How to build a better athlete – starting in kindergarten

This Saturday, while drinking my morning tea and perusing the health and fitness sections of various online newspapers as I often do before a starting work, I came across a headline that caught my attention.

Yup, it’s the same one you read above.

Pretty catchy, isn’t it?

You can read the full article from the Globe and Mail here: Build A Better Athlete – Starting in Kindergarten.

The article starts with a vivid recollection of a knee injury suffered by a young man, Eric Sung, while attempting a skateboarding move, described as a bunny hop, in his driveway at home. The journalist then postulates on a potential reason for all the ligaments of his knee tearing with what was described as an odd-angle landing:

“He was 24 at the time, but Mr. Sung’s childhood phys ed teachers could be to blame. According to a growing body of research, the torn knees, twisted ankles and sore backs that plague so many active adults have their origins in the school gymnasium.”

While the fault for Mr. Sung’s knee injury on his childhood teachers is highly debatable and virtually impossible to prove (it was more likely the “odd angle” at which he landed), the idea that the movement patterns we learn as children may serve us in our adulthood is definitely an important one and an area that needs to be further explored.

With many changes in education curricula shifting focus towards pure academic subjects and increased technology use by children and youth (iPads/smartphones/online gaming), there’s been a substantial shift away from physical activity and transitioning towards increased screen time and sedentary behaviours.

Even with (dwindling) mandated physical education classes in school, many children and youth are still missing out on enough appropriate exposure to fundamental movement skills (also called physical literacy – the ability to complete basic movement patterns safely and effectively) required to create a solid movement foundation for later in life.

“Comprehensive Canadian data presented in Montreal this month shows we’re doing no better: Researchers looked at Grade 4 and 5 students in Manitoba, and whether they had acquired 18 basic movement skills – such as running, kicking and hopping – all of which are laid out in the physical education curriculum. The results were dismal. No more than 10 per cent of the kids showed proficiency in any one of the movements. (As in Australia, girls fared the worst.)”

Is that it?

As our youth age, will they be at greater risk for various aches, pains, and traumas? Do we become a nation of adults prone to injury because we didn’t learn to move well as children?

Is there anything that can save us?

Is there any way to reverse this negative trend and create a nation of agile, nimble, injury-proof* citizens?

In the article, Dr Dean Kriellaars, an associate professor in the department of physical therapy at the University of Manitoba “says that as little as two or three hours a week on basic movement skills can boost kids’ proficiency dramatically and nearly eliminate performance differences between boys and girls.”

And this doesn’t have to be accomplished with traditional competitive sports.

In fact, many of the movement training strategies suggested by Dr. Kriellars would simply be playing games where the foundational physical skills and patterns are an integral part of the game but aren’t the main focus. Think back to the days of playing hopscotch or frozen tag in the playground – those simple games helped improve certain physical skills, but those skills weren’t the focus of those games.

The main focus should be on making movement fun, for life.

And that may be the secret on how to build a better athlete.

Here at Primal Human Performance, we couldn’t agree more.

This includes making movement fun for children and youth who aren’t “athletic” in the traditional sense, who aren’t interested in organized, competitive sports.

In our youth programs and working with youth, we believe that every child, with the right guidance and coaching, has the potential to be athletic in their life. They have the potential to master the fundamental movement skills that will allow them to participate in physical activity of their choosing, to the extent that they wish. They can learn to love to move and use their bodies to their full potential.

To that end, our programs are tailored to the individual and designed on building a solid physical literacy foundation for life, minimizing injury risk, and optimizing performance potential, for every type of child.

For some of our clients, that means systematically progressing to higher performance athletic development as they mature and progress, with an end goal of successfully entering collegiate or professional athletics. This may encompass progression to sports specific training, a greater focus on strength and conditioning, or power drills to enhance explosiveness.

For others, it may simply mean learning how to use their bodies efficiently so that they can stay healthy, active and happy as they grow up. Learning to improve their body awareness, basic balance and general coordination. Often, it’s a stepping stone to get a more sedentary child to feel comfortable in their own skin, outside of a potentially daunting competitive gym class where they feel judged and compared to their more athletic peers.

In the end, we really want everyone to move more. And revel in the enjoyment of that movement.

In essence, we want you to play.

