We sincerely would like to thank everyone who supported us during this time with their kind words and assistance in getting the online program up and going. We will continue this program to assist people who have to be in isolation, who don’t feel secure leaving their house due to compromised immune systems, or those that are in BC, but can’t get into our clinic due to work demands. We are here for you!

As of May 19th, we re-opened our doors once again (how many times do you have to start up a new business in one year!?!) to our amazing community, with a few new changes to ensure both staff and patients are safe during the ongoing pandemic crisis. We were very lucky to be a part of a Canadian National Clinic Owners group on facebook, which allowed us to problem solve the many issues facing healthcare clinic owners in re-opening a space into a safe and practical environment. It was so amazing to see how effective a group of like minded people can be. Thank you so much for your assistance and reassurance!

We would also like to thank some of the local/BC groups who put in time/effort/product to help make our opening not only possible, but a success:
–Okanagan Spirits Distillery for providing our clinic (and many other businesses around Kelowna) with in-demand Sanitizer. In my opinion, they should be Kelowna Business of the Year Winner…NO MATTER WHAT.
–Making A. Mends – A Vancouver Alteration shop that graciously supplied us with the coolest fitted face mask that are repurposed from denim and other fabrics. Thank you.
–Jeremy Brown of Rattlesnake Films. Thank you for making your Rattle Snake Clips to ease ear load from surgical masks on your 3D printer. For both us, and many other healthcare worker in BC. I can’t imagine how much time and money you have personally invested, expecting nothing in return (maybe a smile behind a mask). People… if you like the Avengers movies (and many others), thank him…he does AMAZING work. I look forward to seeing all his future work!!
-and finally CASTANET.NET– thank you so much for featuring us as we returned to in-clinic treatments May 19th. I am very proud that you are showcasing local businesses and how much work we are doing to ride the crazy COVID-19 wave, and all come out healthy on the other side.
Here is a link to the full article and video, featuring Joel, one of our owners:

https://www.castanet.net/news/Kelowna/300612/Physiotherapy-clinic-on-the-new-working-normal-during-pandemic

And here is the full written text from reporter, Laura Brookes.:

NEW NORMAL FOR PHYSIO CLINIC

For many businesses, opening up with all the new cleaning and social distancing measures in place to guard against COVID-19 isn’t an easy task.

But for hands-on services like physiotherapy when a large part of your day is touching people, it’s an even greater challenge. 

Physiotherapy clinic MotionWorx, located in downtown Kelowna, opened its doors just a few months before the COVID-19 pandemic hit and soon had to switch to online appointments, says owner and sport physiotherapist Joel Kryczka.

“We have always prided ourselves on providing education and empowering our patients, but now we had to think outside the box to not only assess patients remotely, but also strengthen/stretch and correct movement patterns without the ability to physically guide them. 

“It really takes an online meeting to a new level when you have to ask people to get down on their home floors or go up and down the stairs to help them out. There have been more than a fair share of funny moments (dropped cameras, dogs participating), which have been hidden gems despite some of the mental and physical struggles that we witness in our patients’ lives. It’s an honour to have people allow you into their homes and lives…I had one patient play her guitar for me, and we talked about ergonomics of playing with a shoulder injury!”

In mid-May, the clinic attempted what felt like “opening the business for the third time,” complying with regulations to ensure adequate social distancing and protection for both staff and customers against risk of COVID-19 infection. 

“Most people are absolutely happy that we’re doing everything we can to make sure they’re safe. You get the odd person that’s reluctant to go to the extremes, but I always pitch it as we’re just practicing and making sure that if there is a problem, we’re not playing catch up at that point. It’s better to be on top of it. Being safe rather than sorry is really what it comes down to.”

New measures in place at the clinic include walking arrows to direct patients, patients waiting outside until they are called into the clinic for their scheduled appointment time, wearing masks inside, plexiglass at reception and a rigorous hand washing routine before any physiotherapy takes place. 

The clinic is also keeping track of who comes in and out of the space to ensure they have information on hand in case of a future outbreak, and they’ve even put special artwork from local artists up on the walls to make the space feel less “clinical”, says Kryczka.

“Now that we’re open, the tricky part is to try and have a situation where we want to be welcoming, we want to be warm, compassionate but still do what we can to stay safe … and so it’s been really neat to find that blend between the two. We’ve really noticed that people feel welcome and not overwhelmed by some of the disinfecting and sterility measures that we implement so people are safe, but it also doesn’t feel like a hospital.”

He says the greatest part of this experience has been the way the community has come together on both a local and national scale. 

“Physio clinics and chiro clinics and massage clinics, as much as we’re part of a community we’ve never really had to come together to try to solve a problem on this scale, and so there’s clinic owners across Canada that have been on a closed Facebook forum and discussing every issue, in terms of how do we address patient needs, what’s the best thing to disinfect and what are the best sources for PPE and all these kind of things.”

