Category Archives: Uncategorized

Why is your core so important?

By Courtney White, Registered Physiotherapist

Have you ever wondered what makes up your core, why is it important, or how to safely train your core without getting back pain? Keep on reading to find out these answers and more!

Your core is more than just the muscles that you can see. There is a group of muscles below the big six pack muscles that wrap around you like a corset. Their job is to support you during every movement. This inner unit is like a TRANSFER STATION. To get power generated from your legs all the way to your shoulders, it must pass through the inner core. So, if you do not have proper control over your core, that power will not move between your upper and lower body as smoothly as you want it to.

What Makes Up the Inner Core Unit?

The inner core consists of the following: the diaphragm, the pelvic floor, transversus abdominus (TA), and multifidus. Collectively, these 4 structures create a CORE CANISTER.IMG_5235-01Pic for Core

Diaphragm: The diaphragm is our primary breathing muscle and it forms the top of the core canister. The diaphragm is the component that has the primary control over the intraabdominal pressure within the canister. It moves up and down as you breathe which changes the space in the abdomen and as a result, influences the pressure within the core canister.

Pelvic Floor: The pelvic floor is a group of muscles that form the bottom of the canister. It supports the weight of all the internal organs within our abdomen, assists with bowel and bladder control, and helps to control the intrabdominal pressure along with the diaphragm. The pelvic floor is partners with the diaphragm. When the diaphragm moves up and down, so should the pelvic floor.

Transversus Abdominis (TA): This muscle connects the top and bottom of the canister as well as creates the front and sides of the core canister. It runs deeper than the external six pack muscles that you can see. Its role is to support your lower back during movement and transmit forces between your upper and lower body.

Multifidus: This muscle forms the back of the core canister and runs along the spine. Multifidus serves as a primary support for the spine, pelvis, and hips.

[1]Canister

What Are the Functions of the Core Canister? 

  1. To support the back, pelvis, hips, and trunk during movement
  2. To serve as a transfer station for power and energy between the upper and lower body
  3. To assist with bowel and bladder control
  4. To improve performance during physical activity

How Does the Core Canister Work?

To gain a stronger core overall, it is important to learn how to “pressurize” the core canister. Previously, inner core training has focused largely on tensing the walls of the core canister through focused contractions of TA. Learning how to activate the diaphragm and pelvic floor was often missed or brushed over. More recent evidence now suggests that breath is the driving force behind influencing the intrabdominal pressure. Therefore, the diaphragm is the leader behind pressurizing the core.

When you breathe in, your diaphragm contracts and pushes down into the abdominal cavity which increases the intraabdominal pressure. In response to this increased pressure, the pelvic floor relaxes and lengthens to accommodate the abdominal organs translating downward. During your inhale, the pressure in the front part of the core canister is increased as your belly expands. This is counteracted by multifidus in the back as well as TA which work together to try and keep the intraabdominal pressure evenly distributed. When you breathe out, the diaphragm relaxes and rises which decreases the pressure within the core cannister. As a result, the pelvic floor should normally contract and rise.

[2]GifCore blog

How Do We Train the Core Canister? 

Many people focus on crunches, planks, and other large abdominal exercises when training the core but negate breathing. Learning to connect your breath with movements is the key to developing a stronger core. It will allow you to control the intrabdominal pressure within the core canister. Exercises like planks and crunches are not necessarily bad exercises as they can be very effective later if you first learn to optimize the control of your core canister.

The first step is to learn how to engage your diaphragm through diaphragmatic umbrella breathing. Once you have achieved this, it is time to add in the pelvic floor so that you learn how to engage your diaphragm and pelvic floor together as a unit, referred to as piston breathing. You can also learn how to connect and activate TA and multifidus to further optimize your control over the core canister. However, it is important to highlight that the goal here is to learn how to change the size of your core canister by recruiting all these muscles together, rather than focusing solely on how to contract each specific muscle. Once you have learned how to control the pressure within the core canister, it is now time to perform bigger movements that require you to maintain control over the canister while doing a larger activity.

