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We have re branded and moved our blog and website to a new home!
for up to date information and new blog posts!
We're getting close to the end of 2015, and oh what a year it has been! When I started treating patients in January this year at Moves Fitness, I had no idea how warm and welcoming of a community it would be, and how much I would learn about myself and about patient care in the process of growing my own practice.
It's been a great first year, and I'm super excited to be celebrating our first birthday on Monday January 4th, 2016! There are some big changes coming to this little clinic, and I'm so excited about them that I can hardly keep the secret.
One of the big changes is that I'll be sending out a monthly (or so) newsletter with updates about the clinic, tips about staying active and healthy, and loads of information about Athletic Therapy and Sports Medicine. If you want to be kept in the loop, make sure that you tell me your email address below!
The blog will still be active, however, it will focus more on education and give you an opportunity to learn about how the body works and different ways we are able to make it work better. If you have any ideas about what should be covered in future blogs, be sure to send me a message, or leave a comment on this blog.
As we approach the end of the year, and holiday and new years, don't forget that income tax season is right around the corner (yea I know, I went there). Please remember to submit all your Athletic Therapy receipts and statements to your insurance company (even if you're pretty sure they won't be covered) and keep any statements of not-covered therapy for tax season. Depending on your financial situation, you could be eligible for a deduction based on health care costs. If you need copies of statements or receipts, please let me know and I'll be happy to send them!
Well, that's it for me from 2015. Stay tuned for a blog early in the new year, and make sure you sign up for our newsletter to make sure you hear the exciting new changes first (I'm so excited!).
Happy holidays, and stay safe.
As Ontarians, we are lucky; we have an abundance of health care providers available to us, and, often we have the freedom to choose where we go for our health care! Even though every individual has the opportunity to choose, I do sometimes hear stories that are disheartening. I heard two statements recently that prompted me to write this blog:
"I don't really like my physiotherapist, but it's the clinic my doctor told me to go to, so I have to"
"My chiropractor says that as long as I'm going to see them, I can only see practitioners within their clinic"
I sincerely hope that both of these individuals misinterpreted what they were told. The bottom line is that no one has the right to make these decisions for you! There are a few regulations that are in place in Ontario, as well as professional ethical guidelines, that help to keep patients safe that everyone should know. In addition to those, I am going to outline a few general rules of thumb to help you choose a team that works best for you.
Often a health care practitioner will refer a patient to another professional to provide treatment they cannot provide themselves. For instance a doctor may refer for Athletic Therapy or Massage Therapy to treat a sports injury, or an Athletic Therapist may refer to a physiatrist or osteopath to treat chronic pain conditions.
No practitioner is allowed to make these referrals based on financial gain. Let me reiterate that; there cannot be any kickbacks, motivation, or underlying business interests that influence the practitioner's decision on where they refer their patient. Referrals must be made in the best interest of the patient.
Take note: if it appears that your doctor may own part of a physio clinic, or if you physio will only send you to the RMT that works for the same employer, they may not only be thinking of your health.
There are many allied health care practitioners in Ontario, including the four big players for sports injuries: Athletic Therapy, Physiotherapy, Chiropractors and Registered Massage Therapists. Each of these practitioners offers different skills and techniques, so even if your doctor recommends one, do your research and ensure that you are seeing the correct practitioner for your condition!
When you're injured, and seeking care from a health care practitioner, you're often in a vulnerable place. It's important that your practitioner makes you feel comfortable enough to be able to accept the treatment, and strive towards wellness. Here are some guidelines I like to follow when I'm seeking treatment for myself:
Making a Change
If you're agreeing with these ideas, and it seems as though your practitioner isn't working their hardest for you, then it might be time for a change!
As part of my Athletic Therapy education, I learned a lot about other practitioners and what tools they use to treat patients. I offer consultations with patients where I can get to know them, and their injury, to see if Athletic Therapy would be a fit. More importantly, it allows the public to see if I would be a good fit for them.
