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Anxiety – Body, Mind – or BOTH?

Heart palpitations.

Stomach sinks.

Palms get sweaty and cold.

Thoughts become erratic, racing and filled with doom.

Anxiety is an extremely common condition affecting more than 3 million new people each year.  While the most common treatments involve medication (chemical) and/or counseling (mental/social), these methods can’t address the physical aspects of this condition.

Clients that suffer with anxiety present with imbalances in their autonomic nervous system.  (This is the fight/flight and rest/digest system) The nerve tissues often become irritated from restrictions in the surrounding structures – an irritation that will keep the system in a more elevated “fight or flight” mode.  With the system already heightened, it only takes a small mental or social challenge to stimulate anxiousness.

Tools and techniques given to you by your psychotherapist are crucial in managing these “flare-ups”, while ongoing counseling helps change the behaviors surrounding the symptoms.  Some medications help suppress the system to reduce symptom severity.  However, to treat the physical triggers and effects of anxiety, the tissues must be addressed through manual therapy to allow the nervous system to regain balance.

ASSESS YOURSELF!:

To find out how a Physio would help your specific situation, schedule a consultation today by clicking HERE.

Already a Nourish Your Mind Client? Click HERE.

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Condition-Specific Uncategorized

Impacts of COVID related stress on the muscle system

Now that I have talked about effects on all the other systems of the body, I will focus on how stress affects the muscles. The initial response to flight or fight mode is all the larger muscles in the legs like hamstrings, quads prepare you to run away. The upper body muscles like biceps, triceps are ready to push, hit, etc.    The postural muscles deactivate, so all the stabilizing muscles and smaller muscles (containing high amounts of proprioceptors) deactivate affecting balance and proprioception.

With so many changes happening initially if the stress cycle continues the long term effects are adverse. Stress leads to muscle imbalances, fatigue, trigger points, balance and proprioception issues and loss of joint protection. Manual therapy plays an important role in addressing all the above issues by educating and treating the effects on muscles.  This is done through the nervous system and the brain by:

  • Balancing the autonomic nervous system
  • Working on stabilizing muscles
  • Postural reeducation
  • Isometric exercises
  • Range of motion and dynamic stretching
  • Balance
  • Proprioception and sensorimotor retraining
  • Trigger point and soft tissue treatment
  • And more!

The last but not the least is sleep. Stay tuned to read more about stress and its effects on sleep.

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Region Specific Uncategorized

Shoulder Pain: “Why does it hurt so much?”

There exists a lack of association between findings on MRIs and pain. In other words, what is seen and reported from an MRI may have all or nothing to do with the pain you are experiencing. There is plenty of evidence that people who have no pain will have positive findings on an MRI.

Much of the approach at Move Physio is geared towards addressing all the other structures in your body that may be causing undue stress on painful parts such as your shoulder. If we treat those other structures the shoulder eventually stops hurting. Pain is a “good” thing, a “sign” that should not be ignored.

But, (the reason you are reading this) why does your shoulder hurt so much? You can’t sleep, raise your arm, throw, etc. A sprain or strain (including partial and full tears of the rotator cuff) likely does not explain your level of pain. Instead, it’s your body’s healing and protective response.

Yes, healing hurts. Even though it hurts, inflammation is a good thing. It is your systems way of repairing by eating up the dead cells and laying down new tissue. During this process, a protein called interleukin is released to help the healing process. This protein alone may contribute to an abnormally increased sensitivity to pain known as hyperalgesia. Furthermore, those with rotator cuff-related pain have high concentrations of other substances (substance P and pro-inflammatory cytokines) released in response to stress for defense, protection, and repair purposes. Yes, healing hurts, and you’ll feel more pain relative to the actual damage. In my experience as a clinician, a healthy but exquisitely exacerbated shoulder is quite common and is unique among the other joints of your body.

A painful experience is further complicated by the brain. Your body is responding to heal the tissues and your brain is reporting the resulting pain. Pain is always an output from your brain. Your brain wants to protect you. Alarming you through the use of pain is one very powerful way for the brain to say, “Hey, don’t do that.” That is why re-establishing appropriate movement with less pain is effective for long-term outcome as it takes the threat away. Without that threat, your brain can relax and not output so much pain.

