Snow!

Snow!!! Maybe I’m alone in this but I really like snow - IF it is on a mountain and IF (and this is a big “if”) I have nowhere to go. Otherwise it’s a fairly large pain. And down here in South Delta I generally am pretty happy! We have plenty of snow up in the mountains that we can access any time we like for fun things like skiing or snowshoeing or what have you, but generally do not have to deal with the white stuff on a day to day basis down here the way the rest of Canada does (which involves shovelling and driving in the snow and is decidedly less fun). That being said, once in a while winter decides that even sunny South Delta gets some snow, and if the weather network is correct (another big “if”) then we have some snow coming our way in the next week.

But here is the thing - snow is not only a figurative pain, it can literally cause you pain or injury. Did you know that every year the average number of emergency room visits due to snow shovelling related injuries in the US is around 11,500!? Shovelling snow can cause back pain, shoulder pain, neck pain or even a heart attack. Not to mention a slip on the ice can result in anything from a bruised tailbone to a broken hip.  As a physiotherapist I would like to take it upon myself to hopefully prevent a few snow related injuries this week.

So without further ado I present to you:

Nicole’s Tips and Tricks for Dealing with Snow-Mageddon 2020 (South Delta Edition)

Shovelling Snow:

• Pace yourself! It is significantly easier to shovel 2 inches of fluffy snow than 8 inches of hard packed snow. If it is going to be snowing all day do yourself a favour and get out there a few times. Not only does it spread the work out over time with rest breaks, but each session will involve less load and strain.

• Push the snow!!! Don’t twist and lift, don’t throw it over your shoulder, just put your shovel on the ground, and walk forwards. When you get to the end of the line squat and use your legs instead of your back to lift the snow and place it in the pile. Your back will thank you for it.

• Use a good shovel. If it is too short you will have to bend more. If it’s too heavy you’re increasing your workload. A shovel that is mid-chest height is a good bet.

• Treat it like a workout. You’re going to be working hard in cold weather. A good warm up and cool down can help decrease chance of injury and post-workout muscle soreness. It doesn’t have to be fancy, a few arm swings, some marching on the spot, and off you go!

• Ask for help if you need it. If you experience any pain or shortness of breath discontinue and seek medical help if needed. If you have concerns about your cardiac health consult with your doctor before shovelling or get someone else to do it for you. We live in a lovely neighbourhood and the guy next door is not going to mind helping you out.

 Walking on Snow and Ice:

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Courtesy of Alberta Health Services

I have already made a short post on this elsewhere but it is worth repeating. A normal upright walking pattern can put you at higher risk of your feet shooting out from underneath you when you are walking on a slippery surface. To decrease the chances of a nasty fall all you have to do is walk like a penguin! That means:

• Lean slightly forward

• Angle your feet slightly outwards

• Take small almost shuffling steps

• Keep your arms out at your sides (not in pockets)

• Wear proper footwear (okay, penguins don’t wear shoes but you should)

Courtesy of ABC News

So good luck everyone and stay safe out there! If you do happen to end up with an injury or two and would like a physiotherapy assessment please feel free to contact the clinic at (778) 630-8800 or through our website at https://ladnervillagephysio.com/

Prolapse Part 1: What is Prolapse?

Whenever I am doing an initial intake interview with a client who has come in with concerns about their pelvic floor I ask about prolapse. The most common answer I get when asking if people have any concerns about prolapse is simply “what the heck is prolapse?” Well, let me tell you.

You have various organs within your abdominal cavity, the lowest of which include your bladder, your uterus and your rectum. They are all strapped into place and held in the correct position with connective tissue, like a marionette being held upright by strings. But sometimes those strings get over-stretched (like during childbirth). So instead of having nice upright puppets you now have puppets with extra long strings, which means you now have droopy puppets. These “droopy” organs then begin to collapse downwards.

It’s like your vagina is a tent (yes, like a camping tent), and then a big old bear (aka one of your organs such as your bladder) comes and sits on the edge of your tent. The bear is not physically inside your tent, but he’s leaning on it and squishing it, and making the space inside your tent smaller. This can lead to a “bagginess” or “sagging” within the vaginal canal which is also known as prolapse!

Women who have a prolapse (that they are aware of) generally describe sensations of vaginal heaviness, pressure, of something being inside of their vagina (like a tampon or a “bubble”), or a general feeling of their “insides falling out.” This can occur all day every day or occasionally. Often activities such as coughing, sneezing, carrying something heavy, or being on your feet all day can increase awareness and sensations of the prolapse. That being said, many women have a prolapse and have no sensation of it at all. This applies to small, moderate, and large prolapses. Some women have tissue protruding outside of their vagina for the majority of the day but if you asked them to stand clothes-free and hands-free they would have no awareness that their anatomy was different or changed.  

The name of the prolapse will depend on the structure causing the issue. I have listed a few of the more common terms below:

• Anterocele/cystocele/anterior vaginal wall prolapse: these are all generally names used for when the bladder is the offender. When the bladder decides to droop, it collapses into the empty space of your vaginal canal. This can sometimes lead to symptoms such as incomplete bladder emptying.

• A rectocele is also known as a posterior vaginal wall prolapse. This is when the back wall of your vagina (the wall between your vagina and rectum) is pushed forward due to external pressure from the rectum. Please note that a rectocele is not the same as a rectal prolapse. This is when tissue is loose inside the rectum resulting in excess tissue bulging out of the anus. A rectocele can cause, among other things, difficulty initiating a bowel movement.

• A uterine prolapse is pretty straight forward. If your uterus is dropping it’s more like the tent is collapsing from above. It can sometimes “drag” the front and back walls of the vagina down with it and seems to be the most noticeable type of prolapse.

You can usually tell which structure has prolapsed with a brief self exam. If you put your finger inside of your vagina and it feels squishy in the front, it’s a cystocele. Squishy in the back is a rectocele. If the extra tissue feels firm like the end of your nose you are feeling your cervix and it means that your uterus is the structure that has dropped.

The grade of a prolapse will depend on how much “droop” there is. If the bagginess is happening in the upper half of the vaginal canal it’s a grade 1. If the bagginess is in the lower half of the vaginal canal it’s a grade 2. If there is tissue protruding out the entrance of the vagina the prolapse is a grade 3.

Treatment options for prolapse vary and the right option for you will depend on a few things such as A)which structure is prolapsed? B) how big is the prolapse? And C) how much does it bother you?

I will discuss treatment options for prolapse in my next blog, but if you have any specific questions or would like a consultation please feel free to contact the clinic or book an appointment and I would be more than happy to help you out!

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If you’re looking for the second half of this blog, check out Part 2 - I Have A Prolapse! Now What?