The birds are singing louder; the sun is shining brighter; the wind is blowing warmer, and our spirits are being lifted as we witness new life springing forth all around us in multiple shades of green.  As we don our gardening gloves, sunscreen, hat, and tools, after a trip to the greenhouse…returning with far too many acquisitions and unlimited inspiration from what I’ve been hearing…keeping these 4 Task-Specific Spine Safety Tips in mind, can make all the difference in helping you maintain your strength and mobility while reducing your risk of unnecessary back strains and sprains that are far too common this time of year. ​

5. Alcohol Consumption 
Research indicates that those who consume 3 or more alcoholic drinks per day, on a regular basis, are at an increased risk of osteoporosis and fractures. Increased consumption can also contribute to an increased risk for falls and is also often associated with poor nutrition which also affects bone health.
 
6. Physical Activity and Exercise 
Being sedentary, can directly impact bone health.  In contrast, performing the appropriate amount and type of exercise can help to protect your spine, slow the rate of bone loss, build muscle strength, improve balance, and assist with the management of other health condition and overall wellness.  All of which can help manage osteoporosis and prevent falls.
 
7. Height Loss 
Losing height as we age can be a warning sign of a spine fracture, and regular measurements can be a valuable tracking tool. Because 66% of spine fractures are painless, you may not even be aware of a broken bone in your back. Therefore, knowing how tall you are and having your healthcare professional measure you annually, is important as you age, especially in those 50 and over.
 
8. Cigarette Smoking 
In addition to being associated with numerous other health risks, it has long been established that smoking can have a negative impact on your bone health. Your healthcare provider can be a great resource for strategies to assist you in making a lifestyle change that lasts.
 
9. Family History
If someone in your immediate family has a history of osteoporosis, you risk of developing the condition is also increased. In addition, having a parent who has had a hip fracture, means that you may be at higher risk of experiencing the same.

10. Medications 
Long-term use of certain medications, including glucocorticoids, can have side effects of increased bone loss and therefore increased fracture risk. The effect of some medications on balance can also increase the risk of falls and fractures.

11. Medical Conditions 
Several medical conditions, such as rheumatoid arthritis, celiac disease, gastric bypass surgery, COPD (chronic obstructive pulmonary disease) or chronic liver disease are also known to be associated with an increased risk of osteoporosis. Additional effects of these conditions can as well increase the risk of falling, and therefore, incidents of fractures.
 
12. History of Falls 
Finally, one of the best predictors of a future fall is history of a previous fall.  In fact, if you’ve experienced a fall in the past 12 months, your risk of sustaining another fall increases by as much as 3x. Individuals with gait and balance issues, are among those at highest risk, and at the very least should be assessed for the safe prescription of appropriate assistive devices and other supports.
 

 

​Osteoporosis is a condition that causes bones to become thin and porous, thus decreasing bone strength, which in turn leads to an increased risk of breaking a bone.

​

In the past, osteoporosis has typically been thought of as a condition of the elderly.  However, the fact that it has more recently been redefined as “a pediatric disease with geriatric consequences,” (1)should command the attention of all ages.
 
Why it’s important for EVERYONE to know the facts about Osteoporosis!
 
Though no one cause for osteoporosis has yet been identified, what has been determined, is that the best time to start guarding against the effects of osteoporosis is ideally from birth.  According to Osteoporosis Canada and Ontario Osteoporosis Strategy, evidence-based research indicates that, “building strong bones during childhood and adolescence can be the best defense against developing osteoporosis later.” (1)In fact, “peak bone mass is achieved at an early age, age 16 in girls and age 20 in young men.”(1)

​At the other end of the spectrum, “women and men alike begin to lose bone in their mid-30s; as they approach menopause, women lose bone at a greater rate, from 2-5% per year.” (1)With these facts in mind, the best time to ensure that you are doing everything possible to guard against the effects of osteoporosis is now! 

How common is Osteoporosis?

• 2 million Canadians are affected by osteoporosis.
• The risk of osteoporosis diagnosis doubles every 5 years, between the ages of 40 and 60.

 
What are some of the potential consequences of Osteoporosis?
 
Statistics indicate that:

• At least 1 in 3 women and 1 in 5 men will suffer from an osteoporotic fracture during their lifetime.
• Over 80% of all fractures in people 50+ are caused by osteoporosis.
• 1 in 3 hip fracture patients will re-fracture within one year.
• Less than 20% of the people who have a fracture receive an osteoporosis diagnosis, bone mineral density test, or an osteoporosis medication prescription within the following year, with men less likely to receive any intervention.

