The team at Envision Physiotherapy is proud to announce that we are now official sponsors of the BC Senior Womens Tennis Association (BCSWTA) and their 3 tournaments across the year. The BCSWTA supports and encourages women aged 30+ to participate in tennis. http://www.bcswta.org/index.htm

The first tournament is the BCSWTA Ladysport Doubles Championships held over March 2^nd-4^th at the beautiful Jericho Tennis Club.  Our physiotherapists are planning to make a presence at the tournament. Come say hi, receive athletic taping, or care for acute injuries.

Hope to see everyone at the event!

-Tony Gui BHKin, MPT, CAFCI

We, the physiotherapists at Envision, have been referring our clients to The Movement Studio pilates studio for years. There is no doubt that the postural awareness and movement correction that pilates instructors can offer is essential to pain-free function. But as much as physiotherapists would like to spend our time working with our clients on fine-tuning posture and movement biomechanics, we truly are pressed for time to squeeze in the necessary manual therapy, exercise, and education into a single 30-minute session.
So when Brent and Harry decided to incorporate clinical pilates into our new multidisciplinary clinic, I was ecstatic. It meant that we physiotherapists could focus on using manual therapy and needling techniques to restore motion, introduce the basics of core stability and motor retraining, then progress our clients to a clinical pilates instructor for progression of the postural and movement retraining. Because clinical pilates sessions are an hour long, much more time can be spent on the correcting subtleties of movement than we can spend in a regular physio session.
In Australia and the UK pilates has been used for years as a complement to physiotherapy practice, and has been integrated into physiotherapy clinics. This has only been a recent phenomenon in North America, but the number of clinics now offering clinical pilates is growing.
How is clinical pilates different than “regular” pilates?
Prior to beginning a clinical pilates session, the client must be assessed by a physiotherapist. The physio will recommend to the pilates instructor how many sessions the client will need, and will tell the instructor what areas need to be addressed and what types of exercises should be the focus. The client may continue with physiotherapy treatment in conjunction with clinical pilates or, if they are not attending physio sessions, will need to follow-up with the physio for an assessment after 6 sessions. Clinical pilates is a physiotherapist-monitored rehabilitation program that is covered by most extended health-care plans, while “regular” pilates sessions are not.

For more information on Clinical Pilates at Envision Physiotherapy, check out our website or The Movement Studio.

Ask your physio for more information, or call our office at (604) 737-7309.

http://www.nytimes.com/2012/01/08/magazine/how-yoga-can-wreck-your-body.html?_r=1&smid=tw-nytimes&seid=auto

I found it to be an interesting piece, echoing many of my own concerns about the practice. However, I also feel that it needs to be taken with a grain of salt (as things often do). I decided to write a blog entry to share my own personal feelings about yoga, based on my experiences as a physiotherapist, my educational background, and my own yoga practice.

I have been practicing yoga for six years, which some may consider a decent length of time, others may not. Let me assure you, I am by no means a yogi; I struggle with focussing on my session and I’m often sneaking glances at the teacher or other students to remind myself of what parivritta utkatasana is. I do, however, pride myself on listening to my body, understanding its limitations, and not getting swept away by my competitive side that always wants to be the best. I have “shopped around” to different studios and tried out different teachers to find out which is the best fit for me. I have had good experiences and bad, and I have learned what works for me.

I think that yoga can play a very important role in some peoples’ lives, whether it is from a mental, physical, or spiritual standpoint. Given that we, as human beings, have morphed from active hunter-gatherers to sedentary folks sitting in front of computers all day long, our joints aren’t taken through their full ranges of motion and our muscles aren’t stretched or contracted within their capabilities. Speaking from a physio standpoint, I feel that practicing yoga is a great way to get our bodies into positions that they normally don’t experience. It allows us to open up our hips, reach our arms overhead, and stretch out our chests. It also allows us to take notice of our limitations and prompts us to work on those problem areas.

For some people, however, yoga can be the cause of physical pain and emotional stress. We are so accustomed to trying to be the best, or to attain the most advanced level of achievement, that this carries over into our yoga practice. Rather than recognizing that we need to listen to our bodies and do whatever is best for ourselves that day, we always try to be better than we were the last time or get into the most advanced pose that the instructor demonstrates.
Working as a physiotherapist, I have seen my share of yoga injuries. I often have people who come in with sacroiliac or groin pain resulting from improperly doing any of the “warrior” positions. I have worked with people who have aggravated their sciatic nerve by overstretching in a forward fold or triangle pose. Another common complaint is shoulder pain from either overstretching in an awkward position or improperly stabilizing with any of the plank or downward dog poses.

I find that I routinely teach the same corrections over and over again to my clients who practice yoga. I’ll share the most common ones below:

1) if you have a history of a lumbar disc injury, be very cautious with any flexion poses (or forward folds); if you feel pain or any sensation down your leg, you have gone too far

2) if you have spinal stenosis, be very cautious with extension (or back bends); only go as far as you feel comfortable and, again, if you feel pain or any sensation down your leg, you have gone too far

3) if you have any issues with blood pressure, vertigo, or dizziness, consult your physician before doing any inversions

4) if you are any posture that is causing tingling or numbness you are probably stretching or compressing a nerve; adjust your position to alleviate the pins and needles, because remaining in that posture will cause a further decrease in blood flow to the nerve, which could lead to permanent damage

5) be very aware of your pelvic alignment in any warrior position; imagine that you have lasers shooting forward out of your hip bones, and at all times these lasers should be pointing in the same direction; if one laser is straight ahead and the other one is pointing down to the ground, this means that there is a torsion in your pelvis, and you are risking injury to your sacroiliac joint and lumbar spine

The most important thing to note, and I borrow this from many yoga instructors I have worked with, is to check your ego at the door. If you try to be better than the person next to you, or if you try to force your body into the most advanced version of the pose before you are ready, you will certainly be dealing with an injury.

