Back Injury Management – Climbing Rehab Torso Twists

An important part of back injury management and rehabilitating it fully is to ensure that you have good rotational mobility in your spine. Here’s a simple but effective exercise that can help with improving the rotation mobility in your spine.

Sitting down on a chair with your feet flat on the floor check your left and right arms into abduction like you’re making the letter “T”. Then check your hip and butt anchored to the chair with your hands.

Sitting with your legs wide and arms straight reach your hand down the inside of the leg to the ankle and reach your opposite hand up to the ceiling trying to create the letter “T” with your arms while your butt is anchored to the chair. Hold this position for 30 seconds doing 3 sets on each side 2x/day.

This is a great mobility exercise to do for the spine as a warm up, a warm down or for recoveries after you finished climbing or training.

Hamstring Pain – Simon Kelly

Mark: Hi, it's Mark from Top Local. I'm here with Simon Kelly of Insync Physio in Vancouver. We're going to talk about something that a lot of people have trouble with, especially as they're trying to do more exercise right now during a pandemic, or just any time. Hamstring pain. What's the story, Simon with hamstring pain.

Simon: Absolutely Mark, thanks for having me. Yeah hamstring pain, I'll just talk a little bit about that. I suppose you can break it down into two different types of hamstring pain, really. One is like hamstring tendinopathy, which is more like gradual in onset. And the other type is more like an acute you know, you might hear somebody kicking a soccer ball and you know, the hamstring is stretched. Or a sprinter, something like that. But you'd know because it would be a very specific event. That would be more the two kind of different areas that I would kind of put them in. 

The one I talk more about today is more the gradual onset, hamstring tendinopathy. I might make another video about the other one at another stage. So I had a client in recently. She was a female. She's a runner. Runs like you just said, during the pandemic. I think she's said she ran six or seven days every week, every day nearly of the week. So, I mean, the history is quite important because a lot of people will come in and say, look, there's pain in my glute region or in my bum region.

Sometimes it refers down the back of the leg. But they won't really say it's like tingling, numbness, burning. That can be more like sciatica type symptom. But in with say that it is aggravated from sitting quite a lot. The pain is quite deep. And sometimes if you can put your finger on your own sit bone or ischial tuberosity we call it, it can be painful right on the insertion point and where the hamstring actually joins. So that's kind of how she presented. And a lot of majority of the gradual onset pain would present. 

Mark: So that's the presenting problem. How do you diagnose it? And then what's the treatment protocol? 

Simon: Yeah. So the diagnosis, Mark, like I kind of said there it's mainly how did it come on? It's usually gradual like I said.And they'll also say it's painful when I go to tie my shoe. In other words, when they bend the body forward. So the main way of diagnosing it is listening to what the client has to say, especially if they're runners. Lots of people who do lots of lunging, deep squats, anything that kind of uses that tendon or pulls the tendon over that bone.

So you break it into two things. It's compression, which can irritate a tendon and it's tensile force. In other words, speed adds a lot of tensile force through the tendon. And the real kicker is when you add the two of those together, the tendon might rear its head and be like listen, you might be doing a little bit too much. 

At that stage, it depends on the client and the individual themselves. What age they are. If they're kind of younger, twenty-five maybe thirty, the tendon is probably and depending on how long the symptoms are, maybe two to three weeks the tendon is probably reactive, we call it. Which means it's just given a signal to the body that something, it might go into tissue disrepair if we keep going at this pace, gradually loading. 

So I kind of describe it at that point as more like a fire alarm going off. Not necessarily a problem at this moment in time, but it may develop into a problem and the tissue may start disrepairing if you continue at that pace. So that would be really how I diagnose and to be honest, the way to deal with it is load management and avoiding compression and avoiding those tensile forces I've just spoke about. 

So, you know, if somebody is doing a lot of dead lifts, a lot of bending with their back, you know, they're going to pull that tendon over the bone. That's going to be very irritating, a lot of very deep squats, deep lunges is also going to be irritating. In that case, it's more compression. But runners will be more the tensile force. So if you have somebody running, it increases the force across where the muscle joins the tendon by four times while you would be if you were walking. So it's a huge increase in the load.

And especially that particular case study. Six days in a row, you know, there's no gyms open. Everybody wants to go out running now because of the pandemic and it's safe and you're on your own. But it can really creep up into somebody like that and present like that. And it's sort of sit down and like I said, it's sort of tie your shoe, which means at that moment in time, it is very, very irritable and something needs to be done.