Four Basic Strategies to Promote Bone Health - in the fight against Osteoporosis.
 
While it’s important to remember that it’s never too early to start thinking about where you are on your own journey toward bone health, it’s also important to remember that it’s never too late!
 
As is the case with most other medical health conditions, successful management of osteoporosis is best achieved by choosing a proactive approach to prevent, delay or reduce bone loss.  By following a healthy lifestyle throughout the lifespan, which includes:

1. Balanced nutrition, ideally starting from childhood.

3. Physical activity and resistance training exercises.

If you need help in coming up with a plan, as physical therapists we are trained to assist you in coming up with one that is safe and specific to your needs and goals.


4. Avoid Smoking and Excessive Alcohol Intake.

​Knowing when to consult with a medical health care professional to achieve your goals, can be the most important first step toward a safe, rewarding, and empowering journey to being “Bone fit”.

​Stay tuned for upcoming blog posts with more specifics regarding: guidelines to determine if you are at increased risk of osteoporosis or fracture; other available strategies that can help you play a more active role in the management of your bone health; the basics of Bone Fit Canada’s highly beneficial “Too Fit to Fracture” Program for Managing Osteoporosis Through Exercise.
 
If you have any questions, please feel free to contact the clinic and we would love to assist you.

Research outcomes to date, have generally been mixed regarding the benefits of stretching.  Particularly regarding its’ role in injury prevention and more specifically as it relates to athletic performance.  But as studies continue, and we realize that most of our population does not consist of elite athletes, we can begin to discover the true value of stretching beyond the role of lengthening our muscles.
​
Whether you are an elite Olympic athlete, a full-time gardener, a teenage skate-boarder, a grandparent keeping up with the grandkids, or you sit behind a desk all day at work, a common question that should be answered before embarking on a regular stretch routine is…why?

​

What is the purpose of stretching?  
​

• Injury Recovery - To restore range of motion and function and to help manage pain post-injury.

“We know that even minor injuries can cause adhesions in the fascia, which mean the layers of this tissue may become “stuck” and lose their ability to glide as they do in healthy connective tissue. These issues can accumulate, with pain leading to reduced mobility and activity, and reduced mobility and activity contributing to worsening pain, resulting in a persistent cycle of deterioration or exacerbation.” (1) 

Also, “Research in animal models has shown that stretching has anti-inflammatory effects in several types of inflammation, and we need to understand better if this holds true in humans.” (1) 

• Injury Prevention - micro-break stretches incorporated throughout the day, can help balance tissue exposure to repetitive and sustained tasks of daily living, and within occupations considered high riskfor repetitive strain injuries such as carpal tunnel syndrome.
  ​
• General tissue health maintenance – Regular stretching to maintain full mobility of structures that cross the joints, can ensure optimal joint health, and can effectively assist with the management of conditions such as osteoarthritis (OA).
  ​
• Cardiovascular health – to assist with the management of blood pressure. 

“A new University of Saskatchewan (USask) study has found that stretching is superior to brisk walking for reducing blood pressure in people with high blood pressure or who are at risk of developing elevated levels,” (2) thus sparking the interest for more research to uncover more specifics as to exact mechanisms behind these results.
And just as the purpose for stretching can be highly variable, so can the tissues it affects.

Exactly what are we stretching?

Structures affected by stretching include:

• Muscle tissue
• Connective tissue, including ligaments and fascia, which serve as the links among the muscles, bone, blood vessels, and organs in your body.
• Nerve tissue including that of the Central Nervous System, dura and peripheral systems.

And just as the type of tissues being stretched can vary, so can each tissue’s response to being stretched.  Therefore, it is also important to focus on: 

How are you stretching?

General Stretching guidelines include:

• Warm up for a few minutes first so your muscles stretch more easily (walk briskly, march in place, or do another physical activity).
• Balance your stretches by doing them at least two to three times on each side, taking turns.
• Keep good form and posture, being purposeful about targeting the area you are focusing on.
• Breathe throughout each stretch — never hold your breath.
• You should feel slight discomfort and a pulling sensation, but not pain, with each stretch.
• Never bounce while stretching — hold steady till you feel the stretch and try to relax while holding.
• In the case of stretching to recover lost range of motion, always balance it with strengthening in the new available range to minimize risk of re-injury.
  
