What's New at Physio Sport Med

About 18 months ago, a friend of mine contacted me to ask if I wanted to be a lead for the Invictus Games.   At the time, I did not know much about the games, but I said yes, as I’m always willing to help a friend.   I asked if I could be the medical lead for Wheelchair Rugby, and that is how this adventure began.

If you Google the Invictus Games, you will see that Toronto is hosting the third ever games.   Invictus Games is the inspiration of Prince Harry, who stated during his opening ceremony speech that his life changed forever during his time in the British Armed Forces.  It was then that he decided to use his position of power to assist with wounded warriors’ recovery. 

If you look a little deeper, you will find that Toronto is hosting veterans from 17 nations including Iraq, Jordan, and Georgia, with Romania and Ukraine joining this year.  These men and women, all injured in the line of duty, will compete in 14 sports throughout the Greater Toronto Area.  Many of these warriors have not only physical injuries, but mental injuries as well.  

What you will not find when you Google the Invictus Games is the gratitude, the tears, and the stories that come from working with these amazing athletes.  They have all suffered a loss, and being selected to be part of the games is just part of their recovery as they adjust to new abilities, new expectations, and for some, new dreams and goals.   The focus of these games is not to win – although they are very competitive people by nature – but to use organized sport to rehabilitate mentally and physically.

I have been part of many games, but I have never had an experience like this.  I encourage everyone in the Toronto area to take advantage of the last few days of competition to come be a part of it.   Take the time to thank these men and women for their service.    Personally, I know that I will never be quite the same.  

Did you know that there are 23 summer Paralympic sports and 6 winter Paralympic Sports? 

Did you know that there has been a vast improvement in the science of prosthetics over the last few years?

Did you know that the current fastest Para-Sprinter can run 100 meters in 10.57 seconds? 

This is just a little bit of what I got to experience over the last week attending the Vista 2017 Conference that focused on the opportunities and challenges in Paralympic sport science and sport medicine.   These researchers have looked at the biomechanics of the athlete, equipment, socioeconomics, and new technology to help these athletes improve their performance and create a safe environment.

This conference came at the perfect time since the Invictus Games have begun in Toronto this past weekend.  These games are about men and women who have honoured their country at war and have returned with a disability.  They are now representing their country again, but in the form of sport. 

After this week at the conference and listening to all the research being done, I find myself studying the   movement of these athletes and the challenges of the sports, some of which I have never watched before.  I find my myself asking “how is that affecting or contributing to their performance?”.  Also, as I watch these athletes, I admire them for what they have gone through to be standing on the playing field or court representing their country.  I wonder if I would be able to have the same strength to achieve greatness with something that many would see as a negative. After giving it some thought, my answer is: I don’t know, but I hope I could.   

On the last day of the conference, we got to visit the CSIO (Canadian Sport Institute of Ontario) in Scarborough, and I got to see the amazing facilities that our athletes get to train in.  It is facilities like this that are a product of Own the Podium – a not-for-profit organization that focuses on investment strategies to improve Canada’s high-performance sport system.  Financial support from Own the Podium allows facilities like CSIO to create ISTs (Integrated Sport Teams) to help support national sports, athletes, and coaches.  Each IST will differ based on the needs of the team, but could include physiologists, mental performance experts, dietitians, strength and conditioning coaches, biomechanics experts, sport medicine practitioners, physiotherapists, and massage therapists.  This combination of experts will support the athletes through their athletic journeys. 

Many have asked me, “I have arthritis.  How can I be considered an athlete?”

The fact of the matter, is that exercise can greatly help with the signs and symptoms of arthritis.   Exercise has been proven to decrease the pain, depression, and fatigue that is often associated with systemic arthritis such as rheumatoid arthritis, fibromyalgia, and lupus.   Will it take the disorder away?  No.  But it will help give you control of the symptoms.    You must grade the intensity to respect the limitations of your body.  Try a specialized yoga class or water exercise to maintain flexibility and strength while minimizing the stress on your joints.

One in 6 Canadians have arthritis and the vast majority of that is Osteoarthritis.  The joints most typically affected are the knees, hips, and hands.   Once thought to be simple wear and tear of the joints happening earlier than expected, current research shows that there are cellular changes to the cartilage of the joints indicating that the problem is more complex than initially thought. 

The number one treatment for osteoarthritis is a program that combines education and strengthening.  The education component assists with understanding what is happening to your body and how you can prevent it through change of active level, proper nutrition with and without weight loss, and joint conservation techniques.   Exercises should focus on form and very slowly progression to strengthening with weights, if at all.   This way of strengthening is call neuromuscular training.  That is a fancy way of saying that the program focuses on correcting the movement pattern of the body to maximize the efficiency of the joint and the muscles surrounding it.    A study in 2015 showed that completing a 12-week program reduced pain, reduced pain medication use, increased activity, and reduced sick leave significantly.   
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So what makes you an athlete?   As long as you are using exercise to make yourself stronger, healthier and more active – you are an athlete in our books.  

