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The perfect solution for a students computer work?

10/20/2018

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In the last decade in an attempt to make office work more healthy there has been mass proliferation of standing while working on the computer (see our blog on how to set up your office workstation here).  Granville Physio's very own therapist, Jim Bowie, not only has a degree in Physiotherapy but also studied biomechanics extensively at SFU and worked as an ergonomist at Humantech the world's largest ergonomics consultant firm.  His suggestions for standing at work is to try to alternate between sitting and standing multiple times per day.  Jim says "ideally as humans we would be switching positions several times per hour but that's not really all that practical so I'd recommend 2-3 hours out of an 8 hour shift in 3-4 standing spells.  Unfortunately for students it's even harder to spread out those spells as they're often forced to sit on the way to school, while at lecture, and also while studying.  They're also more constrained for space and budget."

Enter the Anthrodesk's sliding standing desk converter.  It's a cost competitive $99 CDN solution that doesn't take up too much space on the desk.  Anthrodesk was kind enough to give us a unit so we could see if it was something we would recommend.  We had multiple users at Granville Physio take it apart and set it back up and the comments were consistently that it is easy to assemble (it requires no tools).  Additionally, it is light enough to easily pick up which is a benefit in places like a dorm room where if you need desk space you can lift up the desk converter and place it on your bed. 

Most importantly we need to talk about how it functions.  Once set up, we found that while the hinges for height adjustments are easy to access and use, it takes effort to move the platform upwards and requires removal of your device from the platform before adjusting.  While the desk converter provides ample adjustment for the keyboard level height, the monitor level height is more  constrained.   

As you can see in the photos below for the first individual at 5'2" there is about 4 more inches of height adjustment available for optimal monitor height off of a tablet.  She is able to have the desk converter at a good height for both her elbows and neck.  In the second picture you can see this 5'11" individual has the keyboard tray in a good position but the tablet height is still several inches below the ideal height.
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 Having said that this is still light years ahead of the cardboard box method in terms of durability and providing extra space for items to be stored below and at the same height as the keyboard.  See below for the free but completely unergonomic method and the only slightly better $35 CDN option.
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​Our final verdict was this is a great solution for the price.  This will work for those people on a budget with confined space.  So any parents looking for something for their kids in senior high or university this is a great idea.  Head over to: www.anthrodesk.ca/manual-desk-converter-black.html to purchase yours today.
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Are you doing it right?  Dynamic stretching the lower body.

5/3/2018

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Numerous studies show that as little as 90 seconds of dynamic stretching prior to an activity enhances performance and reduces the risk of injury.

The reasons for this reduced risk are:
  • increase in muscle temperature
  • reduced neural input into the muscle allowing it to be more relaxed
  • gentle increase in heart rate
  • improved mental preparation for activity
  • improved blood flow to muscles
  • short term improvements in range of motion
  • increased synovial fluid production
Synovial fluid is the fluid released in most joints in response to movement.  It helps absorb shock and also provides lubrication and nutrients for the joint!  To understand how it absorbs shock just think of running on really wet grass that is muddy vs end of summer dormant grass that is hard.

To dynamically warm up the lower extremity here are some basic movements:

Straight Leg Swing

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Stand sideways to a wall or stable object. Place one hand on the wall or object and shift your weight to the inside leg. Swing your inside leg forward and back, keeping your hip loose and trying to keep your leg straight as you swing as high as you can in both directions. Do 20 swings (10 forward and 10 back) on each leg.

Side Leg Swing

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Stand facing  a wall or stable object such as a bench or in this picture a golf club. Place your hands on the wall or object and shift your weight to the inside leg. Swing your outside leg to the side and then bring it in front of your body.  On the next swing bring it to the inside of your body. Keeping your hip loose do 20 swings (10 forward and 10 back) on each leg.

Frankenstein Walk

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Stand with your feet together and extend your arms in front of you at shoulder level, palms down. Take a step forward with your left foot, then kick your right leg up as high as you can, keeping it as straight as possible and trying to kick your hand with your toes. Continue, alternating sides for 20 steps. ​

Overhead Reach to Toe Touch

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Stand with your feet hip-width apart, toes forward. Inhale and reach up and overhead with both hands, looking up toward the ceiling. Then exhale and roll all the way down and reach your fingers toward the ground. Repeat for 10 reps.  This is not a yoga-style stretch it is meant to be dynamic, so go down and up slowly with no holds.

Calf raises

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Stand with your feet hip-width apart, toes forward.  Go as high up on the toes as you can and then slowly let your heels come back to the ground.  Complete 10 repetitions.