  

As studies continue, we will likely continue to see that it is important for a well-balanced therapeutic wellness program to not only consist of cardio and strengthening training, but also a component of stretching. Ideally, with purposeful breath awareness, as well as mindfulness of movement and alignment to be considered most effective.
​
“While research points to the various mind and body approaches for managing stress, stretching is an appealing option for those coping with social distancing measures because it’s something you can do daily, at home, and it can positively impact your health. (1)

Curious to know more about Stretching - let us know how we can help!

~ Elizabeth Stefanyshyn-Alonso, Physiotherapist

Now that you have discovered the many benefits of Nordic Walking, and how you can get equipped with the appropriate gear, from previous blog posts, the final step remaining is to get out there and give it a try! 

See for yourself, why this is an activity that is rapidly gaining popularity among people of all ages and fitness levels around the world.
  
As is the case with any exercise or activity you choose to participate in, you are sure to gain the most benefits and enjoyment from your experience with Nordic Walking, if you start off with the proper technique. 

The third and final part of the Urban Poling Blog posts will cover the basics of using both the Activator and the Urban Poles, and include a brief review of the circumstances that would deem their use appropriate.

With the approval of your health care professional, can be appropriate for:

• Pre- and post-surgical hip and knee issues
• non-acute soft tissue injuries
• osteoporosis
• mild stroke
• acquired brain injury
• post-surgical spinal stenosis
• cardiac issues
• arthritis if not severe rheumatoid arthritis that is affecting hand strength
• early stages of Parkinson’s and multiple sclerosis
• respiratory conditions that are stable, and
• non-acute and breast cancer after acute phase of surgery and treatment

Technique can be scary - but you can use the tips below to help get you started on the right foot with the right pole!

• Place your hands on right and left poles as indicated on top of the Core Grip
  
• Be sure to wrap your fingers around the handles without squeezing them too tightly.
• Try and stand with an upright posture, with your poles planted so that they are vertical, and always placed in front of your feet.
• Relax your elbows but have them bent to slightly below 90 degrees.  You may need to adjust the height of your poles to get this comfortable and in the right spot!
• As you begin walking, step forward with your LEFT leg and swing your RIGHT arm forward, planting the bell-shaped tip of the RIGHT pole directly across from the front of your LEFT foot.
• Follow it up with the other side! Right leg with Left arm!
• This will become easier with practice - keep going! It will feel like a regular walking pattern where you swing your arms forward and backward.
• Do YOU want to ACTIVATE your CORE?
  
  • Press firmly on the ledge of the handle with the outside border of your hand to activate your arm and core muscles each time you plant the pole. Remember, this action will off load weight from your lower body joints and spine and assist with stability.

In many cases, you should start off by using the Activator technique until you are comfortable.  Once you feel comfortable, progress to the Urban Poling technique! You can see this for helping with:
​

• Early stages of neurological conditions
• Younger clients and active clients
• Short rehab period – injuries
• Obesity, cardiac rehabilitation, and diabetes
• Weight management and core strengthening, as well as
• Your own general health, and employee wellness

Urban poling technique has a lot of similarities, and some differences! It would be helpful for you to check out the tips below!

• Holding the appropriate LEFT and RIGHT poles with a light grip, stand with your arms straight and your thumbs beside your thighs so that the tips of your poles are on the ground behind you. **NOTE this is a different starting position!
• To achieve the correct length of your poles there will be markings that correspond to your height that you will adjust and lock your setting to, although when starting out it is recommended that you set them slightly below until you are comfortable with the technique.
• Keep your eyes up and begin walking while dragging your poles behind you, moving your opposite arm and leg together as you would with regular walking.
• Keep your rib cage lifted and your shoulders relaxed as you continue walking, gradually making your steps longer and your arm swings higher until they are a little higher than a high handshake position.
• Your arms should be swinging from the shoulders like long pendulums, with your thumbs returning beside your thighs with each swing.
• Maintain a relaxed grip and press on the base of the handle each time the tip of the pole lands and grips the surface, pushing the ground back behind you.
• Then, once you “get the swing of things” so to speak, instead of dragging your pole tips, begin to lift them slightly (approximately 1 cm) off the ground and firmly plant them with each stride.
• This is similar to Activator Poles in that you are using opposite arm with opposite leg!

As mentioned in the previous blog post on “getting equipped,”

the pole tips are interchangeable and can be matched to varying surfaces.

This is exciting, because it increases your options for where you can walk with the poles!

Traction is key when using the poles, so when you firmly plant the pole, you don't want to slip.

Pole Tip Options:

• Bell tip: for general use with activator poles indoor and outdoor on level surfaces for increased stability.
  
