Blog Archives

Resistant Pain: A 3-Dimensional Moving Puzzle

Supernova Remnant Cassiopeia A (NASA, Chandra, 1/6/09)

The following is a copy of an article I recently wrote for BC Physio Magazine:

After fourteen years of literally poking and prodding other people’s bodies all day, I have learned a few things about pain, anatomy and human nature.  I have done more than my share of market research in the hurting yourself category and have managed to work with or train under some of the world gurus in the pain and rehab space.  My name is Brent Stevenson.  I am the co-owner of Envision Physiotherapy in Vancouver and the author of the new book Why Things Hurt: Life Lessons from and Injury Prone Physical Therapist.  It is a collection of stories and lessons, written in a humorous, conversational tone, that I have found to be the most meaningful and helpful for my clients as they navigate their journeys down the path of resistant pain problems.

I refer to pain as a 3-dimensional moving puzzle due to the entanglement of physical and emotional factors that contribute to the end perception of a person’s pain.  When I started my training as a physiotherapist I learned about anatomy and the different systems of the body, like the boney framework of the skeleton and all the muscles that attach to it.  I learned about the nervous system and the basic electrical wiring of the body followed by a superficial look at some of the organs that the skeleton was protecting.  I was then released into the healthcare world to try and help people with my new found knowledge, but quickly realized how superficial my understanding of the body and my ability to help people really was.  I knew about most of the pieces but didn’t really grasp how most of them integrated together as layers of systems within the body.  I helped people, but not the way I am able to today. Read More

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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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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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