Physiotherapists are primary health care providers that have an in-depth knowledge of the body and specialized hands-on clinical skills that can assess, diagnose and treat a variety of conditions and injuries. How physiotherapists work within the guidelines is completely different, which is just one reason why I love my job. I have created my own philosophy, which is often different from other physiotherapists.
Chronic pain is a widespread, disabling condition than affects an estimated 20% of people in the world. Pain is usually regarded as chronic if it lasts or reoccurs for periods of 3 to 6 months, which is beyond the normal amount of time for healing. Chronic pain can contribute to anxiety, depression, disability, sleep disturbances, poor quality of life and certainly impacts healthcare costs.
An article published in February, 2018 studied the connection between chronic pain and negative emotion.
Back pain plagues four out of five Canadians at some point throughout their lifespan. It can be quite debilitating, and affects basic tasks throughout your day. Often clients describe how their back pain started, perhaps by reaching down to grab something off the floor or by twisting and reaching. This is often the straw that broke the camels back, however the true problem likely started many years before. We are very good at creating compensations and moving to get away from a problem. Over time compensating can create more wear and tear somewhere else in the body. Therefore, it is essential to have a look at how people are moving as a whole while comparing their movement to the local pain and dysfunction. This comprehensive view will give a clear picture as to larger movement problems or compensations that may be contributing to the acute problem and pain.
Recently, on CBC radio, a story featured Stuart McGill’s Big Three exercises to relieve back pain. Clinically, I use these exercises very frequently, even for people that may be having shoulder pain or even knee or ankle pain.
One of the biggest challenges facing the massage therapy profession is finding acceptance from the larger medical community as an effective, even necessary, therapeutic intervention. As a Registered Massage Therapist, and as anyone who receives regular massage therapy can confirm, we know that massage therapy can manage symptoms associated with all kinds of conditions. However, we have a hard time explaining exactly how it works and why it consistently provides relief,
Peripheral Neuropathy is a common neurologic condition that affects the peripheral nerves. The most common symptoms associated with peripheral neuropathy are weakness, numbness and pain. The pain is usually in the hands and feet, but can affect other areas of the body. Some people experience the uncomfortable sensation of “pins and needles”, stabbing, burning or tingling pain (especially at night) in their hands or feet. Others may suffer even more extreme symptoms such as muscle wasting, paralysis, or organ dysfunction.
Physiotherapists play a vital role in helping individuals improve and maintain functions that may be limited by Peripheral Neuropathy (PN). PN has a variety of causes, types and symptoms and therefore it is essential for each treatment plan to be tailored to help address each patient address their specific needs and goals. Physiotherapy may be helpful in maintaining strength, mobility, and function regardless of the underlying cause of PN.
Clients commonly ask me if I offer “deep tissue” massage. The simple answer is yes, it is a part of every massage therapist’s training. However, it is not always the most effective approach. In my experience, ‘forcing’ a muscle to release by digging a knuckle or elbow into it often provides only temporary relief. I’m most interested in understanding why the muscle is so tight in the first place, so that the root cause can be addressed for longer-lasting relief.
Can Massage Therapy help with my headaches? Yes! Although Massage Therapy may not spring to mind as a typical intervention for ongoing headaches, I have had a lot of success over the years treating clients for head pain. There are a few ways Massage Therapy can address headaches, but the most common way is by addressing trigger points in the neck and upper back. A trigger point is a specific point in a muscle that, when stimulated, can cause referred pain. These pain patterns are remarkably consistent from one person to another and there are A LOT of trigger points that refer to the head, mimicking a headache. Some trigger points can even mimic migraines or cause some autonomic phenomena to occur, such as watery eyes, runny nose, and light sensitivity. So, by addressing the tension in the neck and associated trigger points, headaches will often disappear!
There are so many different types of headaches, how can you know if Massage Therapy will help you with your specific headache? There are some good clues to watch for that may indicate that your headache pain is associated with a pesky trigger point:
Most of us have experienced a minor headache before, but did you know that over half of us experience an excruciating headache at least once a year? Unfortunately for many of us, headaches happen a lot more frequently than once a year and can be quite debilitating. When treating patients who suffer from chronic headaches or migraines, it is important to understand the “root cause” of their head pain. I find most patients clearly know what triggers their headaches. I have heard explanations ranging from the weather to their mother-in-law, but a key starting point to treatment is always understanding what truly triggers the pain. For the sake of simplicity I will be using the term “headaches” to refer to both headaches and migraines. I completely appreciate that there is a difference as I too was once a migraine sufferer. Regardless of whether your headaches are occasional minor headaches or frequent migraines, the following information may help you feel better.
Before we dive into the “food-headache” connection, there a few common culprits to chronic head pain that should be ruled out first. The following is a list of things to focus on. After correcting for these factors, if the chronic headaches are still present, then it may be worthwhile exploring a food sensitivity connection.