Locally, they’re very thankful to have sourced hand sanitizer from Okanagan Spirits, and a Vancouver company which provided them with repurposed masks for staff, and patients who can’t afford or access masks.

Online physiotherapy services will remain open for people who are immunocompromised or don’t feel comfortable to visit the clinic.

The post MotionWorx re-opens and in the news! appeared first on MotionWorx Physiotherapy.

We are now a few months into the new year and this is the time that the majority of people have fallen short of their goals set in the early mornings of New Years Eve. Perhaps the goals were not realistic. Perhaps the goals were too much too soon. Perhaps the goals were not properly planned or executed.
As we have talked about many times both in the clinic and in these BLOGS, setting small and attainable goals are what is important. It doesn’t have to be important to anyone but yourself. This is not to impress anyone, or to post cool pictures on social media. It can be a slippery slope when you are injured to make excuses for where you are at (or not at). Have a bigger goal, and then create mini steps to get there. Maybe your first goal is just to sit down and create a list of goals….
Setting achievable goals will help to keep you motivated and focused. What are your 2020 goals?

Here is what the MotionWorx team says (so we can be accountable too!):

• “Cycle the Okanagan Rail Trail from Lake Country to Vernon”
• “Compete in a few Brazilian Jiu Jitsu competitions”
• “Find time for activities that I have not done in a few years including cross country skiing, tennis, rollerblading and rock climbing”
• “Become stronger with more regular training/gym sessions to be able to play tennis again without injuring my shoulder, and to improve my golf swing”
• “Continue to explore more of the wonderful hiking trails around the Okanagan”
• “Participate in more trail and road races. They are a good motivator to train and it is fun to push myself once in awhile. There are many great trail races in the Okanagan to choose from throughout the year”
• “Be more consistent with exercise…even if it is 10 minutes. Creating the habit forms the foundation”
• “Explore more of Kelowna with outdoor activities….become a tourist again”

The post Stay on Top of Those Goals for 2020! appeared first on MotionWorx Physiotherapy.

This weekend I re-learned a valuable lesson in the importance in patience. I had the yearly trip up to Big White with my family which fit 7 adults, 3 kids, a newborn, and 3 dogs into 1 house. Chaos personified if I have ever seen it…but I’d have it no other way. With so much going on, it can be hard to take time to focus on yourself…so I made a promise that I would make sure that I would find time to snowboard, and enjoy every minute of it. The thing is, as much as I love snowboarding, I am a snob. I would rather not go at all, then go on a day without powder. Many epic days in the snow have spoiled me….and here in lies the rub. I am staying up at Big White for 4 days, and the weather is sub-par.

The first day we get there (Friday) it is a beautiful blue sky and is nice and warm. There is a lot of activity on the hill, but we are getting settled into our lodging. People were posting online about how beautiful the conditions were, and how there have only been a handful of clear days this year. Looking forward into the weather forecast, the following day was supposed to be colder and not bring any new snow …Did I miss the timing of my day to go snowboarding?

True to the weather guys prediction…As I wake up Saturday morning- no new snow, and cold as heck (read: all that nice snow from Friday is now solid ice). So I decided to spend the day relaxing while the kids were in lessons. Turns out the weather guy was only correct until 11am. Then it once again got beautiful out, but by then I had mentally moved on to spending time with family and prepping for dinner etc. Super important, but definitely not snowboarding….and the weather prediction for the following day was to be cold, minimal snow and windy. Very windy.

Sure enough, this was the worst day of the lot so far. This was definitely a no go for any form of fun snowboarding, unless you are looking to use the wind to sail to the west coast. Seriously…it was that bad….and so it all came down to going snowboarding on the following day…or not at all.

As I was going to bed that final night, I looked back at all the fun things we had done as a family, and will cherish many of the memories forever. It was fantastic. Many of these memories that I was involved in clearly happened because of the fact I was present in what was happening and not thinking about my missed time snowboarding. I had resigned to the fact that I was not going to ride that day, and had put all my focus back into what mattered at that moment. The conditions were garbage anyways, so why waste mental space and time on something that really wouldn’t have been worth it. I think the key thing here was not forcing the issue. When you always tend to focus on others (job, kids, family) sometimes you can feel lost in the shuffle, and then try to force it when you are trying to spend time on yourself. Perhaps not listening to the proverbial weatherman.

In returning to sports, I definitely see patients with a lack of patience. Maybe it’s not my place to say, but I see people forcing the issue to get back to sports for one reason or another. I’m sure those reasons are even valid, but what I’m suggesting is the time just may not be right. I see them do all the right steps in terms of doing rehab, working on other parts of themselves, but there is that innate drive to get back to “the old them”. I’m not sure if it’s the ego talking, or just a goal to overcome adversity and prove to themselves that they are healed. Forcing the issue in either of these situations can lend itself to failure…which has more of a negative impact on mental health, then perhaps waiting for an extra day, week, or month. To be clear, waiting does not mean sitting around doing nothing…in fact it is the exact opposite. It should be doing everything else to clear obstacles and excuses so that when the right time does arrive, there is nothing holding you back, and you can then be present in the moment when you are attempting to achieve your focused goal. Set yourself up for success!

