What can we do about pain?
– sometimes tissues repair but associated protective patterns may not, and that may be creating the persisting pain. Have you developed protective, but harmful, movement patterns? Are there areas of tension, tightness, weakness, compensation, that are not allowing your body to function normally as it once did?
– some tissues don’t repair as well as we would want, so have you learned how to stabilize, support, mobilize, or strengthen the area to make it as healthy as possible?
November. A month where men become a little warmer and (typically) a little uglier due to a bit more fuzz on that upper lip. One of the main objectives of November is to bring awareness to prostate cancer, the leading cancer diagnosis in men (1). Due to campaigns such as Movember, we are seeing more and more support for the use of exercise in cancer care.
According to the Ontario Cancer Care Guidelines for Exercise and the Clinical Oncology Society of Australia, exercise should be an integral part of every cancer patients treatment plan from diagnosis to post-treatment (2,3). With respect to prostate cancer and the effects of the treatments associated with it, exercise has been shown to improve and/or manage(4):
Exercise goes beyond side effect management and into improving survival rates for prostate cancer survivors. When looking at recurring prostate cancer resulting in death, men who participated in vigorous exercise > 3 hrs/week lowered their risk by 61% compared to those who participated in < 1hr/week However, if you are not at the capacity to exercise at a vigorous level, please do not be alarmed, as those who participated in a moderate exercise for <1hr/week lowered their all cause mortality risk by 46% (5).
Through all that scientific medical jargon, the main takeaway is ANY amount of exercise is beneficial for you and should be started as soon as possible.
One of the more concerning stats I have seen is that 82% of survivors of prostate cancer report their supportive care needs are not met (6), but they are also less likely to bring these concerns up to healthcare professionals, especially if it involves sexual dysfunction (6). Therefore, I encourage you to share with your healthcare team if you are experiencing any symptoms listed below (or any others) (4,8):
Sexual dysfunction; Including but not limited to: Erectile dysfunction, orgasm changes, penile shortening (95% of men)
Bowel/Bladder dysfunction (50% of men)
Loss of libido
It is indisputable that a supervised exercise program is one of the best medicines you can provide yourself. It improves physical, social, emotional, and mental wellbeing, all of which can be impacted by a cancer diagnosis and the side effects of treatments. It can be challenging and difficult to initiate this process, so if you don’t know where to start or if you are experiencing any symptoms above, please reach out and ask for help.
As we age we have muscle loss, a process called sarcopenia. If we have a chronic illness or disease such as cardiac disease, COPD, or cancer, this muscle loss is accelerated, a process called cachexia. Although, we cannot slow down our chronological age, we can certainly slow down our physiological age and improve our muscle mass through strength training. Listed below are a few benefits of having more muscle mass:
Every system in our body plays an important role in our health. When coming up with a healthy living plan that works for you, please do not skip over resistance training. The benefits will completely outweigh the time/energy you put in, I promise you that.
Thanks for reading!
P.S. You can build muscle in 1-2 workouts/week in 30 minutes or less.
As an individual journey’s through their cancer diagnosis, the value of exercise cannot be overstated. It has benefits throughout all stages of treatment from pre-diagnosis for prevention, to all stages post diagnosis. It helps prepare your body and mind for treatments, recovery, pain management, coping skills and recurrence depending on what stage you are in (See Picture Below). 1,2
Another important health outcome post-cancer diagnosis is sedentary behaviour. This is concerning for the cancer population because 75% of their time is spent sedentary.1 Furthermore it has been shown that breast cancer survivors spend more time engaged in moderate to vigorous exercise, but spend more time sedentary than their healthy counterparts.,3 Additionally, engaging in this type of behaviour is being associated with cardiovascular risks, diabetes, and increased cancer risk. 4,5 So how do we reduce time spent not moving in a population that can struggle with pain, fatigue, and nausea just to name a few?7
First thing may be to start looking at activity as a continuum,1. When this is done, activity levels progress from doing nothing (.e.g., Watching TV) to activities such as sprinting. Both extremes are recommended occasionally, but not how we want to spend most of our day. In fact, the far right would be impossible to achieve. Now, depending on where an individual is at in their cancer recovery determines their starting point along the continuum. Some people may only be able to perform postural shifts to maintain comfort, and some may be able to do bouts of moderate exercise. Ideally, we want to spend most of our day in the middle of this continuum, with the goal of increasing the amount of time doing activities of daily living and light to moderate exercise.
