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HEAT? Really? Stay Hydrated Winnipeg when exercising this Summer

We Winnipeggers wait so long for summer to arrive that some of us overdo it a when exercising outdoors, especially during unexpected heat and humidity early in the season.

‘Global warming’ is changing the prairie climate, the old models are unpredictable and ‘stormy weather’ is dominating the news.

It takes a while for our bodies to become acclimatized to warmer temperatures and our bodies regulate heat more slowly during hot, humid weather, causing us to overheat that much easier.

Before you head outdoors this summer, take a moment to understand the potential health risks of being active outdoors in extreme heat.

While being physically active has many health benefits, it can increase your risk for heat illness, especially in those with breathing difficulties, heart problems, a mental illness such as depression, hypertension or kidney problems. Even those without any chronic health conditions can be at risk without proper precautions.

In my day, Canada’s ‘food guide’ recommended 8 glasses of water for men and 10, 8 oz glasses for women. Now take into account the daily diuretics we all enjoy, coffee and alcohol, and you must add 2 more glasses for each one of those habits.

Get informed:

• Ask your sports organization or trainer if they have a plan for extreme heat.

• Ask a friend or buddy to watch you during extreme heat; if you suffer from asthma, carry your inhaler with you and make others aware of your condition.

• Modify or reschedule your activities.

• Work out early in the day or in an air-conditioned facility.

• Check the Air Quality Index for air quality conditions.

• Check local weather forecasts so you can plan accordingly.

Keep yourself safe:

• Stay hydrated by drinking fluids and eating raw fruits and vegetables.

• Wear sunscreen and insect repellant.

• Allow your body to recover from heat exposure by sitting in the shade or heading to an air conditioned area.

• Watch for signs of heat exhaustion such as dizziness, fainting, nausea, vomiting, headache, rapid heartbeat and extreme thirst.

• Heat illnesses can lead to long-term health problems and even death. These illnesses include heat stroke, heat exhaustion, heat fainting, swelling of hands, feet and ankles, heat rash, heat cramps and dehydration.

• The most serious heat illness is heat stroke, which can be fatal. Symptoms include a core body temperature of 40.5ºC/105º F, confusion, lack of sweat and unconsciousness. Call 911 immediately if you see someone with these symptoms.

• If you see someone going into shock from heat stroke, move them to a cool place, apply cold water to large areas of their skin and clothing and fan them as much as possible.

More tips for staying safe in the heat can be found at

http://www.healthycanadians.gc.ca/sun.

Stay hydrated Winnipeg, yourPhysio has the healthcare experience you need.

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It’s heavy snow Winnipeg, learn about rotator cuff injuries, the winter cold and shovelling

It’s snowing this morning in Winnipeg; the first heavy blast of winter this season. Car accidents, falls and shovelling injuries are inevitable. Beware of your posture, the load, your balance and fitness level before you ‘shovel for hours’. The shoulder, and its supporting rotator cuff group of muscles are highly susceptible to those strains n sprains of high repetition and little prep.

Rotator cuff injuries are common in all sports and can be career enders for athletes likes quarterbacks and pitchers. But even if you’re just throwing snowballs with the kids or working out to stay fit, it’s important to keep the shoulder joint healthy. Here, physiotherapist Chris Bisignano, answers some of the important questions.

Q1: What exactly is the rotator cuff?

“The rotator cuff is a group of muscles, that act almost like a dynamic ligament. It is comprised of four muscles: the supraspinatus, which is the most commonly injured, the infraspinatus, the teres minor, and the subscapularis. The rotator cuff’s functions are to assist with arm movements and provide stability to the glenohumeral [shoulder] joint.”

Q2: Why does the rotator cuff get hurt so often, and what are the common issues?

Most of the exercises we do actually do not specifically target the RC enough to make a difference to its actual strength.

“Up to 67% of the population will have a shoulder problem at some point in their lifetime, and the rotator cuff is most often the source of the pain. The primary reason for rotator cuff pain is that pinching sensation or ‘impingement syndrome,’ which may be the result of rotator cuff tendon inflammation caused by an activity or trauma. Over time, this can lead to a rotator cuff tear. To make matters worse, evidence suggests that most individuals are likely to experience rotator cuff degeneration by age 40 and rotator cuff tearing by age 60. Thus, in many cases, a seemingly normal exercise session or home-repair project may incite shoulder pain.”

