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Staying Fluid and Injury Free in Dance and Choreography

I am a UK based physio working in Exeter and Totnes. My focus is in helping people to develop a positive relationship with their body allowing them to become injury free, taking control of their own health and enjoying an active life.

When learning new choreography there is often a pressure to get the moves right quickly. This can energise us and enables us to focus our effort but it can also increase stress and tension. By focusing on what we’re trying to achieve it’s easy to forget our bodies, the very thing we need to be tuned in to. In my experience as a physiotherapist, tension is the major risk factor in triggering an injury.

How can I stay relaxed when learning choreography?

As a physiotherapist I work closely with breath. When we are stressed it is easy to lose our natural breathing pattern. This results in breathing into the chest rather than using our full abdomen, increasing tension and reducing performance.

Instead, take opportunities to breathe in softly through the nose feeling the lower abdomen gently expand. Avoid pulling in or tensing the stomach muscles. If you sense tension or discomfort you can take a long, slow and gentle out breath exhaling through the nose. Feel the muscle tension melting away, you can focus relaxation on specific parts of your body.

Dancing is fun and it is important to not be hard on yourself but to treat your body with patience. Often my clients put a lot of pressure on themselves and find that their performance improves when they just relax into their practice. Trust that you’re doing your best and your body will follow. If you have an injury it can be both stressful and frustrating, you may feel unable to train and this stress is likely to slow down recovery. I encourage clients to use imagery in their recovery process, softening breath and imagining yourself doing the choreography. Imagery has been shown to improve sports performance and helps connect the body and mind.

Michael Otto BSc MCSP  Holistic Physio in the UK.

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Do YOU have TMJ?

Have you heard of your temporomandibular joint (TMJ)? It’s one of the most used joints in your body. Did you know physiotherapy can help with TMJ problems?

Your TMJ, also known as your jaw joint, is used for eating, talking, expressing emotion (both consciously and unconsciously) and breathing.

Pain associated with dysfunction in this area may be felt in the jaw line, cheek, ear, temporal region (side of head) and commonly associated with headaches and neck pain. TMJ problems, or TMJ dysfunction (TMD) can also present as inability to fully open your mouth, pain with chewing, popping/cracking with opening and closing your mouth, and/or grinding/clenching of teeth.

Some of the causes of TMJ problems can be derangement or displacement of a disc between your mandible (jaw bone) and skull, muscle dysfunction, habitual clenching/grinding (bruxism), or trauma to the face and jaw. Common contributing factors to TMD can be stress, anxiety, prolonged opening of the mouth (e.g. during dental procedures), mandibular malalignment or orthodontic work to name a few.

A physiotherapist will assess the TMJ by asking a detailed history, taking observations of jaw alignment, posture, and neck position. They will observe how the individual opens and closes their mouth, looking for abnormal movements patterns, and observe for clicking from the TMJ. The therapist will palpate externally for muscle tone, and to assess the movement of the TMJ. Using gloves an intra-oral assessment will be completed as well to determine how the joint is functioning, and to further assess the myofascial system. The neck is generally assessed as it can commonly contribute to dysfunction in the TMJ.

Following an assessment, a treatment plan and home program will be developed.

Ms. W comes in with complaints of pain through the right greater than left temporal region of her jaw, inner ear on right, frequent headaches and stiffness in the jaw that is often worse in the morning. Recently she has begun to noticing a clicking from her right jaw, especially when she yawns or eats chewier items. Her dentist advised her she likely has TMJ problems and recommended that physiotherapy may help.

The physiotherapist may ask a few of the following questions: How long have you been dealing with this problem? Do you ever find yourself clenching your jaw in times of stress or have you been told you grind your teeth overnight? Any recent dental procedures? Any history of trauma to the face or neck?

As mentioned above the TMJ is one of the most frequently used joints in the body. Most clients who receive treatment for their jaws have been experiencing symptoms for some time, and often did not know that physiotherapy can help. Commonly they have seen their doctor or dentist prior to seeking treatment.

In the case above the individual likely has a longer standing history of clenching, also known as bruxism. Commonly people can do this subconsciously during their sleep, or in times of stress. When frequently clenching the muscles of the face and jaw can become fatigued and become sources of pain. When muscle are held tight for long enough they can start to alter the way the jaw moves, and lead to problems with a disc located between the jaw and the skull.

