Category: Bailey’s Big 3

July 29, 2015

Life is like a Spartan Race. No, seriously. Let me explain. On June 5, 2015 I participated in the annual Spartan Sprint at Edelweiss Ski Resort. Being a relatively fit individual, I felt I was pretty prepared for the upcoming 5 km obstacle course race. Spartan was to be conquered and I was going to be the conqueror. I was so confident that my plan was to yell “SPARTA” at the top of my lungs using a deep Gerard Butler-like voice while performing air kicks victoriously over the finish line.

Why was I so foolishly confident?

 Three days a week I work out across at the gym doing some form of weight training at the discretion of my trainer. I run three days a week with a good friend of mine for at least a distance of 5km. I also play beach volleyball in a league every Wednesday night. I like to think I am a fairly active person. I can squat, lunge, jump, sprint, burpee, crawl, climb, push and pull.

Spartan had nothing on me, right? Well, here’s the thing about the Spartan Race. You have to run UP the ski-hill at Edelweiss TWICE. Emphasis on the word, UP. Ski hills are not meant to be run UP, they are meant to be skied DOWN. The ascension up the mountain literally kicked my ass!! I was not used to keeping my heart rate so elevated. This resulted in nausea and feelings of pukey-ness. Not a great start for this aspiring conqueror. Let’s just say I cursed gravity quite a bit during this pesky obstacle course!

 

So alas, here are 3 life lessons I learned (or, probably already knew but effectively ignored) while completing the Spartan Sprint.

spartan race 2015 bails

  1. No matter how prepared you feel you might be, sometimes you just aren’t. That’s life. And it’s ok! You can’t be prepared ALL the time. Sometimes you need to get your ass-kicked to remind you that there is still work to be done.
  1. Sometimes winning is just seeing it through. Instead of me yelling “SPARTA” at the top of my lungs while performing air kicks victoriously over the finish line, I hauled my tired, muddy butt over the finish line in a zombie, pain-induced state. But I finished, and it was AWESOME!
  1. You’re better than you think you are. Although the mountain kicked my butt, the obstacles did not. The obstacles actually served as a much needed break from running UP the ski-hill. And the feeling of being strong is one of the best feelings EVER. Just check out my game face captured in this photo of me after I dominated the gymnast-like rings. Clearly I was high-fiving myself in my mind! My body is capable, and that’s pretty cool!

 

Bailey Gresham is a registered physiotherapist for Whole Therapy. She specializes in manual therapy and movement-based therapy. She likes bridging the gap between rehabilitation and performance training.  More about Bailey here.

Bailey

 

April 29, 2015

It is the last weekend of April and as you know, the theme of April is “Letting Go”. I thought it would be a great opportunity to talk about some of my bad habits because physiotherapists are people too! In the spirit of starting fresh this coming May, here are some of MY bad habits which some of you may relate too! And try not to hold them against me! Haha

1) Chewing my nails. Disgusting, I know. I don’t even know I’m doing it. I’m pretty sure I chewed my nails in the womb, that’s how bad this habit is. Have I tried to quit? Yes. Have I been successful? Not even a little bit. So if anyone has any suggestions on how to quit, leave a comment!

What have I tried? Well my parents offered me $1000.nail biting meme00 to quit for a whole 12 months when I was much younger. I was able to go about 8 months before my nerves got the best of me. I was participating in a cross-country race in The Grove located in my hometown of Arnprior, ON. Fortunately (or, unfortunately) I won the race, but lost the war when it came to my nails. It just took one race and my nails were GONE! I have also tried using that disgusting stuff that makes your nails taste terrible, and guess what? I got USED to the taste and just kept on biting. Biting and biting and BITING. Now, I have no nerve endings left in my fingers for me to even feel pain! Talk about hopeless!

