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Even science can provide ‘stats’ on sitting in Winnipeg to prevent neck and back pain, especially those Downtown, Physiotherapy Winnipeg can educate you

No one will stand all day when they have the opportunity to sit. This is because the body works harder when standing than when sitting. However, when we at yourPhysio.com in Winnipeg review work production studies indicate that workers are more efficient when they stand to work. So how do you decide between the two? Consider these general guidelines Winnipeg!

When Standing is preferred:

the task cannot be performed with arms kept comfortably by your sides.

assembling, testing, or repairing larger products (i.e., greater than 6 inches high)

the work area is too large to be comfortably reached when seated. Stand when you must reach more than 15” past the front edge of the workstation. The maximum reach envelope when standing is significantly larger than the corresponding reach envelope when sitting for both men and women (Sengupta & Das, 2000).

you work in more than one workspace to perform job duties and must move around frequently.
the work task lasts less than 5 minutes.

dealing with heavy objects weighting more than 10 pounds. In general, more strength can be exerted while standing (Mital & Faard, 1990) Stand when you need to maximize grip forces (Catovic, Catovic, Kraljevic & Muftic, 1991) or complete static or dynamic lifts (Yates, & Karwowksi, 1992).the work surface does not allow the worker to comfortably position legs under the surface because of an obstruction (i.e. working on a conveyor or a progressive assembly line, working in a kitchen, using a workstation with a drawer located underneath the work surface or a wide front beam, working at a retail counter, or using specialized equipment)

tasks require frequent application of downward pressures (loading bags, inserting screws)

Jobs that are most appropriately done standing include construction workers, highway flaggers, medical personnel, painters, electricians, plumbers, loggers, firefighters, plant inspectors, and maintenance personnel.

When Sitting is preferred:

Better when visually intensive or precise work is required, the activity is of a repetitive nature; longer tasks are completed (greater than 5 minutes), and when everything can be placed within easy reach. Sitting is not appropriate when heavy objects must be handled or long reaches are required.

However, prolonged sitting has been associated with a high incidence of back complaints (Mandal, 1981), increased spinal muscular activity and intradiscal pressure (Grandjean and Hunting, 1977; Lindh, 1989). Other problems reported include discomfort in the lower extremities (Westgaard and Winkel, 1996) and increased muscle loading of the neck and shoulder muscles when sitting with the forearms unsupported as compared to standing with the forearms unsupported (Aaras et al., 1997; Lannersten and Harms-Ringdahl, 1990).

To summarize the literature, neither static standing nor sitting is recommended. Take note of ‘static’ versus ‘dynamic’ Winnipeg, learn to balance each through your day.

Each position has its advantages and disadvantages. Research indicates that constrained sitting or constrained standing are risk factors and that alternating work postures may be preferable. Alternation between two postures allows for increased rest intervals of specific body parts, and reduced potential for risk factors commonly associated with MSD development.

Ideally, provide workers with a workstation and job tasks that allow frequent changes of working posture, including sitting, standing, and walking. If either sitting or standing is feasible but only one possible, sitting in a properly designed chair is preferable.

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Whether you sit at a computer, shovel snow, lift sandbags or play hockey in Winnipeg, your back pain is probably the result of tight hip flexors

yourPhysio anatomy lesson first; your hip flexors are the dominant muscle in the ‘knee to chest’ action. Anatomically known as your; Iliacus, Psoas Major and Minor, and your Quadratus Lumborum, these muscles are attached to your hip, to your lower back and your pelvis. Consequently, when overused or tight they can reconfigure your lumbar spine, throw out your hip and back, affect your sacro-iliac joint, and change your biomechanics thoroughly.

Even though stretching is essential for all muscle work, it can actually be damaging if not done properly. When you stretch without warming up your muscles, it increases your likelihood of injury, as you are trying to stretch a cold muscle. So before you stretch, make sure you warm up; walk in place, cross-train, and increase the blood flow into your muscles so you can prevent an injury. As a physiotherapist, I do commonly advise patients to hold a stretch for 20-30 seconds, but why? The reason is because our muscles have a protective reflex to avoid over extension or contraction. When you are stretching your muscle, the muscle spindles, which are the components that produce contraction, activate a reflexive pathway which causes them to shorten in order to compensate for the stretch (called the myotatic reflex). This is what causes your leg to kick out when you tap your knee.

