Low Back Pain- Meghan Meagher

January 24th, 2011

LOW BACK PAIN part 1 of 3

Meghan Meager, Registered Physiotherapist

Moveo Sport & Rehabilitation Centre

1. Epidemiology/Background Information: Why is this an important topic?

  • Low back pain, or LBP is a very common symptom among both the general population and athletes. In fact, up to 85% of people will experience LBP in their lifetime with at least 50% experiencing at least one recurrent episode (Brukner & Khan, 2006)(3)
  • LBP is the most common disability under the age of 45
  • You can work with your therapist to take steps that will help ease symptoms and prevent future problems.

2. What are the common symptoms that accompany LBP?

  • Decreased range of motion or stiffness in the back
  • Pain spreading into the buttocks and thighs or foot
  • Spasm of the nearby muscles
  • Stiffness and pain after prolonged sitting or standing, walking
  • Pain when lifting and carrying
  • With Nerve compression:
    • Numbness, prickling or tingling in the hip, leg, foot, or toes
    • If more severe – Muscle weakness in the hip, leg, foot, or toes

3. Why do I have LBP?

There are several causes of LBP. The majority of back problems are a result of wear and tear on the parts of the spine over many years, a process called degeneration. Degeneration is part of the normal aging process and involves shrinking in height of the intervertebral disks found between the vertebrae in your spine. This leads to spinal instability and degenerative changes of structures around the spine which are all potential sources of pain. Degenerative changes can contribute to the development of conditions such as facet joint arthritis, disc herniations, nerve impingement, and scoliosis. Injuries to the spine, such as a fracture or injury to the disc can make the changes happen even faster.

LBP may not even originate in the lower back or lumbar spine itself. The sacroiliac joint (SIJ) is also a common source of LBP if there is instability or reduced muscle activation (of your “core” muscles) in the SIJ region, muscular imbalances or SIJ malalignment.

Think about the typical posture you assume each day, whether it’s working at your desk, or standing at a counter for example. How often do you get up and move around, allowing your spine stretch and your muscles to work as they were made to do? Typically, our backs become subjected to the same postures for hours; another very common cause of back pain.

CALI COLOMBIA, World Cup Race- Dr. Jenn Turner

January 11th, 2011

I have been fortunate enough to acquire a position working with Cycling Canada and their National Team programs, specifically I work mostly with the Track Program and their build to the Olympics in 2012. We have just returned from a successful World Cup race in Cali, Colombia.

From a team chiropractor perspective, Cali was a great learning experience, which is something I am always up for.  The role that I have with the team at this point is multi-faceted and I get to use much of a lot of the training that I have as a Sports Chiropractor to be useful and help this team and Cycling Canada go forward.

To this point I have been working with the team for about 2 years. This year thanks to the support of a company called B210 I have been able to see the athletes on a consistent basis. I have been to travelling quite frequently to Los Angeles, where the athletes live and train as well as seeing many athletes at Moveo here in Vancouver. This is much different than the work I have done in the past with athletic teams as the frequency I see the cyclists, the better able I am to monitor athletes progress and build with subsequent treatments. This allows me to make a bigger difference I feel as I can focus on both injury prevention, and performance enhancement as well as injury management of any current issues.

As a chiropractor, I am doing a residency in Chiropractic Sports Sciences. This has allowed me to broaden my spectrum from typical “chiropractic” duties. I predominantly do a technique called Active Release Technique, which is a soft tissue technique that helps break up adhesions and scar tissue that forms in the muscles, tendons, ligaments and fascia due to trauma or overuse. I also use Graston technique, modalities and exercise prescription as a huge part of my treatment plans.

Cali was the second World Cup race of the 2010/11 season, and after a great start to the  season in Melbourne, the athletes were hungry for more success. We had a bigger team than ever attend and came away with a new Canadian Record in the Men’s Team Sprint, bronze and silver  medals in the men’s and women’s omnium.  We also had an impressive number of top 5 placings, which shows great potential for future development. Moveo patient Zach Bell, added a bronze medal to his silver medal from Melbourne and showed that he is a contender for the overall points leader in the UCI.

