By Dr. Robyn Prescott, Naturopathic Physician

Fall this year has taken everyone by surprise with the rapid transition from a glorious warm sunny summer to this cold and blustery bold statement that fall has indeed arrived. Many of my patients are expressing how recently they have been feeling low, a bit more fatigued then normal, and just uneasy with the transition. Even in myself I have noticed urges to stay in bed longer, hibernate, and curl up under a warm blanket with a cup of tea. This led me to write this blog about how you can warmly accept fall.

I love fall – but sometimes the transition to a different state takes a bit of time and there are some ways to make this season change easier and a positive experience.

Try to take a moment to incorporate these small changes:

1. Eat warming foods – your digestion requires lots of blood flow to process your food and during the colder days your body needs to use more energy to produce heat. Warm up your digestive system with herbs and spices like ginger, turmeric, chipotle, and cayenne to help your system’s internal heater. How I have done this is through making vegetarian curries, burrito bowls, and squash or chicken noodle soups. Sometimes I find this is a nice time of the year to do a short diet change. My husband and I are currently doing 2 weeks of vegetarian/vegan to help reset and get back into a healthy schedule.
2. Drink more tea – now is the time to order your favorite teas – one of my absolute favorites for this time of year is the Traditional Medicinals ginger. Ginger tea is warming and also very helpful for digestion. Other good options would include chai tea or other teas with cinnamon, cloves, and cardamom.
3. Candles – as the sun sets earlier it is important to light and warm your spaces with the yellow glow of candle light. Often I find treating yourself to a pine or spruce scented candle can lightly scent your space and help you relax and accept fall. Of course please use your personal judgement as some patients can be highly allergic to scents. Make sure it is safe for you. I typically buy soy or beeswax candles – one of my favorites is the North Shore candle by Vancouver Candle Co.
4. Warm and fuzzy blankets – on a rainy day nothing is more satisfying then taking the time to curl up under a warm blanket sipping a cup of tea with a good story. Consider reading that book you have been meaning to all summer or go and treat yourself to thought provoking novel. I find myself gravitating towards books like 7 Habits of Highly Effective People or Blink to stimulate my mind and get it ready for powering through the next few months ahead.

If none of these things help – maybe there is more to the story? Seasonal Affective Disorder is when you have felt depressed for two or more consecutive winters and you feel significantly better in the spring and summer. Typically there are some compounding factors that should be considered that may be the underlying cause of your low mood:

• What are your vitamin D levels? I always check vitamin D levels in patients at risk of SAD. Low levels are highly correlated with an increase in mood disorders.
• Serotonin levels? Questionnaires or seeing your doctor can help determine what neurotransmitter you may be low in. Serotonin is one often contributing to SAD. To help this I have had great success with herbs and nutrients specific to build neurotransmitters.
• What is your circadian rhythm doing? Often sleep quality and length are important for a healthy and happy mind. There are specific nutrients we can use like 5-HTP, theanine, and magnesium glycinate to name a few that help to reset and promote a healthy circadian rhythm. For more info on circadian rhythm see my next blog post!

 

Happy fall nesting!

 

With love,

Dr. Robyn

Movéo is hosting its first ever health and wellness series! Our practitioners will be sharing their passions, teaching various interactive classes on different topics and answering any questions that you may have! If you’ve made any new years resolutions, this may be a good complement to help you achieve them! From yoga to Traditional Chinese Medicine (tongue and ear diagnoses), you won’t want to miss out. Classes will take place on Thursday nights and Saturday mornings at Movéo. There is limited space so be sure to call the clinic (604-984-8731) early in order to reserve your spot for any of the classes. As a bonus, you’ll receive 10% off your next treatment at Movéo! It’s a win-win, so please come join us! The Movéo Team is looking forward to being part of your 2016 health and wellness journey.

Written by Student Kinesiologist Janice Leung

Hitting the gym, figuring what to do and how to do it safely can be a daunting combination. Sometimes the easiest solution beyond googling and searching on YouTube is just taking a peek at what others are doing in the gym. Unfortunately, “monkey see, monkey do” is not always the brightest. Even when the person next to you is doing something that is safe, it might not necessarily be a suitable exercise for your body mechanics, injury history, etc. So here are 5 common exercise mistakes that I see in the gym all the time.

 

1. Rotator Cuff Exercises

 

 

 

 

 

 

 

 

I’ve seen countless iterations of exercises intended to strengthen the rotator cuff muscles of the shoulders. Unfortunately, rarely any of them are done correctly. One gut wrencher that I’ve seen is wild arm circles with 5lb plates. I’ve seen a powerlifter, who I highly respect, perform the movement. Perhaps there is merit and a reason behind it. But as mentioned before, the common fault is when people copy what others do without proper consideration of what the exercise is trying to accomplish and whether it is appropriate for them. The other very popular “go-to” warm up exercise is grabbing dumbbells or weight plates and externally rotating (as pictured above). This is all fine and dandy, but the truth is, it’s not accomplishing what most think that it’s accomplishing. Yes, you are externally rotating your shoulder, but think about how you’re working against gravity. You’re just using your bicep muscles to hold the weight up and taking the weight through a range of motion of external rotation. Simply bringing your elbow up to shoulder height and doing the same movement will target the external rotators more efficiently.