Knee Reflex

There are two main types of stretching: dynamic and static. Static stretching is what we just talked about, which is a stretching routine that includes holding 30 second stretches for specific muscles. When using static stretching before a sport that requires you to use specific muscles to initiate specific movements, it is hard to relate static stretches to dynamic activity. This is where dynamic stretching comes in. Dynamic stretching is designed to mimic the actions and movements you are expected to perform during a specific sport. For example, this would include kicking around a soccer ball in warm-up before a soccer game, so your body can get accustomed to activating the required muscles. That way, your muscles can make the necessary preparations to prevent injury, as playing a sport requires many specific dynamic and explosive movements.

Starting blocks

For your hip flexors, I teach a ‘dynamic lunge’; such that your hip flexors, quadriceps and pelvic muscles are used within the stretch. If you add Kegel exercises to this movement, the pelvic floor muscles are activated more and a greater effort can be applied to this core stretch. Remember those pre-natal classes guys? A patient was recently surprised to know that guys can do Kegels too! Guys are equipped with those same pelvic floor muscles and ladies should appreciate these efforts, as do the men!
Overall, stretching is very beneficial for movements involved in a regular day, and those involved in heavy labor, repetitive activity and sports. Therefore, it should be a priority for everyone to incorporate some sort of stretching into their daily routine (after warming up of course!), in order to maintain optimal functionality.  Flexibility is a highly underappreciated component of muscular strength and function, but key to good performance at work, home and recreation.

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Winnipeg, have you heard? Sitting is bad for you…solutions by Physiotherapy Winnipeg, yourPhysio.com

Winnipeg, by now you know you probably know that sitting down all day is terrible for you. As computer hardware and software accelerate the ‘web 3.0’, we can do more than ever before from a sitting position. Ergonomics is no longer a foreign word, and our ‘core’ exercises need to be performed everyday!

Who needs scientists to tell you that sitting for even one hour causes the production of fat-burning enzymes to decline a whopping 90%, or that more than four hours of desk time each day raises your risk of a heart attack by more than 100%?

You can feel exactly how crappy sitting all day makes you feel at the end of each workday; though you may be shocked to learn that being a regular gym-goer doesn’t protect you from the harmful effects of all that sitting. Standing up more is scientifically proven to have huge health benefits, but in our digital world it’s not as simple as it sounds. Here’s how to make the switch to an upright workday.

Try the latest DIY option, I have had so many patients describe their attempts at raising their work surface by box, crate, home-made devices, etc. I’m sure you could find the latest ‘how-to-video’ on YouTube to get an idea as to how to produce something for your workstation. Ergonomic clients of yourPhysio.com have purchased electronic and hydraulic ‘sit-stand’ workstations to allow their employees the postural variety that may be necessary for back pain, hip strains or knee sprains. These rehabs require movement throughout the day, and consistent changes in posture is a great place to start.

Invest in an ‘anti-fatigue’ mat, change your shoes every 6-8 months or try an over-the-counter orthotic to replace those worn insoles. You may require a doctor’s note to have orthotics covered by your insurance plan, but it is an employment benefit; so benefit!

Tweak your ergonomics, hire an ergonomic consultant for an hour and learn the proper way, not only how to sit, but how to perform your job so that it will not cause pain. Ask questions about posture, exercise and equipment available to make any task easier and less painful.

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Steroid injections for back pain can lead to bone loss, beware those with elbow pain, chronic pain, use Physiotherapy Winnipeg

Lately, many patients with chronic pain, including those with back pain, shoulder rotator cuff pain, elbow tendinitis pain or other chronic pain, have been asked by their family doctors ‘if they would prefer corticosteroid injections to physiotherapy?’

A Henry Ford Hospital, in Washington, D.C., study ( http://t.co/W3gj4dJt ) has found that postmenopausal women suffered significant bone density loss in their hip after they were treated with an epidural steroid injection for back pain relief.

Bone density loss after six months was six times greater when compared to the typical bone density loss seen in a year in a postmenopausal woman who doesn’t receive steroid injection, researchers said.

