Lynda McClatchie, Author at Elevation Physiotherapy & Wellness

Change Your Brain—Neuroplasticity Rocks!

As we get older, we unfortunately discover that our brains can slow down too. Some studies that involve both humans and animals have shown that regular aerobic exercise like walking or jogging can give a boost to memory and cognition. Aerobic exercise can increase the number of new neurons in the brain’s memory centre, and also decrease inflammation. It’s inflammation in the brain that can lead to the development of dementia.

Until recently, there has not been much research on how resistance training can affect the brain. Obviously weight lifting builds muscles, but can it affect the cells and function of the brain?

An interesting study was recently published in the Journal of Applied Physiology, where the authors taped weighted pellets to the butts of rats, and had them train on a 100cm ladder. After several weeks, the climbing rats showed increased muscle mass.

A separate group of rats were injected with a substance that causes inflammation in the brain that created symptoms of early dementia. Half of these rats began weight training, and over weeks, the weights strapped to their butts became heavier to progress their strength training.

After 5 weeks, all rats were let loose into a maze where they were expected to run immediately for one dark chamber, and they would learn where that was located so that each time they were admitted into the maze, they should run directly there. What they learned is that after a few repetitions, the cognitively impaired rats who did the weight training surpassed the speed and accuracy of the control rats . The authors of this study concluded that the weight training had restored the rats’ ability to think, since the untrained rats with mild dementia continued to lag far behind the others in their ability to find the dark chamber.

Upon examination of the brains of these rats, there was inflammation found in the brains of the rats who had been injected with the chemical, but the brains of the rats who did the weight training showed a huge number of enzymes and genetic markers that would create new neurons, allowing the brain to remodel itself.

Obviously rats are not people, and it isn’t known that the brains of people who weight train would behave in the same way to lifting weights. It is fair to say that resistance training is beneficial for muscle mass and strength, for bone density and metabolism, and if it does help to protect the brain, so much the better!

At Elevation Physiotherapy & Wellness, our Physiotherapists are able to develop a resistance program that is individual for you, based on your own goals. Call us to talk about how we may be able to make your brain stronger!

Suffering From Vertigo?

There are several reasons for vertigo, and all of them suck, but positional vertigo is a common type of dizziness that can be treated with a simple maneuver.
Benign paroxysmal positional vertigo (BPPV) is the medical term for positional vertigo. BPPV is caused when tiny stones in the inner ear are dislodged from the sticky cushion where they usually sit, and travel into the semicircular canals, which determine our perception of three-dimensional space. When these stones are trapped in the semicircular canal, it gives your brain the wrong message about your body position, and creates a false sense of motion.
If the stone is dislodged on the left side, when you turn your head to the left you would experience extreme vertigo that lasts several seconds to one minute, then settles until the next time your head turns to the left.
In 1979, Dr. John Epley discovered a maneuvre that could treat most cases of BPPV without medication, and is essentially placing the head and body in certain positions to get the stone out of the semicircular canal and back onto its sticky pad in the inner ear. The Epley maneuvre is a series of head and body movements that try to reposition the stone out of the semicircular canal and back onto its sticky pad in the inner ear. Once back in place, the stone will no longer cause the symptoms of vertigo. Some patients can be trained to perform the maneuver at home.
It is important that other causes of vertigo are ruled out before trying the Epley maneuvre, such as inner ear infections, migraine, neck issues, and multiple sclerosis. Once BPPV has been determined to be the cause of vertigo, then it is often very treatable with postural correction and the Epley maneuvre.

At Elevation Physiotherapy, we can help with vertigo from BPPV or neck issues. Let us help you get better, faster.

Weight Lifting For The Vagina

The pelvic floor group of muscles work like every other muscle in the body, but they are generally fairly ignored until someone has a problem. The muscles sling underneath from the pubic bone at the front of the pelvic to the tailbone at the back, and also wrap around the vagina, urethra and rectum.

Since these muscles are at the base of the core and attach onto the spine and pelvis, they can help support the pelvic structures, and are involved in control of botht the bladder and the bowel.

If these muscles are weak, and they are in most people due to the above-mentioned fact that people generally ignore them, some people can experience stress urinary incontinence (SUI), which is when urine leaks occur with exertion, like coughing, sneezing, and jumping. Pelvic organ prolapse (POP) can occur when the weakness of the pelvic floor muscles and other supporting structures causes the bladder or uterus to descend down into the vaginal canal.