*While the term “injury-proof” was used, I’m not aware of any method to completely eliminate the risk of injury from physical activity or even life. What we aim to do is minimize the risk of injury by trying to control for the factors that we can control.

Is walking considered the best exercise?

An oft repeated, and overheard, expression suggests that walking is the best exercise.

And people want to know.

Is it true?

Is walking really considered the best exercise?

Does is rank higher than squats? Push ups? Or any of those fancy machines at the gym?

Does is do better for your body than running hills or pushing yourself through grueling marathons?

Or are the health and fitness benefits of walking being overblown and shown out of proportion from the reality?

The truth, as is almost always the case with these types of questions is, it depends.

It will depend on your current level of fitness and your current health status.

As a physiotherapist, I see people who come in varying states of de-conditioning, disease or injury healing.

For some of these people, a short walk may be an extreme challenge, zapping massive amounts of energy and requiring tremendous physical resources. A few slow steps may necessitate a 10 minute rest before the next attempt. The heart and lungs screaming, sweat dripping down the brow. This would be considered exercise.

As a physiotherapist, I also see people who come in with excellent baseline fitness levels and no active injuries. In their cases, walking would be considered a physical activity (Non-Exercise Physical Activity, or NEPA) but not exercise in the traditional sense. In order for them to be challenged by walking it would likely have to be over rugged terrain, over long durations, and at higher speeds.

Now that we’ve established that walking can be both considered, and not considered, exercise based on individual background, is it the best?

This gets even trickier.

What does “the best” even mean?

I propose that the best exercise is the one that you’re able to do consistently over time at a sufficient intensity that challenges you and moves you towards your goals.

If you’re sick, ill, or out of shape, then walking may be the best exercise for you at that time.

If you’re healthy and fit, then walking, while offering all sorts of associated physical and mental benefits, may not be the best exercise for you. It’s likely too easy for you in your present state.

So to reiterate, it all depends on where you’re starting.

And if you need some professional help finding out where you stand and what exercise is best for you, feel free to get in touch with us.

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.

Small steps, big results…

More often than not, by the time my clients come see me, they have a problem.

And to them, it’s often a big one. Well, big enough for them to seek outside help.

This can include general problems like low back pain or neck pain, sports injuries like sprained ankles or twisted knees, or functional limitations such as loss of strength or loss of flexibility after a surgery or medical procedure.

In almost every case, the rehabilitation protocol will follow a set procedure of problem solving which involves the use a technique called chunking.

What is chunking?

Chunking is exactly what it sounds like: breaking a bigger, more challenging problem into smaller, more manageable bits, or “chunks”.

Take for example someone coming in with low back pain.

Their present level of pain may be so bad that the idea of doing exercises makes them feel ill; their protective guards would go up and the minute I suggest exercise, they’d look at me like I was out of my mind – there would be no buy-in.

And without that buy-in, most physical therapy doesn’t work as well.

But if I know that specific movement would help get them out of pain and back to their regular activities, how could I overcome that initial resistance and get them to start?

By chunking it.

Instead of going head first in to more complicated exercises or rehab movements, I may just work on something that they already do or that they already need to do.

In many cases, I just work on the basic transition from lying to sitting, or sitting to standing – activities that they would need to do already anyway. By working on these simple tasks and enabling them to solve a small problem in the context of the bigger problem, my clients are empowered. Confidence goes up. And usually, pain levels go down. When pain goes down, function usually improves. And a positive feed-forward loop is created with subsequent chunks added in.

In the end, all these little chunks add up, creating big results.

The best part about chunking: it can be used for almost any problem, in any area of your life.

From human performance to debt management.

Now that’s a chunk of advice I’m glad I came across.

 

 

Low Back Pain – A video guide

To follow up with the last post regarding back pain red flags, here’s a quick 11 minute video that explains the back pain process with some pretty neat illustrations and drawings.

If you have back pain, or know someone who does, this may be a good place to start.

 

Should I go see a doctor?

There you are, going about your daily routines. Washing your face. Brushing your teeth. Putting on your socks or shoes. Or perhaps you were involved in something more active like playing sports, golfing, or just going for a walk with your kids.

And then it happens.

That sudden grabbing sensation, powerful enough to make you catch your breath. Making you gasp audibly. Possibly dropping you to your knees. Or laying you flat out on the ground.

That feeling of pulsing fire spreading across your back with every wave of seemingly intractable spasm. The almost instant inability to move or function like you did just a few seconds ago.