Squat

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Stand with your feet hip-width apart, toes forward.  Keeping the back straight lower the buttocks towards the floor trying for thighs that become parallel to the floor.  Try to not let the knees go forward completing 10 reps.
​If you are completing submaximal cardio or doing weight training you can stop here and begin that activity knowing your body is more ready to cope with what it is about to be put through.

If you are about to partake in sport, HIT, or bootcamp continue on with the below

Sport specific light cardio

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Jog for 2 to 5 minutes. Follow up your jog with....

Heel ups

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Jogging for 25-50m trying to get your heel to hit your bum.

Knee Ups

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Jogging for 25-50m trying to get your knee up.

Grapevine

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Jogging for 25-50m with each leg leading alternate left and right foot going in front of the other foot or behind.  

Jumping

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Squatting down slowly and then exploding into a jump repeat 10 repetitions.

Sprinting

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Complete short bursts of sprints 5-15m 5 repetitions.
Here is where the individuals doing bootcamps or HIT can start with their class.  Hopefully your instructors are guiding you through a warm up similar to this already!

Sport Simulation

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Complete 5-15 minutes of activity that will happen once the game begins.
Here at Granville Physio we can elaborate on and adjust warm ups based on why your injury occurred.  Book in with us today to make sure your warm up has everything you need! 
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Are you following the 9 Rules of stretching?

4/18/2018

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As Fido is demonstrating above, everyone enjoys a good stretch. Typically, we feel more relaxed and our movements feel less restrained. In order to reap the benefits of stretching, you need to do it correctly. Here's what you need to know about stretching the right way and at the right time so you can enjoy all the outdoor activities Vancouver has to offer!

Rule #1: Warm Up

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If you want to get the most out of stretching make sure you're warm.  Heat helps your nervous system calm down which helps the muscles relax.  It also makes collagen more extensible and this is the primary component of most of the soft tissues in our body. 
If you don't have a hot room or tropical location to stretch in that's ok, stretch after you've done some cardio.  Even going for a short walk and doing some arm movements can warm up your muscles.

Rule #2: Hold It For A While But Not For Too Long!

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For almost all cases you want to hold your static stretches for 15-30 seconds.  That's because during this time frame you're causing change in the contractile portion of the muscle.  This is not going to cause the same permanent change that longer holds would in the non-contractile muscle component, ligaments, and joint capsules but it also won't cause any instability in the joint or overly stress the joint surfaces.  Additionally, research shows that if you're changing the non-contractile component you increase your chance for injury immediately following stretching. ​

To know if you need to do longer holds all you have to do is ask yourself if after doing dynamic warmups before activity and static stretches after you still feel tightness or restriction.  Alternatively if during your normal daily routine you may also feel tightness or restrictions doing simple movements like putting your coat or socks on.  At Granville Physio we'll be able to assess which joints have restrictions and what stretches would benefit you the most!

Rule #3: You Should Feel It A Little Bit!

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You should never feel a stretch to the point of injury or pain. When you’re performing an effective stretch, you’re going to feel it but it should never be unpleasant.  If it is back off and do more repetitions of the stretch!
The time when people most frequently stretch and they shouldn't is after sustaining sprains or strains (damage to muscle or ligaments).  Often patients will say they felt something in their calf when running and tried to "stretch it out".  When in doubt book in with one of Granville Physio's highly trained therapists to assess if you should be stretching.

Rule #4: Breathe!

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During stretching remember to breathe deeply. This will help you relax more therefore ramping down the nervous system and improving your results.  Nowhere is this more important than the spinal muscles. 
That's right some of your back/neck pain could be attributed to the way you breathe.

Rule #5: Don't Bounce

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Although some dynamic movement may be required for certain stretches, bouncing into and out of stretches can cause injury and should be avoided! ​

Rule #6: Only Dynamic Stretches Before Activity

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With the exception of stretches that restore joint mechanics or alignment you should only do dynamic stretches before activity.  Ideally, you've worked on the mechanic and alignment issues at other times and don't need to work on them before activity.   Numerous studies show that as little as 90 seconds of dynamic stretching prior to an activity enhances performance and reduces risk of injury.  Dynamic stretching has a significantly smaller impact on flexibility when compared to static stretching though. 

Here is a link to our blog on how to perform a dynamic stretch routine: Lower Body & Upper Body coming soon!