 

 

 

 

 

 

 

 

Alternatively, grab a resistance band or use a functional trainer cable machine and do the same. Take note that this changes the resistance that you’re working against. Now you’re working against a horizontal force that is actually resisting external rotation, i.e., your external rotators will be the primary muscles targeted.

 

 

 

 

 

 

 

 

 

2. Foam Rolling

 

 

 

 

 

 

 

 

 

Let’s be real here. Foam rolling tight, sore muscles is never fun and can be down right painful. There’s no easy way around it. This is why it’s common to see people, myself included, to be rolling too quickly. Unless you’re a proud masochist, it’s almost natural to roll muscles too fast because it’s just not comfortable. But think of it this way. When you get a massage, does your massage therapist quickly reef on your muscle a couple of times and then move on? No. In the same way, roll slowly. Thomas Myers, the author of Anatomy Trains, says, “Your muscles need time to get used to this sensation to allow the nervous system to actually relax and reduce tension.” If you simply can’t tolerate the pain, try releasing specific points or very small areas while taking in a couple of deep, slow breaths.

Watch Physiotherapist Dr. Erson Religioso’s video about breathing to release trigger points:

 

3. Leg Swings

 

 

 

 

 

 

 

 

 

 

As a former competitive track athlete and assistant high school track coach, I’ve seen many different leg swing variations as part of warm-ups and/or cool-downs. I never really realized the issue until I attended a weekend course from The Running Clinic. Then I saw Dr. Ryan DeBell of The Movement Fix post a great video on the same issue. Leg swings seem harmless because it’s a dynamic movement and the absence of pain tells an athlete that they’re doing it right, along with sensation of stretch through the groin, hamstring and hips. However, as Dr. DeBell discusses, this movement should in fact, be solely isolated to the hip joint. What often happens is that the lower back becomes involved and may have too much flexion and extension, especially as athletes involve the swinging of the opposite arm to reach their toes. I’ve been guilty of this as well. When we try to increase the range of motion of our swing, we often compensate by introducing too much movement through the lower back. Dr. DeBell gives a great tip: you can simply put your hand on the small of you back while you swing, so you can make sure that there’s minimal to zero movement through your back.

 

 

 

 

 

 

 

 

 

Watch Chiropractor Dr. Ryan DeBell explain and demonstrate how to perform leg swings properly:

 

4. Scapular Movement in Push Ups

 

 

 

 

 

 

 

 

 

A lot can go wrong with the push up, but I’ve chosen to specifically talk about the scapular movement. It’s not necessarily wrong, but what a lot of people do is that they lock down their shoulder blades or scapulae in retraction, i.e., squeezing the shoulder blades together. When people do this, they’re missing out on scapular protraction, i.e., shoulder blades moving away from each other, and using a muscle called the serratus anterior. In general, scapulothoracic rhythm is coordinated movement between the scapula and humerus (Blanton, 2012). If the scapulae are locked down in retraction, then you are likely missing out on that. As Eric Cressey of Cressey Sports Performance explains, this could lead to problems in the long run.

 

 

 

 

 

 

 

 

 

Watch Strength and Conditioning Coach Eric Cressey explain further about scapular movement during the push up:

 

5. The Eccentric Phase

 

 

 

 

 

 

 

Generally speaking, it’s a common mistake to speed through the eccentric phase of exercises. There may be exceptions if you’re training according to a specific protocol or specific goals. But for those that aren’t familiar with what the eccentric phase is, think of any exercise working in 2 phases: 1. contracting and shortening muscles generally against gravity, i.e., concentric phase, 2. contracting and lengthening muscles in the same direction that gravity works, i.e., eccentric phase. In the squat, the eccentric phase is when you bend your knees and lower your hips down. In a standing cable triceps extension, the eccentric phase is when you’re bending your elbows to return to the starting position. (You’re working in the same direction that gravity works because the weight stack is being lowered down).

 

 

 

 

 

 

 

I have clients that speed through their repetitions because they simply want to get it over with and reduce the discomfort they feel as their muscles fatigue. As much as that makes sense, not only can rushing through the eccentric phase prevent you from getting the most bang for your buck, in time and effort spent exercising, it could potentially increase risk of injury. Eccentric contractions lead to more muscle damage and hypertrophy, i.e., muscle growth (Poliquin Group™ Editorial Staff, 2012), which is a good thing. It might be hard to keep your tempo slow, but it ensures better technique and strength gains!

 

If you are unsure of whether you are doing exercises right, always consult your health professional first. With that being said, hopefully you may have learned something new within those 5 exercises discussed to prevent injury and improve performance.

 

References

Blanton, D. (2012, Sept 5). When Coaching Cues Attack! “Packing the Shoulder”. Retrieved from http://bretcontreras.com/when-coaching-cues-attack-packing-the-shoulder/

Poliquin Group™ Editorial Staff. (2012, Sept 6). Ten Things You MUST  Know About Eccentric Training To Get Better Results. Retrieved from http://www.poliquingroup.com/ArticlesMultimedia/Articles/Article/923/Ten_Things_You_MUST_Know_About_Eccentric_Training_.aspx 

Written by Student Kinesiologist Janice Leung

“Sitting is the new smoking.”