  
• Carbide tip: If terrain is challenging or if carrying a back-pack to help with pole traction and stability (keeping elbows bent and poles more upright is also helpful in this situation).
  
  
• Boot tip: rubber type traction for use indoors and outdoors on concrete sidewalks and asphalt surfaces (attached facing backward at the end of your poles).
  
  
• Trekking baskets: used as an attachment with carbide tips for use in muddy or rocky terrain.
  
  
• Snow baskets: used as an attachment with carbide tips to help keep poles from sinking into deep snow (great for use with snowshoeing).

It is good to REMEMBER, Although it is recommended that your activator and urban poles NOT be used intentionally on icy surfaces, keeping a set by the door in snowy climates where slippery conditions are quite common makes good sense as one way of being proactive in fall prevention.  

Also - Don't Forget
Talk with your physician or therapist before using the poles if:

• you currently use a cane or walker,
  
• have any medical condition which affects your balance, stability, grip strength, vision, depth perception, judgment or co-ordination or
  
• if you are currently recovering from an injury or surgery.

So if using the Activator or Urban Poles is something that interests you, whether

• as a means of becoming more active through a safe and fun activity that will improve your level of confidence and quality of life,
• or simply to step up your fitness game for added strength, posture, and conditioning benefits, let us know. 
  
  We would be happy to consult with you, as well as others on your health care professional team, to confirm if Nordic walking might be appropriate for you, or for someone you know.  

​

DID YOU KNOW - We Offer the POLAR BEAR CLUB - a FREE program as a means to get out and exercise this winter! I am excited to be running it once again!!  It is a great opportunity to use some of the TIPS provided to you above!

Click below for more details!

~ ​Elizabeth Stefanyshyn-Alonso BScPT, FCAMPT
​

References:

1. The Urban Poling Ultimate Guide to Nordic Walking; Barb Gormley; Volume one updated and revised; Custom Press 2019
2. Urban Poling – Activator course for rehab professionals

http://urbanpoling.com/old/programs-events/community-programs/professional-training/urban-poling-activator-course-for-rehab-and-wellness-professionals/
​

Have you been wanting explore Urban Poling more? Did you happen to read my first blog Urban Poling - Part 1 - The Untapped Treasure? You should definitely give it a read if you are at all interested in Urban Poling!

Although I can attest to the benefits of using nature’s original walking poles from a personal hiking experience I had this past summer (as seen in this photo), without a doubt, setting yourself up with the proper equipment that best suits your individual needs will be key to getting the most out of your urban poling experience.

Fortunately, the equipment required for this rewarding activity is quite minimal and need not be complicated.  Apart from what most of us would already have on hand to enjoy a routine walk, such as appropriate

• clothing and footwear best suited to your chosen activity and environment,
  
  

selecting the right poles is all that is left to get you one step closer to reaching your fitness goals. 

If you do a quick search for Nordic or urban walking poles and the most optimal experience, the most invaluable information will be found at Urban Poling.  Click on the link to see more! 
​
Why Use Equipment?
1. The equipment available has been designed by a Physical Therapist, who’s goal at the core of the healthcare professional team makes including optimizing body mechanics and functional movement a key priority

2. The level of research involved in creating this product’s design, keeps

• functionality
• safety
• and ergonomics in mind to suit a wide variety of populations, making its’ inclusivity very appealing.
  
  

3. It highlights a clear picture of this activity’s benefits, backed by numerous evidence-based research studies which are provided throughout the literature, and…

4. The equipment is Designed in Canada!

What Urban Pole is Best for ME?
Although at Urban Poling there are several designs to choose from, there are two basic types of poles available based on your specific needs or ability:

1. The Activator Poles (including Activator 2) for Rehabilitation, and
   ​
2. The Urban Poles for Fitness​    
   
   ​                                                                                                             

The Activator Poles are designed to:

• assist with balance,
• increasing safety and confidence which can eliminate some of the fear and
• add to the enjoyment of your walking routine. 
  
  

These poles help to:

• reduce pressure on your back and lower joints and
• transfer it into your upper body,
• allowing you to walk further, faster, or even pain free. 
  
  

These poles are appropriate for use indoors as well as outdoors with interchangeable accessories that adapt them for use in all seasons.

​
Activator poles are most suitable for use with:

• pre and post hip and knee replacement surgery
• conditions that affect your balance
• rehabilitation programs
• older adults
  
  

Consultation with your physician or physical therapist

• before use is necessary,
• if you are already using, or
• if it has been recommended that you use a device for walking. 
  