If you are unsure if your course of treatment is working, or you don't know if AT is for you, give me a call, and we can work together towards creating your wellness plan.
The Dangers of Over-Reliance on Tape
While we all know that many athletes need taping to be able to practice their sport correctly, are we getting dangerously close to over-taping?
This weekend I had the pleasure of providing Athletic Therapy services to a youth Rugby 7's tournament. This event had games for U16 and U18 boys and girls, and I split my time between the treatment and taping tent, and field side emergency care.
Most of the players in this tournament play at the club level for both Rugby 7's and 15's, and most of them played for school teams as well. These kids were in shape, skilled, and used to the rigors of a contact sport.
But I saw a problem. Way too many kids were depending on tape to feel comfortable playing their sport, and this is a worrying trend. I turned away at least 50% of the kids because they either:
a) Didn’t actually need taping, or
b) Had an injury that was beyond the point of being safe to play with.
And most were in the former category.
Review of the uses of Athletic Tape:
A while ago, I wrote a blog about the uses of different kinds of taping, which you can read about here. To recap, there are a couple main reasons to tape for participation in Rugby:
1) To provide protection to a contusion: In this application I will tape a foam pad or felt pad to an area (such as the hip bone, or the bursa of the knee) to protect from additional impact.
2) To limit range of motion of a joint: These applications help protect tendon and muscle injuries by preventing the structures from going into full stretch during the game. This is often applied to the groin, hip flexor, elbow, knee or shoulder with a tensor bandage or elastic tape.
3) To provide stability to a laxity in a joint: After a ligament is injured, the laxity, or amount of play, in the joint is usually increased. A very small amount of stability can be added to a ligament with tape (a brace is better), and is usually applied to ankles, knees, wrists and fingers.
One of the major ideas of taping, however, is that it is a short-term solution to a problem, or as I like to call it a Bandaid Treatment. Tape is a fantastic tool to use to help the process of return to play after an injury, however, should not be a life-long requirement to be able to participate in sport!, and can actually promote damage!
Wait... Taping can be BAD for you?
YES! Taping, unless used in specific conditions following a thorough assessment can cause many problems down the road.
1) If tape is assisting in the stability of a joint, then muscles take a break and get weaker! The body likes to take the path of least resistance, so, if something else is doing the job (such as preventing ankle rolling) then the small stabilizing muscles turn off and atrophy. The body is then more prone to injury when tape is not applied.
2) Superman Syndrome: If an athlete has a taped body part, they may feel as though they are ready or able to perform athletic tasks that should be saved for later down the road. Many people depend on tape to protect them, and take un-necessary risks or return to play too early. This allows for re-injury or prolonged recovery of injuries.
3) Psychological Dependency: If an athlete wears tape for a long period of time, they may feel unable to participate in sport if the tape or therapist to apply the tape is not available. If they do participate, they may hesitate in crucial moments, and leave themselves vulnerable to injury that otherwise could have been avoided.
So what should I do if I over-use tape?
My rule of thumb, which I recommended to every single player that I taped this weekend is this:
Assessment and treatment by an Athletic Therapist:
So whenever an athlete approaches you asking for tape, an effective therapist needs to ask the question, "Am I taping to satisfy the injury, or am I taping to satisfy the athlete?"
These past couple of weeks, I have been reflecting a lot about barriers to success. We all have barriers to our goals and our successes, and they vary greatly from person to person. These are barriers to our work goals, barriers to activities and fitness, barriers to our social lives, and barriers to health. These barriers can be very real (or at least perceived as real), or they can be barriers created to explain lifestyle choices. Some of these barriers are firm and permanent, while others are, fortunately, surmountable.
What prompted my reflection was my involvement with the Para PanAmerican Games, hosted in Toronto. I was working with Wheelchair rugby, and I was forced to realize the very real barriers to success that these athletes faced on a day-to-day basis.
