Reflections

Part 1: How Can Developmental Patterns Improve Your Performance?

Understanding the most basic patterns of human movement starts with understanding developmental patterns and how these patterns build upon each other in a neuro-developmental sequence. Throughout our life it can be advantageous for us to spend time revisiting these developmental patterns to break up compensations and restrictions in movement.

Photo from: On Target Publications

Photo from: On Target Publications

What are developmental patterns?

During infancy, these primitive patterns include rolling over from belly to back, moving away from our base of support we begin to become aware of our spine and how to move a little body under the weight of the head. From here, we learn to crawl then walk.

As adults the most fundamental activities of the human body revolve around simple and basic patterns such as; running, climbing and bounding.

The developmental patterns include the following:

  1. Supine & Prone
  2. Quadruped
  3. Tall & Half Kneeling
  4. Standing

This week is the first of 4 articles in of our “Ground Foundations” programs. Let’s start with the most basic posture, supine and prone. Supine, Meaning laying on your back and prone meaning laying on your belly.

Developmental Pattern #1: Supine & Prone Rolling Pattern

The Spine is designed to move, yet many of us compensate by moving more in one segment and less in another. Moving those segments creates changes to the neuromuscular support around that particular segment. It may free up some muscle tone and allow you to move through your spine a little bit better, but it will not last unless it’s combined with sequential release patterns.

Apart from mobility, we also need to address the other side of the proverbial coin and that’s stability.

Perry Nickleston, of Stop Chsaing Pain states it best; “What is the missing component? Stability – the ability to control movement under change. Uncovering an underlying fundamental stability dysfunction is a critical foundation of functional movement patterning. Going back to primal basics of fundamental movement and core sequencing reveals just how vulnerable a client is to re-injury. In order to discover why clients are in pain, as opposed to just chasing their symptoms, one must look at core function and neural sequencing.

For a more detailed overview of rolling pattern, check out Perry Nickleston’s article “Primal Rolling Patterns for Core Sequencing and Development.”

Simply put, rolling pattern offers us the opportunity to re learn basic flexion and extension of the spine, with the integration of rotation. This can improve our ability to reflexively engage the intrinsic core muscles that stability spine. Moving from upper to lower body-rolling patterns also allows us to differentiate between upper and lower halves.

Upper body rolling pattern helps to bring a greater awareness to the thoracic spine, an area that often lacks the necessary mobility and causes the upper and lower segments of the spine to become sloppy or stiff.

Lower body rolling pattern:  helps to bring greater awareness to the lumbo pelvic hip complex, an area that is usually stiff. The lower back is meant to be stable, but if the hips are not mobile this can cause the lower back to become sloppy and the rhythm of the pelvis will be off.

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Remember that everything in our body is connected, much like a pulley system. Our bones are meant to float in our body, thus we must work to find optimal range in both the joint and their associated tissues in all developmental patterns.

The main role of movement and performance is to sense, adapt and respond to stimulus in a way that saves energy and produces force. This is how movement naturally develops.

However, movement changes over time. Lifestyle habits, postural changes and stress cause significant limitations and asymmetries in our movement and tissues. This significantly increases risk in performance and our health.

Revisiting developmental patterns can be used as a screening tool to help identify limitations and asymmetries. This is what it means to test for durability.

Stay tuned for next week’s article focused on the Quadruped posture. For a complete 4 week program on working through the developmental patterns, please check out and subscribe to Onnit Academy On Demand, on my Durability Channel. The Supine and Prone program starts this September.

Sources:

  • Functional Movement Systems
  • Perry Nickelston, DC, FMS, SFMA, Stop Chasing Pain
  • Onnit Academy Durability

Review: Onnit Academy Durability On Demand

Screen Shot 2016-02-15 at 4.36.32 PMA comprehensive library of tools for joint and tissue health at your fingertips 24/7! There are so many online programs these days for every niche in the health and wellness industry, and it can be hard to navigate which ones are truly best for you and, or your clients wellbeing.

When it comes to mobility and ensuring the health of tissues and joints, it’s important to choose a program that aims at recovery and longevity. Not just standard warm up and cool downs for training days. Recovery is the key to ensuring you move well without pain or restriction for not only the long haul of your sport, but for your life.

Why is joint health so important?

Inevitably, each of us is subjected to the experience of aging and its detrimental impact on quality of life. The degradation of joint and tissue health are a large part of what leads to the increase in chronic pain and reduction in function that people experience.

Why is tissue health important?

Our tissue over time starts to lose it’s viscosity and pliability. This means at the cellular level our tissue loses water and elasticity and becomes stiff over time. What this also means is that as we age, we must take more time and effort to reclaim that lost elasticity and mobility to the tissues that act upon our joints. By addressing mobility issues in both the tissues and the joints we can allow greater access to range and rotation which improves the overall durability of movement.

Prevention versus treatment:
As a corrective movement coach working in both the clinical as well as the performance arena’s for nearly 2 decades, I have learned that prevention is the KEY to longevity to any given sport, and of course in life. No matter what genre of the industry you work in:

– Sports Development
– Bodyweight Training
– Unconventional Training
– Mobility
– Corrective Exercise
– Strong Man
– Endurance
– WHATEVER!

Screen Shot 2016-06-11 at 7.40.47 AMThe one thing every sport, and of course life, has in common is the necessity for optimal recovery and sustaining durability over the long haul.

That is why I chose to create a comprehensive system of recovery strategies that are designed to provide the public with the tools through this systematic approach to maintain and improve the health of your joints and the tissues that support them.

 

Benefits to a Durability practice:

  • Learn to apply the Body Mapping process as a tool to regularly assess the current state of various joints and tissues.
  • Understand the impact of fascial health on longevity and performance.
  • Utilize ground based drills to help increase strength and skill in targeted movement skills.
  • Develop a systematic approach to Decompression as an integral part of a performance enhancement program
  • Release unwanted restrictive tension through the practice of a Restorative Mobility practice.

At the Onnit Academy, we would argue that having the tools to positively impact yourself and others with a comprehensive joint health program is likely to provide the greatest return on investment of any physical activity.

Let me introduce you to Onnit On Demand. As the Onnit Academy Durability Master Coach my hope is that these tools can help identify and address movement limitations, tissue and joint compensations, and even reduce pain.

If you are all about optimizing your health and vitality, and interested in learning how Durability and movement competency can translate, as well as compliment, other movement based systems of training out there, then this channel is for you!

I invite you to take my 4-week challenge.