Rule #7: Static stretches after activity

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 Static stretching can cause very small loses in strength (1-5%) for periods up to five minutes if held for longer than 45 seconds. This is one of the reasons it should be done after activity and typically only held for 30 seconds.  Static stretching causes improved economy of motion, increased muscular strength, increased speed of muscular contraction, and a reduced risk of certain injuries.  Static stretching should be done immediately following activity particularly if you've just done an activity over a prolonged duration or to a high intensity level.  ​
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Muscles that feel “tight” are not always the ones that need stretching.  Short muscles usually require flexibility training.  Tight muscles are often weak muscles or overworked muscles (if we ignore post-exercise soreness). Persistently stretching them may lead to increased fatigue (due to reduced peak power output) and lead to more “tightness” feelings. Strengthening “tight” muscles is often a very effective intervention to relieve that persistent tension feeling.  Every week I see someone who “carries too much tension in their shoulders" – and they "stretch and stretch and it just won’t loosen up”.  This is an excellent example of muscles that are likely overworked or lack endurance. Stretching is not likely to provide any long term resolution for this problem.  Again the physios at Granville Physio can help you determine what strengthening or stretching you should be doing!

Rule #8: Don't Forget Your Nerves!

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Did you know just from moving your wrist back and forth the ulnar nerve moves on average 14mm at the point of your funny bone?  Sometimes tight nerves are responsible for pain, numbness, tingling, and tightness that doesn't go away with stretching.  This is where you could use guidance from one of Granville Physio's experts to make sure all your nerves move correctly. ​
We now know that the nervous system controls our flexibility much more than we thought.  Part of the limits of our flexibility is how much our nerves “put the brakes on” to protect our tissues from damage by excessive length or tension.  This is part of our “danger” mechanism.  There are receptors in our muscle spindles (muscle cells) and golgi tendon organs (stretch receptors in our tendons) that provide feedback to the nervous system and constantly drive a certain amount of tension that resists excessive length in the muscles.  Remember your muscles do not do anything by themselves – they need the brain and the nerves to tell them what to do.  When people are under general anesthetic (and their neural drive is turned right down) – suddenly they have excellent flexibility! Stretching is now thought to inhibit that neural drive, or modulate the “danger” response. 

Rule #9: Release First!

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If you release your muscles first then stretching will be greatly improved.  Particularly if your range is limited/you have any pain while doing a stretch.  Our therapists are happy to show you the areas you need to target and how best to target each zone.

References:
​Small, et al. (2008). A systematic review into the efficacy of static stretching as part of a warm-up for the prevention of exercise-related injury.Research in Sports Medicine, 16(3), 213-231.
 
Lauersen, et al. (2014). The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 48(11), 871-877
 
Konrad & Tilp, (2014). Increased range of motion after static stretching is not due to changes in muscle and tendon structures. Clinical Biomechanics, 29(6), 636-642
 
Schroeder et al., (2015) Is self myofascial release an effective pre-exercise and recovery strategy? A literature review.  Curr Sport Med Rep 14,  200-208
 
McHugh & Cosgrave, (2010). To stretch or not to stretch: the role of stretching in injury prevention and performance. Scandinavian Journal of Medicine & Science in Sports, 20(2), 169-181.
 
Amako M, Oda T, Masuoka K, et al. (2003) Effect of static stretching on prevention of injuries for military recruits. Mil Med. ;168:442-446