Frozen in place. The fear. The anxiety. The apprehension. They all come rushing in.

Afraid that any little movement will set off another wave worse than the previous one.

That sinking sensation that something bad just happened.

Does that sound familiar?

In my years as a physiotherapist, the above is a fairly standard description of the first few minutes after an acute back spasm as often experienced by clients. I’ve received numerous phone calls, emails and texts from them over the years when this happens, and invariably the first question that comes up is the following:

“Should I go see a doctor?”

The answer, as it almost always comes up, is a resounding “it depends”.

While it might seem like the severity of the back pain is so intense that only immediate medical intervention and imaging (e.g. MRIs or X-rays) will give sweet relief, that’s not always the case for the former, and never the case for the latter.

In terms of emergency room wait times and hospital triage, someone heading to the ER for back pain and spasm may end up waiting for hours and hours, just to be seen. And often, they will be sent home with nothing more than a basic pain killer such as Tylenol and possibly some muscle relaxants for their troubles.

I don’t know about you, but I don’t know if that’s worth 7 or 8 hours of my life, especially because all that plays on the TV is CP24 on loop…

That being said, what if the back pain is caused by something more serious? What if a trip to the doctor or emergency room is the appropriate plan of action?

How could someone quickly and readily figure out if a trip to the doctor or ER is the best option?

Enter the Red Flags.

Red flags are a checklist of features, signs, symptoms or medical history that, if present, could indicate that more serious issues may be at hand. At the very least, these allow us to have a best practice approach as to when one should seek further medical investigation/treatment or when one should wait a few days to see how the natural course of the injury plays out.

Cancer

  • Any history of cancer
  • Any unexplained weight loss
  • Night pain or pain at rest
  • Failure to improve with treatment

Infection

  • Persistent fever
  • Recent bacterial infection (e.g. pneumonia, urinary tract infection etc)
  • Immuno-compromised (e.g. organ transplant, HIV, diabetes etc)
  • Intravenous drug abuse
  • Pain at rest

Cauda Equina Syndrome

  • Bowel or bladder issues (incontinence, retention)
  • Saddle anesthesia (loss of sensation in the groin/buttocks)
  • Bilateral lower extremity weakness or numbness

Significant Disc Herniation

  • Significant muscle weakness
  • Drop foot

Vertebral Fracture

  • Recent history of significant trauma (big fall, car crash, industrial accidents etc)
  • Any history of osteoporosis
  • Age greater than 70
  • Prolonged use of corticosteroid medication

While the above is not an exhaustive list, it is a good starting point.

That being said, if you have concerns, always follow up with the appropriate medical professional to be assessed in person. The internet, which happens to be where this post is found, should only be used for educational purposes and is not a substitute for, nor should it be construed as, medical advice.

Primal Human Performance

Red Flags

 

Is physiotherapy for me?

So who really needs physiotherapy anyway?

Is physiotherapy just for sports injuries like sprained ankles or knees? Or is it for post-surgical rehabilitation after ACL repairs or arthroscopic surgery?

Can it help someone with low back pain? Neck pain? Shoulder pain?

What if pain isn’t involved, but weakness is? What if lack of strength, or coordination, or endurance is the problem?

What if there is no pain or injury? Could physiotherapy still help improve human performance for someone who has no immediate limitations?

Ultimately, the reason most people seek out the expertise and knowledge of a registered physiotherapist is because they can’t do, or want to improve on, something that’s important to them.

This is often due to pain, loss of range of motion/flexibility, loss of strength or because of some medical intervention (e.g. surgery or bed rest). This loss of function could have an impact on so many different aspects of someone’s life from looking after their kids to playing sports, to something as simple as doing everyday chores or tasks such as driving.

However, with preventative health awareness on the rise, more and more people are looking to be more proactive.

They’re looking to do as much as they can to avoid being impacted by repetitive strain or overuse injuries before they occur. They’re looking to improve their base strength and fitness so they can minimize risk of a variety of lifestyle related diseases and disorders (diabetes, cancer, heart disease etc) as they age.

They’re looking for optimal health and ultimate performance. They want to be at their best.

So in the end, physiotherapy from a registered physiotherapist may be the right option if you’re looking to do the things you want to do, or get back to doing the things you want to do.