From a rehabilitation standpoint, it would not be expected for someone to jump from sedentary to moderate exercise if they are physically and mentally unable to tolerate it. Understanding that discomfort and fatigue are two barriers to reducing sedentary behaviour in cancer populations6 is essential to this process. This makes us aware that we need to take more of a stepwise approach of building up tolerance by slowly pushing the limits of where your current level is to try and achieve the next activity goal (See Below). This is where professionals can help you gain a new perspective of why you are experiencing pain and fatigue, and give you strategies to better approach your activity transitions such as edgework and pacing. This may start with gentle postural shifts or mobility exercises to prep the musculature and nervous system to allow you to spend more time toward the middle of the continuum. It can also include multiple light walks or strengthening exercises, it all depends on your tolerance level.
Ultimately, the goal is to be as active as you possibly can throughout the day, and to understand that consistent movement within your limits has the potential to reduce various health risks. Although there is not a specific formula, what we know is that pain and cancer education, movement, exercise, and nutrition will put you in the best position to manage or overcome this cancer diagnosis, meanwhile reducing your future risk of side effects, recurrences, and other health issues.
“It is important to move and to move often, no matter how simple or limited the movement may be.1 ”1. Lucas AR, Klepin HD, Porges SW, Rejeski JW. Mindfulness-based movement: a polyvagal perspective. Int Can Ther. 2016. https://doi.org/10.1177/15347354166820872. Segal R, Zwaal C, Green E, Tomasone J, Loblaw A, Ptrella T, et al. Exercise for people with cancer. Toronto (ON): Cancer Care Ontario; 2015 Jun 30. Program in Evidence-based Care Guideline No.: 19-53. Phillips SM, Dodd KW, Steeves J, McClain J, Alfano CM, McAuley E. Physical activity and sedentary beavhiour in breast cancer survivors: new insight in to activity patterns and potential intervention targets. Gynecol Oncol.2015;138:398-4044. Wilmot EG, Edwardson CL, Achana FA, Davies MJ, Gorely T, Gray LJ, Khunti K, Yates T, Biddle SJH. Sedentary time in adults and the association with diabetes, cardiovascular disease and death: systematic review and meta-analysis. Diabet. 2012;55(11);2895-29055. Lynch BM. Sedentary behaviour and cancer: a systematic review of the literature and proposed biological mechanisms. Can Epid Bio Prev.2010. doi: 10.1158/1055-9965.EPI-10-08156. Courneya KS, McKenzie DC, Reid RD, Mackey JR, Gelmon K, Friedenreich CM, et al. Barriers to supervised exercise training in randomized controlled trial of breast cancer patients receiving chemotherapy. Ann Behav Med. 2008: 35;116-122.
My inspiration for this blog article comes from a recent visit I had this weekend at my sister in-law’s house. They are dealing with an issue that many North American families have to deal with….kids that spend way too much time using electronic devices. She was upset because on a sunny day, her son spent 6 straight hours playing X-box. In addition to that, he spent time on the computer on MSN, Youtube, Facebook, and numerous other websites. Don’t forget television as well. This trend is growing at a ridiculous rate, and as a physiotherapist I get to see the physical effects.
RSI, or Repetitive Strain Injury, is a collective term for syndromes characterized by discomfort, impairment and loss of muscle strength and function. RSI often affects the neck, the back and particularly the arms and hands. It is found primarily in adults who perform repeated movements such as those involved in typing or playing musical instruments. It is commonly named according to the part of the body affected, e.g. tennis elbow, carpal tunnel syndrome, golfer’s elbow. We are starting to see RSI turn up in younger and younger patients which is rather alarming.
In addition to computers and gaming devices, there has been a substantial increase in the amount of time teenagers spend on their cellular phones sending text messages, thereby potentially affecting the prevalence of RSI in this group (2). The increased frequency of texting is leading to a condition popularly termed “Blackberry Thumb”, or “teen texting tendonitis”. This occurs because these devices rely almost solely on the use of your thumbs (not all of your fingers) for typing. Any device that relies on the thumbs for typing can cause this type of injury because the thumbs simply weren’t designed for such use (1,3). Repetitive mechanical loading of the thumb, combined with inactivity, and prolonged slouched postures resulting in increased neural tension results in increased risk of developing RSI.
Symptoms of “Blackberry thumb” include pain and numbness in the thumbs and joints of the hand (1). But there are also other bodily symptoms:
It is estimated that teenagers sending and receiving an average of 80 text messages each day may be vulnerable to repetitive stress injuries of the thumb (4). If you think this is a high number and unlikely, consider these statistics:
If you think my sister in-law’s son is a minority, then guess again. Here is another interesting statistic: Americans between ages 8 and 18 spend an average of 7.5 hours a day using an electronic device, be it a computer, cellular phone, or television (4). If this sounds like your child, or one you know, then consider these tips to avoid developing these repetitive strain conditions:
Restricting time spent on electronic devices, and increasing physical activity will significantly reduce the risk of developing RSI conditions. If your child develops symptoms of RSI, please see an appropriate health practitioner to help deal with the issue. If left unchecked, these symptoms can progress and become quite severe and debilitating. If this issue is familiar to you, the staff at One To One Wellness would like to help you.
