Category: chronic pain

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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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Canada’s Growing Demand for Ergonomics in Kitchens…for Aging in Winnipeg Place, for the disabled and the post Surgical

As the first Boomers move into their later 60’s, their growing demand for services, for activity and for health has spurred the demand for ergonomics in kitchen design.

Aging in place is a term used to describe a person living in the residence of their choice, for as long as they are able, as they age. This includes being able to have any services (or other support) they might need over time as their needs change.

To be clear: the act of aging in place takes place during a period of time in an elderly person’s life where they can have the things that they need in their daily life, while maintaining their quality of life.

The reason this distinction is important is because many people think aging in place will fix the problems they have in their lives. The only problems that can be fixed while aging in place are the ones that a person has planned for (i.e. finances, health, personal or health care, etc.).

The kitchen has always been a place for family and socializing. Making changes for aging in place in the kitchen space can greatly increase its usability and the safety of those that live there. With home modification, people will no longer have to spend less time in the kitchen as they age.

In a growing trend observed by the brand Smeg, European consumers are opting for compact appliances to give their kitchens a homogenous look and more efficient arrangement of appliances. Will this trend make it to Canada? to the USA?

One of the most popular trends in kitchen design is the demand for ergonomics with more and more consumers choosing a linear look for the placement of their appliances. Smeg, a leading Italian home appliance manufacturer, has observed this trend with a significant growth in the sales of its compact appliance range.

Smeg is the only brand to offer its appliances in two design styles – the classic stainless steel look and the linear look in stainless steel with glass. Both design styles are made in standard sizes and have matching aesthetics to ensure the kitchen gets a clean and homogenous look.

All standard compact appliances are 600mm wide and 450mm high and designed to be easily installed in a bank at midway level (chest or eye level) or under the bench. Smeg’s current range includes convection ovens with microwave, combination/steam convection ovens, dedicated steam ovens, microwave ovens with grill function and built-in coffee machines.

Appliances play a major role in a person’s ability to use and work in the kitchen safely and efficiently. Appliances that do not incorporate universal design, or that are placed improperly, can inhibit this. Select appliances that display information clearly, have convenient functions and are easy to use. Many appliance makers are incorporating universal design principles in their designs, which allow consumers to get a variety of more functional appliances. You should also consider investing in energy saving appliances, which will help you save money. Currently, the most popular placement of any appliance or storage cabinet is at the midway level since it ensures easy and safe access to a range of appliances without the need to bend or stoop.

As in lifting or reaching mechanics, the placement of load or where you interact with that load is of key importance.

Beware of your biomechanics. Know your Ergonomics.

Know yourPhysio Winnipeg!

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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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Even science can provide ‘stats’ on sitting in Winnipeg to prevent neck and back pain, especially those Downtown, Physiotherapy Winnipeg can educate you

No one will stand all day when they have the opportunity to sit. This is because the body works harder when standing than when sitting. However, when we at yourPhysio.com in Winnipeg review work production studies indicate that workers are more efficient when they stand to work. So how do you decide between the two? Consider these general guidelines Winnipeg!

When Standing is preferred:

the task cannot be performed with arms kept comfortably by your sides.

assembling, testing, or repairing larger products (i.e., greater than 6 inches high)

the work area is too large to be comfortably reached when seated. Stand when you must reach more than 15” past the front edge of the workstation. The maximum reach envelope when standing is significantly larger than the corresponding reach envelope when sitting for both men and women (Sengupta & Das, 2000).

you work in more than one workspace to perform job duties and must move around frequently.
the work task lasts less than 5 minutes.

dealing with heavy objects weighting more than 10 pounds. In general, more strength can be exerted while standing (Mital & Faard, 1990) Stand when you need to maximize grip forces (Catovic, Catovic, Kraljevic & Muftic, 1991) or complete static or dynamic lifts (Yates, & Karwowksi, 1992).the work surface does not allow the worker to comfortably position legs under the surface because of an obstruction (i.e. working on a conveyor or a progressive assembly line, working in a kitchen, using a workstation with a drawer located underneath the work surface or a wide front beam, working at a retail counter, or using specialized equipment)

tasks require frequent application of downward pressures (loading bags, inserting screws)

Jobs that are most appropriately done standing include construction workers, highway flaggers, medical personnel, painters, electricians, plumbers, loggers, firefighters, plant inspectors, and maintenance personnel.