Bacurau RF, Monteiro GA, Ugrinowitsch C, Tricoli V, Cabral LF, Aoki MS (2009) Acute effect of a ballistic and a static stretching exercise bout on flexibility and maximal strength. J Strength Cond Res 23:304–308
Bandy WD, Irion JM, Briggler M (1998) The effect of static stretch and dynamic range of motion training on the flexibility of the hamstring muscles. J Orthop Sports Phys Ther 27:295–300
Beedle BB, Mann CL (2007) A comparison of two warm-ups on joint range of motion. J Strength Cond Res 21:776–779
Behm DG, Chaouachi A. A review of the acute effects of static and dynamic stretching on performance. Eur J Appl Physiol 2011: 111: 2633–2651.
Behm DG, Bambury A, Cahill F, Power K. Effect of acute static stretching on force, balance, reaction time, and movement time. Med Sci Sports Exerc 2004: 36: 1397–1402.
Christensen BK, Nordstrom BJ (2008) The effects of proprioceptive neuromuscular facilitation and dynamic stretching techniques on vertical jump performance. J Strength Cond Res 22:1826–1831
Covert CA, Alexander MP, Petronis JJ, Davis DS (2010) Comparison of ballistic and static stretching on hamstring muscle length using an equal stretching dose. J Strength Cond Res 24(11): 3008–3014
Gelen E (2010) Acute effects of different warm-up methods on sprint, slalom dribbling, and penalty kick performance in soccer players. J Strength Cond Res 24:950–956
Jaggers JR, Swank AM, Frost KL, Lee CD (2008) The acute effects of dynamic and ballistic stretching on vertical jump height, force, and power. J Strength Cond Res 22:1844–1849
McHugh MP, Cosgrave CH. To stretch or not to stretch: the role of stretching in injury prevention and performance. Scand J Med Sci Sports 2010: 20: 169–181.
O’Sullivan K, Murray E, Sainsbury D (2009) The effect of warm-up, static stretching and dynamic stretching on hamstring flexibility in previously injured subjects. BMC Musculoskelet Disord 10:37–42
Papadopoulos G, Siatras T, Kellis S (2005) The effect of static and dynamic stretching exercises on the maximal isokinetic strength of the knee extensors and flexors. Isokinetics Exerc Sci 13:285–291
McMillian DJ, Moore JH, Hatler BS, Taylor DC (2006) Dynamic vs. static-stretching warm up: the effect on power and agility performance. J Strength Cond Res 20:492–499
Samuel MN, Holcomb WR, Guadagnoli MA, Rubley MD, Wallmann H (2008) Acute effects of static and ballistic stretching on measures of strength and power. J Strength Cond Res 22:1422–1428
Sekir U, Arabaci R, Akova B, Kadagan SM (2009) Acute effects of static and dynamic stretching on leg flexor and extensor isokinetic strength in elite women athletes. Scand J Med Sci Sports
Simic L., Sarabon N., Markovic G. Does pre-exercise static stretching inhibit maximal muscular performance? A meta-analytical review Scand J Med Sci Sports 2013: 23: 131–148
Torres EM, Kraemer WJ, Vingren JL, Volek JS, Hatfield DL, Spiering BA, Ho JY, Fragala MS, Thomas GA, Anderson JM, Hakkinen K, Maresh CM (2008) Effects of stretching on upper body muscular performance. J Strength Cond Res 22:1279–1285
Unick J, Kieffer HS, Cheesman W, Feeney A (2005) The acute effects of static and ballistic stretching on vertical jump performance in trained women. J Strength Cond Res 19:206–212
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Are you injured or having surgery?  This is what you should eat.

4/2/2018

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You are what you eat is something we’ve all heard. But did you know that eating the right foods after injury or post-surgery can help you recover more quickly?

Eating the right foods can help speed up the healing process and decrease any potential swelling, bruising, and/or inflammation that may have occurred as a result of the injury.

So what are the best foods to eat after injury or surgery?
Lean Protein
Collagen is the most abundant protein in the human body and plays an important role in knitting damaged/torn tissue back together. This is especially important when healing cuts or incisions. Generally, it is recommended that people consume 0.8 grams of protein per kilogram of body weight but these numbers should increase after injury as demands for protein will be significantly higher. You should aim to get 1.5 to 2.0 grams of protein per kilogram of body mass.

Excellent lean protein sources include eggs, fish, turkey, legumes and beans.
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Fiber
A common condition post-surgery is constipation. This is due to side effects of pain medications, anesthesia, dehydration, changes to diet, stress and reduced physical activity. To maintain healthy eliminations, it is recommended to drink plenty of water and consume foods that are high in fiber.
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Prunes are a rich source of both soluble and insoluble fiber which softens and adds bulk to stool.
Other foods include beans and legumes, apples, pears, bran flakes, oatmeal and flaxseed meal. 
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Fermented Foods
It is standard protocol to be given antibiotics as a preventative measure before or during and sometimes after surgery. Antibiotics kill both pathogenic and beneficial bacteria in our digestive system. The problem with this is that since 75-80% of natural immunity resides in our digestive system, this actually reduces our natural protective barrier.
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There are foods rich in probiotics and digestive enzymes you can eat to help keep your immune system integrity strong. Some of these include:
  • Yogurt
  • Kefir (both dairy and water)
  • Apple cider vinegar or other traditionally fermented vinegars
  • Naturally fermented vegetables; sauerkraut, kimchee
  • Fermented beverages; beet kvass, kombucha
  • Fermented bean and legumes
  • Naturally fermented chutneys and salsas
  • Additionally, companies such as AOR provide well researched solutions to combat bad intestinal bacteria (fighting bacteria with bacteria) and good bacteria in the form of probiotics. 
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Deeply Coloured Fruits
The body is under constant oxidative stress but the stress of surgery or an injury, in addition to the drugs used during and after the procedure, further increases the stress placed on the body through free-radical production. Your body will naturally utilize antioxidants to combat these harmful molecules but the demands will be much higher post-injury or surgery.

