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Glucosamine, Chondroitin supplements for Joint Pain in Downtown Winnipeg

If you work in Downtown Winnipeg, you experience the ‘hardness’ of your daily commute. It is a ‘concrete jungle’, and the impact on your feet, knees, hips and back can be felt on a daily basis.

We all know someone who takes ‘vitamins’, or some kind of ‘supplement’ with the latest health benefit.

I get asked almost everyday about ‘glucosamine supplements’ for arthritis, joint pain, etc. Those ‘horse pills almost choked me’ exclaimed one patient, ‘how much do I need to take to even notice a difference in my knee pain?’, ‘where can I get those pills that supposedly help my joints?…are common questions in Downtown Winnipeg.

In a 2010 British Medical Journal, one of the most reputable of all scientific journals; an article published this conclusion:

“Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space. Health authorities and health insurers should not cover the costs of these preparations, and new prescriptions to patients who have not received treatment should be discouraged.”

So is it fair to conclude that it’s not worth taking glucosamine, and/or chondroitin supplements?

Maybe.

May I present the evidence to people to let them make an informed decision. I have seen patients describe dramatic reductions in pain after taking G&C. If the supplement helps your symptoms it may be worth continuing it, especially if stopping taking it causes an increase in pain. I’ve also seen many report no change and complain about the ongoing cost. 1 or 2 have reported occasional side effects, although these supplements are generally considered fairly safe to take.

Other studies have shown more promising results, with Bruyere et al. (2008) concluding G&C may reduce the need for total joint replacement. It’s worth noting however, that in terms of quality of evidence, a systematic review of multiple research papers is usually considered better evidence than an isolated study. A recent analysis by Lee et al 2010 did show that G&C may slow progression of osteoarthritis (as measured by X-ray change) although it required taking it daily over 2-3 years.

But Sawitzke et al. 2010 found “no clinically important difference in pain or function” when compared to placebo. The Cochrane Review (2009) – Glucosamine Therapy for Treating Osteoarthritis had somewhat mixed results but concluded it may reduce pain and improve function.

Prices of G&C vary a great deal. Most clients speak of Costco having ‘bulk’ prices, while Walmart still has the edge on discount pricing for ‘reasonable amounts’. But physicians I have questioned here in Winnipeg, some at our best sportsmedicine centres, still recommend greater than 1600 mgs per day, over greater than an initial 6 week period to judge the supps usage.

Personally, I have recommended our local Winnipeg stores, like Guerrilla Jacks and Sunrise Health; as there is still nothing like more opinions and education about your health.

So the question you need to ask yourself is, am I willing to spend that much on a treatment that might help or may make no difference to my pain or the progression of arthritis?

Words of caution: If you are planning to take supplements to treat arthritis or other conditions discuss this with your GP or Pharmacist.

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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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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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Sitting a ‘disease in Winnipeg? Just a necessary evil of our computer driven ergonomics Downtown

Really…too many media driven articles on sitting as a disease”…since 1991, it’s been a necessary evil of our increasingly computer driven ergonomics at work, rest and play; the desktop, the laptop, the smartphone, the tablet, next?

But then why are exercise plans so quick to add the situp? or bench press? or knee extension? All of these place our biomechanics, our posture into greater flexion! Beware, add more extension exercises now! add those planks!

Give yourself more reasons to stand…even every 12 minutes is ideal. If you cannot figure it out, give me a call…your ergonomics may be your disease…and you are not retiring anytime soon.