How long will it take?

How long will it take?

How long will it take?

How long will it take…That is the question.

How long will it take to lose weight? To fit into my favourite pair of jeans?

How long will it take to build muscle? To get lean and ripped? To see a six pack?

How long will it take for my injury to heal? To get back to sports? To doing the things I love to do?

How long will it take to get fit? To get healthy? To have more energy and stamina?

While the end results of all of these questions may be a little different from each other, with some focusing on changing physiques, other dealing with injury rehabilitation and some primarily focused on general health and wellbeing, all of these questions are really asking one thing:

“How long will it take before I see changes?”

If we were to base our expectations on the headlines often seen on the covers of any of the health, fitness or fashion magazines that we’re constantly bombarded with, the answer lies somewhere between 10 days and 12 weeks.

We read about celebrities and their fad diets and intensive training regimens dropping 10 lbs in 10 days, or bulking up and adding massive slabs of muscles to their frames for their upcoming superhero roles in just 12 short weeks.

We see athletes with seemingly unsurmountable injuries return to play in what appears to be just mere weeks or months after major surgical repairs and broken bones.

And then we believe that’s what the norm is. We believe that those types of results are typical. That those types of results are the expectation.

We use those media published stories as the foundation of our own barometer of success.

Have I lost weight fast enough?

Have I put on muscle fast enough?

Have I come back to sport soon enough?

And then sadly, we are disappointed when our reality sets in and we haven’t achieved those lofty goals in the desired timeframe.

The scale has hardly budged. Our injury hasn’t healed.

So what’s missing?

Why didn’t our reality match the other reality?

Why weren’t we able to do what “they” did?

One thing: context.

For those actors and celebrities transforming their bodies, their work opportunities (and corresponding paycheques) often depend on their physical appearance. The roles they’re cast in may require a certain look or physique such as Christian Bale’s extreme and drastic transformations from The Machinist to The Dark Knight.

The same broad scenario applies to the high performance and professional athletes, whose finely-tuned bodies are the tools of their trade. The performance of their bodies dictates their salaries and endorsements. It has very real and tangible impacts on their livelihoods.

For them, they now have the drivers (both internal and external) to push them to allocate the resources (or find the resources) to achieve these targets.

They have teams of highly skilled and trained people at their disposal.

They can hire the elite physiotherapists, personal chefs, sports nutritionists, and specialized personal trainers to craft structured programs.  They have the time and resources to allocate to go to work – in this case, changing their bodies, building their bodies or healing them.

For them, their body is their job.

For those of us not in that context, we have matters that may take greater precedence. Like young kids or aging parents. Like our jobs and careers, the means by which we pay for life. Like our housework and chores. Our day to day tasks.

By the time these pressing daily items are dealt with, we often don’t have the eight or nine hours left in the day to sleep and recover. We don’t have the two, three or more hours a day to lift weights, do cardio or rehab. Our meals are often grabbed on the go, instead of being homemade, perfectly balanced, and fully nutritious.

Our context, when put in perspective against these media marketed norms, is very, very different.

So how long will it take?

As always, the honest answer is it depends.

It depends on our context.

It depends on what resources we can invest into our results – how much time, money, effort and energy we have to spare.

What we’re willing to sacrifice.

So while these media based standards of transformation and rehab seem unattainable, that’s not to say that we can’t make change happen. We can. Our bodies are capable of incredible feats, if given the opportunities and means.

We just have to figure out what we’re willing, and able, to put in.

From there, we can then figure out how long it will take.

And looking honestly at our context, it may just take longer.

Simple Formula For Results

In this short video clip, we discuss a simple formula for results.

Paying attention and addressing any (or all) of the components has the potential to take your results to the next level.


Risk to Benefit. Is it worth it?

“Can I go back to playing [insert sport or activity] yet?”

In physiotherapy and sports medicine, this is one of the most common questions we get asked. And at it’s most fundamental, it’s a question about risk to benefit.

The athlete wants to go back the the activity she enjoys. She wants to hit the field, return to sport and get back to her team.

Unfortunately the answer to that question, as always, is: it depends.

It’s very seldom a straight yes or no. There are often many individual and situational variables to consider when assessing risk to benefit for return to sport or activity.

These include:

  • What type of injury did the athlete suffer?
  • What was the severity of the injury?
  • How long has she been injured and how is the injury progressing?
  • How long has she been doing her injury rehabilitation?
  • What type of rehab has she been doing? Is it passive? Active? Both?
  • What type of sport does she participate in?
  • What level does she play at?
  • What intensity will she be going back?
  • Is her fitness level adequate or has the layoff led to a loss of sport conditioning?
  • Can she gradually ramp back up to normal levels? Or will she be going back in all out, right away?

