How to Pick the Best Cardio Machine for YOU!

How many people pick this cardio machine to get your sweat on?

Let us tell you WHY there is a better choice…

1. This machine is NOT Functional….normal walking has our right arm swing with our left leg (called opposition) not like this machine where the same arm and leg move together. We would look like zombies if we walked the way this cardio machine trains us.

Exercises should simulate the activity that you are training for…

THREE good options:

  • Treadmill walking similar to normal walking (see related post)
  • Spinning or Upright Biking similar to road cycling

Rowing machine similar to open water rowing

2. This cardio machine applies NO Impact….you think this would be a positive but no impact means no bone density maintenance

  • You need to apply force from the body touching the ground with impact to help build and maintain bone mineral density and reduce your chance of osteoporosis
  • Even osteoarthritic joints need gentle impact to drive new nutrients into the joint to keeping it healthy and having less pain

3. This cardio machine causes NO HIP Extension….it has you doing more hip flexion (bending) than extending which means you are not using your glutes (butt) as much as you could.

  • When you use a big muscle group like the butt you can increase your metabolism and burn more calories
  • Also we do a lot of hip flexion in our everyday lives, like tons of sitting, so pick a cardio machine that allows you to extend your hip behind your body like walking on the treadmill

The Road to Recovery: It’s a bumpy ride! Active Rehabilitation

One of the issues that comes up frequently in an active rehabilitation context is the re-aggravation of an existing injury that often happens during the recovery process.In our minds, healing and recovery often looks like a straight line graph: The start point is the injury, and the end-point is feeling back to 100% normal. In reality, the graph would look much more like a jagged zig-zag of a line with almost countless small peaks and deep valleys, and the occasional prolonged plateau.

One of the most common comments we get from patients is that they felt great one day, and then the next day they felt like they were right back where they had started. Often, this experience leads to frustration and disappointment, because it makes the individual feel like they are not making any progress and that they will never achieve a better quality of life, improved pain management, or higher level of physical function.

What is hard to understand from inside that experience is the small milestones and achievements that happen throughout the recovery process. It’s hard to celebrate being able to raise your arm over your head for the first time in months, or your first step taken without a limp, when you are focussed on your end goal of being able to wash your hair or go for a run or hike.

What is often missed during this time of frustration is the reason why you are having the “flare up,” which is often BECAUSE you felt better the day before. It’s a basic feature of human nature to do everything you can to the full extent of whatever your abilities are at the time. When abilities are limited due to an injury, you are constantly pushing right to the edge of what you can do on a daily basis. So when you feel better for a day, you are naturally going to do everything you can because for once you feel like you are able to do you! The unfortunate consequence is that you will exhaust your resources and push your physical boundaries, so the next day tends to result in feeling exhausted and sore.

It works on much the same principle as how you would feel if you decided to run a half marathon without training for it. Afterwards you would expect to be sore and exhausted and TEMPORARILY be unable to do a lot of things, because you pushed your body beyond the limits of what you would normally have been able to do. In the same way that your body needs to recover from an intense workout, your body needs to recover when you’ve pushed the boundaries of your ‘in-progress’ level of function. Just remember you cannot compare to your pre-injury level of function just yet. Wait until you are closer to 90% recovered to start comparing to the end goal. Remember you are in the RECOVERY phase of healing.

That being said, we will often encourage some boundary pushing as part of your active rehabilitation process. If you never push hard enough to find out where your boundaries are, you won’t know when you have made significant progress. The trick is to find a balance of pushing them enough that you continue to see improvement, but not so hard that you have to spend the better part of a week getting back to where you were before you started. Often, especially early in the recovery process, those pushes are much more subtle than you would like, and it’s hard to see where progress is being made. When it comes to that, it is helpful to have objective baseline measurements and the guidance of an experienced therapist to gently point you in an appropriate direction.