This probably isn’t the first time that you’ve heard that statement. It’s been a recent growing message in the health industry. Even with the rise of standing desks that are becoming more and more popular for office workers, a big barrier is the hefty price. Matt Gereghty of areyouergo.com runs a blog all about ergonomics and sitting. He has a blog post that shows some innovative ways to use home furniture to create a makeshift standing desk. But if you don’t work at home, and you’re looking for other ways to combat bad sitting posture, keep reading.

It’s unfortunate, but the reality is that for some of us, whether we are students or employees whose jobs involve seated work for long hours, we sit. A lot. Add in the time spent sitting in the car, on the bus, at meals, at home, and the truth is there. We sit. A lot.

Even though I work in the healthcare industry and know fully well how sitting posture can have negative impact on health, whether it’s metabolic, cardiovascular or musculoskeletal, I too, sit in terrible postures. Sadly, I confess that I’ve done many marathon study sessions with friends and we all turn into different variations of the Hunchback of Notre Dame. I’ve seen my friends, hour by hour, cringe closer and closer to their laptop screen until they’ve become the Hunchback. Their upper back is rounded and their neck is stuck far more forward than it ever should be. If you spend long hours sitting and working at the desk where stress builds up and fatigue sets in, it gets easy to throw proper posture out the window because getting your work done is all that matters. But over time, this can lead to chronic pain and quite disabling injuries.

So the question remains, what can you do?

The answer is simple. The 5 exercises below can relieve chest tightness, strengthen muscles to improve posture and help you look more like a superhero and less like the Hunchback of Notre Dame.

 

1. Towel Lying

 

 

 

 

 

 

 

Why: After trying this for the first time, it’s more like, why not? Sitting and working at the desk for hours easily tightens muscles through the chest and shoulders. This simple exercise is the antidote for reversing all the wound up muscles.

How: 

• Lie on a foam roller (it can be a half foam roller or tightly wound up yoga mat which will decrease the amount of stretch due to decreased leverage) and make sure to align yourself so you make contact with the back of your head and tail bone on the foam roller.
• Keep your feet on the floor and knees bent. Open your arms out in a “T” shape.
• You can bring your arms lower if it’s too intense of a stretch. Or, start to bend your elbows to 90 degrees to increase the intensity and modify the angles of the stretch.
• You can play around with the amount of bend in your elbows and where you place your elbows in relation to your shoulders, as long as you feel a gentle stretch without pain.
• Relax, focus on your breathing and hold for 1-5 minutes.

 

2. Chin Tucks

 

 

 

 

 

 

 

 

 

Why: Yes, you’re making a double chin. But if reducing neck pain is a priority of yours, I guarantee that it’ll be worth it. Performing this exercise activates the deep neck flexors at the front of your neck, while decreasing the tension in your suboccipitals and other muscles behind your neck, which get overstretched when your neck is protruding towards the computer screen. This is a monumental basic exercise that can be incorporated into many other exercises because it helps to keep the cervical spine in check to complete your neutral spine. If you’ve ever heard of “packing the neck” in a deadlift, this is how you do it.

How:

• Stand tall, roll your shoulders back and bring your shoulder blades back and down, i.e., away from the ears with a slight squeeze between your shoulder blades.
• Keep your head in a neutral position as you pick a spot straight ahead to focus your eyes on. Pull your chin straight back gently without tilting your head up or down.
• Hold 2-3 seconds and then relax. You can put two fingers just below your chin to make sure that you’re not tilting your head as you perform the chin tuck.
• Do 10 repetitions, 2-3 sets. Alternatively, throw in a set throughout the day, like when you’re in the car or sitting on the couch.

 

3. Brugger’s Relief Position

 

 

 

 

 

 

 

 

 

 

Why: It teaches you to engage the shoulder blades and pull the shoulders back instead of rounding forwards. Having your arms by your side also helps to open the chest up.

How: 

• Stand tall, roll your shoulders back and bring your shoulder blades back and down, i.e., away from the ears with a slight squeeze between your shoulder blades.
• Have your arms by your sides with palms facing forward.
• Squeeze between your shoulder blades, like you’re squeezing a pencil between them, without raising your shoulders towards your ears.
• Hold for 2-3 seconds and then return to the starting position.
• Do 10 repetitions, 2-3 sets. Alternatively, throw in a set every hour or so while sitting. Once you get comfortable, incorporate the chin tuck at the start of each repetition.

 

4. Dowel Hip Hinge

 

 

 

 

 

 

 

 

 

 

 

 

Why: Call me a mad scientist, but even though you’re not deadlifting a heavy barbell at your desk, I believe that there’s merit to practicing your hip hinge for improving desk posture. If you watch Dr. Kelly Starrett, the creator of MobilityWod, he talks about setting up for desk work or even texting just like you would for a deadlift. You definitely (or hopefully) won’t be bent over your work space as in the ending position picture. But the idea is that when you have to lean forward while sitting at the desk, e.g., for writing, you lean from the hips while maintaining a neutral spine and not from the upper back or neck.  This exercise will give you more awareness of your posture from the waist up.