Mark: So is this mostly a function of increasing your load, running farther and more often than your body's able to adapt, especially since muscles get stronger way faster than tendons do. 

Simon: Yeah, absolutely Mark, exactly. In her particular case, it really was that there was just no respite. Like she was running like quite a lot. I think it was like somewhere between 5 and 10 k's. So it wasn't just like one k every day it was like, At least 5 everyday or 10 K, which is quite a lot of mileage. And she was young and fit and able bodied, but the tendon was just giving her a sign. Listen, we just need to offload this tendon somewhat.

Now, some physios or what I did was because, even for your mental, a lot of people to run just for mental relief. And I know it is COVID. I kind of said, look you can run, but maybe just do it once or twice a week. Maybe do it Monday and Friday and keep it to like five kilo meters and just see how that is.

So it really is a little bit of trial and error. That's kind of how we have to load manage it. Like I was saying. So you are keeping a little bit, or maybe reduce your speed. Don't run maybe just go just above a walk rather than do quick speed that the tensile forces goes through. The other thing about tendons is when prescribing they usually speak to us two days after.  So, if you go running on Monday, you might feel pain Wednesday, because of that run on Monday and be like, well, I didn't do anything on Wednesday. I don't know why this is painful. 

So very important in the rehab to give that two day break after you run, just to see, has it irritated the tendon or not? So that's probably one of the most important points people need to know when rehabbing after not just hamstring tendinopathy but most tendinopathies in general. 

Mark: So other than reducing the load, what else would you recommend? Or what else would you, do you manipulate the body? Do you do IMS?  What other protocols are you going to use to help them reduce the pain?

Simon: Absolutely Mark. Yeah. So sometimes it can be a bit of stiffness and tightness through the hamstring. So you might do a little bit of soft tissue work through through the hamstring. You might do a little bit of IMS, that needling, intramuscular stimulation, and maybe a small bit of stretching. I don't tend to stretch too much, not too aggressively. Just to kind of distend, I don't, I wouldn't friction over where it joins right onto the hamstring either. Like we used to do that back in the olden days, but that can just create a compressive force, which may actually irritate it further. 

So. In clinic, it's important to come in and get that treatment. Usually three or four sessions is usually good enough to just get a little bit of tissue extensibility back into it. But after that it's really all about load management. The other thing I would say about load management is most people, you know, they have pain and they just rest for a couple of weeks and sometimes they take off maybe a bit slower or maybe just as they left off, and that in theory is unloading the tendon. Sometimes too much. So even if they go back sort of slightly decreased or even just where they left off, you've already unloaded the tendon so much at that point. So even then it might get irritated again if you know what I mean. So it's kind of a tricky one and avoid lumbar flexion, or bend forward positions, especially in the very early stages. Hugely important. You got to take out those two things first and then you got to load it. 

So the real part of the treatment then is kind of introducing speed and introducing those, compressed positions, and then eventually introducing both of those components at the same time. The way I do it is, I'd load it up with a single leg bridge, if you even know what bridging is. That's how you load the tendon, it's not compressed and it's an isometric contraction, which means you're not moving at that point. That just breaks down some of the cross links in the tendon and sort of tells it where to the load up properly. 

And then what I do is I would introduce speed, kind of in a bridge position, but I'd be dropping down and catching, dropping down and catching. So you're introducing speed, but not compression. At that stage into rehab, and then I would introduce more compression, like deadlifts, not from the ground, but from knee height. And then you go down to mid shin height and then you go down to like the ground. So that's just speed one side, compression the other side.

And ideally if your clinic has something, it's like, we call it a push sled. Where you start pushing a sled with weight on it across the floor. So at that moment in time, you're introducing compression and you're introducing speed. And obviously you can alter how quick you push the sled. What kind of friction the sled is on, like how much resistance you are pushing through it.

And obviously you progress it by pushing the sled faster and more weight on the sled and so on and so forth. And maybe on a more friction on the surface that the sled is sliding on. If that makes sense. So that would be the idea of rehab for someone with hamstring tendinopathy, but it's so important to know any education of how we do it for people to buy in, to be honest.

Mark: And so typical rehab period might be a little bit longer. 