2) Slouching. Ironically, I’m the self-proclaimed posture police when it comes to my clients. I’m especially strict when it comes to my clients who sit at a desk all day! Slouching can lead to loads of dysfunction in your neck and shoulders. Take my shoulder for instance: My poor right shoulder has been getting quite “ouchie” over the last few months. This is because I tend to sit/stand with my shoulders in a forward, rounded position. I am also right hand dominant, making me more inclined to use my right hand for essentially EVERYTHING. Because my shoulders have been creeping forward, the back of my right shoulder has gotten pathologically tight. As a result, my ability to put my hand behind my back is restricted and painful. Overhead movements can be often uncomfortable.

Thankfully, I work with a great team who is able to help me restore my passive accessory movement back to normal. Even though I’m a physiotherapist, sometimes you just need another set of eyes and hands to help resolve some of your issues!

3) Don’t wait! Procrastinate now! Take this post for instance: My boss likes me to post things every Wednesday morning. Heaven forbid I try to have something written BEFORE Wednesday! I like to think I thrive under the pressure of having a deadline. Realistically though, instead of “thriving” I often find myself stressed! There is enough stress in the world without procrastination. My goal in May is to try and set aside some time each day to do something productive (i.e. study for my Level 3 Manual Therapy Course). A half hour is nothing in the grand scheme of things. Maybe my goal should be to de-activate Pinterest? I’m sure I’d get a lot of my life back after doing that!

Keeping it real everyone! With the warm weather approaching, now is the time to make those much needed changes to better yourself! I’m going to try, so should you!

Bailey Gresham is a registered physiotherapist for Whole Therapy. She specializes in manual therapy and movement-based therapy. She likes bridging the gap between rehabilitation and performance training and has really really REALLY short nails.  More about Bailey here.

Bailey

 

April 17, 2015

So the theme of April at Whole Therapy is “letting go.” I struggled with coming up with a blog topic to compliment this theme. This past week, however, I came across this article on the web and thought to myself, Eureka!  This is my teachable, “letting go” moment!

I want to preface by saying that medical imaging technology has developed into something amazing. The amount of stuff we can see without actually cutting into the body is phenomenal. Sounds morbid, I know, but it’s true! Medical imaging can be very valuable in identifying serious medical conditions such as fractures, dislocations, etc. That being said, it is often difficult to discern what findings on imaging are related to natural aging processes or rather a pain-provoking injury? Words like arthritis, degenerative discs, disc bulges, tendon tears all sound very scary! And the fact that they sound scary is a problem in itself. They can create fear- a lot of fear. But, what if I told you that the above are all minor findings and do not really add much value to your plan of care?

Confused? Let me clarify. Mrs. A came to see me at the clinic for a “MRIdisc herniation.” On my subjective intake, I asked Mrs. A about her pain. Mrs. A had NO PAIN. Confused, I asked Mrs. A about her ability to perform her day-to-day activities. Mrs. A had NO DIFFICULTIES performing any of her day-to-day activities. Now very confused, I asked Mrs. A about this suspected “disc herniation.” Mrs. A had a hysterectomy in which she had some complications. She had to undergo repeat CT Scans to make sure all was well and healing appropriately. It just so happened that a disc bulge was seen as an incidental finding on one of these CT scans. Nervous about this finding, Mrs. A sought out physiotherapy to treat her disc herniation, for which she had no pain, no loss of function and for all purposes, NO impairment!

The fact is, arthritis, degenerative discs, disc bulges and tendon tears are usually just a natural result of aging against gravity. Don’t believe me? Check out this recent article (2015!) summarizing a cross-sectional study looking at abnormal findings on MRI in the cervical spine (a.k.a. neck) in 1211 asymptomatic people (a.k.a. NONE of the 1211 people had ANY neck pain). You can find it here: http://europepmc.org/abstract/med/25584950\

Three things you should know about neck imaging:

  1. Everyone has disc bulges. This study found that 87.6% of the 1211 had disc bulges and no neck pain. So for every 10 people, 8.76 of them have disc bulges! And remember, none of these people had any pain!
  2. You even have disc bulges in your 20s. They found that 73.3% and 78.0% of males and females in their 20s had disc bulging. Yep, even your 20 something co-worker who barely seems out of the womb probably has a disc bulge.
  3. A small percentage of people even have spinal cord compression and no pain! Sounds unbelievable eh? But 5.3% of people, generally over the age of 50, had evidence of spinal cord compression with no pain. That’s not to say that the compression shouldn’t be monitored, but it goes to show you that the perception of pain is a lot more complicated then we may give it credit for!

