What's New at Physio Sport Med

The long weekend is coming and for some of us that means field lacrosse provincials, but for many more it is the weekend of planting, gardening, and preparing our backyards for the warm summer weekends to come.   And although the thought of warm days spent outside tending to our plants is relaxing and refreshing after a long winter, we need to remember that gardening is physical activity and there are some hints that can make it less stressful on the body.   Here is what I recommend.

1. Warm up:  If you are not someone that exercises regularly, or if you have been particularly sedentary lately, take time to warm up your muscles and joints.  This does not mean that you have to jump on the treadmill before heading outside, but maybe take a few minutes to walk around the yard.  Not only will you get blood flowing, but you will be able to scope out all of the work that needs to be done.
2. Think about getting a gardening stool:   Bending over is stressful for our back and legs.  Using a stool to sit on to reach lower beds can be helpful in preventing back and leg pain.   Some stools can also be flipped over to ease the stress of kneeling and prevent knee pain.
3. Change up activities:   Any repetitive work can cause stress on our tendons and muscles.  Every 15 minutes or so change the work that you are doing.   For example, weed a low bed for 15 minutes and then change to pruning a higher bush or tree.  The change in work load and posture will help make sure that you are still feeling well the next day.
4. Use the right tool for the job:   Using the proper equipment can make the day go smoother and reduce stress on the body.    For carrying heavy bags of soil or mulch, think about investing in a wheelbarrow.   Electronic and gas hedgers are also available to help with pruning and trimming.  If you are not sure that you would like to purchase these items, look into your local rental shop.  They often have equipment available for reasonable prices.
5. Continuing with the right tool, there are ergonomic aids available to assist if you have a joint that can flare.   Hand tools with larger and soft grips can reduce the stress if you have forearm and hand issues such as carpal tunnel syndrome or OA of the fingers.   Look for ergonomic rakes and shovels if your issues involve hip and back pain.

So, get out and enjoy the nice weather that is promised in the days to come.  But make sure to follow these top five hints to prevent injury and pain. 

There have been big changes happening at Physio Sport Med.   Our regular clients will notice that there have been many new faces in the clinic over the last few weeks.   We welcome Mark, Registered Physiotherapist, and Ashley, Registered Massage Therapist, to our team to get you back to the lifestyle you love.   To learn more about them, please see our bio page.  With the addition of these practitioners, we are very happy to offer extended hours and more convenient times, while maintaining the high-quality standards that our clients have learned to expect.  You can see our practitioner hours here.

​It is that time of year again.   Time to take your closed shoes and boots and stick them in a closet.   Ladies, it is time to take your socks and push them to the back of the drawer.   Time to pamper yourselves with pedicures.  As the weather gets warmer, the structure and form of our footwear will often change from supportive closed shoes and running shoes to sandals and slip-ons.  With this change, healthcare professionals often see an increase in plantar fasciitis.

First, what is plantar fasciitis?  The plantar fascia is a long, triangular layer of connective tissue that runs from the mid point in your heel to the base of your toes.   Its job is to support your arch and help create power when you push off in walking or running.   This tissue will often start to fray at the insertion point creating micro tears.   This damage to the tissue is called plantar fasciitis.    Symptoms often include arch pain with walking and tired, aching feet.  There is also a sharp pain with the first step in the morning and for some, the first few steps after sitting for a long time.

Treatment for this disorder can be frustrating and long.   Orthotics or taping can be helpful for some.  Most find that stretching their calf muscle before standing in the morning can relieve the sharpest pain, but not all of the pain.  Traditional physiotherapy treatment of Ultrasound, massage, mobilization, and strengthening of the intrinsic (small muscle) of the foot can also reduce symptoms.

However, Shockwave therapy is often the solution for many.   Research shows that 94% of people that did not respond to previous treatment have a significant reduction in pain and an increase in function with 2-3 treatments of Shockwave.   Shockwave is a pulsed sound wave that creates blood flow and regeneration of the plantar fascia tissue.   Shockwave is applied through the skin via a hand-held device.  And although it can be tender during treatment, most clients state that this is temporary and worth it. 

If you would like to know more about Shockwave, please contact any one of the associates at the clinic and we will tell you if it is right for you. 
​

As we age, our physical strength, bone density, and cognitive abilities decline.  This in turn deteriorates our sense of balance and we take longer to recover from falls. With age and inactivity, the unconscious processes in your brain that are responsible for balance may not integrate as well or as quickly as they used to, resulting in a fall.

To reduce the risk of falling, you can slow the process of deteriorating balance with Pilates exercise. Pilates focuses primarily on strengthening deep internal muscles of the abdomen, lower back, and hips, often referred to as the “powerhouse”.

The largest benefit of Pilates is developing a strong core; the most important thing aiding in mobility and balance. Whether you are practicing Pilates on the mat or with equipment, your balance will be challenged on a scale from moderate to high based on your current ability to perform the exercise. 

​If you're a child of the 90's, or raised children in the 90's, a purple dinosaur probably taught you that 'sharing is caring'. Although he may have been talking about sharing toys, there's something to be said about sharing meals too.
 
To say that Canadians are busy people may be an understatement. When it feels like time is scarce, it can be difficult to make time to connect with family or friends to share a meal. Roughly one-quarter to one-third of families never or seldom eat together as a family. But it's important to share meals. It allows people to connect, share traditions, learn, communicate, listen, and it also helps us eat a more balanced diet. Sharing meals is an enriching experience for people of all ages-from children to older adults. 