Simon: Absolutely Mark. Yeah, you're talking like, and this again, very important point. Like it's not, there's no magic pill here. It can sometimes take three months, like, especially with the more irritable tendons, now obviously there's a bit of grace. Some people are better after eight weeks. Some people take a little bit longer than three months or 12 weeks. But like if you don't tell that to someone on day one, like you got to tell them, look, this can take two to three months, especially like some people come in after a year of trying to deal with with the pain, like it's even a number of years.

So they might take a bit longer than the three month period. But the education is quite simple. It's just believing in the process and believing that it will actually work if you do sort of what we say. And it's very important that the people actually do the crossover at home. I think it's more important to actually, the education part and sort of loading the tendon gradually is better than actually to hands-on treatment or some of the passive treatments, after four sessions, if you get my drift. 

Mark: Yeah. So one thing's curing it. The other thing just makes it feel better. So you're dealing with the symptom, not with what's actually the core problem and making it better.

Simon: Mark, absolutely like, you've hit another topic on the head. It's kind of a lot of the passive treatments we do. They're very good, but they're more, they get you better in the shorter. Symptom relief, we call it pain modulation, or I call it pain modulation in the business. So you are. You're modulating somebody's pain, which is obviously very important, you don't want to be in pain, but you need to have the education and you need to have that, know the transference of the education's really get longer results. I don't want anyone relying on me forever. I love to see them obviously, but I want him to get better and not have to come back. 

Mark: So, if you're dealing with hamstring pain, the guys to see, Simon Kelly at Insync Physio. You can book online at insyncphysio.com. Or you can call the office (604)566-9716 to book your appointment. You have to call and book ahead, he's busy. He's well-respected in the physiotherapy community and he will get you feeling better. It might take a little bit longer than you want, but then the problem will be gone for good if you keep working at it. Thanks Simon. 

Simon: Cheers Mark, thank you. 

Hand and Finger Injuries – Rock Climbing Rehab – Crimp Grip Strength

If you’ve injured your finger tendon or hand from rock climbing any other hand and finger intensive sports or activities, then this exercise might help you get back to a better functional recovery!

Start with your wrist in neutral, not flexed or extended. Then flex your index to last fingers at the knuckle joints only - or the Proximal Inter phalangeal joints, and then flex the last two digits of every finger and pull into the hand for a tight crimp grip flexion.

Extend the fingers back out and repeat this for 30 seconds doing 3 sets 2 times daily.

This can help you recover and rehab your hand or finger injury more effectively and increase your contact strength for rock climbing or any other hand or finger intensive type of activities. If you have pain or are unsure about what you are doing consult a local physiotherapist before continuing.

Knee Osteoarthritis with Simon Kelly

Mark: Hi, it's Mark from Top Local. I'm here with Simon Kelly of Insync Physio in Vancouver. We're going to talk about osteoarthritis. Something that's probably rampant in the population. Something that has, I get more grey hairs, I start to wonder about things around this particular subject. So Simon, tell me what's the deal with osteoarthritis.

Simon: Thanks for having me. Absolutely, like osteoarthritis, a lot of people are well aware or have heard the term arthritis any way for sure and osteoarthritis is more, to be honest, it's sometimes healthy, not healthy, but we all get a bit older and sort of, we do develop some wash terminology can be like degenerative, osteoarthritis, wear and tear. They all kind of mean the same thing, but I think sometimes our terminology can get a bit out of hand as well. So it is just wear and tear and break down of cartilage. 

Now, one thing I like to let people know is that once the cartilage is worn out, they know physio can really get it back, which you can really increase the longevity of your joint by increasing the muscles around that joint and maybe the joint evolve. I'll speak about the knee in this video just for simplistic reasons. So like the real hard part about osteo, so that's osteoarthritis sorry. And it's not to be confused with rheumatoid arthritis, which are autoimmune diseases and that's kind of the body attacking instead of a little bit. So it's  a little bit different from that. 

Osteoarthritis generally, you know, it usually affects the older population. It's rare that, you know,  it would present gradually. People will come in and say, Oh, I just suddenly have pain in my knee. And generally they're pointing to the inside of their knee because that compartment gets loaded more than the outside compartment of the knee. Some people do complain about pain behind the knee cap as well. That can be put in with patellofemoral pain syndrome, but usually it's a bit of wear to the cartilage behind a knee cap as well. And some people would present with the three different components. The inside of the knee, the outside and  behind the kneecap. 