Next up is Beijing World Cup, which takes place on the same stage as the 2008 Summer Olympics. I am looking forward to a few more sessions in LA with B210 early Jan, then to experience Beijing Track Style!

Hip Flexors part 3- Treatment and Rehab

January 6th, 2011

Treatment

 

It is important that this hip flexor injury or dysfunction be managed timely and appropriately.  Many athletes wait too long to deal with this injury and the compensation patterns can take extensive rehabilitation and months to reverse.

First the tight tissues must be released.  A soft tissue technique such as Active Release Techniques (ART®) can be a useful method to decrease scar tissue buildup.  Combined with stretching, massage and foam or triggerpoint ball rolling this can be an effective way to loosen the psoas muscle.  Depending on the level of compensation, other muscles of the hip or leg will also need to be released.  Active Release of the gluteus maximus can also be helpful to activate the inhibited muscle in preparation for the next steps of rehabilitation.

In this next step of rehab, the neuromuscular repatterning of the glute must be re-established and strength of the glute can be restored.  The release of the psoas muscle helps with this, but combined with specific neuromuscular patterning exercises can help to expedite the process of normalization. Specific exercises include a split squat, with a focus on keeping a posterior pelvic tilt, which strengthens hip muscles in a lengthened position preventing them from getting over tight.

Another exercise  for glute firing includes the leg “drop” where the trained practitioner drops the patient’s leg from an extended position and it must be “caught” by the athlete before it hits the table.

By introducing certain exercises, pelvic stability can be optimal and provide stability to the lower extremity, lumbar spine and pelvis. A strong hip/pelvis complex helps to prevent injury recurrence, and improve athletic performance.

HIP FLEXORS part 2 of 3

December 29th, 2010

The pelvis is supported muscularly by the psoas as mentioned in the previous post, but also very importantly the gluteus maximus and the gluteus medius muscles.  Pelvic stability is often referred to as “core stability”, and the importance of core stability is very prevalent in the athletic society today.  That is why when the psoas muscle is dysfunctional as in each of the hip flexor injuries listed previously, it is a major concern to pelvic or “core” stability.

Various researchers have demonstrated that not only does the psoas provide stability to the lower lumbar spine directly but If the psoas muscle becomes excessively tight or shortened, it inhibits or “turns off” the gluteus maximus muscle.  The phenemon, described as “reciprocal inhibition” can occur in various muscles of the body, and is characterized by a contracted or shortened muscle forcing the opposing muscle to relax. Thus in the above situation, the gluteus maximus is neurogically weakened by this inhibitory reflex and an imbalance of pelvic muscles results.

The resulting muscular imbalance is where the injury becomes a detriment to performance and creates potential for further injury.  When the power of the glute max muscle is lost, the body will look for other muscles to compensate beyond their regular capacity. This creates a cascade of tight and weak muscles all the way down the leg in an attempt to recreate proper movement patterns.  These muscles then usually end up becoming injured themselves, as they are overloaded and cannot correctly compensate for the dysfunction.

Next post will talk about treatment strategies for this injury/imbalance.

HIP FLEXOR INJURIES

December 13th, 2010

HIP FLEXOR INJURIES

Part 1 of 3

By: Dr. Jenn Turner

Hip flexor injuries are a common injury in runners, triathletes and cyclists, yet there is little research or information available about how to properly rehabilitate this injury.

The hip flexors are made up of three different muscles, the rectus femoris, the psoas major and the ilacus. These muscles are located in the front of the hip and their action is to flex the hip or bring the knee up.  These muscles also play an important role in stabilizing the pelvis.

There are various types of injury that can occur to the hip flexors: snapping hip syndrome, iliopsoas tendonopathy, anterior acetabular impingement or a nerve entrapment.  Many of these injuries present very similar to each other, yet each different injury actually causes similar muscle imbalances and thus has a similar biomechanical solution.