The biggest barriers to eating together are busy schedules like work and evening activities. Balancing a busy schedule certainly takes a little bit of creativity, but everyone benefits when you make the effort to eat in the company of others!

• Children who eat with their families tend to have more nutritious diets, do better in school, have a lower risk of being overweight and less risk of eating disorders.
• Teens who share meals with their families are less likely to smoke, use drugs or alcohol, or get involved in serious fights.
• Adults who eat with family and friends tend to have a lower body mass index (BMI), drink fewer carbonated beverages, and eat more fruits and vegetables.
• Older adults who eat as part of a group eat better quality foods and in a greater quantity, helping to improve nutrient intake and lowering the rates of malnourishment.

Now, whether out to dinner with friends or at home around the table with family, we have all experienced phubbing. What is that you might ask? Phone snubbing, it's when someone ignores their real-life companions in favour of their phones or other devices. A 2015 study found that 46.3% of participants experienced this regularly from their loved ones. As addicting as phones may be, it is possible to have a fun dinner with friends and family without anyone using their devices...I promise!
 
If you've exhausted all your usual topics of conversation and caught up on each other's days, a well-worded question can go a long way. Try and ask questions that require more than a simple 'yes' or 'no' answer.
​

• If you won $5 million, what's the first thing you would buy?
• If you could eat only one food for an entire year, which one would it be?
• What's the funniest or strangest thing that happened to you today?
• If you could have named yourself, what name would you have picked?
• If you could travel back in time, where would you go?

 
Sharing a family meal doesn't have to only mean dinner! If you have hectic evenings, share breakfast meals instead, or have brunch together on the weekends. Most studies done on the benefits of family meals suggest starting with at least four meals together each week. They all count!

Good Posture: Pilates will teach you to gain and maintain good posture. The exercises require that your body is always in alignment. This is especially beneficial if you suffer from lower back pain.

Muscle Tone: The exercises involve the use of muscles that you may not use on a daily basis. This is especially good for those who are normally quite sedentary in their daily life as well as older people because muscle tone is usually lost with inactivity and age.
 
Stronger Core: One of the benefits of Pilates is that it will result in a flatter tummy because it focuses on strengthening your core, which includes your abdominal muscles.
 
Less Back Pain: Back pain mostly results from faulty posture and a sedentary lifestyle. Pilates addresses the muscle imbalances that most typically contribute to back pain, namely weak abdominals and glute muscles. Pilates also stretches out the tight and overworked back muscles. Proper alignment is the main factor that helps to alleviate back pain. If you do Pilates, you’ll understand how to use your body in ways that protect your back from injury.
 
Flexibility: Pilates exercises stretch the muscles and the joints while they strengthen the body. As we age, we tend to lose the flexibility we had when we were young. Pilates helps restore flexibility. This is especially important in order to avoid injuries from falls.

More Awareness: If nothing else, doing Pilates should give you a new awareness of your body. You may never have thought about pulling in your tummy, sitting up tall, or keeping your shoulder blades down away from your ears. And you may never have thought a lot about how you breathe. The things you discover in Pilates will start to filter into your daily life, and you may find that you correct your own posture and habits naturally.

Better Balance: Through the mind-body connection which is taught in Pilates, you will become much more aware of how your body moves and performs. Therefore, Pilates not only improves your physical balance through correct posture, but also restores your mind-body balance.
​

Greater Strength: Any exercise regimen should increase your body’s overall strength. But Pilates strengthens the muscles in your body that you may actually notice on a day-to-day basis. Whatever activity you do, you’ll find that Pilates exercises improve strength in meaningful ways and can help with the overall health of your spine. Doing Pilates can prevent injuries, too!
 
Reduces Stress: When doing the exercises, you'll be totally engrossed and won't be able to think about all those responsibilities that weigh you down on a day-to-day basis. You'll be more focused on your breathing and on the moves that you are making with your body. This is an excellent way to relieve stress.
 
Introduce Pilates to your weekly routine, but be patient. No exercise program works miracles. Changes in your body will become apparent if you maintain a regular Pilates program.
 

Pilates isn't just for fitness fanatics. It's a complete fitness method to build strength in your core muscles for better posture, balance and flexibility, and when performed regularly, it positively changes bodies. It combines awareness of the spine, proper breathing and strength, and flexible training.
 
Research has found that Pilates can be an effective treatment for injuries and illnesses such as:

• Chronic neck and back pain
• Hip or knee replacements
• Multiple sclerosis
• Fibromyalgia
• Scoliosis

 
It is also excellent for athletes, dancers, and other sports professionals who have had some kind of injury and need rehabilitation to get back into top form. Because Pilates is a low-impact exercise, it can be tailored to work on certain areas of your body as long as you have a trained and qualified instructor – like me.  :) 

Injuries are an unfortunate and sometimes unavoidable aspect of participation in sport and exercise. Treatment options for injury often include rest, ice, massage, manual therapy, heat, electrical stimulation, and acupuncture. An often overlooked intervention is nutrition.
 
To understand the potential of food to help in the healing process, we first need to understand a little bit about the stages of injury.
 
Most exercise-related injuries go through three main stages in the recovery process. In the first stage, which lasts anywhere from 1-7 days, pain, swelling, redness and heat draws chemicals to the injured area to start the healing process and increase blood flow to the area. In the second stage, which can start as early as day 4 and last about 6 weeks, inflammation begins to settle down and the body starts to repair the damaged tissue by laying down collagen. These new collagen fibres are put down in the form of scar tissue, which is weaker and less flexible than normal tissues. In the third stage which starts around 2-3 weeks post injury, healing continues to progress and the collagen fibres improve in quality, organization and strength.
 