Antioxidant intake can be substantially increased by eating deeply coloured fruits such as strawberries, raspberries, blueberries, cherries, and pomegranates. These fruits contain anthocyanidins, which are compounds that enhance the effects of Vitamin C, as well as improve the integrity of your capillaries and stabilize collagen.
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Vegetables & Orange-Coloured Fruits
Vitamin A is needed by the body for the repair and maintenance of soft tissue, mucus membranes, and skin and is thus, important when dealing with an injury.

Sweet potatoes, carrots, darky leafy greens like kale are excellent sources of beta carotene, or pro-vitamin A, which the body converts into Vitamin A as needed. Orange-coloured fruits such as cantaloupe, mango, and dried apricots are also exceptional sources of beta carotene.
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Bell Peppers & Citrus Fruit
Vitamin C is a water-soluble vitamin that helps to cross-link collagen. As mentioned previously, collagen is a crucial protein to proper wound healing, especially if you have had an incision during surgical procedures. Stress also depletes Vitamin C stores so increasing your intake is highly recommended after surgery (up to 900 mg per day).

Excellent sources of Vitamin C are bell peppers (340 mg per medium pepper), papaya, broccoli, strawberries, citrus fruit, kiwis, and broccoli.
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Cruciferous Vegetables
There is always the risk of infection after surgery and the best protection is to build up your immune system. Phytonutrients are natural compounds found in plant foods such as vegetables, fruit, whole grain product and legumes. There are many different phytonutrients and they have been shown to possess antioxidant properties, act as antibacterial or antiviral agents, and have positive effects on the immune system.

Foods rich in phytonutrients include dark green leafy vegetables (such as spinach, kale, bok choy), cabbage, brussel sprouts, and cauliflower.
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Nuts & Seeds
Zinc is necessary for proper immune system function. The body requires zinc to develop, mature and activate cells that are integral to the process of immunity. Furthermore, zinc is essential for wound healing as it is integral to protein synthesis and cell growth.

Sesame seeds, squash and pumpkin are excellent sources of zinc. Oysters have the highest concentration of zinc and red meats have some incredibly high concentrations as well. 
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Inflammation & Eating
In a healthy body, inflammation is a normal and effective response that promotes healing. However, sometimes inflammation persists on a daily basis even when you are not injured or ill. This is when inflammation can become a problem. Many major diseases such as cancer, heart disease, diabetes, arthritis, depression, and Alzheimer’s, have been linked to chronic inflammation.

Studies have shown that certain foods and beverages have anti-inflammatory effects such as tomatoes, olive oil, green leafy vegetables, nuts, fatty fish and fruits. Conversely, there are some foods that can promote the inflammation response and should be limited as much as possible. These include refined carbohydrates (such as white bread and pastries), fried foods, soda and other sweetened beverages, red meats, processed meats, margarine, shortening and lard.
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Once you’ve filled your shopping cart with these foods call into the clinic and let one of our expert physios help guide you back to a full recovery!
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Vertigo and Benign Paroxysmal Positional Vertigo (BPPV)

3/22/2018

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While dizziness remains one of the most commonly diagnosed issues by physicians in North America for aging populations, it is not a normal part of aging. Commonly referred to as "dizziness," issues with balance, vertigo, or spinning can actually arise from issues in the inner ear or the visual system. Dizziness or a lack of balance, can lead to issues that drastically affect quality of life. It can affect your ability to go to work, it can cause falls, or even make basic functional activities such as walking or getting out of bed seem difficult. 

Here is a video to help explain how the inner ear works: http://www.granvillephysio.ca/other-conditions.html

What is Benign Positional Paroxysmal Vertigo (BPPV)? 

BPPV is the most common cause of vertigo in the aging population. It causes dizziness or spinning with rapid positional changes such as moving/turning the head or getting up and down. BPPV gives you the feeling that the room or environment is spinning around you. 

BPPV is caused by problems in the structures of the inner ear. The inner ear has canals containing fluid that end in a structure called the cupula. When you move your head, fluid flows freely in your cupula and helps you determine where you are in space. BPPV is when small sand-like particles from the vestibule in your inner ear become detached and tell the fluid that you are in a different place than you actually are. It can cause vertigo immediately or shortly after head movement.

What is Vestibular Rehabilitation?

During Vestibular Rehabilitation the cause of dizziness/vertigo is determined by assessing eye movements, balance, posture, aggravating movements, or visual system influences. Information such as medical conditions, medications, and prior history are taken into account for their involvement in exacerbating the condition.

