March 1, 2024 - Arnold's Cove Inn

What are Physio Exercises and How Do They Relieve Pain?

I was waiting for my turn at the hairdressers the other day, when I became aware of a conversation in a nearby chair. The client was telling her hairdresser how much she disliked her physio exercises…they were too complicated, too hard to remember, took too long to do, etc. And not at all like her massage stretches, which were really easy. It struck a chord with me, because we occasionally hear very similar accounts from clients in St John’s; about our competitors, of course! I’m sure at another physio clinic, they may hear similar accounts about our exercises. I have to accept that there’s ‘a thing’ about physio exercise that some people don’t like.

As I waited for my turn, my mind wandered. I thought…don’t people understand that, of all the groups that advocate for or use exercise as therapy, physiotherapy is the one best aligned by education to provide exercises when muscles are damaged and it hurts to move? How ‘easy’ exercise often misses the mark, as far as addressing the muscle dysfunction which causes pain? How important it is to correct alignment before strengthening, lest you increase dysfunction? etc…my mind was in a spin!

Then I decided to look at this issue from a client’s perspective. Buried deep in our DNA is the notion that we can ‘walk off’ or ‘work through’ muscle and joint damage and pain conditions; and it used to be pretty true. That is, before the advent of convenient transportation and the digital age. For some reason, the conveniences of cars and computers which were intended to free up time, had the opposite effect. In combination with social pressures, people rarely have any spare time, today; and the time they do have? They can think of better things than difficult, time-consuming physio exercise. I can see it from our clients’ perspective.

Which makes me think of a phrase I hear my sister say to her daughter… Suck it up, Buttercup! Who knows where that comes from, but it suits.

Here’s three truths:

The site of an injury often doesn’t align with the cause of injury. As an example, a stiff hip could shift whole body motion to the point where shoulder muscles become inflamed and painful. No amount of shoulder exercise is going to correct the stiff hip. If the shoulder pain subsides, it has more to do with time than therapy, and…it will return!
The mind-muscle connection is real. Nerves transport information from muscles to the brain; and from the brain to muscles. And it is changeable: the nerves actually adapt to the environment, even poor ones. In this way, the brain can be ‘tricked’ into accepting crooked as straight. We see this everyday in people around us, with the rounded backs and forward head posture of those who spend too much time playing with their devices. They think they’re standing up straight! Aside from creating a stooped society, there may be no immediate pain or short term consequences. Over time, however, this stooped posture causes early degenerative changes, cardiac, digestive and pulmonary challenges, etc.
There’s nothing more effective for most muscle and joint pain than allowing proper healing and correcting the cause of pain. In our clinic, we use photobiomodulation, better known as low intensity laser to stimulate/ accelerate and generally ensure proper healing. The most common block to normal healing is poor alignment, either at the site of injury or involving other body parts. Our physiotherapists will look beyond the immediate site of injury to seek the true causes of muscle & joint pain and dysfunctions. Complex pain conditions that involve systems beyond muscle require more complex treatment plans.

To my mind, the real disconnect with respect to physio exercises, has to do with communication. I’m pretty sure that the lady I heard unloading to the hairdresser, or our own clients who admit to difficulties with physio exercise, didn’t really hear (or believe) their assessment findings. For if the consequences of assessment findings were clearly understood, not many would compromise present recovery and jeopardize future health, to choose to blow off a few physio exercises. So…the physiotherapist wasn’t clear enough or the client wasn’t actively listening.

Which brings up another truth … Success requires that assessment findings be remedied; your body, your remedy. It’s really worthwhile to make the effort to find a physiotherapist with whom you can effectively communicate. When muscles are involved in injury, the test of recovery is the lasting restoration of normal motion, which makes exercise a key part of a remedy. The exercise you need is the exercise which addresses assessment findings. For all recurrent, chronic and first time injuries in a poorly aligned body, exercise starts with retraining the brain to restore default movement. How difficult the remedy depends upon the severity of the findings. For first-time, low-grade injury, the remedy can be as simple as ‘walk it off’, but that’s rare. More often, it’s a multi-layered process; as obvious faults are restored, others become visible. It’s the understanding here that’s most important; and the reason for a physiotherapist with whom you can communicate. True recovery can be an extended affair, three to six months or longer. Following an early period of intense physio, during which the rapport between client and physiotherapist is established; and early, ‘retrain the brain’ exercises understood and well-done, a treatment plan can be stretched out, with only occasional review. The duration?…as long as it takes! The prise? Best possible health and pain-free mobility…your future!

