Meet Gabrielle!

We are so happy to introduce one of our newest additions to the team, Gabrielle De Winter! Gabrielle (pronounced GABE-ree-ELLE) is a registered massage therapist, graduating valedictorian of her class from the West Coast College of Massage Therapy in 2017. Learn more about Gabrielle below!

What is something totally random that people won’t know about you? I LOVE panda bears!

When did you decide you wanted to be an RMT? Oh that’s a complicated one. I thought about it when I was 17 years old and visited the school. At the time I didn’t feel ready for all the touching of strangers! I knew that I wanted to eventually, though.

Which sports are you into? Basketball, martial arts, swimming, rock climbing and archery.

Where did you grow up? I grew up in Richmond, BC.  

What is your favourite orthopaedic condition to treat? Tension headaches!

What makes you happiest? Simple things like finishing a long hike, drinking a warm drink by the fire, or holding the hand of a loved one.  

LIGHTNING ROUND!!!!!

Cats or dogs? Dogs

Favourite food? Fresh steamed mussels in a white wine and cream sauce with a fresh baguette.

Favourite dessert: Pie, any and every type (except for cow pies)

Favourite Junk food: Green Tea Pocky or Cream Dill kettle chips (I can’t decide)

Beach or mountains: Beach

Favourite colour: Peach

Favourite music: Experimental Rock/ Rock Electronica (think Radiohead, Björk, Portishead)

Favorite day of the week? Thursday

Nickname? Gabe, Gabies, Panache, Gabriella poompe paya, Sweetie- kins and Sweetie- Pie. If you forget my name, just say , “chocolate” and I’ll turn around.

Would you rather be able to speak every language in the world or be able to talk to animals? Every language in the world.

Favorite holiday? Christmas

How long does it take you to get ready? 30 minutes

Invisibility or super strength? Super Strength

Is it wrong for a vegetarian to eat animal crackers? HAHA no

Dawn or dusk? DAWN

Do you snore? I think I do on the RARE occasion. I’m a light sleeper and I’ve woken myself up.  

Place you most want to travel? Belgium

Last Halloween costume? Tiger

Favorite number? 4

Have you ever worn socks with sandals? NEVER

Would you rather cuddle with a baby panda or a baby penguin? PANDA

Would you want to live forever?  Yes

What's for dinner tonight? A salad with all the nuts and bolts

Overhead Shoulder Pain in Volleyball Players

Kheya McGill graduated from UBC with a Bachelors Degree in Kinesiology. A lifelong Tsawwassen resident, Kheya has recently joined Ladner Village Physiotherapy as a registered kinesiologist. In this article, she reviews the most common causes of shoulder pain in overhead movements common with volleyball players and five great exercises to help combat the pain.

Shoulder pain is common in volleyball players, particularly while arms are in the overhead position. The shoulder is one of the most mobile joints in our body, meaning it is also one of the most unstable joints. If you enjoy playing volleyball (or other overhand activities such as lacrosse, tennis or fly fishing), chances are you’ve experienced shoulder pain at some point whether that be soreness, stiffness or sharp pain.  

What causes overhead shoulder pain?

Common causes of overhead shoulder pain include:

• Shoulder impingement - A shoulder impingement occurs when tendons get “impinged” or compressed between the head of the humerus (aka the arm bone) and the bony architecture of the scapula (aka the shoulder blade). When you lift your arm overhead, the space between these bones in your shoulder decreases and increases pressure on the tendons. This can cause irritation, which can lead to an impingement. 

• Rotator cuff injury - The rotator cuff is a group of 4 muscles which surround your shoulder. These muscles help move the arm and scapula, while protecting the shoulder. Rotator cuff injuries are common and can occur for many reasons, including overuse, trauma, or degeneration. (Need more on this? Read our blog on the rotator cuff!)

• Osteoarthritis - A degenerative joint disease, osteoarthritis causes problems with the cartilage, synovial membrane, ligaments and bone in a joint. Osteoarthritis can cause tissue loss, remodeling, inflammation and lead to loss of normal joint function. A history of shoulder injuries leads to a higher risk of developing osteoarthritis here. Remember, arthritis isn’t just seen in “old” people!! (For more on osteoarthritis, read our blog!)