Check out our post on our Facebook and Instagram pages (dated May 21, 2020) for exercises you can try at home to increase your control of the core canister!

What Can Happen If You Do Not Have Control Over Your Core? 

It is not uncommon to have a weak inner core or lack control over your core canister. This can originate from prolonged sitting and slouching which distorts and changes the shape of the core canister (see part B in Figure 3 below). This positioning leads to breathing through the accessory muscles in your neck and chest, decreasing the engagement of your diaphragm. As you can see in the figure below, this puts a lot of strain on the lumbar spine which can lead to pain and injury. Ideally, your core canister should look something like part A in the figure below where the intraabdominal pressure is equally distributed. Without proper control over your inner core, it makes it very difficult for you to be able to hold your body in a good position during exercise and physical activity. This increases your risk for injury.

[3]DNS-Scissor

Now that you have learned more about what the core is and why it is important, if you have any questions or are interested in setting up an appointment with one of our Physiotherapists, contact us today! We will be happy to help you achieve your goals by developing an individualized treatment plan. 

BodyTech Physiotherapy

Text References

Diane Lee & Associates: core training vs. strengthening (internet). South Surrey: D G Lee Physical Therapist Corp; (cited 2020 May 22). Available from: https://dianeleephysio.com/education/core-training-vs-strengthening/

Key J. ‘The core’: understanding it, and retraining its dysfunction. Journal of bodywork and movement therapies. 2013 Oct 1;17(4):541-59.

Pronatal Fitness: the first move to teach your clients (internet). 2018 July 18. (cited 2020 May 22). Available from: https://pronatalfitness.com/2018/07/18/360-breathing/

Image References 

[1] The role of the diaphragm. Digital Image. Chiroup.com. Nov 2016. [Accessed on 2020 May 22]. Available from: https://chiroup.com/the-role-of-the-diaphragm/. 

[2] Breathing variations. Digital Image. S. McLaughlin. Aug 2019. [Accessed on 2020 May 22]. Available from: https://www.alignforhealth.com/self-care-for-pain/category/core%20stabilization 

[3] The “pop can” core. Digital Image. J Smeaton. Apr 2019. [Accessed 2020 May 22]. Available from: https://www.depthtraining.ca/the-pop-can-core/.

Cupping Therapy

By Tim Penner, Registered Massage Therapist

Cupping therapy is a technique using cups applied to the skin to treat an array of illnesses. Used for centuries, its popularity continues to grow as people seek alternative and natural methods for treatment. Cupping stimulates healing by pulling blood to the region being treated. It promotes new blood flow to the area and removes stagnant blood which causes an anti-inflammatory effect by encouraging the body to release white blood cells, platelets, fibroblasts and other healing substances. Cupping is an effective technique to stretch fascia and muscles by helping to separate the different layers of tissue through the use of suction.

Cupping therapy uses cups, made of soft silicone and hard plastic, to suction soft tissue.  It is this vacuum effect, or negative pressure that provides a therapeutic result when applied to the skin. Many types of cupping therapy have been developed over the years. At BodyTech Physiotherapy our massage therapist uses 2 different types of cupping techniques: massage cupping and dry cupping. Massage cupping is usually done in a massage therapy treatment in which the cups are applied to the skin and moved around. Dry cupping is slightly different as the cups are applied to the skin and the affected body part is moved around to create a stretching effect.

Is cupping for me?                          

Massage or dry cupping can be used for many different conditions. The effects on the body include helping decrease stress, encourage relaxation and improve circulation. It can also be used to decrease swelling in certain areas and can help improve respiration when applied to the ribs and chest.  When it is used in conjuntion with massage and in specific areas, it helps reduce tension in muscles, and fascial tissue restrictions. The combination of massage and cupping leads to improved range of motion and posture. It can reduce tone in the muscles, help to improve flexibility and aid in reducing fascial adhesions left behind by old injuries. Cupping can help with many conditions such as low back pain, fibromyalgia, whiplash and tendonitis.