How:

• Stand with feet shoulder width apart and a slight bend in the knees.
• Hold a dowel (or broomstick) behind your back with one hand above the head with palm facing forward and the other hand at your lower back with palm facing backward.
• You should feel 3 points of contact with your head, upper back and tail bone area.
• Maintain this neutral spine position as you hinge at your hips by pushing your hips back and lowering your chest towards the ground. Go as far as comfortable, feeling a stretch through the hamstrings.
• Squeeze your glutes to return to the starting position. If you’re having trouble maintaining contact with the dowel, make sure to keep your chin tucked (aha! What a keeper that exercise is) and shoulders pulled back.
• Do 10 repetitions, 2-3 sets.

 

5. Shoulder W

 

 

 

 

 

 

 

Why: When you’re sitting at the desk, it’s very easy to hike up your shoulders and overuse the upper trapezius muscles in addition to rounding the upper back. This exercise strengthens the external rotators of the rotator cuff muscles in addition to activating more of the lower trapezius muscles rather than the dominant upper trapezius muscles. This exercise also reinforces good shoulder blade positioning. You can watch Physiotherapist Mike Reinold demonstrate this exercise.

How:

• Start by rolling your shoulders back to make sure that you’re in a good starting position.
• Flex your elbows at 90 degrees and hold a resistance band at about shoulder width apart with your thumbs up. Bring your hands up slightly so your forearms are not parallel with the ground.
• Pull the band apart, forming a “W” shape from hand to hand.
• Hold for a 1-2 seconds, and then return to starting position.
• Do 10 repetitions, 2-3 sets.

 

Extra Tips

Take very short active breaks!

One of my favourite professors is the only professor in the Biomedical Physiology and Kinesiology department to get the class up for stretch breaks every half hour during our lectures. He encourages it even when we write our 3 hour final exams. If you decide to do this, the stretch breaks don’t have to be long. They can be as short as 30 seconds to 1-2 minutes just to shake things out and get blood flowing through stagnant muscles. If you want to get fancy, you can check out Bret Contreras’ article and slyly incorporate the glute squeeze or crucifix stretch without attracting too much unwanted attention. Recent research has actually showed that taking brief 2 minute walks every hour decreases the risk of premature death by 33%!

Make a to-do list!

Like most busy people, I find excuses not to put effort in doing extra postural exercises when working for long hours at the desk is already taxing enough. But it might help to keep a note posted somewhere visible in your work area with a short list of some of these exercises or other stretches. When you see the list, you’ll be cued to remember that you should do these things. Once you start doing them more often, they’ll become routine. And once you reap the benefits from them, it’ll be easy to turn them into habits.

 

If you can begin incorporating these exercises into your daily routine, you’ll be able to decrease any aches or pain from sitting at the desk for too long. Remember, before starting any exercise program, always make sure to consult with your healthcare professional.

Written and Edited by Student Kinesiologist Janice Leung with contributions from Dr. Kim Graham, Dr. Jenn Turner, Sonya Scheer and Jason Shane

“The pain in my knee hasn’t gone away. I think I have an injury. Should I see a physiotherapist or chiropractor? Massage therapist? What about an acupuncturist (Doctor of Traditional Chinese Medicine)?”

Does this sound familiar to you? When a nagging ache or pain doesn’t go away, it’s a debacle that everyone faces. With the rise of the internet, googling about an injury is an easy knee-jerk reaction. Even with the plethora of information on the internet, it can be overwhelming and confusing to determine what will help you to recover the fastest and return to pain-free frolicking (the frolicking part is always optional).

At Movéo Sport and Rehabilitation Centre, we approach patient care as a unique multidisciplinary team that includes several therapies and treatment modalities. Sometimes we have patients that are still unsure about who would be most appropriate to see, or especially what each therapist does. Today we’ll be going through each type of treatment at Movéo to dispel common misconceptions and give insight to what they can do for you.

 

MOVÉO ACUPUNCTURE (TRADITIONAL CHINESE MEDICINE)

What it is: Traditional Chinese Medicine (TCM) is more than just acupuncture. Although acupuncture is the most well-known practice of TCM, the practice of TCM includes the use of herbal and dietary therapies, as well as massage (tui na and acupressure) and exercise prescription. TCM and Acupuncture are not only for adults; children can benefit from them too!

What it isn’t: Acupuncture isn’t only for pain. Many illnesses may be treated using acupuncture including digestive disorders, gynecological/menstrual disorders (infertility, PMS, menopause, etc.), mental/emotional concerns (anxiety, depression, post-partum, etc.), migraine headaches, and stress management to name a few.

 

MOVÉO ACTIVE REHABILITATION 

What it is: Active Rehabilitation at Movéo involves one-on-one sessions with a Kinesiologist that will create individualized programs to return clients back to work, sport and daily activities. Clients will learn how to move with correct posture, body mechanics and proper technique to maximize recovery and prevent re-injury.

What it isn’t: Active Rehabilitation at Movéo isn’t just for those that have sustained a motor vehicle accident (ICBC Claim) or work place injury (WCB Claim). It can be for anyone that is struggling with injuries and would benefit from an active approach to injury rehabilitation. It isn’t just general strength training either. The goal is to ensure that clients receive the knowledge base and tools to continue exercising and functioning at home or at the gym and avoid future injuries.