When Sitting is preferred:

Better when visually intensive or precise work is required, the activity is of a repetitive nature; longer tasks are completed (greater than 5 minutes), and when everything can be placed within easy reach. Sitting is not appropriate when heavy objects must be handled or long reaches are required.

However, prolonged sitting has been associated with a high incidence of back complaints (Mandal, 1981), increased spinal muscular activity and intradiscal pressure (Grandjean and Hunting, 1977; Lindh, 1989). Other problems reported include discomfort in the lower extremities (Westgaard and Winkel, 1996) and increased muscle loading of the neck and shoulder muscles when sitting with the forearms unsupported as compared to standing with the forearms unsupported (Aaras et al., 1997; Lannersten and Harms-Ringdahl, 1990).

To summarize the literature, neither static standing nor sitting is recommended. Take note of ‘static’ versus ‘dynamic’ Winnipeg, learn to balance each through your day.

Each position has its advantages and disadvantages. Research indicates that constrained sitting or constrained standing are risk factors and that alternating work postures may be preferable. Alternation between two postures allows for increased rest intervals of specific body parts, and reduced potential for risk factors commonly associated with MSD development.

Ideally, provide workers with a workstation and job tasks that allow frequent changes of working posture, including sitting, standing, and walking. If either sitting or standing is feasible but only one possible, sitting in a properly designed chair is preferable.

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Whether you sit at a computer, shovel snow, lift sandbags or play hockey in Winnipeg, your back pain is probably the result of tight hip flexors

yourPhysio anatomy lesson first; your hip flexors are the dominant muscle in the ‘knee to chest’ action. Anatomically known as your; Iliacus, Psoas Major and Minor, and your Quadratus Lumborum, these muscles are attached to your hip, to your lower back and your pelvis. Consequently, when overused or tight they can reconfigure your lumbar spine, throw out your hip and back, affect your sacro-iliac joint, and change your biomechanics thoroughly.

Even though stretching is essential for all muscle work, it can actually be damaging if not done properly. When you stretch without warming up your muscles, it increases your likelihood of injury, as you are trying to stretch a cold muscle. So before you stretch, make sure you warm up; walk in place, cross-train, and increase the blood flow into your muscles so you can prevent an injury. As a physiotherapist, I do commonly advise patients to hold a stretch for 20-30 seconds, but why? The reason is because our muscles have a protective reflex to avoid over extension or contraction. When you are stretching your muscle, the muscle spindles, which are the components that produce contraction, activate a reflexive pathway which causes them to shorten in order to compensate for the stretch (called the myotatic reflex). This is what causes your leg to kick out when you tap your knee.

Knee Reflex

There are two main types of stretching: dynamic and static. Static stretching is what we just talked about, which is a stretching routine that includes holding 30 second stretches for specific muscles. When using static stretching before a sport that requires you to use specific muscles to initiate specific movements, it is hard to relate static stretches to dynamic activity. This is where dynamic stretching comes in. Dynamic stretching is designed to mimic the actions and movements you are expected to perform during a specific sport. For example, this would include kicking around a soccer ball in warm-up before a soccer game, so your body can get accustomed to activating the required muscles. That way, your muscles can make the necessary preparations to prevent injury, as playing a sport requires many specific dynamic and explosive movements.

Starting blocks

For your hip flexors, I teach a ‘dynamic lunge’; such that your hip flexors, quadriceps and pelvic muscles are used within the stretch. If you add Kegel exercises to this movement, the pelvic floor muscles are activated more and a greater effort can be applied to this core stretch. Remember those pre-natal classes guys? A patient was recently surprised to know that guys can do Kegels too! Guys are equipped with those same pelvic floor muscles and ladies should appreciate these efforts, as do the men!
Overall, stretching is very beneficial for movements involved in a regular day, and those involved in heavy labor, repetitive activity and sports. Therefore, it should be a priority for everyone to incorporate some sort of stretching into their daily routine (after warming up of course!), in order to maintain optimal functionality.  Flexibility is a highly underappreciated component of muscular strength and function, but key to good performance at work, home and recreation.