Shlomo Mandel, M.D., an orthopedic physician and the study’s lead author, said physicians should exercise caution prescribing an epidural steroid for select patients, suggesting that multiple injections may compromise bone strength.

“The findings of our study suggest that epidural steroid injections for back pain relief should be approached cautiously in patients at risk for bone fragility,” Dr. Mandel said.

“Physicians who do prescribe them should consider measures that optimize bone health such as calcium and vitamin D supplements and exercise as part of their patient’s treatment plan,” he added.

Back pain is one of the most common medical conditions in the United States, affecting 8 out of 10 people at some point during their lives. As people age, their spine ages with them, causing degenerative changes in the spine.

Patients are typically treated with anti-inflammatory drugs and physical therapy. If symptoms persist, an epidural steroid is often prescribed to alleviate pain and improve function. However, steroid use has been linked to diminished bone quality.

There has always been the link, and the questions concerning steroid injection and tendon or bone deterioration. One of the more famous cases was that of Joe Montana, Hall of Fame NFL quarterback and his elbow tendon rupture following multiple injections. Now there are not many of us that perform at this level, but chronic pain of any type can be debilitating and life altering. Please know your options and be aware of all the side effects associated with longterm medications; the list of side effects may outweigh any medical advantage.

If you are considering steroid injection as a form of treatment; ask your doctor about his/her experience in delivering such a treatment option. An orthopedic surgeon or experienced sportsmedicine doctor would be a wise choice.

Your Physiotherapist should be able to address your concerns about such a treatment option, and he/she should be able to provide treatment relevant to your pain trigger points and the appropriate exercise to assist in your longterm rehab.

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How people choose a Physio, a Doctor, a Chiro, in Winnipeg…for back pain, for health advice, for whiplash

Thanks again to my fellow members at the Winnipeg Executives Association, for the positive feedback and referrals following my 2012 Business Profile presentation; How do you choose your Healthcare Providers? Based on the US pre-election survey by INC magazine…

In reverse order of importance, the top five were:

#5 a great Receptionist.

Oooops, if you have been to my clinical location in the formerly TD Centre, at Portage & Main, you would know that I have been a ‘sole proprietor’ since 1991. Clients know that when they call for an appointment or have any kind of question, that they are going to speak directly with me, the Physiotherapist. Whether it be by phone, text, email or video-chat; I do not hesitate to educate you on the spot and answer the greatest concern in real-time!

#4 your Insurance Coverage.

In Manitoba, you do not need a doctor’s referral to see a Physiotherapist. But, you may need one to be covered by your particular insurance coverage. Manitoba Health only covers physiotherapy treatment if obtained in hospital, and WCB, and MPI, only cover a specific number of treatment sessions. So, beware of your coverage and be proactive in your rehab!

I DO direct bill to most insurance plans, if they do allow this to occur as some plans prefer that the client do it by mail or online, such as Sun Life or ManuLife. Healthcare Spending Accounts are becoming more of the norm with ‘flex’ benefit plans. These accounts are excellent ways to be proactive in your health plan by applying these funds to ergonomic assessment or exercise programs.

Like some other providers, I typically do NOT charge for ‘tray fees’, ‘chart maintenance’, exercise tubing or even for Doctor’s notes.

#3 convenient Parking.

Well…again, we are located in Downtown Winnipeg’s most secure parking complex; the Exchange District Parkade, off Albert Street at #35…my entry is at ground level, directly across from Winnipeg’s best kept secret, parking meters inside a parkade entrance.

#2 convenient Office Hours.

For the approximate 60,000 people working within a 5 minute walk of Portage & Main, the most requested appointment time is between 10am and 2pm, with a normal treatment day from 845am to 530pm in the clinical location.

My research begins at the home office, and ergonomic assessments take me onsite to clients’ work places; from garbage trucks to police cruisers, from bus depots to gold mines, from military helicopters to postal distribution centres, from bank tellers to executive offices, from lumber plants to product warehouses, from grocery clerks to sports professionals, from grain elevators to your cottage kitchen…I’ve worked the day and night shifts, and experienced a huge variety of task conditions.