Some conditions that can be treated with cupping

  • Tendonitis
  • Fibromyalgia
  • Frozen shoulder
  • Low back pain
  • Whiplash
  • Tension headaches
  • Carpal tunnel syndrome
  • Plantar fasciitis
  • Sprain/strain
  • Golfer/tennis elbow
  • IT band friction syndrome

cupping1                cupping2

Low back pain                                      Iliotibial Band Friction Syndrome

Along with the conditions listed above, cupping also can be beneficial to the people suffering from the effects of Parkinson’s and Multiple Sclerosis, as well as using it to aid in rehabilitation after a major injury or surgery.

The most common side effect of cupping therapy is the bruised appearance that you see after the treatment is completed. The discolouration of the skin is only on the surface of the skin and does not generally cause pain after the massage. The bruised appearance can last for a few days or even up to a week. If significant bruising occurs your therapist will promptly remove the cups and discuss the effects with you.

Overall, cupping therapy can be beneficial to almost everyone. Just like massage, every treatment is specific and individualized to each client and their needs.

Concussion Management Part 2: How Long Does Recovery Take?

By Cassandra Kroner, PT

In part 1 of the concussion management blog series we covered how the brain is affected following a concussion, common symptoms, why early intervention is critical, and how physiotherapy can help optimize recovery. One of the most frequent questions people have following a concussion is about recovery time – ‘when can I go back to work full time?’ or ‘when can my son/daughter play soccer again?’. It can be helpful to understand the general stages of injury and potential progression of symptoms:

concussion blog image_jan2019

The initial days following a concussion are considered the acute stage of injury, and cognitive and physical rest is critical at this time. After 7-10 days of adequate rest the chemical balance and blood flow in the brain has been restored, and symptoms that continue are known as post-concussion syndrome. Some symptoms can last upwards of 6 months or years post injury. It is important to keep in mind that not everyone will progress through all three stages, and the length of time symptoms last will vary between individuals.

Why Recovery Can Take Longer

There are a number of factors that can complicate and prolong recovery, and these can help us predict if symptoms are likely to persist longer than the usual 6 weeks. A history of migraines, mental health conditions such as depression or anxiety, or learning disabilities, have been found to increase recovery times. Additionally, visual or vestibular dysfunction or a high number of initial symptoms following a concussion usually indicate prolonged recovery.

History of Concussion

People who have had a previous concussion are more susceptible to have another one due to a lower threshold for injury after each concussion – meaning the next concussion can happen from a lower severity injury than the first time. Additionally, there is often an increased number of symptoms and a longer recovery time after each subsequent concussion. A concussion at a young age risks disruption of brain circuits yet to be developed, and also creates a wider window for repeated future concussions.

Repetitive hits that are common in sports such as hockey or football, which do not cause a concussion, are known as sub concussive trauma. Research has shown this repetitive trauma can result in increased reaction and processing time, memory impairments and increased chance of making mistakes. These effects can place an athlete at an increased risk for a concussion during sport. If the athlete does sustain a concussion at this point, the brain has a diminished reserve capacity to manage injury, and the effects of subsequent concussions are cumulative and result in increased impairment in function with each concussion.

Additional Injuries

Another complicating factor is the presence of other injuries, such as whiplash or neck sprain/strains, that can occur with falls or car accidents. These neck injuries alone can cause similar symptoms to a concussion including headaches and dizziness, and in combination with a concussion can result in more severe and prolonged symptoms. Having an assessment by a physiotherapist can determine which symptoms are from the neck injury and which are from the concussion – resulting in individualized treatment strategies to target the cause of each symptom.