 

MOVÉO CHIROPRACTIC

What it is: Chiropractic involves a broad scope of practice that includes but is not limited to Active Release Technique®, Graston Technique®, and rehabilitation exercises. Chiropractors will work with patients to determine and correct the sources, not solely the symptoms of an injury.

What it isn’t: Chiropractic at Movéo isn’t limited to adjustments. Rather, they are utilized when most appropriate in conjunction with other techniques. Movéo Chiropractic isn’t “once-you-start-seeing-a-chiropractor, -you-have-to-keep-going-type-of-chiropractic”. We like to find the problem and fix it, or work with a different type of therapist that can!

 

MOVÉO MASSAGE THERAPY

What it is: Registered Massage Therapy is the assessment and treatment of soft tissue to prevent injury, pain and physical disorders. Massage Therapy will treat symptoms by addressing the underlying cause of pain and dysfunction. Massage Therapists use hands-on techniques that can provide immediate relief, as well as long term benefits by working on the muscles, fascia, ligaments, blood vessels and nervous system. At Movéo we are all dedicated to educating you on injury prevention and management techniques. We work together with our Kinesiologists, Chiropractors, Physiotherapists and Traditional Chinese Medicine Doctor to provide a team approach for your health.

What it isn’t: Registered Massage Therapy isn’t just for relaxation. Therapeutic techniques can be used to relax the nervous system or energize it. Do you have an upcoming sporting event? Massage Therapy will increase circulation, improve response time and prepare your muscles for action.

 

MOVÉO PHYSIOTHERAPY

What it is: Physiotherapy is finding the cause of a person’s pain and not just treating the symptoms. Physiotherapists use a hands-on approach to clinically assess and diagnose injuries and dysfunctions. Movéo Physiotherapists have extensive post-graduate training in many topics including sport and orthopedics, as well as post-surgical rehabilitation.

What it isn’t: Physiotherapy isn’t just home exercises. Physiotherapists are also trained in soft tissue massage, joint manipulations and dry needling, and incorporate each when appropriate for the patient.

 

THE MOVÉO TEAM

What it is: A group of like-minded therapists from different backgrounds that collaborate through close communication and teamwork to ensure that each patient capitalizes on the specialties of the therapies available to them at our unique clinic.

What it isn’t: The team isn’t a collection of super practitioners to attract patients. Nor does it mean that a patient must receive treatment from every type of therapy offered at Movéo. There is neither a single best type of therapy nor specific combination of therapy that is necessary for every patient. The coordinated effort of the multidisciplinary team guarantees that each patient receives the appropriate individualized treatment at the right time.‎‎ The team concept also means that we will communicate with you and your medical team to ensure that everyone is working towards a common goal.

 

If you want to learn more, explore our website to see all the services that we offer. Also feel free to peruse our online booking system, which will allow you get to know more about each of our practitioners through their bios!

Written by Physiotherapist Amanda Sin, Edited by Student Kinesiologist Janice Leung

Compare mountain biking to biking on the road, and for most road cyclist beginners or novices, their hearts may skip a beat or two if they aren’t natural adrenaline junkies. It’s hard to fathom how mountain bikers can navigate tree roots and rocks while flying down a decline or curve. The thought easily brings an ache despite the chamois pads in cycling shorts. Riding a bike gives you the sense of freedom to explore where you want while covering lots of ground. But maybe sometimes it gets a bit too monotonous riding on the road for hours. If you’re curious to mix things up a bit and try your wheels in the realm of off-road riding, here are 5 tips to help you have an easier transition into the mountains and beyond.

1. Look ahead and towards where you want to go.
Your bike will go where you’re looking, so don’t stare at the obstacle that you don’t want to hit. Look ahead at the line you want to take and your bike will go there.

2. Stand up.
When going downhill or over obstacles, stand up out of the saddle. This will give you more control and stability. Keep your arms and legs relaxed. As the terrain gets steeper or more obstacles appear, increase the bend in your arms and legs to increase stability.

3. Modulate your braking.
Be familiar with which brakes are for your front and rear wheels respectively. Your front brake is more powerful and will slow your bike down more than the rear brake. If you simply don’t want to go any faster, mostly use your rear brake. If slowing down is the priority, then use more of the front brake. Think of your brakes as dials that can be turned up and down, as opposed to on and off. This allows you to control the bike while slowing down in a controlled manner.

4. Move forward when climbing a steeper hill.
As the hill gets steeper, moving your weight forward on the saddle will help to keep both wheels on the ground and it’ll be easier to control your bike.

5. Be prepared.
Always leave home with a tool kit that will allow you to change a flat tire and tighten bolts on your bike should they become loose. Also, make sure you bring adequate food and water for the duration of your ride.

About the Author
As a member of the Canadian National Mountain bike team, Amanda has represented Canada at many international events. In 2011 she won a bronze medal at the Pan American Games, and in 2012 qualified to the Olympic Selection Pool for the London Games. Amanda joined the team and has been working at Movéo since March, while still instructing and racing on her bike!