So what happened with me being OK with the possibility of not snowboarding, and putting off going out in far less than ideal conditions? I woke up looking out the window throughout the night to heavy snowfall, and in the morning was treated to 30cm of fluffy snowfall. Boom.
It was an amazing day of riding fresh tracks. I met an 86 year old with a perma-grin beating people half his age down the hill. Everywhere I went I heard people laughing and high-fiving over the “best run ever”.
For those of you that had patience this weekend…High Five.

When I was done, I walked back to the cabin where we were staying and realized the vast amount of snow that had to be cleared for us to be able to get our vehicle out. I look around and see a small scoop shovel…I think to myself “Self, you got to have fun, and this is a little bit of work to pay for the fun you had…no biggy”. I set to work clearing an ENORMOUS amount of snow (think knee high x 30 SUVs)…and JUST as I finished shoveling for well over an hour, a massive CAT with chains and snowplow attachment showed up to finish the job.

Perhaps, I should have been more patient…

The post The Value Of Patience appeared first on MotionWorx Physiotherapy.

Snow, ice, chilly weather, shorter days… so how do you keep yourself active and moving through the winter in Kelowna?

Here is what the MotionWorx team says:

What are your favorite activities to do in Kelowna in the winter?

The post Stay in Motion in Kelowna: Winter Addition appeared first on MotionWorx Physiotherapy.

1- Find a registered healthcare practitioner that you trust and feel comfortable with
This is EXTREMELY important. If you plan to work through an injury, which can often be a significant barrier in your life, it is vital that you find someone that you know is going to go to bat for you, and that you “buy” into what they are asking you to do. If you do not feel that they truly understand your injury, how are you supposed to? If they are not educating you on what is wrong, or what you need to do to self manage, how are you supposed to know when you have done too much, or what to do when you have?
More important than knowledge, and even experience, is knowing that your healthcare provider (physio, chiro, massage, other) is there to help YOU. If they do not know what to do, they should refer you on to another practitioner who can help, or at least give guidance. There is nothing wrong with someone saying they “don’t know”, especially if they will find the answer. There is everything wrong with someone showing they “don’t care”. Do not settle for anything less than the best for your body.

2-Set goals
I can confidently say that most peoples only goal in injury rehab is to get rid of the pain. But as discussed in a previous post on pain, that pain is only a signal from the body saying (or screaming) that something is wrong.
Unfortunately, pain is also very subjective, and can change intensity with poor sleep, medication, or even emotional variances. For this reason, it is preferable to set a series of small goals that are objective and attainable markers along the path towards getting better. This could be as simple as walking down the street with no limp. It could be sitting upright for 30 seconds, every hour of the day. Or it could be getting a certain amount of sleep in a night. It is very individualized (like a snowflake!), so please discuss this with your healthcare practitioner to ensure that it is attainable/realistic and the best approach to reaching those goals.
Just remember: If you don’t know where the finish line is (or many lines in most cases), how would you know when you have crossed it?

3- Create a habit around doing your rehab
As there are MANY causes for “weakness” in an injury (such as atrophy, inhibition, neurological weakness, anatomical tear etc), the most important thing when doing a home exercise program, is to, as NIKE said, just do it. Creating the habit is vital for both doing the exercises on a regular basis, but also bringing your attention back to your injury on a regular basis. Early on, you may only be able to do half of the prescribed exercises (with great technique), but the fact you were able to regularly set aside time to do half of the prescribed exercises is more than a step in the right direction. In fact, its more beneficial than doing the exercises randomly, and then doing more than you should (with poor technique) to make up for the times you missed…Teach your body to move correctly on a frequent and regular basis, and eventually it will move correctly all the time.

4- Develop pain limits and management strategies that align with your goals and beliefs. Pain limits will help you decide when you have done too much
Many people feel that they have to endure pain to get better. “No pain, no gain” is a load of BS. Remember that when you are doing a proper rehab program, you are trying to improve your weaknesses, or get your stiff spots moving etc. There is a limit to what your body will be able to tolerate in a given session, and doing double or triple than that, does NOT make the injury heal any faster. In fact, doing more will help reinforce compensation patterns that we are trying to overcome.
When you are listening to your body (often for pain, tightness, fatigue), you are more likely to know when you are at the limit of what you are able to do with proper technique. At this limit you should consider stopping what you are doing, and managing the symptoms. When you expect the symptoms, and you know HOW to manage them, the symptoms themselves are not scary. They are a natural obstacle to overcome on your journey to the small goals you have laid out. Make sure to discuss symptom management techniques (both by yourself, or by a practitioner) as you continue to move your body in proper movement patterns needed to regain normal function.