But anyway, it would be gradual in onset. People would be like I can't remember doing anything, no specific event. And it usually points to the inside of the knee. So usually what we do is when they come into clinic, first of all, we do take a history. We look at the age of the person. Could be mid fifties sometimes, maybe late fifties and onwards. What's important to know osteoarthritis is it is painful. But not all the pain is bad in that it's okay what I said to have 2 out of 10 pain are 3 out of 10 pain when you're doing your activities. 

I had a guy in recently, actually, I kind of link it to this case study. He was a 58 year old man loves his tennis and obviously quite worried about like is his joint degenerating? What can he do moving forward and wanted to be proactive. So I told him, look, it has a bit of wear on the joint, not to be worried about the terminology. But you can also settle, pain isn't always linked to the where prior to the joint, it can be linked to just a bit of over activity. He was doing a bit of tennis in his case, so maybe more higher impact then just normal squats or when your foot is fixed on the floor.

So, and, but he was also doing like, again, it's nice weather now at the moment here in Vancouver. And he went from like zero to like hero of like five days in a row of tennis and Vancouverites love the outdoors. Just like a woman in the previous videos. So they love to run a lot and get out a lot and I don't blame them in the pandemic.

Like if he came in with a very swollen knee in his case, I asked him what he was doing. And he told me he was playing tennis five times a week and cycling two or three times a week. So really had to address the load his knee was on. Obviously he was 58 years old. He had a previous MCL injury, which is the ligament on the inside your knee. So he was wearing a big brace with two metal bars down, either side of his knee, which is good for MCL strain or injury. It prevents the knee from kind of going from side to side. But Ironically, he thought it was still an MCL injury, but I tested him in clinic, we do a few tests and his MCL was pretty good.

So it was really just early onset osteoarthritis that we were dealing with. So he just had to, the plan for him was just to offload. Maybe again, don't play a tennis five days in a row. Even if the weather is good. I know you like the weather and we'll probably get some rain next week here. Well, like if you just went to like Monday and again, every Wednesday or Thursday, and they'll be cycled on the alternate days, his knee might not have swelled up at all.

So the real trick osteoarthritis, even if you are feeling a bit of pain with your activities like 3 out of 10 is okay, but like, I don't want his knee ballooning up swollen like he presented to me in clinic. That's just too much and that can really progress the disease that much quicker actually. So like, he'd be looking at a knee replacement like, I dunno exactly maybe three or five years, as opposed to maybe 10, 15 years. If he's to play tennis at that level, where his knee is swelling up, which is just not ideal.

However, too little load is also detrimental because I used the analogy like astronauts in space. You go up into space, like you just lose all your bone density. So like gravity and weight is actually quite important for new bone growth. Every 10 years, our body makes new bone growth until we die. You stop growing between the ages of 17 and 25, but they keep regenerating every 10 years.

So it's also not going to like, not load the joint at all. So the real trick is to load the joint pain, 2 or 3 out of 10 on a pain scale, 10 being excruciating pain and zero being no pain. And it's kind of what we're seeing in the research is okay without obviously ballooning up of the knee and obviously like not giving it kind of time to rest. So it really is getting that  happy medium again. 

No w in clinic obviously you have to assess all of that. And then we do a lot of exercises. A lot of the time it's actually the hip muscles that become weak that cause the knee to kind of turn inwards. That puts the load down through that kind of inside compartment of the knee.

That's why they point their finger to the inside of the knee. It's in your glute medius, it's the name of the muscle, we've all heard of the glutes and glute minimus. That keeps the pelvis level in single leg stance. It also pushes the knee back into neutral. Prevents a kind of caving inwards. So a lot of the exercises are geared towards the joint above because it's mostly weakness in the hip. And a little bit in the knee, but mostly in the hip that we need to kind of correct. 

So when someone comes in, we'll look at the biomechanics of the body. We'll sort of get the load more neutrally distributed down through the lower limb, and then we'd obviously allow the person, I like to get the person to do their activities. In his case, it is tennis. It was high impact. You know, he's only 58. I want him to have enjoyment out of tennis. So I'm not going to cut it out completely because I don't believe he needs to cut it out completely. He just needs to cut it down and drastically for a while initially. Like maybe once a week he could go twice a week and then his knee could last him 15, 20 years.

Mark: And what's the typical treatment protocol for him to get to a place where the pain is minimized, maybe not gone, but just minimized.