Q3: What kinds of moves should I avoid if I want to stay injury free?

Repetitive reaches with even a simple load can isolate alot of force upon the RC. Movements above shoulder become risky when a joint is not supported well, or even unstable because of weakness.

“Many of the more common gym exercises—such as upright rows and lateral deltoid raises—may lead to rotator cuff injuries. Modifying these exercises to keep the end position of the arms or elbows below shoulder height may help prevent injury.”

Q4: How can I tell if I have a rotator cuff injury?

“Many people already have a rotator cuff injury and aren’t aware of it. Unfortunately, evidence suggests that these individuals will eventually develop symptoms. Early on, if you have pain when reaching overhead—pain located at the tip of the shoulder or the outside of the arm, where the lateral deltoid is located—that suggests a rotator cuff injury. Weakness when reaching the arm out to the side is also suggestive of a tear.”

Q5: How can I prevent a rotator cuff injury?

“Three key measures can be taken to reduce the chances of experiencing a rotator cuff injury.

“First, strengthen the external rotators; specifically by tubing or dumbbell exercises that need to be learned from a professional; these will help restore and maintain shoulder stability and may prevent impingement.

“Second, avoid sleeping on your side with your arm positioned overhead.

“Finally, try to achieve muscle balance—that’s key. Many weight-training routines are inherently biased, creating muscle imbalances that may lead to a rotator cuff injury. Try to perform an equal number of ‘pull’ versus ‘push’ exercises. Moreover, try to replace a few sets of shoulder exercises—such as lateral deltoid raises or shoulder presses—with exercises that strengthen both the deltoids and the rotator cuff, such as prone ‘Y’ or ‘T’ exercises.”

Visit yourPhysio or ask your healthcare provider for specific RC education and exercises.

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Posture, Form, Biomechanics…all important in Exercise Winnipeg to avoid injury

Winter is knocking at the door Winnipeg, back to your gym routine. You must practice the correct posture, form and biomechanics to avoid injury and the right choice in exercise. As a orthopedic physiotherapist, it is crucial to learn the biomechanics of an exercise first; otherwise injuries are eminent. Ask your trainer, yourPhysio or the gym supervisor for education as to how to perform exercise correctly, and gain the greatest benefit.

Ever tweaked a muscle when working out? Whether due to a loss of focus or chronic poor form, getting hurt when exercising can be a huge setback. Fortunately, weight lifting and cardio needn’t be dangerous if you can keep a few concepts in mind. For this blog post, you’ll learn how to stay safe with some of the more common resistance exercises, with good posture and technique.

Try this posture test: When viewed from the side, an imaginary vertical line should pass through your earlobe, the tip of your shoulder, midway through your trunk, over the bony part of your thigh, and then through both your knee and ankle. If there is any deviation from this alignment, like if your ears are in front of your shoulders or your shoulders roll toward your chest, you are set-up for potential injury.

Aside from maintaining ideal posture, try these technique modifications to avoid injuring yourself during 5 common exercises:
1. Squat:

Don’t let you knees drop inward. This common mistake can be remedied if you actively spread your knees apart. Try to keep your back straight as possible, body weight over your heels such that your center of gravity does not fall forward, potentially injury for knees and hips.

Our advice: Doing air squats with a mini band around your thighs is a good way to train proper technique.

2. Deadlift:

Avoid low back injury by maintaining your natural lumbar curvature.

Our advice: Imagine a broomstick running along the length of your spine; if your pelvis curls off the bottom of the stick during the deadlift, then you’ve lost your lumbar curve.

3. Shoulder Press:

Decrease the risk of shoulder impingement by mimicking the natural plane of shoulder motion.

Our advice: Hold your elbows slightly forward of your chest, rather than directly at your sides.

4. Plank:

Spare yourself unnecessary spinal compression by preventing your head and belly from sagging to the floor. Maintain thoughtful and regular ‘belly breathing’ to elicit a better core effort.

Our advice: Tighten your core and shoulder girdle so that you are one straight line from the top of your skull to your ankles.

5. Running:

Land as softly as possible to decrease impact on your joints.

Our advice: One method to do this is by decreasing your stride length, while simultaneously increasing your cadence.