  Guidance by your healthcare professional team is also necessary to determine if, and when the activator poles may be appropriate pre-surgery and post-surgery according to surgical protocols confirmed by your surgeon.

  
Types of Activator Poles:

Activator Pole specifics:

• For use with clients up to 6 ft/183 cm tall
• 200 lbs./91 kg pressure per pole capacity
• 250 lbs./113 kg maximum user capacity
• No straps, to minimize risk of wrist hyperextension and fall injuries that are commonly experienced with use of general hiking poles and ski poles
• Button lock system for ease of height adjustment and for more secure locking
• Capability to upgrade to urban pole capacity by changing tip from bell (stability=vertical) to boot (mobility=angled) making them highly versatile and cost-effective
• Carbide steel tip for sand, snow, and trail capabilities
• Core shape handle with shelf to off load, increase ease of grip for reduced grip strength and alternate holding patterns for various mobility issues involving the hands
• Indicated for:  gait retraining, post-surgery recovery, balance and stability issues related to chronic conditions, walking device vs. fitness tool, clients with limited grip strength, older adults in retirement to LTC
  
  

Activator 2 Pole specifics:

• Designed for the same purpose as the Activator Poles but with increased load capacity
• For use with client up to 6 ft 4 in/195 cm tall
• 250 lbs./113 kg pressure per pole capacity
• 3 section button and flip locking system, making them not only stable, but more compact for convenience for those who travel
• 320 lb max user capacity, making them appropriate for use with weight management

Urban Poles
 ​

How are Urban Poles Designed?

Urban Poles are designed with fitness in mind for those who are looking for a more intense workout over regular walking. 

Research indicates that using the urban poles can:

• burn up to 46% more calories and
• assist in toning your core
  
  

As your abdominal muscles tighten each time you push off with your poles, working out to approximately a thousand abdominal contractions per km! 

And like the activator poles, using them:

• takes pressure off your lower joints, including the hips, knees and spine, and
• transfers the force into your upper body, allowing for the use of 90 percent of your muscles at once. 

This is especially good for your upper body muscles which are typically underused during regular walking. Although similar to the activator poles, the urban poles are can be used for indoor walking, they are versatile and made for outdoor activities such as hiking, winter walking & snowshoeing.

The key features that set the urban poles apart from the activator poles

• the telescoping vs. button locking mechanism for height adjustment, and
• the increased shock absorption features which make them great for higher impact activities.
  
  

So taking into consideration that both types of poles have interchangeable tips that can accommodate for use on any indoor as well as outdoor surface including snow, sand, trail, cement sidewalk or pavement, there is virtually nowhere that these poles cannot be used for your benefit and enjoyment. 

And since most of us will be staying put in Saskatchewan this year, let’s get out there and make the most of our beautiful winter!


Need help in deciding whether this activity is right for you or for someone you love?  Call us!  We would love to help!​ 

Urban poling, alternatively known by its’ generic name “Nordic Walking, ”is an activity that has been popular in Scandinavia and other parts of Europe for years.  Initially developed as a method of off-season training for skiers, it rapidly gained popularity among people of all ages and fitness levels including pre-school children and seniors, and for good reason!
​
It takes the simple activity of walking and incorporates the use of poles to assist in propelling your body forward, making it a great total body exercise for just about anyone.  In fact, evidence-based research supporting the clinical rehabilitation potential of Urban Poling in treatment of:

• Post hip and knee surgery
• Osteoarthritis, Osteoporosis, Rheumatoid Arthritis
• Parkinson’s, Multiple Sclerosis, Traumatic Brain Injury
• Spinal conditions
• Return to work, Soft Tissue Injuries, Sports Injuries
• Older Adults
• Respiratory Conditions
• Cancer Rehab
• Cardiac Rehab
• Mental Health and
• Fall Prevention,
  
  

has been available for several years.

In addition to this activity’s benefits in assisting with the general recovery process and effective management of many chronic conditions, its potential to promote an active lifestyle throughout the lifespan is priceless.

As I approach my own senior years, I find myself cultivating an even deeper appreciation for the concerns conveyed to me by many of my clients, regarding the perception or stigma that can often be associated with the use of canes, crutches and walkers. Despite the obvious benefits these walking aides can provide in the form of safety and maintaining independence, their use can unfortunately initiate a transition or a milestone with the potential to have a negative effect on a person’s self-worth. An effect that is highly variable among individuals and can perhaps never be fully understood unless you experience it for yourself.