Here are some important steps to recognize during your path to recovery:

1. Shoulder pain is a sign. Have us figure out what is contributing to the reason for that pain.

2.  Understand that healing hurts and may take some time. Follow step one to keep it from having to constantly heal and return to pain.

3. Do not be afraid of appropriate movement with limited or no pain. Instead, stop movements that exacerbate the shoulder. “Motion is lotion” for joints as continued pain-free movement can decrease the threat. Too much inappropriate movement leads to increased healing and threat, perhaps resulting in why you decided to read this blog post.

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Condition-Specific Uncategorized

Sleeplessness from quarantine??? Here is why!

We are going through an unprecedented time and in addition to so many other adverse effects, COVID is causing sleepless nights.

The effects of stress on mental and physical health are getting worse. The acute phase of stress leads to a reduction in sleep, vigilance and an adrenaline rush in the system to prepare you for flight or fight. The continuation of stress causes difficulty in falling asleep, fatigue, no deep phases of sleep, sensitivity, irritability and decreased memory. This eventually accumulates to causing more physical issues – and the cycle continues.

The most important treatment is pain neuroscience education (PNE) to explain the symptoms and reduce the threat to the brain. PNE in combination with manual therapy can lead to amazing results with a patient’s recovery. The primary goal is to regulate and calm the nervous system and the brain down. Sleep hygiene, sleep study evaluation, nutrition, exercise, journaling are other great treatment options to help address sleep issues.

Now that I have covered a lot about stress and its impact on various systems of the body and have also suggested different treatment options please do not wait to take care of yourself and loved ones. My team at Move Physio is open for consultation, evaluation and treatment.

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Condition-Specific Uncategorized

Is it COVID or fear of COVID challenging the immune system?

People with underlying conditions or immune compromised patients are severely affected by COVID. Can fear of getting COVID suppress your immune system making you prone to illness?

Initial phases of stress begins to slow the immune system. As the stress continues immune deficiency sets in, which makes you more prone to infection – like sore throats, flu, etc. This causes prolonged swelling and inflammation of tissues increasing overall tenderness. It can also lead to memory changes, altered body maps, neglect and spreading pain.

Specific manual therapy methods can focus on organ mobilization, help circulation, oxygen exchange, ion channel balance, clearing toxins from the system and promote healthy cell growth – which helps boost immunity. Other potential things like goal setting, coping skills, humor social interaction are also very important.

I hope you are enjoying the blogs and learning a lot. Keep reading to learn the impacts of stress on musculoskeletal (muscle) system.

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Condition-Specific Uncategorized

Does stress affect your breathing???

Have you ever felt like you are unable to take a deep breath when you are anxious, frightened or angry? With heightened stress, the diaphragm shuts down and you start using all the accessory muscles in your chest and neck… and the breathing becomes fast and very shallow. When the stress continues longer, it creates muscle imbalances, decreases blood flow and oxygenation of tissue, increases nerve sensitivity and increases heart rate – leading to a chronic fatigue.

Targeted, functional manual therapy treatment helps to improve the activation of the diaphragm, retrain the system to correct muscle imbalances and use the primary muscle for breathing. This enhances the ability of the body to take deep breaths. Other treatments like yoga, breathing exercises, relaxation techniques and meditation can also play a huge role in recovery.

Keep reading…My next blog will be focusing on immune response to stress!

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Condition-Specific Uncategorized

Endocrine Response to Stress

The Endocrine system causes changes at the tissue level as well as changes in the brain due to the fight or flight mode initiated by stress. The changes at the tissue level include fatigue, sensitivity, soreness, tiredness and sluggishness – which leads to deconditioning.

Changes at the brain level can be serious, like short term memory loss, weight gain, mood swings, problems with focus and concentration and changes in appetite.

Targeted, manual therapy can help regulate the endocrine system and in turn help the tissues and brain. Other treatment options include nutrition, pacing, meditation, cardio exercises.

My next article will discuss how the respiratory system is also affected by stress, changes and potential treatment options.

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Condition-Specific Uncategorized

Sympathetic response to stress

Stress (fear, panic, anxiety) leads to activating the sympathetic nervous system (fight or flight). When you are in that mode the brain secretes hormones (adrenaline and cortisol) to keep you wide awake – your pupils dilate, heart rate increases, blood is diverted to areas in need of extra blood and oxygen and you become hyper vigilant as you are preparing to flee or fight.

What happens when this phase continues longer – like it is right now with these unprecedented times?