Nutrition plays an important role in each of these stages.

​Pilates is a system of exercises using various props and special equipment, designed to improve physical strength, flexibility, posture, and enhance mental awareness and overall well-being.
 
Pilates emphasizes your body’s core — the abdomen, obliques, lower back, inner and outer thighs and glutes. For this reason, Pilates develops much of what exercisers need — strength, flexibility, muscular endurance, coordination, balance, and good posture — with a much lower chance of injury than with other forms of exercise. This discipline emphasizes correct form.
 
Pilates moves require you to engage virtually your whole body. At times, you may strengthen one muscle while stretching another. The moves take lots of concentration; you can’t simply go through the motions like you can on gym equipment. And then, for every move you think you’ve mastered, Pilates has another version that’s a little different and a little harder. Pilates teaches you to think about how you use your muscles during your workout so you use them better in daily life. For instance, because much of the focus is on good posture and body mechanics, you stand and sit taller, and walk more gracefully.
 
Pilates also focuses on the mind-body connection. While doing the various exercises, your mind needs to be constantly aware of your breathing and the way your body moves.  Although there are similarities between yoga and Pilates, yoga is a more relaxing form of exercise that tends to focus more on spiritual well-being, whereas Pilates is more of a physical program which focuses on toning and strengthening.
 
Pilates is named after its inventor, a German physical fitness specialist Joseph Pilates, a former carpenter and gymnast who invented the exercise for injured dancers. Many of the moves were inspired by the principles from the ancient Greeks and how they trained their Olympians. He had a great library and was always studying - he was a genius of the body.
​

Lifestyle factors, including good nutrition and adequate exercise, have the potential to influence our health. A nutritious diet can help prevent illness and can help lower the risk of developing chronic diseases like Type 2 diabetes, heart disease, stroke, dementia and certain types of cancer. In fact, almost 80 per cent of premature stroke and heart disease can be prevented through healthy lifestyle behaviours (such as eating healthy, being active, and living smoke free).
 
What's Best?
There are many diets or eating patterns, some healthier than others. So you may be wondering, which eating pattern is best?
 
The reality is that there is no one absolutely, positively best diet for everyone. Everyone differs in terms of their:

• Dietary preferences and exclusions: some have food allergies, intolerances and food beliefs that influence their food choices.
• Budget: some have a limited food budget, while for others it may be unlimited.
• Cooking and nutrition knowledge
• Time: some have lots of free time to devote to proper eating and adequate exercise, while others have limited time.

So the best eating pattern is one that you enjoy and can stick to even on your worst days-not just your best. Dietitians can help you follow a healthy eating pattern suited to your individual needs and health goals.

Role:  Registered Dietitian
 
Stephanie, the newest member of our team, is our registered dietitian.   See her full bio here. 

Qualifications:
BSc. Kinesiology
BSc. Nutrition and Dietetics
MHSc (c) Nutrition Communication
 
What is your favourite part of your job?
The favourite part of my job is helping others be the healthiest version of themselves.
 
What is your favourite sport to watch?
Hockey!! Although summer is my favourite season, the morning sports highlights just aren't the same without hockey.
 
Have you ever needed sports medicine or therapy?
Yes! As a competitive runner and former varsity athlete I've needed my share of sports medicine therapy. Most recently I tore one of my hip flexors at the end of a running workout (grass was slippery, footing wasn't great) ...not fun!

If you a crayon in a Crayola box, what colour would you be and why?
Purple-it combines the stability of the colour blue and the energy of the colour red. It also happens to be my favourite colour.

What cartoon character best represents you?
Belle-she was my favourite Disney cartoon character growing up, and I admire her bravery, independence and intelligence. 

In this, the second week of Nutrition Month, I'm going to discuss foods potential to discover: Foster healthy eating habits in children by teaching them to shop and cook.
 
In a culture that is increasingly relying on heavily processed, packaged and take-out foods, many children are growing up lacking basic food skills, including how to shop, cook and build a balanced meal. Teaching children from a young age, how to shop for and prepare healthy meals can set them up for a lifetime of healthy eating. 

Shopping for and preparing healthy meals is also a great way to help your child learn new skills and build on lessons they learn in school.

• Math: how to measure ingredients, work with fractions or make change at the grocery store.
• Language: how to read a recipe or write a grocery list.
• Science: why does an apple turns brown.
• Health: what makes a healthy meal or snack.
• Social skills: how to work together to accomplish a goal.
• Social studies: what food is grown in Canada and in countries around the world.
• Food skills: how to whisk, stir, chop, and scoop.

​Cooking is also a great way to spend some extra time with your children or to reconnect after a long day apart at work and school. You can also use it as an opportunity to keep your cultural roots alive by teaching your children some of your favourite traditional family recipes. 

​Getting children involved in meal preparation is fun and rewarding! For an easy school lunch that you and your child can make together, give this Rockin' Ranch Roll Up a try!

Makes: 1 serving
Preparation Time: 5 minutes
 
Ingredients
1 10-inch whole wheat flour tortilla
2 tsp light ranch style dressing (or honey mustard)
2 slices deli turkey, chicken or ham
2 Tbsp shredded cheddar cheese
1 large leaf of iceberg, Romaine or Bibb lettuce
2 slices of tomato
 
Instructions
1. Spread ranch dressing on tortilla.
2. Top one half of the tortilla with meat, cheese, lettuce and tomato.
3. Starting with the meat/cheese edge of the tortilla, roll up and enjoy!
 