Though certainly not appropriate in all circumstances, the use of walking poles can be an opportunity to bridge this transition in a way that helps represent ability versus disability.  It can motivate toward exercise despite the limitations one may have with their chronic condition, while at the same time addressing:

• Core strength
• Upper body strength
• Improved cardiovascular health
• Increased walking tolerance with motivation to walk further, faster and more frequently
• Stability and balance
• Improved postural alignment
• Factors related to fall prevention
• Decreased pain
• Weight management goals
• Psychological benefits
• Reduced impact on knee joints
• Increased potential for back country trekking
  
  

Like any other form of exercise or activity, reaping the maximum benefits of Urban Poling does require matching the appropriate equipment to your individual needs and incorporating the proper technique in your practice.  If this sounds like an activity that you, or someone you know might be interested in, stay tuned for this information and more in my upcoming blogs.  …And let’s go!

Elizabeth Stefanyshyn-Alonso, Physiotherapist

Reference:  Urban Poling – Activator course for rehab professionals
https://urbanpoling.com/old/programs-events/community-programs/professional-training/urban-poling-activator-course-for-rehab-and-wellness-professionals/
 

Most babies start walking independently between 11 and 14 months of age.  It’s a basic, yet highly functional skill thatrequires1000 plus hours of practice to master.  The developmental milestones that immediately precede walking, serve to strengthen the back and core muscles, establish balance, assist with co-ordination and build up confidence until no further conscious thought is needed to perform the activity. 

It’s actually quite amazing how our nervous and musculoskeletal systems are so complex in organizing all the right joint movements and muscle actions in order to propel us forward with minimal effort. Auto pilot or cruise control essentially settles in.

As we journey through most of life, it isn’t very likely that we will give this gift of locomotion much of a second thought. However, rest assured there will certainly come a time when it will be to our advantage to review our skill level when it comes to walking.

Whether you are recovering from an injury, from surgery or are simply being challenged by factors that can occur alongside the blessings of advancing years, pain, joint restriction, arthritis, nerve compression, neurological disease, depression or poor balance can all directly affect the quality of your walking or gait pattern. Regardless of the cause, considering the value that walking offers toward our independence and overall general health, any deficits that affect mobility should be promptly addressed. 

A few key considerations for maintaining longevity in your stride:

1. Be aware of ongoing or progressive limitations– If following an injury you find that your mobility, strength, balance, endurance or speed are not progressively improving over time, or if you are experiencing symptoms that can be described as sharp, persistent or progressively worsening, seeking help to identifying the area of limitation early can often mean the difference between effective treatment strategies with resolution and long-term deficits.
   
   
2. Remain active within reason–Unless symptoms are sharp, in which case you most likely won’t be able to bear weight, or your gait pattern is significantly altered sot hat it is affecting your balance and safety, keep moving.  Occasionally following an injury, we can be tempted to rest more than is necessary for optimal recovery.  Your body is designed to move, and doing so within reason will improve circulation, promote healing and allow you to remain aware of changes to more effectively self-monitor your own recovery. That first step can often guide the entire course – with even small steps taken consistently over a period of time, adding up to a favorable recovery.
   
   
3. Use assistive devices when necessary –Using a cane, walker or other assistive device is intended to restore or improve your mobility by keeping you active while keeping you safe during recovery.  Contrary to what some may believe, it simply will not cause you to become weak by way of dependence. If your gait pattern is significantly altered by your current restriction, the inefficient movement that results by refusing to use a device can often have a negative effect on other areas of the body.  This may in fact lead to a longer recovery time.
   
   
4. Seek to maintain ongoing support – The support of immediate family, close friends, and even organized walking groups can help with motivation.  All the virtual groups that have emerged since the onset of COVID-19have helped to create a social structure and support network that can also help to benefit your mental health, particularly during this difficult time of ongoing isolation and social distancing. Having consistent support available can also be great in terms of an ongoing assessment strategy. Changes that might be difficult to recognize in ourselves can often be easily identified by those who have the privilege of spending time with us.
   
   
5. Set concrete realistic goals for yourself –It is always easier to get somewhere when you know where you are going and how to get there.
   
   

As it currently stands, my long-term goal is to walk and possibly even continue running well into my retirement years, and I plan on doing it the only way I know how…one step at a time. Since the onset of COVID-19, setting aside some time every lunch hour to appreciate where my feet can take me, has been a concrete step that has been well worth it both physically and mentally.  It helps to keep me accountable in practicing what I preach, while at the same time clocking kilometers toward a virtual pilgrimage to Camino de Santiago, until my family and I can complete it in person post pandemic.

What are your goals?  We’d love to hear them!  If you feel that you might have mobility issues that are holding you back, give us a call.  We’re here to help.

