Ouch!! My Back!

by Graham Breault, RMT

Lately I’ve been seeing a lot of patients  with general low back pain and it usually ends up being a problem with the Sacroiliac (SI) joint. 1200px-Sacroiliac_JointI initially calm down the aggravated muscle or tissue by using some simple massage techniques and some heat. When the swelling and inflammation of the tissue decreases, I then begin to involve an active component within the treatment. If the patient has a relatively pain-free range of motion, I will then incorporate some Muscle Energy Techniques (MET).

Unlike many massage therapy techniques, MET is an active process for both the therapist and the patient. During this process, the patient is asked to contract the injured muscle while the therapist provides a resistance, allowing them to stretch and lengthen the muscle.

MET can be used in two ways:

  1. Post-Isometric Relaxation – the client first contracts or shortens the muscleh9991476_001_1 before the therapist stretches or lengthens it.
  2. Reciprocal Inhibition – the therapist has the patient contract one muscle in order to relax the reciprocal muscle.

 

An example of this would be: Contracting the quadriceps in order to relax the hamstrings.

Katy Anderson from Silicon Valley Bodywork has a great set of videos that go over the different ways to strengthen the back and how to maintain an aligned SI joint using basic MET techniques. This video shows MET for SI joint alignment https://youtu.be/rJFvq_rJY7o.

MET can help realign muscle groups, re-educate muscles to restore a full range of motion, strengthen and repair weak or damaged muscle tissue, reduce muscle pain and stiffness.

References:

 

Graham is a Registered Massage Therapist and sees patients at Rocky Point Wellness Clinic Tuesday to Saturday. To learn more about Graham, or to book an appointment, Click Here. If you have any questions about how massage therapy can help you, you can contact Graham on facebook @grahambreaultrmt.

Giving Advice To Your Counsellor??? 5 Types of Feedback That Can Be Very Helpful

by Melanie Rathgeber, MA, MC, RCC

It may not seem natural to think about giving feedback to your counsellor, but we really do want to hear your reflections. It helps us think back on the session, evaluate your progress, and direct where to go next. Here are five types of feedback that can be very valuable for the effectiveness of your sessions.

 

  1. What you liked about your session. A great way to wrap up a session is to talk about what you found helpful in this session. What stuck out for you? What are your main take-aways? Are there things you talked about or discovered that you would like to pick up on next time? I try to make a point to ask my clients at the end of their sessions for their reflections, but if there is something that is coming up for you, please feel free to bring it up on your own.

 

  1. What you didn’t like about your session. I once had a client come in and tell me that she was really upset with one of the questions I had asked her the previous week. It was awesome feedback! It allowed us to start down a path of why it was upsetting, what it meant to her, and why that particular question provoked the response it did.

 

  1. What style of counselling has worked for you in the past. If you have had counselling before, and are starting with a new counsellor, it can be very helpful to talk about your previous counselling experiences. Is there a particular type of therapy you found helpful? Do you like when your counsellor is more directive? Less directive? Do you like to do tasks between sessions? We likely won’t completely change our style, but we can certainly incorporate your preferences.

 

  1. What is sticking with you. If there are certain ideas that stuck with you from the previous session, it is helpful to know that. If you spent a lot of time reflecting on a certain topic, that can be a good starting point for the next session. If you found that you used some techniques more than others, that is good for us to discuss. If you found that some techniques didn’t make sense to you, we can look at the instructions and maybe modify it to suit you better. I always like when my clients tell me that they are teaching their friends and family some specific techniques – that lets me know that it must be something that is working for them!

 

  1. How you are feeling about your progress. It is really important for you and your counsellor to be on the same page about your goals. If you feel like you are not making enough progress towards your goals, that can be a good signal that the style of counselling may need to change. Or sometimes, it is a good prompt for you and your counsellor to remember how much progress you actually have made, even if it doesn’t always feel like that every day. Or maybe what you want to get out of counselling has changed. Maybe you are now managing some things better, but want to focus on others. Those are always important discussions to have together, and if you feel your counsellor isn’t picking up on the change of direction you want to take, please bring it up.

 

All this feedback is valuable and counsellors welcome it. We are trained to reflect on our practice, and your thoughts are an important part of that. Your ideas will help you and your counsellor direct your sessions and will be helpful in making your counselling effective. Thanks for the feedback!