A few things we often recommend to our patients and that we will keep track for you are:Objective, specific details about current abilities, examples:

  • Range of motion
  • Functional movements (Eg. squats, getting up off the floor, ability to wash hair)
  • Perceived pain (0-10 pain scale)
  • Frequency of headaches/other symptoms
  • Energy Level on a daily or weekly basis
  • Sleep duration

There are many more, and they will always be selected to be appropriate to each patient’s circumstances. Having a few key items to track allows you to feel some reassurance when from the inside, you don’t feel like you are making any progress. These measures can also help your therapist to determine if the current program is appropriate, or if it needs to be altered to better suit your needs.

The goal of active rehabilitation is always to get you back to as close to 100% as possible; however long it takes, and however many peaks, plateaus, and valleys your individual graph looks like. “Bad Days” or “Flare up” may feel like you’re taking two steps backwards, but often they are an indication that you felt good enough to try something you had previously been unable to do – and that is a clear sign of progress. So try not to let those “bad days’ drag you down!!

Think about an active rehabilitation plan supervised by your Physiotherapist or Kinesiologist for your Road to Injury Recovery.

Spinal Stenosis, What???

Are you experiencing pain in your back with walking? Stiffness in your back in the morning that lasts for less than 30 minutes? Are you more comfortable leaning on a grocery/shopping cart? Are you getting symptoms like numbness, tingling or pain down either one of your legs?

OR

Have you seen your doctor for back pain and been told you have Spinal Stenosis?

All of this can sound foreign and scary especially if you haven’t had back pain before. What this article sets out to do is to give you comfort that there is a lot you can do to manage your symptoms and keep your quality of life. If you are not sure what is causing your back pain consult a Physiotherapist or Physician for help.

What is Spinal Stenosis?

Spinal Stenosis/Foramen stenosis is the narrowing (stenosis) of the opening (foramen) on either side of the spine where the nerve comes out that supply our sensation and muscle movement.

Spinal Stenosis Low Back Pain

Reasons why Spinal Stenosis occurs:

  • Age
  • Natural change in the spine over time
  • Loss in disc height between the vertebrae
  • Arthritis around the back joints (bulkier joint with some boney growths (osteophytes))
  • Family History
  • Sedentary Lifestyle

Most commonly we see spinal stenosis in the neck (cervical) and low back (lumbar).

Why do I feel pain, tingling or numbness in my legs or arms?

Often this can be related to the Spinal Stenosis where the nerve that innervates the affected arm or leg is irritated where it exits through the foramen at the neck or low back because it is being encroached on by the smaller nerve opening (foramen). There are also other causes like, Multiple Sclerosis, pinched nerve, nerve damage, tumour, Diabetes, etc. Make sure to check with a clinical professional if this is occurring.

Why does my back feel worse with walking?

Walking keeps the curve of your spine in an backward arched position which causes more closure of the foramen (the holes on either side of the spine where the nerves exit from).

Why do I feel better leaning on a shopping cart or counter, etc?

When you bend forward, you mechanically open the foramen in the spine taking pressure off the irritated structures. Although this helps, you can’t always walk leaning on things everywhere you go.

What can I do to help reduce my pain?

MOTION IS LOTION…keep moving.

YES, this is the answer for a lot of things. You may feel like you should listen to the pain and in some cases this is true (consult your Physiotherapist or Physician to know if this is the case) but often you just need to gradually get moving.

What can I do that is safe that will help TODAY?

You can start practicing seated forward bends. Do 5 in a row and complete them many times throughout the day. Practice this when you go for your next walk, if your symptoms increase, stop at the next park bench and bust out 5-10 seated bends as shown below. These should make your Spinal Stenosis symptoms feel BETTER (i.e. less back and/or leg pain), if they don’t then STOP and consult your Physician or Physiotherapist.

Low back pain exercise

Repeat 5x times in a row throughout the day

There are other things that you can do to help with increasing your tolerance for longer distance walking and other activities. If you have success with these forward bends, then you would likely benefit from seeing your local Physiotherapist to learn more tricks like this to help manage your symptoms and to keep you moving!

Rotator Cuff: What is it and do I have one?

This is not actually one thing it is a group of muscles often mis-named by terms like rotatory cuff, rotator cup, and just plain rotater or roter. So no surprise that this group of muscles is complicated and misunderstood.