#1 my Location.

Do you know anyone that works within walking distance of Portage & Main?

Do you know anyone who works in an office connected through the Winnipeg ‘W’ walkway system?

Do you know anyone with a schedule that demands a guaranteed appointment time? …there is no waiting room

I invite you to refer them to our services, for healthcare that may not always be what they expected or even be the best in town, but I will always move them in a direction to make it right for them. Thanks.

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Active Release, Myofascial Release, Trigger Point release therapies for back pain in Winnipeg by Physiotherapy Winnipeg

You’re back is Achy, You’re neck may be Sore, and You Have No Idea Why…It feels like muscle pain, but unlike a tight hamstring, hip flexor or shoulder that makes you yelp when you stand up, your ache isn’t triggered by a particular movement, and you can feel it in different places at various times. The culprit could be your fascia, that relative “sheet” of tissue, made up of densely packed protein fibers, weaves throughout the entire body, and it binds and supports your muscles, bones and even your organs.

You know how your muscles feel cramped and stiff when you wake up in the morning? After a night’s sleep (or another long period of inactivity, like a car trip or plane ride), the parts of your fascia that wrap around and through your muscle fibers, which are normally stretchy and flexible, can stick together like previously chewed bubble gum. Stretching like a well rested cat in yoga, is a great way to release those sticky fibers at home.

Just today, I’ve recommended a client to work out those overused sore spots with a foam roller. You’ve probably seen people at the gym using these things, which look like pool noodles, to stretch their back, hamstrings and the notoriously tight IT band on the outside of the hips. To start, take an old pillow from home, fold it in half length wise and duct tape it into a hardened roll. It may not provide the stiff surface of a good foam roll, but you can begin slowly, and graduate to harder surfaces later. Sit or lie upon the roll, and when you get to a sore spot that feels like a bruise, pause for 15 to 20 seconds. The discomfort should melt away as the fascia softens and the muscles release. If you feel intense pain that doesn’t dissipate, stop and consider making an appointment with a physical therapist.

Don’t Let the Tissues Get “Crunchy”

If you’ve ever had a shoulder rub and heard something that sounded like crinkling plastic under your skin, that wasn’t your imagination—it was probably your parched, stiffened fascia. The collagen, protein fibers that make up fascia need to stay supple to work properly, and to slide over and under muscles and other inner-body surfaces. One way to keep the fascia hydrated is obvious: drink lots of fluids, especially water. I have had chronic back pain clients change their coffee to water on a 8x per day basis to gain relief from their fascial pain. Another easy (but easily forgettable) way is to make sure we stand up, stretch and flex regularly throughout the day to keep the fascia from locking up. Those pressure points are warning you for a reason!

If you need some foam roll instruction or relative treatment with myofascial release techniques, don’t hesitate to contact me.

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Snow, garbage, warm winds and bags of leaves in Winnipeg, need Physiotherapy?

Our first snow fall has come and gone in Winnipeg, unfortunately for those who lost their hydro in the first blizzard of this winter season in Manitoba, it dragged on for 4-6 days. Sounds like our garbage collection woes this October, as Winnipeg introduces the automated, curbside, private company collection, not to mention a shortage of paper bags to dispose of the fall leaves. Snow, garbage, raking leaves, the dreaded fall cleanup can all lead to acute, or even chronic back injuries.

My ergonomic tip for you this fall season; switch the way you do things, especially those repetitive tasks, the raking, the shovelling, switch direction, go from right to left and vice versa. Avoid the pitfalls of the weekend warm winds, get it done, but pace your work and enjoy the time outdoors, stretch occasionally; hands on your hips, bend backwards comfortably and repeat.

Next, we’ll talk about whiplash injuries; what to expect from MPI and driving ergonomics for the ice n snow of winter.

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Winnipeg Soccer, as outdoor ends, indoor begins and the knee injuries need Physiotherapy

It’s almost the end of September in Winnipeg, and its all too common on the soccer field and basketball court.  An athlete jumps to get the ball, lands and blows out a knee. And most of that time those athletes are girls. Girls are four to six times more likely to suffer a certain kind of knee injury than boys, according to Mayo Clinic research.