So what can be done? Since the pelvic floor muscles are just like other muscles, there are strength-training exercises called “Kegels” that can be very effective in helping SUI and the symptoms of POP. Kegels can be done with short pulses (contraction and release of the pelvic floor muscles that takes 1-2 seconds, repeat 10x) or longer holds (squeezing the pelvic floor muscles and holding them engaged for 5-10 seconds, relaxing completely between repetitions).

Pelvic floor weights (vaginal cones) involve inserting a weight inside the vagina for the time that you would do the Kegel exercises—they are not meant to be worn through the day. The series of weights start out bigger and lighter so they are easier to hold inside, and get smaller and heavier as you improve.

A review of the data tells us that pelvic floor weights are no more effective that simply doing Kegel exercises for strengthening the pelvic floor muscles. If the idea of weight-training for the pelvic floor appeals to you (some women love tools and devices), then they are fine to try. Be sure to use a medical grade set that can be cleaned appropriately.

Making sure that you are doing a proper Kegel is most important. At Elevation Physiotherapy & Wellness, we assess each person to ensure they are performing Kegels properly and get you started on a program to help build strength, endurance and control through the pelvic floor. If you are experiencing urinary incontinence or a prolapse of the pelvic organs, we can help!

The ProSTATE Of Affairs

Do Men Need to Work Their Pelvic Floor Too?

Both men and women have biceps, quads, and most other muscles, so why would working this very important group of muscles be important only to women? Think of the pelvic floor as a group of muscles that act as support and stability for the base of the core—these muscles attach to the spine, hips and around the pelvis, and they blend very directly with the lower abs, oblique abdominals, and deep back muscles. If you are working your pelvic floor muscles with your other core training, you will build a better, stronger core!

Breathing very much influences how these muscles move. When we inhale, our diaphragm lowers and the pelvic floor descends and relaxes. With exhalation, the pelvic floor contracts and raises with the diaphragm, and the lower abdominal and deep back muscles contract to squeeze around the spine and pelvis. If exercising lower abdominal muscles, there is a better and more efficient contraction if we exhale and engage pelvic floor muscles at the same time!

Let’s Talk Prostate!

We can’t talk about the male pelvic floor without mentioning the prostate. The prostate gland sits right below the bladder wraps around the urethra, which is the tube that drains urine from the bladder. If the prostate is enlarged, it can squeeze around the urethra and limit the flow of urine.

If the prostate has to be removed or have other treatments to manage issues at the prostate, many men will be incontinent for a time. Working the pelvic floor muscles will help to build more external support around the urethra, along with proper “core“ breathing and strengthening other parts of the core, will help to restore continence in men faster than if men do nothing. There is much that can be done for men to improve or fix their continence issues after prostate surgery, and it all begins with the pelvic floor!

How To Do A Proper Plank

There has been plenty of conversation lately around doing plank exercises after age 50—is it safe? What is the effect of estrogen depletion of skeletal muscles? Can doing planks to strengthen the core actually cause a prolapse of the pelvic organs?

The answer is a resounding NO—planks can continue to be a great strengthening exercise, but there is more to it than that.

Like any other exercise you would ever do, your form really matters. Don’t start planking at a level that is beyond where you are. Start on your knees or a modified version and progress onto your toes as your strength improves.
Make sure that you are engaging your pelvic floor muscles while you are holding your plank—meaning that you have to know that you are engaging them properly, and remember to breathe as well
You have not become fragile when you reach age 50, or beyond for that matter! Decreasing levels of estrogen in your body has been shown to reduce the strength in our skeletal muscle. Let’s not forget that general inactivity, at any age, will also decrease strength in our skeletal muscle. There is also evidence to show that we can still build muscle when we age, and everybody should do this!
When you stop challenging your body physically, you WILL get weaker over time. That is the same for all muscles. Many people have weak pelvic floor muscles because they don’t work them specifically unless they have developed a problem! So if you are starting to plank (at any age), you should have a pelvic health physiotherapist assess you if:
1. You leak urine while holding a plank
1. You feel a heaviness or pressure in your pelvic floor after planking
1. You can’t hold good form
1. You are experiencing back or hip pain to do a plank

HOW TO DO A PROPER PLANK:

Keep your body in a straight line, whether you are on your knees or your toes

Tuck your pelvis under

Stack your elbows under your shoulders

Think about pushing away the floor with your elbows

Squeeze your glutes hard!