The physiotherapist will develop a treatment plan specific to Ms. W’s presentation completing treatment specific to the muscles surrounding the TMJ and the joint itself.

 

If any of the symptoms described sound familiar, book in for an assessment today!

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Welcoming incoming therapist Kendra Usunier!

As many of you know I, Haylie Lashta, will be going on maternity leave soon, with my last day scheduling clients being June 2, 2017. I have searched for the perfect person to come in to cover for my maternity leave that can also complete women’s health assessment and treatment, and she has been found!

Kendra Usunier BMR(PT), MClSc, FCAMPT will be joining our team starting on May 23, 2017!

Biography

Kendra graduated from the University of Manitoba in 2008 with a Bachelors of Medical Rehabilitation in Physiotherapy. She went on to complete a Masters of Clinical Science in Manipulative Therapy from Western University in 2015.

Since graduating Kendra has worked in Saskatchewan and Manitoba. She returned to Saskatoon in 2012, and is excited to begin working in Warman. Having grown up in a smaller community, she is happy to return to that environment.

Kendra’s primary focus has been orthopaedics and women’s health. She has taken extensive additional training in orthopaedics, becoming a Fellow of the Canadian Academy of Manipulative Physiotherapy (FCAMPT) – an internationally recognized qualification in manual and manipulative therapy. For more information on CAMPT therapists please click here.

In addition to orthopaedics, Kendra has a passion for women’s health and pre-and post-natal care. She has also taken additional courses in treatment of temporomandibular joint dysfunction, acupuncture, pain management, and myofascial release.

Kendra has a passion for ongoing education in physiotherapy, striving to provide the most up to date, evidence based treatment for patients. She assists in instructing muskuloskeletal courses at the University of Saskatchewan and within the Canadian Orthopaedic Division Syllabus.

Kendra enjoys spending time with her husband and daughter, running, playing soccer and doing yoga in her spare time.

Areas of Practice Interest:

  • Spinal Assessment & Treatment
  • Osteoporosis Management
  • TMJ Dysfunction
  • Sports Rehabilitation
  • General Orthopedics
  • Prenatal & Post-partum
  • Urinary Incontinence
  • Pelvic Pain
  • Acupuncture

Kendra’s schedule has been provided and is available for appointments. Contact us to book your appointment today! Don’t want to wait? Cole Digel has availability as early as the week of May 15, 2017.

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Is your NECK causing your arm or shoulder Pain?

Case Study: A client HD came to the clinic after several weeks of shoulder, shoulder blade and arm pain. This pain started in the shoulder and moved down the arm. The client would describe the pain as ‘sharp’, ‘burning’, ‘shooting’, ‘deep achy’, and ‘pins and needles’ depending on what they did. Initially their pain would come and go, but over time the pain would stay for longer periods of time. This client found that sometimes anti-inflammatory medication and massage helped, but it always came back. Since their pain started in their shoulder it was believed that it was a shoulder injury (rotator cuff). After assessment by a physiotherapist it was identified that HD had issues from the neck resulting in shoulder and arm pain. With treatment including home exercises, stretches and programming, the client was able to return to full function and a pain-free state of being!

neck-pain

The story of HD is not uncommon. Often people are not sure where to go for a variety of issues and complaints. Your local Warman Physio is able to provide assessment and treatment of any ache or pain occurring within the body, whether it was caused by an injury or ‘just showed up’ one day.

Physiotherapists are trained to provide assessment and treatment of all the body systems including the muscles, tendons, ligaments, and nervous system to identify what is causing any pain or issue.

Following is a list of conditions that Physiotherapists can help with in the neck and arm:

  • Disc bulges in the neck
    • often causes pain as is outlined in the image above with the red highlighted areas depending on the level the bulge is present
  • Nerve compression or irritation of nerves of the neck
    • pain down the arm with moving the head a particular direction like in shoulder checking
  • Carpal Tunnel syndrome
    • pain and tingling in the hand often upon waking from a night’s sleep to start
  • Rotator cuff injuries
    • pain in the shoulder often with reaching over head or behind the body
  • Tennis/Golfer’s elbow
    • pain on the outside/inside of the elbow often with lifting/carrying

 

How does the neck cause pain in the shoulder and arm?