Pain in itself is a complicated construct. I’m not trying to undermine anyone’s pain experience, but it is important to recognize that the scary-sounding results on imaging may not be so scary at all. Giving these words power over your life, however, has been shown to lead to more doctor’s visits, more pain, more disability, and a poorer quality of life. The only way to overcome this is to let go of the power we give these words and understand that they are probably just a natural result of aging! Don’t worry, you’re going to be just fine!

Bailey Gresham is a registered physiotherapist for Whole Therapy. She specializes in manual therapy and movement-based therapy. She likes bridging the gap between rehabilitation and performance training.  More about Bailey here.

Bailey

 

 

 

 

 

April 8, 2015

shin splints

If you have been reading my blog, my goal was to initially complete a series on needling in the profession of physiotherapy. Don’t worry folks, I still plan on completing that series! It’s just on pause for now. I have chosen to stray from my previous plan and look at a common problem that plagues many runners, because as we all know, April showers bring May flowers, and a boat-load of running injuries! Also, my boss wanted me to do a blog on running. Since she is of course, my BOSS, I figured I should make like a good employee and write about shin splints!

Shin splints is a funny diagnosis. It’s a funny diagnosis because shin splints is typically used as a catch-all term to describe shin pain. In fact, shin splints is defined by the American Academy of Orthopaedic Surgeons as “pain along the inner edge of the shinbone (tibia)”. So in a nut shell, shin splints = shin pain. This makes its diagnosis confusing. Imagine this typical made-up conversation:

              Hello doctor, I have pain in the inner, lower portion of my legs after running.

              That is easy! You have shin splints!

              Oh, that answers EVERYTHING. I have shin splints!

But I just told you that shin splints = shin pain. See the problem here? Shin splints doesn’t actually tell me what’s causing your pain! Here are three reasons you may develop shin pain, also known as the notorious shin splints.

1) Medial tibial stress syndrome. This is also known as “too much, too soon” syndrome. MTSS is typically the result of overloading the tibia with biomechanical inefficiencies. This can lead to periostitis, an inflammation of the membrane (a.k.a. periosteum) covering the bone. Ever wonder why it feels like your bone is bruised? Muscular imbalances commonly seen in the tibialis anterior, tibialis posterior and soleus muscle in combination with excessive pronation often puts too much stress on that poor tibia bone. As a result, the tibia bends and bows more than it should. This pulls on the connective tissue attaching to the bone itself. More pulling = more inflammation = more periostitis = more pain. Addressing the biomechanical inefficiencies while decreasing excessive load is key in making sure this bad guy goes away! It usually presents as a dull, diffuse ache along the bone of the tibia.

2) Compartment syndrome. Compartment syndrome is the compression of nerves, blood vessels, and muscles inside a closed space, or compartment, surrounded by a sheet of fascia. There are four different compartments in the lower leg. In order to understand compartment syndrome, you need to understand the role of fascia. Fascia is connective tissue, which attaches, stabilizes, encloses, and separates muscles and other internal organs. It is literally EVERYWHERE in the body. It also does not like to expand very much. As a result, if a compartment in the lower leg swells beyond the stretching capability of the fascia, pressure inside the compartment can increase and increase, and INCREASE. This is serious and can cause tissue death due to the compression of blood vessels (lack of oxygen). If you are experiencing extreme tightness, burning, pins and needles and/or temporary paralysis with running, PLEASE STOP and seek a medical opinion!