How can I improve my shoulder pain?

Although these injuries are all quite different, the good news is all of them can be improved with the right exercises! Here are a few of our favourite exercises and stretches to add to your routine: 

1. Internal and external rotation with band 

Using a band, secure one end of the band to a stable point (we suggest tying a large knot in one side and securing the band behind a door).

Internal rotation: 

• Grab the band with your hand so that the band is pulling your hand away from your body

• Bend your elbow and tuck it gently into your side

• Move your hand from the outside of your body towards the inside, bringing your hand closer to your belly
  

External rotation: 

• Turn your body around so the band is now going in front of your body and pulling your hand towards your body

• Bend your elbow and tuck it gently into your side

• Move your hand away from your belly while keeping your elbow tucked in
  

2. Shoulder flexion with resisted external rotation 

• Put a band around your forearms and bend your elbows at 90 degrees 

• With your arms shoulder width apart, place small amount of tension in the band, and lift your arms up from the shoulder
  

3. Thoracic spine openers

• Start laying on your side, with your hips and knees bent in front of you 

• Place both arms straight out in front of your chest 

• Keeping your bottom arm on the floor, reach your top arm across your body and towards the floor on the other side, opening the chest 

• Follow your top hand with your head and eyes, and then slowly return to starting position
  

  4. I, Y, T, W’s 

• Laying on your stomach, face down, with your arms overhead, thumbs pointing upwards (You may want to place a folded dish towel under your forehead - this helps you keep a neutral neck and breathe!)

• Pick a position (I, Y, T or W) and raise your arms, pulling your shoulder blades together

• Lower your arms back down to the ground, and repeat

• Try in each position to target different muscle groups
  

5. Pectoral stretches 

• Standing next to the corner of a wall, place your forearm against the wall, with your arm and shoulder at 90 degrees

• Lean your body forward until you feel a stretch across your chest

• Play around with the height of your arm to stretch different portions of your pectoral muscle
  

There you have it! Five simple exercises you can do at home or add to your daily workout routine to improve shoulder pain and scapular stability. 

If you’re suffering from shoulder pain, give us a call at (778) 630-800, email us or book online to seek treatment from a physiotherapist or to work with a registered kinesiologist.  

Five Simple Strategies for Symptom Management Post-Concussion

Stephanie Yip is one of our vestibular therapists here at Ladner Village Physiotherapy. Since her own concussion many years ago, she has been passionate about learning as much as she can about concussion rehabilitation. Here, Stephanie shares a few of her favourite strategies for symptom management post-concussion.

Have you (or a loved one) suffered a concussion? Are you finding yourself struggling with day-to-day tasks? Are you constantly overwhelmed by the onslaught of bright lights, noises, and people coming and going? Are you hiding in a dark room by late afternoon?

If you’ve answered yes to one or more of these questions, you are not alone. There are over 200,000 concussions diagnosed in Canada annually, and those are only the ones that are reported. When healing from a concussion, symptoms can be difficult to control.

Only about half of people know what to do when they or their loved ones suffer a concussion. For what to do in the first days and weeks after a concussion, check out Part 1 of our series So You’ve Had A Concussion and download Concussion Recovery 101.

Here are a few simple strategies that you can start implementing right away to start easing your symptoms when you’re having a bad day.

Full disclaimer: these are tools for symptom management, and can be used throughout the day to help you cope. These are not meant to replace concussion treatment/rehabilitation.

Five Strategies for Post-Concussion Symptom Management

1. Palming

This is my personal favourite strategy. Let’s say you’re at the grocery store because you desperately needed eggs but it’s a lot busier than you expected, and you are suddenly hit with a wave of dizziness as you scan the aisles. You want to run and hide in a dark room except there’s nowhere to go.

What do you do? Create your own “dark room”! Cover your eyes with your palm and bathe your eyes in darkness. Look forward into the black and count as you take 10 deep breaths. This works as a recovery tool and you can use it anytime you need a quick break from your surroundings.