So, to the lady at the hairdressers…take my sister’s advice! Look beyond the easy and consider your long game…. make the time to take care of You!

For further information on the conditions we treat and services we offer, or to book an appointment please call 709-757-3313
Email: info@monasteryhealth.com

Tips for better sleep

We need sleep to recharge and repair our bodies. It is meant to be an automatic function, triggered by the circadian rhythm, which controls our internal clocks. We can appreciate this when we have the opportunity for distance travel and it takes a few days to accommodate to a different time zone. For others, sleep eludes them for many reasons, including: they can’t turn their thoughts off; they are very anxious or stressed; they can’t get comfortable; and some are in such pain that they can’t settle. Really, anything that disturbs homeostasis, the steady-state of our bodies’ operations, has the potential to disturb sleep. For our clients, in the St John’s NL area, we always ask about sleep because we expect that sleep could be impacted by the pain that brought them to the clinic. It is surprising how many have pre-existing sleep problems! It is concerning because disturbed sleep is a reason for delayed healing; and that can certainly affect treatment success.

Beyond the reasons already mentioned, an emerging and important reason for disturbed sleep is the blue light emitted by computers, which associates with an emerging health concern – named by some authorities as digital dementia. Essentially this refers to the breakdown of cognitive abilities as a result of the overuse of digital technology. This breakdown of cognitive abilities is similar to what is more usually seen following a head injury or Alzheimer’s. When excessive computer use is the cause, it is generally reversible. Other reasons for poor sleep relate to automatic functions, over which we don’t have such easy control. This refers to balance within the area of the brain responsible for sustaining life, such as breathing, heartbeat, blood pressure, sleep … and many, many reflexes. Powered by the autonomic nervous system, and generally responsible for our ‘flight or fight’ response to danger, much has been written about dampening this sympathetic ‘flight or fight’ response to attain a parasympathetic state of calm. Meditation is the exercise of attempting to focus conscious thought to invoke the parasympathetic state of calm. There are decades and centuries of experience that support this practice; and while not originally intended to induce sleep, it is a much written about strategy for sleep management.

Did you know there is considerable sleep help available to clients within our clinic, and most health care clinics? Both acupuncture and massage very directly induce calm and the parasympathetic response, which can last up to a couple of days after treatment. In our clinic, clients who are being treated with Laser often report improved sleep. Muscle work and fitness strategies, selected and graded to match injury, have a huge and increasingly lasting impact when repeated over time. In fact, our control of muscles represents the primary way in which we can influence baseline factors which can influence both automatic and conscious brain function. Within our clinic, we appreciate there are multiple potential contributors to disturbed sleep, and strongly advocate for a collaborative approach to care for our clients with disturbed sleep.

Our clients with disturbed sleep are also offered home management strategies, which target righting, sleep and respiratory reflexes of the brainstem; glymphatic (lymph) drainage of the brain; and home exercise to prolong treatment effects.

So….the tips from our team are:

Sleep position: Your best rest comes when your head and spine are in a neutral (extended) line. In side-lying, this means your neck is supported so your nose and ears are in the same plane, and parallel with the floor. In back-lying, your head is not elevated and your ears are in line with your spine; for people with rounded shoulders, this often requires a small pillow so that your head doesn’t drop back below the level of your shoulders. Stomach lying is generally not a healthy sleep position. A good sleep position allows for best drainage of the brain, which occurs mostly at night.
Small things to do throughout the day…as many times as possible (think every hour)…put yourself in an extended position. Our need and ability to withstand gravity is a powerful reflex, and we can use it to modulate brainstem activity.
- stand with you back to the wall (for feedback) and actively practice good posture. Feel your hip and shoulder blades against the wall. Make sure your feet and knees are in line with your hips. Let your ears pull your head closer to the wall (don’t tip your chin up) and hold the position for up to 2 minutes.
- standing on one leg for 10 to 40 seconds. Be careful not to twist. Use the back of a chair or the wall, if you need help to balance. Be careful not to lean forward to take weight through your arms and lose your extended position.
- take time for a walk, the more often and longer, the better.
Deep breathing – this can be done in isolation, but it is also a part of all exercise …. Breathe In with effort and breathe out with a release or relaxation of effort, to the rhythm of 1:4. Breath in slowly, then exhale to the count of a slow 4. Deep breathing can be performed in association with hold and relax of muscles, one pair at a time, in a process called progressive relaxation; often with a relaxation tape. This works because breathing also stimulates normal activity within the brainstem and has a calming effect.
Research and manage blue light from the computer – Use tinted glasses or tinted computer screen covers to negate the blue light; and turn off your devices 30 minutes or more before bedtime. This is a big consideration, given that early research is associating poor sitting posture and excessive computer time with neurodegenerative conditions, including Alzheimers. It’s very worthwhile to do your own research with respect to this.
Do your physio exercises – All of the above activities could contribute to improved sleep, especially if pain or discomfort hasn’t been the factor which tipped you into disturbed sleep. That said, physio exercises are always given to correct muscle balance around a joint; whether that is the result of trauma, a repetitive strain injury, or a degenerative joint condition. etc. What is significant is that using the muscles impacted by injury has a positive effect on pain and a calming effect on the brainstem. Physio exercises are graduated to take into account the degree of injury…just exercising often exaggerates the problem, and can be counter-productive. Your physio will modify exercise to match the ability of healing muscles. These exercises are unique to your injury.
Massage & Acupuncture; and Laser. With physio, a client has to do the work to derive the benefit; it requires you use your muscles. Massage & acupuncture are passive therapies, in that the therapist does the work. They can, however, directly impart a parasympathetic calm, and improved sleep, which can last a couple of days. There are many reasons why these modalities may be recommended as part of a treatment plan. A very good reason is the identification of disturbed sleep. Laser is an electrotherapeutic modality, like TENS in that it is powered by electricity or battery; but very, very different in function. Laser supplies additional ATP, cell fuel, to injured or underperforming cells within muscles, joints and most other tissue types within our bodies. This stimulates cell metabolism and healing. It stimulates brain-stem activity and improves lymph drainage which is probably why our clients often report improved sleep following laser treatments.
Control Sound and Scent, etc. Your general sleep environment is also an area to consider when sleep is elusive. For instance, window open/window closed; sleep with your back to the wall / or facing the wall; and pillows between your knees, etc. All of these strategies can be impactful. Two areas of consideration which also have considerable potential to be effective are sound and scent. With sight (mentioned above), these senses have direct access to your brain and can also impact steady-state operations. Lavender is reported to be a particularly effective scent for calm and relaxation. Classical music is calming for many. However, scents and sounds are individual preferences; and what works for one may not for another.
Professional psychological Counseling. When simple strategies don’t work and/or when the issues driving poor sleep are more related to stress, anxiety or emotional drivers, counseling may offer the sleep assistance you need.

To summarize, poor sleep is significant, both to overall and future health but also to healing from any particular pain or injury. It is very personal, yet often benefits from inputs and therapies across several disciplines to understand and manage. When poor sleep hampers recovery, we believe it is really important that our client’s confide in us; not so much about the details of an emotional crisis as the fact that they are dealing with one. We can personalize the helpful strategies within our sphere of influence to best effect. And we know that a problem with many inputs often needs a multi-dimensional solution. We will always respect your confidences!

We always welcome new clients! Please call if you think that, working together, we can help you. Call 709-757-3313 or email: info@monasteryhealth.com

For further information on the conditions we treat and services we offer, or to book an appointment please call 709-757-3313
Email: info@monasteryhealth.com

When it hurts to move

When it Hurts to Move, and you just want the Pain gone…You have Options!