Simon:  Absolutely Mark. So, and you're right with the minimize there. A timeline, rough timeline it's not as long as the tendinopathy, mostly four to six weeks. All depends on how would a patient adheres to like the knowledge that you kind of pass on as well. If they really like in his case, actually, I saw him just during the week. He'd cut down his tennis. He'd done what I told him. And he had no swelling at all on the next visit. He'd stop wearing his knee brace because he doesn't need it to, because of the old ligament injury he thought he had. And he understood like, you know, a little bit of calm weight is important, but not to be ballooning up.

So you know, that was almost like a magic trick he felt, I felt it as well. It's almost like a magic trick, but just because he was loading it in such a different manner to like doing the weekend warrior stuff on it, you know? So I usually just treat that like four to six weeks, you could argue it is a bit of a lifestyle. He will need to monitor his knee from this point onwards. With or without me, you know, it has kind of reared its head. If he keeps continuing at that point, his knee will decline much quicker. But if you kind of just alters those few bits, his knee could last him like 10, 15, more years, maybe even longer. Obviously it depends on his activities and whether he wants to play a tennis in two or three years. And at that point you might want to look at maybe lower impact activities, more like biking. Also depending on how we would present maybe in three or four years time. 

Mark: And what would be the kind of typical hip exercises that you would prescribe? 

Simon: So yeah, we do a bit of single leg bridging again. I kind of spoke about it before. A lot of glute medius exercise, kind of like single leg stance. We call them hip hikes. So you're kind of standing on the edge of step and let your hip drop down and then you pull it back up. So this glute medius pulls this hip back into neutral. That's kind of what happens.

We call it a trendelenburg gait. Usually it's hard to see though the early stages of osteoarthritis, but you know, you're 80 year old women, you know, you really notice it.  They try to step on their pelvis, but their pelvis is dropping because it can't keep it level in order to take a step. If that makes sense, but we really want to prevent getting to that stage.

And obviously if it does get to that stage, you do have to get, like it's usually pain that people get a hip replacement for eventually. But that's maybe a conversation for another day, but at times, like it depends on your age. You probably don't want to get a hip replacement at 90, just because you might get an infection or something in clinic, so it's better to kind of choose. Usually have a 20 year life span. So a lot of people might get a knee or hip replacement around 65, 70, and that would probably do them their lifespan. As opposed to like maybe 88 and then, you know, because there's a bit more comorbidities. People are kind of struggling at that moment in time. So that's just something that you'd have to discuss with the individual, depending on how it presents.

 Mark: If you're noticing some pain in your knee, could it be osteoarthritis? Come and see Simon Kelly at Insync Physio. You can book an appointment at insyncphysio.com. Easy one click, boom, boom. You can find the opening and where works for you get in there. Get to see him.  Get some treatment. Get the pain minimized or you can call to book at (604) 566-9716. Thanks Simon. 

Simon: Thank you Mark.

INSYNC PHYSIO Testimonial for Skier & Rock Climber – Allison

So I started going to you Insync Physio about two ski seasons ago when I had a fall while skiing. And I didn't think it was a really big deal, but when I got home, I was in a lot of pain. I could barely lift up my arm. 

So I was really lucky I was able to quickly get an appointment and then I got some physio treatment and also the really great take home exercises and the support that I received really allowed me to rehab my arm quite quickly and I was still able to ski for the rest of that season. 

I'm also an avid climber. I climb three, four, sometimes even five times a week. And I'm also an avid cyclist. And so I had been really been able to get a lot of support from the physiotherapy team. And also have the massage therapy team as well. For me to really continue doing all the activities that I love at the level that I want to do it at. 

So thank you so much for all your support in the past two years. Thank you.

Hand and Finger Injuries – Rock Climbing Rehab – Hand Intrinsic Muscle Strengthening Part 2

If you’ve injured your finger tendon or a pulley ligament from rock climbing, then doing specific strength training for them can help you better rehab from it.

Start with your wrist in neutral, not flexed or extended. Then flex your index to last fingers at the knuckle joints only - or the Proximal Inter phalangeal joints, and then spread all the fingers apart (into abduction).

Return the fingers together and repeat this for 30 seconds doing 3 sets 2 times daily.

This exercise can help you heal, recover and rehab more effectively and increase your contact strength after a hand or finger injury from rock climbing. If you have pain or are unsure about what you are doing consult a local physiotherapist before continuing. 

