progression to restore movement

As I write this post, my wife is 32 weeks pregnant with our third child in three years, so I dedicate this one to Katie….you, and your body, have endured more than most can imagine.


Our boys

I will concede right off the bat that I am not a woman and have not been pregnant, but I have worked with and treated women at all stages of pregnancy, including immediately after C-sections and women 20 years later that are still trying to get their bodies back.  From what I have seen, there is no other experience a person can go through that is both physically and mentally more challenging on your body than getting pregnant, having the baby, and making it through the first five years in one piece.

Medicine has come a long way in making sure that the mother and baby are physiologically OK from conception through to the birth, but there still remains a significant lack of proper support and education for women when it comes to pain, posture, movement and physical function both during and after pregnancy.  The most important factor to consider is that most women don’t have great posture, movement mechanics or strength before they get pregnant, so this issue it not solely created by pregnancy, but merely exposed by it.  Most women are not used to carrying 10-30lbs around all day, or having to bend and pick things up off the floor sixty times a day, or hunching over breast feeding time and time again.  These are physical demands that would be hard on anyone, but particularly hard on someone whose body has changed so dramatically in a relatively short period of time and is functioning on very little sleep.

If you haven’t already please read everything your mother taught you about posture is wrong or how to standRead More

Posted in Blog, Fitness, New Moms Tagged with: , , , , , , , , , , , , ,
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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: , , , , , , ,
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Everything your mother taught you about posture is WRONG

Big Myth:

  • Chest up, shoulders back and down is the best posture

Most people think of posture as simply the need to keep your chest up and your shoulders back and down.  Sounds like a simple feat right?!  Then why will most people admit that they think they have bad posture?  The answer to that is because good posture is not a simple thing, it is actually a learned, coordinated skill that encompasses the whole body.  We are what we repeatedly do and our posture is a reflection of our childhood, our sports, our jobs, our emotions and our attitudes.

There is a continuum of flexibility and mobility among the population.  Some people are naturally very loose jointed and hypermobile while others are compressed and stiff as a board.  Where you end up on the spectrum seems to be partly genetic and partly personality.  The people that fall in the middle or the average/normal people tend to have the least pain and injury problems.  The further a person strays in either direction from the average the more and more posture, movement and pain problems they tend to develop.  There is not one perfect posture for everybody, but there is a norm that we should all be trying to achieve no matter which side of normal we are on.

Compressed/Hypomobile——————Average———————-Hypermobile
“Stiff as a board”                                            “Normal”                             “Loosey-goosey”

Our bodies are brilliantly built to deal with gravity as a constant downward force, unfortunately most people don’t know how to use their bodies properly or efficiently and end up with muscle imbalances, pain and dysfunction.  Posture should be looked at as a life skill not a genetic trait we can blame on our parents.  A very basic understanding of anatomy and biomechanics can save people a lot of grief throughout life. Read More

Posted in Blog, Knees, Low Backs, Mid Backs, Necks, Pain, Posture, Shoulders Tagged with: , , , , , , , ,
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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: , , , , , ,
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