The number one goal we should all have with an exercise program is to prevent injury.
 
This must come before any goal of fat loss, weight loss, muscle building, or performance enhancement, because if you get hurt, then none of those goals even matter. You can’t train.
 
The primary cause of athletic injuries is neither weakness nor tightness, but rather muscle imbalance. Just because you can squat three hundred pounds doesn’t mean you won’t tear your Achilles during a squash game. Raw strength does not equal functional strength, and ignoring whole-body stability in favor of isolated muscle mass and power is a recipe for disaster.
 
We enter the world as limber, symmetrical babies but over time, we develop muscle imbalances and asymmetries. These can make us less efficient and more prone to injury. Think of it this way: Even if a car has a flat tire, you can still drive it, but that tire uses up extra energy and will eventually alter the overall alignment of the car.
 
We need to ask ourselves:

1. Are we moving correctly?
2. Is our body stable when we move?
3. Is our body balanced?
4. Are we moving as nature intended?

 
Most of us have probably answered “I think so”, but how can we really know for sure?
 
That is where the Functional Movement Screen (FMS) comes in. It is a seven-part test which helps identify muscle asymmetries, tightness, weakness and other risk factors for injury by examining the mobility and stability of the hips, core, shoulders, knees, spine and ankles. It is different from other screens as its focus is on dynamic movement.
 
                                     “Movement never lies” (Martha Graham).
 
The FMS lets us know how the brain is controlling the body and how the joints and muscles communicate.
 
You may find the movements are a bit awkward and challenging to do. That is by design - each isolates a different area of the body to prevent you from compensating and hiding weakness. It’s not magic — it’s simply good mechanics. The main purpose of the FMS is to seek out poor movement patterns so you can retrain the body to move in the most stable, efficient way possible.
 
It is essentially a quick and easy way to screen fundamental movement before you train it. If you train with a baseline of a poor quality of movement, the risk of injury is significantly increased. If, however, you correct baseline movement in a methodical, corrective exercise strategy prior to advancing performance training, the risk of injury is significantly reduced.

The FMS is designed for all healthy, active people as well as for healthy, inactive people who want to increase physical activity. It is designed for those that do not have pain or injury. 
 
With the increased desire to be fitter, stronger, and more athletic, people need to realize the importance of having fundamental movements before advancing into higher-level activities. What often happens is people are putting exercise and performance on top of dysfunctional movement, which can impair performance and cause injuries.
 
I personally believe it is very important to know how your body is moving so that you are exercising at your full potential and not increasing the risk of injury.  Movement Matters! Come in and see us for a movement analysis.
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I find that the beginning of September brings as many resolutions and promises to improve people’s health as January 1st.  The advantage of starting your active lifestyle in September, is that it is still warm enough to get outside and enjoy Mother Nature.  Veggies are fresh and the farmers markets are still in full swing, so eating healthy is simple and tastes great.   So, what are some tips to making your new lifestyle count?

1. Start small:  In order for your changes to make a difference, you need to make a lifestyle change – not take part in a diet fad or exercise trend.   Making huge reductions in your calorie count or hitting the gym 5 days a week can be difficult to maintain over the long haul.    Start by slowing changing the nutritional quality of your food, or reducing portion sizes.   For exercise, start with a daily walk or a simple exercise class available in your local community centre.  
2. Reward yourself: not all changes have to be removing something from your life that you enjoy.  Add in a hobby or an activity that you have always wanted to try such as an art class, a new hair cut or regular pedicures.    Take a look at that bucket list and see what is possible.
3. Work healthy habits into your lifestyle:   You have a life that works for you, so try to incorporate changes into what you already do.   Are you a sports parent?  Take a walk in the community around the arena during practice to kill time.   Do you commute?  Try walking from the train station or park at a parking lot a little further away while the weather is nice.  Do you order a gourmet coffee every day?  Try ordering something with low fat milk and skip the whip cream.

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You can do this!  Yes, you are probably going to occasionally couch surf or sneak in that tasty treat, but that is all part of the gradual lifestyle change.   Allow yourself these exceptions, then get back on track.   Remember – We are all athletes!

Pop quiz!  Which picture below depicts the best sitting posture?

 
Before we go over that, try this out.  Place your hands together (as if you are holding a piece of paper between your hands) and squeeze them together as hard as you can. Keep squeezing.  Notice that after a certain amount of time, your muscles became tired and gave out?  Now imagine you squeezed these muscles (at a lower intensity) but for 13 hours a day, every day?  Do you think those muscles would be stiff and sore? 

Well, this is what happens when we choose a single sitting position and never move out of it!

Staying in the same position for an extended period of time can lead to sore muscles and/or back pain.

So maybe the better question is, how often should we be changing positions? 

Best-case scenario – stand up and go for a small walk / take a stretch break / visit the water cooler every 20 minutes.

Second best-case scenario – change your sitting position every 20 minutes. 

The idea here is that we want to give your muscles a break by changing positions.  Simple as that. 
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Try this out and leave a comment below to let me know how it goes!