We’re pleased to welcome Phillip Wendt to our professional team!
Phillip is a registered Occupational Therapist holding a BScOT from the University of Wisconsin-Madison and an MScOT from Queen’s University. He has also received additional education and training in home adaptation and universal design, life management and lifestyle redesign, cognitive remediation, and capacity evaluation. He has an intense passion for primary health care and his practice is focused on working with people to modify and change their daily routines, environment, and lifestyle to promote healthy independent living and prevent disease. In his practice at KIHC, Phillip aims to help people to manage a wide variety of health concerns including stress, chronic pain, chronic disability, diet, weight, and headaches.
Phillip currently serves on the board of directors for the Canadian Association of Occupational Therapists and is past president of the Society of Alberta Occupational Therapists. He is also a member in good standing with the College of Occupational Therapists of Ontario and the Ontario Society of Occupational Therapists.
Joel Ackerman, RMT
I’m sure you can probably guess the most common complaints I hear from clients: sore low backs, tight shoulders and necks, headaches, cranky knees, and so on. In addition to all of these more predictable aches, one complaint I hear more often than you might expect is jaw pain. Often it is mentioned in passing, and almost as a joke; “But I don’t suppose there’s anything you can do for that…” My clients are always surprised when my response is, “Yes, we can absolutely do some massage there!”
I have seen Massage Therapy be very effective in relieving all sorts of jaw pain, or as we call it, TMJ pain (named after the Temporomandibular Joint). In fact, there are a number of clients who have made intra-oral massage a part of their regular treatment plan, as they recognize the preventative benefits, even if they aren’t in pain! Other times, one or two treatments are all it takes to make a significant difference in how much pain someone is experiencing. In other situations, when people aren’t complaining of jaw pain, a little bit of release to the jaw makes a vast improvement in the overall tension they are feeling in their head and neck.
So how does Massage Therapy work exactly when it comes to the jaw? Treatment options for jaw pain include fascial work around the jaw joint at the ear, massage done directly to the muscles in and around the jaw. This includes some intra-oral massage. Using latex-free disposable gloves, and after establishing a clear communication system with the client, I begin by working on one muscle at a time (there are 4 on each side of the jaw). This can be a bit uncomfortable, as these muscles almost never get touched, but then the relief felt afterwards is almost instant! And because these muscles don’t get touched very much, a minute or two of massage goes a long way. Then we finish with more fascial work and massage to the muscles in the neck. The jaw and neck are very closely related, and dysfunction in one of these areas often leads to dysfunction in the other.
Rachel Young, RMT
Hot stone massage therapy uses heat therapy, both as a static application and while performing effleurage, to ease muscle tension and stiffness, and increase circulation and metabolism. Hot stone massage therapy promotes deeper muscle relaxation by placing smooth, water-heated volcanic basalt stones, which have the ability to retain heat for an extended amount of time, at key points on the body. Heat therapy applied to these areas helps to keep the parasympathetic nervous system, that is, the nervous system that promotes the release of hormones which relax the body, stimulated. During effleurage, the direct heat of the stones relaxes muscles more quickly than if the heat was not applied, which allows the massage therapist to gain access to the deeper muscle layers more efficiently. The steady heat from the hot stones expands blood vessels, which encourages blood flow throughout the body. This sedative effect can relieve chronic pain, reduce stress and promote deep relaxation. Heat therapy is especially helpful at this time of year, when the body is subjected to the cold that keeps muscles contracted, restricting circulation, causing the nervous system to be in a sympathetic state, meaning the promotion of stress-related hormones to be released, even more than what normal-life stresses and disease already cause in the body. Combining hot stone protocols with a full body massage provides a very healing experience.
Neurological, including headaches, vertigo, tinnitus, muscle spasms, neuropathies, insomnia, fatigue;
Skin rashes, burning or itching skin, nose bleeds;
Heart palpitations or arrhythmias;
Click here to read our entire online January e-newsletter on inflammation and pain.
Dr. Sonya Nobbe, ND
INFLAMMATION. We’re told that it causes anything from heart disease to arthritis to aging. Medical science has developed countless pharmaceutical and surgical interventions to suppress or circumvent its destructiveness, to alleviate pain and treat chronic disease. We even have drugs that affect how our DNA is involved in the generation of inflammation! But now science is starting to understand the long-term consequences of this approach, including the real possibility that our anti-inflammatory pharmaceuticals are actually contributing to prolonged low-grade inflammation that makes us more ill. There are safer, more complete ways of addressing the inflammation that causes pain and disease.
Inflammation is a whole-body complex biochemical process initiated by the body’s immune system as a response to some form of “danger”, such as an injury or infection. It’s the red soreness of a scratch on our skin, the ache in our lower back, the stomach pain that follows a meal that didn’t agree with us. It’s the body’s warning that something isn’t right and so… we suppress it.
Click here to view our entire online January e-newsletter on inflammation and pain.