Real barriers, such as loss of limb, spinal cord injury, or genetic conditions affecting the ability to use the extremities. Some of these athletes from other countries also faced extreme barriers to adequate healthcare, barriers to financial assistance, and most heart-breaking, barriers to meaningful employment.
The whole experience shifted my perspective and brought the barriers that I had placed on myself into focus. When I reflect upon my barriers they include things like a lack of motivation, or not enough time. Most of my barriers to success fall into the 'excuse' category, and are possible to overcome.
All this reflection reminded me of my amazing support network, and that while it may take work to overcome my barriers, I have the opportunity to make most of my goals a reality (with a little bit of help, of course)!
Each day in my clinic, I experience my patients' barriers. Their barriers often include pain, reduced range of motion, or the inability to complete a specific task or activity. I feel great being support person to help others overcome their barriers, and to help others reach out of their comfort zone, reach out to their own networks, and learn to achieve their goals.
Barriers are knocked down in a few ways. We break them down until they don't exist, we find ways to climb over them, or we learn to love them and succeed despite the challenge!
If you are experiencing a barrier to your fitness or activity goals, whether that barrier is chronic pain, an old injury that's not quite ready, or a need to learn new movement skills, then Athletic Therapy can help!
Find me at my clinic at Moves Fitness in Guelph, and we can work together to reach your goals, regardless of your barriers.
The PanAms are a massive undertaking for any city, and a huge part of that undertaking is ensuring the medical coverage is not only adequate for the athlete, officials, workforce and spectators, but is top notch and up to the challenge!
For these games, there are over 1800 medical professionals, including medical doctors, physiotherapists, chiropractors, massage therapists, and, taking the lead in many venues are Certified Athletic Therapists!
Many of the visiting teams brought medical support with them, however, the medical professionals on the host medical team have access to hospital referrals, advanced equipment, and knowledge of local protocols to ensure that every athlete, home or away, is well taken care of!
That being said, the planning committee has followed the Athletic Therapist's motto: Plan for the Worst, Hope for the Best!
So far, I've been stationed at the Mississauga Sports Centre (AKA, the Hershey Centre) taking care of Judo and Wrestling athletes as they prepare for and recover from their matches. Athletes are invited to use the facility to train in the days prior to their competition, and we are here to respond to serious injuries, but more importantly help with recovery and damage control for chronic conditions.
A great opportunity working with medical professionals from such different backgrounds, and we all have a different way of approaching each individual injury or condition! Taking home new skills to be able to better care for my athletes in my practice in Guelph makes the volunteerism worth it.
The BEST part though? Treating a athlete (even if it's something as tiny as an ice bag) and later watching them step onto the world stage to do what they do best! While the athletes are training hard and giving their best, I like to think that the treatments and TLC that we offer are helping to create the best environment for athletic performance.
Today I watched one of the athletes that I worked with while at the University of Guelph compete in the Greco Roman wrestling competition, and got a overwhelming sense of having been part of something bigger, even though my part in his athletic journey was minuscule. Hopefully as I progress through my career, I have more opportunities to help athletes do what they do, by doing what I do best!
One of the biggest things that I learned when studying to become an Athletic Therapist was that we always have to look beyond the injury that is presenting at an initial assessment, and instead look at the entire person! A phrase that has stuck with me was to 'find the athlete within, and bring that athlete back'. This means that no matter what the injury, my job as a therapist is to help you modify your activities to maintain uninjured areas, and ultimately set realistic goals to return to pre-injury activities and sports!
This week I came across three athletes who were so busy taking care of their injuries, that they forgot about the athlete within, and it made me very sad.
These first two are High school aged football players who are currently not playing:
1: I can't run more then a lap since my shoulder surgery, and my legs are jelly. Fall season will be hard when I get back.
2: Ever since I hurt my shoulder 2 years ago, I haven't done squats because I can't put the bar on my shoulder.