What kind of treatment can I expect during Vestibular Rehabilitation?

You will be given a customized treatment plan consisting of manual techniques within the clinic, at-home exercises, or home-care principles. During the assessment, symptoms may be exacerbated but your treating therapist will guide you through the process. 

If you are suffering from vertigo, spinning or dizziness and you are unsure of the cause, don't wait to get assessed. You will be surprised that such delicate structures of the inner ear can have such a profound effect on your quality of life.  Book today with Graville Physio's Inner Ear specialist Brendon Ip.
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5 Key Workplace Mistakes You Need To Fix!

7/18/2017

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​"Sitting is the new smoking."

It's a drastic statement, but it has caught much attention and popularity in recent years, as study after study has shown the drastically negative impact that sitting has on our overall health (read a few by clicking here or here). While simply sitting for less time may seem like the easy answer, unfortunately for a lot of us, sitting at a desk comprises a large portion of our work week.

In fact, we are willing to bet that you are sitting at a desk - whether your work station or at home - right now as you read this. If you are, freeze! Don't move! Take a moment to investigate your positioning right now, simple things like how far away from the computer you are, or where your mouse and keyboard are in relation to you. While sitting may not always be avoidable, we have five easy adjustments that you can make, to help reduce the negative impact your desk habits may be having on your health. 

How many of our five key workplace habits do you think you are guilty of?  Read on below to find out, and to see what our physiotherapists recommend to help alleviate these problems.

1. Distance From The Monitor

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Why it matters?
Sitting too close to the monitor can have serious consequences on your vision, while sitting too far away often results in individuals leaning forward, which creates poor posture. This in turn can lead to increased pressure on the low back, tension in the shoulders, and a strained neck. 

Jim Bowie's suggested fix:
Avoid poor postural mistakes or eye strain by ensuring that your monitor is set up at a proper distance. Your gaze should naturally fall within the top third of the screen, and the monitor should ideally be between 18-20 inches from your face. Adjusting your keyboard to an easily accessible position at this distance, or investing in a  desk chair that enables a proper height, are two great options to help make this new position seem more natural.

2. Sitting Too Long

Why it matters?    
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As we mentioned above, prolonged periods of sitting have a wide array of negative health effects. Interestingly, studies have found that many of the negative effects of sitting are irreversible, meaning that the damage done over long periods of sitting cannot simply be undone by a later change in habits. Complications such as disc herniation, hypertension, diabetes, and even cancer are drastically reduced when individuals make an effort to sit less and move more. In fact, the Conference Board of Canada predicts that if only 10% of Canadians were to make an effort to reduce their sitting hours, national health care costs would be reduced by 2.6 BILLION dollars!

Jim Bowie's suggested fix:
While options like a sit-stand desk are fantastic alternatives to the traditional workplace, they are not always financially feasible. Instead, try incorporating some of these simple ideas into your everyday work routine:
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  • Take the stairs, not the elevator
  • Stand up when on the phone
  • If an email recipient is in your office, opt for walking over and verbally relaying your message
  • Refill your water glass every hour
  • After you eat lunch, take a 5 or 10 minute walk
  • Set a timer for yourself, and try to incorporate some gentle stretching or exercises at your desk throughout the day
  • Organize walks with coworkers, instead of seated meetings

You may get a few silly looks from your coworkers at first, but we are confident that by incorporating these simple activities into your routine, you will feel better, be more focused and productive, and may even inspire others to make healthier changes for themselves as well! ​

3. Sitting Angle

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Why it matters?
Studies have shown that the angle at which we sit has a drastic effect on the amount of pressure that we place on our intervertebral discs. As you can probably guess, this pressure is not a good thing, and over time can lead to disc herniation, chronic pain, and decreased range of motion. 

Jim Bowie's suggested fix:
By simply adjusting the angle of your seated position, disc pressure can be reduced by up to 85%! As you can see in the image above, Nachemson et al. demonstrate that relative to standing, sitting at an angle of 110 degrees (leaning slightly backwards from the monitor) places only marginally more pressure on the spine, whereas leaning forwards into the screen can almost double the pressure our discs undergo. Ensure that your desk chair can facilitate these healthier postures, press your hips as far back into your chair as they can go, and be conscious of your shoulders slumping forward. It is important to note as well, that the old adage "sit up straight" is not necessarily true; as you can see from the image above, trying to hold yourself perfectly erect actually places more strain on the back. Instead, try to find a comfortable position that is lengthened but relaxed, and remember to incorporate movement at regular intervals.
  