A recent hot topic in the sporting world has focused on the severity and long-term consequences of concussions. It is no surprise Pittsburg Penguin’s Sidney Crosby has been the talk of the town for the medical community because of his recent recurring concussion symptoms (headaches resurfaced after taking an elbow to the head after missing in action for 11months).  Likewise there were concerns about a possible concussion to our Vancouver Canucks’ Cody Hodgson after a hit to the head during a game against the Ottawa Senators.

Currently there are no medical scans or blood tests that can give a conclusive physiological diagnosis of concussion.  However there are several standardized tests to help physiotherapists, physicians, and athletic trainers determine if an athlete has suffered a possible concussion. One of the most commonly used tests is the Sports Assesssment Concussion Tool (SCAT2).  The NHL has also adopted the ImPACT test in their concussion protocol (Immediate Post-Concussion Assessment and Cognitive Testing).

The sensitive issue arises when an athlete like Chris Pronger from the Philadelphia Flyers has passed all his tests and is cleared to play but continues to complain of concussion symptoms like headaches and sluggishness. These concussion tests should not be the gold standard for athletes returning to play. Likewise, athletes need to respect and listen to what their bodies are telling them.

For more information regarding concussion symptoms and management go to the impacttest.com

http://impacttest.com/concussion/overview

On the flip side head injuries are not limited to a sporting situation. Anybody can experience a concussion if there is impact to the head, from a fall or motor vehicle accident.  However, as a Physiotherapist I can appreciate the complexity of a head injury.  Not only do you need to monitor for concussion symptoms, but also assess for whiplash like consequences, the winding up of the nervous system, and possibly a vestibular (inner ear/balance/dizziness) component.

As for athletes returning back to the game after a head injury, I believe that British Columbia can pride itself for being an epicentre of world leading and innovative Sport Physiotherapist that can guide athletes in the right direction.

Tony Gui BHKin, MPT, CAFCI

As a physiotherapist, one of my responsibilities is to be an educator not only in injury prevention, but also preventative health and wellness. I stumbled upon this great video produced by Dr. Mike Evans (a physician at St. Michael’s Hospital and an Associate Professor at the University of Toronto) regarding the best medication out there, EXERCISE! 

A short list of the benefits of JUST 30 minutes of activity a day presented in the video include:

-reduction in pain and disability of knee arthritis by 47%

-reducing the progression of Dementia and Alzheimer’s by 50%

-reducing the progression of Diabetes by 58%

-reduction of hip fractures in post-menopausal women by 41%

-reduce anxiety by 48% and depression by 30%

I have no doubt this video will go viral.  The message is clear and the illustrations keep the audience engaged.  Watch it for yourself and I guarantee you’ll be motivated to go out for a walk afterwards.

Tony Gui BHKin, MPT, CAFCI

Here is a recent update in research posted by the American Academy of Pediatrics:

PEDIATRIC SPORTS-RELATED CONCUSSIONS CAN ALTER BLOOD FLOW IN THE BRAIN FOR MORE THAN A MONTH

Much media attention has been given to pediatric sports-related injuries, but questions still exist as to what happens to a child’s brain after sustaining a sports-related concussion (SRC). According to researchers who authored, “Pediatric Sports-Related Concussion Produces Cerebral Blood Flow Alterations,” in the January 2012 Pediatrics (published online Nov. 30, 2011), most children in this small study demonstrated a significant reduction in cerebral blood flow compared to uninjured controls, with 27 percent having persistent alterations more than a month after the initial injury. The authors also found that an SRC is primarily a physiological injury, without measurable evidence of structural or metabolic damage. This data suggests that there may be significant differences between pediatric and adult neural responses to SRC; these may have important implications for management and treatment in the future.

For the full abstract, with discussion, results and conclusions, go to http://pediatrics.aappublications.org/content/early/2011/11/28/peds.2011-2083

This further demonstrates that the SRC management framework used for adults can’t simply be transposed to children and adolescents.

For more information presented in a clear and useful format, go to thinkfirst.ca.  They provide plenty of resources for athletes, parents, coaches and physicians.

Harry Toor BScPT, Sport Physio Dip, FCAMT, C.G.IMS

Harry and Brent will be up early Saturday morning moving the rest of our equipment in. The whole team will spend the next week getting settled. Can’t wait to get started!

We’ve also added to our team by bringing along some of the best allied health care practitioners in the city, each of whom we have dealt with professionally over the past few years. Our new, multidisciplinary clinic will bring on Kinesiologists from Essential Kinetics, Massage Therapists from Kor Clinic, and Pilates instructors from The Movement Studio pilates. See our main page to learn more about each of them.

Our physiotherapy team has also grown with the addition of Tony Gui. To learn more about Tony, see his profile on Our Team page.

We will be running many open houses in early 2012 for physicians, personal trainers, coaches, our new South Granville neighbors and everyone else as well. Stay tuned for dates and times.