For $9 a month, you will access to full 4 week programs that help you integrate recovery, decompression and movement preparation into your daily lifestyle. With educational tutorials, an e book and full length follow along videos you will start and end your day restoring movement.

Feel free to contact me at sjamieson@moveolution.com for questions, comments or just a good ole chat!

Subscribe HERE.

Sources:

Onnit Academy Durability

The Science of Movement Part 1: Primal Patterns

Primal Patterns:

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Each of us is born into this world free of restriction with the blueprint to move. As infants, we are asked to earn our stability in the world as we learn how to crawl and then eventually walk.

As adults, the most fundamental activities of the human body should include basic movements such as; walking, climbing, crawling, running and bounding, without pain or restriction.

However, movement changes over time and many of these activities are lost and replaced by exercises in the gym, recreational sport on weekends, and occupational stress from the job with the traditional 9 – 5 profession..

Losing the ability to connect with that authentic movement of primal patterns changes how we move amongst our environment. Movement is really a measure of quality and preparation.

Movement is your gauge. It will tell you when things start to break down. Taking care of the negative repercussions that can occur from the adaptations in training, application of load, and challenging your body doesn’t have to be complicated, but it does need to be practical and transferable to ensure you maintain the quality of life you desire.

Would you ever drive your car if it had a flat tire? Probably not. The same should be said for your body. If our body is the vehicle that carries us throughout our life, should we not take care of it?

Consider some of the common areas people feel restricted in on a daily basis:

  •   Common issues in the foot: People give up their stability.
  •   Common issues in the ankle: People give up their mobility.
  •   Common issues in the knee: People give up their stability.
  •   Common issues in the hip: People give up their mobility.
  •   Common issues in the low back People give up their stability.

It is safe to then say then; that as adults and as we age, we are asked to re-earn our mobility. The number one prerequisite for sensory pathways and learning new skills —proprioceptors and neurological connection—is appropriate mobility.

This loss of structural integrity and lack of range can over load the surrounding tissues creating stiffness, rigidity and a loss of durable elastic movement. Understanding this knowledge, as well as applying mobility tools to your practice provides the energy to keep going in a state of high quality.

Next week we will look at Durability and re integrating tissue and joint health into your daily practice.

Sources:

Functional Movement Systems

Durability Certification at The Onnit Academy 

Part 2: Screening Heart Rate Variability For Improved Health Optimization

Part 2: Screening Heart Rate Variability For Improved Health Optimization

Screen Shot 2015-10-25 at 12.05.44 PMThe autonomic nervous system (ANS) has been carefully developed and improved over the course of our evolution.

The ANS plays an important role not only in physiological situations, but also in various pathological settings. Autonomic imbalance is an increase in sympathetic activity and reduced vagal tone has been strongly linked to chronic pain, disease and illness.

Over the few years, HRV emerged in the health and wellness industry as a means to monitor, assess and test for optimal training and recovery zones in athletes and clients.

In last weeks article we introduced stress and the biochemical changes that can occur in our nervous system when stress becomes intolerable or prolonged. After researching recovery and stress resilience there seems to be 3 key screening protocols that can help give insight into a client’s stress tolerance and training optimization.

These 3 screening protocols were:

  1. Heart Rate Variability (HRV Advanced Analysis)
  2. Sleep Patterns
  3. Resting Heart Rate

Today we feature heart rate variability (HRV) as a simple and practical way of monitoring autonomic nervous system activity.

When looking to improve stress resilience we must consider all the physiological factors that contribute to stress, performance and recovery.

Knowledge is power, and understanding your scope of practice and what you can offer is one piece of the optimization pie. Having a referral network offers you a greater advantage to support your client’s overall health and wellness. Always consider the physiological building blocks. Here are a few we feel are the top building blocks to a client’s success.

Top 10 physiological building blocks:

  1. Central Nervous System & Autonomic Nervous System
  2. Cardio-Respiratory System
  3. Neuro-Muscular System (movement efficiency)
  4. Fascial System Integration
  5. Energy Systems: alactic anaerobic, lactic anaerobic and aerobic
  6. Hormonal Systems & Stress Response
  7. Hydration & Detoxification Systems
  8. Immune System
  9. Brain-Body Loop (Psychoneuroimmunology related systems)
  10. Brain-Body Link (Mental health & cognitive health)

The ANS & Stress Resilience:

Allostasis is our Sympathetic (fight or flight, survival) and Parasympathetic (calming, rest and digest) nervous systems automatic response to external environmental and psychological triggers. These stress responses affect blood glucose, adrenal activation, glucocorticoid/cortisol, testosterone and the digestive system.

In a nutshell, the sympathetic and parasympathetic nerves carry efferent (motor) signals to the heart and afferent signals to the brain for reflex functions.  Parasympathetic nerves slow heart rate through the release of acetylcholine.  Sympathetic nerves accelerate heart rate and force of contraction through the release of epinephrine and norepinephrine from nerve terminals and the adrenal glands.

In a well-rested athlete the body will make micro-adjustments to heart rate based on breathing patterns as well as other physiological processes. The better your vagus nerve innervates your heart, the stronger your vagal tone which is a direct indicator of the health of your sympathetic (fight or flight response) and parasympathetic (rest and recover) nervous system.

HRV has a direct connection to your Autonomic Nervous System (ANS) and can therefore be used to gain insights into your stress resilience and functioning of your overall nervous system.

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Heart Rate Variability:

Basic Heart Rate Variability (HRV) is the degree of fluctuation and change in time between successive heartbeats (also called inter-beat intervals, R-R intervals, N-N intervals, etc.).

HRV differs from traditional resting Heart Rate (HR) that averages the number of heart beats per minute. HRV looks much closer at the small fluctuations of the heart that occur in response to internal and external stimulus.

A high HRV can be an indication of a healthy autonomic and cardiovascular response; and it can also tell you if your client is currently training at optimal levels. Understanding how to build and peak your client, as well as when to program for recovery and de loading is critical to ensure your client is always progressing.

A low HRV could be an indication of age-related system depletion, chronic stress, pathology, or inadequate functioning in various levels of self-regulatory control systems. It can also be an indicator of intolerable volumes in training, which can result in overtraining or undertraining.

A low HRV reading for a prolonged period can also be a red flag. Keeping in mind that HRV is only a glimpse at internal functioning and cannot tell you your client’s glycogen levels, testosterone levels, CNS fatigue, or if there is illness. Therefore, if there is a prolonged low HRV and you have adjusted training volume with no improvement there may be other issues at hand. The largest advantage of HRV analysis is that it can give you the signal that something needs to change or validate that your training volume is optimizing your client’s health.