Pain is the main reason why our clients seek care; and I expect this runs true for clinics throughout St John’s, Mount Pearl and all the communities of Conception Bay South and throughout the Avalon environs. Whether back or neck pain, arthritis, tendonitis, bursitis, or trauma like a whiplash injury, etc, our clients can access care through physiotherapy, massage therapy, acupuncture and laser. All of these therapies offer modalities for pain relief, but our experience indicates that collaboration between the therapies offers the best and longest lasting pain relief. But, as manager of your own health, you have options.

Pain follows injury and trauma; it is a protective mechanism initiated by the brain to prevent worsening damage, and it is part of the healing response. Pain may also be complex, triggered by multiple threats, such as large or multiple sites of trauma, stress, possibly NSAID use and poor alignment. Whether simple or complex, the modalities we can offer at our clinic are the same for both simple and complex pain, although the manner of application may change depending upon the nature of pain. The purpose of this blog is to familiarize you with how our modalities actually relieve pain; offer some useful hints for managing pain at home; review the common medications and their impact on therapy; and to explain why we believe a collaborative approach to managing pain provides the best outcomes.

Acupuncture is both the name of the health profession and the main modality the profession provides. By inserting very fine needles into ‘acupoints’ located along energy meridians, it is speculated that acupuncture rebalances energy flow throughout the body. Pain is relieved because it stimulates the release of endorphins, the body’s natural pain-relieving chemicals. One well-known endorphin that is stimulated by acupuncture is serotonin, a brain chemical known to be involved with mood; and which can relieve anxiety. Our experience is that pain relief is improved when a client is anxious, and acupuncture is part of their treatment plan.

There is some risk associated with poor needle technique, not a problem we’ve seen at our clinic; and symptoms such as fatigue, soreness, bruising, and light-headedness are rare and generally short-lived findings following treatment.

Massage Therapy is a hands-on and mostly well-loved experience of manual stimulation of muscles, joints and soft tissues. There are believed to be several reasons why massage may relieve pain, including relaxation of painful muscles, tendons and joints; improving local circulation and the supply of nutrients to the painful area; and by soothing the joint nerve receptors which transmit the information of pain to the brain. All together, an important effect of massage therapy is to stimulate parasympathetic function, the body’s rest and digest mode. This diminishes stress and promotes self-repair. Relief following massage is reported to be short-lived. A deep massage may increase pain for a couple of days immediately following massage; with subsequent relief lasting for 2 to 3 days. Our experience is that pain relief is improved when massage is combined with other therapies.

Massage techniques range from the mild lymph massage to the moderate Swedish massage to the intense deep muscle massage. There are also special techniques for specific client populations, such as pregnancy massage. Trigger point release is an example of a deep tissue technique which is often required for those with muscle and joint pain.

Because massage is used for relaxation and stress relief as well as for re-aligning and restoring muscle tension, the recommendations for frequency and duration are variable.

Physiotherapy offers a wide range of electrotherapeutic modalities and manual techniques specifically for pain relief. The main electrotherapeutic modalities in common practice today include:

Ultrasound, low energy sound waves
Extracorporeal shock wave therapy, high energy sound waves
Interferential current
Electrical stimulation and TENS
Non-electrical modalities include heat and cold.

The risks of treating with heat and cold are mainly of burns and frost-bite.

With respect to the other electrical modalities, except laser, risks are quite varied.

Ultrasound left in one spot can cause a cavitation burn (damage deep before there’s evidence of burn on the surface). Interesting that Extracorporeal shock wave therapy uses the cavitation effect to treat calcifications in tissues like tennis elbow. Interferential current and other electrical currents can interrupt cardiac rhythm, especially if a client is dependent on a pacemaker. There are other more common cautions and contra-indications which are not listed because we don’t use these modalities in our clinic.

The best of the modalities that physiotherapy uses for pain relief is actually motion itself. The use of thermal and some electrical modalities were originally used to manage the pain and swelling associated with early trauma. They were intended to ease and support early movement, starting with gentle muscle contraction without motion and progressing to motion within pain-free and normally aligned range and on to more challenging exercise. The risks of early exercise are poor alignment, too much/too little effort, and delayed healing. Sometimes, the modalities steal focus from early movement and all the neurological benefits early movement provides.

