The end of the heating pad in physiotherapy

It has just come to our attention that a new initiative from the American Physical Therapy Association aims to shed light on a few archaic treatment techniques that just don’t pass scientific muster.

You can check out the post at the following link and read about the end of the heating pad in physiotherapy:

Farewell Heating Pads – Say Physiotherapists

While it’s great to see our colleagues down South take a strong position on some of the physical therapies that continue to be used simply because of tradition or even for financial reasons, for us at Primal Human Performance, this isn’t really news.

Since our inception, we have focused on using the physiotherapy treatments that have a large body of evidence that support their use: active rehabilitation, exercise and education.

That’s why we aim to get most of our clients moving and using their bodies as quickly and as safely as possible.

And that’s also why we don’t even own any of the standard or traditional physiotherapy electrotherapeutic modalities such as TENS, IFCs, ultrasounds, or even hot and cold packs.

Instead, we have a fully appointed gym with power racks, dumbbells, barbells, bands and medicine balls.

Because exercise is medicine.

What should I do when I get injured?

While the answer to the above question depends on the type and severity of the injury, for most simple, uncomplicated musculoskeletal traumas such as slight sprains and strains, R.I.C.E will come to the rescue. For all others, seek the assessment and advice of a qualified expert.

Rest: To reduce risk of further injury, trauma, pain, or compensation patterns. This can include stopping the painful activity or using supports such as slings/crutches to offload the injured area for a short period of time, and as appropriate. Rest should NOT usually entail complete sedentary behaviour but rather should be directed towards avoidance of pain-provoking activity. For example, if you’ve hurt your shoulder playing golf and it hurts every time you swing a club, might be a good idea to take a break from golfing.  It doesn’t mean you should stop walking and set up shop on your couch, feeding your feelings of woe with chips and ice cream.

Ice: To control swelling and pain. Commercial gel ice packs work really well, with frozen peas coming in a close second. Ideally you want a cold pack that will conform to the injured area. When using any form of icing, be wary of putting the cold pack directly against the skin as this can potentially lead to frostbite. A safer option is to cover your ice pack in a moistened towel and place the covered pack over the injury site. Typically aim for 20 minutes on followed by an hour off. Repeat once or twice.

Too much compression?

Compression: To help with swelling, to brace/support the injured area, and to remind yourself that the area is injured. Tensor bandages, various commercial sleeves (e.g. elbow, knee, ankle), athletic tape can all help with creating compression in the injured area. Compression should be strong but should not be so intense as to cut off circulation. Also, to make sure that you aren’t overly compressed, remove your support/brace/tape every so often to let circulation flow unimpeded. You should never develop numbness, tingling or loss of sensation from using a compressive device.

Elevation: To help control swelling, which in turn will often decrease pain. Gravity is not just a good idea, but a law. Use this to your advantage to help drain extra fluids from injured areas. Try to get your injured site above heart level. The longer you can keep the area higher up, the less likely that fluid will pool at the injured area. Elevation works really well when coupled with R.I.C from above. For example, if you’ve sprained your ankle, you could lie on your back with your foot supported above you (pillows, stool etc), ankle wrapped in a tensor and covered in a cold gel pack for 20 minutes.

These four action steps, held in high regard by physiotherapists, chiropractors and personal trainers globally, have helped numerous individuals manage and mitigate the negative fallout from a sudden minor traumas for years.

They are, and will continue to be, one of the best first responses for these types of acute injuries.

Yours in movement.

Team Primal

 

The Three Worst Abdominal Exercises for People with Low Back Pain

The internet has reshaped our world.

It has the ability to transfer information and knowledge across the globe in real time.

You have a problem, Google your signs or symptoms, and more than likely you’ll find thousands and thousands of pages of solutions with Dr. Google coming to the rescue!

So what’s wrong with that?

As a physiotherapist in Vaughan, these are the questions I ask myself: How good is the information? What’s the source? Can it be trusted? Will it help? Or will it harm? What are the risks? The benefits?

This becomes even more important when dealing with various injuries or illness where the potential for making things worse may be higher, where the risk of aggravating already irritated tissues may compound or where delaying appropriate treatment may lengthen the course of recovery.

It’s no different with relieving low back pain. Plug in those search terms and instantly you’ll have at your disposal more information than you could possibly even use.

Often, a good portion of the information that shows up discusses strengthening your abs to fix your back problems. This may sound quite similar to the advice many people are given by their medical or fitness professionals:

“Strengthen your core to protect your back”.