 

Written by Student Kinesiologist Janice Leung with contributions from Dr. Kim Graham, Dr. TCM, R.Ac

The weather on the west coast has been great and a lot of recreational cyclists have been out and about. If you’re not a seasoned cyclist, it might be easy to make rookie mistakes and end up sidelined with an injury. Although cycling is considered low impact, there are still many injuries that can occur especially due to prolonged postural adaptations and repetitive limb movements (Callaghan, 2005). Injures are not limited to but often include those involving the knee, IT band, neck and back (Mellion, 1991; Callaghan, 2005). If you’re experiencing some pain on long rides, a few tweaks to your posture will probably prevent them from turning into full-fledged injuries. Here are 6 tips to help keep you riding healthy and happy.

1. Resetting your neck position every so often.
Your neck is an integral part of your spine and it’s important to try to maintain a neutral spine and avoid hyper-extension or -flexion. You can incorporate a chin tuck to reset your neck position. Try to imagine a string from your upper back that goes straight through the top of your head. Keep the string straight and taught and when your head is in a neutral position, i.e. your chin is positioned in between extremes of being too far or too close to your chest, make a double chin.

2. Resetting your upper back position every so often.
It’s easy to just bear down, focus on your pedal strokes and forget about your upper back. Wearing a backpack makes this worse as you’re more prone to shrugging or rounding your upper back to compensate for the weight, especially on uphills. Think about performing a “scap push up” where you protract your scapulae (bringing your shoulder blades towards the outsides of your rib cage) and then retract your scapulae (pulling your shoulder blades down back). This can help as a reset to bring your upper back into a better position.

3. Keeping “soft” elbows, not hyperextending, especially on downhills.
Think about keeping your elbows slightly flexed and tucked in by your sides. I found myself hyperextending a lot when I first started riding and got sore elbows, but making this tweak to my posture helped solve the problem right away.

4. Be mindful of your knee tracking.
There are “normal” variances of pedal stroke, but most importantly watch for the extremes, such as wide-leg-knee-out or knock-kneed positions. Although knock-kneed is normal for some cyclists, proper alignment and pedaling mechanics dictate an “up and down” motion to be most desirable. Pedaling drills, along with assessment and treatment for any contributing physiologically limiting issues, e.g., hip, back, etc., will only help you to be more efficient and limit knee problems.

5. If riding for long bouts of time, consider gloves with specific palm padding and / or switching hand positions every so often.
Some common injuries in cyclists involve compression of nerves, such as the ulnar and median nerves, from prolonged pressure from the handlebars. Numbness and tingling in the fingers and hands may occur. This can be prevented by switching from the drop-down handlebar to the hoods or other positions every so often. There are also cycling gloves sold with padding in specific locations where the nerves are normally compressed to give more cushioning to reduce chances of irritating the nerves (Rehak, n.d.).

6. Get a bike fit.
Although this is an extra cost to your already expensive bike and bike gear, it’s definitely worth it to have a professional adjust your bike to be personalized to fit your body. Even if you initially feel like riding your bike is completely comfortable, after some time, aches and pains may start to appear. As well, your saddle and seat height are big factors that affect the amount of flexion through your lower back. So if you tend to have issues with low back pain, make sure you get a bike fit in addition to professional help to ensure that you aren’t having issues elsewhere, such as in your hamstrings. For me, the most pivotal changes included actually being able to fully grasp the brake levers from the hoods (talk about safety) and a decrease of neck tightness after I got a bike fit.

Concluding Remarks
With all that being said, do your best. Sometimes neck posture or back posture inevitably goes out the window when you’re struggling up a massive and long hill. But by keeping these few tips in mind and adjusting your posture throughout your long rides, it’ll help to stave off injuries that force you to take time off the road.

If you ever have any concerns or questions, always consult your health professional. Make sure to stay tuned for the next blog post on tips for mountain biking from Movéo physiotherapist Amanda Sin, who has a national competitive background in mountain biking.

References

Callaghan, M. J. (2005). Lower body problems and injury in cycling. Journal of Bodywork and Movement Therapies, 9(3), 226-236. doi:10.1016/j.jbmt.2005.01.007

Mellion, M. B. (1991). Common cycling injuries. Management and Prevention. Sports Med, 11(1), 52-70. doi:10.2165/00007256-199111010-00004

Rehak, D. C. (n.d.). Cyclist’s Hands: Overcoming Overuse Injuries. Retrieved from http://www.hughston.com/hha/a_15_3_2.htm

Written by Student Kinesiologist Janice Leung

Last week I discussed some of the research behind compression socks in Part 1. If you missed out, you can find it here. This time I will be talking about the differences between compression socks and sleeves and share my own experience. Let’s get right to it.

So, Socks or Sleeves?

In reality, the only difference between socks and sleeves is that the compression will only start above the ankle when wearing sleeves. You may find out that you simply prefer one over the other. However, wearing sleeves for racing allows runners to wear their favourite lucky racing socks. Plus, imagine having to stuff your hot, swelling feet into full socks in the transition from swim to bike or bike to run during a triathlon. It would be less tricky to pull on calf sleeves than socks. For minimalist lovers, sleeves will allow them to still wear Vibram Fivefingers. Injinji now actually makes toe compression socks in addition to a whole variety of toe running socks, so runners can wear their Vibrams and receive compression through the feet. Although there are different opinions on wearing compression sleeves for racing and recovery, it may be best to wear sleeves only during exercise so that blood does not pool in the feet during more static recovery.