HRV Technology:

HRV technology makes it easy and practical for any trainer or healthcare provider to implement into their daily routine. In thinking about the hardware and software tools that are currently available, there are many out there but prices range significantly.

The top tested are Omegawave, Bioforce, ithlete HeartMath and Elite HRV systems. They are all best suited for those who want to use HRV monitoring for the “short term reading” application.

At Moveolution, we have chosen Elite HRV as it is the most economical and practical for our business and our clients. The technical support has been exceptional and the design of the online and mobile system is attractive, easy to navigate, collect data and interpret for our clients. All you need is a heart rate monitor strap and the mobile app. 1-3 readings per day to collect the data and our coaches do the rest!

For trainers and coaches interested in knowing more about the application of HRV and integration into your business model, or just for your own health and performance we will be offering an online monthly HRV analysis webinar series in December of 2015. For more information email Sarah Jamieson at sjamieson@moveolutin.com

Next week we will look at sleep patterns and why sleep and restorative rest is integral to optimizing recovery and performance.

Improve Stress Resilience With Breathing

Improve Stress Resilience With Breathing

Screen Shot 2015-10-10 at 10.25.58 AMBreathing is the most simple, yet complex thing we do all day long. It is also one of the most important factors for progressing movement and ensuring optimal recovery. Controlled by our autonomic nervous system; breathing can be influenced by the presence of stress.

Compensations in posture can be triggered in response to emotional stress, injury, poor movement patterning and illness; which can cause breathing to be altered. We can also reverse that; breathing pattern dysfunctions can also cause changes in posture, and movement.

Stress:

Stress changes the very structure and function of your brain. Your nervous system cannot distinguish whether stress is mental or physical, it just feels STRESSED. Therefore, we are asked to consider that perhaps it is not the strongest which survive, but the most adaptable. Darwin was only half correct.

Stress can be positive (eustress) or negative (distress), how we react and respond ultimately becomes the primer for living an optimal lifestyle.

Distress directly relates to high levels of stress that we cannot recover from. This can include overtraining and the physical stress of intolerable volumes or loads of physical stress, as well as trauma and prolonged mental and emotional stress.

Eustress directly relates to positive stress such as; tolerable levels of physical and psychological stress like sport and exercise, meditation and things we enjoy.

Building stress resilience starts with acknowledging where stress is most paramount, then removing any negatives that stand in your way to achieving optimal health.

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A great approach to this is the biopsychosocial model, which offers a general approach to mapping out the biological (which entails biochemical, physiological and genetics), psychological (which entails thoughts, emotions, and behaviors), and social (which entails, work environment, relationships, and cultural) factors, all play a significant role in human functioning in the context of disease or illness, so that you can strive for optimal health. Once you have established some of the most stressful triggers you can start to design coping strategies towards managing stress. Breathing is a very effective strategy and a great place to start.

Breathing:

Two great breathing drills that can be easily implemented into your training is see- saw breath; which aims to teach the ability to breathe more deeply and divide the chest from the abdomen and  the elbow lock breathing pattern; which can be used for to provide more emphasis on the lateral openings of the ribs. The elbow lock variation encourages thoracic opening to the sides of the ribcage, and extension of the thoracic spine. Both will also improve diaphragmatic release.

Breathing encourages the parasympathetic response to kick in; which is your central nervous systems main deep recovery system towards improve allostasis and relaxation to the body and mind.

Here is a link to our Moveolution YouTube Channel and Video on See-Saw Breathing and Elbow Lock Breathing.

Enjoy!

Sources:

  • Elite HRV, adding heart rate variability to improve stress resilience and optimize health.
  • Moveolution, (Recovery)Rx lab
  • Onnit – Durability Certification
THE ABDOMINAL WALL: STRUCTURE & FUNCTION OF WOUND HEALING

THE ABDOMINAL WALL: STRUCTURE & FUNCTION OF WOUND HEALING

Incision and closure of the abdominal wall is one of the most frequently performed; yet least discussed, of surgical procedures. Another often over looked topic is; understanding the rehabilitation process and post surgical care. Placing the power in the clients hands and arming them with the knowledge to self manage the healing process can significantly reduce movement dysfunction caused by scar tissue or change in posture habits and inactivity; as well as, a basic understanding of the timeline for wound healing and wound health.

The structural integrity of the anterior abdominal wall depends upon the rectus abdominis muscles, the muscles of the flank, and the conjoined tendons of the flank muscles that combine to form the rectus sheath. These terms, the anatomy and function were introduced in length in my last article. The rectus abdominis muscle is found on either side of the midline with the pyramidalis muscle lying superficial to the rectus muscle just above the pubis.

Factoring in connective tissue; we mentioned the rectus sheath also forms and intertwines with the superfiscial front line and the deep front lines of the fascia matrix. However, two notable structures are often overlooked when discussing abdominal wall surgery and post surgical care. They are the pyramidalis and the transversalis fasica.

 

abdominal wall 1

The Pyramidalis:

One important muscular structure that is often not discussed in re training/ re patterning post-surgical rehabilitation is the pyramidalis.

The pyramidalis muscles arise from the pubic bones and insert into the linea alba in an area several centimeters above the symphysis pubis. Normally, the precise function of the pyramidalis muscle is unclear and considered to be of no value in the human structure. That is until abdominal incisions are made along the linea alba and near the umbilicus. The function this muscle acts to contact the linea alba, as well as stabilize the pelvis.

Therefore, if scar tissue or adhesion builds up, as it naturally will due to cutting through the abdominal wall and connective tissue, the innervation and nerve response could be diminished. In many patients, I have worked with I have seen Si joint dysfunction and low back pain that was not present prior to surgery. Something to consider in rehabilitation.

Transversalis Fascia 

Deep to the muscular layers, and superficial to the peritoneum, lies a layer of fibrous tissue called the transversalis fascia, which lines the abdominal cavity. It is visible during abdominal incisions as the layer just underneath the rectus abdominis muscles.

It’s importance lies in the nature of it’s structure. The transversalis fascia in its entirety is second in importance perhaps only to the peritoneum as an encasing membrane of the abdominal contents. It acts to reinforce and stabilize the spine, as well as regulate intra abdominal pressure. Where function demands, it thickens and develops its strong elastic fibers to a protective perfection. When there are multiple incisions necessary for surgery, like a laparoscopic appendectomy this wall is perforated and comprised for several weeks to months. Tissue strength is a integral concern and factor in corrective rehabilitation; as well as wound healing.