Unfortunately, over the years, abdominal training has become popularized as the foundation of core training. In reality, abdominal training accounts for only a small part of the bigger core training picture.

To make matters worse, poorly designed or applied abdominal training can make you worse and keep you in pain.

So in keeping with the spirit of this post, here’s my list of the three worst abdominal exercises for people with low back pain:

  1. The traditional crunch or sit-up: These staples of most back rehab programs should be eliminated due of the incredible compressive loading forces created through the spinal discs. Dr. Stuart McGill, one of the foremost spine researchers in the world, has measured compressive forces of approximately 3300N (730 lbs) in the spine with these types of exercises. The scary part: this is equal to the amount of force listed by certain government health agencies as the amount of force needed to cause injury!
  2. Abdominal twist machines: So if crunches or sit-ups can cause as much damage to your spine, imagine what happens when you take a similar exercise, restrict movement at certain joints, isolate movement at others, twist and then add a load? By taking a flexion movement and adding a loaded rotation component on these machines, you’re well on your way to sending yourself off to the disabled list. In fact, we’ve  dubbed these types of exercises “disc herniators” and inform our clients that they should only continue to do these if they wish to help us finance our latest facility expansion.
  3. Back Extension Machines: As described by Dr. McGill, the repeated spine flexion/extension movements (forward/backward bending) used by these devices create the same conditions that were necessary in his lab to produce disc herniations in his spine models. Enough said. Why would you want to do the same to your back at the gym when you’re trying to help it heal?

So there you have it…The 3 worst core exercises for people with low back pain. If you love your back, you should probably stop doing them.

In our next post, we’ll discuss 3 spine sparing core exercises that are appropriate for people with low back pain.

Yours in movement.

Dev Chengkalath

Rehab and Performance: Can the Two Co-Exist?

You were super active up until the moment you got injured.

You might have twisted your ankle stepping off a curb while out on a 10K run. Or your knee buckled underneath you while you were hitting the slopes hard. You may have tweaked your low back while playing horsie with the kids. Or maybe you pinched your shoulder reaching into the back seat of the car to grab your purse.

Whatever the body part, something bad happened. And things suddenly changed.

You know what usually happens next, right?

“I’ll take a few days to let it rest, it should clear up.”

Maybe a little ice. A couple ibuprofen. A tensor wrap here, a hot pack there. Some Tiger Balm. And a big glass of red wine.

For some, that’s all it’ll take and things will clear up. They’ll be back to their everyday activity, pushing the limits, and living life. The pain, the dysfunction, and the misery will be nothing more than a long forgotten memory.

For the unlucky few, it unfortunately doesn’t work out that way. Things stay the same, or they get worse. More pain. Less movement. Weakness. Decreased function and performance.

Out comes the Ben & Jerry’s, on goes the TV, and the moping begins.

“Why me?”

“Why won’t this heal? Why won’t it get better?”

And here begins the sad, downward spiral of the once lofty fitness goals and aspirations.

The running stops cold. They gym, heck, that could be on another planet! Even the kids will have to wait till you feel better to play with them.

Limping. Hobbling. Shuffling. Modifying how you do things.

“Exercise?! Are you kidding me, I’m injured!”

Days grow into weeks. You feel your once toned muscles soften like freshly kneaded dough. Your shape slowly shifting, growing at the paunch almost imperceptibly at first, but then quickly gaining steam.

The couch, which remarkably wasn’t made of memory foam, has developed new physical properties, and has somehow molded to your new and expanding body contours. Like a plush glove that embraces you, welcoming you, caressing you. Bidding you to stay for a while.

Your motivation levels drop. Depression creeps in. It gets harder and harder to even do little things. You’re on edge. Your mind’s not as sharp and clear as it used to be. You feel anxious without even knowing why. Restless like a caged animal that needs to let off steam.

You realize that you miss your former active self; enough is finally enough.

You’ve realized that nothing truly changes if nothing changes.

“That’s it, I’m going to get ________(insert injured body part here) fixed!”

You dutifully look up your physiotherapist/chiropractor/massage therapist (insert your injury rehab professional here) and call them up and get booked in for your treatment.

You diligently go through your rehab and at the end of it all, you are free from pain, you have your range of motion, and your strength is coming back.

You’re now just a softer and weaker, albeit pain-free, version of your old injured self.