Keep your hips level: don’t let them sag or rise up

Remember to breathe

Your Spine is Stronger Than You Think!

Low back pain is the leading cause of pain and disability worldwide. Statistically, the prevalence of lower back pain is increasing, so what are we doing wrong? Historically, people have often been told to rest or to strengthen their core muscles, and for many, that is not helpful advice to get to the root of the problem.

We need to change that message. The structures in the back that cause pain, and the biomechanics of spine do not seem to be as important as we once thought they were. We need to stop thinking that someone will break when their spine is put under load. Our bodies are much more resilient than that, and it is never helpful to promote fear. The spine is designed to move in all directions, and it is important that it does. Telling someone NOT to move in a certain direction as it will damage the spine is both wrong, and can change their brain over time. If someone is scared to move into flexion and tries to avoid it at all costs, when they have to move into flexion to tie their shoes, they will consistently be thinking that they could damage themselves. Is tying up a shoe really dangerous? No it’s not.

We can train ourselves to do almost anything, and the risk of injury is dependent upon much more than how we move.

Several studies have shown that spinal flexion cannot be avoided, even when trying to keep the spine in a “neutral” position with activities like squats, dead lifts, or a multitude of ab exercises. If such movement cannot be avoided, no matter the loads or conditions, why do we teach people this will result in low back pain? Fear and limiting beliefs about the fragility of the spine are hurting us more than actual movements.

People with low back pain need to hear reassuring, positive and empowering language. A person who has lower back pain WILL get better; they WILL get back to what they love to do. Almost everybody does. As a Physiotherapist, it is important to ensure people with lower back pain are empowered to stay active and strong in ways that they enjoy.

One of the most important messages to convey to someone who is suffering from lower back pain is to remind them that they are strong, their spine is robust, and they will recover. Each person needs to keep moving in ways that feel good, and temporarily avoid positions that seem to create pain. The big word here is temporarily—once pain settles down, there should be no restrictions in movement. Get back to everything!

The Shoulder Bone’s Connected to the Spine Bone…

So most people wouldn’t realize that your mid-back would be related to your shoulders, but if you’re sitting right now, try to slouch. Go ahead, fully slump down… see how when you do that, your head pokes forward and your shoulders round inward?

Now from that position, try to lift up your arms overhead. Hard to do, right? That is because you need your mid-back to be fairly straight and your chin tucked to get full shoulder movement.

Most people spend too much time slouched forward, and over time your mid-back, neck and shoulders can tend to stay a bit rounded forward, or at least it feels stiff when you try to get out of that position. Your thoracic spine are the 12 middle vertebrae located between your neck and lower back, and connects to your ribcage. When it’s moving well, your back is happy and your neck and shoulders move well too. If your mid-back doesn’t move well, you may develop some aches and pains.

Here’s why mid-back mobility matters:

Improving your mid-back and shoulder mobility can help with headaches and neck pain.

Upright posture is important. When your thoracic spine is stiff, it’s harder to sit up straight and rotate your upper body. When your mid-back is rounded, your head automatically pokes forward, which can contribute to pain in the neck and even to headaches. But working on the mobility of your mid-back can give you more mobility in the shoulders and neck.

Better Overhead Movements: when you’re slouching and your mid-back is rounded, you don’t reach overhead well. You need a straight thoracic spine and tucking the chin back in order to achieve full overhead shoulder movements. All of those people you see walking around with a forward head posture and rounded shoulders don’t have normal shoulder movements and can’t take a full deep breath. True story. Practicing an arch through the thoracic spine by relaxing over a foam roller can help improve mobility through the region. Take a few deep breaths to encourage rib expansion while you’re there.

Smoother Breathing: When your thoracic spine is mobile, your ribcage can move well too, allowing your lungs to fully expand and your diaphragm to descend. This can translate to better performance in whichever activity you choose!

Hopefully you’re seeing it’s important to give your shoulders and thoracic spine a little love.

You might be surprised at how much improving your thoracic spine and shoulder mobility makes you feel better — at the gym and in your day to day life.

3 Exercises to Help You Slow Down and Settle Your Mind

Are you feeling tire, stress, and have no energy? These restorative exercises can help relieve tension in your body, improve sleep quality, improve movement, increase blood flow, tap into your central nervous system, and calm your mind.