These are just a few of some of the questions that should be taken into consideration for safe return to sport – a return where risk to benefit is  heavily skewed towards the benefit side of the equation.

Any physiotherapist or sports medicine practitioner who has been involved in the industry for any length of time will have learned early on that many athletes will return to sport with or without our blessings. This is often more prevalent in a competitive realm where being seen or performing consistently may have an impact on future opportunities (e.g. playing in front of college or university scouts, rep team tryouts etc).

So then the important part comes down to making sure that our athlete is clearly informed about what becomes the biggest consideration for a safer return to activity: risk to benefit.

Is the risk of returning to sport early worth the potential benefit?

One of the biggest educational items we work on with our athletes is to let them know the major possible risks and let them compare those risks to the potential benefits of returning to sport.

It’s that same risk to benefit consideration that keeps popping up.

Having knowledge of her particular risk to benefit ratio will give the athlete the power to make the informed decision for herself as to whether or not the risks of returning to play (e.g. re-injury) are worth the benefits (e.g. exposure in front of scouts).

Or if it would be a better option for her to hold off for a little while longer until her risk drops and the benefit increases.

If you’ve been injured and you’re wondering if the risk to benefit in your specific case is worth it, get in touch with us. We can help you make an informed decision.

Do the work.

It’s not good enough to just show up.

You have to do the work.

Yes, we all think we do the work.

We often do enough to get by or satisfy our belief of what’s work.

Or we do what’s comfortable, what we’ve always done.

But when it comes to fitness and health, there are so many forces pulling us in so many directions that we aren’t always truly doing the work we need to be doing.

This is not meant as a personal attack.

But if you want to start seeing results*, the first item on the agenda has to be taking stock of where you’re actually starting from, doing a current audit of sorts.

When you go to the gym, how hard are you working? How efficient are you? Do you take your mobile device and check Facebook every few minutes? Do your water breaks seem to stretch out into happy hour territory? Does the intensity of your exercise actually leave you feeling like you’ve put everything you had at that time into it or could you go for round two without even breaking a sweat?

In most cases, we find short cuts. We find the easy outs.

We find any number of ways where we can make the work easier. Longer rests. Lighter weights. Slower pace. Lower difficulty setting. And so on.

This is human nature (at least for the vast majority of us) – we seek the path of least resistance.

When it comes to health and fitness, that’s not always the best course of action.

To teach the body to adapt to higher levels of fitness, we need to put it in higher levels of challenge and stress, beyond what we’re comfortable with, with enough consistency over a long enough period of time.

Being at the gym for an hour will not suddenly confer improved performance, decreased body fat or improved cardiovascular fitness or stamina.

Unfortunately, the feeling many people get from just showing up translates into the feeling that the work was done. This is almost like a mental check mark. And what do we do when we’ve crossed something off our to-do list is we often congratulate ourselves for the job well done and take a break in celebration.

Now, being at the gym and busting your butt for an hour, pushing yourself, putting it out there in a progressive manner, that, when repeated over time, will confer physiological changes. That will be the stimulus your body needs to change and adapt. That’s how fitness is earned and physiques are crafted.

Basically, showing up is not the same as showing up and doing the work.

So if you’ve been working on your health and fitness and haven’t been seeing the results you want, it may be time to sit down and do an honest, objective audit of the actual work you’re doing.

And keep in mind that to earn the results, we have to do the work.

*The work audit should also take into account the “work” you’ve been doing with your nutrition. Exercise without appropriate nutrition will not yield optimal results.

Perfect Form in Exercise – Does it even exist?

There is no such thing as “perfect form” in exercise.

There is, however, ideal form, which is more of a range of forms rather than one fixed position.

Ideal form changes from person to person based on myriad variables which can include at a minimum:

  • body shape (e.g. height, limb length, anatomical structure/build)
  • training experience (beginner, intermediate, advanced, elite)
  • injury and/or fitness status (rehab, post-rehab, post op, fit, sedentary)
  • goals (recovery from injury, lose body fat, gain muscle mass, improve mobility, increase endurance).

Take for example an individual who comes in with knee pain when squatting (either with body weight or with external load). Once cleared for any underlying issues such as nerve involvement or ligament/cartilage injury, there are few ways to aim to get back to squatting pain free.