You may have heard people talking about having “torn their rotator cuff” and how they have a ‘bum shoulder’ now because of it. What are they really talking about, is four muscles of the shoulder Supraspinatus, Infraspinatus, Teres minor, and Subscapularis that may not be working optimally together. We believe there is not really a ‘bum’ anything just something that has room for improvement. We aren’t expecting you to remember or even be able to pronounce those words, but know that the rotator cuff is a group of four muscles. We remember them as the SITS group to keep them straight. The four muscles work together to stabilize the shoulder joint because the joint is very shallow, like a golf ball (arm bone) on a tee (socket). Each muscle on their own is responsible for producing a specific movement of the arm.

Your Supraspinatus muscle runs from the top of your shoulder blade out to attach on to the top of your arm bone. Its main purpose is to start the motion of lifting your arm up at your side.

Your Infraspinatus muscle sits below the supraspinatus on the shoulder blade. This muscle covers most of your shoulder blade and is shaped like a fan. It is larger and attaches right next to the supraspinatus on the arm. It’s main movement is to rotate your arm to touch the back of your head.

Your Teres minor is the smallest muscle in the SITS group. It sits below the Infraspinatus muscle also attaching to arm bone with the two muscles above. Because it is so small it only helps Infraspinatus with its main functions.

Your Subscapularis is the only member of the rotator cuff group that sits on the front side of your shoulder blade, between the blade and the rib cage. This is the largest of the SITS muscles, and it fans over the whole front of your shoulder blade and attaches on the exact opposite side of the arm bone compared to the other three muscles. It’s main function is to internally rotate your arm to put it in the sleeve of your coat, scratch your back or squeeze your arm to your side.

Rotator Cuff Muscles of the Shoulder

Rotator cuff injuries are quite common, many people find out later in life that they have a tear from many years ago without ever knowing it. However, some result from falling and jarring your arm and shoulder or during some other incident that involved a lot of pressure or force being pushed/pulled through your shoulder (e.g. seatbelt during a motor vehicle collision). These impacts can result in anything from minor injuries like partial muscle tears to more severe injuries like full thickness muscle tears or even, in rare cases, the muscle being torn completely off from where it attaches to the bone. Even where the muscle has been completely torn off, surprisingly surgery is almost never the first option and often it’s not used at all. In all cases, appropriate exercises can help to re-train and strengthen the attached muscles back to full or near full function.

However, outside of the more traumatic injuries that can happen to your rotator cuff basic overuse/misuse injuries are much more common (e.g. tendinitis, bursitis or non-inflammatory injuries like Tendinopathies). Repetitive movements can often result in muscle and tendon irritation and you will often see athletes in sports like baseball, volleyball, and tennis having some problems with overuse injuries in their dominant shoulder. These injuries are most often not caused by inflammation meaning they are not an ‘itis’ like tendinitis instead they are a dysfunctional thickening of the tendon referred to as tendinopathy. With overuse/misuse injuries, the most effective treatment starts with the Physiotherapist diagnosing the areas for improvement in painful movements and muscle compensation patterns. The Physio will assess the extent of the injury and then create an appropriate treatment plan to stabilize, strengthen and return to activity.

Treatment for shoulders typically starts in the acute phase, days after the pain starts. In the acute phase treatments like massage therapy, acupuncture, soft tissue work, IMS (needling) and shoulder stabilizing exercises are often used. As the injury starts to improve, the treatment will shift into a more active approach where exercises are used to target the movement patterns that resulted in misuse in the first place.

Find a Physiotherapist and a Registered Massage Therapist, in your town, to help get you on the right track to getting back to the activities you love!

Hip Flexors are More than Trouble Makers

Do you have low back pain that has been around far too long? Hip Flexors may be a contributing factor, so learn what they are and why they matter.

