Why is it that some days are better than others? How many factors can play a part in the pain experience? The short answer is that nearly everything can play a role in what we feel in our bodies, but how can we picture that more easily? 

There is an excellent tool that has been developed by the Neuro Orthopedic Institute (NOIgroup) that strives to give people a better understanding of the many factors involved in their pain. It is called the Protectometer. More information about the NOIgroup can be found at their website http://www.noigroup.com, but we will go through the basics below.  

Please feel free to look at the previous posts regarding the topic of chronic pain if you would like more information on general concepts.  

Let’s begin with a refresher on a definition of pain. Pain is defined in the literature as - An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. 

In this context, pain can be understood as a defence mechanism or protector of our body, meant to alert us to an area or issue that requires attention or modification. For example, to move away from something too hot, or to remove our feet from the sharp stones underneath us.  

The Protectometer, otherwise known as a “danger meter”, is an idea that can help to explain the many factors that may influence the pain experience. Referring to the definition of pain above, we know that the perception of danger in a body tissue or area can be enough on its own to create a pain response, under the right conditions.  

Another way to visualize this is as a set of balance scales. With so many potential factors that can influence the positive and negative sides, it can be very difficult to decide which particular thing seemed to increase or decrease the painful symptoms. This helps to explain why sometimes it is very hard to pinpoint which one thing caused a problem when a combination of countless factors could be to blame. It can be very difficult to interpret all of the things that happen in a single day, let alone a week, or a month.  

The scale can have a protective OR amplifying effect on symptoms. People who have more positives on their scale are likely to be more resilient, while people who have the deck stacked against them are likely to have more difficulty overall. The brain, nerves, and tissues, add up all of the different factors to decide what we feel and how much of it we feel in any particular moment. All physical activity, and all mental activity can play a role in adjusting the scales. All the things we do in a day, plus the things that are said, heard, thought, and believed, can make a difference. Even the environment we are in can play a role in what we feel.  

Identifying the negative parts of the condition, environment, thoughts, activities, and feelings is an important step in determining what can change and how to go about it. This works in the reverse as well in that all of the positive things about feelings, activities, thoughts, environments, and support from others can help to balance the scales in our favour.  
This is a dynamic and ever-changing balancing act between the positives and negatives in the body. While there can certainly be habits and a leaning in one direction based off of history, we know that the system is always capable of some measure of change.  

So how do we tip the scales? We can add things to the positive aspect, or remove negative things from the other side. Now, not all of these things are changeable, but there are often a number of things that are. Everyone will have different things to consider and a different starting point, but that’s where we begin.  

Please feel free to leave a comment or reach out to our office if you have any questions. 

~ Trent, PT
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References: 
·         Moseley, G. L., & Butler, D. S. (2017). Explain pain supercharged: The clinician's manual.

So guess what everyone! I’m pregnant! Baby number 3 is expected shortly and my husband, myself, and two toddlers are very excited. I could chat about pregnancy for a long time (and if you know me, you know I like to chat), but I wanted to discuss some of the many changes that occur in the body with pregnancy, some common issues that I see (and have experienced for myself), and a few things that you can do to stay more comfortable and prevent soreness.
 
First, let’s talk about some of the common body issues that are experienced during pregnancy. Low back pain, lower abdominal pain, groin pain and knee pain are quite common, although other things certainly occur as well (1). Sometimes these pains are serious, so you should always continue to have regular follow ups with your doctor, but there are many times that these pains are simply body aches that can be helped with movement and treatment.
 
There are many reasons why these aches and pains may present for different people. Relaxin hormone elevates during pregnancy to allow for the development of your baby and your body (2) and its function includes ligament and tendon modification to allow for the pelvis (and the rest of the body) to get ready for delivery of your little one (3). Extra mobility throughout your body as well as your changing core and the way that the body compensates for those changes are common culprits for pain.
 
Exercise during pregnancy is crucial to staying comfortable. There is a lot of information available for safe exercise during pregnancy (check with your doctor to make sure that you are safe to exercise) and many prenatal exercise classes that you can participate in that makes exercise during pregnancy fun and easier to understand which exercises are good to do during pregnancy. Personally I can say that my first pregnancy was comfortable with some mild low back pain toward the end. The second pregnancy was certainly less comfortable, but chasing around a toddler and a full schedule certainly made exercise trickier to fit in. I have made exercise a priority during my third pregnancy and have felt quite comfortable, and I would like to share some of what I am doing with you:
 
1.      Breathe! I can’t understate how important this is for reducing muscular tension around the abdomen and pelvis. I know for myself and other moms that we commonly begin to grip around the abdominal and gluteal areas as our core changes. Catch this, breathe, and let your beautiful bumps be free, mamas!
2.      Do squats and lunges. Staying strong around the low back and pelvis is helpful with building the muscular strength and endurance during your pregnancy as things loosen around these areas.
3.      Make a point to do frequent easy movement activities such as walking or prenatal yoga. This is especially important if you are stationary during the day at work or at home.
4.      Ball release and stretching on a daily basis is helpful with managing muscular tightness that can develop in the gluteal and low back areas. Massage is also very lovely for this!
5.      Listen to your body and put your feet up (literally, especially if you have swelling) to allow your body some time to rest and recover from exercise and daily activities.
6.      Ladies, don’t ignore your pelvic floor. Breathing helps to manage tension that can occur here, but seeing a pelvic health therapist can help you to recognize how to relax and contract which will put you at an advantage for recovery from your birth (c-section or vaginal delivery).
 