Notes: serve with a side of baby carrots and cucumber slices
 
Visit Cookspiration or download the app for more great recipe ideas!

I'm so excited to be part of this year's Dietitians of Canada Nutrition Month Campaign! We are celebrating Nutrition Month 2018 by helping Canadians unlock the potential of food to fuel, discover, prevent, heal and bring us together.
 
Dietitians all have one thing in common: we love food! Shocking, right? Whether we are counseling a patient recovering from a heart attack, teaching a cooking class or taking students through a tour of a grocery store, we are all passionate about the potential of food and its connection to health. You will learn so much this month about the amazing potential of food!
 
To kick off Nutrition Month, I'm going to discuss foods potential to fuel. 

Almost half of all Canadians say they find it challenging to eat a balanced diet because they are so busy. They often skip meals and close to 30% of Canadians say they eat of lot of snacks to stay fueled throughout a busy day.
 
Snacks sometimes get a bad rap. To some, snacking means eating when you're not hungry and to others it means loading up on unhealthier foods like chips, cookies and candy.  
 
Nutritious snacks, in the right portion sizes can be part of a healthy eating plan and is a great way to get all the nutrients the body needs each day.
 
Five Smart Snacking Tips

Fueling your body with healthy snacks between meals can help maintain stable blood sugar levels and lead to more consistent energy throughout the day. Snacks can also curb your appetite and prevent overeating at meals. Make snacking a piece of cake (okay, maybe that was the wrong analogy here) with these five tips:

1. Plan ahead. Make yourself a snack bucket at the beginning of the week. Cut up veggies, portion out nuts or cubed cheese. Having read-to-eat snacks on hand for when you get hungry can help you avoid less-healthy treats.
2. Listen to your hunger cues. Ask yourself: Am I really hungry? Or do I just want to eat because I am bored, stressed, tired or upset?
3. Practice portion control. Manage portion size by putting a single portion on a plate instead of eating from a bag or box.
4. Eat mindfully. Avoid snacking when you are reading, working, watching TV or playing on a computer. You may eat more than you need if you are distracted.
5. Find the right 'pear' (see what I did there?) The best type of snacks are those that contain protein and fibre.

Healthy Snack Ideas

​Next time you're looking to fuel up between meals, skip the vending machine or coffee shop and give one of these tasty snack suggestions a try:

1. Raw vegetables (carrots, cucumber, bell peppers, cherry tomatoes) with hummus.
2. Fresh fruit (banana, apple, pear, orange) with a small handful of unsalted nuts.
3. Hardboiled egg with a handful of grapes.
4. Stalk of celery filled with low fat cottage cheese or peanut butter.
5. Greek yogurt topped with berries.
6. Whole grain crackers with cheese.
7. A bag of homemade trail mix made with dry cereal, dried fruit, nuts and seeds.
8. Unsweetened applesauce topped with chopped walnuts.
9. Roasted chickpeas.
10. Cheddar cheese and apple slices.

​Visit Cookspiration or download the app for more un'beet'able snack ideas!

This is often a reaction I get when I tell people what I do.
 
There are many misconceptions when it comes to chiropractors.  If you ask a group of people what chiropractors do for a living, odds are cracking backs are at the top of the list.  In this post, I hope to shed some light on some of the misconceptions that come with what we do for a living.
 
1.    "Chiropractors only work on neck and low back pain" 
We work on essentially anywhere in the body as it pertains to musculoskeletal (MSK) conditions and their associated neurological system.  This includes most things from head to toe.
 
 
2.    "Once you start, you'll have to see a chiropractor forever" 
Not true!  If you are injured, your chiropractor will put together a plan to get you back to where you want to be.  Most importantly, the plan will have an expiry date.  Meaning, if you're not better, the chiropractor will either update the treatment plan, or refer you to another health care professional.  
 
Also, similar to how you see your family doctor for a yearly physical to make sure things are going well, or your dentist twice a year for a cleaning to keep cavities from creeping up, seeing a chiropractor a couple of times a year, even if you're not injured, can help keep you functioning well and out of pain! 

3.    "The only thing that chiropractors know how to do is crack backs"  
A "crack" (the correct term is actually manipulation) is just one of the many tools we possess!  You don't see a carpenter only use a hammer 100% of the time, right?  After a thorough history and physical examination, a diagnosis is made along with a plan of management and the appropriate tools are used.  Here are a few examples of some of the tools we use:

• Spinal and extremity manipulations
• Various soft tissue techniques
• Exercise prescription / supervision for fitness and rehabilitation purposes
• Modalities (ultrasound, stim, etc...)
• Injury prevention screening
• Running / gait analysis
• Acupuncture

 
Thus, because our chiropractor at Physio Sport Med has many tools in the tool box, expect a typical treatment to last approximately 30 minutes.  We take the necessary amount of time to do a great job and not "rush" things.
 
I hope this article helps to shed some light on what chiropractors really do.  If you're interested in having a chiropractor help you, please call the office at 905-257-3456 to book!
 

Role: Registered Physiotherapist

Paul is one of our two amazing physiotherapists here at Physio Sport Med.  His full bio can be found here:  http://physiosportmed.ca/practitioners.html

Education, certification, and courses:
BA (honours)
Masters in Physiotherapy (MPT)
Diploma of Advanced Manual and Manipulative Physiotherapy
Fellow of The Canadian Academy of Manipulative Physiotherapy
Acupuncture Foundation of Canada

1.    What is your favourite part of your job?
I love the clinic environment.  I'm a bit of a fixer, I see myself as a human mechanic.  I enjoy being able to figure out what is wrong and working on a plan with the patient as well as other practitioners as needed to fix the problem and get the person back to doing what they love.