A Different Kind of Physiotherapy in Woodbridge and Vaughan

If you’ve found this page, you were likely looking for physiotherapy treatment in Woodbridge from a registered physiotherapist.

You might’ve been looking for a solution to that pesky, long-standing back pain that’s been stopping you from doing what you really want to do.

Like getting down on the floor and playing with your kids, or participating in your favorite golf tournament and taking home the long drive trophy.

Or even looking for a way out of the pain so that you can be more productive at work, so you can tolerate sitting down at your desk without having to shift around to try and find a comfortable position.

Heck, it might not even be back pain on your mind. Could be your shoulders, your neck your ankle or your knees.

Wherever it is, it’s definitely painful and you want it to stop.

You’re tired of it and you want to be back in control again.

Maybe it’s not even an old injury.

Maybe it’s something more recent and acute. A sports injury or trauma. Aches and pains from a fall.

Or perhaps you’ve recently had some shoulder or knee surgery and you’re looking for focused high-performance physiotherapy and rehabilitation to get you back on track again. Some post-op therapy. You’ve been told by your surgeon to “get some physiotherapy” without any real instruction beyond those words. And you’re not sure what to do.

Maybe you don’t have any injuries right now but you just want to improve your health, fitness or athletic performance.

It’s possible that you just want to be able to go up a few set of stairs without ending up doubled up huffing and puffing because you’re that out of shape.

Maybe you want to be able to prepare for that 5K starter run because you know you can.

Or you’re a seasoned athlete looking to take your athletic development and performance to the next level, pushing limits and resetting boundaries. Becoming the champion you know you can be.

No matter what your reason for searching for a physiotherapist in Woodbridge and Vaughan, you’ve found this page.

Why choose us?

That’s a great question. And I’m sure it’s one that’s at the top of your mind.

Why choose our physiotherapy clinic when you have so many other choices for your physiotherapy treatment in Woodbridge and Vaughan?

Why choose us when there are a so many other physiotherapists in Woodbridge and Vaughan?

The Primal Difference.

That’s why.

Wake and Break

As the shrill scream of your morning alarm slices through your dreams of flying over tall buildings, and otherwise saving the world from destruction, you realize that your peaceful respite from wakefulness has unceremoniously come to an end.

Morning has broken and it’s time to start your day.

You slowly rub the sleep from your eyes, fling the warm, enveloping covers off your body and allow the frigid air of your bedroom to jolt you further from your reverie.

“Why does my back feel so stiff?” is your first, fleeting thought as you hunch forward on the edge of your bed, pawing for your fuzzy slippers with your feet. Your sleep-drunk legs have trouble locating their targets so you bend farther forward through your back to get a better look. From this forward bent position, you’re finally able to find the foot-hugging sanctuary of your slippers and your daily routine carries on.

You pull yourself to a somewhat upright position, stumble to the bathroom on your unsteady legs, turn on the tap, bend down to the sink and splash the last vestiges of sleep from your being…

So maybe you don’t dream of saving the world, and perhaps you don’t have fuzzy slippers. Heck, you might not even wash your face. But if you’re like most people, you likely go through some of the same movement patterns described above.

What’s the big deal?

The big deal is that your intervertebral discs (yup, the same discs that are often erroneously described as “slipped”) are actually in a hydrated state which unfortunately puts them at higher risk for injury with certain types movements, according to Dr. Stuart McGill’s research.

Why do the discs “inflate” overnight?

After having spent six to ten hours in a horizontal position while sleeping, the effects of gravity are minimized through your spine. So instead of being compressed (as they are when you’re upright), your discs are unloaded to a certain degree and actually suck up fluid like a sponge. This is why you’re actually taller after waking.

What can you do about it?

This is the simple part. Avoid flexion (bending forward) through your spine until the discs have had a chance to lose some of that fluid. See, I told you, simple.

McGill’s research suggests that it will take about an hour after waking for this to occur. After that golden hour, it’s safer to bend that way.

Now the hard part: avoiding flexion means you’ll have to modify how you get out of bed, how you sit on the edge of your bed, how you wash your face, brush your teeth and even sit on the toilet.

And depending on how fast you are at getting pretty in the morning, it would also mean you’ll have to avoid slouching at the breakfast table, if you even eat breakfast.