ELEVATION-Physiotheray-diaphragmic breathing

Diaphragmatic Breathing:

Sit in a comfortable position and cross your legs
Place 1 hand on your lower ribs and the other on your abdominal muscles
Take a deep breath in and make sure your hands move outward, expanding your torso
Take a long exhale, making sure your hands and your abdominal muscles move inward
Once you feel your belly is expanding and contracting well, rest your hands on your thighs and close your eyes
Take about 10 deep breaths

Hip Flexor Release:

Lie on your back and lift your hips to slide a yoga bolster or folded blanket under your tailbone
Relax your hips and gluteal muscles and try to keep your pelvic neutral as you pull one knee towards your chest (using your hands around your thigh), and bring the opposite leg off the floor and straighten the knee
Keep your chin tucked and ribs down while you take several deep breaths in this position
Switch legs

Child’s Pose:

Start on your hands and knees, keep your knees wide and bring your big toes together
Sit your hips back towards your heels, rest your trunk downward and stretch your arms in front of you
Rest your forehead on the floor or a yoga block in front of you, take several deep breaths over 1 minute

The Evidence is In: Slouching IS the Culprit!

Lower back pain is prevalent and patients frequently seek help to deal with the pain and functional limitations that arise. It sounds oversimplified, but commonly lower back pain begins without any trauma, but more due to the cumulative effect of too much lumbar flexion each and every day—sitting in slouched posture at the computer, sitting to eat all meals, brushing teeth, washing feet, doing laundry etc. We don’t get out of that position very much and over time, the back can become aggravated as a result.

A recent study provided information about the type of movements of the lumbar spine performed by 208 pain-free individuals over a 24-hour period, and the proportion of time spent in flexion and extension.

Main Results:

The median total number of movements with a change in the lordosis angle greater than 5° was approximately 4,400 within the 24 hour period. Most of these occurred within a small range of movement.

On average, full flexion was achieved 50 times within the 24 hour period, whereas full extension was achieved 0 times.

94% of the day was spent in the 0-50 degree range of flexion and 2% of the day (24 minutes) was spent in any extension relative to the standing position.

Conclusions: The data illustrated the spine mainly moves through a small range of movement during normal daily activities, the minimal amount of time spent in any lumbar extension, and the majority of time spent in flexion.

A huge 66% of the movements occurred within a very small range – only 5 to 10 degrees of movement. It appears that those movements are occurring within the flexion range, but of course may not be at full end-range. It is good to finally have some evidence about the number of movements and the type of movements that an individual without symptoms performs in a normal 24 hour period. What this research does not tell us is if individuals with lower back pain have a different movement pattern.

Physiotherapy for people with lower back pain often involves education on correcting sitting posture using a lumbar support in chairs to prevent slouching, and various spinal mobilizations and exercise into lumbar extension to lessen or abolish the pain and functional limitations due to living in flexed positions! Back pain can often be completely abolished when lumbar flexion positions can be avoided for a short time, and repeating lumbar extension movements.

Prostate Issues are Not Just for your Grandpa

Prostate cancer is often diagnosed in men in their 50s and 60s, but younger men can experience this as well. About 40% of men diagnosed with cancer are low-risk, and will have “active surveillance” over time, but it should start with a blood test to see the PSA (prostate-specific antigen) level. If this is at all concerning, then it can be followed up with an MRI to see if a biopsy is even needed.

Often men will first have their PSA tested at age 50, but it is now recommended that a man has his first test in his mid-40s. If the PSA level is low, then it needs to be repeated only every 5 years until about age 60. Doctors are suggesting that healthy lifestyle choices might help to lessen the chance of developing prostate cancer—regular exercise, maintain a healthy weight and eating less animal fat.

For those who develop prostate cancer, it needs to be treated aggressively. If a man has to have the prostate removed, better surgical techniques have been developed that allow sparing of the nerves that control the bladder for urination, as well as erection and ejaculation. For several months after the surgery, almost every man will experience urinary incontinence and erectile dysfunction, but pelvic floor physiotherapy can be helpful to return to a much better quality of life.

The pelvic floor is a group of muscles that sling under the pelvis, and act as support and stability, as well as assisting as a sphincter. These muscles work collectively, and are generally ignored by all until there is a problem with leaking urine. Your pelvic physiotherapist can help you to make sure that you are engaging these muscles correctly and effectively, as well as teaching you how to manage the abdominal pressure changes that come with coughing, sneezing laughing or moving around.

There is much that can be done, and seeing a physiotherapist who practices pelvic health can get you back on the road to full function quickly.