In many cases, the above described individual will find relief and be able to continue squatting with just three simple positional alterations:

  1. Change in stance position: Many people do better and experience less knee discomfort with a wider stance. There are some people who do better with a narrower stance. Play around with this to find your sweet spot. You may also find that comfortable stance position changes for different types of exercises (e.g. wider back squat vs narrower front squat).
  2. Change in foot position: This involves changing the position of the foot itself. For some people, this may mean turning the foot out (toes pointing away from midline of the body). For others, this may require bringing the foot back to a more forward facing position (neutral foot). Again, your ideal foot position may be slightly different for different exercises. Play with your foot position to find the one that allows you the best range of motion with no pain.
  3. Change in hip travel path: This involves changing the direction of travel of your buttocks as you squat. For some people, a more backward travel path may help, while other may find a more vertical path less painful. As with the previous two, your ideal movement with this may be different with different exercise.

If you’ve been having knee trouble with your squats, give these three a go. Some people may only need to alter one item on the list, while other may have to work with a combination.

And if you’re still having trouble after trying the above, get in touch with us.

We’ll help you get back to squatting pain free.


Exercise as medicine: One physiotherapist’s journey

It’s almost always the same…time slowing to a crawl, certain sounds growing crystal clear, others fading quietly to the background. A sharp cut or twist attempted in a moment of fatigue. A mistimed step on unforgiving turf. An unfortunate collision of two bodies in accelerated motion. Or even just a simple fall. And then it’s over almost as quickly as it happened.


Having been active in sports and physical activity my whole life, I am no stranger to various aches, pains and injuries.

Through my years playing competitive soccer, I have faced my share of down time from myriad sprains, strains and even broken bones and ruptured muscles. Because of these, I am also no stranger to the world of sports physiotherapy and injury rehabilitation as a patient and a client.

In the years before I would become a physiotherapist myself, after each injury I would make the hour-long trek to my physiotherapist’s clinic on the other side of town; she was the only one I trusted to get me back on the pitch in the shortest period of time, with my body ready to perform as before.

I knew she would help put me back together again.

She would run me through her complete physical assessment, gauging my injuries and devising an appropriate physiotherapy treatment plan, one that was built on the tasks that my body would be required to complete on return to sport. The running. The jumping. The sudden change of directions.

Unfortunately, as was the norm 20 years ago, and still practiced at some clinics today, each of my sessions always included hot/cold packs as well as various electromodalities: therapeutic ultrasound, interferential current, and other electrical stims.

These were used because they were always used: “for swelling, for pain, for speeding up tissue healing”.

These were the unchallenged physiotherapy traditions and at the time, I didn’t know any better.

But in addition to these thermal agents and electrical devices strapped to the various injured body parts, my physiotherapist would give me specific exercises. Empowering exercises.

Movements that started out simple enough: standing on one leg, hopping from side to side, or even just partially squatting down on one leg. With time, these would be progressed to more complex patterns, with greater challenges of speed, balance, control and precision. Eventually, I would be flying through sports specific drills at full tilt, exploding through intense plyometric jumps and pushing through challenging strength exercises.

With her encouragement, this is where I invested my time. These were the activities I took home with me, working on them consistently and diligently between math assignments and science papers.

And every time I returned for a follow-up physiotherapy session after doing my exercise-based homework, I would be stronger, faster, and more powerful.

I would be better. And more confident.


While our knowledge of injury rehabilitation, pain science and motor control has grown by leaps and bounds, there still remains so much to learn and discover, especially when it comes to the nervous system and how the body heals and repairs.

Due to these new challenges, and new opportunities, the physiotherapy profession has also progressed tremendously.

These advances in better understanding the human body have led to novel treatment therapies and techniques and have opened the door for us to challenge and revise old, scientifically unsupported ways of thinking and doing.

Various professional associations, such as the American Physical Therapy Association, have adopted policies and practice guidelines eschewing traditionally used treatment modalities such as heating pads. Our research-focused colleagues have devoted their time and resources at trying to find the most efficient and effective therapies for our clients, the treatments with the lowest risk and highest returns.

This evolution has caused many of us in the physical therapy profession to move away from the traditional passive care approach which primarily used machines and into the realm of active rehabilitation using progressive exercise as the main modality of choice, our gold standard of treatment.

At least that’s where I find myself.

Looking back at what I did as a physiotherapy patient, and what I do now, as a physiotherapist, only one component remains the same…

Using exercise as a way of helping the body heal. Using appropriate movement to create a safe environment for the body to repair and fix itself.

Using graded physical activity to decrease the threat, real or perceived, to an over-excitable nervous system.

Using exercise to help my clients perform.

Using exercise as medicine.

Ring My Bell – Youth Athletes and Concussions, and What You Need to Know.

It’s that time of the year when school is back in session and youth sports begins to ramp up again.