Discharged from therapy, you start from ground zero again to build yourself back up. Step by slow step. For most people, that’s almost as daunting and depressing as being injured!

What if there were another way?

What if, during your rehab, you actually IMPROVED your fitness? What if you shed a few of those injury pounds? What if, at the end of your treatment plan, you were able to perform at, or beyond, the level you were at BEFORE you got injured?

At Primal Human Performance, we believe that the above should be part of every injury rehab treatment plan. We believe that your injury treatment should not merely cover the bases, but should empower you to attain physical peaks you didn’t think possible.

That’s why as soon as you’re body is ready, we’ll have you in our high performance gym, pushing, pulling, squatting, lunging, crawling, and throwing your way to optimal health and ultimate performance.

Who says you can’t rehab an injury while improving your performance at the same time?

Team Primal

Dangerous job? 40,270 injuries per year! Are you at risk?

Photo Credit: Sylvain Pedneault

If this is your profession, that should scare you.

According to the National Fire Protection Agency in a 3-year period, there were an estimated annual average of 40, 270 firefighter fireground injuries in the U.S. Of these injuries, 24% were attributed to minor sprains/strains, 12% to pain and 34% moderate to severe sprains/strains (1). This accounts for a whopping 70% of total fireground injuries reported!

Since the job requirements are likely fairly similar, it’s not hard to imagine these injury percentages being equivalent here in Canada.

As a firefighter, what does that mean to you?

Quite simply, firefighting is a high risk, dangerous profession!

These types of injuries can cause all sorts of problems, both personally and professionally.

  • Lost time at work
  • Inability to safely complete physical job requirements
  • Placement on modified duties
  • Risk of further injury or disability
  • Challenges with everyday tasks such as playing with kids, exercising
  • Drop in morale and confidence
  • Increased rates of frustration, depression due to pain and dysfunction

So what can you do to protect yourself?

In our opinion, there are two things you can do to put yourself in the best possible position to have not only a long, safe career as a fire fighting professional, but also a healthy life outside of work as well.

Photo Credit: AMagill

“An ounce of prevention is worth a pound of cure”

The first item is simply represented by the quote above. This means decreasing your risk before you get hurt. This means doing all you can to make sure your body is in the best possible position to tolerate the rigors of your specific work tasks: that your shoulders and rotator cuff are strong enough to pull heavy hoses, that your legs can tolerate repeatedly climbing ladders in full gear, that your back and core are tough enough to withstand crawling through dangerous terrain, or smashing down walls.

Research has shown that having your body conditioned by improving certain fitness factors, much like a professional athlete, will allow you to perform safely at the highest levels possible, with the lowest risk of injury (2, 3).

These factors include:

  • Improving your cardiovascular fitness and stamina to buffer against thermal stress
  • Augmenting anaerobic capacity, allowing you to perform bursts of high intensity work such as breaking down walls and doors
  • Bolstering muscular strength and endurance to help you lift, carry, and drag anything you need to, with greater ease and less strain on your body
  • Optimizing core strength to protect your back against potentially harmful job-specific movement patterns
  • Maximize shoulder stability to avoid disastrous rotator cuff or shoulder injuries

Photo Credit: Joshua Sherurcij

By addressing these important fitness factors before you’re injured and increasing your body’s capacity to tolerate profession-specific stresses in a preventative fashion, you can avoid the unnecessary aggravation and pain of common firefighter sprain/strain injuries to your shoulders and rotator cuff, your neck, your back (upper/lower), or your knees and legs. Your workplace benefits package may cover treatments with highly trained physiotherapists and chiropractors who possess specialized knowledge of your job-specific needs, so be smart – Think prevention, not rehabilitation

“You don’t fix the problem until you define it” John W Snow

Secondly, it’s imperative to treat and rehabilitate your existing injuries properly the first time. This means not just dealing with symptoms and giving you a band-aid solution. These only work superficially, but don’t really fix the problem. Proper treatment and rehab should first involve a comprehensive and thorough assessment to find out the underlying causes and risk factors relating to your injury and it should include a complete treatment plan which addresses them in a task specific, functional manner.

Let’s use the example of a firefighter with low back pain. An assessment would look at the typical positions or movements this individual is exposed to throughout the day:

  • Do they slouch?
  • Do they bend or twist through their back too much?
  • Do they bend forward and backward repeatedly?
  • Do they twist and turn through the wrong parts of the spine?