Take note that there are specific brands and models of sleeves that are meant for post-workout recovery. For instance, CEP does not advise customers to use their calf sleeves for recovery because their compression grade increases blood flow during activity, but not during rest. Now they have made specific recovery socks, just like other companies such as 2XU.

When purchasing socks or sleeves, look for those with graduated compression. It is better than constant compression because there is decreasing compression from the ankle to the knee which makes it more effective. Look for sleeves or socks that have around 20 mmHg as their medical compression grade. Sometimes the compression grade may be listed as a range, ie. “15-20 mmHg”, which indicates that it is 15 mmHg at the calf and 20 mmHg at the ankle.

My Experience During Workouts:

Socks:

I have unfortunate large muscles for the small anterior and posterior compartments in my lower legs, so when my calves are tighter than usual and they begin to tighten and swell, the socks can give quite a squeeze. At first, I thought that maybe I was just not well suited for compression socks. But I gave a few more tries and ended up liking it. I find that my calves adjust after 10 minutes or so, and then they don’t feel overly constricted and actually feel good! Usually I find that my calves (as well as the tibialis anterior muscles) feel well recovered and not overly fatigued or sore for workouts the following day.

Sleeves:

I never considered wearing sleeves, but my friends had them and seemed to like them. So when they went up on sale, I thought, why not? When I first wore them on a run, contrary to everyone’s concern about the sleeves, I didn’t feel like my feet were pooling with blood or, on the other end of the spectrum, feeling numb. I was quite aware that my feet were not receiving the compression love, as there was quite a contrast in tightness between my calves and feet. However, I still felt the same benefits as wearing compression socks once I felt adjusted to them. Again, the day after wearing them, my lower legs feel ready for another challenge. Perhaps if you suffer from any feet pain such as plantar fasciitis or Achilles tendinopathy (tendonitis), it may be better to use socks to receive compression below the ankles as well. Note however, that different brands will have different sizing or comfort. I found that Zoot recovery socks don’t give enough compression in my small feet and through my arches. Currently, I’ve found performance 2XU socks to do pretty well.

Post workouts:

Socks

After strenuous workouts or long runs, I try to make sure that I get my recovery specific socks on for at least a few hours if possible. I can secretly also feel a tad less guilty if I do not have the time to roll or stretch, and justify that I am putting in some effort for recovery and prehabilitation. I have not tried recovery specific sleeves before, so I can’t comment on them.

Conclusion

Whether you wear the socks during or after races and workouts, and they make you feel better and perform better, then no one is to say that they do not work for you. The bonus is that while you know people in their cars are staring at you as you cross the street, you can hold your head up high and jaunt effortlessly in epic, professional looking running gear. If you are looking for any advantage and have the budget, find and test out the brand and type of socks or sleeves that work best for you. My advice is that if your running performance is quite important and you have troubles with tightness below the knee, try it out. Wear them in a variety of workouts to determine how they feel for you and how it affects your running. Then you can decide whether you want to race in them or not. If you plan to race in compression gear, train like you race; wear your socks for key workouts to simulate race conditions. Ultimately within the current research, there is no definitive verdict as to whether compression socks truly boost your performance levels or not. But at the very least, these socks surely help with recovery and can help decrease muscle soreness.

Movéo sells Compressport full socks and sleeves.

Written by Student Kinesiologist Janice Leung

These days, it is not uncommon to see runners sporting an assortment of high knee socks at races, or on the sidewalks through your car window. As many professional runners have now donned the compression calf sleeves or full socks, many have followed suit in hopes of enhancing their performances. However, the question remains whether or not there is true benefit to wearing such head-turning socks.

Whether it is compression socks or full compression tights, the main principle is to increase blood and lymph flow while preventing blood pooling in the lower legs. This is useful clinically in those that have deep vein thrombosis, varicose veins or any conditions with blood circulation difficulties (Metzler, 2008). The compression also comes in handy for those that travel a lot because sitting for extended periods of time will lead to blood pooling in the legs. Similarly, those that are forced to sit all day or stand for several hours at work can benefit from compression. Another reason to wear compression clothing is to decrease muscle vibration by compressing and hugging the musculature. Every footstrike sends force and vibrations upwards into the muscles and tendons of the lower legs (Magness, 2010). This is one of the theories behind what causes DOMS (delayed onset muscle soreness). Both motives of promoting blood flow and minimizing vibrations contribute to the overall goal of increasing venous flow and decreasing the by-products that accumulate and lead to muscular fatigue (Magness, 2010). Essentially, the goal is to bring in good nutrients such as oxygen, and to flush out muscular waste.