Because of that, it’s also probably a good time to get informed about an injury that didn’t used to get a lot of conversation in the past, concussions.

In the short 6 minute video below, Dr Mike Evans, gives us a quick primer on concussions, what they are, and how to return to activity once you’ve had one.

If you, or someone you know, needs help getting back to function following a concussion, feel free to contact us.

It’s never too late to start, to work on your abs.

A few years back, before the clinic doors opened, I was doing some freelancing mobile physiotherapy work.

My travels often took me to various clients’ homes, some of which included retirement and long-term care facilities.

It was in a retirement home where I worked with a lovely young women in her late 80s who was experiencing some memory loss and physical decline. It was with the gentle coaxing of her caring and attentive family that she decided to work on improving her strength, balance and endurance.

She could just as easily have decided that all she wanted to do was sit on her comfy recliner and read her incredible, diverse collection of books.

But in those moments of lucidity, she wanted to maintain her independence as much as possible and minimize her risk of a serious fall, so we would head to the home’s physiotherapy gym a couple times a week and work diligently on various exercises.

Each week, when I knocked on her door she would greet me with “Hello, fella!” as she couldn’t remember my name or what exactly I did. And every time, I would find a way to let her know that I was a physiotherapist and we would be working on getting her moving.

She would then follow up with a half-hearted diatribe against exercise, exclaiming that she was too old and exercise was for the young.

In the end, she would always agree to do a little bit today, but just a little bit.

We would make our way down to the exercise area, my automatic cues of “pick your feet up, don’t drag them”, “look up, don’t look down”,”bigger steps” and “take your time, there’s no rush” bouncing off the walls.

Her retorts of “my aren’t you bossy?!” bouncing right back at me.

When we first started, 5 minutes of total movement was an eternity for her. We would work in one minute bursts.

Even then, she would ask for multiple rest breaks, trying to drag them out as long as possible with shrewd negotiations and offers.

By the end, we were spending at least 20-30 minutes straight on various exercises specifically chosen to help her complete her most important daily physical tasks: getting out of a chair, getting on and off the toilet, transfers, and walking with her walker as safely as possible.

But at the end of every session, without fail, exhausted from all the work she had just put in, she would turn to me and say:

“I need to do some sit ups now to flatten my stomach.”

And so we would make our way to the large elevated therapy bed, and she would do a few sets of sit ups and crunches, before making the trek back to her room.


If you pay attention to this once concept, could it change your results?

If you’ve come to see me for physiotherapy treatment or for physical training, you’ve probably noticed, I use the term, “it depends” a lot.

When engaged in debate and discourse in the health, fitness or rehabilitation industries, I tend to straddle the fence, rarely committing fully to one side or the other.

That’s because one side never has all the answers, or is the right choice, in all situations.

There are never any absolutes.

The missing ingredient is often context.

Without context, it’s easy to throw absolute statements around and come across as certain. But in a world with as many dynamic and fluid situations as you can imagine, context can change and impact so much.

For one client, taking rest in the short term may be what’s required to assist with tissue healing and a faster return to function in the long term.

Because she doesn’t ever sit still and is always on the go. Rest helps her.

For another, the key ingredient may be early return to specific movement or exercise.

Because he’s usually sits at a desk and is mostly sedentary. Movement helps him.

As you can see, it all depends on the context.

Context matters – it drives the intervention.

And context can change.

So the next time you’re not seeing results using XYZ athlete’s rehab program or following XYZ celebrity’s fitness routine, maybe it’s not the intervention that’s wrong, maybe it’s the context you’re using it in.

Stress relief, one drop at a time.


It sure does have a bad reputation, doesn’t it?

Like carbon monoxide, it’s dubbed the silent killer because of how stealthily it can exert its nefarious effects.

Now don’t get me wrong, not all stress is bad.

We need stress in our lives. We need it to grow, improve, and more importantly, to thrive.

We need it as a stimulus that initiates an adaptation (for more information on the science of stress, one can follow the google trail on Dr. Hans Selye, the “grandfather” of stress, and learn more about his General Adaptation Syndrome).

But in order for stress to cause a beneficial change, it must be managed.

So without further ado, here’s one of our favourite stress management techniques that doesn’t involve chugging back half a bottle (or full bottle) of wine:

A hot bath.

Sounds simple. And it is.

Just follow the 3 easy steps listed below:

  1. Place stopper over drain and turn on faucet at desired water temperature.

  2. Let water run until desired level of water in bathtub is reached. Do not overfill.

  3. Carefully step in to stress-killing oasis and soak for requisite time being careful not to drown.

That’s it. That’s all there is to it.

Give it a try and let us know how you feel.