 

Melanie is a Registered Clinical Counsellor at Rocky Point Wellness Clinic and offers individual counselling sessions on Mondays and Fridays. To learn more about Melanie, Click here.

TCM Interview

Have a listen to part 1 of Dr. Eran Even’s interview for SFU radio where he discusses his start in Chinese medicine, the benefits of Chinese medicine, some history of the medicine and his work as a translator of classical texts.

Click here to listen

 

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Myofascial Release (MFR)

by Graham Breault, RMT

Myofascial Release dates back to the 1940’s, but the term was created in 1981. Since then it has become a very popular treatment modality for both athletes and active individuals looking to increase their overall mobility.

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In recent years athletes and everyday individuals have been using foam rollers or a type of a roller massage; such as a tennis ball or lacrosse ball, in order to increase or maintain the joint range of motion (ROM) and to help decrease the delayed onset muscle soreness (DOMS) after an intense exercise.

Emily Day from the USA Volleyball’s Beach National Team has a great set of 7 different foam rolling exercises and 2 different ball exercises that are great for a pre or post workout or for general muscle maintenance.

What is Myo and what is Fascia?

Myo means muscle in Greek and Fascia is the connective tissue (elastin, collagen) that surrounds and protects every other tissue, tendon, muscle, bone, ligament and organ of the body. It is essentially a 3D continuous web for the body.

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Fascial restrictions do not show up on CAT scans, MRI’s or X-Ray. Research has proven that fascia, similar to muscle, can contract and relax. Fascia acts as a tensegrity (tensional integrity) model where tension and resistance need one another for stability and function.

Fascia does not stretch nor does it soften like muscle, but instead it requires a slower and a more focused approach. Because of this, myofascial pain can be difficult to identify. When identified it is often treated with manual therapy techniques such as myofascial release (MFR).

Myofascial Release Techniques

There are many different types of deep and superficial MFR techniques that are used to mobilize and release the adhesive tissues. Both direct 23063142621_406b822d71_b(against tissue resistance) and indirect (in the direction of the least tissue resistance) MFR techniques are performed as the patient remains passive. Minimal pressure is applied to the tissue and it can be be applied in one direction or multiple depending on the restriction of the tissue.

Other MFR techniques can be active treatments; such as: Active Myofascial Release/Contractile Myofascial Release, in which the patient uses contraction of the muscle while the therapist mobilizes the adhesive tissue.

There is no oil or lotion that is used during these techniques but a hot pack or heating blanket is used pretreatment in order to provide the tissue with more blood circulation. Other techniques include J-stoking, Bear Claw, cross hand/finger shear, skin-rolling of superficial tissues, or picking-up and bowing of the deeper adhesive tissue.

What are the Benefits?

MFR is effective for treating myofascial pain syndrome (pain that originates from specific points within the fascial tissues called “trigger points”), orthopaedic conditions (fibromyalgia, arthritis, fractures)  and repetitive strain conditions, such as: plantar fasciitis, lateral epicondylitis (tennis elbow) and medial epicondylitis (golfer’s elbow) and carpal tunnel syndrome.

Myofascial Release promotes the idea that the mind and the body work together. Whether you have superficial pain, deeper pain within a muscle or joint, or cellular dysfunction, MFR can offer some benefit.  

Graham Breault is a Registered Massage Therapist at Rocky Point Wellness Clinic. Graham sees patients Tuesday through Saturday and offers both daytime and evening appointments. To learn more about Graham, click here.

 

The Holidays from a Counselling Perspective

by Melanie Rathgeber, MC, MA, RCC

The holiday season can bring strong emotions — some positive and some negative — for all of us.  Earlier this year I completed a training course on grief, and I was reminded how beneficial the principles of grief counselling are to many of my clients. Emotional challenges often stem from loss of some kind, and it is important to recognize and process those losses accordingly.  So for the holidays, I wanted to share thoughts on Grief During the Holidays, written by my colleagues at Living Through Loss Counselling Society in Vancouver. I hope their reflections are helpful to you, whether you are experiencing loss yourself, or want to provide comfort to others in your life.  I encourage all my clients to pay special attention to the first point – planning ahead. It will give you some control over the days ahead.  Read below for further thoughts and reflections from experts in this area.

Wishing you all peace, comfort, and hope during this holiday season.  