2. Musician’s Earplugs

After a concussion, your brain becomes very inefficient at filtering out background noise. This is why you’ve probably noticed yourself yelling at the kids for playing their video games too loudly, or maybe you’ve suddenly developed a newfound loathing of the lawnmower. It can be tempting to start wearing earplugs or noise cancelling headphones to cope. The problem with this is if you start perpetually living in silence, you’ll never learn to tolerate noise again, which will stall your recovery.

Instead, give musician’s earplugs a try. These earplugs have varying levels of filter, so you can choose the least amount of reduction that you can tolerate. You’ll still be able to hear the lawnmower and hold a conversation with a friend, but you won’t want to rip your hair out.

3. F.lux

Do your eyes fatigue easily after using your computer or phone? I promise I’m not sponsored by F.lux but I do love their software.

F.lux is basically a fancier version of the “night mode” setting on your phone. F.lux makes your computer screen look like the “daylight” depending on the time of day, so it will be a warmer glow at night, and then brighter like sunlight during the day. You can adjust the settings to your bedtime so it gradually changes as your day progresses. You can also just keep it “warm” all the time if that’s what you’re able to tolerate that day. (But as your physio, you know I’ll be getting you to gradually increase the brightness over time...’cause that’s the only way we get better!)

4. Reading Tips

Reading is hard after a concussion! But that doesn’t mean you can’t still read and enjoy all the books you used to.

Try placing a piece of paper under each line as you’re reading. This reduces the amount of visual input that your eyes have to take in and filter and allows them to track the letters with less difficulty.

Large font books or enlarging the font on your kindle can be another lifesaver.

Audiobooks can also be a great option, and can even be used as a restful activity. I know they can seem daunting, but try starting out with some easy teen lit (think Harry Potter, Twilight or the Hunger Games) and make sure you like the voice of the reader! Before you know it, you’ll be listening to audiobooks every night.

5. Surface Orientation

Do you ever feel like you’re floating or walking on clouds? I’ve had clients also describe it as walking with pillows for feet. Or maybe you just get hit with waves of dizziness throughout the day. This one is for you.

You can do this sitting, standing, or lying down, depending on the situation you’re in. Whichever position you’re in, find something very firm and solid to stand, sit, or lie on. If you’re near a wall, press your full back against the wall. Focus on the feeling of your feet on the ground, your bum in the chair or the wall on your back. Really focus on each part of your skin that is touching the surface. Take a few deep breaths. Continue focusing on the firm surface you are supported against, and tell yourself that you are not moving. Imagine that gravity is gently pulling you straight down into the surface of the chair, wall, or floor. Check in with yourself. You should feel more grounded.

There you have it – five simple, easy strategies you can start implementing right away. And don’t forget the importance of sleep hygiene, exercise, and pacing!

Remember that concussion rehabilitation does not come with an instruction manual - there is no one-size-fits-all approach. A person dealing with persistent concussion symptoms needs a team experienced, knowledgeable and up-to-date with the latest evidence. Surround yourself with a good team to help navigate your way out.

If you have any questions about concussion rehabilitation, feel free to contact us through email or phone us at (778) 630-8800. If you would like to book an appointment, you can do so online.

Meet Sofy!

Our newest orthopaedic and pelvic floor physiotherapist, Sofy was born in Taiwan before moving to Kimberley, BC at a young age. She eventually ventured down to Vancouver to complete her degrees and now calls this beautiful city home. Growing up in the East Kootenays introduced Sofy to many sports and outdoor activities, where she spent most of her time in the mountains or at the golf courses. Besides being a physiotherapist, Sofy is also an artist. She loves oil painting and everything art! 

What is something totally random that people won’t know about you?

I moved to Kimberley because I had terrible eczema and allergies living in Taiwan and Kimberley was the only place that magically made my symptoms disappear (after exploring several countries and cities).

When did you decide you wanted to be a physio? 