The body is a complicated group of systems that work together to allow us to complete our everyday tasks. Our neck has 7 vertebra (C1-C7) that go from the base of the head to the base of the neck. Within your neck there are 2 joints at the top and bottom of each vertebra, and most of them are separated by small discs. Our spinal cord is enclosed inside a tunnel within the vertebra. The nerves that go down into the shoulder and arm come out from between the vertebra, through the muscles and down the arm. These nerves then control the muscles (creating movement) as well as sensation (touch, temperature, etc). If something happens to the nerve throughout it’s path down into the arm it can create issues in the movement, sensation, or both!Sometimes it is hard to figure out where pain is coming from – the muscles, joints, nerves, tendons (attach muscle to bone) or ligaments (attach bone to bone). Leave the guess work out of your pain and have it assessed by your local Warman Physio!

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Shoulder Injuries: The Rotator Cuff

A common pain to have is shoulder pain. Shoulder injuries are often diagnosed as a ‘Rotator Cuff’ injury, but what does this mean and what can YOU do about it?

Case Study – PJ

PJ came to the clinic reporting a left-sided shoulder injury that was sustained 1 month previously. At the time PJ was having severe pain and difficulty reaching forward, backwards, sideways and overhead. He was limited in daily activities experiencing pain up to 8/10 with getting dressed (particularly getting the left arm into a shirt or jacket). By the time PJ sought treatment he had already changed many of the ways that he moved, compensating for the pain and weakness. This client had also already had an ultrasound taken of the shoulder and a rotator cuff tear was identified on the report and he had been referred to an orthopedic surgeon. He was fearing the worst – that this injury would stop him from doing all the things he wanted to do through the summer, including getting back to his active job and it had been ‘too long to get it fixed’.

During the assessment a few things were discussed with PJ:

  1. Imaging does not always clearly indicate that you will or will not need surgery. In fact, many individuals end up resolving their pain with physiotherapy alone!
  2. The length of time an injury has been present does not dictate if it will get better or not
  3. Hurt does not necessarily equal harm – but we don’t always push through pain. There is a time and place for ‘no pain no gain’ just as much as there is a time and place to protect and rest
  4. If the client was able to complete the exercises, stretches and guidelines provided then things should get better pretty quickly

When we started the assessment PJ was unable to lift his arm sideways past the level of his belly button, was unable to reach past his hip behind his back, and unable to reach overhead without pain reaching up to 8/10 and stopping him from going farther.

After 8 appointments, PJ is now working on return-to-work programming, strength and conditioning and is back to full PAIN FREE range of motion. This does not happen by accident. PJ was encouraged to complete the exercises and stretches provided, and he was able to stick with them and continue to make progress between appointments.

Our motto at Warman Physio is that

We are here to help you help yourself

There is no point having a client into the clinic to just do things to you that you are unable to continue progress at home. We want to help you resolve your shoulder injuries as quickly as possible.

Now many people will think…

My shoulder injury can’t get better because:

  1. I don’t know how I hurt it
  2. It has been going on for ‘too long’
  3. It just keeps coming back
  4. I’ve already seen someone for it and it didn’t help

What we are here to tell you is:

  • You do not need to know HOW you hurt yourself, you just need to be able to explain how it hurts (and we help you with that!)
  • It is ideal to get in for physiotherapy as quickly as possible after an injury (we do after all do sports therapy and assess injuries as they happen on the field!)
    • BUT this doesn’t mean that pain lasting a month, a year, or 10 years cannot be assessed, treated and resolved
  • If you have a pain that keeps coming back, there could be some underlying factor that keeps starting it up – weakness in another area, tightness in the front or back – our job is to identify what that underlying cause is
  • Seeing one therapist does not mean that they had the right tools to help you at the time that you saw them. Sometimes it just takes seeing someone at this particular time that allows you to get better

So what are you waiting for? Stop suffering with your shoulder injuries and pain (or any other pain for that matter!) and book and appointment with your local Warman Physio

shoulder-advert1

 

There is no ‘one treatment’ for ALL shoulder pain, as each underlying reason and client is different. This means that although we would really love to provide “4 simple exercises to cure your shoulder pain” we are unable to, since each client requires their own assessment, exercises and stretches that is individual to each of them.

You can call to book, or schedule online with our Physiotherapists, in WARMAN and SASKATOON starting September 23, 2019 we will have SAME and NEXT DAY availability for assessments!

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