Beyond the early exercise mentioned above, it is key that synergy between muscle fibers within a muscle and the nerves which transmit information to the brain be restored to normal function. This is often referred to as retraining the brain or the mind/muscle memory; and it is essential when using movement for successful pain relief. It is like hitting reset on the computer to clear a software glitch. Such exercise is first performed with minimal effort and for longer durations than is typical of regular exercise. You may think…wait, Yoga or Pilates does that; and it does. They are great exercise systems when the neural ‘software glitch’ is minimal; but they can’t generally restore a more entrenched ‘glitch’.

Laser Therapy, specifically low intensity laser,is also an electrical modality, but in a class by itself. All other electrical modalities either influence circulation and the supply of hormones and nutrients; or, stimulate larger sensory neurons to block transmission of pain fibers. Laser, properly termed photobiomodulation, replicates the healing rays of red and infrared energy; and directly delivers ATP (cell fuel) to injured cells to directly stimulate cell function. It is analogous to photosynthesis, the mechanism by which plants grow. Laser is reported to restore normal cell function and structure. It has one contra-indication; and that is not to treat the exposed eye. Neither do we treat over the pregnant womb nor over a known cancer. If any modality, alone, could provide total pain relief, it would be laser…. But that would be assuming normal function before injury; and that’s rare.

Pain Medications & NSAIDS

It is more common than not for our clients to try non-prescription meds as a first line of treatment when it hurts to move. Once clients seek help from their physicians, some will move on to prescribed medications. From the perspective of our therapists, it is important to know what medications are being taken, and whether or not they are effective in relieving pain. Also, because there may come a time when it is important to distinguish between the medication effect and true recovery, sharing knowledge of medication usage is important.

Perhaps the most common medication our clients report taking is Tylenol, acetaminophen, a drug used to reduce fever and relieve minor pain. It is thought to work by elevating the body’s overall pain threshold. It has many side effects, many of which are allergenic.

NSAIDs are a group of drugs, used to block prostaglandin effects during the inflammatory process. They include Aspirin, Ibuprofen, Aleve, Motrin, Naprosyn and Celebrex, etc. While it seems intuitive that it is good to block that which causes pain, the inflammatory process is also the body’s repair process, and the prostaglandins, in addition to sensitizing nerve endings and increasing the pain, serve an important function in regulating this process. The published literature is mixed on the use of NSAIDs for muscle and bone injuries. In some reports, it is considered a possible cause in delayed healing. One alternative is the use of topical NSAIDS, in cream or gel form. It is reported to relieve pain, without adverse systemic effects, especially for knee osteoarthritis.

Many of our clients receive corticosteroid (cortisone + a steroid + an analgesic) shots for joint pain when medications and other more conservative measures don’t provide sufficient pain relief. The purpose is to dampen the inflammatory response. The Mayo Clinic reports that side effects could include: cartilage damage, thinning or death of nearby bone, joint infection, nerve damage, tendon weakening or rupture, etc.

Although there appears to be no widespread consensus regarding the frequency of shots a person can have, it is common for physicians to limit the number of cortisone shots into a joint. For more specific advice, let your own physician be your guide. For our part, we will treat clients who’ve recently had or who are awaiting corticosteroid injections. It is only important that we know that you’ve had such an injection and the date; this allows us to better gauge your progress, and modify if necessary your treatment plan.

For complete information on medications and possible side effects and interactions, it is best you consult your pharmacist or physician to determine what’s best for you.

Home Strategies. There’s quite a bit you can do to manage pain at home and to extend the benefit derived from in-clinic treatment. Beyond medications, there is pain relief to be found in good positioning; in ice and elevation following recent injury; and in movement. The following ‘exercises’ are amongst the most commonly included in the home exercise programs we provide:

1) Static Back Position. The purpose of this ‘exercise’ is to allow back muscles to relax such that the back can assume a more normal alignment. It is important that hips and knees are supported at right angles, as this negates rotational strain on the back.