2.    What is your favourite part of the body to treat?
 can't say I have a favorite, although I really enjoy a fixated joint in the spine and ACL rehab.  However, every injury has a story or a process.  I enjoy learning the whole story of how something happened and why it is the way it is.

3.    What is your favourite sport to watch?  
It’s too hard to say.  Any game of the big 4 during the playoffs, usually hockey in the winter, baseball in the summer, football on Sundays, and mixed martial arts when I'm interested in a specific fighter.  I love that baseball provides the comfort of always being there since there are 162 regular season games for any given team.

4.    What is your favourite sport to do/play?
I love to snowboard and ski in the winter.  I started skiing when I was 6, but switched to snowboarding after a torn meniscus in my early 30's.  During the spring/summer/fall I love to golf, cycle, and rollerblade.  I also lift weights and box pretty regularly to stay in shape.  

5.    Have you ever needed sports medicine or therapy?
Yes.  I’ve had a right labrum tear in the shoulder, right hip impingement, and a right lateral meniscus tear in the knee.   All injuries actually happened as I was in physio school, imagine that.  Took some time but I rehabbed them all.  Mental note: do not go trekking with a torn meniscus, really bad idea.

6.    If you could sing one song on American Idol, what would it be?  
I don't sing.  Period.

7.    If you were a crayon in a Crayola box, what colour would you be and why?  
Navy Blue.  It reminds me of the ocean water, soothing.

8.    Would you rather fight 1 horse sized duck, or 100 duck sized horses?  
The odds are not in my favor in either scenario.  A horse sized duck would be awesome to see, but you must understand that this is a mutant.  Although the duck sized horses seem like a better option, I would imagine that they would attack in a pack.  In the end, I would take the giant duck.  I have better odds one on one - but I'm not fighting in water.

9.    What cartoon character best represents you.            
Muttley - a little mischievous, but overall harmless with an infectious laugh. 

Role:  Registered Massage Therapist

Although Kristy is passionate about sport massage, her talents go much deeper than that.  She can get you back to your active lifestyle.    Her full bio can be found here:    http://physiosportmed.ca/practitioners.html

​Education, certification and courses:

• BA Kinesiology and PE
• Sports massage (Certified Sports Massage)
• Pregnancy massage
• Kinesio Taping (Levels 1 and 2)
• Myofascial Techniques
• Pre- and Post-Surgical massage

1.   What is your favourite part of your job?
I became an RMT because I wanted to help people both in everyday activities and in a sport environment.  My passion is sports and working at events on the sideline.  The best part of this is being part of the athletes support system and seeing the athletes achieve a personal best or medal. Pre-event and post-event massage is exciting and fast paced which is different than clinic work

2.    What is your favourite part of the body to treat?
As horrible as it may sound, I like treating the most tender body parts such as the IT band, hip, and plantar fascitis. But hear me out.  These are the body parts that provide the most release and really help relieve my patients’ pain and discomfort, getting them back to their activities of daily living or sports.  

3.   What is your favourite sport to do/play?
In 2003, I moved to BC and hit the ski slopes.  Nothing can compare to the scenery on BC Mountains, but life has changed and now I get to experience this sport all over again from the beginning through my husband and my 2-year-old son, Max. It’s a great way to spend quality family time as they learn to ski. 
 
Running in recent years has become a way to deal with stress and bond with the girls.   I would have never thought a High school field hockey goalie would eventually run a half Marathon while pregnant.
 
4.   If you could sing one song on American Idol, what would it be?
As my sister would say, get your ear plugs. I cannot sing.
 
5.    If you were a crayon in a Crayola box, what colour would you be and why?
Orange because it is a bright and fun colour that most people smile at when they see it.

6.   Would you rather fight 1 horse sized duck, or 100 duck sized horses?
Neither by myself.  I would call in a team of people to help me.  You have to know when you need to ask for help!!!
 
7.   What cartoon character best represents you?
​Mulan.   Why you ask?  Because she is an independent, bold and courageous woman who will do anything for her family and will risk her own life for them. Her determination and courage in the end is what helps her achieve her goal.  I have always been able to set a goal, see it through and determine a plan to make the steps towards achieving that dream or goal.    

​Role:  Sports Specialist Chiropractor

Dr. St-Onge has a special interest working with active individuals. Beyond manipulations (cracking), he uses an integrated approach including massage techniques, exercise and movement analysis to maximize rehabilitation.  His full bio can be found here.

Education, certification and courses:
 
DC - Doctor of Chiropractic           
ICCSP - Internationally Certified Chiropractic Sports Practitioner
FRCCSS(C) - Fellow of the Royal College of Chiropractic Sports Sciences (Canada)
Contemporary Medical Acupuncture Provider
CSCS - Certified Strength and Conditioning Specialist® SFMA - Selective Functional Movement Assessments
FRCms – Functional Range Conditioning
FR – Functional Range Release (Lower Limb)
​

       1.   What is your favourite part of your job? 
       Being able to empower my patients to take charge of their health and play an active role in their                                             rehabilitation  /treatment.

       2.  What is your favourite part of the body to treat?
         As the wise Chubbs used to say, “It’s all in the hips”

      3.  What is your favourite sport to do/play?             
       Though I have many years of competing in Kettlebell Sport under my belt, I’ve taken a big liking to climbing                     (mainly bouldering) in recent years and I am completely hooked!  