5. Do not fear the injury. Focus on education about your injury and what you can do about it.
As discussed in another blog post “Where is the Battle?” , the best thing you can to minimize issues in the future is educate yourself about your injury (start with getting a proper diagnosis about what is ACTUALLY going on). The less you are shocked by seemingly random bouts of pain, the more likely you can tackle the injury with a clear head and not let fear or emotion drive your decision making process (such as returning to work safely or getting back to a regular/modified training program). Sometimes, the best thing you can do to an injury is simply stop making it worse by irritating it with silly habitual patterns. If you have a sore neck, you may have to stop checking social media for hours in a slouched position on the couch. Just because you used to be able to do it, doesn’t mean you still can do it, or that it’s the best thing for your recovery.

6. Work hard. This is the equivalent to a job…not an inconvenience.
There is no substitute for hard work, but the truth is, its not always about working hard, its about working smart. For most people, an injury is an inconvenience that they tolerate until it goes away (or more commonly until the pain goes away). Only when it interferes with work or play, do they stop and take it seriously. If an injury is “big” enough to impact your work/play, then it definitely demands some respect and that comes in the form of learning about it, being consistent with rehabbing it, and doing little things (such as modifying behavior, being aware of posture)…all things that you would do if it were your job to get better. Why do professional athletes get better quicker than the average person? Genetics? maybe…More likely it has to do with the fact that they make millions of dollars to be in the best shape possible and have a team working with them daily….they treat it like a job, because it is.

7. Modify your expectations.
Many people think that returning to normal work/sports is an all or none thing. In many cases, that can be true…but not always. Some jobs may require the person to return to full function before they safely return to their normal duties (such as a firefighter), and other jobs allow for a modification in duties until the person is ready to progress.
In sports, you may be able to return to practice, but you may just have to limit what you are doing in that given practice (limit intensity, or volume or directional changes). This may mean that you have to return to sports at 80% effort or half the duration, or if you need to go back 100%, realize it may take longer than expected. Think about being the “play maker” instead of being the “super star”.
It is important to lower the expectations of what you can safely accomplish, and also to develop your body to better handle these loads.

8. Sleep
The importance of sleep in healing is often overlooked. The majority of tissue healing takes place while we are sleeping. Pain tolerance is also lowered when someone gets less than their normal amount/quality of sleep. The problem is that pain itself can interrupt or completely interfere with sleep, which creates a vicious cycle. Often I will suggest that pain medication is perhaps the most important at sleep time (to allow sleep if it is being interrupted) and least valuable during the waking times, to allow the patient to be able to listen to their body when they have done something that irritates the injury. Make sure to discuss sleeping positions with your health care practitioner if you find that you are waking with pain that is not there during the daytime.

9. Monitor your change in activity levels and associated mood/psychology.
It is important to monitor (or have someone monitor for you) any changes in psycholological states such as anxiety, depression or even just frustration. This is particularly a concern in concussions- This will be discussed in a future series of blogs on concussions (stay tuned!)
While sometimes these changes can be beneficial, such as using frustration to drive you to seek out professional help, more serious forms require attention on their own. Progressing depression and anxiety can completely halt any form of activity and thus progress in the injury. These mental health issues do not carry the stigma they once used to, and if you feel (or your loved ones feel) that you may need assistance with your growing anxiety/depression (or other), do NOT be afraid to ask for help. If nothing else, bringing this issue up, allows others to help monitor your state, and can help you recognize when things may be “falling off the tracks”. As with all things surrounding success, communication with yourself and others is key.

10. Reward your small successes
It is truly amazing when an ongoing injury can be fixed overnight. But the truth is, that is almost never the case. Even if it feels significantly better, there are likely many things to work on to ensure that it does not return. With that in mind, make sure you set small and attainable goals. Then celebrate when you achieve a goal!
Think of it as taking one step up a staircase at a time. Definitely something that can be done one step at a time…try to jump up 5 steps, and you may fall back down the staircase. No one likes being that guy.

11. Re-Evaluate on a regular basis.
Not daily, but perhaps weekly/monthly. This will help you figure out where the new battle is. Many people fail to see the positive (or negative) changes that have been occurring as they are focusing on comparing day to day. This can make it very difficult to see overall improvements if there are subtle set backs that make it feel as though you are going nowhere. Ask others if they notice changes in how you move, write down things you can now do that you couldn’t a month ago, or schedule a monthly appointment with your trusted healthcare provider to reassess your progress and help give you new focus.

13. Refocus your priorities in life

While many people tend to focus on the things that they cannot do because of an injury, this puts a negative spin on every action. Acknowledge the things you cannot do currently and then use those as functional markers to your success (rather than pain). Now that you have more time on your hands not focusing on what you cannot do, perhaps this is the perfect time to spend more time with your family, or read, or do your taxes, or focus on strengthening the other parts of your body unrelated to the injury. The key is make a habit of finding success elsewhere, and it will carry over to your injury, and the rest of your life.