WOUND HEALING:

Understanding the fundamental processes that are responsible for these functions is necessary to best create and close an abdominal incision and limit the risk of inflection, as well as to understand the complex process of healing post surgery.

Inflection is the first major risk; or failure of the healing process to synthesize adequate quantities of collagen to restore abdominal wall strength.

Psychoneuroimmunology (PNI):  (Pyschological + Neurological + Immunology)

The wound-healing process is a balance between the amount of damage done to the tissue during an operation, and the ability of the body to decontaminate and repair its function.

With any incision, there is exposure of blood and platelets to connective tissue; which ultimately begins the inflammatory response that will sterilize and heal the wound. Psychoneuroimmunology (PNI) plays a critical role in both healing and immune function at the biological and biochemical levels. PNI is the study of the interaction between psychological processes,  the nervous and immune systems of the human body.  Recent work in psychoneuroimmunology (PNI) has demonstrated that stress delays wound healing; which is directly related to the pre and post surgical anxiety and nervousness a patient will ultimately feel.

Greater fear or distress prior to surgery is associated with a slower and more complicated postoperative recovery because anxiety presumably interferes with recuperation through both behavioral and physiological mechanisms. Seems logical enough.

Listening to mindful music for an hour every day can reduce chronic pain by up to 21% and depression by up to 25%, but I will leave that stat for another article.

Our body’s nature inflammatory response

During the initial phases of this process, the small vessels in the region of the injury become permeable to both molecular and cellular mediators of the inflammatory response. First, healing is under the direction of the inflammatory response, as this is essential to eliminating bacteria; as well as immunology. Every person has a unique biological and biochemical healing process; which should be taken into account.

After this initial phase, the polymorphonuclear neutrophils (PMNNs) and wandering tissue macrophages begin their work of digesting damaged tissue, killing bacteria, and synthesizing the chemotactic factors that direct wound repair. These cells lay the groundwork for the later appearance of the fibroblast that will reestablish wound strength.

The next critical factor in proper healing is the amount of necrotic tissue created. Actual repair must begin from healthy tissue. Healing must then begin from the uninjured tissue behind the area of damage.

Collagen & Tissue Strength

The re-establishment of abdominal wall strength depends upon the synthesis of new connective tissue. This is accomplished by fibroblasts and requires, not only the protein precursors for collagen synthesis, but also occurs most rapidly in a normally oxygenated environment where the enzymes and cofactors needed for collagen synthesis are present.

Collagen, the primary structural protein of the body, is synthesized by the fibroblast. It begins to appear in the wound on the second day, as an amorphous gel devoid of strength. Maximum collagen synthesis occurs around the fifth day. It depends especially upon the presence of oxygen, vitamin C, and amino acid precursors.

Maximum strength development does not occur for several months and depends upon the interconnection of the collagen subunits. Approximately 80% of original strength is reached in about 6 weeks; therefore it is recommended that light activity building up to moderate activity are only encouraged after 6 weeks and as long as there is no pain or discomfort.

It is important to recognize that perfusion of the wound is the most important factor in wound healing. Integrity of the microvasculature and flow is responsible for the oxygenation needed for cellular metabolism. Damage to tissue that impairs the delivery of oxygen to the wound increases the number of wound infections and the likelihood of herniation or infection. Which could complicate and impair movement quality in the future.

CONCLUSION:

Empower the patient is first and foremost. Education each client on the complex healing process and concerns moving forward with post surgical care is crucial to not only the healing process but self management on behalf of the client. Understanding tissue strength and the body’s healing process from the inside out is of equal importance when re entering sport, play and or professionals that require manual labor.

Sources:

  • Milloy FJ, Anson BJ, McAfee DK: The rectus abdominus muscle and the epigastric arteries. Surg Gynecol Obstet 110: 293, 1960
  • Cruse PJE, Ford R: The epidemiology of wound infection: A 10-year prospective study of 62,939 wounds. Surg Clin North Am 60: 27, 1980
  • Cherney LS: A modified transverse incision for low abdominal operations. Surg Gynecol Obstet 72: 92, 1941
  • Surgical anatomy of the transversus abdominis and transversalis fascia. Ann Surg. Jan 1971; 173(1): 1–5.

 

 

Getting to the “CORE” of the Abdominal Wall Post Surgery

Getting to the “CORE” of the Abdominal Wall Post Surgery

lap

 

The abdominal wall encloses the abdominal cavity, which holds the bulk of the gastrointestinal viscera. A topic I have grown quite font of over the last couple of weeks, post appendectomy.

It’s structure and function can be broken down into these key areas:

  • Forms a firm, flexible wall which keeps the abdominal viscera in the abdominal cavity
  • Protects the abdominal viscera from injury
  • Maintains the anatomical position of abdominal viscera against gravity
  • Assists in forceful expiration by pushing the abdominal viscera upwards
  • Involved in any action (coughing, vomiting) that increases intra-abdominal pressure

Its structure is complex, yet in most cases we think of the abdomen as merely the “six pack.” When it comes to rehabilitation of abdominal injuries like an appendectomy we should consider this two fold: (1) The Rectus Sheath and (2) The Abdominal Sheath and the Superficial and Deep Front Lines.

 

The Rectus Sheath:Abdominal-Muscles-Rectus-Abdominis

The rectus sheath is formed by the aponeuroses of the three flat muscles, and encloses the rectus abdominus and pyramidalis muscles. It has an anterior and posterior wall for most of its length:

  • The anterior wall is formed by the aponeuroses of the external oblique, and of half of the internal oblique.
  • The posterior wall is formed by the aponeuroses of half the internal oblique and of the transversus abdominus.

But what about the front line connective tissue? Should that not be included when discussing the complexity of the abdominal cavity and strength of the front line connective tissue? Yes!

The Abdominal Sheath & The Superficial and Deep Front Lines:

If we include the superficial front line to the integral working of “the abdominal sheath,” we can see that the entire structure starts at the feet, then travels up the front of the body and all the way to the neck and skull. The Superficial Front Line acts to contract the front of the bod.

The Deep Front Line makes up our myofascial “axial core.” This means that out of all the myofascial meridians, it is the deepest and has the function of maintaining our core alignment and core stability.

The orientation of fibers in the muscles of the left and right abdominal wall; give it strength and flexibility of movement in many directions. By contrast, the fibers of the rectus sheath are oriented for flexing the trunk.

The anterior wall is reinforced by the tough rectus sheath and one muscle. Since the sheath is composed of aponeuroses anchored at the midline, the lateral muscles oppose one another to make the trunk of the body rigid when they contract (for structural support or to increase intra-abdominal pressure).