3) Tibial stress fracture. A stress fracture is exactly what it sounds like, a fracture or crack in the bone. It is the consequence of the tibia failing mechanically due to repetitive submaximal stress. It is also known as “too much, too soon, too late” syndrome. But Bailey, I’m only running. This is a submaximal stress! How can I get a fracture?! Well, repetitive submaximal stress can cause an imbalance in your body’s ability to resorb bone and form bone. In this case, there is more bone resorption then formation. So even the smallest, most microscopic crack in a bone can progress and worsen under repetitive, submaximal stress. With tibial stress fractures, a runner will experience very localized tenderness directly on the bone. You may even feel a bony anomaly under your finger. Unlike MTSS, you will probably experience pain immediately when you start running in a very point-specific spot. If you suspect a fracture, PLEASE STOP and seek a medical opinion!

Bailey Gresham is a registered physiotherapist for Whole Therapy. She specializes in manual therapy and movement-based therapy. She likes bridging the gap between rehabilitation and performance training.  More about Bailey here.

Bailey

 

 

 

March 25, 2015

AcupunctureSorry for my absence on Whole Therapy’s social media for all of my devout followers (If you are reading this at all, THANK YOU very much!). I was in Cuba for a WHOLE WEEK vacationing from thinking. I’m back though and ready to educate poison all of your minds!

It’s Wednesday and I’ve noticed that I’ve been performing a lot more needling techniques over the last week (with quite a bit of success!). This has inspired me. I feel like writing a series of blogs on the use of needling techniques in the practice of physiotherapy. Today’s goal is to clarify some misconceptions I commonly see in the public’s eyes. In future posts, I’ll look at its utility as an adjunct therapy, because contrary to what some of my client’s might think, I do not enjoy stabbing people with needles just for the fun of it (I will NEVER admit that the masochistic side of me loves seeing that angry, little hypertonic muscle twitch, wink wink).

So here is blog 1 of my needling series!

  1. First of all, I am NOT an acupuncturist. I am a registered physiotherapist who has taken extensive post-graduate course work in order to implement needling techniques as an adjunct therapy in my practice. What does this mean? This means I treat musculoskeletal injuries using acupuncture. I am NOT qualified to treat infertility, digestive issues, silence your nagging spouse, etc using acupuncture. That is outside the scope of practice for physiotherapists. For those types of health concerns, you need to go see a Doctor of Chinese Medicine or your family doctor.
  1. If you’re not an acupuncturist, why are YOU allowed to perform acupuncture then? Physiotherapists who have been trained in Canada now undergo six years of intense training in human anatomy and physiology. Six LONG years! Therefore, the Regulated Health Profession Act (RHPA) provides physiotherapists the authority to perform needling techniques provided we complete the appropriate post-graduate course work to use needling safely (even MORE training). What does this mean? The Regulated Health Profession Act has complete confidence in our ability to use acupuncture. This is because we KNOW the human body. We are little encyclopedias of bones and muscles. We’re pretty much obsessed with the human body (on the cusp of being neurotic). Rest assure, we are knowledgeable and safe!
  1. What schooling do physiotherapists need to take in order to perform acupuncture? There are many post-graduate courses that offer training in acupuncture. I completed two acupuncture and dry needling series with Meridian Health Education (total of 5 courses). Other notable programs include McMaster University’s Acupuncture Program, the Advanced Physical Education Institute, Ontario College of Traditional Chinese Medicine, etc. Feel free to enquire as to what your therapist’s educational background is with regards to needling. It is also the law to roster with the Ontario College of Physiotherapists. This means that if you search us up on our Regulatory College website, it shows that we are rostered to perform acupuncture (and the College knows about it). This is really important! If we do not roster, we can get into big trouble! It’s the public’s right to know that our regulatory body is aware of the skills we are qualified to do. And if your therapist isn’t rostered, STOP. They may not have the expertise we pride ourselves on having (BAD, BAD, BAD).

Bailey Gresham is a registered physiotherapist for Whole Therapy. She specializes in manual therapy and movement-based therapy. She likes bridging the gap between rehabilitation and performance training.  More about Bailey here.

Bailey