12. Understand that pain is the worst marker for success.
It is known that pain is the last one to the party and the last one to leave. Make sure that, while it is important to listen to your body, pain is just a way for your body to communicate with your brain to tell it that something is not going correctly (See our blog post on this topic). It is VERY IMPORTANT to remember that pain does not always equal harm. Sometimes, it is just pain.
The other thing that is important to remember is that success in injury rehab is not linear. This up and down progress can be normal with functional markers such as range, strength, and timed feats such as standing endurance. Pain, on the other hand, when used a marker for success looks like a crazy rollercoaster, especially as pain can come and go for many reasons unrelated to the injury itself.

14. Use this injury and rehab process to be a catalyst to be a better you.

If your injury is caused from sitting in a slouch too frequently, use the feedback of pain as a reminder to correct your posture. Do this consistently enough and you are making an improvement in your body and your life. If you are injured from being a weekend warrior, perhaps this is a perfect time to re-prioritize activity in your life and consistently make time for well-rounded exercise. If you spend all your time at the gym picking heavy things up, the injury will often require you to go back to the drawing board and work on smaller stabilizer muscles, which in turn will help you lift more, and in a safer manner.

15. Continue to work at your weak spots that lead to your injury, not only to prevent the injury, but create relative new weak spots as you are now a stronger you.

While much of rehab can focus on isolating and improving your weak links (muscles or movements), the end goal is really to make you more efficient with moving, so there is less stress to the injury. By sharing the load with other, newly developed muscles, you become more efficient with movements, which allows you to focus on developed techniques, plays or more complex movements. Essentially, be cleaning up your weak spots, whether injured or not, you become a better you. Often plateaus in sport happen when athletes focus on one training technique or plane of movement for too long. Keep improving your weak spots and keep changing directions and you will inevitably improve.

The post 15 Keys to Success in Injury Rehabilitation appeared first on MotionWorx Physiotherapy.

So you have just been injured. Welcome to the club. The club no one wants to be a part of.

Was it caused by some other persons error that wasn’t following the rules? Were you just not paying attention? Did we get the goal? Can I still play?….Often these can be the first thoughts that go through our heads when we get injured. In fact, the last one that can enter the mind is ” Am I OK?”.
Once that thought jumps into our heads, sometimes it will never leave. When things are slow to progress, it can feel like it will never get better. Dreadful thought.

After we have assessed the damage to our best ability (some people when injured are more capable than others at this), we carry on and then have to make some important decisions about the best course of action after an injury, or as I like to call it: Damage Control.
The funny thing about damage control is that, while it’s important to deal with any emergent situation (fractures, open wounds, concussions etc.), the vast majority of poor decisions that happen for less scary injuries, can often lead to prolonged or worsened conditions, if only due to the fact that they are poorly handled early on.

THE MOST IMPORTANT THING YOU CAN DO WITH ANY INJURY IS GET A PROPER AND THOROUGH DIAGNOSIS. This seems obvious enough, but what often happens, is the injured person gets thrown off the correct path towards a diagnosis due to subtle, but powerful, “Red Herrings”. A Red Herring in an injury is when a person focuses on the pain, not the cause of the pain. This can be due to the unrelenting nature of the pain, the emotional attachment to the injury, or the masking nature of the injury itself (such as a low back nerve injury that feels like pain in the leg or foot).
The reason that a proper diagnosis is KEY to tackling an injury is that if done correctly, should put all possible related diagnoses on the table, and come to the final diagnosis (or differential diagnosis of a few similar ones) by exclusion. The nature of this is important to shed the fears of the patient towards more ominous potential injuries, when a simple injury is just not being treated correctly. By removing fear, a patient can then better look at “Is the pain I’m feeling directly from something I did wrong?” or “Is this injury more serious than I thought?”, versus “Will this ever get better?” or “poor me! I can’t do anything!”

Here is a real life common example of decision making early in an injury… Young Timmy is playing soccer and reaches out for the ball with his foot, and feels a pain in the back of the thigh. There is a lot of pain, but no swelling or bruising. Timmy sits off the field and puts ice on his hamstring, and stretches it out as it is going into bouts of spasm (both ice and stretching weirdly seemed to make it sore afterwards). The next day there is still no bruising, but misguided young Timmy is unable to reach his leg out in front to walk, and has pain all down the back of the leg. Timmys Mom tells him to take some ibuprofen and continue to stretch.
The following day Timmy has pain into his glut region (and in the previous areas) and is getting numbness in his foot.
So where did they go wrong?
The best question to that is when did they go wrong? Immediately.
In this case, Timmy’s injury is commonly thought of as a hamstring strain. Except when it isn’t. In the case of a hamstring injury (please see upcoming BLOG on stretching post acute injuries), Timmy did what most people will instinctively do, even if it is incorrect- stretch a tight muscle after an acute injury.
In this case, the injury was a traction injury to the sciatic nerve, which lives anatomically under the hamstring. The hamstring will be the last anatomical structure left to protect it in an outstretched position, and will “throw itself on the sword” to protect that valuable sciatic nerve. The muscle is tight either because it itself is injured, and is trying to auto-splint itself, or the sciatic nerve was injured in a traction fashion, and the hamstring is tight in attempt to prevent further stretching to the nerve. Either way, stretching was not a good decision in an acute injury.
On a side note, acute nerve injuries do not tend to react well to traction forces, compression forces, cold temperatures, or vibrational forces. It is easy to see how stretching and cooling an acute nerve injury would make things worse (even just for a short duration). If an injured person does not listen to these important signs, they could continually irritate the nerve, and then grow frustrated when it does not heal as expected.