2) Towel Wrap around Neck. This ‘exercise’ supports the neck muscles, essentially taking some of the weight of the head off the neck. It is particularly useful following sprain/strain injuries, such as whiplash; but we use it for muscle spasm as well. Leave the neck wrapped for 2 hours or so, at a time. We don’t recommend continual use, but the ‘exercise’ can be repeated as needed. Our favorite towels for this application are worn, fairly skinny towels. They wrap in closer to the neck and are more supportive. Either tie with a scarf or tape to secure. To further relieve your neck muscles, support your forearms on blocks, or cushions, close to your body; and with shoulders held in a relaxed, neutral position.

3) Side Sleeping. The important things here are that pillow support under your neck and between your legs is just enough to maintain a straight spine, as viewed from behind (as in picture). What you can’t see, but which is important, is that the support is sufficient to discourage rotation; as when the top knee falls forward of the bottom knee and/or the top shoulder slides forward of the bottom shoulder.

4) Resting Positions of Joints. This is the position in which there is the greatest laxity of the joint capsule, and where recovery will be the most comfortable. For the knee joint, it is slightly bent and supported by pillows. For any joint, consult Dr Google.

The Collaborative Approach Not everyone needs a coordinated, collaborative approach to care; we offer both single service and collaborative care plans. We do recommend the collaborative approach for those:

Collaborative care requires discussion between care providers to compare findings and define a care plan; and it provides opportunities to extend insurance benefits by combining and/or spacing treatments. All care is provided within the same facility, which enables easy discussion between practitioners and offers convenience for our clients.

For further information on the conditions we treat and services we offer, or to book an appointment please call 709-757-3313
Email: info@monasteryhealth.com

Getting the Most out of Laser & the Package of 10

Why include Laser in your treatment Plan?

Adding light energy to injured areas jumpstarts healing, and shortens healing times. It is effective following acute trauma, as well as slow to heal and chronic injuries. It stimulates and accelerates the healing process and prevents the development of adhesions which can occur when healing is slow or delayed.

Our bodies have light receptors, situated within cells, which are able to absorb light energy of specific wavelengths to stimulate cell function… very helpful when the body’s normal reaction to injury and disease is to depress function. For best results, it is used throughout the healing process. Laser also decreases pain, improves mobility and sleep, and reduces the requirement for pain and anti-inflammatory medications.

Physiotherapy

It is not necessary to have physiotherapy to access laser therapy; but it is a good way to start – and our best recommendation for your care. For all muscle and joint pain conditions, the site of pain does not always match the cause of pain. A physiotherapy assessment confirms the appropriateness of laser as well as best application sites and protocols. An alternative to physiotherapy oversight is assessment by a nurse practitioner. This is particularly relevant for those who are seeking care for other than muscle and joint pain conditions; e.g. gout, lymphedema or post-herpetic neuritis (shingles).

Why 10 lasers?

Based on the accumulated statistics from many Bioflex users, 10 is the average number of treatments a client requires to meet treatment objectives. Long-standing and degenerative conditions require an average of 20 treatments, in our experience. Hence, a 10 treatment package. It seems to be the best offering, considering that some clients will require more than one package.

A typical treatment plan starts with 3 lasers a week, which can be on successive days. This takes advantage of the cumulative benefits of laser, and allows for early improvements to be noticed. After the early concentration of laser, treatments drop off to twice a week, once a week and less frequently…depending upon your response to treatment.

Stay the course!

It is highly recommended that you complete your treatment plan. Laser is most beneficial when it is applied throughout the active healing stages, typically 4 to 8 weeks, depending upon the type of tissue injured, e.g muscle, ligament, bone etc. Degenerative and nerve related injuries may take even longer, or benefit from maintenance laser following and active treatment plan. We urge you to stay the course, because your condition can relapse when treatment is discontinued before the active healing stages are completed.

Safety and Treatment Precautions.

Low intensity laser is a very safe treatment option, with only clear danger associated with direct application of the laser probe to the eye. It is for this reason that you use eye shields when the laser probe is being used. It is customary to avoid the lower abdomen and back during first three months of pregnancy, the thyroid and sites of known cancer, but research is not clear in these situations. Some medications increase sensitivity to laser, but are not in themselves contra-indications.