I wanted to become a dentist since I was 8 years old. It wasn’t until 3rd year university when I realized that I couldn’t talk to people if I was working inside of their mouths. I love talking and getting to know people as well as learning about how the human body works. After exploring a few different professions, physiotherapy seemed to be the perfect fit!

Which sports are you into? 

Golf, golf, and golf! Tennis in the summer, squash in the winter. Rock climbing, spikeball, and volleyball are pretty fun too. 

Where did you grow up?

Taiwan and Kimberley BC. 

What is your favourite orthopaedic condition to treat?

I like them all! Each body part is fascinating in their own ways in my opinion, hard to pick a favourite. I took a special interest in hands and the upper extremities early on in my career, but now I like to treat everything. 

What makes you happiest? 

Camping on top of a mountain or painting away in my little studio. 

LIGHTNING ROUND!!!!!

Cats or dogs? Dogs

Favourite food? Thai food

Favourite dessert: Tiramisu 

Favourite Junk food: Instant noodles

Beach or mountains: Mountains

Favourite colour: Baby pink

Favourite music: Pop

Favorite day of the week? Sunday

Nickname? Sof, Meng (but I really don’t like it)

Would you rather be able to speak every language in the world or be able to talk to animals? Speak every language

Favorite holiday? Christmas

How long does it take you to get ready? 30 mins

Invisibility or super strength? Invisibility

Is it wrong for a vegetarian to eat animal crackers? No

Dawn or dusk? Dusk

Do you snore? I “breathe loudly” 

Place you most want to travel? Nepal, South America

Last Halloween costume? Cannot remember the last time I dressed up

Favorite number? 3

Have you ever worn socks with sandals? Whenever I’m too lazy to put on shoes

Would you rather cuddle with a baby panda or a baby penguin? Baby panda

Would you want to live forever? No

What's for dinner tonight? Turkey burger with yam fries

Yep, she painted that.

What is Kinesiology?

Kinesiology, also known as human kinetics, is the study of human movement, performance, and function. Kinesiologists work with people of all ages and physical abilities to help them achieve their health and wellness goals as well as improve their quality of life. 

A kinesiologist (kin for short) uses knowledge of anatomy, physiology, neurology and biomechanics to maximize the effectiveness of exercise rehabilitation. A kinesiologist can implement your exercise program, provide support in your rehab,  and help improve physical performance in sport, work or daily life.

In more simple terms, kinesiologists are exercise rehab rock stars!

Kins use exercise to get you back to the things you love. They will discuss your goals and current treatment plan with you and your physiotherapist (if you have a physio) and help develop an exercise program to meet your needs. They work with you for one-on-one exercise sessions to ensure your technique is perfect while they help progress you through your recovery process. Strength, endurance, balance, and general fitness goals will all be addressed - there will be no stone left unturned!

What kind of training does a kinesiologist have?

Kinesiologists have completed a 4 year bachelors degree from an accredited university. Both UBC and SFU have fabulous programs! Our kinesiologists are also active members of the British Columbia Association of Kinesiologists (BCAK).

Is a kinesiologist like a personal trainer? 

The primary difference between kinesiologists and personal trainers is education level. Kinesiology requires a four year university degree whereas personal training education is generally a few weekend courses. The increased scientific knowledge base and use of evidence-based research translates to a higher quality of care, a more comprehensive approach to your exercise, and more capability of helping you troubleshoot issues that may arise.

What can a kinesiologist do for me?

There are many reasons people can find kinesiologists valuable. Kins can:

• Create an exercise plan that is safe and realistic

• Identify muscle imbalances through assessment of your movement

• Help with maintaining fitness while you deal with an injury

• Develop an exercise rehab program to address an injury

• Ensure proper exercise technique to avoid unnecessary injury

• Provide motivation and accountability to stick with your exercise program

• Help you have fun while achieving the results you want!

Is kinesiology covered by my extended health benefits?

Usually yes! For most people kinesiology, active rehab, and physiotherapy assistant appointments (which are, for this purpose, mostly interchangeable terms) are included within your physiotherapy coverage. Some plans have separate categories for “Physiotherapy” and “Kinesiology”. It is always best to first check with your insurance provider to confirm your coverage.