​       4.   Have you ever needed sports medicine or therapy?
       You don't play sports to a high level without ever needing therapy!  I sustained a minor back injury from                             Kettlebell Sport while in undergrad and visited my chiropractor that I hadn't seen in a few years - she fixed me               up, and that's how I decided to enroll in chiropractic school.
 
       5.   If you could sing one song on American Idol, what would it be?
      ”Turn the Page” from Bob Seger, BUT it must be the Metallica version.  Obviously. 
 
       6.   If you were a crayon in a Crayola box, what colour would you be and why?
       Green, more specifically color code 8cc145.  Yes, I’m a precise person.
 
       7.   What cartoon character best represents you?
       Popeye the sailor man, because of his excellent grip strength, made spinach cool for kids, loves his wife, and has           questionable vocabulary skills.  

​During the off-season, the average golfer can gain anywhere from 5-10 pounds. This will not only increase your pant size, it may also raise your golf score too! One often overlooked way to cut strokes from your game and feel better all round is eating and drinking right.
 
Here are a few simple tips to keep in mind when trying to manage your weight in the off-season:
 
1. Be mindful of portions
There's no denying that portion sizes are creeping up. Just compare the size of a standard coffee shop muffin today to those from 20 years ago. They are almost double the calories! If not mindful of this, it could lead to a creeping waist line.
An easy way to know portion sizes is to use the "plate method":

• Fill half your plate with non-starchy vegetables such as salad, green beans, carrots, broccoli and cauliflower.
• Fill one quarter of your plate with a grain or starchy food like bread, noodles, corn, rice or potatoes.
• Fill the last quarter of your plate with protein like fish, chicken, lean beef, tofu or beans/lentils.

2. Eat on a smaller plate
Ever heard of the Delbeouf Illusion? Well it might just help you eat less. The Delboeuf Illusion is an optical illusion of size perception. If you put a small piece of food on a large plate, your brain will tell you that you are eating a small portion. Put this same small piece of food on a smaller plate and your brain will tell you that you're eating a larger portion. From a psychological standpoint, it feels less like you are depriving yourself. So don't make that large plate mistake!

3. Don't drink your calories
Calories that sneak in through beverages are often forgotten. This is particularly true when talking about alcoholic and sugary drinks like soda and fruit juices. These forgotten calories can really add up throughout the day, sabotaging even the best weight management efforts.
Water is a great low calorie way to quench your thirst. Not a fan? Try sprucing up your water by infusing it with some fruit or spices. Now that's refreshing!
 
4. Eat your veggies
Who hasn't heard this one growing up. While your parents may not have meant this to help with weight management, they may have been on to something. Vegetables (and fruits) can add bulk to a meal but do not provide many calories. They are what we call nutrient dense foods. Plus, their vitamin, mineral and antioxidant content can help protect us from disease and help keep us looking and feeling our best. Thanks mom and dad!
 
5. Eat more slowly
Many of us live life in the fast lane, so it's understandable that we might try to save time by rushing our meals. However, eating quickly really does us no favour.  It takes about 20 minutes for our brains to register that we're full. When we eat too quickly, we can continue eating past the point where we're full, leading not only to weight gain, but also poor digestion and a lower satisfaction from eating. Eating slowly on the other hand, gives us time to realize that we're full and stop on time. Imagine that! So maybe the tortoise does beat the hare at meal times.
 
Meeting with a Registered Dietitian is a great way to help you integrate these tips into your diet to help you optimize your health and performance. 

Physio Sport Med was honoured to be invited to the Oakville Golf Club to take part in their Wellness Lunch and Learn Series.  Stephanie MacNeill, dietitian, and myself, Tricia Hayton, sport physiotherapist, discussed what can be done during the off season to benefit your game next year.

I specifically talked about low back injuries and what can be done to prevent them.  Did you know that up to 30% of golf injuries are low back injuries, and that professional golfers have more low back injuries that ANY OTHER PROFESSIONAL ATHLETE?    On average, an amateur golfer misses four weeks for each injury.   When we are talking about the short Canadian summer, that can be a large percentage of your season.

So, what are the top five things you can do to avoid missing your weekly tee off time?
 

1. Work on low back flexibility: Particularly being able to rotate.   To stretch it well, lie on your side, and extend the top leg out.   From this position, twist your upper back to lay your shoulders flat on the bed.  Hold this position for 15 sec.  For best results do both sides.
2. Increase Hip Internal Rotation:    Making the large strong hip joints do the work is a great way of reducing stress on your lumber spine.   To increase hip rotation, sit on a table top or bar stool so your feet are dangling.   Squeeze your knees together and hold them there with your hands or forearms, maintain this position as you take your ankles as far apart as possible.
3. Mobilize your thoracic (rib cage) spine:   This can be done using two tennis balls or lacrosse balls.  Place them on either side of the bony prominence of the back and gently roll back and forth.  Concentrate on the area between the shoulder blades as this is where we are generally the stiffest.
4. Don’t side bend:  make sure to keep your hips under you during your swing.   An increase hip swing greatly adds stress to your back, and nothing to the distance.  If you have (or have had) considerable low back pain in the past, it may be worth having a pro look at your technique
5. Build up your core:   This does not mean sit ups and external oblique crunches.  These are dynamic muscles that create power.  Although logic may suggest this is what you need to hit the ball further, studies demonstrate that lack of stability strength is the limiting factor.  Working on planks and side planks are a simple and great way to increase core strength.

Give these suggestions a try, but if you would like a specific program to maximize your game, we are here to help. 
  