One other notable fact is that the anterior rectus sheath is complete, but the posterior sheath is deficient (absent) below the arcuate line (linea alba).

mm-superficial-front-line

The layers of the abdominal wall consist of (external to internal):

  1. Skin
  2. Superficial fascia (or subcutaneous tissue)
  3. Muscles and associated fascia
  4. Parietal peritoneum

 

 

“The Core” of An Appendectomy:

What is the appendix?

The appendix produces a bacteria destroying protein called immunoglobulins which help fight infection in the body. Its function, however, is not essential; however there is some evidence to suggest it play a role in maintaining a healthy gut. People who have had appendectomies do not have an increased risk toward infection. Other organs in the body take over this function once the appendix has been removed.

Laparoscopic Surgery:

In most laparoscopic appendectomies, surgeons operate through 3 small incisions (each ¼ to ½ inch) while watching an enlarged image of the patient’s internal organs on a television monitor. In some cases, one of the small openings may be lengthened to 2 or 3 inches to complete the procedure. The notable factor here, is one of those incisions (for me) is directly above my belly button.

How can the incisions affect the function of the superficial fascia?

The superficial fascia consists of fatty connective tissue. The composition of this layer depends on its location:

  • Above the umbilicus: A single sheet of connective tissue. This continuous with the superficial fascia in other regions of the body.
  • Below the umbilicus: It is divided into two layers; the fatty superficial layer (Camper’s fascia) and the membranous deep layer (Scarpa’s fascia). Superficial vessels and nerves run between these two layers of fascia.

The umbilicus is the most visible structure of the abdominal wall, and is the scar of the site of attachment of the umbilical cord. It is usually midway between the xiphoid process and the pubis symphysis.

The linea alba is poorly vascularised, so blood loss is minimal, and major nerves are avoided. All can be used in any procedure that requires access to the abdominal cavity. This is a common site for incision because it can leave minimal scar tissue.

Conclusion:

Understanding the nature and complexity of the human structure can aid in supporting your rehabilitation program. Fiber composition, the body natural inflammatory response, and the body’s ability to compensation post op is equally important to reduce the impact of surgery, as well as reduce the risk of tissue restrictions and movement dysfunction.

When there are alterations made to our structure, even the smallest of cuts changes the way our body moves, adapts and responds. Our viscera is the gateway to our nervous system and when recovering from surgery we must take this into account and begin to rebuild from the inside out.

Regarding rehabilitation, understanding that the tissue around the incision is only 60% repaired for the first 4 weeks after surgery means you should take care when re entering your sport or hitting the gym. Hernia’s are the biggest consideration when returning back to work or sport after an appendectomy. Make sure to consult with your surgeon or GP prior to engaging in physical activity post surgery. Use this as a time to nurture and honor other priorities in your life so that when you do get back to your sport, you are 100% and ready to pick up where you left off.

Next week, we will look at rehabilitation and corrective movement to reduce the risk of movement dysfunction in post operative patients appendectomy.

Sources:

Anatomy Trains

University of Michigan Medical School – Clinical Case, Abdominal Wall

Instant anatomy – Anatomy lecture made easy – Anterior abdominal wall

Empower Women & Girls Globally: Join Walk In Her Shoes Vancouver

Empower Women & Girls Globally: Join Walk In Her Shoes Vancouver

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On Sunday March 9th, 2014 WALK IN HER SHOES 103 KM RELAY Celebrates 

103 years of International Women’s Day

Vancouver’s Sarah Jamieson, founder of RUN4ACAUSE joins forces once again with CARE Canada for the annual Walk In Her Shoes campaign. An annual run event, that aims to empower women and girls globally.

Vancouver, February 1, 2014 – To help break the cycle of poverty and in celebration of the 103 years of international women’s day (IWD), Sarah Jamieson  of RUN4ACAUSE & CARE Canada want to empower Vancouverites to join a Walk In Her Shoes 103km relay team.

Who is CARE?

CARE focuses on global issues such as maternal and child health, education, economic empowerment, adaptation to climate change and emergency relief. The necessities to empowering women, children and whole communities through the ability to live, learn and earn.

CARE Canada’s staff, many of whom are citizens of the countries in which CARE works, help strengthen communities through an array of programs that work to create lasting solutions to root causes of poverty.

What is Walk In Her Shoes?

She needs to walk an average of 6km per day to gather the things she needs to keep her family alive. CARE & RUN4ACAUSE are challenging you to try and experience what this is like. On Sunday March 9th, join thousands of Canadians in celebration of International Women’s Day to empower women and girls to fight global poverty – Join Walk In Her Shoes.

How Can You Help?

RUN4ACAUSE & CARE are challenging Vancouverites to participate in our 2014 Walk in Her Shoes campaign. This 103km relay is divided into 8 relay legs ranging from 10km – 12km in length and each supports a specific CARE project. You can join as part of a team and run or walk at your own pace or become a run ambassador. As a run ambassador, participant or volunteer you inspire your community to help CARE empower women and girls in the developing world.

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Here’s how you can get involved:

  • Sign up to be a Run Ambassador and build a team for your relay leg, supporting a specific CARE project.
  • Join a relay team, walk or run at your own pace.
  • Raise funds to help women and girls fight global poverty.
  • Donate to our cause here and see how your support can impact below

This is your chance to…

  • Learn more about global issues.
  • Become physically active.
  • Inspire girls around the globe.

What Impact Can you Make:

Your support and donation is then leveraged at 3:1 ratios by our Canadian Government; thereby increasing the impact! All projects are instrumental towards empowering women and girls around the world.

How does your donation impact these families?
  • $10 can purchase schoolbooks in a child’s native language for a year.
  • $25 can purchase life saving vaccinations, treatment and micronutrients which prevent a child from diseases like malaria, anemia, and diarrhea.
  • $26 can provide a week long leadership training course to an adolescent girl to help her understand her legal rights at home, work and in the community.
  • $60 can purchase clean water for a family and help build a well.
  • $100 can help a woman start a business.

What The Numbers Tell Us:

  • When women earn an income, they reinvest 90 percent of it in their families.
  • For every year a girl spends in school she raises her family income by up to 20 percent.
  • Educated girls grow into educated women, who have healthier babies and are more likely to educate their children.
  • When a girl in the developing world receives seven years of education, she marries four years later and has 2.2 fewer children.
  • Engaging men, boys, girls, and women can transform gender roles and increase gender equality.