Do I have coverage if I was in a car accident?

Yes! With ICBC coverage, within the first 12 weeks of a car accident you are automatically approved for:

• 12 visits with a kinesiologist

• 25 visits with a physiotherapist

• 12 visits with a registered massage therapist

If your accident was more than 12 weeks ago or you have had treatment for your accident at another clinic, please let our front desk know so we can help you sort out the logistics.

Do I have coverage if I have a WorksafeBC claim?

Yes! Our kinesiologists works closely with our physiotherapists to aid in the delivery of your recovery program.

What will my session look like?

Your first visit with your kinesiologist will be an hour long. Your kinesiologist will meet you and begin the session with a quick chat. They will ask you about your reasons for coming in, your goals and your current exercise program. They will then take some time to assess your movement, strength and capabilities before taking you through an appropriate exercise program.

The kinesiologist is in constant collaboration with your physiotherapist to ensure your exercise sessions are as effective and pleasant as possible. Follow up sessions can be 30 minutes, 45 minutes, or 60 minutes long. If you are a WSBC or ICBC client your appointments will always be 45 minutes.

If you want to learn more or you would like to book a session with a kinesiologist please contact the clinic via:

• phone at 778-227-8030

• email at clinic@ladnervillagephysio.com

• book online

We look forward to meeting you!

Low Back Pain in Dancers and Gymnasts

For dancers and gymnasts, low back pain can come in many forms and can involve the spine itself. Two of the most common spinal injuries are:

1. Spondylolysis - a stress fracture of the pars interarticularis, a thin area of the vertebra that is more vulnerable to injury.

2. Spondylolisthesis - occurs if stress fractures are on both sides of the vertabra and allow a slippage of one vertebrae over the other to occur.

Dancers and gymnasts are at a higher risk of developing these spinal injuries due to repetitive hyperextension-type movements such as back-bending. These movements put significant load on the pars interarticularis, a thin part of the vertabra that connects the main part of the vertebra at the front with the bony bits at the back.

When you combine hyperextension with forceful dismounts and landings (gymnasts, we’re talking to you), it increases the risk of both spondylolysis and spondylolisthesis significantly. As more and more dancers are combining gymnastic skills into their routines, I expect to see more dancers with these conditions as well.

A slippage of less than 50% (a Grade 1 or 2 spondylolisthesis) is often treated with physiotherapy including hands on treatment techniques and exercise. A slippage of greater than 50% (a Grade 3 or 4 spondylolisthesis) is considered more serious and usually involves the care of a specialist.

Both spondylolysis and spondylolisthesis can happen at any spinal level. It most commonly occurs in the L5 vertebra, with L5 slipping forward over S1 (see the photo above). The second most common site is L4. 

What do spondylolysis and spondylolisthesis feel like?

Athletes will often complain of the following:

• Dull pain that can be sharp with movement

• pain with extension type movements including arabesque, bridges, back walkovers, back hand springs etc.

• Focal pain in the low back but may radiate into the buttock or down the legs

• Symptoms that are worse with activity and better with rest

How is it diagnosed?

Diagnosis starts with a thorough subjective history. If a spondylolysis or a spondylolisthesis is suspected, imaging via X-ray, CT or MRI will be ordered to confirm a diagnosis.

It is important that athletes with suspected spondylitic conditions be medically cleared before beginning an exercise program. This is crucial for the health and well being of the athlete as the wrong exercises can aggravate and worsen the injury.

How do we treat it?

Spondylitic conditions can cause instability of the low back. Spinal stabilization through core stability training is a key component in prevention and rehabilitation in these young athletes. Often, athletes focus on the large muscles and neglect the little guys that are responsible for stabilization. Core stability training targets the little muscles that directly support the spine including the transversus abdominis, multifidi, paraspinal, and internal and external obliques.

Appropriate flexibility is also important after a spinal injury. Tightness of certain hip muscles can increase the extension of the low back which can exacerbate symptoms.

If you’re suffering from back pain, give us a call at (778) 630-800, email us or book online. 