While this scenario seems drastic, it is very common on some level with many different injuries. This can be further perpetuated by a rushed timeline (such as an upcoming competition or strict coach/parent). It cannot be stressed enough that emotion is very powerful in influencing the injured person to make poor/rash/desperate/anxiety or fear-driven decisions. WHEN YOU ARE ABLE TO TAKE EMOTION OUT OF THE DECISION PROCESS, YOU WILL ALWAYS MAKE THE CORRECT CHOICE. The best way to do this is to educate yourself (hopefully from a thorough diagnosis, not just Dr. Google) so as to best decide WHERE IS THE BATTLE that you have to focus on- and solve it correctly, before you move on to the next battle.
Think of it as you need to finish kindergarten before you can move on to grade one, and so forth, before you graduate high school. Sometimes, you may have to go back a few steps and do them correctly before getting back on track, as injury healing is not always a linear path.

A very important aspect of this process is to not let pain be your guide as an indicator of whether or not the injury is actually improving and ready to go (SEE BLOG ON PAIN). Just because something FEELS better, doesn’t mean it is better. You may just be amazing at compensating and working around the pain, and possibly creating another problem. The key again, is to get a proper objective indicator of how you are doing at that moment (strength, timing, range of motion), and then gauge your progress and direction from there. This is where your trusted physiotherapist, chiropractor, doctor, massage therapist (or other), can be an invaluable guide on your journey to getting back to your regular (or better) self.

When medical professionals are initially assessing your injury (or your progress for that matter), the first thing to rule out is the presence of anatomical dysfunction (such as a fracture, cartilage damage or an actual tear on the muscle). Once that is ruled out, the next thing they should be screening for is the presence of a nerve injury (compression or traction injury) causing weakness and/or impairment in the periphery. Both of these complications can cause the muscles in the body to do some pretty crazy things, and can lead you down the wrong path towards success in your injury management.
The next thing to screen for is the presence of joint hypermobility (too much movement) or hypomobility (too little movement). This again, can cause your body to move differently, and thus inappropriately load the injury, or other parts of the body attempting to help you continue to move around “normally”.
Finally, they should be screening for biomechanical strength, control, movement patterns, and timing. This is commonly what people associate with physiotherapy and the homework they are given to do at home (or in the gym with a kinesiologist).
If for some reason the gains in strength are not being made, we have to readdress WHERE IS THE BATTLE? and perhaps look at: Did we miss an underlying nerve injury?, What are the other patterns of weakness present? Are there any compensatory patterns?, Was the homework done properly? Has the injury been overloaded in daily activities? Are there any underlying emotional or psychological factors slowing down or masking the progress?

So if you are finding yourself frustrated with your injury, make sure you slow down and try to analyze where things are going wrong, rather than just stating that things aren’t getting better, or worse, just focusing on the pain. This is a great time to talk with a trusted healthcare practitioner and have them thoroughly assess where you are at, and to help guide you. Make sure to explain any concerns you have with your current plan, and discuss what things seem to help or hurt your injury. The more information you provide to your healthcare practitioner, the better they can help figure out where WHERE IS THE BATTLE that is important to fight at that time, and they can then help set a realistic plan to help you achieve your goals.

Keep at it… Educate. Rehabilitate. Dominate.

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Ankle sprains: one common problem after an ankle sprain is stiffness and reduced mobility into ankle dorsiflexion. This is the position of the ankle during a squat. This range of motion is very important to restore; as this is the position sustained in skiing and snowboarding. If there is residual swelling, this will also reduce the mobility at the ankle joint and may make it difficult to put on your boot.

Test yourself: Try the knee to wall test: keeping your entire foot flat on the floor, see how far you can move your foot away from a wall and still touch your knee to the wall in front of you by bending your knee. Make sure you do not lift your heel. Do you notice a difference when comparing side to side?

Now try putting on your boots and see if you feel comfortable standing, walking and squatting with your ski or snowboard boots on.

Poor balance and weakness after a sprain are also quite common. Think about the balance required when you stand on one leg while pushing with the other leg to get from the chalet to the lift. Skiing down the run also requires a quick reaction time when navigating bumps, ice and differences in snow quality. A home program to improve your ankle mobility, strength and balance will help you to have a successful ski season.

Knee injuries: this includes pain under the knee cap, called patellofemoral pain, muscle and tendon injuries, ligaments sprains and knee joint pain.