To put it simply, the hip flexors are a muscle group that works together to bend the hip, bringing the legs up towards your chest. If only it was that simple none of us would have low back pain, knee pain, pelvic floor issues, groin tightness, etc. The list can go on and on connecting the hip flexors to some pain or dysfunction. But the hip flexors are so much more than trouble makers, in fact, they are three very powerful muscles, the psoas and iliacus (often referred to as iliopsoas, pronounced like illy-oh-so-as) and rectus femoris (our main thigh muscle) We would be lost without them all work in concert to produce movement like kicking, walking, sprinting and dancing. These muscles are largely focused on bending the leg at the hip but the psoas muscle also helps to turn our hips outward like a ballet dancer (external rotation) and bend our trunk forward to pick up a box. The iliacus muscle also contributes to turn the hip out, but it is big helper in getting you up from laying on your back and swaying side to side like you are dancing at high school prom. Rectus Femoris has two purposes it bends the hip and straightens the knee (not shown in the image). The images below show how the muscles attach to the body.

Hip Flexors: psoas and iliacus

Tight hip flexors can put additional pressure on your spine that can contribute to lower back pain. They can also cause some exaggeration in the curve of your lower back which we often call sway back.

If the hip flexors are not working optimally, other muscle will try to jump in and do some of the work. The body is very good at coming up with compensation patterns to keep us moving. Other muscles that may start to do more work than they should include the glutes (butt muscles), the core (deep tummy & back muscles) and the pelvic floor (your pee stopping muscles). An imbalance in use of these muscles can result in some muscles overworking, while others are “underworking”. The result can be low back pain, strained posture, sacro-iliac ‘SI’ joint pain and pelvic floor issues.

The pelvic floor muscle group (muscles that make up the floor or bottom of our torso) plays an extremely important role with regards to support and stability of reproductive organs and other internal organs. Without the pelvic floor muscles all our organs would fall down because of gravity. Issues can occur if extra stress is placed on the pelvic floor muscles (sometimes related to shortness in the hip flexors). The pelvic floor muscles may start to “overwork” which may lead to an inability to “relax” this muscle group which can lead to potential pee leakage (incontinence) and/or low back or pelvic pain. On the other hand, the pelvic floor muscles may start to “underwork” as a result of mixed signals coming from other, overworking muscles. This can also lead to leakage, bowel incontinence and pelvic organ prolapse, where the organs start to fall down due to gravity and lack of support.

So, do you pee a little when you laugh, cough or sneeze? Do you have low back pain that seems to never really go away with trying many different treatments? Do you feel a ‘fullness’ in your pelvic floor that gets worse with long periods of standing? Well, a thorough assessment, stretching and strengthening routine with this added awareness of how some of the muscles in the lower body function would be a great place to start tackling some or any of these issues!

SOCKS for SUCCESS

The Value of Giving Back

Christmas/the holiday season is coming! Whatever you celebrate (or don’t), the time of year is coming when there is an increased focus on taking care of those around you and contributing to causes for those less fortunate. Colder weather brings a host of problems to Victoria’s significant homeless population and commercials glorifying extravagant gifts and indulgent meals polarize the reality that many of those around us are going without. However, many of the issues faced by those who get extra help around the holidays are in fact present year ‘round, so although there is more social focus on giving back through December, there is value to spreading out volunteer time and donations evenly throughout the year.

So what can you do to help?

The first thing to decide is whether you have the time and/or the money to offer support. If you have neither time nor money, chances are that at this time you are not in a position to help those less fortunate, or you may be in the position of needing help – and that’s ok. Asking for help is so hard but so necessary for everyone at some point in their life. The key there is to know what it feels like now, so that hopefully when you are at a point in your life where you have resources to offer, you are more likely to do so.

If you have TIME, you can start with these ideas:

There are a host of volunteer opportunities in Victoria that, depending on your skill set and interests, are options to look into. A few of our staff favourites are as follows:

Big Brothers Big Sisters: Our Kinesiologist, Cara, has been a big sister for over five years now, and she loves it. The commitment to being a Big Brother or Big Sister is a minimum of two hours a week for one year. Once you complete the vetting process (including a criminal records check for working with an at risk population, reference checks, and an interview), you will be paired with a little brother or sister, and from there you get to build a bond. It’s fun, rewarding, and you get to do and try things that you might not otherwise think of doing if you don’t usually hang out with children. Also, because the goal of Big Brothers Big Sisters is to not put a significant financial burden on their Bigs, they offer a lot of donated events and tickets to their pairings, as well as suggesting a host of discounted or free events to try. For more information you can visit https://victoria.bigbrothersbigsisters.ca/volunteer/ to see what options might work for you.