We NEED your input to progress treatment protocols!

Responsiveness to laser is an individual thing, similar to an individual’s response to sunlight – tanning or burning. Our laser techs will ask you before the start of each treatment how you felt after preceding treatment. If we overstimulate, you will experience a temporary sensation of increased sensitivity and possibly pain. About 10% of clients will experience immediate review and their treatment protocol remains unchanged. No change following treatment is harder to interpret…usually we will repeat the treatment once before nudging up the treatment protocol.

When you’re more sore after treatment…

we see this as a sign your body is responding to treatment….we’ve stirred up the inflammatory process. Generally, patients describe feeling better after 12 to 18 hours. This is important information to give us because it may be necessary to adjust your treatment protocol. If you are more sore, ice and tylenol are recommended. If you are really concerned, you may contact us at info@monasteryhealth.com or call the clinic at 709-757-3313.

If you should find you have more pain following treatment, use cold packs and mild pain medication, such as tylenol, to help settle the inflammatory response.

Massage

Finally, massage enhances the effect of laser by improving circulation and lymph drainage in the area. If there are areas of adhesions, super tight muscles or trigger points, these are identified for later treatment. Massage is not a compulsory part of the laser experience, but we find it most helpful to treatment results. We recommend adding it after you’ve had 4 laser treatments, as this helps to clarify treatment response.

For further information on the conditions we treat and services we offer, or to book an appointment please call 709-757-3313
Email: info@monasteryhealth.com

Monastery Health Physiotherapy Plan of Care/Treatment Plan

During the last few minutes of your initial assessment, your therapist will review your assessment findings and develop with you a treatment plan. Some milestones include:

Frequency & Duration of Treatment

Your assessment findings and general health status determine the time requirements for care – how many treatments, over how many weeks. For best results, it is important that care continue throughout the healing process to diminish the likelihood of re-injury

Choosing your Treatment Goal(s)

Your lifestyle demands and treatment goal(s), determine the content of your treatment plan. Although pain reduction is important, it is not generally the best treatment goal. We have observed that our clients achieve better outcomes when they focus on an activity or a future planned event rather than pain; such goals can keep you motivated when progress slows or the treatment plan just seems very long! Examples might be completing the Signal Hill hike, a European holiday, carrying groceries from your car to your kitchen, or working on your computer for an hour – the choice of goal is yours! A question we will ask you is: “What activity or planned event is most compromised by your present pain?”

Choosing Early Modalities & Exercises

Most treatment plans contain measures for pain relief as well as recovery or restoration of muscle function and a rehab plan for return to activity. In our clinic, laser is our modality of choice, for early care. It provides pain relief and accelerates healing (an average 40% faster); and allows an earlier start to rehab efforts. Isometric, posture and positioning exercises contribute to pain relief and are started early. As a general rule, we observe that, when an individual reports a 50% to 60% reduction in pain, the requirement for laser subsides, laser sessions become less frequent, and the focus of care shifts to muscle function and strength.

Focus on Muscle Function & Rehab

As pain recedes, the focus changes to muscle function. Re-assessment is necessary to identify muscle issues which may have been masked by pain during initial assessment; and to set up the rest of the treatment plan. Exercises become more challenging, and a rehab framework is introduced. For many of our clients, this occurs at the 4 to 6 week mark, although more serious injury or chronic pain presentations may need more time before their treatment plan is updated.

Preventing Recurrence

We observe that some clients ‘drop their guard’ or become a little less committed to their home exercise programs as pain decreases. For this reason, we view this phase of care as the most risk prone, with respect to achieving a successful treatment outcome. Over-stressing healing tissue is an obvious risk, but a more subtle risk is associated with not fully correcting muscle alignment, balance and strength. This risks future joint health, and early arthritic changes.

Who needs a Maintenance Plan?