Test yourself: Can you move from sit to stand 10 times? Can you do 10 squats, holding for 10 seconds each time? Can you crouch and get up and down off the floor? Can you stand on one leg and bend your knee? (hold on to support for this one).

Do you have pain or weakness with any of these tests? Trying to stand up with all your equipment on after falling on a run (perhaps on a powder day) is not going to be easier than getting up off the floor at home. Similar to the ankle, it is important to restore mobility, strength and balance after a knee injury prior to getting back on the slopes.

Hip and low back injuries: this includes any pain or weakness noted in your hip, pelvis or low back.

Test yourself: Try standing on one leg (do this next to the kitchen counter in case you need support). Can you stand for 20 seconds on each leg? Can you stand on one leg and move the other leg to the side 10 times? Now test your ability to squat, crouch, bend and get up off the floor. 

Did you find any of these tests painful or difficult? Since falls happen while skiing and snowboarding, no matter what your ability level, it is important that you have the flexibility and strength to get back up. A home program to improve your core, pelvis and hip strength and flexibility will go along way to improve your conditioning and confidence on the mountain this winter.

Upper extremity injuries: this includes wrist and elbow pain, shoulder injuries and neck and upper back pain. Upper body injuries may not seem as relevant, but you will have a better ski season if you address them now. While speeding down the mountain it is important to be aware of your surroundings and be able to turn and look quickly or put your arms out for balance without worrying about neck or shoulder pain.

Test yourself: dig out your ski pole or grab a broom handle. Grip and plant the pole as you would while you ski. Can you do this without hand, wrist, elbow or shoulder pain? Can you reach both arms out in front of you, to the side and behind you without shoulder pain?

A home program to strengthen your upper back and shoulders and address any residual muscle tension will help with your posture and get you moving pain-free.

I hope you all have a wonderful ski season full of powder days and corduroy groomers!

Krista Smith is a registered physiotherapist at MotionWorx Physiotherapy. She can be reached by e-mail at krista@motionworxphysio.com or by phone at (778) 478-9679.

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1. We are a boutique physiotherapy clinic

We focus on doing one thing well: Physiotherapy.
We realize we can’t be the best at everything. For that reason, rather than being a multi-disciplinary clinic, we refer out to our partners in the community. We try to provide the best physiotherapy possible. For other services including massage therapy, kinesiology, chiropractor, bracing and orthotics we will set you up with a health care provider in our community that we know and trust. Make sure to check out some of our friends!

2. We offer a calm and friendly atmosphere

We are a small clinic complete with individual treatment rooms with large windows in all the rooms. We pride ourselves on finding the right blend of privacy and open concept to find the right motivation for you. One on one care, or a supportive high five from the team!
We are here to support you for what YOU need to get better.
Our receptionists are very skilled, helpful and friendly. We can direct bill for most Extended Health Care plans to help ensure that money is not a barrier to getting back to a better you.

3. We might just have the prettiest clinic in town

We are perched on the second floor of a new building across from Capri mall. We have large windows surrounding the clinic with lots of natural light. All of our equipment is brand new. Thanks to two local artists, Shawn Wiebe and Sara Gagnon, the clinic is beaming with gorgeous wood work and paintings of the Okanagan. Even if you don’t currently have an injury, please stop by and see our space. We would love to give you a tour of the clinic, which feels like it doubles as an art gallery…

4. We strive to provide excellent patient care

We spend a minimum of 30 minutes one on one with our patients at each appointment. A detailed assessment helps us get to the source of the problem. We focus on education, active rehabilitation, individual home exercise programs, manual therapy and intramuscular stimulation (IMS).
We also TRULY work as a team. We often have patients that get treated by more than one of our physios at the same time- to ensure the best care for our patients. We often collaborate, as three brains are better than one (hopefully…).

5. All of our physiotherapists have a minimum of 8 years working in private practice

MotionWorx is owned and operated by two physiotherapists. The three physiotherapists at the clinic have over 41 years of combined physiotherapy experience. Meet our whole team!
Our skill set includes manual therapy, active rehabilitation, IMS, acupuncture, taping, concussion management, treatment for vertigo disorders, athletic pre-screens and golf movement screens. Check out our Services and Rates!

6. We offer a convenient location and free parking

We are conveniently located at 203 – 1810 Gordon Drive, near the Harvey and Gordon intersection. The clinic is across the street from the Capri mall. We offer free parking behind the clinic. Click here to find us on a map and get directions!

From all of us at MotionWorx Physiotherapy, we can’t wait to see you soon! If you would like to book online, click here!

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While babies haven’t developed an ability to have an intellectual discussion with mom on the merits of breast feeding, they are very clear when they are hungry.  The key is to understand that they ARE speaking to you, and that if YOU pay attention, you can sort the problem out and make sure the little tyke is happy and healthy.

Picture an injured body. Would you let it continue to send pain signals to your brain without trying to figure out why it is sore? Is something damaged? Weak? Nerve Injury? Workout too hard? Or would you just take pain medication and ignore the problem?