Join today…

To register contact Sarah Jamieson @ 604 789 0203 or Email: sarah@fittotrain.com.

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An “anterior dominant” society

An “anterior dominant” society

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Man’s Not so Great Invention (for our structure):

Over the course of human evolution there has been one invention that is used around the world, yet has de evolved our structure. That invention is the invention of the chair, and with this, our modern bodies have started developing tendencies and compensatory patterns. From the age of grade school we are taught to sit for hours in what we now know to be the hardest position for our structure to hold. The seated position is also the most amount of energy expenditure used and not in a positive burning calories way.

Those of us who are sedentary, or spend countless hours seated at a desk, as well as those of us who are active, seem to migrate to a group of similar mobility and stability problems as we age. Our society overall is what we call an “anterior dominant” society.  Almost everything we do in our lives results in muscle length and stretch imbalances, sloppy and stiff joints and as a result our daily posture compensates.   Many injuries have been linked to these structural changes ranging from cervical and occipital ridge headaches, to shoulder impingement or dysfunction, to low back pain and herniated discs, to mal aligned hips to plantar fasciitis. All apply.

One of the most significant tendencies I see in my practice is less than optimal mobility in the thoracic segment of the spine, rounded shoulders, forward head carriage and poor posture overall. At the least 80% of clients have some form of low back pain, and this usually comes with a concurrent trigger of pain or soreness in the upper neck and shoulders. It’s the chicken or the egg complex really. Pain changes movement. Which one came first? Most often, we don’t know, but what we do know is that addressing the major point of dysfunction is key, and that we must also address the joints above and below.

The T-Spine & Posture:

The thoracic region has a tendency toward stiffness and rigidity and most often could benefit from greater amounts of mobility and flexibility. The architecture of this region is designed for support, but poor postural habits can promote stiffness and then decrease the body’s natural ability to rotate. When this happens the joints above and below the thoracic region can become sloppy, less stable and this increases the client or athlete’s risk of injury. We need to ensure we do not just address these symptoms, but follow the breakdown of the whole chain and consider the rest of the structure, by looking at both a lack of optimal mobility in the T-spine, but also the instability of the lumbar and shoulders (the joints above and below).

A Functional Approach:

Changes in posture over decades cannot be reversed in a short period of time; we may not be able to change posture right away, but we can remove any negatives and poor postural habits at work, and in daily activities.  This requires a combination of therapeutic approaches and models, some of which could include:

  • Functional assessment of structure and compensation
  • The funcational opposite – postural positions that provide decompression and relief to the client
  • Lengthen shortened muscles
  • Release postural trigger points
  • Inhibit overactive muscle groups
  • Activate inhibited muscle groups
  • Strengthen synergistic force couples
  • Normalize proper joint biomechanics and arthrokinematics
  • Dynamic Neuromuscular Stabilization (DNS)
  • Corrective Intervention Strategies for pain management
  • Client education and management resources

Yoga and Therapeutic Movement:

As a yoga teacher and movement specialist, after I have assessed and evaluated my client, we move onto our corrective strategy; which will usually include addressing 1 or 2 dysfunctional patterns that have the highest risk factors, and we do so by implementing corrective exercises into their daily prescribed program.

Here is one of the key stretches/ yoga poses I offer clients who require more spinal mobility and postural change.

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Yoga: Cobra Pose

One of the first stretches we give to clients when addressing postural imbalances and thoracic limitations is cobra pose. This particular pose focuses on the second bulleted point above; “the functional opposite.” If you spend hours seated in that anterior dominant position then this pose if a great way to decompress the structure and improve thoracic extension. Once you have achieved better extension and reduced tension in the front and back lines, thus making it much easier to move into rotational patterns.

                              Seated Posture           Cobra Pose

Head                          Flexed Forward            Extended Back

Upper Neck              Flexion                            Extension

Lower Neck              Flexion                            Extension

Shoulders                 Round Forward            Back / Packed

Thoracic Spine        Flexion                            Extension

Lumbar Spine          Flexion                            Extension

Hips                           Flexion                           Extension

Knees                        Flexion                            Extension

Ankle                        Dorsi Flexion                 Plantar Flexion

 

Extension exercises are often used in therapeutic approaches to rehabilitation, but this is an exercise I give to all clients who may not experience low back pain, but spend many hours seated throughout the day. Prevention of injuries is most important in the hustle and bustle of our society. Once you have increased extension in your thoracic spine, you can then start to move onto rotational exercises and stretches to improve mobility. Next week we will look at rotational exercises for improving t-spine rotation, as well as how this can affect the lumbar region and shoulder regions of our body.

Own Your FORM: Linkage vs Leakage

Own Your FORM: Linkage vs Leakage

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The human body is a system, a machine, and like any system they can leak energy if not properly tuned up for peak performance. In Movement Coaching this term pops up a lot regarding the join by joint approach. In kettlebell and clubbell training this refers to properly locking out joints to reduce torque and undue load, as well as force leaks.

Most of corrective movement is based on addressing compensation and dysfunction in the body and looking for these leaks in the system and in movement.  One of the most important aspects of movement coaching is addressing the joint by joint approach and educating clients on the importance of this concept. Looking at how one joint works in conjunction with another can improve overall performance and connection to the tools they use for strength gains, as well as preventing injury.

Definitions:

Linkage refers to the structure; our mechanics working in an efficient and effective manner, joints packed, and tissue ready, moving without pain, without compensation or dysfunction. When our joints and systems are linked, we move with effective energy output, and with synergy.

Leakage refers to the opposite, where our structure performs inefficient movement, usually due to dysfunction or compensation in the body. The systems and joints do not move as they should and thus performance and energy is reduced and less efficient. Most often this occurs without the client or athlete’s knowledge, increasing the client’s risk of injury.

Coaching Linkage:

I encourage clients to look at the structure as a system of links; from hands to feet, inside to outside and to use this visualization every session as a sort of check list to avoid potential injury, avoid leaks (which over time can lead to injury), and to avoid decrease in performance. The joint by joint approach teaches athletes to look at the body as a whole system vs a compartmentalized system.

When you teach proper technique or address correcting a client’s lifting who’s been performing compensated patterns for some time, we have to consider and address what happens to their training lifts. The answer is that to move from leakage to linkage their performance output for a short time will almost certainly go down temporarily, but it is absolutely necessary for long-term sustainability and performance gains.  You are building a foundation for progress and crisper movement.