Neck Pain – Heather Camenzind

Mark: Hi, it's Mark from Top Local. I'm here with Heather Camenzind of Insync Physio in Vancouver. And we're going to talk about neck pain. Are you seeing a lot of neck pain these days, Heather? 

Heather: Yes, I'm seeing quite a bit of it actually. So I'm seeing one person in particular, she's coming in for a lot of neck pain. Due the pandemic, she's working from home. So we've been working a lot on her home set up just including trying to raise her computer up a little bit for her. Not working on the couch in a slouch position. So she's trying to create a desk, like situation for her. 

But we're also talking about just trying to increase her movement quite a bit and trying to build in ways that she can do that throughout her day. 

Mark: So what does that look like? 

Heather: Yeah. So I think just with people working from home a lot, and we get stuck in this work, work, work mode. And we're forgetting that when we were going to the office, how much movement, just that in itself builds in throughout the day. 

The act of getting yourself ready. The traveling to your workplace, walking from the train or your car, to the amount that you've actually looked and turned around and moved your neck and head. And now people are, we're waking up. We're probably looking on our phones for the news or something in the morning, and then we're plugging into the computer. We're not really actually moving quite as much as we want to. 

And a lot of people are doing exactly what we're doing. We're Zoom or talking video conference. So a lot of people are in, and they're describing these meetings to me. And some people say they're all day they're six hour meetings that people are on their computers and they're looking straight ahead. 

If you were in your office, you would turn and look at people and maybe you would stretch, get up for a glass of water. And all of that movement that was built in throughout our day is lacking now. So we're trying to develop strategies with clients that they put a timer on for themselves. To remembering that they get up and they move around their apartment or house, something that they're moving half an hour or every hour, at least every hour. Encouraging people to get up, do some stretching, just stretch your neck, doesn't even have to be a big stretch. Just move your neck, twist your neck, look over your shoulder.

And then also I've been encouraging people to reach over their heads. This is so good. It gets your shoulders going, gets your mid back moving. That gets really kind of rounded and hunched. So just reaching overhead. It actually feels really good to just reach overhead. And just to give your body a little kind of movement and some shape because we're so forward these days. 

So it strategies like that, just it's nothing simple. It's just remembering to do it. And we were getting in this work, work, work mode that we feel like we have to be on all the time, I think. And we want to change those habits for people. That you don't get that like, couple of minutes chit chat with people that you used to when you were going to get your water, your coffee or something like that. Those things are lacking these days.

Mark: So when someone comes in with neck pain like that, how do you diagnose it? And then what's the protocol to get them feeling less neck pain. 

Heather: That's a great question. So a lot of it's just history kind of figuring out what could be contributing to their neck pain. Some people have a history of a prior car accident or a ski accident or something like that.

So knowing people's histories of what could be potentially contributing to something is key. So we do a detailed history. As well as then we just talk about what your day looks like in general. When you experience the neck pain? Is it in the morning or is it in the evening? Is it all day long? Could that neck pain be contributing to headaches that people get. A lot of neck pain refers up and contributes to headaches for people. So detailed history is very important. 

And then we go into just a basic assessment. So looking at how people move. Can they rotate? Can they twist? How do they do that? Also looking at their shoulder mobility, kind of like I referenced earlier, reaching up over your head. And also their mid back. So a lot of neck pain can be contributed to stiffness in the shoulders as well as through like the chest and the thorax. So your mid back. So we want to make sure that those things can move and have the ability to move as well. 

Mark: So, how do you actually treat for that? Is that all manual manipulation, like getting in there and loosening things up? Is it the horrors of needles? How do you actually get it loosened up?

Heather: It's often a combination. So you chat with people about what they're comfortable with. Often some manual therapy, so hands-on therapy. So working on the joints, getting those moving can be something as simple as like massage, just some, some muscle release and fascial release a little bit in there.

Some people, or actually a lot of people respond well to needles. It doesn't have to be needles though, but IMS is a great way to release muscle tension. And then From there, it's teaching the client, talking to them about movement strategies. Like I referenced earlier. 

They can only see me so much. They can see me probably for about half an hour in the week and the rest is up to them. So we try to kind of use the analogy as I'm their coach. We kind of talk about the strategy and they kind of go and try to implement the strategy. So moving and then a lot of it's stretching. So teaching them how to stretch properly.