Symptoms of a hip flexor injury can include:

-pinching or pain when the knee is brought up to the chest

-snapping or clicking in the front of the hip, hip tightness when stretching compared to the opposite side

-pain when pushing off while running

-pain in the low back or sacroiliac region

-weakness or a loss of power in the affected leg

It is important to try to rectify hip flexor issues as soon as the symptoms appear as chronic injury can manifest itself in pain or tightness all the way down the leg as compensation and create more problems for the athlete.

Stay tuned for the next blog in this series of hip flexor injuries.

Moveo Adds a New Physiotherapist to its Team!! Welcome Meghan Meagher!

October 16th, 2010

Meghan graduated with high honors from the University of Toronto with a Bachelor’s degree in Physical Health and Education and returned to Vancouver to complete a Master’s of Physical Therapy from the University of British Columbia. Meghan’s treatment approach incorporates correcting muscle imbalances, manual therapy, and exercise prescription to help restore optimal movement patterns. She aims to empower her clients with education and injury prevention strategies so they can return to, and maintain their optimal level of function. She has a special interest in treating running injuries and is also interested in treating women during and after pregnancy experiencing pelvic pain, diastasis rectus abdominus (separation of abdominal muscles), or women looking to resume an active lifestyle.

Meghan has worked with athletes of all ages and abilities, volunteering at various events and races including short and long-distance road races and wrestling matches, and working as a team trainer with the Vancouver Rower’s Rugby Club. She previously worked as a personal trainer, helping clients to achieve their personal fitness goals.

Meghan is passionate about living an active lifestyle outdoors and enjoys trail running, rock climbing, biking, multi-day hikes and snowboarding. She is excited to be back in the North Vancouver community to pursue these passions.

Meghan will be starting full time at Moveo in November, call 604-984-8731 to make an appointment with her.

MOVEO GETS GEAR!

September 2nd, 2010

After much design and deliberation Moveo is pleased to introduce it’s brand new WORKOUT GEAR!  The practitioners at Moveo will be sporting their MOVEO branded Sugoi gear ath events such as the Coho Run, The Canuck Place Adventure Challenge and the Brewskidaddle.  Come into Moveo to find out how you too, can be racing and training in style as all our gear is available for purchase at the clinic. Please contact us for more info!

How Acupuncture can Help Sports Injuries

June 27th, 2010

Acupuncture and Sports Injury

By Kelsey Jackson,  Registered Acupuncturist

When people think about needles, they often think about vaccinations and blood tests. This can instantly get the palm sweat flowing and the heart beating a little faster. This is very common, and of course understandable. One thing people tend to forget or may not know is that the needles acupuncturists use are about 3 times the size of a human hair and you can fit about ten acupuncture needles inside one hypodermic needle. Phew, what a relief!

Treating sports injuries with acupuncture is very effective and can help to speed up the healing process of both acute and chronic injuries. Acupuncture, which is based in the eastern healing traditions of Chinese medicine, also has many attributes that can be explained when looked at through the spectacles of western medicine.

Acupuncture dates back thousands of years and is based on energy, or “Qi”, flowing through twelve meridian pathways in the body. Acupuncturists are working to balance the flow of energy in these pathways.  We try to figure out what the root of the problem is, create a diagnosis based on Traditional Chinese Medicine principals, and then come up with a treatment plan based on our diagnosis. For example, there might be many reasons to why a stubborn injury won’t heal. One reason might be that the digestion is weakened, if the nutrients are not absorbing as efficiently as they should, then the tissues aren’t receiving the nutrients they need to heal. Another reason might be lack of sleep. The body does much of it’s healing when we are asleep so it is very important that we are getting the rest we need. Stress is another major culprit, often causing both digestive and sleep disorders. These are just a few examples of things your Acupuncturist will assess when you come in for treatment. By bringing the body back into a state of balance, we can achieve better results in treating the injury itself.