In Gray Cooks Athletic Body in Balance, Gray discussing this linkage vs leakage as the following:

“It is possible for an athlete to perform well even when poor form is used, but eventually the athlete will experience breakdown, inconsistency, fatigue, soreness, and even injury.

It should be the goal of the training program to create efficient movement in the activity. This will conserve energy, keep the athlete relaxed, and allow the athlete to practice more and compete with less stress.

The problem is that poor form may be easier, more familiar, and more comfortable, and it may even seem to take less energy than proper form. Proper form, however, will take far less energy in the long run.

Poor form, even if it leads to some initial success, will eventually rob the athlete and cost far more time and effort than what is required to fix the weak links. Poor form can incorporate less overall muscle activity and therefore seem easier, but don’t confuse this feeling with efficiency.”

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The Deadlift: Shouldering Responsibility

As an example of linkage vs leakage we will look at the mechanics of the deadlift; which not only includes the hip hinge, but the mechanics of the shoulder complex as well; which is greatly overlooked. We can explore this importance in the 2 phases of the KB deadlift; the “Lift” and the “Unload” phases.

The Lift:

The three directions in which forces are applied to human tissues are compression, tension, and shear in the deadlift . In a lift such as the weight being lifted and center of mass of the upper body and arms are a relatively long way from the vertebrae, and this creates torque (moment of force) that is transmitted to the lumbar vertebrae. Although the vertebrae are a collection of joints, we can visualize that the disc between lumbar vertebrae 4 and 5 is the center of rotation for this force and thus must be managed to ensure prevention of injury and proper distribution of load.

Coaching clients on locking the surrounding joints is an effective tool of bringing attention to possibility of leakage and replacing it with linkage. Locking the joints can act as a tool to visualize a “power source” in the locked elbow. It sends “energy” up the forearm and down into the shoulder. Simultaneously the arm is “growing longer” towards the kettlebell and “pressing hard into the shoulder socket”.

Very quickly the athlete or client will realize that the strength of his shoulder complex and lats in the deadlift is significantly dependant on the locking of the elbow and wrist because even if there is a minor bend in the elbow, the shoulder will destabilize and there will be a loss of control with minimal engagement of the lats .

How about the scapulothoracic complex? The mechanics of this complex are crucial because if the scapula does not perform efficiently there will be leakage in shoulder packaging.  In the scapulothoracic complex, there is only one boney connection of the scapula to the entire axial skeleton (rib cage or vertebra) and that’s at the sternoclavicular (SC) joint. This is where the top end of the collar bone and sternum meet. The acromioclavicular (AC) joint and the SC joint are at each end of the collarbone connecting the shoulder girdle to the rest of the body. But that poor scapula is floating on the rib cage, held in place mostly by muscles and by two joints that aren’t much bigger than the joints in the index finger will result in leakage.

Cueing on how to engage and pack the shoulder effectively can greatly improve an athlete’s success in the deadlift pattern. When your structure has increased stiffness, this ultimately improves the transmission of the force up the chain with minimal waste and minimal loss of energy. The lift becomes much easier and flawless.

The Unload:

Once the athlete has lifted, the eccentric phase of lowering the weight is often not a focus point and where the athlete is fixated on the lift, the unload phase they can reduce efficiently by letting go of shoulder pack or losing mental fortitude. I coach clients to process the deadlift in two phases and we use verbally cueing for both. Pressing the KB “down” as you deadlift the KB up is a great way of ensuring linkage in the lift, but also coaching the athlete to stay stiff as they unload  the body around the trajectory of the bell, moving through the hips will trigger more lat lock which then helps stabilize the shoulders more importantly the spine.  The shoulders don’t move much during deadlifts–they stay back and down without protracting. The ankles, knees, and hips move and the arms “slightly” rotate in the shoulder joint, but the shoulders themselves do not round forward. This is what is meant by linking joints.

This is a process of not only restructuring mechanical patterns, but patterns within the brain. Muscles and tissue don’t just “leak” efficiency; they are trained to do so.

A great demonstration of how to coach “linkage” can be found in this video by Gray Cook: http://www.youtube.com/watch?v=ile7azMZpLA

Conclusion:

Not only does the “leakage” reduce the power of an athletic move but also it increases the stress on the joints. Replacing “leakage” with what Dr. Stuart McGill calls “linkage” is central to any system of strength training and or corrective movement. Whether that be training with kettlebells, Olympic lifts, clubbells sports, endurance athletics or yoga; making the connection to linking joints and systems will result in improved performance and reduction of risk overall. There is always the possibility of sacrificing form for output and this leaks the body of energy and potential; therefore, ensuring you are practicing proper technique for crisper coordination and movement.

Our Connective Tissue, The Weather & Changing Pain

Our Connective Tissue, The Weather & Changing Pain

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There has always been a relationship between changes in weather and body aches and pains since the dawn of time (or at least since we became aware of the fascia system and moved away from the equator). The earliest recording dates back to the classical Roman age.

 Hippocrates was the first to write, in 400 B.C., that many illnesses seemed to be related to changes in season. The majority of people who suffer from conditions such as arthritis, fibromyalgia, connective tissue disorders, and even those who have suffered structural injuries, like hip replacements, knee replacements, even witt post deployment and shrapnel recovery; all report findings address the feeling of severe or less commonly moderate pain when a weather front is approaching. These symptoms can also occur when the humidity level and or precipitation levels change. Much can be said about the impact of weather on our system as a whole.

Stiff neck, tight shoulders, and pain in the hip, low back and/or knees: You might be thinking it’s your joints, but it’s actually most often connective tissue. Fascia is a webbed, interconnected matrix, that acts like a sleeve that holds muscles, tendons and joints and ideally your bones and skeletal frame. It connects to our adipose tissue via our superfiscial fascia lines, holding the shape of our body and interacting with our nervous system.  As well, as our deep fascia, the thick white fibrous tissue that connect muscle to bone and then our visceral fascia, much like a spider web that encases our organs and co-mingles with our structure.

Jill Miller, a renowned Yogi and functional teacher, once said;

 “Fascia is your body’s soft-tissue scaffolding. It provides the matrix that your muscle cells can grow upon and it also envelopes, penetrates and surrounds all of your joints.”

According to the American Journal of Medical Sciences in 1887, the very first publication of documented changes in pain perception associated the weather with this change in body sensation and pain.  This case report described a person with phantom limb pain who concluded that “approaching storms, dropping barometric pressure and rain were associated with increased pain complaints.

Many of my clients who have had hip and knee replacements, also exhibit changes in structure, like tightness and stiffness in the coming of Fall and Winter, as well as those who are more susceptible to aches and pains, like those who a higher percentage of pain receptors and or chronic pain conditions.