Long term effects from the ramped up sympathetic system will cause increased sensitivity in the peripheral nerves in the body, sleep disturbance (unable to get into deep phases), changes in the digestive system, increase development of trigger points, irritability, increased pain – leading to exhaustion.

A lot of things can help balance the nervous system… like specialized manual therapy that focuses on treatment of the nerves and brain, mindfulness and meditation, yoga, sleep hygiene and aerobic exercise.

Follow up for the next phase of the stress cycle – endocrine system coming up in my next blog.

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Methodology & Techniques Region Specific Uncategorized

Access Your Ankles – Reduce Pain and Enhance Performance

Do you wish you could squat like that?

Proper ankle mobility is important for most of our functional and higher level movements. Specifically, decreased dorsiflexion, or bending of the ankle (the foot getting closer to your shin), will likely add undue stress on joints up the chain including knees, hips, and the spine. If you cannot access your ankles well, you will have to borrow (compensate) extra movement from those other structures. From lesser to greater extents, dorsiflexion is utilized during walking, running, stair negotiation, and squatting. Here is a classic example of a test that illustrates the impact of decreased dorsiflexion on deep squatting. This is a test that you can do yourself. This “deep squat” is limited in depth:

 

 

The addition of a 2×4 under the heels decreases the need for dorsiflexion, allowing for greater depth. Although there may be more to this including hip and spinal mobility and control limitations, the ankles in these pictures are the limiting factor in a functional squat:

Another test you can try yourself requires only a wall and floor. Keeping your foot completely flat, bring it away from the wall as far as you can while still being able to touch the wall slightly with your knee. Measure the distance between your toes and the wall. Roughly speaking, this measure should be approximately 3 to 6 inches depending on your specific needs. Take note of what you feel when you do this test, either a stretch feeling behind the ankle and into the calf, or tightness and possibly pinching in the front of the ankle. The first picture illustrates limited dorsiflexion.

This is better:

How much should you have? That depends on what you need it for. If you squat (whether it’s for strength training or tying your shoes) or walk or run up hills or stairs, you will likely need more. Many of my high level and younger clients are lacking this range of motion, which is likely a reflection of how we move or don’t move in our society. It is also what prompted me to write this blog post.

If you noticed tightness or a stretch feeling behind your ankle and/or in your calf, then the muscles and tissues of your calf and Achilles are likely the limiting factor. You may try adding a typical runner’s wall calf stretch (not shown) to your routine. However, soft tissue mobility may be restricted. We find it helpful to gently loosen these tissues and calm the muscles down with some self mobility using either a rumble roller:

– Or a lacrosse or tennis ball:

There is no need to force anything. Keeping your calf relaxed, slowly roll your muscles over the points of the rumble roller or over the ball until you find a stiff or semi-tender spot. Let that spot “melt” over the point for 30 seconds or so. You can then get those tissues to move by slowly dorsiflexing your ankle back and forth.

If you had felt a pinch, stiffness or block in the front of the ankle during the test, then it’s possible the ankle joint (talocrural joint) is the restriction. One optional self-mobility technique I prescribe for this uses a pull-up assistance band. This is a great tool for mobilizing ankles and hips and can be purchased fairly cheap in stores or online. Just make sure you anchor it to something very stable (such as a squat rack):

In this position, keeping your foot and heel flat on the ground and keeping the band where the ankle meets the foot, gently lunge your knee forward thereby dorsiflexing. Perform 10-20 times.

This serves only as a basic guide to self-assessing your ankles and does not discuss other reasons you may have difficulty with your ankle mobility or functional movements such as a squat. The numerous bones and tissues of the ankle and foot, the knees, hips, pelvis, spine and trunk may all be factors. Only a thorough assessment can help identify these factors. Once found, manual and exercise therapy directed at these problem sites can help make your movements looser and more efficient.

 

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Condition-Specific Uncategorized

COVID stress cycle…The real culprit of physical pain?

Emotional response (fear, anxiety, grief, frustration) to COVID 19 can lead to adverse effects on physical health. Wondering how? Stress releases chemicals like adrenaline and cortisol which leads to increased heart rate, tightening muscles in the body, eventually leading to musculoskeletal limitations causing physical pain such as low back, neck, shoulder, hip, knee pain, etc..

I will be posting follow up articles explaining each phase of the cycle, its effects on the body and how to manage them.