And then also sometimes it involves some strength. So just getting your mid back muscles stronger, but a lot of it I find we can get with just implementing some movement strategies or stretching on a daily basis. 

Mark: And how often, or how much of a contributor is, are these evil devices that we tend to want to spend way too much time staring down at. 

Heather: Yeah. So I think it's all a big portion and we're actually seeing younger and younger people come in and start to complain about neck pain. And it's because we're on devices so much and often the way they are it's like as you said, you're looking down all the time. And so it's contributing to, people just kind of this like head, we call it head forward posture. So it's kind of this chin poke. So teaching people to sit up tall. And it doesn't mean it has to be like strong military posture that makes our backs really sore really quickly.

So it's just imagining, something's just pulling you up tall and you don't have to be perfect posture, but just upright posture, is key. 

Mark: Perfect, and how long to relieve kind of this sort of neck pain that you're seeing a bit of a epidemic of these days. 

Heather: Yeah, it varies on everybody. It depends on what would be the contributing factors. Sometimes just teaching people to move more. And if they're compliant and they actually do what they should do, they can alleviate their neck pain quite quickly. They find the movement really helps. Some people, it takes a little bit longer.

If there's something else that maybe is underlying there. You talk to a lot of people and they're having an acute moment of neck pain. But you start to talk to them and they do have a history of kind of a chronic neck pain. You're like, yeah every once in a while, it kind of, people say, goes out.

Can get a kink in the neck. You wake up funny and you can't move. So those people tend to maybe take a little bit longer. So if it's just something acute, like just, you woke up with something and it's your first time of neck pain, or you are having just this kind of epidemic, as you say, of lots of neck pain, just from people working at home.

If they elicit strategies at home, they can be quite successful and maybe it takes a few weeks, maybe a month to kind of make those changes. It takes time to change habits but maybe a month to six weeks. And then sometimes if it's something else that's a little bit more complicated would take a little bit longer.

Mark: If you have neck pain, if you have a pain in the neck, divorce him. Yeah. Other than that, call Insync Physio. You can book an appointment to see Heather at insyncphysio.com. Or you can call the office on Cambie Street, (604) 566-9716. Book your appointment. Get in there, get your neck pain solved. Thanks Heather.

Heather: Thanks, bye.

Hand and Finger Injuries – Rock Climbing Rehab – Hand Intrinsic Muscles

If you have a finger tendon or annular pulley ligament injury, then doing strength training for the intrinsic muscles of your hand and fingers can help you rehab much better!

Start with your wrist in neutral, not flexed or extended. Then flex your index to last fingers at the knuckle joints only - or the Proximal Inter phalangeal joints. Return the fingers to the start position and repeat this for 30 seconds doing 3 sets 2 times daily.

This exercise can help you heal, recover and rehab more effectively and increase your contact strength after a hand or finger injury. If you have pain or are unsure about what you are doing consult a local physiotherapist before continuing. 

Low Back Pain & Injuries-One Leg Looped Band Bridges

Wrap a looped resistance band around your thighs just above your knees. Engage the core muscles below the belly button by pulling them inwards while you keep breathing.

Ensure your knees are aligned with your ankles and your hips while you take up the slack in the looped band. Push through your heels with the feet flat on the ground and bridge the butt up keeping both sides of the pelvis level with each other.

Then straighten out one leg, hold it here for 10 seconds, and then bend your knee and lower your butt back down. Repeat this for 10 repetitions doing 3 sets daily.

This exercise progression helps to further strengthen and rehab the functional strength of your low back whether it’s a chronic pain issue or more of a weakness from an acute injury that you have experienced. If you have pain or are unsure about what you are doing consult a local physiotherapist before continuing.

Neck Pain & Injuries – Raise the Roof!

Loop the band around your hands and have your elbows bent at 90 degrees by your side. Keeping your palms facing downwards towards the floor, spread your palms so that the hands are in line with your shoulders.

Driving through the elbows, and keeping your hands shoulder width apart, slowly elevate your hands to the level of your face and up over your head. Do not lose the parallel alignment of your hands and arms and do not bend your elbows (flexing your biceps).

You should be feeling this work through the back of your shoulders, and the back part of your neck and upper back.

This is a great exercise to build more core strength in your neck if you are recovering from chronic neck pain or a neck injury. If you have pain or problems doing this exercise consult your local Physiotherapist before continuing.