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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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What is Visceral Manipulation? An Integrated Part of Physiotherapy

Diaphragma
photo: euskalanato
Visceral manipulation is the practice of an experienced therapist using his or her hands to move and release fascial restrictions in your abdomen and pelvis to encourage the normal movement and function of your internal organs.  Most people are familiar with the idea of joint and muscle restrictions causing tightness, pain and limited movement in their bodies, but don’t consider the role of their organs.  It is common place for people to go to their physio, chiro, or massage therapist to treat pain and alignment issues; unfortunately, many times these practitioners may just be treating the outer shell of the problem if they aren’t considering the mobility of your organs in your alignment and movement patterns.

I have been a physiotherapist for ten years and have continued to add layers of knowledge and skills to my tool belt.  Two of those skills have been real eye openers and game changers for me.  The first big one was the profound effectiveness of skilled dry needling called IMS acupuncture.  I trained with Dr Chan Gunn in 2008 and the skills I learned completely changed my practice for the better.  I recently took a course on Visceral Manipulation through the Barral Institute and feel like I can now properly treat the body as a whole.  I had previously learned how every joint in the body works, where all the muscles attach and which nerves innervate them, but had failed to properly learn how the inside of the body effects the outside.  Visceral Manipulation is helping me properly understand just how connected everything really is.

Your trunk and pelvis form a boney, muscular, fascial outer shell to protect and encase all of your internal organs.  Your organs are not just loosely floating around in there though; they are mostly supported by tissue called fascia and pleura.  The whole thing is a sealed system under pressure that squishes everything tightly together; each organ is wrapped in its own pleura and bathed in a little bit of fluid so it can slide and move around or over its neighbouring organs.  Things that affect the pressures in the system or the ability of the organs to slide and move around in their close quarters will affect the ability of the body to move and function properly.

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Posted in Anatomy, Blog, Healthcare Tagged with: , , , , ,
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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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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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