One of our Physiotherapists’, Beth, uses her Physio skill set to volunteer twice a month at the Cool Aid Community Health Centre downtown. You don’t need to have a health care skill set to offer, there are also lots of opportunities for people with a wide variety of experiences or interests to be involved. Cool Aid has some details about the type of jobs they have available if this interests you.

If animals are more your type of person, the Victoria SPCA is often looking for people to help out with socialization, walking, and other events around town. SPCA . Other organizations like Cat’s Cradle animal rescue and the Greater Victoria Animal Crusaders are often looking for safe homes to foster animals who are waiting for adoption or are recovering after having been rescued Cats Cradle Animal Rescue.

If you have craft skills and want to put them to good use, the list of organizations that accept donations of warm clothing items is long: Victoria Homelessness you can crochet or knit hats and socks to help keep people warm through the cold months. Some organizations also accept gently used warm outerwear options if you come across some when you’re cleaning out your closet. Lab Health is doing a sock drive over the next few months to collect socks to help keep feet warm over the cold winter months.

If you have MONEY to offer:

There are some benefits to donating, like tax receipts and feeling like you’ve done something good. Whatever cause you choose to support, here are a few things to keep in mind:

Cash allows any cause to buy in bulk and allocate resources most effectively. The temptation to do a food drive and collect non-perishable foods for the food bank is high, but it makes it harder for the food bank to manage their resources and actually provide nutritious options for those in need. Non-perishable foods are often high in sodium and other preservatives, and need to be stored until they can be used, taking up valuable space. Cash allows food banks to budget consistently throughout the year, covering times when donations are low. It also allows them to purchase fresh fruit and vegetables in season to support the health of those who need to use the food bank.

Maybe you don’t have time or money:

Even if you don’t have either you may have one pair of clean, dry, great condition socks that you can donate to us, so that we can pass them onto the Cool Aid Society. We all know the horrible feeling of wet socks and giving just one pair of socks will pass on the feeling of WARMTH and COMFORT to perfect stranger. For the whole month of November we are collecting Socks for Success, come in and drop off your socks and know that you are providing someone with the much needed feeling that someone else cares!

Whatever way you choose to give, volunteering and giving back is a great way to support your community, be involved, and know that you are making a positive impact.

BOO!!! Don’t let scary medical words derail your progress.

With Halloween right around the corner, we thought it would be a great time to touch on some of those scary medical terms that patients hear everyday. If you’ve ever read the results of an X-ray, MRI or Ultrasound you most certainly have heard of some of these terms covered below.

Osteoarthritis

X-rays are the easiest way to take a look at the bones and joints in our body. Osteoarthritis (OA) describes the often normal thinning of the cartilage (smooth gliding surface) on the bones of our joints. Hip and knee osteoarthritis is the most common lifestyle process in those aged 65 years and older. Although you hear a lot about arthritis pain, it does not mean it is always a painful or debilitating condition. In fact, up to 85% of adults with signs of knee OA on x-rays have NO knee pain. This means that seeing OA changes on x-ray doesn’t guarantee that you will have pain or dysfunction . Take a look at our past blog on how exercise is the best form of treatment for mild to moderate hip and knee OA but also safe for severe end stage OA, as well.

Rotator Cuff Tear

Ultrasound or MRIs are used to look at “soft tissue” such as tendons or ligaments. A tendon attaches muscle to bone and ligaments provide stability around our joints. The rotator cuff refers to tendons connecting important muscles of the shoulder to the upper arm. Tears of the rotator cuff are a common finding when imaging shoulders with ultrasound or MRI. So common in fact, it has been shown that up to half of those aged 60 and older showed rotator cuff tears on MRI without corresponding pain or disability. Rotator cuff tears are even common in high functioning athletes. A study of baseball pitchers revealed that over one third of all the pitchers had full or partial rotator cuff tears without having any reported pain or limitations.

