Physiotherapy

What's the best thing we can do for our health?

As a society, we are obsessed with things we can do to look younger, live longer, avoid disease and feel good. We spend billions on medications, special foods, creams and a whole slew of other things. So, what really works? What is the best thing we can we do to live longer, healthy lives and avoid disease? Although some pills, supplements and foods may contribute to longevity and health, the answer is a simple intervention that everyone can do and often costs nothing: exercise!

We all know that exercise makes us look better but its benefits are far more widespread. A recent systematic review published in the British Medical Journal found that active individuals experienced significantly less serious disease with heart attacks, strokes and diabetes all being reduced by as much as 25%. Other studies have found significant reductions in various forms of cancer, depression, Alzheimer’s, dementia, anxiety and osteoarthritis for those who exercise regularly.

While some of these studies suggest a more intense exercise program can lead to greater health benefits, many studies found substantial health benefits with simple exercise programs at lower intensities such as walking 15 minutes, five times a week. What this means is that you don’t have to do a triathlon or live at the gym to get benefit from exercise – low levels of exercise also help benefit our health.

....many studies found substantial health benefits with simple exercise programs at lower intensities such as walking 15 minutes, five times a week

As if these benefits are not enough to convince you to exercise, people who are active also live longer. In fact, one large trial published in the Lancet followed almost half a million people and found that those who regularly exercised at a low intensity for only 90 minutes a week lived an average of 3 years longer than inactive individuals. Those people who were classified as being very active found further health benefits, with the most active group living about 4.5 years longer than the inactive group. There is even more to the benefits of exercise on longevity. Not only did these people live longer but they also lived more of their life without disability. We all show some decline with age but those who exercised regularly tended to have a better quality of life for a much longer period of time.

Physiotherapy, Steve Young

So, there are lots of benefits to regularly exercising but only 20% of the population gets the recommended weekly amount of exercise – 2.5 hours of moderate cardiovascular exercise and two strength training sessions per week. Why is this? Well, it has been said that if exercise came in a pill form, everyone would be on it and herein lies the problem. Exercise does require more motivation, time and commitment than taking a pill. Here are a few tips and pieces of information to make you successful at starting up an exercise program:

  • Choose an activity you like. Your much more likely to stick with an exercise program if you are having fun.

  • Try a group activity where you are accountable for showing up. You’ll benefit from the socialization and be more likely to attend when others are expecting you to be there.

  • Know that it is common to get some aches and pains when you first start an exercise program. This does not mean you should stop! We can help and a visit to your physiotherapist can get you back on track quickly!

Often exercise programs are preceded by a disclaimer that you “Should contact your doctor before starting any new exercise program” but after reading this blog I hope you think that you should contact your doctor if you don’t plan on starting an exercise program!

 

To orthotic, or not to orthotic?

There are many options out there in the world of orthotics: off the shelf, custom made, custom-moulded.

There are also many questions: which option is better for my needs? Do I actually need them? And, um, what are they, really?

How do orthotics work?

Orthotics are a tool to manage how stress falls through the bones and tissues, primarily in the feet, and in so doing they impact how stress falls through the knees and, to some degree, the hips.

Similar to using a brace, it’s very common for people to notice immediate relief from foot and knee pain when they start to use orthotics.

However, and unfortunately, this doesn’t mean that the underlying problem is fixed.

Rather, it indicates that the irritable structures are being shielded. Sometimes this stress-shielding gives the tissues the rest they need to heal, in which case treatment with orthotics can be curative.

In other situations, one needs to wear the orthotics consistently on an ongoing basis to avoid symptoms.

While this solution works for some, many folks don’t like the idea of orthotic-dependency.

The way to side step wearing orthotics indefinitely is to perform some corrective exercises and movement training, which improve the function of the feet and lower extremities. Wearing orthotics while you go through this course of exercises and treatments will improve or fix the mechanics of your foot, so that you no longer need to wear them.

How do you make custom orthotics?

At Tall Tree, we are unerringly thorough when it comes to creating orthotics.

We start with a musculoskeletal assessment consisting of an analysis of movement during gate, standing, changing directions, etc. The assessment also includes orthopaedic testing of the joints, ligaments, muscles, and nervous system of the lower extremities and feet.

Following this assessment, we do a state of the art scan of your feet and generate a digital replica of how your foot contacts the ground while walking. This data gives us diagnostic info and the foundation design for the corrective orthotic: measuring your foot posture during the movement of walking provides more relevant information than measuring a foot at rest. 

Then, we are able to make adjustments, additions, and accommodations based on a physical exam of the foot. This covers all the bases in creating an optimal foot orthotic.

How do I know if I need them?

Just because we can make you an awesome pair of custom orthotics doesn’t mean you need them.

A good first step is to determine if your condition is one that would benefit from orthotics. An assessment with a physiotherapist, chiropractor, or family physician will give you direction.

Once you’ve determined that you would like to get orthotics, it’s often worth trying the off-the-shelf variety first. These are less expensive and you can find them most local pharmacies and running stores. Sometimes these are enough to adjust how load falls through the foot and decrease symptoms. If they don’t do the trick, custom orthotics may be your next step.