4. HiP tILT

Why it matters?
The majority of us tend to sit favouring one side over the other, without even realizing it. If you are unsure whether or not you are guilty of this, simply take note of how you typically sit at work. Do you find yourself leaning on one armrest more than the other? Do you lean your head onto the same hand regularly, or cross your legs with the same leg always on top? These habits indicate an imbalanced pelvis, which can cause movement and alignment problems, as well as back pain. 

Jim Bowie's suggested fix:
Since so many people are unaware of this lean, simply being more conscious of your seated position will drastically help alleviate the strain that the pelvic imbalance is creating. Avoid crossing your legs, and leaning forward onto your desk or armrest. Try to feel both sides of your buttocks and hips pressing equally into the chair, and if you are feeling tired or need to lean, try standing up and moving for a few minutes instead.
  

5. mOUSE pOSITIONING

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Why it matters?
 
Improper positioning of the mouse can cause individuals to bend wrists, and lift or reach arms out for extended periods of time. This in turn places increased stress on the wrist and elbow joints, over time weakening these systems and creating pain and dysfunction.

​Jim Bowie's suggested fix:

Make sure that your mouse is placed in the "Usual Zone" pictured above, within 25 cm of your seated position. The hand and forearm should maintain a straight line, and the upper arm should not have to extend or elevate to use the mouse. By keeping the mouse in the green zone displayed above, regular reaching motions are eliminated, strain on the elbow is reduced, and your body will thank you! 
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Shockwave Therapy for Achilles Tendinopathy

6/14/2017

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In our previous article explaining the causes and symptoms of Achilles tendinopathy (click here if you haven't seen it yet!), we did not address treatment options for individuals suffering from particularly stubborn or severe cases of Achilles tendinopathy. If traditional treatment options or previous physiotherapy sessions have not helped to treat your injury, we believe we can help you here at Granville Physio.
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​We are excited to be able to offer our patients Shockwave Therapy, a newer treatment option that has shown incredible results in the treatment of Achilles tendinopathy, amongst other conditions. Intrigued? Read on below to learn how Shockwave therapy works, and what makes it so effective in treating Achilles tendinopathy. If you would like to book an appointment for Shockwave therapy, click here for access to our online booking system!

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IMS for Achilles Tendinopathy

5/31/2017

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​We've discussed before the symptoms of Achilles tendinopathy, and what potential factors may be contributing to your injury (click here if you missed that article, or would like to read it again). However, sometimes simply treating the calf is not sufficient. For conditions caused by deep-rooted dysfunction, a treatment option called IMS (intramuscular stimulation) is a fantastic alternative that yields immense relief. 

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Achilles Tendinopathy - Don't Let it Be Your Weakness!

5/6/2017

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Whether you're hiking the mountains of Vancouver or going for a walk in Richmond it would be tough to do it without your Achilles.  The Achilles is the thickest tendon in the human body, it attaches the calf muscles to the calcaneus (heel bone), and is responsible for plantar flexion at the ankle (pointing your toes). 
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​As we perform activities that use our Achilles tendon, small "micro-tears" occur within the tendon band. This process is completely normal, and occurs in our body when most movements are performed. Our body is constantly repairing the microtrauma that results in our tissues when we move, and in a healthy body these tiny injuries are healed at approximately the same rate that they occur.

However, if this cycle of microtrauma and repair in the Achilles tendon becomes unbalanced, Achilles tendinopathy may result. Over time, these microtraumas accumulate in the tendon, until major injury and dysfunction force a halt to normal movements and activities. Achilles tendinopathy is described as pain, swelling, stiffness, and weakness in the Achilles tendon, and is exacerbated by any movements involving the Achilles tendon (as described above).
  
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A number of factors can contribute to the damage leading up to Achilles tendinopathy, such as:
  • Overuse of the Achilles (the most common cause, and often seen in runners, dancers, or athletes that do a lot of jumping)
  • Wearing inappropriate footwear
  • Exercising and/or training with poor technique and alignment
  • Increasing intensity of exercise
  • Issues with one of or all three arches
  • Inappropriate use of toe muscles for propulsion or stabilization
  • Poor flexibility

If you are experiencing any sort of stiffness or pain in the Achilles region, it is very important to have your injury assessed and treated accordingly, as ignoring the signs of Achilles tendinopathy can result in a complete rupture of the Achilles tendon. However, here at Granville Physio we have a variety of successful treatment options for Achilles tendinopathy, such as shockwave therapy and IMS treatment. Click here to book in with one of our physiotherapists today, and treat your injury before a tendon rupture occurs!