Degenerative Disc Disease / Bulging Disc / Joint Space Narrowing

Any back disc injury has been made out to be a scary idea. However, degenerative disc disease (DDD) is not a disease at all, it actually refers to normal changes in the discs (pads that provide cushion between the bones) of our spines. It is the difference between PATHOLOGY and MORPHOLOGY. Pathology is a true disease process like cancer but Morphology describes normal change over our life time. DDD is most often found in our necks and low backs. Studies have shown DDD of the low back is present in over 30% of people aged 30 and younger and 90% in ages 50-55. In some cases, DDD can lead to disc bulges which sounds scary but up to 25% of healthy young adults (aged 20 to 22) have low back disc bulges with no back pain and nearly 50% have at least one degenerated disc on MRI. If DDD and bulging discs were the true cause of all back pain then we would all have back pain at 20 that would only get worse as we age!

This post isn’t meant to replace the medical advice of your doctor or medical professional. But rather to help inform people that these scary terms don’t automatically subject you to a life of pain and dysfunction. We as healthcare professionals are changing the way we use these words to try and educate our patients with fact-based knowledge that does not foster fear but encourages a focus on function and optimism. We are still not perfect at this yet, but being told you have the back of an 80 year old at 25 does not help anyone heal!!

Knowing that these findings are common in healthy young and old populations can help reduce the anxiety around what “degenerative disc disease”, “rotator cuff tear” or “osteoarthritis” may mean for your future. Remember, MRIs, X-rays and Ultrasound imaging are very good at ruling out major health concerns such as fractures, tumours and spinal cord injuries, but they are also very good at picking out normal changes in our body that we would never otherwise known were there. Use the results to know that there is likely nothing BIG and ScARy going on inside of your body. If you have had medical imaging and are concerned over the result, be sure to ask your medical professional what those changes mean for you.

Happy Halloween!

References

VOMIT poster LSP, Shoulder and kip/knee

Healthlink BC

Don’t Let the School Grind, Grind YOU!

As October starts, the back to school grind winds to a close and we all start to settle into the routines of the coming months. It may be time to talk about staying healthy while you’re a student.

There are the basics, like remembering to wash your hands regularly, now that you’re back in close quarters with a bunch of other humans, so you avoid sharing any germs with one another. Sleep hygiene also becomes important, as parents have to re-adjust their schedules to make sure kids get to school on time and adult students have to get used to the reality of 8am class times. Let’s not forget the long term stuff as well, like muscle aches that happen when you are stuck in a classroom for hours on end with ergonomically questionable seating. Students also run into issues prioritizing self-care when balancing multiple deadlines and course work. Academic pressures can result in students experiencing higher levels of depression compared to the general population, and in some cases can go as far as burnout. Parents can struggle with the added stressors of daily after school programs and scheduling and the ever stressful forgetting cupcakes or signing the field trip notice.

Let’s start tackling the physical issues: The time demands of student life can make it difficult to maintain a consistent workout schedule, and some weeks eating a balanced diet goes out the window because you’re lucky if you can grab a slice of pizza before your next class. Add all that to increased time sitting in awkward positions in chairs and desks that often seem designed for 5 minutes of sitting only. All these are a recipe for sore muscles and unfamiliar aches and pains.

Here are a few basic tips that we have found can help (the Lab Health team is as close to experts on this a possible as we have a collective 3+ decades of post secondary experience to draw from)

Plan Ahead. Map out your semester so you know where the major deadlines are, when you are going to be in a time crunch.

Find meals that are quick, easy, and at least semi healthy

E.g. hardboiled eggs, frozen pre-cooked chicken with salad mix, etc. This website https://www.budgetbytes.com/ has provided some really tasty meals that are simple and budget conscious. Consider investing in a slow cooker (They are often found for ok prices at thrift stores) – they are both a time and a money saver when you’re stressed out.