  – Melanie Rathgeber, Registered Clinical Counsellor

Grief During Holidays (from Living Through Loss Counselling Society)

The pain we experience when we lose someone we love is more intense during special days. The expectation of relaxation, happiness, and celebration makes a sharp contrast to the pain of loss. Nothing can change our reality but there are some things to do to manage grief and help ourselves to cope.

Plan Ahead

Decide in advance how the special day or days will be spent. However, be flexible if you find things aren’t working out as expected. The plan was made to help, not to cause more distress. So be realistic.

Talk About Your Grief

Friends and family do not always understand that your loved one is never out of your mind. Try to give your sorrow words, or write them in a journal. It is healthy to share your memories both happy and sad with people who care.

We Have Tears For A Purpose

Scientists speculate that tears contain a component that has the effect of improving our emotional state. However it works, experience tells us that crying is healing. If you don’t feel comfortable crying in the presence of others, allow time to cry alone. It will relieve the pressure and help you to control your grief in social settings. Holidays are arbitrary but your grief has a life of its own and won’t always allow you to put it on hold.

Re-evaluate Family Traditions

This may help to blunt the sharp sad memories of how things used to be. Consider altering the way things have always been done. Design new rituals and traditions, or do something symbolic to memorialize your loved one.

You Are The Best Authority On Your Grief

During the holidays well meaning friends may try to help by keeping you busy or making sure you are never alone. It is important for you to determine for yourself what is best. Discuss your wishes with someone you trust. It will help clarify your needs and make it easier to explain what your limits are.

Spend Time With People You Trust

Try not to isolate yourself with your feelings. Friends who do not judge your behaviour, who allow you to talk about your grief and accept your feelings are invaluable. Ask them to help you guard against wearing them out! You will need to save their valuable help for the days ahead.

Recognize Your Physical and Psychological Limitations

Most people experience fatigue during grief. Don’t hesitate to excuse yourself from commitments you feel too tired or sad to attend. Keeping busy has its uses but also risks delaying or avoiding sadness that must be experienced to heal. Avoid places, situations and people you believe may cause you stress or anxiety. Instead allow time for simple activities that sooth and relax and provide creative outlets of your own choosing. Allow yourself to just ‘be’.

Use All Resources That Are Available To You

If you have a faith or religion that gives you comfort, this is a time to depend on it. A vacation in a new environment is not necessarily avoidance of a loss, it can help you feel alive again and somewhat involved with life. Sharing feelings with others, even strangers, who have had similar experience can give perspective and assure you that you will survive. Grief counselling in groups or individually can assist you in understanding your grief, and help you to cope with its manifestations. Above all, be kind to yourself and know that your pain is entirely appropriate, considering your loss. Grief comes as a result of love and is a tribute to your relationship.

Cupping

Cupping has been used throughout the world for centuries and had been a part of mainstream medicine in Europe until the 1900’s. It faded from practice in the Western world after the Second World War, but has always been a mainstay in Chinese medicine and has been used in China for thousands of years. Cupping is making a comeback, and it’s popularity has really shot up after Michael Phelps was spotted at the Rio Olympics sporting cupping marks all over his back and shoulders.

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If you’re unfamiliar with cupping, it does seem strange. Cupping is actually a highly effective method for relaxing sore tight muscles, improving blood circulation, and helping reduce pain.

How does it work exactly? Traditionally, a Chinese medicine practitioner will use glass cups, and using a flame, removes the oxygen from the inside which creates a vacuum effect. Cups can be made from glass, bamboo, silicone, or plastic.

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Occasionally the cups will be moved along larger muscles, often likened to a deep tissue massage and will come with similar benefits. Often though, the cups will be left in place to exert their benefit. After 15-20 minutes the cups will be removed, leaving pink, to red to purple marks. Darker marks usually mean there is more stagnation in the tissue. These marks will fade and disappear within 5-7 days.

Cupping is beneficial for so many things, from tight muscles, areas with knots and pain, trigger points, pain from being in front of a keyboard all day (think hunched shoulders)… It can reduce adhesions and softens scar tissue (surgical scars, c-section scarring), help with menstrual pain, chronic coughs, early stages of the common cold, carpel tunnel, tennis elbow, IT band tightness……. AND…… it just plain ol’ feels amazing.

If you think you would benefit from cupping, give the clinic a call or book yourself in for a treatment.