Some mild aches and pains may happen with pregnancy, especially as your get closer to your due date, but there are so many things you can do to stay comfortable and functional during your pregnancy. If you have any questions, please feel free to ask! I am only a phone call away, and my wonderful colleagues at the clinic are also passionate about helping you stay healthy and mobile. Keep on moving your beautiful bumps, mamas!
 
References:
1.      Sharp Pain During Pregnancy. American Pregnancy Association: Promoting Pregnancy Wellness. https://americanpregnancy.org/pregnancy-complications/sharp-pain-pregnancy/.
2.      Ann N Y. Relaxin in Human Pregnancy. Acad Sci. 2009 Apr;1160:10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3856209/.
3.      Dehghan F  et al. The effect of relaxin on the musculoskeletal system. Scand J Med Sci Sports. 2014 Aug; 24(4): e220–e229.
 
 

The past few months have brought great change.  Not only to me but to my 'group'.  There have been new jobs to be celebrated, new additions to the family, the loss of a significant member to the family, the end of the school year, new relationships, old relationships ended, new trips planned, new plans for the future.  I could go on but the point is that change is everywhere.  I think about those who have been beside me as we have been going through these changes and it makes me think about the word 'Community'.  The definition of community is

com·mu·ni·ty    /kəˈmyo͞onədē/
noun
1. a group of people living in the same place or having a particular characteristic in common.
"the scientific community"
2. a feeling of fellowship with others, as a result of sharing common attitudes, interests, and goals.
"the sense of community that organized religion can provide"
 
I grew up in a small town so to me the word community meant my actual town.  As I get older I realize that there are multiple ways to use the word 'community'.  I think for me, the most important way to use this word is when I describe the people whom have surrounded themselves around not only me but my children, my family, my grandparents and even my friends.  I used to think that the world was so big and so vast that the sense of community pertaining to the whole world was not possible.  I was wrong.  As I age I have been humbled in knowing that we are all connected in some small sort of way.  Anyone who knows me knows that this would thrill me.  I would love to be related to Ellen or Oprah or Serena or Alexandria.  OR BEYONCE (notice these are all powerful women???).  And in a way, I guess we are all are in our connection to the world. 

Relation or not, we are all living on this plane at the same time.  I am so grateful to those who have become part of my community.  I think back to growing up and unconsciously having people in my life who taught me about the responsibility of community.  I remember living on the acreage and having a giant snow storm.  We had a neighbor come over and plow out the driveway with his tractor since there was waaaaaaay more snow than what my dad's snow blower would have been able to manage.  Instead of the job taking my dad hours and hours in the freezing cold our neighbor was able to clear the snow in an hour.  A small act for him but it had a huge impact for our family that winter.  My parents no longer live on the acreage and live in Calgary.  My dad still uses the snow blower when it's needed.  He now snow blows the driveways and sidewalks for their neighbor who has had a heart attack and for an elderly couple who are physically not able to shovel.  My grandparents lived in their house on 8th and Clarence for over 50 years.  There was a widow with no children who lived on the same block as them.  As she got older my grandma started bringing her supper.  Every day.  Every supper.  For over 30 years.   

When I had my babies people would say, It takes a village to raise a child'.  I thought what a stupid comment.  But again, I realize I was wrong.  What a true statement.  Whether its teachers, coaches, your children's friend's parents, etc.  To have people who are vested in your children's lives, who want to help raise them into responsible, kind, and helpful members of society is a gift of community that makes me truly grateful.  I don't know where I would be, or my children for that matter, without those who have become a part of our community.  I think the only feeling that is better than someone helping you is being able to help someone else.  Knowing that at some point our lives will intertwine with someone who knows someone who knows someone.  I was at the airport in Calgary and had just been cleared at security.  I went to find a place to sit at my gate and sitting in front of me was Gordie Howe.  Mr. Hockey himself.  He was sitting by himself so I went and sat beside him.  I asked him if he minded that I sat beside him.  We started talking and I asked him about growing up in Saskatoon and if he remembered my grandpa since they used to play baseball together and grew up on the same street on Avenue G.  Mr. Howe told me stories about my grandpa and about the beginning of his career and leaving Saskatoon.  We took some pictures and when it was time for me to board my flight he passed along his greetings to my grandpa.  Community can connect us in ways we never thought possible.   
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My heart is filled with gratitude when I think of all the people whose paths have crossed mine and who have become a part of my community.  For those who remind me that we have a responsibility to each other to stay connected.  To those who challenge me to do better and be better.  To those who fulfill their roles in the various communities that they are involved in.  To those whom I have been blessed with to be counted in their community.  It's not something that I take for granted or take lightly.  My life has been enriched with all of you in it.
 
Sheri
 
PS.  I will be VERY busy for the next few years celebrating the win last night