Below, you can also find four of our favourite exercises for the stretching and maintenance of a healthy Achilles tendon. We recommend performing these exercises regularly, especially when heavy exercise is performed or tightness in the Achilles is experienced. As always, if you have any questions, we are happy to assist you. 


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Posture Perfect!

10/12/2016

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Poor posture and alignment places unnecessary stress on our bodies, and while most people are aware of what "good posture" looks like, it can often be very difficult to overcome our bad habits and adopt a correct position. We've compiled a quick list of our favourite exercises for correcting posture. The best part? They are quick, easy, and can be done anywhere from your home to the workplace. Try incorporating these exercises into your daily routine, and you'll be amazed at the postural improvement you see! 
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Cat/Cow

We love it because... It targets extension (bending backwards) in the area of the mid-back that people tend to keep mostly flexed (especially when sitting)! 
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Instructions:
  1. Begin on your hands and knees
    • Hands (or fists) and knees should be directly under the shoulders and hips, respectively
    • Legs should be hip width apart, and the stomach muscles should be engaged to support the spine
    • Try to flatten the back, so that you have a straight line from ear to hip
  2. Cat pose
    • Tilt the pelvis so the lower back curves upward and arch your mid back up like a stretching cat
    • Try to keep the neck in a neutral position during this phase
  3. Cow pose
    • Try to focus the movement in the middle of the back, keeping it relaxed

Thoracic Spine Foam Roll

We love it because... It relaxes the spine, increasing mobility and strength in the vertebral joints.
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Instructions:
  1. Begin with the foam roller placed in the middle of your back (between the shoulder blades)
    • Keep the abs lightly contracted, and try to maintain a neutral spine in the neck and low back
    • If you feel any pain beyond a light ache, stop doing the exercise immediately
  2. Slowly begin to roll up to the top of the shoulder blades, and then back down to the bottom of the rib cage
    • Hands should be clasped behind the head, and elbows pulled slightly together
  3. Do NOT roll to the neck or lower back, always stop the motion before reaching these areas
  4. Repeat the process, and breathe regularly 

Doorway Pec

We love it because... It lengthens shortened pecs, which can put strain on the back muscles and cause the shoulders to pinch the rotator cuff tendons. Lengthening the pecs makes it easier to hold the shoulders back in a correct posture, and feels great too! 
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Instructions:
  1. Stand in a doorway, feet lined up with the opening
    • Place one foot in front of the other, for stability
  2. Place your arms at shoulder height in the doorway, make right angles with the elbows
  3. Hold for approximately 15 seconds for each side 

Hip Flexor

We love it because... Many people have an anterior pelvic tilt, and this exercise will lengthen the hip flexors and allow for a more extended, upright posture. 
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Instructions:
  1. Kneel on one leg, with the heel directly under the knee and the back leg in line with the thigh
  2. Square the hips
    • Imagine having headlights on the front of each hip bone
    • Ensure both "headlights" are directed straight forward as you tilt the pelvis backwards (think of rotating the pelvis towards the bellybutton)
    • Low back should stay straight or slightly curve forward
  3. Press forward gently from the tailbone, while holding the lower abdominals and pelvis upright
  4. Breathe into the stretch, hold for 30 seconds
  5. Repeat on the other side

Lower Trapezius

We love it because... It opens the front of the chest, encouraging the shoulders to press back into correct postural placement. Granville Physio's Damien Wild recommends saving this exercise for last, as a tool to fine-tune your postural improvement! 
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Instructions:
  1. Begin on your stomach, with your legs straight out behind you and hip distance apart
  2. Position your arms down by your sides, with your palms turned towards the floor
  3. Lift both arms towards the ceiling
    • Think of drawing the shoulder blades down and together
    • Arms stay straight, and shoulders are pulled away from ears
  4. Hold this position for 10-15 seconds, breathing normally
  5. Release both arms down to the floor
  6. Repeat to complete a set of 10

If you are struggling to perform any of the above exercises, or would like more exercises/advice for your posture or any pains you've been experiencing, our physiotherapists at Granville Physio are here to help. Click here to book in with James, Damien or Jim today!
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Directions to Granville Physiotherapy
Behind the Safeway at Granville and 70th.  Access from southbound lanes on Granville or off of 70th between the Royal Bank and BC Liqour store.  There is ample parking outside of the clinic.

We provide physiotherapy services for Vancouver and  Richmond including: Dunbar, Kerrisdale, Oakridge, and Marpole neighborhoods.
Granville Physio
8501 Saskatchewan Lane
Vancouver, BC,
V6P 0C7


info@granvillephysio.ca
P 604-630-0108

Marpole physiotherapy clinic