To conclude, although concussions can be an invisible injury, they need to be properly managed and rehabilitated just like any other injury. This management includes assessment to determine the cause of symptoms, specific treatments to address each impairment, and strategies to manage recovery at home. Visiting a physiotherapist trained in concussion rehabilitation will ensure that both concussion symptoms and neck injuries are addressed. The goals of treatment are to restore physical and cognitive function while facilitating a safe return to work and sport. Awareness and education about concussions and treatment options are important to ensure that people don’t suffer unnecessarily from prolonged symptoms – this is where a trained Physiotherapist can help!

BodyTech Physiotherapy

Physiotherapy for Temporomandibular Joint Disorder

Temporomandibular joint disorders (TMD) is a broad term that encompasses various disorders of the temporomandibular joint (TMJ). If you experience jaw pain with chewing, jaw clicking/popping, facial pain, or frequent headaches, you might have a TMD. Physiotherapists can diagnose and treat TMD.

Temporomandibular Joint (TMJ) Anatomy and Function

The TMJ is composed of two articulating bones: the temporal bone (part of the skull) and the condyle of the mandible (jaw bone). There is an articular disc located between the two bones. The disc is firm but flexible, and its purpose is to reduce friction and cushion the repetitive force between the two bones during chewing, talking, and any other joint movement.

During jaw opening, the condyle of the mandible and the articular disc normally slide forward in unison. The muscles surrounding the joint are responsible for moving the mandible and the disc in sync. If the condyle and the disc are out of sync with each other, this is called disc displacement and is characterized by pain and clicking sounds when opening the mouth.

image1

Symptoms

Symptoms of TMD can include the following:

  • Jaw pain when opening the mouth wide or chewing
  • Locking of the jaw
  • Limited range of motion, or unable to fully open the mouth
  • Painful clicking or popping when opening or closing the mouth
  • Tooth wear and tear from grinding or clenching the jaw
  • Facial pain
  • Headaches
  • Ringing in the ears

Causes of TMD

Often, there is no single cause of TMD. There is usually a combination of factors which predispose a person to TMD.

Poor posture of the neck, head, and shoulders contributes to muscular tension and strain. Poor posture may cause muscle imbalance and changes in muscle length in the neck and shoulders. These muscles pull on the jaw and can alter the resting position of the mandible in the joint, resulting in increased stress on the TMJ and disc. After prolonged time, the joints in the neck and back may become stiff and cause associated symptoms such as neck pain, limited range of motion, and headaches.

image2

In addition, jaw clenching or teeth grinding may contribute to the development of TMD. When the jaw is clenched, the muscles are under increased tension and may pull the disc out of position. It normally happens while the person is asleep, so they are unaware they are doing it. Clenching or grinding can also result from being under stress (e.g., at home or at work) for a prolonged period of time.

Finally, trauma or injury to the TMJ (such as a broken jaw) may predispose a person to TMD.

Treatment for TMD

Physiotherapists assess and treat TMD using non-surgical and drug-free techniques. The physiotherapists at BodyTech Physiotherapy will evaluate your condition to determine the underlying factors contributing to your pain. They will prescribe an individualized exercise and stretching program based on your unique needs. Our physiotherapists are also trained to correct biomechanical changes of the TMJ and neck using manual therapy.

Other options for treatment include:

  • Relaxation procedures
  • Acupuncture
  • Dietary modification to relieve jaw pain during chewing
  • Dental orthotics or mouthguards worn at night. These help to prevent teeth grinding and jaw clenching
  • Pain relief and anti-inflammatory medications
  • Medications to relax the muscles of the jaw
  • Surgery, in rare cases

Temporomandibular joint disorder is a complex and multifaceted condition. With all the factors that can contribute to TMD it is important to visit a physiotherapist for a detailed assessment to ensure treatment is individualized to your specific issues.  If you experience jaw pain and headaches, consider seeking help from a physiotherapist.

BodyTech PhysiotherapyBodyTech Physiotherapy 519-954-6000