Yup, these are all automatic habits you’ve been reinforcing for years. It’s not going to be easy to change them, but as many former low back pain sufferers will tell you, they much prefer dribbling toothpaste down their chins than having bolts of lightning shoot down their legs.

Yours in movement.

Team Primal

 

My Top 3 Core Exercises for People with Low Back Pain

In the previous post, I wrote about the 3 worst abdominal exercises for people with low back pain.

In reality, I could have written a list of ten, fifteen or even more ab exercises that should be avoided.

The three exercises that ended up on my no-no list, ended up there for a variety of reasons. Since this blog can’t account for every individual difference and most people wouldn’t stick around to read my tome if I tried, I picked those exercises that I felt were most commonly used or encountered in the real world.

This means I chose the exercises that a LOT of people with low back pain are doing.

They’re doing them at home (sit ups/crunches) or they’re doing them at the gym (twist and extension machines). And they’re potentially aggravating their back pain situation while under the notion that they’re doing something that should be helping them.

That was my rationale for part 1.

Now onward to part 2:

For starters, gold star if you noticed that this post used the word “core” instead of “abdominal” in the title.

Most incomplete low back pain programs will tout the advantages of abdominal training to relieve pain and resolve dysfunction.

Unfortunately, it doesn’t work that way.

Our core is much more than just the abdominal muscles. It’s more than the pretty six pack (rectus abdominis) that’s visible along the front of lean bodies. It’s also more than just the other muscles that make up the abdominal box (internal obliques, external obliques, transverse abdominis, diaphragm and pelvic floor).

Since there are so many different definitions of the core, I’m not going to list them all out. Suffice to say that I believe the better functional definitions of the core should include muscles of the hip, back and torso. All of which should work cohesively to stabilize the spine and allow for appropriate mobility at the hips and shoulders.

How’s that for a vague description? But I digress…

Moving on to what you’ve all been waiting for, here are my top 3 picks for core exercises for people with low back pain:

  1. The Birddog:This exercise has been a staple in my clients’ low back rehab programs for years and has proven its worth and then some. In fact, it’s a staple in my own programs whenever I’m getting back into any heavy lifting involving compound movements such squats, overhead presses, and dead lifts. The kicker, I don’t have any low back problems. Why the birddog? Because it’s simple to execute but forces the exerciser to pay attention to what he or she is doing. I’ve never seen anyone build rippling washboard abs using this exercise alone, but that’s not its purpose. It’s designed as a scalable, entry-to-mid-level core activation exercise that minimizes the compressive loading on the spine while still activating the appropriate protective muscle patterns. Which really just means that it helps stabilize the spine without having to creating excess force. Huge benefit with less risk. As with most injury rehab or performance-based training programs, I’m always looking to tip the scales in favour of benefit over risk, as often as possible.

  2. The Hip Hinge:This is another stalwart of my spinal rehab programs for much the same reasons as the birddog above. It’s simple, requires no equipment, and teaches a fundamental movement pattern that has the ability to protect our spines from current injury or potential trauma. When executed correctly, the hip hinge teaches us to move through our hips while keeping our spines stable. In my injury rehab and physical therapy treatment book, that’s a great combination! Benefits 2 – Risk 0.

    Woodbridge Physiotherapy Vaughan Hip Hinge Exercise

    Hip Hinge Start and End Positions

  3. The Plank Variations:The ubiquitous plank…I actually like to break this exercise down into two distinct versions, the front plank and the side plank (each version can be either regressed or progressed according to ability and technical mastery of the person doing them). Again, this body weight based exercise requires no fancy equipment and very little space. It’s portable, straight-forward, and can teach numerous beneficial postural habits if we’re willing to learn from it. For most back pain sufferers, I prefer to start with the side plank variations as these minimize the loading on the spine while still engaging the core musculature. As technique and ability improve, these can be progressed to more challenging version then in to the front plank variations.

    Front Plank and Side Plank

The most important component of choosing the appropriate core exercise for low back pain is to make sure that the exercise doesn’t cause you any pain. If it hurts, that’s usually your body’s signal that something’s wrong. In the end, it comes down to making sure you’re doing all your exercises right because you get what you train.

And there you have it, my top 3 choices of core exercises for people with low back pain.

Agree? Disagree? Have your own exercises?

Feel free to share your thoughts!

And if you’re struggling with back pain, contact us today to get booked in for your assessment!