During treatment, specific exercises or interventions would be implemented to reduce pain, address problem areas, and protect against further injury. These can include:

  • Postural corrections
  • Hip mobility drills
  • Core strengthening exercises
  • Functional retraining

Photo Credit: Joshua Sherurcij

This comprehensive assessment and treatment approach not only treats your injury, it also improves your performance. Not as an afterthought. Not as an aside. But as an integral part of your rehabilitation program.

At Primal Human Performance, we’re focused on specialized treatment for emergency service professionals.  Our practitioners, using a variety of specialized assessment, treatment, and therapy techniques, can diagnose your problem and trace it back to the root causes. From here, we will design and implement an individualized treatment plan that will not only deal with the causes of your injury and get you out of pain, but also take your performance to the next level in the shortest time possible.

Yours in Optimal Health,

Dev Chengkalath, Physiotherapist and Katie Au, Chiropractor

References:

(1) Patterns of firefighter fireground injuries. Karter, MJ. National Fire Protection Association, Fire Analysis and Research Division. May 2009.
(2) Curr Sports Med Rep. 2011 May-Jun;10(3):167-72. Firefighter fitness: improving performance and preventing injuries and fatalities. Smith DL.
(3) J Occup Environ Med. 2010 Mar;52(3):336-9. Implementation of a physician-organized wellness regime (POWR) enforcing the 2007 NFPA standard 1582: injury rate reduction and associated cost savings. Leffer M, Grizzell T.

One Man. Two Ratchet Sets. And lots of metal.

Beyond Survival. Learn to Thrive.

7 Simple Steps to Perform at Your Best

If you’re looking to perform at your highest level, there are a few things you should consider to ensure that your systems are firing on all cylinders and that you’re actually achieving your full potential.

Stay Hydrated: Many studies have shown that even a small drop in hydration levels can negatively impact performance. The ideal beverage is, of course, water. Being calorie free, it can be an important component of not only helping your physiological systems do what they are designed to do, but also helping you shed those unwanted pounds.

Fix Your Fuel: As any of the top race car drivers could tell you, their finely tuned machines wouldn’t be able to push the limits of performance without a solid supply of the best fuel out there for their engines to burn. Think of your body the same way. Eating the right foods, at the right time, will ensure that your body has the energy source it needs to keep you going. And going.

Pre-hab: The easiest injury to treat is the one you don’t have! Pre-habilitation means doing the right things to make sure your body is able to tolerate your sports and activities before you get hurt. This is prevention at its finest. Adding a pre-hab component could be as simple as putting a joint mobility/stability program in place (e.g. mobile hips and stable spine for low back pain avoidance), or it could mean working on some of your weak points (e.g. increasing core strength).

Rehab: While pre-hab is a great and can help reduce the risk of many injuries, unfortunately, it’s not 100% guaranteed. In sport, as with life, injuries can, and do, still happen. What’s important here, though, is that they are dealt with immediately before any secondary or compensatory issues occur. This is where enlisting the help of a sports-injury focused physiotherapist or chiropractor can really make a difference. The sooner you address the problem and resolve any lingering issues, the sooner you can get back to what you love!

General Fitness and Athleticism: Who couldn’t use more strength and flexibility? Or more cardiovascular endurance? Or more anaerobic power? While you may not be paid millions of dollars to play a sport, you are still an athlete! And these are just a few of the physiological components that you can significantly improve with a well-constructed, progressive and consistent training plan. As a bonus side effect, you’ll burn off a bunch of unwanted fat and have to buy yourself a new wardrobe to compliment your new chiseled, athletic physique.

Sleep: Tired. Fatigued. Fighting to keep your heavy eyes open, and your mouth closed from perpetual yawning. Sound familiar? If you’re like most people, you’re probably not getting enough of it. Or, if you’re one of the lucky few who gets enough hours down,  you’re might not be getting the quality of sleep your body needs. To help with this, develop good sleep hygiene habits. Set up a pre-bedtime routine that allows you to free your mind of the day’s stress and negativity. Disconnect from all your tech gadgets and gizmos (that means leaving your cell phone out of your bedroom!) and make sure your room is as dark as you can get it.

Rest and Recover: This goes beyond sleep. If you’re always on the go, there’s a good chance that you’re not getting enough rest and recovery. While not all stress is bad (it can be a really good thing, under the right circumstances), fighting it day in and day out without the opportunity to reset will leave your endocrine and nervous system fried. Carve out a small chunk of time where you can decompress, de-stress, and just let yourself unwind. Take a walk, read a book, or hop in the tub for a stress-busting soak. Your mind, and your body will thank you.