While the body hasn’t developed clear language to communicate with the brain on specifically what is wrong, it is VERY clear that there is SOMETHING wrong. This language is pain (and other subtle cues that likely were given beforehand). While there are many different types of pain, it is clear that pain does not equal harm.

Pain is the equivalent to a fire alarm. It is telling the people that there is smoke/fire/burnt supper. All the alarm knows is its job is to tell the people to investigate the source, and then either take the burnt pizza out of the oven, or in more serious cases- get out of the house and call the fire department. The Alarm is NOT the problem. More importantly, if you had a fire, and chose to ignore the alarm, there may be dire consequences.

So while there is absolutely a time a place to take medication to control the pain or more importantly bring it to a reasonable amount, it is an important message that many people chose to not listen to, and that may lead them to unknowingly do too much, thus, perpetuating the cycle. An important time to manage pain levels is especially true at night- poor sleep will lower ones pain tolerance, which again feeds the cycle.

While pain can be scary, when you realize what increases pain, and what decreases pain (physically, not with chemical intake) it helps you narrow the field of what is safe to do and therefore allows you to safely continue to move your body, in addition to educate yourself about your body.

One piece of advice that I will end with is that injuries can be a great way to focus on ourselves, perhaps learn what we did wrong, and make decisions moving forward that can prevent the injury coming back, make us a stronger well-rounded athlete, or to just further teach us about our body…If nothing else, it can make us a better version of ourselves when we come out the other side.

“A knight in shining armor is a man who has never had his metal truly tested” -Unknown-

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Sit up straight! (Seriously…try it. Right now. Sit up straight. Just do it for me)

This is one of the thousands of cues that you will hear parents tell their kids before they give up to the unrelenting nature of gravity and seemingly uncaring slouching of their children. Poor posture however, is by no means limited to just indifferent teenagers. As physiotherapists, we deal with a myriad of issues that directly relate to posture, and its importance in rehabilitation. I read a great article a few years back that noted that while the human head weighs approximately 8-10 pounds, when leaning forward at a 45 degree angle the stress at the base of the neck is equivalent to 50 pounds of force (significantly higher forces at higher angles). And that’s only 45 degrees! Think about that next time you are scrolling through your facebook/Instagram feed hunched over like Golum just found his precious ring.

Whether we are dealing with an upper extremity nerve injury stemming from bad posture, post MVA whiplash, low back pain, TMJ dysfunction, or headaches (to name a few) or are looking to get stronger in the gym, look more confident for that new job, or get taller to get on that special ride at Disneyland, all are directly affected by poor posture.

So why the heck don’t we all just sit up and stay that way? If you were one of the few people that tried to sit up from my prompt at the start of this, are you now? (Ever notice how when you say the word posture, people in the room sit up?- or maybe that’s just a byproduct of my profession….)
If I asked you to lift your arm out to shoulder height and keep it there all day, could you? If this is not something that you have been working up to, is this a realistic expectation (or just painful)? Do learn-to-run programs start with having someone just go and do the marathon, or do they work up to it and train for it?

In my experience, people approach posture as a all or nothing task. As in, Sit Up Straight. If they are not up straight, that is a FAIL. What if we took the approach of NOT being in the problem position being the focus, and any consistent amount of time working TOWARDS proper is a WIN.

The truth is, people are not meant to sit for prolonged periods, especially focused on a screen that pulls our attention away from the many signals that our body says to our brain about load, stress or even pain- FAIL. People are meant to MOVE their muscles. So, when people ask me what the ideal posture is for sitting, it is easy to spout off the rules of sitting ergonomics- but the reality is that anything upright that is not passively resting on your joints for prolonged periods is a WIN. Are standing desks the answer? Only if you change your positions frequently and use your hip/core muscles appropriately…not standing locked out on one hip, looking like the teenager with too much attitude. OMG Becky!

So what can we do?

Yes, it is important to try and sit tall. When sitting, this can be accomplished by trying to get off your tailbone, and sit…on your sit bones (shocking). This will bring your pelvis into a more neutral position. It’s also important to try and be as tall through the back of your head as possible- think of someone pulling the hair on the back of your head up to the sky. Lastly, think about gently squeezing your shoulder blades together, or sticking your sternum out a bit, looking proud.

If the goal is to succeed, there is no point trying to hold this all day, as previously mentioned. Focus on doing lots of a little- like doing interval training for your posture. This is accomplished by finding a cue that you do ON A REGULAR BASIS. Examples of this are:

• Every time a commercial comes on TV while watching shows, posture up for duration of commercials (no fast forwarding!)
• Every time you are at red light/stop sign, posture up for duration of car being still (no blowing through lights/signs!)
• Every time you get a text message, posture up for duration of messaging (no cutting off friendships)
  • Note: Good text posture can be achieved by resting elbows ON your ribs to hold you upright. No more setting phone in lap, causing your head to creep overtop causing the slouch.

That’s it. Start there. And succeed. Get a WIN and posture up.

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