Dr. Sonya Nobbe, ND
1. Eat a clean, whole foods diet that includes some raw veggies daily. Many of these foods have natural anti-inflammatory properties as well as nutrients that support optimal organ and tissue function. Processed foods of any kind are linked with inflammation, chronic disease, and premature death. Food intolerances such as gluten or dairy are also linked to chronic disease and pain. Please speak with a Naturopathic Doctor or Holistic Nutritionist to optimize your diet for reduced inflammation.
2. Relax. This branch of the nervous system, the parasympathetic nervous system, has some real healing potential. Meditation, Qigong, and time in the quiet outdoors are repeatedly associated with decreased pain and inflammation. Many older philosophies suggest that consciously working with the pain, rather than against it, provides significant relief.
3. Breathe. Our bodies detoxify
Dr. Sonya Nobbe, ND
One of the most frustrating outcomes of an IBS diagnosis for many patients is the common judgement that “it’s all in your head”. If group hypnosis and “psycho-education” studies demonstrate positive benefits for people with IBS, then this must be true, right? Here’s a little bit of what “all in your head” means to me.
IBS is a “diagnosis of exclusion”, which means that to the best of our current medical knowledge, all causes of digestive pain have been ruled out, and there is no known cause for the pain. In fact, there are many additional causes of digestive pain involving seemingly unrelated systems in the body, including the nervous system (the gut makes more serotonin than the brain), endocrine system (there are many estrogen receptors on the gut, which is why many women experience symptoms only during certain times of their menstrual cycle), and immune system (which generates inflammation when “danger” is perceived).
This past decade has seen a substantial amount of scientific research about “the second brain”. The gut contains its own huge nerve network that can amazingly work independent of the brain. It connects to the brain largely through the part of the nervous system that works when a person is relaxed (i.e. the parasympathetic nervous system).
Joel Ackerman, RMT
Anyone who has had, or been around someone experiencing jaw discomfort, knows that it is no laughing matter. It is a class of pain unto itself, and it makes perfect sense, since we use our mouths more or less constantly throughout our day. Talking, biting and chewing our food, yawning, and most of our facial expressions all involve significant work by our mouth and jaw muscles. Not surprisingly, some of these muscles are among the strongest muscles in our body. So what happens when these muscles get sore?
You may be surprised to hear that massage therapy is a VERY effective way to deal with sore jaw muscles. Often referred to as TMJ pain (much easier to say than ‘Temporomandibular Joint’), TMJ dysfunction is fairly common, and can arise for a variety of reasons. Your TMJ is just in front of your ear, and where your lower jaw articulates with your skull. Teeth grinding, trauma (like a blow to the jaw, especially with the mouth open), improper positioning of the teeth, postural issues, and even prolonged dental work can all cause TMJ dysfunction. Interestingly though, apart from some serious dental work (i.e. having your mouth open for an hour or more at a time!), or some stress-related teeth grinding, the most common contributing factor to TMJ pain is tight neck muscles! When our necks our tight,
Carol Belanger, BA, RM, BHS
There are many contributing factors of low back pain. Among them, lifting, bending, turning or in combination, seem to be the most common causes of low back pain. I want to discuss a factor that not many would consider. Yet, it is a factor that can affect us all. I want to describe for you, the influence of low energy levels on back pain.
How many of us say things like, “Ah, I have no energy today.” Or, “I’m spent.” Or, “I’m pooped.”? Yes, we can recognize when our energy levels get low.
But have you stopped to consider your energy level, where it comes from and where it goes? Those are easy questions on the surface to answer when we do start to consider them, and some of the answers are pretty common too.
~ Dr. Christina Vlahopoulos, ND
Sleep disturbances can be one of the more prevalent complaints in people with chronic pain. Of course it is hard to relax and get to sleep when you cannot get into a comfortable position. However, what if it was your lack of sleep that was making your pain worse? Or maybe it was the lack of sleep that caused your chronic pain in the first place?
Recent research has shown a reciprocal relationship between chronic pain and sleep. Some studies showed that sleep deprivation indeed caused an increase in pain perception in previously healthy adults. The participants felt overall muscle and joint pain, tenderness and fatigue. Therefore, the less sleep a person got, the more pain they felt.
~ Joel Ackerman, RMT
It is easy to associate massage therapy with relaxation, stress reduction, and ‘working out the knots’. However, one of the most underappreciated aspects of receiving a good massage is the wonderful night of sleep that so often follows a massage therapy treatment. In a society that seems to be moving towards an epidemic of sleep debt, where an estimated 50% of adults in North America are chronically underslept, it is vital that we understand the importance of sleep in our lives and find ways to improve how we sleep.
Sleep was once thought to be a passive activity, but as the science of sleep develops, we now understand how important sleep is! Sleep is actually a highly regulated process, in which the body performs several vital activities, some of which simply don’t occur at any other time.