At Tall Tree you can meet all your orthotics needs under one roof - come and see one of our chiropractors or physiotherapists, then drop by the orthotics office for a consultation with our kinesiologist, Jeremy. We'll help you take the next step - with or without orthotics in your shoes.

 

How to be smart and active with pain

In our busy society, we do not take time to care for ourselves as much as we should with things like relaxation, getting together with friends, and exercise. When we do get the opportunity to do something important for our well-being like exercise, we often expect our bodies to operate at full capacity and without complaints. This is quite unrealistic and can often lead to aches, pains, and possibly injury. Often when these things show up, we don’t take the time to properly care for them, rather we continue to exercise the way we normally do, and expect the aches and pains or injury to resolve on its own – and sometimes it does. But what if it doesn’t?

The goal of this post is to help you better understand how to stay active while dealing with pain. We will cover the different views of pain, highlight the contemporary view of pain, as well as discuss how to interpret your pain and work with it.

"However, training to improve performance it is always a matter of balancing enough stress to create physical improvement, but not so much that we cause injury."

"However, training to improve performance it is always a matter of balancing enough stress to create physical improvement, but not so much that we cause injury."

3 views of pain:

The Old View of Pain – In the old view, pain meant damage to a body part. It was thought that the body sent a pain signal to the brain informing it of damage. This can lead to a mentality of “always listening to the pain.” We now know that the body actually does not have any pain receptors, nor does have the ability to send pain signals to the brain. Instead we have receptors which tell us about potential harm (nociceptors), but these can’t tell the difference between potential and actual harm.

Sport & Performance View of Pain – This is the “No Pain, No Gain” attitude that is commonly found amongst athletes or die-hard exercisers, and is often accompanied by the belief that “pain should be ignored.” However, training to improve performance it is always a matter of balancing enough stress to create physical improvement, but not so much that we cause injury.

The Modern View of Pain – We now know that pain is an OUTPUT of the brain. It is a behavior modifier, meaning that your body and brain are trying to get your attention! As an OUTPUT of the brain, pain is influenced by all our senses, past experiences, and stress/emotional level, which all reside inherently in the brain. As an example, professional violin players will report pain in their pinky finger at a lower temperature and pressure than the rest of us, demonstrating greater sensitivity as their little finger is vitally important to playing the violin and to them as a whole person (Zamorano et al., 2015).

To put it simply – Pain is complicated! However, this modern view that has emerged from 'Pain Science' demonstrates that “pain should be respected, and can be worked with.”

To put it simply – Pain is complicated! However, this modern view from ‘Pain Science’ demonstrates that “pain should be respected, and can be worked with.”

Bottom Line on Pain – Pain is good in that it serves a purpose! It is the messenger that gets your attention, BUT it is just the messenger and not the problem! Pain is your brain and body’s assessment of your own health, and it can be influenced by many things. Your pain should be respected, but it can and should be worked with to help you improve. This is the idea of training and being active intelligently!

How to be active with pain:

Respecting Pain – The first question that you need to ask when you are learning to deal with pain is how is it behaving? Is it always there (constant)? Is it only there sometimes (intermittent)?

Constant Pain – Here I mean truly constant, as in the pain never goes away even for a second. There are a few reasons for constant pain, but the one that we are most familiar with is after an acute injury. If you have an acute injury, you will know it. There will have been something you did that led to pain immediately and you will see signs of inflammation such as redness, heat/warmth, swelling, pain, and loss of function.

Look for redness, heat/warmth, and swelling – if these are all there, this is likely an acute injury and it deserves to be cared for. This is when protection, rest, ice, compression, and elevation, or PRICE, is the thing to do.

Intermittent Pain – This is great news! It means that there are some things that are perpetuating the pain and some things that are relieving the pain. This pain can be worked with!

  1. Determine which things cause your pain, and then minimize these for a short period.
  2. Keep pain after activity down(i.e. irritability). Here are some helpful guidelines to assess your pain with activity, think of it like a traffic light:
    • Green Light – the activity helps my pain; I should do more of this.
    • Yellow Light – I feel my pain while I perform the activity, but when I stop it goes                   back to normal in less than 5 minutes
    • Red Light – My pain is aggravated by this activity and stays aggravated for more than 30 minutes or I have notable pain the next morning.

The big take-away here is that pain does not always mean damage and, while it should be respected, you can work with it if you know how. Hopefully now you know a little more of the “how.” Think of pain as the messenger that the brain and body uses to get your attention. This messenger is meant to change your behavior, so don’t ignore it…work with it! Finally, if you continue to have difficulty or pain, reach out to your physiotherapist (book an appointment here). We can help with some hands on treatment, exercise and education to help you get moving better and pain-free again.

www.taitphysio.com

Reference:

Zamorano, A. M., Riquelme, I., Kleber, B., Altenmuller, E., Hatem, S. M., & Montoya, P. (2015). Pain sensitivity and tactile spatial acuity are altered in healthy musicians as in chronic pain patients. Frontiers in Human Neuroscience, 8. doi:10.3389/fnhum.2014.01016