Your Physio Winnipeg always concentrates on proper training, biomechanics and technique of exercise, otherwise, why do it if you’re going to hurt yourself.

When an athlete cuts, pivots or jumps, the athlete puts stress on the ligaments of the knee; Medial, Lateral and especially the Anterior Cruciate Ligament or ACL in the knee.  If the knee collapses inward during these moves, that ligament can tear, along with severe injury to the surrounding soft tissue.

ACL injuries are especially a problem for girls, possibly because of the angles of their leg bones or imbalanced muscles around the knee. But proper biomechanics, education and training can help prevent ligament injuries.

Train to jump properly, and actually practice to inherit a good habit; “Legs shoulder width apart. you have to jump as high as you can and when you land you have to land straight and your knees can’t go in or out,” explains Winnipeg physiotherapist, Chris Bisignano.

At the heart of research now is jump mechanics and landing mechanics.  These drills teach how to move more safely and will strengthen the muscles around the knees.

Ligament injuries can mean a trip to the operating room and reconstructions are not minor.  Recovery can keep you out of the game for nine months to a year.  But injury prevention training, and cross activity training can keep kids in the game. Westwood High School in Winnipeg, actually has a “high performance training or phys ed” class for its athletes. “They give their kids some training techniques I would never try in practice,” says Bisignano, “but its excellent training to be involved in to prevent injury”.

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Back pain in Winnipeg, your remedies; from analgesic creams to core exercises, and physiotherapy

Back pain is still, just too common. Our medical treatments tend to be too reactive and not proactive. Most people know that they should be exercising more, not sitting for greater hours at work and home, and not jumping on n off the latest bandwagon cures or diets.

Today’s new submitted an article on the risks of burns with over-the-counter heat/cold rubs or creams, see link (http://t.co/Cmu5yEDS). Given the ingredients, occasional misuse or combining these ‘patches’ with other forms of heat/cold can cause severe skin reactions.

Physiotherapists have always been the healthcare provider to prescribe exercise, in rehabilitation of an injury or surgery, and in prevention. Don’t hesitate to ask, or come in for an ‘exercise review’, if you’re just not sure on your biomechanics or plan for an activity, like golf, hockey or your next marathon.

‘Core exercises’ should be the eventual focus of a back patient’s exercise plan. The individual may not be able to do a ‘side plank’ the second week, but we as physiotherapists prescribe exercise and breakdown biomechanics based on a person’s ability.

Core exercise by Physiotherapy Winnipeg yourPhysio.com

This core exercise example could be done with a small dumbbell, standing, lying on your back or even on an exercise ball. It should be performed with your own restrictions in mind, and not attempted if you are in pain. An excellent exercise for rotational stability for golf, hockey, baseball, etc.

Call us for an exercise review 2 0 4 9 4 3 8 4 1 1

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your Ergonomics, line of sight and that nagging neck-shoulder-upper back pain, by Physiotherapy Winnipeg

Whether it be at work, rest or play; a candy bar cannot make that pain go away…but your ergonomics at the workstation, at home or doing any activity can make a significant difference to your health.

We can often find those simple modifications, those easy answers to perform a task easier, and safer. The problem is that many of us do not take the time to change our habits, make changes and implement them consistently at our busiest work areas…the kitchen, in this case. The ‘pant hangar’ keeps the recipe near eye level, there is no awkward posture to maintain and the cabinet can even be accessed quite easily, well done!

 

This concept always applies to those that must ‘sit for a living’, the ‘desk jockeys’ of the finance, legal, grain and media industries here in Downtown Winnipeg. Like a ‘whiplash’, those muscle aches can proliferate throughout the upper back and neck.

 

Such that, you must remember to adjust your computer monitor height; use some yellow pages or photocopy paper bundles. Some recent ergonomic assessments have resulted in 8-10 inches of monitor height changes to accommodate the individual’s line of sight. Your eye level should be equal to that of the curser start position, in the most frequently used software program. This position allows the eye to adjust to a variability of 2-3 inches of text/toolbar and decreases or eliminates the chronic forward head posture.

Let your human resource department or health & safety manager know that I am available for any size group education, assessments and ergonomic design.