Remember, none of these exercises should be attempted without proper individual instruction; there is no ‘recipe’ that works for everyone, consult yourPhysio or your nearest sportsmed doctor.

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Core training not just for your abs, improve your sitting posture, prevent back pain by Physiotherapy Winnipeg

We’ve all heard physios, chiros, docs and fitness experts claim that core training is important for overall fitness and health. Health clubs offer core training exercise groups and physiotherapists recommend it for those recovering from spinal injury. Your core is the collection of muscles that stabilize the spine, this includes the hips, pelvis, abdominals, lower back, mid-back, and neck regions of the body. These muscles are extremely important in all sports, so why do so many ‘office athletes’ that basically sit for a living overlook core training?

The reason most people skimp on this vital part of their workout is because the benefits are simply overlooked.

Benefits of core training:

It’s important to note that performing a few crunches is not proper core training. As a matter of fact, I recommend that these be avoided for much of a lower back stabilization program. We simply just do not need any more ‘flexion’ in our daily routine; you sit most of your day!

Since your core involves many different muscles groups, a variety of exercises are needed to ensure you work them all; some exercises to explore include, but are not limited to, lunges, bridges, planks, and crunches. Every patient learns how to properly stretch their hip flexors, the ‘culprit’ muscle that usually guards when the ligaments are sprained in the lower back.

Pilates and Yoga classes are also excellent for strengthening your core muscles while also improving balance and posture. Check out Pilates Manitoba as they are offering 50% off their introductory classes for first-time participants.
When your core is strong, your whole body works better. Core training isn’t just for athletes, it’s for anyone who would like to have their body working at its greatest potential. For anyone just starting an exercise program, be sure to talk to yourPhysio first.

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How people choose a Physio, a Doctor, a Chiro, in Winnipeg…for back pain, for health advice, for whiplash

Thanks again to my fellow members at the Winnipeg Executives Association, for the positive feedback and referrals following my 2012 Business Profile presentation; How do you choose your Healthcare Providers? Based on the US pre-election survey by INC magazine…

In reverse order of importance, the top five were:

#5 a great Receptionist.

Oooops, if you have been to my clinical location in the formerly TD Centre, at Portage & Main, you would know that I have been a ‘sole proprietor’ since 1991. Clients know that when they call for an appointment or have any kind of question, that they are going to speak directly with me, the Physiotherapist. Whether it be by phone, text, email or video-chat; I do not hesitate to educate you on the spot and answer the greatest concern in real-time!

#4 your Insurance Coverage.

In Manitoba, you do not need a doctor’s referral to see a Physiotherapist. But, you may need one to be covered by your particular insurance coverage. Manitoba Health only covers physiotherapy treatment if obtained in hospital, and WCB, and MPI, only cover a specific number of treatment sessions. So, beware of your coverage and be proactive in your rehab!

I DO direct bill to most insurance plans, if they do allow this to occur as some plans prefer that the client do it by mail or online, such as Sun Life or ManuLife. Healthcare Spending Accounts are becoming more of the norm with ‘flex’ benefit plans. These accounts are excellent ways to be proactive in your health plan by applying these funds to ergonomic assessment or exercise programs.

Like some other providers, I typically do NOT charge for ‘tray fees’, ‘chart maintenance’, exercise tubing or even for Doctor’s notes.

#3 convenient Parking.

Well…again, we are located in Downtown Winnipeg’s most secure parking complex; the Exchange District Parkade, off Albert Street at #35…my entry is at ground level, directly across from Winnipeg’s best kept secret, parking meters inside a parkade entrance.

#2 convenient Office Hours.

For the approximate 60,000 people working within a 5 minute walk of Portage & Main, the most requested appointment time is between 10am and 2pm, with a normal treatment day from 845am to 530pm in the clinical location.

My research begins at the home office, and ergonomic assessments take me onsite to clients’ work places; from garbage trucks to police cruisers, from bus depots to gold mines, from military helicopters to postal distribution centres, from bank tellers to executive offices, from lumber plants to product warehouses, from grocery clerks to sports professionals, from grain elevators to your cottage kitchen…I’ve worked the day and night shifts, and experienced a huge variety of task conditions.

#1 my Location.

Do you know anyone that works within walking distance of Portage & Main?

Do you know anyone who works in an office connected through the Winnipeg ‘W’ walkway system?