What did Stephanie have to say about diet….  Stayed tuned for more information to come!

​The start of the New Year is a common time for everyone to take a closer look at their health. Those of us that hit the gym have probably noticed that it is busier than ever! While being physically active is important, our diets also play a large role in our health. Anecdotally, I have often had patients and friends opt for sweeteners in their food and drinks (aspartame, sucralose, stevioside, etc.) as they are calorie neutral compared to sugar. We like to think that this will help us lose weight (which comes with a host of health benefits!), but are non-nutritive sweeteners better for your health?

Will they actually help you lose weight?

A recent study was published in the Canadian Medical Association Journal in December 2017 on this very question. It combined the results of multiple studies that looked at the effect of non-nutritive sweeteners on body mass index, weight, obesity and other cardio metabolic outcomes such as the incidence of hypertension (high blood pressure) and diabetes (poorly controlled blood sugar). Interestingly, consumption of non-nutritive sweeteners was associated with weight gain, increase in waist circumference, and higher rates of obesity, hypertension, and diabetes. It should be noted however, that the study did not take into account family history, individual behaviours with respect to health and exercise, total daily calorie consumption, and other variables that would influence the outcome. Basically, people who choose non-nutritive sweeteners may have other health conditions or behaviours that predispose them to these negative outcomes. Further studies are needed to investigate these variables in relation to non-nutritive sweeteners and other health behaviours in the population.

At the end of the day, it seems that we cannot have our cake and eat it too. Although the above study shows that non-nutritive sweeteners are not helpful when it comes to weight loss and improved cardio metabolic health, we need to remember that there is more to our diet then just relative sugar consumption and that exercise is also an important factor. While non-nutritive sweeteners have been approved by Health Canada and are safe for consumption, it is important to remember that although the cake sweetened with stevia may not contain calories from glucose (sugar), it will contain calories from all the other ingredients. Opt for a smaller piece or replace it entirely with a much healthier fruit.

A healthy approach to weight loss is a plan that combines proper diet and regular exercise. Please speak with a healthcare professional if you have any questions or concerns about healthy weight loss.

There are members of the medical community that have added competencies that recognize additional expertise and skill sets which allow them to have a focused practice.   In a recent article from The Journal of the College of Family Physicians of Canada, Marni Wesner wrote, “the leaders in Sports and Exercise Medicine in Canada have been identified and awarded certificates of added competency.”

Does this mean that Sports and Exercise Medicine Physicians only see elite athletes?  No

Again, to quote Wesner, “Sport and exercise medicine (SEM) physicians have specialized training and skills directed towards assessment, diagnosis and treatment of acute, sub-acute and chronic injury and illness as they pertain to participation in an active, healthy lifestyle.  More than expert musculoskeletal assessment, the knowledge and expertise of the SEM physician extends to fracture management, joint reductions, joint and soft tissue injections and interpretation of imaging studies, as well as rehabilitation of injury, nutrition, concussion/head injury, sport psychology and orthotics/braces.  SEM physicians have a keen interest in sport, but also in the lifelong promotion of physical activity for wellness and the prevention and treatment of chronic diseases (i.e. diabetes, hypertension, obesity and arthritis)". 

What does this mean for those of us who are not elite athletes, but are just trying to stay active and enjoy sports with our friends to keep moving and stay healthy?   Our doctors are here to make this easier for you.    They are experts in assessing injuries to muscles and joints to give you a solid diagnosis as well as advice regarding how to minimize damage while also continuing to stay active.   This expertise moves beyond strains and sprains, to advice regarding concussions, osteoarthritis, and chronic joint issues that are preventing you from being as active as you can be.   We have seen a wide variety of patients – from those who are preparing to travel internationally to represent Canada, to the executive that plays squash with friends on the weekend, to the older gentleman who is now struggling to walk through the grocery store due to foot pain. 
​
We often get phone calls asking, “Can I come see you even if I am not an athlete?”  The answer is a resounding - YES!   Give us a call and we can book you with one of our Sports Medicine Physicians. 

It is that time of year again.  There is a lot of rushing to and from the mall, holiday concerts, and social gatherings.   And although this time of year can be fun, it is often very difficult to stick to a healthy lifestyle.  This includes diet, exercise, and relaxation.  Here are some helpful hints to help.

1. Make it a priority:  I do realize that this is easier said (typed) than done.  But the conscious effort to prioritize yourself will yield good results.  This doesn’t mean that there won’t be times of indulgence, but overall, the balance of good habits vs bad will be in check.
2. Water:  The elixir of life.   Bring a favourite sparkling or flavoured water to your social gathering and even your healthy drinks will feel like a treat.   Does this mean that you can’t slip in an egg nog or two – of course not, but try to alternate with water to minimize your calories… and your hangover.
3. Make exercise fun:   Make some of your social and family gatherings active.   A feisty family game of laser tag, a scavenger hunt, or hockey on an outdoor rink (weather permitting) can be a great and active start.  If you are not as competitive as my family, go for a hike, tobogganing or walk to see the lights in your neighbourhood.
4. Plan Ahead:  If you’re hosting a party, make sure to have a veggie or fruit platter.  I’m sure that you are not the only one who will appreciate the healthy option.  Also, make sure that you eat a healthy dinner prior to the party.  This will prevent you from filling up on the rich foods that are often served.
5. Don’t be tricked:  It can be helpful now that restaurants are including calorie counts.  Make sure to pay attention.  I was stunned when I first realized that some salads have more calories than the tasty(ier) Asian noodle dish I was eyeing.