Every hour you sit after the age of 25 takes 21.8 minutes off your life.
That’s a pretty eye opening statistic considering the majority of us are sedentary workers and/or enjoy sitting back and watching our TV shows. Suddenly binge watching a Netflix series doesn’t sound so fun (4 seasons of Ray Donovan just took a toll on me). I feel a lot of this comes down to habit and routine.
Most people go to work (sitting), drive home (sitting), eat supper (sitting), then relax (sitting). Sitting is a habit that is now blueprinted into our routine and according to this study is slowly taking time off our life. Breaking habits and routines is central to what physiotherapists do, and it is arguably the hardest part of the job. We need to educate on why it is important to break these habits and form new, healthier ones to not only combat and prevent pain, but to prolong life. So how do we get people to break them?
I recently watched an interesting TEDtalk about how curiosity might be the key to breaking these bad habits.
Although the main focus of this was on smoking and eating, their concept of curiosity, I felt could be translated quite well into time sitting. The gist of it is quite simple; you need to become curious to make you more aware of the impact of your habit. Could I feel better if did more in standing? Would I feel better if I went for a walk instead of watching TV? Do I hurt more after watching TV? Is this worth the 21.8 minutes?
Their success rate was high for smoking, and I am curious to see if it would be similar across the board with most habits. I hope that the statistic alone intrigues your inner Curious George about what it would feel like to go for a walk, get back into the gym or do more work while standing. Life is too short to be subtracting minutes.
I’m often asked “Is walking good for you?” In short, the answer is YES but the rewards and drawbacks of ‘walking for exercise’ depends heavily on the individual.
For example, are you are free of injuries or impairments that would cause you to walk with a correction?
Do you have a sore heel causing you to put more weight on one leg?
Do you experience pain while walking or after?
Do you have poor balance and at times worried you might fall?
If you’ve answered yes to any of these questions, it’s important that you minimize risk. Injury will take the benefit out of any workout.
For me, walking is an activity that can be fun (who doesn’t love a social walk with a friend on the waterfront.)
Walking gets the body moving.
Increases blood flow which contributes to a healthy heart and brings greater fluidity to lower body joints.
Walking challenges your weight bearing bones to help fight osteoporosis.
In general walking is a low-impact activity that has minimal “wear and tear” on your joints. Walking is free, can be done most anywhere and is one of the best things for your mind & body.
Walking gives you a great cardiovascular boost but offers little improvement in muscle strength. As we age (after the age of 25) we start to lose muscle mass, this is called “sarcopenia”. It becomes fairly critical that we continue to build muscle mass as we age. Walking alone will not give you everything you need to be fit for the long run.
I like to think of walking as an “activity” rather than “exercise”. I think any type of sport or recreational movements are in the same column. Activity in my opinion still has many benefits (physical, as well as psychological and social) but if you really want to play or engage in an activity with less chances for injury or “wear and tear” on your joints, then you need to do the fundamental work called “exercise”. I highly suggest weight training using machines or free weights, yoga, pilates, and body-weight training movements (squats, push ups, planks).
In summary, walking is great. It’s just not the “be all and end all” of a complete fitness program. If walking is the one thing you do, good for you. You are moving! That’s better than a lot of people! If you are keen to experience the benefits of true fitness try adding exercises that build muscle. You will soon discover an ability to enjoy all types of physical activity safely and with greater ease.
By Nick Matheson, Owner
It was eleven years ago; a birthday truly worth celebrating. My oldest daughter, Maryn, had reached a milestone. Three years old and she was cancer free. Born with a rare tumour in her liver, the disease had progressed to her lungs, reaching stage 4, before we had the good fortune of an accidental discovery. A fall on her belly a few months previous ruptured the tumour, threw her into shock, and propelled our family into a 4-month sprint to conquer this disease.
On this particular day, she raced all over the playground, climbing, swinging, and jumping. Not a big deal for most three year olds, but quite a feat for a kid who was only three weeks post liver transplant! Having donated a significant chunk of my liver to the effort, I was quite the contrast as I winced with pain and hobbled lethargically around the park trying in vain to keep up. At only 31 I was already envious of the energy and recovery potential of youth! My family’s brush with cancer taught me that there are many things in life that I cannot control. It was in that moment, full of joy in Maryn’s victory and facing struggle in my recovery, that I vowed to control those things I could. Until that point, health was something I took for granted. It’s easy to do that until you start to lose it. So many people spend so much time and energy focused on things that do not matter at all when their own health or the health of those they love is at risk. Illness can be an important wake up call.