Soft Tissue Injuries Just Need Some PEACE & LOVE

You may have heard the acronym RICE before (rest, ice, compression, elevation). This protocol was developed by Dr. Gabe Mirkin in 1978 and remained the primary recommendation for management of acute soft tissue injures (like ankle sprains).

In 1998, it was adjusted to PRICE (protection, rest, ice, compression, elevation). PRICE was en vogue from 1998 until 2012 when the research evolved yet again and we were given the newly named POLICE protocol (protection, optimal load, ice, compression, elevation).

POLICE had some positive changes, especially as it included active participation and appropriate loading rather than just several passive treatments.

But now there is a new kid on the block:

PEACE and LOVE 

The researchers behind PEACE and LOVE are Blaise Dubois and Jean-Francois Esculier. They identified how the previous RICE/PRICE/POLICE strategies ignored the subacute and ongoing stages of healing*. Because the subacute and ongoing stages compose the majority of the post-injury timeline, we welcome suggestions for this phase with open arms.

*We classify injuries as acute in days 0-4 after the injury, subacute from days 4-14, post-acute is after 14 days.

Without further ado, I present to you a protocol that emphasizes the PEACE-ful stages of immediate care, which emphasizes doing no harm, and the subsequent management that gives the soft tissues some LOVE.  

• P is for PROTECTION: Avoid activities that increase pain during the first few days after an injury.

• E is for ELEVATION: Elevate the injured limb higher than the heart as often as possible. 

• A is for AVOID ANTI-INFLAMMATORIES: These medications can reduce tissue healing. Avoid icing. 

• C is for COMPRESSION: Use elastic bandage or taping to reduce swelling. 

• E is for EDUCATION: Your body knows best. Avoid unnecessary passive treatments and medical investigations and let nature play its role. 

• L is for LOAD: Let pain guide your gradual return to normal activities. Your body will tell you when it’s safe to increase load. 

• O is for OPTIMISM: Condition your brain for optimal recovery by being confident and positive. 

• V is for VASCULARIZATION: Choose pain-free cardiovascular activities to increase blood flow to repairing tissue.

• E is for EXERCISE: Restore mobility, strength and proprioception by adopting an active approach to recovery. 

---

Most of the above is self explanatory but there are a few points which are new or warrant some further explanation. Below are some key points for each factor. 

A for Avoid Anti-Inflammatories

• Inflammation is a natural and beneficial process to repair damaged soft tissues. 

• Using anti-inflammatory medications may negatively affect long-term tissue healing.

• Ice is analgesic but can interrupt regeneration and can lead to impaired tissue repair via disrupting angiogenesis, delaying macrophage and neutrophil infiltration and increasing immature myofibrils. 

E for Educate

• An active approach to recovery is better than a passive approach. 

• We want to avoid people feeling therapy-dependent or “needing to get fixed.” 

• Better education and correct load management can decrease the need for unnecessary injections or surgery.

• There is no “magic cure” and expectations should be realistic. 

O for Optimism

• Optimistic clients have better outcomes and prognosis. Beliefs and emotions are thought to explain more of the variation in symptoms following and ankle sprain than the degree of pathophysiology.  

• Catastrophisation, depression and fear can represent barriers to recovery.

V for Vascularisation

• Cardiovascular activity is important for the management of musculoskeletal injuries and should be completed in a pain-free way to boost motivation and increase blood flow to the affected area. 

• Early aerobic exercise and mobilisation improve physical function which can aid with successful return to work and decrease the need for pain medication. 

• Further research needs to be done for recommendations on dosage. 

E for Exercise

• Exercise can help restore mobility, strength and proprioception. It can also reduce prevalence of recurrent injuries such as ankle sprains. 

• Avoiding pain to ensure optimal repair during the subacute phase. Progress exercise as tolerated. 

For the full paper, download it here!

Top Ten: Backpack Tips

If you’ve seen me around town, I’m usually carrying my bright blue backpack on my shoulders and either zipping around on my bougie cruiser bike (and my new wicker basket!) or walking while zoning out to a podcast. Backpacks are my favourite way to carry my essentials while keeping the weight happily distributed and my hands free.