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Fall Transitions for Families

By Melanie Rathgeber, MC, MA, RCC

Families change over time and transition through different stages. In psychology, we use the term Family Life Cycles to describe the patterns of changes and transitions that most families go through. Transitions from one stage to the next are often where challenges are seen.[1]

The start of September can bring many transitions for individuals and for families. My nephew is leaving for university today and I can’t help but think of all the emotions it brings for him, as well as his parents. For him, it brings feelings of excitement, adventure, and independence. His parents of course have mixed emotions. They are proud and are confident they have prepared him well for this next stage in life. However, many of you will know that this time can also bring feelings of loneliness and sadness: the feelings that come with an ’empty nest’.

With any major life transition, we can experience excitement and anticipation. At the same time, we can expect there to be feelings of loss. Transitions signal a change in our identity — yes the building of a new identity, but also the loss of an old one. As with any loss, we experience new thoughts and emotions in order to adapt. We need to allow ourselves time and opportunities to reflect upon the past, and then to envision our life in our new reality. It can be tricky. For a while, we feel like we are going back and forth. Will my nephew feel like a brave young man setting out in the world, or will he feel like a child, needing the advice and guidance of his family? For a long time, he will likely feel both. He will waffle back and forth, and at times it will feel confusing, but eventually he will become more comfortable with his new identify while looking back fondly (but not forgetting) his life with his family.

For his parents, the feelings of loss will be more central. They will notice his absence in their daily lives; they will notice the difference in conversation at the dinner table; ; they will miss the sounds of banging drums coming from the basement (okay maybe they won’t miss that so much!). But underneath, there will naturally be feelings of excitement for them too, though they will not come as quickly or easily. There is excitement about pursuing new individual interests (or rekindling old ones), there are chances to reform a stronger bond as a couple, similar to the bond couples have before their children are born, and there are new traditions to build and to look forward to. There will be new weekend trips to visit their son. There will be holiday celebrations with special significance. Because after all, now when he comes home he will truly notice and appreciate how clean the house is, how good the cooking is, and how much he truly still needs to be part of his family, just in a slightly different way.

If you are experiencing a life transition and want to learn more about feelings associated with loss and change, you are welcome to book a counselling appointment or consultation with Melanie.


[1]Gerson, R. (1995). The family life cycle. Phases, stages, and crises. In Mikesell RH, Lusterman, DD & McDaniel S. (Eds.). Handbook of family psychology and systems theory. Washington, DC: American Psychological Association.

 

 

 

 

 

 

[1]Gerson, R. (1995). The family life cycle. Phases, stages, and crises. In Mikesell RH, Lusterman, DD & McDaniel S. (Eds.). Handbook of family psychology and systems theory. Washington, DC: American Psychological Association.

Learning from Yourself

by Melanie Rathgeber, MC, MA, RCC

One of the questions I often ask clients is “What can you learn from another area of your life?”.

Clients usually can name what skills or strategies have worked well for them in the past, it’s just that when they have low mood or are anxious, it can be hard to tap into what they know works.  If I can get them to think outside of their current challenge or situation, it can become clearer.

For example, if a client is feeling worried about a family situation and having a hard time managing the anxiety, I might ask “How do you manage anxiety in your career?”.  Even though it is a different area of life, the strengths are often transferable.

In counselling, we often think about different areas of life, or domains, such as:

  • Immediate family
  • Extended family
  • Marriage or intimate relationships
  • Friendships and social life
  • Community
  • Wellbeing and lifestyle
  • Career, employment or education

Even though our roles in these varied areas may feel different, it can still help to draw upon successes we’ve achieved in those areas. Sometimes even just pausing to think about a past success, or something you are proud of, can give you enough of a boost to feel a bit more hopeful about your current situation.

A few more examples that you may be able to ask yourself:

  • “How have I successfully handled similar situations in my workplace?”
  • “How did I manage to make changes in my lifestyle (exercise, leisure activities, healthy living, etc.)?”
  • “What tools or strategies did I use when I was feeling overwhelmed by all my community responsibilities?”

You might not find a direct answer, but think about the skills and strengths that have helped you in those other areas of life. How can you draw out that same underlying attribute for your current challenge? One small shift in thinking can help you to realize and to believe that you do indeed possess the skills to manage, to cope, to change, and to succeed. Learning to identify those skills and to draw them out — learning from yourself — is a good step.

Melanie offers individual counselling sessions at Rocky Point Wellness Clinic on Mondays and Fridays. Click here to learn more about Melanie.