If money is an issue (which student doesn’t have this issue?), consider checking out volunteer opportunities with student organizations who pick food for food banks and allow their volunteers to keep a portion in return (add to the resumé AND FREE food, too!). http://gleaning/Lifecyclesproject.ca/signup

If you have a sport/activity you are interested in or passionate about, consider joining a club or student organization. The social aspect can help keep you going.

Take a water bottle with you – dehydration just sucks.

Keep moving. If you are one of those people who is able to sit through a whole class without fidgeting, you are amazing. But you should still consider moving despite your superpower. Sitting still for long periods of time can result in sore muscles and can do long-term harm in terms of muscle imbalances and eventually osteoarthritis. Stretch breaks, shifting positions and begin active between classes and study sessions can all help.

One trick that is great is you can convert your notes to word documents and then have your phone or other smart device read them to you while you go for a walk or work out. It is call Kinaesthetic learning and the research says the information will last with you longer and you can study while being active!

Mental health. As for burnout and depression some of the tips above can be help. The key thing to remember is that academia/post secondary school is a snippet in time just like any other phase in your life, it too shall pass. Try your hardest, have fun and make sure to take some time to remember the reason you are there. Keep in mind that school exists to evaluate you and your understanding of a particular subject. It is important to maintain ties to aspects of your life where you feel accomplished or the constant grading of school can be wearing. It is also important to recognize that the feeling of being not enough or overwhelmed is very common, and that most academic institutions have counselling services available to their students at a reduced price or free.

Student life is hard, often overwhelming and expensive. It can also be rewarding, fun, and provide some of the best times or your life. It can help you to pursue career, life opportunities and relationships that you might not have otherwise experienced or developed. So remember, the crazy weeks will happen and the deadlines will pass and it will all be ok. Some weeks, no amount of planning or determination will stop you from feeling like the workload is getting the better of you. So order that pizza, study your face off and remember that tomorrow is another day.

University of Victoria Mental Health Support Resources:https://www.uvic.ca/mentalhealth/home/immediate/index.php

Camosun College Mental Health Support Links: http://camosun.ca/about/mental-health/students.html

Royal Roads University Food Bank and Mental Health Links:http://www.royalroads.ca/current-students/food-bank http://www.royalroads.ca/current-students/counselling-services

Doctor….DRE

When you are over 40 and male, DRE no longer represents your favourite Rap artist of your teenage years. DRE stands for Digital Rectal Exam which is a major barrier for men getting their regular physical exams. Many men just don’t want to go there, well actually they just don’t want the doctor going there and fair enough but having a DRE has been used clinically to help doctors look at your full prostate risk profile. The DRE is just a piece of the examination process and a full history is needed to make the best recommendations. Consult your doctor to make sure you are doing all you can to reduce your risk. UPDATED: We have removed the recommendation to include the PSA test with the DRE to meet the current best practice in Canada, based on the Canadian Task Force on Preventive Health Care

In Canada, On average, 58 Canadian men are diagnosed with prostate cancer every day; however, only 11 men die daily from this condition. That is why early detection is key to reducing the mortality rate and increasing the survival rate. We would all ignore below-the-belt issues if we could, however we need to continue talking about these concerns to keep the conversation on early detection going.

Men diagnosed with prostate cancer have many treatment options with today’s advanced medical practices.

Treatment Options:

  1. Multiple Surgery Options
  2. Radiation Therapy
  3. Hormone Therapy
  4. Chemotherapy
  5. High-intensity focused ultrasound

From some of these treatment options there are possible side effects. One of which is urinary incontinence (peeing yourself) following a below-the-belt surgery. However, this can be very treatable with pelvic health therapy by a qualified Physiotherapist.

In 2015 Dr. Patel, a Urologist, published results in the European Urology journal, concluding that “preoperative pelvic floor muscle exercises may help early continence recovery, but may not influence long-term incontinence rates beyond six months”. Essentially, pelvic health therapy can help you get back the control sooner than not doing it.