Like most people I know, I have fallen victim to poor backpack habits in the past. I have definitely been that person in class treating my pack like a clown car, pulling out item after item and desperately trying to find the thing I need. At the end of those days, it was all I could do to pop an Advil and get in the bath - not exactly the smartest thing to do.

So, dear reader, it’s a great time to learn from my mistakes! Let’s go over the essentials of backpack wearing - how much weight is appropriate, how to pack your backpack and what red flags you should pay attention to.

Top Ten Backpack Wearing Tips for Back To School:

1. Ensure your pack weighs no more than 10% of your body weight. We commonly hear that 15% is the upper limit, but current research questions this number. Another journal article identifies “significant biomechanical, physiological and discomfort impacts on the wearer, especially with loads above 10% of the student’s body weight”. The take home? Keep it under 10%.

2. Buying a new pack? Go for wide straps and a padded backing. The cushion will help distribute the weight and make it much more comfortable especially on long days.

3. While you’re at it, make sure the pack actually fits your back. Try it on (preferably with some weight) - the bottom of the back should be right around hip height and not hitting your bum.

4. Use both straps. Please, for the love of everything holy, distribute that load across both your shoulders.

5. If your pack is particularly heavy one day, use the waist strap. It will help keep the load closer to your centre of gravity and distribute some of the weight from your shoulders to your pelvis.

6. Place heavy things close to your body at the back of the pack. There’s a reason the laptop pouch is at the back of the bag (beyond the whole projecting the valuable thing part) - it keeps the weight close to your body’s centre of gravity and places less stress on your muscles and joints.

7. Use those multiple compartments. They keep your load spread out and in place, reducing the chance of injury from load shifting.

8. Putting your backpack on and off should be easy. If you’re struggling, it means your pack is too heavy.

9. If you’re leaning forward to carry your pack, it’s too heavy. Your backpack shouldn’t be pulling you backwards. If it is, back pain won’t be far behind.

10. Other signs of too much weight in your pack: neck pain, tingling and/or numbness in your shoulders, arms or hands, and visible strap marks show up on your shoulders. If you start experiencing any of these signs, it’s time to re-evaluate your pack situation ASAP.

We see a lot of poor backpack practices lead to postural changes and pain. Develop good habits early and avoid the problems down the road - you’ll be happy you did!

If you’re suffering with backpack-related pain, give us a shout at (778) 630-8800, email us or book online.

Are Your Nerves Limiting Your Mobility?

Our dance physiotherapist Anh is back! Here, she discusses neural mobility and tension - what it is, why it occurs and why dancers especially should know about its wide-ranging effects.

Hey dancers! Are you or do you know someone who stretches for hours a day, every day of the week and still can’t get into their splits? As dancers we often think about stretching our muscles to improve mobility. But what if it isn’t your muscles that are preventing you from touching your toes or achieving the splits? What if the problem is your nerves?

Your nerves are meant to move freely throughout your body. They connect our brains to our big toes and everything in between.

Neural tension occurs when a nerve’s ability to move has been impeded.

You can think of your nervous system as a tangle of ropes, extending from your brain to all areas of your body. Imagine one of these thick ropes starting at the top of your head, running down your spine, behind your glutes, down the back of your leg and all the way into the bottom of your foot and toes (this would be your sciatic nerve). If there is a restriction anywhere along the line of this rope, you won’t be able to move your leg the way you should.

Like rope, nerves do not like to be stretched or squeezed - both affect the ability of the nerve to do its job. In order to achieve full range of motion, nerves need to glide back and forth in the body. If a restriction is present and not removed, further stretching can cause irritation of the nerve over time.

So how do I know if it's neural tension that's preventing my mobility and not muscle?

1. If you are experiencing burning, tingling, numbness, or shooting pain that radiates past the muscle that is being stretched

2. If the sensation of stretching changes with different head and neck positioning

3. If the sensation of stretching changes with a change in position of a joint unrelated to the muscle being stretched (ie. stretching your hamstring feels better when your feet are pointed vs when your feet are flexed)

How do I get rid of neural tension?

