Is Surgery my BEST option for Knee OsteoArthritis?

A recently published article in a peer reviewed journal, discusses medical exercise as an alternate option to surgery for a degenerative meniscal tear in the knee, otherwise known as Arthritis. Now they are not just talking about doing any exercise but working with a trained healthcare professional (ie. Physiotherapist, Kinesiologist, Chiropractor or Athletic Therapist) supervising specific exercises for rehabilitation. However, we do already know that staying fit and active will always improve your health and reduce your risk for arthritis.

So they took a group of 17 patients who had degenerative meniscal tears and they either underwent a 3 months medically supervised exercise training program or an arthroscopic partial meniscectomy surgery. They measured their pain and quality of life at time points up to 1 year after the enrolment. Both groups showed similar reductions in the pain and increases in function and quality of life. However, the group who participated in the exercise program showed significantly greater improvements in anxiety and depression.

So if you want to avoid surgery for your knee arthritis then ascribe to the old adage “Motion is Lotion…” with supervision. Try our GLA:D Supervised Exercise Program for Knee and Hip pain and stiffness. Register for a FREE education class today. If you have questions about the exercises you currently do or want to start exercising for prevention, function and pain reduction then contact a healthcare professional in your area to start medically supervised exercise today. 

3 Tips for Managing Knee Arthritis

  • Weight Lose: lose 5 lb if you are over weight, it can reduce the load on your joint by 2.2 times
  • Exercise: find a safe exercise you enjoy and do it 3-5 days a week
  • Prolonged Sitting: if you have been sitting in a restaurant or at a movie, move your knee before you try to stand on it

Most of all get out and enjoy life even with knee arthritis!

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!

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!

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

To Foam Roll or NOT to Foam Roll??

Is Foam Rolling going to be the NEW cupping of the 2018 Winter Olympics?

PyeongChang 2018 is on the brain, all over media and everywhere around us. This might remind you of the Summer Olympics of 2016 when Michael Phelps created quite a stir with his use of cupping for his shoulders and back. Athletes are always looking for an advantage on and off their playing field. They can’t always have their team of therapists around them and neither can you! So many people use foam rolling or trigger point balls to help with their pre and post training performance.

What is Foam Rolling? Foam rolling is the use of a stiff, smooth or nubbley foam/padded cylinder to ‘mush’ out soft tissue. It feels very uncomfortable… which makes us feel it might be needed. It definitely does not follow the fail safe adage “if it feels good do it” because it does not feel good, immediately. However, if you give it a try, even every other day for for a few weeks, you’ll notice it hurts less and you tolerate it better.

But does hurting less actually mean that you have caused a beneficial physiologic change? Like increasing range of motion, decreasing tightness and improving performance? You may hear people claim foam rolling reduces fascial (skin-like covering on muscles) restrictions, increases length of muscles, tendons, IT Band etc, improves strength output and the list goes on.

What does the peer-reviewed research say about foam rolling? We’re not sure if foam rolling does cause any of the above claimed physiological changes, but the latest research does tell us that foam rolling is effective in reducing pain perception after post workout soreness or delayed onset muscle soreness (DOMS) (Romero-Moraleda et al. 2017). Self-massage (assuming foam rolling falls into this category) has also been found to significantly improve stretch tolerance and flexibility when compared to a normal held stretch (Capobianco et al. 2018). Foam rolling even shows decreasing muscle sensitivity through muscle brain pathways, which may explain post-rolling improvements in range of motion and pressure tolerance (Young et al. 2018). However, like anything there is also a whole host of research that disagrees or finds that foam rolling has no significant positive effects.

So how do we decide whether it is right for us or not?  Some examples of situations where foam rolling may be appropriate are:

  1. Do you feel you have more tightness on one side compared to another, in the thigh for example?
  2. Do you have one-sided pain?
  3. Do you get really sore after a workout, in your calves for example, and want something to do after your workout to try and reduce this?

How do you foam roll? You may be among the crowd that looks at the foam roller and has no idea what to do with it, but would like to try without looking like a fool in the process. I have many patients say they have seen people using it in the gym and cast an awkward stare while trying to figure out what they are doing. They have even gone to Youtube for video instruction avoid looking silly. Check out ours below to learn how to roll the calf. Or you may be of the group that has figured out a few things that work for you, but would like to know some new tips and tricks. No matter what group you fall into, below are a few easy to follow instructions to get started.

DOs

  1. ROLL large meaty muscle bellies ​​examples: calves, thighs, glutes, hamstrings
  2. ROLL every other day, no more than 2-5 mins to start
  3. Stay below your shoulders and above belly button

DON’Ts

  1. DO NOT Roll over bones close to the surface examples: shin bones, hip bone, knee cap, elbow, sitting bones
  2. DO NOT roll your LOW BACK
  3. DO NOT roll your tummy or chest

MAIN MESSAGE Try foam rolling every other day or after your workouts for 2-5 minutes for at least 2-3 weeks and notice if you feel better or not. If you don’t then don’t waste your time. If you do, then keep it up and maybe try new areas of the body to foam roll, like the lats or the middle back!

Check out our foam rolling video for how to progress from basic to more advanced calf rolling! As always, if you have any questions comment below or email at [email protected]

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!

Common knowledge or common misconception? Motion is lotion.

Raise your hand if you’ve been doing a squat or lunge and been told “don’t let your knees go past the front of your toes”. Or “never bend forward because you may cause a disc bulge”? Or “don’t squat to the floor because it’s bad for your hips and knees”

There are many misconceptions that we hear in the clinic and around the gym that in some cases, cause more limitation or fear than necessary. In some cases, if we were to follow all of the ‘rules’ we would be walking around like robots!

Now, there are certainly situations that warrant specific movement restrictions and attention to form i.e. after surgery, while lifting heavy weights or when performing high intensity repetitive movements. But in everyday life, our bodies are amazing machines and are made to move! In fact, our joints stay healthy through movement and help prevent and manage conditions such as osteoarthritis.

When you stop to think about it, there are many movements we just don’t do in our daily life. Maybe because our daily demands don’t warrant it or our jobs have us working at a desk all day, for example.

A great example to think of this is how often do we ever bend our hips and knees past 90 degrees (i.e. deeper than chair height)? Or our ankles past neutral? For a lot of us, really not often, especially when we work standing at a till, sitting at a desk or driving in a car.

Here is a great tip from a well respected physiotherapist, Bahram Jam, to help keep you feeling young and your joints mobile while reducing the dread of bending down to pick something off the floor

Practice unloaded deep squatting everyday.

  1. Try holding onto a kitchen counter, banister or rail and gently lower yourself until your bum touches your heels and your armpits touch your knees
  2. Hold it for a few seconds while you get comfortable
  3. Then repeat 5-10 times using your arms throughout to help with the movement, if needed
Deep Squats for mobility

This is a simple yet great way to keep your back, hips, knees and ankles healthy and mobile by using their available range of motion!

Obviously this goes against what we may hear about not bending our hips past 90 degrees and knees past our toes. The movement itself is not damaging. In fact, it helps keep the mobility in our joints while making things like getting on and off the floor or squatting to pick things up much easier.

Of course this should not replace any medical advice but if you have any concerns or would like ideas to help stay mobile and keep your joints healthy and strong visit a local physiotherapist or kinesiologist!