​
~ Elizabeth Stefanyshyn-Alonso PT

After spending “virtually” all weekend expanding our knowledge at the “Treating and Training the Female Runner” course with Physiotherapy Clinician and Educator Julie Wiebe, my colleagues and I are excited to use our new skills to assist our clients in achieving ALL their fitness, wellness and recovery goals.

Though the course has equipped us with increased problem-solving skills to assist our well-deserving pregnant and postpartum moms to achieve their sport specific fitness goals, including Cross-Fit and running, the underlying principles can be effectively applied to empower ALL of our client populations to reach their full potential. And thankfully so! 

As I find myself surrounded by peers of a different age cohort, as I continue to learn and grow, I realize that these new concepts are just as applicable to where I am at in life. I am at the stage of accepting menopause, and all its glorious hormone related changes that can affect us as we mature. Thank God for research and support, as we continue to challenge ourselves beyond previously held beliefs to grow through discomfort, to a place of acceptance and positive change.

As we age and go through life’s cyclical changes, we ALL develop strategies.  Whether internally imposed or resulting from external sources, we all develop alignment, breathing and movement strategies and beliefs that allow us to function to the best of our known ability. Repeated regularly these strategies can subconsciously become our “go to” that will either allow our bodies to operate efficiently or afford us unexpected signs and symptoms as we progress through life.  And I am no exception when it comes to some much-needed work in that department.  These strategies can become so imbedded in us that they are often difficult to recognize without looking at them from a different lens, or from what Julie Wiebe might call, a new set of eyes.

As physiotherapists our role is to provide you with that new set of eyes as we assess and establish what your strategies are, and where your current limits lie.  We will explore with you what you value most and build upon your current successes, with the aim that through education and support we can empower you to progress safely toward achieving your current and future goals.

Through neuromuscular retraining strategies we can work with you to:

**Optimize the alignment of your pelvis, as Lindsay mentions in Donald Physiotherapy’s recent Facebook post where she discusses the importance of addressing the postpartum “mom bum,” to gain better access to the pelvic floor muscles. Muscles that she so clearly explains are important for more than just improved continence.

**Optimize your breathing strategy, to allow for improved access to your diaphragm, not only as an efficient respiratory muscle for oxygen exchange, but also as a muscle important in central or core stabilization and posture control. In fact, the diaphragm, when trained to be used effectively also helps:

• maintain mobility in your ribs as well as your upper and lower back
• aid circulation
• restore balance
• improve gastro-intestinal function which aids in reducing constipation
• regulate intra-abdominal pressure to help absorb impact during WB activities, as well as
• balance your sympathetic and parasympathetic nervous systems, assisting to regulate heart rate and emotional response

**Optimize engagement of your deepest abdominal or “transversus” muscle so that it works together as a team with the diaphragm, pelvic floor, and deep spinal “multifidus” muscle to assist in:

• stabilizing and controlling the spine, allowing for simultaneous functional movement to perform tasks like lifting and carrying safely, and
• the management of diastasis rectus, that enables for maintenance and restoration of the strength and control necessary to return to functional meaningful tasks and performance goals in a timely manner.

It is this deep abdominal muscle’s vast attachments extending throughout the ribs, pelvis and spine and its slow tensioning action which make it such a powerhouse for controlling this region. This is in stark contrast to the obvious quick and bulging bracing that is created by the superficial abs.

From perhaps well-intended verbal cues of “tighten your tummy” to less well-intended visual cues in fitness magazines that promote perpetually flat abs, what one may have thought back then is not what we know right now.  What it comes down to is really getting to know, appreciate and listen to what your body is telling you so that it can continue to serve you well into the future.  Come and ask us about the benefits of neuromuscular retraining strategies and let us show you how using central control as a foundation for ALL your performance fitness and wellness goals can benefit you and your family.  Our commitment to growing in knowledge transfers into our commitment to serving you.

~ Elizabeth - Physiotherapist
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References:
www.juliewiebe.com
https://www.facebook.com/DonaldPhysiotherapy/posts/3045234788890061
 

 Maintaining balance when it comes to caring for self and others can be challenging at the best of times, but more-so now as we navigate through COVID-19 and our more recent tragedy in Nova Scotia, a place that I still consider home after having lived there for several years.  We often struggle to regulate and process the vast and varied input and uncertain nature of our current landscape, as we journey toward sometimes extreme and often unavoidable change.  As we set our goals toward a so-called “new normal,” being able to recognize the importance of i) taking a break, ii) knowing when to take a break, and feeling supported in that process, are crucial components to both short and long term mental and physical wellness.  Considering many of us may have already faced or continue to face mental health challenges even before these crises began, having useful resources available to guide us as to when we as caregivers need care, can prove to be invaluable going forward.