When treating an injury locally there are many different techniques we use. Motor point needling is a contemporary style of Acupuncture, and one of the more popular techniques used in treating injury. It is the practice of needling into the most excitable area of the muscle, where the nerves innervate, and eliciting a twitch response. This in turn encourages the short tightened muscle to relax and reset. Often we will treat the affected muscle group as well as the surrounding and opposing muscle groups, or all the muscles surrounding an affected joint. For example, when treating a hamstring strain, we would treat the hamstrings as well as the quadriceps and hip flexors. This not only releases the affected muscle, but also brings a surge of blood and energy into the entire area which helps increase circulation. The fresh blood brings nutrients to the area helping to speed up the healing process. This type of acupuncture is called IMS in physiotherapy practice.

During the treatment other modalities may be used such as Tui na (tway nah) or Chinese medical massage. This is a type of massage that combines deep tissue, acupressure, and many other techniques to break down scar tissue, loosen the muscles, and increase circulation.  Cupping is another popular technique we use which involves the suction of either glass or plastic cups on the skin. This helps to draw toxins from the body and increase local blood flow. Electrical stimulation, and a warming herb called moxabustion, is also sometimes used depending on the ailment.

Your practitioner will go through an initial assessment with you to figure out the best course of treatment for your situation. In many cases people are pleasantly surprised by their first acupuncture session, and find themselves very relaxed for hours afterwards. Studies have shown that Serotonin is released in the brain during Acupuncture, which helps to promote relaxation and a general sense of wellbeing. This is why Acupuncture is so widely used in treating both depression and anxiety.  In application to the athlete, this is great for someone who experiences performance anxiety or pre-race jitters. A treatment can not only benefit the body, but help to calm the mind as well.

The essence of Chinese Medicine is prevention. In medieval times the doctor did not get paid when his patients fell ill, he was paid to keep people healthy.  This is often forgotten in today’s society where we are praised for our ability to multitask and can sometimes overwork ourselves into injury. Ideally acupuncture is used to KEEP our body healthy and performing at it’s best!

Some of the more common injuries seen in practice are: low back pain, frozen shoulder, carpal tunnel syndrome, whiplash, tendonitis, shin splints, plantar fasciitis, muscle strains, and the list goes on. When combined with other therapies such as Active Release Technique or Rehabilitation exercises, Acupuncture can be a very effective addition to any treatment regimen and help heal that injury fast.

Kelsey is a registered acupuncturist practicing at MOVEO SPORT & REHABILITATION CENTRE. Kelsey is an avid athlete herself and favours the local mountains for some great snowboarding.   If you have any questions regarding Kelsey’s method of treatment feel free to email her at kelsey@moveo.ca.


Active Release Techniques Article

May 26th, 2010

Moveo’s Involved in the Vancouver 2010 Olympics

May 26th, 2010

The Olympics were an exciting time for the whole country as we watched our athletes thrive and our city come alive! We saw celebrations of every kind, but what we didn’t hear about was the Olympic Village Medical. The Olympic polyclinic was unrivaled in the history of the Olympics with the most thorough medical coverage to date. Massage Therapist Leah Startup from Moveo was proud to be a part of the team and also proud to see how the Olympic medical clinic vision of team approach paralleled that of Moveo! The Olympic medical team included Massage Therapy, Physiotherapy, Chiropractic, Acupuncture, Medical Doctors, Bracing & Orthotics, Imaging, Dentistry, amongst other healthcare specialists and a huge recovery centre. The entire medical team took this amazing opportunity to learn from each other and utilize each others skills in a team approach, and the result was quick and effective recovery for the athletes. The clinic saw athletes from almost every sport and country for a truly international perspective on the Games!

Moveo clinic itself also saw a little bit of athlete action as members of the USA Snowboard team were staying just up the street for the clinic and some athletes and coaches took advantage of being close by!