When to Push Through Pain & When to Rest

June 16, 2017

We’ve heard the term “RICE” - rest, ice, compression, and elevation.  But when do you rest?  When do you ice?  When should you just ignore “RICE” and push through the pain?  There is both art and science to knowing when to rest and when to keep going, and we’ll be shedding some light on this subject in this episode. 

00:0000:00

Where do you start? Chiropractic, physical therapy, medical doctors, orthopedics….or something else

June 3, 2017

If you choose to use the medical and alternative healthcare system it is important to know the strengths and limitations of each profession, how they are intertwined, and how the history of each profession affects the view of the public.  

Currently, MoveU is fighting for a change in order – in addition to a new industry called “online movement recovery”.  The purpose of this change is to help millions of people get back to an active and pain-free life as quickly as possible by through movement education and the development of a winning mindset.

 

 

00:0000:00

Research Supports the MoveU Method

May 24, 2017

“The health care system faces enormous challenges, with both the disability burden and financial impact relating to LBP escalating.  Growing evidence suggests that current treatments and surgeries is conflicting with the evidence today, and is in fact often worsening the problem.  Change will demand a cultural shift in beliefs and practice.”

Unraveling the Complexity of Low Back Pain

Peter O’Sullivan, PT, PhD

Mary O’Keefe, PT, PhD

J Orthop Sports Phys Ther 2016;46(11):932-937. doi:10.2519/jospt.2016.0609

In this episode we’ll be reviewing one of the most comprehensive research papers written on Low Back Pain. We’ll read what we believe are the most relevant sections, and interpret them the into simple terms. You’re going to love this episode!

 

With all due respect to Peter O'Sullivan, some interpretations of his findings may reflect the MoveU Philosophy. 

00:0000:00

Why Your Diagnosis Doesn’t Matter!

May 18, 2017

In this episode we’ll be reviewing one of the most comprehensive research papers written on Low Back Pain.  Below are sections from the research article, and on the podcast we’ll break down the language into simpler terms that everyone can understand.

Unraveling the Complexity of Low Back Pain

Peter O’Sullivan, PT, PhD

Mary O’Keefe, PT, PhD

J Orthop Sports Phys Ther 2016;46(11):932-937. doi:10.2519/jospt.2016.0609

The health care system faces enormous challenges, with both the disability burden and financial impact relating to LBP escalating.  Growing evidence suggests that current treatments and surgeries is conflicting with the evidence today, and is in fact often worsening the problem.  Change will demand a cultural shift in beliefs and practice. 

Current Healthcare practices

Various approaches to diagnose and manage low back are on the rise.  Paradoxically, this trend is also associated with an increase in disability and chronicity. 

The current medical belief and practices focus on “magic bullet” treatments targeting presumed damaged structure or bio mechanical faults.

Exponential increases in MRI’s identify these damaged structures have led to escalating rates of spinal fusion and disc replacements. This is in spite of evidence that abnormal MRI findings are prevalent in asymptomatic populations and are poor predictors of future LBP and disability. 

In terms of symptom relief, there has also been an exponential increase in spine injections; pharmacology, opiod prescriptions; and implanted spinal cord stimulators.  All these interventions have limited long-term efficacy and carry significant health risks. 

In parallel, there has also been an expansion in physical therapies offered for LBP.  Many of these therapies focus on symptom relief and/or correcting supposed biomechanical faults, using spinal manipulation, soft tissue techniques, electrotherapy, dry needling and taping, to name a few.  These therapies, when tested, have only demonstrated small at best short term benefits.

Indeed, there is also growing evidence that nonspecific factors, such as therapeutic alliance, patient beliefs and expectations, therapist confidence, pain catastrophizing, and self-efficacy, are more predictive of clinical outcomes than changes to the target of the therapy (i.e. changing posture, muscle timing, joint position). 

Also, in the ergonomic industry continues to reinforce the belief that backs need protected, teaching people to sit up right, and lift with a braced abdominal wall and straight back.  This is in spite of lack of evidence that ergonomic interventions reduce the risk of low back pain, or that the way you bend increases the risk of low back pain.

This commonly “threatening” clinical climate frequently leaves the patient with LBP confused and fearful that his or her spine is frail, vulnerable, and damaged.  This in turn reinforces protective and avoidant behaviors, leaving people with few active coping strategies to mange their pain and maintain quality of life.  

This commonly leads to health care shopping and stepped care, in which patients progress to more invasive and risky treatments.  

Sadly, this current practice is disagreeing with patient expectations regarding the importance of clear communication about their disorder, their desire for individualized self management strategies to control their pain, and goals relating to functional restoration and maintaining quality of life.  

Patients with persistent low back describe this process as having their “live on hold” in which they don’t understand their pain problem, have few coping strategies to manage it, and lose their ability to do the things in life that they value.  The is often associated with escalating distress, disability, and depression.  

Contemporary understanding of LBP

In contrast, there is growing evidence that LBP is a multidimensional disorder.  It is increasingly clear that persistent and disabling LBP is not an accurate measure of local tissue pathology or damage alone.  Rather, it is best seen as a protective mechanism to the individuals perceived level of danger, threat, or disruption to homeostasis.  

These systems constantly interact and are influenced by an interplay of physical (loading exposures and levels of conditioning), psychological (cognitions and emotions), social (socioeconomic, cultural, work, home environment, and stress), lifestyle (sleep, activity levels), co-morbid health (mental health, obesity), and non-modifiable (genetics, sex, life stage) factors.  Interestingly, the emerging evidence reveals that man of these factors are interrelated, rather than being mutually exclusive.  The relative contribution from these different factors is unique to the individual. 

this interplay between multiple systems and factors restricts reductionist approaches that attempt to neatly categorize or subgroup people with LBP in order to target treatment. It also highlights why magic bullets and symptom palliation have largely failed, as the capacity of these approaches to positively impact this interplay is limited.  