I know I’m not alone, in expressing my gratitude for all our front-line essential services staff and support workers that are currently dedicating their lives to our care, often at the cost of extreme self-sacrifice.  The toll it can take on their overall wellness is undeniable. In my opinion, it’s when clear and tangible ways of expressing our gratitude for their service are demonstrated, that we can emerge TOGETHER with greater resilience.

Continuing to do our part in following Health Canada’s current guidelines for hygiene and social distancing, https://www.canada.ca/en/public-health/services/publications/diseases-conditions/social-distancing.html , is one way we as individuals can clearly demonstrateour gratitude.  In my mind,ensuring that our healthcare team is well equipped:

• to recognize their own need for self-care both physically and mentally,
• to recognize what that care might look like, and
• to have resources readily available for them to access supplemental care whenever necessary, is also key.
  
  

The “COVID-19 Resources for Healthcare Sector,” https://theworkingmind.ca/healthcare-resources, released by The Mental Health Commission of Canada, is a great resource for ANYONE interested in obtaining a clear perspective regarding their mental health.   Making sure our caregivers are themselves well cared for, will benefit everyone in the long run.  Arguably, as we are all called to be caregivers in one capacity or another as we journey through life, this resource should be considered a must read for everyone!  The “how am I doing” quick tool, (see link below)is a great place to start. https://www.espritautravail.ca/sites/default/files/how-am-i-doing-healthcare-poster-en.pdf

Taking a break or initiating a self-care strategy to help prevent a mental health crisis, can look very different for everyone and can evenvary for an individual over time.  In general,something that helps to increase resiliency, or your ability to recover from or adjust easily to misfortune, change or stress can be the most helpful. For some,self-care can includesomething as simple as reading a book, taking a walk, or talking with a friend.  Occasionally,an effective breakmay even require all three, depending upon yourcircumstance.  For myself, I recognize that it often requiresa fair bit of effort toconsciously shift from certain tasks and thought processes to what feels like a truemental break. However,the benefits are worth it!

As a first-year beekeeper, beekeeping continues to be a reprieve amidst the feelings of isolation and uncertainty that the pandemic brings and what I consider to be one of my mental resets.  It’s been a way for our family to connect with each other and with nature and to see the value in life’s small but mighty miracles as we learn and grow together.  It’s also been a gift to be able to share our bounty of liquid gold with friends, family and ANYONE who’s curious.  It’s a real toss-up as to whether the honey itself or the joy of sharing it with others is what brings the most gratitude and continues to stoke my mental health.

A couple of weeks ago we approached our hives for the first time since fall, after having had them insulated and undisturbed all winter, and we did so with a mix of excitement and apprehension.  Believing that we’d done all we could to follow proper procedure, we were at some point left to trust the process.  From there, it became essential to rely heavily on patience, faith and hopein order to trust that we would be returning after an unpredictable prairie winter to a thriving hive, never a guarantee.

Even before the hives are unwrapped, it becomes apparent that our efforts and the process has prevailed.  Our colonies are highly active as they swarm around a small opening thatremains for necessary air flow.  Clearly, no social distancing memos have been received here!  It seems we’ve done enough to give our bees a solidchance of carrying on into the emerging spring.  A clear sign of hope and some much-needed light on the path of the future to come. 

Are there new challenges or experiences that have offered you reprieve in this time of crisis and waiting? What are some of your most trusted self-care or mental break strategies?We’d love to hear from you!  Also,stay tuned for our upcoming presentation on the importance of including exercise as one of your self-care strategiesin managing your mental health.

~ Elizabeth Stefanyshyn-Alonso, Physiotherapist

References:
1)  Government of Canada – Physical Distancing - How to slow the spread of COVID-19 https://www.canada.ca/en/public-health/services/publications/diseases-conditions/social-distancing.html
2)  Mental Health Commission of Canada – The Working Mind https://theworkingmind.ca/home
3 ) Merriam-Webster Dictionary - https://www.merriam-webster.com/dictionary/resilient
4)  Government of Saskatchewan Mental Health Support Resources - https://www.saskatchewan.ca/government/health-care-administration-and-provider-resources/treatment-procedures-and-guidelines/emerging-public-health-issues/2019-novel-coronavirus/mental-health-and-covid-19