My final piece of advice, don’t expect to be perfect.  After all, the holidays only come around once a year.  On this note, I’ll end with a useful quote.

“Giving up on a whole day of healthy eating because you allowed yourself one treat, is like dropping a cell phone, then stomping on it just to make sure it is broken.” 

It is that time of year again.   We are back in the rinks and the kids (and kids at heart) are playing hockey.  Did you know that upper body injuries happen more frequently than lower body injuries during hockey? 

​
Let’s break down what happens.

1. Head trauma:  Obviously the most common injuries are concussions, and that is a post or two all on its own.   For a great run down on concussions, please see our learn article:   http://physiosportmed.ca/learn.html.  There can be other, more serious forms of head trauma, but this is extremely rare, especially with modern helmets.
2. Lacerations:  These are cuts that often occur to the face.  One of the more common spots is the chin – make sure that your strap is done up and fitted correctly.   Once you graduate from a face mask or shield, the eyebrow region can also be easily damaged.   Although the face is the most common location for lacerations, they can also occur at the wrist in the gap between the jersey and the glove.   This region can be more serious, especially if it is due to a skate blade.
3. Sprains and Strains:  This is when a muscle or ligament gets stretched, resulting in pain and lack of movement of a joint.   If the ligament or muscle is stretched too far, it can tear.   This should be treated with ice, compression, and rest.   If it is still sore in 2 days, visit your doctor or therapist.   One of the more common sprains is a separated shoulder, which results from hitting the boards shoulder first. 
4. Contusions:  This is the medical term for bruise.  It is by far the most common injury in hockey and is usually caused by hitting another player or the boards.  Bruising usually responds to ice and rest, however, if the bruising is severe, firm to the touch, or restricts movement, it is wise to seek medical advice.
5. Fractures:   A medical term used for any break or crack to a bone.   Look for swelling, loss of ROM (range of motion), bruising, and tenderness along a bony prominence.   Seek medical attention as soon possible.

As always, the best treatment for any of these injuries is prevention.  For a quick reference sheet in preventing upper body injuries follow this link from ProStock Hockey (Upper Body Injuries) and check out their website for more information!  In general,  make sure you are strong, use good technique, and have all of the proper equipment that is certified and well fitted.

When I look outside, I know what I will be doing this weekend.  Beyond packing up the Halloween decorations, it’s time to clean up the backyard for winter.   However, raking and trimming can be very stressful on your body.  It is one the leading causes of low back and shoulder injuries at this time of year.     Here are some helpful hints to keep you going and keep you healthy.

1. Warm up:  Raking is more exercise than some of us are used to.  Walk around for 5 minutes to increase the blood flow to your limbs.  This can be a walk around the neighbourhood, or just around the yard to assess how much work there is to do.
2. Pick the right tool for the job:   There are ergonomic rakes that can reduce the risk of injuries, particularly of the lower back.
3. Change it up:  Switch activities every twenty minutes or so.   For example, rake, then bag, and then trim the garden.  The change in posture and movement will change the muscles and joints that are under the most stress.  
4. Keep it light:   Although there may be more room in the garden bag, remember to consider the weight of the contents, especially if you must carry it from the backyard to the curb.   If the leaves are wet, or there is considerable soil in the bag, it will be heavier, adding stress to your back and knees.
5. Wear good shoes: There are often sticks and other obstacles under the leaves (or in my case, dog toys).   Shoes or boots with good foot and ankle support will help you to keep your balance and prevent ankles from rolling
6. Step it up:  Stepping forward and back with a rake will reduce how far you have to stretch your shoulders to gather the leaves.   The further our arms move away from the body, the more vulnerable they are.   Sharing the work with the large strong joints of the legs is a good way to reduce the risk of shoulder injury.

​Hopefully these tips will help keep you strong and injury free this season.    After all, it won’t be too long until we are shovelling snow… 

Introduction
Hi, my name is Kimberly Fernandes and I am the new sports physician at Physio Sport Med. I want to take some time to introduce myself, as well as the role of sport medicine physicians, in helping you, whether you are a full-time athlete, a weekend warrior or are just looking to treat chronic musculoskeletal issues.

Education
I completed my Doctor of Medicine degree at McMaster University’s Niagara regional campus in 2015. I then moved back home to Mississauga to complete my Family Medicine Residency training at the University of Toronto’s Trillium Mississauga site. I acted as chief resident during my final year and did research on wellness among medical trainees. I have also attended the Ontario Medical Association’s Sport Med Conference in the last few years to keep up with current innovations in the field.

Experience
During my many years of medical training, I have always been interested in sports medicine. I have spent time in many sports clinics, and with many rehabilitation specialists including physiatrists, neurologists, physiotherapists, athletic therapists, and chiropractors. I have also provided medical coverage at sporting events including the Skate Canada World Junior Synchronized Skating Championships and the Little League Ontario Baseball Provincial Championships.

How I Can Help You
As a sports physician, I treat a variety of issues that range from sports-related injuries to chronic musculoskeletal conditions such as osteoarthritis. Whether you are looking to overcome an injury and get back into sport, or to find alternative solutions to long-standing issues, I, as a sports physician, am here to guide you. I am also trained to do joint and other soft tissue injections as indicated for treatment. If you have an issue you would like to discuss, call or drop by the clinic to inquire about an appointment. Visits to a sport medicine specialist are covered fully by OHIP, and while a referral note is always appreciated (as the referring doctor can provide necessary information about your current health status and imaging results), it is not required to book an appointment with me. 

​I look forward to meeting you!