First things first - if there’s neural tension, there’s a reason for it. As physiotherapists, we assess and identify the source of the tension. Is there something squeezing the nerve in the back? What about in the glutes or behind the knee? Finding the source of the problem is always the first step.

We then use a combination of techniques including manual therapy, soft tissue massage and specific exercises designed to help settle the tissue down and not reaggravate it.

Without a doubt, nerve flossing comes into play. Nerve flossing is a dynamic stretching technique that mobilizes the nerve. Think of a piece of dental floss: when you are flossing your teeth, you pull on one side of the floss and allow the other side to slacken, then reverse directions. Nerve flossing is the exact same idea - it is performed by tensioning one end of the nerve while slacking the other end.

Nerves control your muscles. If a nerve feels unsafe (like when going from sedentary to being over stretched) it will send signals to the muscle to contract and stiffen. This puts the dancer at risk of muscle strain. It is important to incorporate nerve flossing techniques and movements into your warm and stretch routine. 

For more information on neural tension and its effect on mobility, book online or give us a call at (778) 630-8800.

Summertime in Delta

That big shiny thing in the sky… I’m told that’s the sun. According to the weather man “June-uary” is over and the heat has finally arrived. How exciting!

Before we all just rush outdoors to soak it all in I wanted to point out that we Vancouverites are not so great at dealing with warm days (kind of in the same way we aren’t great with snow. How can you be expected to be good at something if you never get to experience it am I right?). Let’s take this opportunity to remind ourselves of some important factors to consider before heading out into the sun to exercise.

Nicole’s Top Tips for Summer Exercise

1. Stay hydrated! Your body will sweat extra when it is hot out. Keep yourself cool and help prevent heat injury (such as heat stoke) by keeping the H2O handy!

2. Be aware of your fitness level. Unless you are acclimated to the heat your exercise tolerance will go down when it is hot out. Take it easy and listen to your body. Go at an intensity that feels good for you. You probably won’t be able to run as far or as fast when it’s 28 degrees out as you did a few weeks go when it was 10 degrees and cloudy. And that’s okay.

3. Timing is everything. Take advantage of the long days! Early mornings and late evenings are significantly cooler and more pleasant for exercise (or just to exist in generally speaking, just ask my golden retriever).  

4. Wear sunscreen. Just do it.

5. Wear appropriate clothes. Loose fitting thin clothes in a light colour will help you stay cool.

6. Location location location! Is there a shady spot that you could go for your run instead of the track? Could you bike along the water where there is a breeze? It’s worth checking out!

Some of our favourite outdoor summer exercise opportunities in Delta include:

• Swimming - Whether it’s at Centennial Beach, the outdoor pools in Ladner and North Delta, or your own backyard, swimming has many benefits. It’s great exercise, it’s fun and it keeps you cool. What’s not to love?

• Hiking or nature walks - If climbing mountains isn’t your thing than A) you chose the right place to live because Ladner is as flat as a pancake, and B) Delta has some lovely little forest walks including Deas Island, Watershed Park and Burns Bog. If mountains are your thing then that’s great too. Be safe and take pictures for us!  

• Walking - Walking as exercise is underrated. It gives you cardiovascular benefits and is well tolerated when it’s hot out (need more details? Check out our earlier blog on the health benefits of walking as well as our favourite walks in our neighborhood). You can make a walk more challenging by changing the terrain (walking on sand is more difficult that concrete) or by increasing distance. Remember that walking doesn’t have to be fancy - I love my evening neighbourhood walks with my dog.

• Water sports - Paddle boarding and kayaking are great options in South Delta. They work your core and upper body while you get to stay cool out on the water. Just remember your hat and sunscreen!

Remember to go indoors if needed - not everyone likes the heat and that’s okay too. You could do yoga inside your own home, or workout at the gym (woo hoo for air conditioning).

Whatever you decide, I hope you have a great time and stay safe. It’s been a doozy of a year and I’m glad that we can all take an opportunity to enjoy some of this lovely weather.