Elmarie Terblanche, a sports physiology professor from Stellenbosch University of South Africa, conducted the first real-world study involving athletes competing in the Two Oceans ultra-race (O’Mara, 2013). It was found that athletes who raced in compression socks, compared to those in regular knee-high socks and those that raced in neither, experienced significantly less muscle damage and even ran an average of 12 minutes faster (O’Mara, 2013). Massey University of New Zealand conducted a study where twelve runners performed five 10km time trials and a vertical jump test was performed before and after each 10km (Ali, Creasy, & Edge, 2011). Subjects wore either a “control” sock without significant compression or “high”, “medium”, or “low” degrees of compression. Both subjects in “high” compressive and non-compressive socks had a decrease in their jump heights, but those that wore “low” and “medium” degrees of compression had in fact increased their heights. Ali and colleagues (2011) stated that no significant effects on lactate accumulation or heart rate were found when wearing compression socks. However, evidence in the vertical jump heights of the subjects that wore “low” and “medium” degrees of compression led to the premise that the subjects’ muscles were less fatigued during their 10km time trial with the socks on (Ali et al., 2011). Therefore the socks assisted in improving muscle recovery.

From personal experience, after grueling workouts where I know my calves took a beating, I jump straight into my compression socks. (Though in reality, it actually takes a bit of a sweaty effort to squeeze my calves in.) Sometimes when I have little niggles (small aches that runners tend to ignore and run through) that are anywhere from my heels up to my knees, I don the tight socks. And most of the time, the pain subsides after I wear the socks long enough. Sadly, compression socks and sleeves are not magical; they will not help kiss your problems below the knee goodbye. For serious injuries, my best advice is to seek professional help, book in for an appointment at Movéo! But usually the day after wearing the socks, my calves feel much fresher and ready to tackle the next workout.

Stay tuned for next week when I compare compression socks to sleeves and give details on my own experience in using compression gear.

 

References

Ali, A., Creasy, R.H., & Edge, J.H. (2011). The effect of graduated compression stockings on running performance. J Strength Cond Res, 25(5), 1385-92. doi: 10.1519/JSC.0b013e3181d6848e.

Magness, S. (2010, Jul). Compression Socks. Retrieved from http://www.scienceofrunning.com/2010/07/compression-socks.html#more

Metzler, B. (2008, Jul 22). Owner’s Manual: Do Compression Socks Work? Retrieved from http://www.runnersworld.com/running-apparel/owners-manual-do-compression-socks-work

O’Mara, K. (2013, Dec 11). Do Compression Socks Really Work? Retrieved from http://running.competitor.com/2013/12/recovery/do-compression-socks-really-work_62611

Written by Physiotherapist Shayla Hall

Foam rolling has exploded from an obscure practice of professional athletes to a staple among weekend warriors and grandmas alike.

Why?

Because it works. Clinically, personally, and anecdotally I see great results with adding rolling to one’s rehab program.

I’ve heard (and historically have probably said…oops) that foam rolling breaks up scar tissue, stretches fascia (IT band), and reduces adhesions that form between muscles. Years after the pioneers brought rolling to the masses, research about the force required to effect tissue structure has become available.

I’ll spare you the p-values and probability clusters (what?). Essentially, I would have to drive a truck over your IT band to break the first 1% of the superficial layer of fascia. It is highly unlikely that foam rolling has a direct and significant structural effect on soft tissue. If you think about it, thank goodness our bodies don’t work that way. I would be covered in dents and divots. Office workers all over the world would suffer from “Square-butt Chair-Syndrome” as their glute structure morphed into their swivel chairs. What about people in car accidents? Thankfully our bodies are designed to be strong, resilient, and force resistant.

So why does foam rolling work?

The explanation for rolling, much like many physiotherapy modalities, is a neurophysiological one. This is where my patient’s eyes usually glaze over and I wonder if the resulting boredom-slash-patient-confusion is worth it. In this case, it absolutely is. Focus those eyeballs and read on.

We roll muscles that feel “tight” or have “trigger points”. In the rehab world, we call this “tonic” muscles – basically the nervous system is firing signals at the muscle that make it impossible for the muscle to relax. Rolling provides a proprioceptive input, which triggers the nervous system to send an output. If done correctly, foam rolling provides a non-threating input which triggers a down-regulation of the tone by the nervous system.

Phew. You still with me? I’ll summarize: Foam rolling works via our fancy-pants nervous system…it doesn’t break up scar tissue or obliterate fascia.

Who cares though right? **she grabs a PVC-pipe roller and rolls the &*%$ out of her ITB**

In this case, it is important that patients know how foam rolling works because the dosage changes. If I am trying to break up fascia, I’m going to roll HARD. I’m going to hold my breath through the pain. If I’m trying to send input to the nervous system, I am going to dial down the intensity, use my breath, and avoid the intense pain that could actually further “threaten” my nervous system. I’ll probably get better results. The duration can change too. If my knee is sore doing a squat, I will foam roll my leg. If I’m trying to break down the ITB, then I’ll probably need to spend a long time rolling. In actuality, I just need enough rolling to down-regulate my lateral quad and make my squat pain free. If this happens with 30 seconds of rolling, then I’m done. I won’t see additional gains by rolling around for 20 minutes because my nervous system has already gotten the message.

While practicing in Whistler, I have come across a lot of athletes who swear that HARD rolling is what they need. I believe them, even though I don’t believe they are breaking down fascia. Everyone’s body is different. People respond differently: to rolling, to treatment, to exercise. I encourage you to experiment with the roller to see how little you need to see a result. Life is short, so if 30 seconds of moderate rolling is all you need to hit the trails, then get up off the floor and get going!