Keep your buddies accountable and make sure you get the necessary tests done and don’t ignore any below-the-belt concerns.

Turn Back Time: choosing your priorities instead of having them chosen for you.

Yes, we know you’re thinking “Don’t you know I would have done the exercises if it was that easy??!!!” One of the biggest concerns we hear from our patients trying to complete their exercise or postural homework is not being able to find the TIME.

We get it, you’re busy and you’re human, so when family, work, household, school, relationships, sport, hobbies, health issues, meal planning, vehicle maintenance and caregiving get in the way we understand; it all takes time. The idea of adding one more thing to your already packed schedule is a daunting request because in addition to your HOMEWORK, we also want you to prioritize some time for some occasional downtime, R&R, and maybe just once in a blue moon, sleep.

We do our best to make sure that what we ask you to do can actually fit into your schedule as it stands. For example:

  • Postural or core exercises you can do while sitting at your desk,
  • Ankle stabilizing you can do while sitting down to catch up on reading or while watching your favourite TV show
  • Balance training works great while you’re brushing your teeth or waiting for the kettle to boil

These are some ways we try to help you recover and improve without having to find extra hours in your day.

So how to do you go about making the ‘choice’ to take back your time? Well, firstly, you need to list all of your ‘duties’. For example, picking up the kids, going to coffee with a friend, making homemade cupcakes for the whole class on your child’s birthday, always supervising the neighbourhood kids when they’re out playing in the street, taking on the extra tasks at work when you are already overloaded, completing your physio homework everyday, etc. If you have a partner get them to do a list as well. Not so you can say my list is bigger than yours, but so you can equitably go through the lists to make sure you both have things that build you up or fill up your bucket!

Once you have made your list, itemize it based on three categories:

  • I must do this (things that just got to get done and it HAS to be ME, like going to your job!)
  • I love doing this (things that fill up your bucket)
  • You can do this (‘you’ can mean anyone, the neighbour, the partner, a grandparent, the child, etc.)

Some things that fill your schedule are inevitable, like work (unless you’re independently wealthy or have a sugar mama). The same goes for basic household maintenance and food: they have to happen, but take in the consideration of delegating some of those task and transitioning them to another capable human. Just remember, relinquishing the task will give you time. Try and somewhat ignore the execution (it will get better and closer to your standard) and don’t forget to be happy in the task’s completion!

If you have children or any other dependents, they will also demand a certain percentage of your time and sometimes that may fall into your ‘I love doing this’ time. This can be used as a teaching and transitioning opportunity. Kids thrive on boundaries and clear expectations so even though they are very young, children can have tasks that help the household run (not chores)!

Just remember it is freeing to acknowledge to yourself that you haven’t made that coffee date with so-and-so for three months because it is not really a ‘I love doing this’ task. Recognizing that you would rather eat with your family than shred those last 15lbs down to your ‘goal’ weight is important. Knowing that for you, getting at least seven hours of sleep matters more than meeting people for drinks at 10pm. With clear boundaries and social supports, some of the burden of those ‘I must dos’ can be managed on your schedule while the, ‘you can do this’ task delegation, can free up time from your schedule for those ‘I love doing this’ tasks!

After itemizing, make sure you organize how to give up/transition the ‘you can do this’ tasks to the appropriate winners. Also, make sure you have at least one ‘I love doing this’ on your list everyday. Finally, make sure that your ‘I must do’ list matches the ‘I must do’ list of your partner.

Summary

  1. Make your duties list (it may be extremely long)
  2. Itemize the list by the three categories
  3. Put your itemizing in to action, transition and shuffle tasks that need to be shuffled

Basically, this is about getting to know yourself, and what you prioritize. When you take a step back and recognize that many of the unreturned phone calls, emails, or event invites sitting at the edge of your consciousness are things you simply don’t love/need to do. Prioritizing opens up the possibility of making conscious choices in how you spend your time. Instead of getting caught up in the never ending deluge, you can pick your path. And maybe, just maybe, you’ll actually get to do some of the things you ‘love’ with a little time for a few physio exercises thrown in along the way!