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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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Winnipeg, have you heard? Sitting is bad for you…solutions by Physiotherapy Winnipeg, yourPhysio.com

Winnipeg, by now you know you probably know that sitting down all day is terrible for you. As computer hardware and software accelerate the ‘web 3.0’, we can do more than ever before from a sitting position. Ergonomics is no longer a foreign word, and our ‘core’ exercises need to be performed everyday!

Who needs scientists to tell you that sitting for even one hour causes the production of fat-burning enzymes to decline a whopping 90%, or that more than four hours of desk time each day raises your risk of a heart attack by more than 100%?

You can feel exactly how crappy sitting all day makes you feel at the end of each workday; though you may be shocked to learn that being a regular gym-goer doesn’t protect you from the harmful effects of all that sitting. Standing up more is scientifically proven to have huge health benefits, but in our digital world it’s not as simple as it sounds. Here’s how to make the switch to an upright workday.

Try the latest DIY option, I have had so many patients describe their attempts at raising their work surface by box, crate, home-made devices, etc. I’m sure you could find the latest ‘how-to-video’ on YouTube to get an idea as to how to produce something for your workstation. Ergonomic clients of yourPhysio.com have purchased electronic and hydraulic ‘sit-stand’ workstations to allow their employees the postural variety that may be necessary for back pain, hip strains or knee sprains. These rehabs require movement throughout the day, and consistent changes in posture is a great place to start.

Invest in an ‘anti-fatigue’ mat, change your shoes every 6-8 months or try an over-the-counter orthotic to replace those worn insoles. You may require a doctor’s note to have orthotics covered by your insurance plan, but it is an employment benefit; so benefit!

Tweak your ergonomics, hire an ergonomic consultant for an hour and learn the proper way, not only how to sit, but how to perform your job so that it will not cause pain. Ask questions about posture, exercise and equipment available to make any task easier and less painful.

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Steroid injections for back pain can lead to bone loss, beware those with elbow pain, chronic pain, use Physiotherapy Winnipeg

Lately, many patients with chronic pain, including those with back pain, shoulder rotator cuff pain, elbow tendinitis pain or other chronic pain, have been asked by their family doctors ‘if they would prefer corticosteroid injections to physiotherapy?’

A Henry Ford Hospital, in Washington, D.C., study ( http://t.co/W3gj4dJt ) has found that postmenopausal women suffered significant bone density loss in their hip after they were treated with an epidural steroid injection for back pain relief.

Bone density loss after six months was six times greater when compared to the typical bone density loss seen in a year in a postmenopausal woman who doesn’t receive steroid injection, researchers said.

Shlomo Mandel, M.D., an orthopedic physician and the study’s lead author, said physicians should exercise caution prescribing an epidural steroid for select patients, suggesting that multiple injections may compromise bone strength.

“The findings of our study suggest that epidural steroid injections for back pain relief should be approached cautiously in patients at risk for bone fragility,” Dr. Mandel said.

“Physicians who do prescribe them should consider measures that optimize bone health such as calcium and vitamin D supplements and exercise as part of their patient’s treatment plan,” he added.

Back pain is one of the most common medical conditions in the United States, affecting 8 out of 10 people at some point during their lives. As people age, their spine ages with them, causing degenerative changes in the spine.

Patients are typically treated with anti-inflammatory drugs and physical therapy. If symptoms persist, an epidural steroid is often prescribed to alleviate pain and improve function. However, steroid use has been linked to diminished bone quality.

There has always been the link, and the questions concerning steroid injection and tendon or bone deterioration. One of the more famous cases was that of Joe Montana, Hall of Fame NFL quarterback and his elbow tendon rupture following multiple injections. Now there are not many of us that perform at this level, but chronic pain of any type can be debilitating and life altering. Please know your options and be aware of all the side effects associated with longterm medications; the list of side effects may outweigh any medical advantage.

If you are considering steroid injection as a form of treatment; ask your doctor about his/her experience in delivering such a treatment option. An orthopedic surgeon or experienced sportsmedicine doctor would be a wise choice.

Your Physiotherapist should be able to address your concerns about such a treatment option, and he/she should be able to provide treatment relevant to your pain trigger points and the appropriate exercise to assist in your longterm rehab.