Maintenance plans are recommended for our clients who have arthritis and for those who have not fully restored muscle function. For those with arthritis, this often involves an occasional laser, as this has research support for its ability to delay progression of arthritis. For those who are working to improve muscle function, occasional treatment sessions provide for re-assessment and modifications to exercises needed to work towards treatment goal(s).

Feedback, always!

Good health and many of your future plans require good muscle function. In today’s world, physical therapy is not a ‘one and done’ event. Good muscle function requires close monitoring because of the stresses of our digital world; and it needs continual attention. To achieve your treatment goal(s) and maintain post-treatment function, we need your feed-back!. Please tell us your observations and response to exercise recommendations, including the bad stuff. We will keep you well informed and help you achieve your treatment goals.

For further information on the conditions we treat and services we offer, or to book an appointment please call 709-757-3313
Email: info@monasteryhealth.com

New Sports Initiatives and Health Care Services in St John’s NL

It’s a wonderful Fall Season in St John’s and the nearby Avalon communities! Everyone is moving:

Competitive gymnasts in Mount Pearl;
Hockey, soccer and rugby teams of all experience levels in every corner of the Avalon,
The Lakecrest Independent School physical education students (across from us)
Those resuming fitness routines at the Works
Hiking enthusiasts racking up miles on the Signal Hill trails, etc

It seems everyone is on the move.

There’s a special buzz in our neighborhood created by the recent opening of a new sports venue “The Cove Bouldering and Cafe”

It is centrally located on LeMarchant St, next to the Urban Market. It is a safe, whole body workout for just about everyone. Many of their training programs focus on youth, starting at 9 years of age. They also offer complimentary introductory sessions, small group and private coaching sessions for adults of any age.

Beyond a salute to an active lifestyle, bouldering offers a great opportunity for post Physio or post Rehab fitness. Many of our clients are not as active as they would like to be and understand that fitness is one of the markers for healthy aging. A repetitive strain injury or a diagnosis of early arthritis can be a wake-up call, prompting a more active lifestyle after a successful course of physiotherapy. Bouldering challenges both mobility and strength; and it’s fun! Early bouldering training programs take into account an individual’s fitness level, and can be safely undertaken by most people. Thumbs up for bouldering!

If you live an active lifestyle and participate in sport activities, injuries are a fact of life. They range from minor cuts, bruises and abrasions, sprain/strain injuries of all degrees of severity, fractures, contusions, etc. It is also normal, even desirable for individuals to adopt a do-it-yourself approach when they first take note of persistent aches and for minor injuries. From the perspective of this physiotherapist, a d-i-y attitude is fabulous. It is informative, promotes engagement when a physiotherapy treatment plan is necessary and can truly focus on client goals. A relatively new source of on-line information is PhysioCheck. It has a tremendous library of muscle and joint injuries and pain conditions and early d-i-y recommended treatments. The following is their description on ‘climber’s finger’. It is easy to navigate to other injury descriptions once in the database.

Another consideration for injury management relates to persistent and disabling pain, slow-healing injuries and injuries which involve an arthritic joint. Too often these injuries stop participation in well loved activities and sports. These injuries are effectively treated with low intensity laser therapy. The beneficial effect is described as photobiostimulation, and it occurs when low level light energy is absorbed by injured tissue. New injury healing is significantly accelerated, enabling faster rehab, recovery and return to activity. More chronic injuries are stimulated to restart the healing process, and can progress to normal healing. More information on laser therapy and photobiomodulation can be found in the link.

Part of injury management may involve the requirement for bracing or joint support. Whether the goal is to protect a joint while participating in a sport or to rest / immobilize the joint when participation is harmful, acquiring a brace in St John’s NL has been difficult. Local stores offer limited selections of braces and other health care supplies, and since Covid, supply has been an issue.

The Physio Store offers a solution to both supply and selection. This on-line Canadian store offers good quality, affordable braces, fitness and other healthcare supplies, with access to expert advice with respect to selection and fit, door to door service and a good return policy…. Check it out!

These braces are appropriate for some of the more common climbing injuries, to fingers and to the knee, and are a sample of what is available through on-line order.

For further information on the conditions we treat and services we offer, or to book an appointment please call 709-757-3313
Email: info@monasteryhealth.com