This one came from a friend of mine who desperately would like to return to daily activity:
3: My doctor told me to rest until my carpal tunnel starts to get better.
This individual interpreted the instructions as total body rest, and despite receiving treatment for her wrist, has never asked about a total body rehabilitation program!
The Athletic Therapy Approach
This year's Athletic Therapy month is extra exciting, as it's my first in my new clinic located at Moves Fitness in Guelph! I am pumped to be able to share knowledge of my profession with members of the gym, and with members of the community!
The theme of June 2015 is a song that we've been singing for a long time: Athletic Therapy is for everyone! While we're a profession that is famous for our members on the fields of professional and university teams, we are also able to help anyone with a musculoskeletal injury (muscles, bones and joints) as well as head injuries, and general fitness goals!
This month, my goal is to educate as many individuals about Athletic Therapy as I can! I will be sending info packages to local sports teams, schools, organizations and companies telling them what Athletic Therapy can do for their safety, rehabilitation, and continuing health!
If you are interested in more information, or would like to bring an information package to your family doctor, get in touch at email@example.com and I will be happy to provide you with some materials!
The body, and the major joints in the body, need to be mobile enough to do the work that we want it to, but also be stable enough to support itself and also whatever it's carrying. For example, our shoulder must be mobile enough to reach over head during a baseball pitch, but also enough stability to transfer forces from the entire body to the ball to produce propulsion.
Division of Labour
The major joints of the body can be divided into 'stable' joints and 'mobile' joints. A simple description of this is as follows:
Ankle — Mobility
Knee — Stability
Hip — Mobility
Lumbar Spine (Low Back) — Stability
Thoracic Spine (Upper Back) — Mobility
Scapula (Shoulder Blade) — Stability
Gleno-humeral (Shoulder Joint) — Mobility
This is an over simplification of the principle, but helps to understand the concept.
What happens when it goes wrong?
The body loves to compensate when things go wrong. We are able to adapt for an injuries body part by working harder in other areas. Ideally, when the injury is resolved, so will the compensations, but this doesn't always happen without a helping hand.
An Example: Low Back Injury and Pain
The low back is made up of 5 lumbar vertebrae, and the attachment to the sacrum (tail bone) and illia (pelvis) via the sacroiliac and lubrosacral joints. The low back should be a stable area of the body, with stability being provided by strong ligaments, boney arrangements, and muscular strength.
Sometimes this goes wrong, either from a traumatic injury, decreased strength of core stability musculature, or a strenuous posture over a long period of time. The low back becomes a mobile area due to the dysfunction.
So what happens then?
Sometimes a low back dysfunction does not actually present as pain, in fact we may not even know that there is a problem until weeks or months later!
Often the pain will arise first in the hip joint (which can be felt in the bum, groin, or side of the hip), or in the upper back or neck. These areas that are designed to be mobile will over activate, stiffen up and become more stable to compensate.
Sometimes a problem is not where the pain is! My objective as an Athletic Therapist is to find the CAUSE of the dysfunction, which may be in the joint above or below where the pain is. If a stable joint is too mobile, or a mobile joint is to stiff and stable, some other area in the body may be causing the compensation.
If you've been treating an area of pain with little or no decrease in symptoms, perhaps you are focussing on the wrong area, and the dysfunction is actually arising from somewhere else. Book an appointment with me at my clinic in Guelph, or call and I can refer you to someone in your area or a thorough orthopaedic assessment.
Every athlete I know either has a foam roller, or wishes they did! These rollers come in many shapes and forms, from 3 foot long dense foam cylinders, to kitchen rolling pins, to fancy fabricated tubes that double as a kit carrying case.
But does everyone really know how many uses their foam roller has? This blog is to show you the three main categories of foam roller use, and a few examples of application!
Alana Gulka Athletic Therapy is now Guelph Performance Therapy.
These blog posts will remain as an archive, but no new posts will be made.
Please visit Guelph Performance Therapy for more information and up to date blog posts!