I’m sure my family has claimed more than our share of Nova Scotia’s health care dollars. We are very grateful that the stress of coping with a kid facing a serious illness was not compounded by wondering how we would pay for her care. We are incredibly thankful for the exceptional care that was provided and, of course, for a miraculous outcome. I realize that it is not without problems; however, the system was there for us when we needed it. For the most part, health care in Nova Scotia works when you are sick. The challenge is that it does very little to keep us well. And, frankly, I don’t think there is much it can do. The population of Nova Scotia is aging rapidly, chronic disease continues to increase, and unhealthy lifestyle habits are among the highest in the country. Illness places a growing burden on health care budgets and personnel. I understand fully that there are many things we cannot control. I invite every Nova Scotian to accept responsibility for controlling those they can.
Wellness is too often sacrificed to denial or lack of awareness. Every choice takes one closer to or farther from a state of good health. The scientific literature is full of results demonstrating the positive impact that diet and exercise have on chronic disease. And yet many continue to rely instead on taking a few pills or being caught by the health care system once they’ve fallen. As I’ve said, I’m as appreciative as anyone for that safety net. I’m also determined to strengthen my health and give those around me every opportunity to thrive.
Thriving comes from attention to 3 main areas:
Mind: The first step toward change is awareness. The second is acceptance. In words from those far wiser, all suffering comes from wanting things to be other than they are. Learning to be aware of my ability to respond rather than react has brought great freedom. Practices like meditation and yoga can bring focus, clarity, and relaxation. Becoming more awake means recognizing that I always have choice.
Muscle: As the engine that makes us go, muscle must be maintained in order to do the things we want to do. Loss of muscle begins as soon as we stop naturally growing unless something is done to stimulate strength. Being stronger makes everything you want to do easier. Body composition, which provides an indication of muscle mass, is actually one of the most important measures of overall health and one of the most significant determinants of an active lifestyle.
Movement: Our bodies are meant to move. From a young age, we learn that we are our thoughts and we become somewhat disconnected from our bodies. Sedentary lifestyles contribute to tightness, stiffness, and weakness. Pain can cause further restriction and avoidance. Crappy weather can make us cocoon in front of the TV instead of embracing the great outdoors. There are lots of excuses and all must be overcome. Quite simply, movement is the best medicine for creating change in a person’s physical, emotional, and mental state.
Ultimately, we must all be the change we wish to see in the world. I can see a healthier Nova Scotia. I work every day to become more aware of my choices and to help others align mind, body, and spirit toward their own vision. Please accept this as a Nova Scotia Wellness Challenge and commit today to whatever changes you feel are most important to move you – and all of us – to a greater state of health. That would be worth celebrating!
It’s hard to believe that just a few short months ago we were chipping away at ice, and spent hours shoveling snow. If anything, the winter that we had has maybe sparked something in all of us; to get out there and take advantage of our summer and warmer weather. As someone who enjoys going for runs, cycling, and just being active outdoors I can certainly attest that the hot weather can bring about its own challenges. I decided that I would share some tips to help with these hot summer days. Though they may seem basic, putting these into effect can make a difference.
I’ve included a link to a short video that describes what happens when you have heat stroke.
The weather is warming up and many of us are spending more time in our gardens lately. This can involve a range of activities from light to heavy tasks. It is easy to sustain an injury or feel pain with awkward movements, too much loading, or sustained postures. Adhering to some simple principles will minimize your risk and allow you to get outside and enjoy your garden all summer long.
Do not bend over too far when doing a pulling activity, and do not overreach. Use tools with a longer handle when possible.
Combining bending and twisting together can get you in trouble, this can add strain to your back. When lifting, keep the load directly in front of you.
Do not bend from the waist. Squat or kneel on a kneeling pad. Sit on a milk crate or a low stool to weed or plant; this will be easier on your back.
If you can move a task so it is at counter height then do so. This will be easier than trying to crouch or bend over.
Use a wheelbarrow to move heavier loads. Even if it is not a heavy load, a bag of soil or mulch can be an awkward lift so a wheelbarrow still makes the task much easier (well worth the investment).
Pacing is important! Spread the task out over a longer period of time, alternate between tasks and rest in between. If you get absorbed into a task and do it for too long, you may pay for it later in pain or discomfort.
Take your time and don’t rush or cheat. When we are in a rush we lose focus and this is when we get into trouble.
Your next posture is your best posture! Be dynamic and move a lot.Periodically move in the opposite direction of the posture you sustained. Do not sustain one posture for several minutes at a time. Sustained postures restrict blood flow, and lack of blood flow leads to mechanical pain.
Enjoy the summer and be safe!