Yours in Optimal Health,

Team Primal

Our Philosophy Wall: Get Primal.

 

 

Why am I in pain?

Do you get out of bed feeling tired, sore and achy, even after having slept for 8 hours?

Do you come home from work, at the end of along day, your neck and shoulders screaming at you, tight and tense?

Does your knee wobble, give out, and curse every time you try to jog around the block or even tackle a set of stairs?

The bad news: you’re probably hurting yourself every single day without even knowing it.

Sounds strange doesn’t it? But for most of you out there, it’s true.

From back pain to neck pain to shoulder pain or even knee pain, there is likely something you do everyday that keeps you in pain.

The good news…

It can be fixed!

There’s a good chance that with the appropriate steps, a splash of education and a dash of dedication, you can be pain free and doing the things you love. And usually, these fixes don’t have to consume your free time or even cause huge changes in your life!

So what’s the fix?

Postural Awareness!

Postural awareness is your awareness of your posture throughout the day. Since a large number of injuries, aches and pains (such as those described above) can be attributed to repetitive strain and overuse, being aware of your posture can help you decrease the chances of this happening.

How is posture implicated in repetitive strain and overuse injuries?

For example, if you work in an office setting all day, you likely spend a large amount of time sitting at a desk. This would likely involve using a computer, talking on the phone, writing etc. But overall, it’d be fair to say that you’d spend most of your time seated. If you’re like most people, you also likely slouch when seated. And again, like most people, you probably slouch the same way you always do, in the same position.

By holding these sustained slouched postures for a good chunk of the day (5 or 6 or more hours), the various components of your body such as your joints, muscles, tendons and ligaments are forced to do more work or different work than they’re designed to do. Over time, these repetitive stresses build up and cause small injuries called micro-traumas to these structures. As time goes on, these micro-traumas accumulate causing changes in how you move or use your body (compensations).

At first these compensations are quite small and you probably won’t even notice them. It may be something as simple as a slight weight shift onto one hip more than the other when you’re sitting or a sneaky elevation of the shoulder when you reach for something.

As these compensations continue to take place, the micro-traumas become bigger problems, which we call macro-traumas. Think of this as the straw that breaks the camel’s back. These are the ones you’ll notice. This is where the pain stops you from doing the things you love doing and really starts impacting your life.

What can you do?

  1. Change your postures often: You can do this by getting up and moving around more. Or change your position every time the phone rings. Our bodies are designed for movement. The more they move, the better they function and the healthier we are!
  2. Improve your fitness: If your fitness level is higher, you, and your body, can tolerate more stress before hitting a breaking point. Plus, as an added bonus, exercise can be a great stress buster! Who couldn’t do with less stress in their life?
  3. Improve your nutrition: In fact, this component may be one of the most most important steps you can take to change your life for the better. As your mama always told you, you are what you eat! Unfortunately for many North Americans, life is busy. And that means that we try to find fast and convenient ways to feed ourselves. Sadly, our choices tend to be sub-optimal which will then impact our body’s ability to prevent injury or recover from injury.

How we can help

Our highly trained team of physiotherapists, chiropractors, massage therapists, personal trainers can help you get back to the business of life by consulting with you to design a personalized treatment plan to assist with a variety of injuries, aches and pains. Contact us to start on your journey to your Optimal Health and Ultimate Performance.

How can a physiotherapist in Woodbridge improve your health?

There’s Health and Then There’s Optimal Health.

Health is the ability to survive. Optimal Health is the ability to thrive.

Optimal Health is about taking, or regaining, control of your life, from managing stress to dealing with nagging aches and pains. It means doing everything you can to recover from injury, illness, or surgeries; it means being an active participant in your own care.

It’s about taking the right steps to improve your most valuable asset: your health.

Optimal Health is about living with an abundance of energy so you can readily take on daily challenges. It encompasses your nutritional status and your general fitness. It’s more than just doing the bare minimum to get by. It’s about reaching your true, untapped potential. It’s your opportunity to show the world who you really are. It’s your opportunity to shine.

The choice is yours…

You can choose plain, regular health. And just float through life in a haze, scraping by.

Or you can choose Optimal Health and experience the endless possibilities.

At Primal Human Performance, we’re here to help you find solutions to your problems.

Contact us today to start living your life, on your terms!