“boxing patients into subgroups may miss the crucial interrelationship between factors for an individual 

This contemporary understanding demands a shift away from providing a simplistic structural and/or biomechanical diagnosis and treatment for LBP.  Rather, this process empowers the patient to develop a clear understanding of the contributing factors that promote pain and disability.  This enables the patient to become a partner in a therapeutic journey that aims to lower the threat of pain, develop active coping strategies to self-manage the disorder, and engage in value based activities.  

There is growing evidence that the management of LBP needs a paradigm shift.  This perspective considers LBP as a protective mechanism that emerges in response to perceived threats from multiple domains in the individual context. IN this context, negative societal beliefs and fear about the meaning of LBP can escalate pain and lead to unhelpful behavioral responses, leaving patients distressed and disabled.  

This approach places patients at the center of their care, validating them while understanding their goals and expectations. 

00:0000:00

WARNING SIGNS That You’re Wasting Time with Treatment

May 14, 2017

How to know when you’re on the right path heading towards recovery

    • The process of seeking help for chronic pain and ending up frustrated 

      • You feel pain - you seek professional help - treatment fails - you seek more help - treatment fails again - you feel defeated and frustrated
    • Step 1:  Create a clear goal where you're going 
      • Make a SMART goal (specific, measurable, actionable, relevant, timely)
      • A goal of "pain-free" is NOT a long term goal - and can cause you more harm than good
      • Neither is a simple goal like "putting your shoes on pain-free", as they can be achieved in a day or a week
      • The healthcare professionals plan for you should be crystal clear and guide you to your SMART goal
      • if you have any doubts or questions you must ask
      • If the professional gets defensive if you ask, find another professional. 
    • Beware

      • Passive therapies for more than a few days (ice/heat/ultrasound/lasers/lights/adjustments/passive stretching)
      • Pain relief procedures and surgeries (cortisone, creams, pills)
      • Doctors who do not live by the very values in which they teach
      • Uninspiring environments 
      • Confusing insurance or payments plans
      • Professionals that aren’t successful and inspirational (success is not money - but a mindset)
      • Professionals that have not been down the path to where your going
      • DO NOT expect long term results without you putting in effort
      • If you're laying on a table and somebody or something is doing the work on you - dont expect the results of that to last more than a few days or weeks.
    • The process is full of challenges and pleasures - and full of breakthroughs

      • The process to living pain-free is a process like a baby going crawling to walking
      • There is a clear process that starts with fundamentals and builds upon them
      • its very difficult to improve a full body movement by practicing more of that movement.  Ex. Improving yoru deadlift by deadlifting more
      • The timeframe to recovery is measured in years, not days or months
00:0000:00

Foods and Supplements to Ease Muscle and Joint Pain

May 4, 2017

Chronic Pain and Reducing Inflammation

Chronic pain is a direct result of inflammation in the body.  SO, what causes inflammation:

  • What we put in the body: food, water, beverages, pharmaceuticals, supplements, drugs, alcohol.
  • What we put on the body: lotions, make-up, perfumes, sunscreen, other chemicals.
  • What the body cant get rid of: toxic load. Anything the body doesn’t need that remains in the system is considered excess and becomes toxic load.  This could be from what you put in the body, to what you put on the body, to what the body is exposed to (environmentally), AND what the cells are dumping but are having a hard time getting OUT of the system.

Best ways to reduce inflammation:

  • Eat organic to avoid herbicides and pesticides which are chemicals that drench our food sources with toxins that create inflammation in the body. Eating a diet comprised of veggies, clean meats (organic, grass fed, wild); low fruits, nuts, seeds, legumes, and grains. Grains are very inflammatory.
  • Start working with an integrative doctor that can help guide you through removing your pharmaceuticals and teaching your body how to be balanced on its own. Usually this will require a supplement region at first to make the transition.  Looking for a knowledgable naturopathic doctor, integrative doctor, alternative medicine doctor, or acupuncturist or chiropractor is helpful!
  • Make sure your water is filtered (what you drink and bath in!).
  • Limit alcohol and sugar intake. IF there are 3 things you could remove from your diet to reduce inflammation it would be alcohol, sugar, and grains.
  • Visit www.EWG.org and see what products are clean vs laced with chemicals. Remember the body heats up to break down these chemicals you ingest or put on the body… excess heat = excess inflammation. Excess toxic load = increase levels of inflammation.

Top 3 nutraceuticals to reduce inflammation:

  • Turmeric, devils claw, boswellia.

Top 3 foods:

  • Ginger, turmeric, garlic.

Drainage remedies are the best. You can only get this seeing a practitioner like myself but its combination herbs and vibrational medicine. The vibrational medicine works like homeopathy to help send a signal inside the cell to help stimulate a detox and removal response. Its super powerful and this is actually how you get to a place where you don’t have to take anything even naturally for maintenance.

Stop taking anti-inflammatories. They stop the type 2 collagen fibers from knitting appropriately and make the repaired areas weaker….

Dr. Michelle Wolford, ND
 

Thanks for Listening!

Have some feedback you’d like to share? Leave a note in the comment section below, and if you enjoyed this episode, please share it using the social media buttons you see at the top of the post. Also, please leave an honest review for MoveU Unfiltered on iTunes. Ratings and reviews are extremely helpful and greatly appreciated!

If you have any questions, email info@moveu.com. And finally, don’t forget to subscribe to the show on iTunes to get automatic updates.

00:0000:00