Do you know anyone with a schedule that demands a guaranteed appointment time? …there is no waiting room

I invite you to refer them to our services, for healthcare that may not always be what they expected or even be the best in town, but I will always move them in a direction to make it right for them. Thanks.

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Active Release, Myofascial Release, Trigger Point release therapies for back pain in Winnipeg by Physiotherapy Winnipeg

You’re back is Achy, You’re neck may be Sore, and You Have No Idea Why…It feels like muscle pain, but unlike a tight hamstring, hip flexor or shoulder that makes you yelp when you stand up, your ache isn’t triggered by a particular movement, and you can feel it in different places at various times. The culprit could be your fascia, that relative “sheet” of tissue, made up of densely packed protein fibers, weaves throughout the entire body, and it binds and supports your muscles, bones and even your organs.

You know how your muscles feel cramped and stiff when you wake up in the morning? After a night’s sleep (or another long period of inactivity, like a car trip or plane ride), the parts of your fascia that wrap around and through your muscle fibers, which are normally stretchy and flexible, can stick together like previously chewed bubble gum. Stretching like a well rested cat in yoga, is a great way to release those sticky fibers at home.

Just today, I’ve recommended a client to work out those overused sore spots with a foam roller. You’ve probably seen people at the gym using these things, which look like pool noodles, to stretch their back, hamstrings and the notoriously tight IT band on the outside of the hips. To start, take an old pillow from home, fold it in half length wise and duct tape it into a hardened roll. It may not provide the stiff surface of a good foam roll, but you can begin slowly, and graduate to harder surfaces later. Sit or lie upon the roll, and when you get to a sore spot that feels like a bruise, pause for 15 to 20 seconds. The discomfort should melt away as the fascia softens and the muscles release. If you feel intense pain that doesn’t dissipate, stop and consider making an appointment with a physical therapist.

Don’t Let the Tissues Get “Crunchy”

If you’ve ever had a shoulder rub and heard something that sounded like crinkling plastic under your skin, that wasn’t your imagination—it was probably your parched, stiffened fascia. The collagen, protein fibers that make up fascia need to stay supple to work properly, and to slide over and under muscles and other inner-body surfaces. One way to keep the fascia hydrated is obvious: drink lots of fluids, especially water. I have had chronic back pain clients change their coffee to water on a 8x per day basis to gain relief from their fascial pain. Another easy (but easily forgettable) way is to make sure we stand up, stretch and flex regularly throughout the day to keep the fascia from locking up. Those pressure points are warning you for a reason!

If you need some foam roll instruction or relative treatment with myofascial release techniques, don’t hesitate to contact me.

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Winnipeg Soccer, as outdoor ends, indoor begins and the knee injuries need Physiotherapy

It’s almost the end of September in Winnipeg, and its all too common on the soccer field and basketball court.  An athlete jumps to get the ball, lands and blows out a knee. And most of that time those athletes are girls. Girls are four to six times more likely to suffer a certain kind of knee injury than boys, according to Mayo Clinic research.

Your Physio Winnipeg always concentrates on proper training, biomechanics and technique of exercise, otherwise, why do it if you’re going to hurt yourself.

When an athlete cuts, pivots or jumps, the athlete puts stress on the ligaments of the knee; Medial, Lateral and especially the Anterior Cruciate Ligament or ACL in the knee.  If the knee collapses inward during these moves, that ligament can tear, along with severe injury to the surrounding soft tissue.

ACL injuries are especially a problem for girls, possibly because of the angles of their leg bones or imbalanced muscles around the knee. But proper biomechanics, education and training can help prevent ligament injuries.

Train to jump properly, and actually practice to inherit a good habit; “Legs shoulder width apart. you have to jump as high as you can and when you land you have to land straight and your knees can’t go in or out,” explains Winnipeg physiotherapist, Chris Bisignano.

At the heart of research now is jump mechanics and landing mechanics.  These drills teach how to move more safely and will strengthen the muscles around the knees.

Ligament injuries can mean a trip to the operating room and reconstructions are not minor.  Recovery can keep you out of the game for nine months to a year.  But injury prevention training, and cross activity training can keep kids in the game. Westwood High School in Winnipeg, actually has a “high performance training or phys ed” class for its athletes. “They give their kids some training techniques I would never try in practice,” says Bisignano, “but its excellent training to be involved in to prevent injury”.