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The historical Lineage:

The term “rheumatism” was one of the first “terms” placed on this kind of condition and it is still used in conventional speech and historical contexts, but is no longer used in medical or technical literature. The term “Rheumatic Diseases” is used to refer to connective tissue disorders, but the scope is so very broad and we are constantly learning more and more about the connections of our fascia, nervous system and other systems. Although these disorders probably have little in common in terms of their epidemiology, they do share two primary and foundational characteristics, which cannot be overlooked.

They are:

1. Can cause chronic (though often intermittent) pain, and they are difficult to treat because we still do not have a prescribed standardized direction, or assessment for proper treatment in our healthcare system.

2. Collectively, very common – 1 in 4 Canadians will suffer chronic pain at some time in their lives; which is why there are many great organizations; Pain BC is one at the top of my health and wellness food chain; which focuses on programs, services and resources for people in pain, but also works with health practitioners and our heathcare system to educate GP’s and professionals who work with chronic pain patients one on one.

Case Studies:

There has long been said to be a link between “connective tissue” pain and the weather. There appears to be no firm evidence in favour or against, apart from the ramblings of scientists, as shown above in the 1800s. Yet in 1995 a questionnaire given to 557 people by A. Naser and others at the Brigham and Women’s Hospital’s Pain Management Center showcased barometric changes and pain. It concluded that “changes in barometric pressure are the main link between weather and pain. Low pressure is generally associated with cold, wet weather and an increase in pain, because of the fact that they restrict movement. Studies have shown that changes in barometric pressure and temperature may increase stiffness in the joints and potentially trigger subtle movements that heighten a nociceptive response. Cold also slows down fine motor control and motor skill. This kind of alteration to our structure may be particularly problematic in inflammatory joints whose receptive and sensitized nociceptors are affected by movement overall.

Clear, dry conditions signal high pressure and a decrease in pain. We all know that when we are warm, we move better, and we feel better overall. Here are a couple great resources for people who not only have chronic pain, but also for those who are more sensitive to the weather and aches and pain.

Therapeutic Treatment:

Many of the clients I work with suffer from mild to acute chronic pain, yet many of them can attest to the fact, that in warmer weather, they feel better. As a Yoga Teacher and Movement Coach I understand that when a client feel pain, they immediately want to stop moving, stop all activity and this, in itself, can be isolating. One of the key foundations I focus on, is to keep moving, keep staying active. In many of my posts I discuss the difference between “rest”  and “relaxation,” the body requires both, but it heals best, not in “rest,” but in a natural state of relaxation. I have found two forms of gentle relaxation and movement; to be successful in many of my clients, including myself are what i like to classify as an internal and external relaxation. Now, both stimulate internal healing and both focus on connection with our external… but when I say “internal” and “external,” I am referring more to the benefits of on the systems, and it is a great way to educate clients on the physiology of changing pain and how everything in our body is connected.

They are the following:

Internal Relaxation: Infrared Sauna & Eucalyptus Steam:

Infrared rays are one of the sun’s rays. Infrared rays are the healthiest, penetrate into your skin deeply and they dissolve harmful substances accumulated in your body. The Infrared Rays vitalize your cells and metabolism through the stimulation of sweat glands, as well as vibration. When infrared waves are applied to water molecules (comprising 70% of our body) these molecules begin to vibrate and this vibration reduces the ion bonds and the eventual breakdown of the water molecules causes encapsulated gases and other toxic materials to be released. One of my favorite spots to go is Spruce Body Labs on Richards, it’s like a weekly spa visit with all the perks of self compassion (notice how I did not say self indulgent)!

Eucalyptus steam works much the same as the detoxification process,but it is a wet vs a dry sauna, and does not offer you the benefit of the infrared rays. However, what it does offer you is the healing benefits of eucalyptus.  Eucalyptus steam inhalation is recommended by many alternative practitioners for relieving nasal congestion and sinus congestion, usually from colds and flu, as well as healing tissue. .Toxic substances build up in the soft tissues of the body over time. Without a proper flushing of these toxins your muscles and connective tissue can become sore, create adhesion’s and stiffness and bind together; which reduces movement and increases tight, toned tissue.  The more you perspire – or sweat – the more toxins release from your body. I use a eucalyptus steam once a month to release any nasal and respiratory congestion. Beverly’s spa on fourth avenue in kits, is an amazing spot and it’s kiddy corner to YYoga, combining a class and a steam after – brilliant.

Both stimulate your internal organs and tissue to “sweat it out,” release toxins; which reduces stress, improves metabolism, accelerates healing, eases muscle soreness and tension, enhances heart function and improves connective elasticity.

External Relaxation: Warm Yin, Yin & Restorative Yoga:

Yin Yoga postures are more passive postures which are mainly performed on the floor, where the body and mind can be still The majority of postures equal only about three dozen or so, much less than the more popular yang like practices. Yin Yoga is unique in that you are asked to relax in the posture, soften the muscle and move closer to the bone. While yang-like yoga practices are more superficial, Yin offers a much deeper access to the body. It is not uncommon to see postures held for three to five minutes, even 20 minutes at a time. This style of yoga is very beneficial for clients who have pain, because it allows them to ease into the form and function of the pose. In my YogaFORM sessions with clients, I combine a Yin style practice with Qi Gong and elements of gentle movement sophistication flow sequences to gently open tissue and open the awareness of systemic integration. In the Fall and Winter, this can be very therapeutic for those who are affected by the colder months.

 

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Resources:

Pain BC – Pain BC works toward an inclusive society where all people living with pain are able to live, work, play, relate, and learn with confidence and hope, and without their experience of pain being a barrier to pursuing their lives, through:

  • Reducing their pain and mitigating the impacts of their pain on all aspects of their lives and their families’ lives
  • Accessing the pain management resources that they need, ranging from prevention to self management, and early identification and intervention to more complex and long term pain management programs

Ted Talk – “Elliot Krane: The mystery of chronic pain”

” We think of pain as a symptom, but there are cases where the nervous system develops feedback loops and pain becomes a terrifying disease in itself. Starting with the story of a girl whose sprained wrist turned into a nightmare, Elliot Krane talks about the complex mystery of chronic pain, and reviews the facts we’re just learning about how it works and how to treat it.

At the Lucile Packard Children’s Hospital at Stanford, Elliot Krane works on the problem of treating pain in children”.

Link: http://www.ted.com/talks/elliot_krane_the_mystery_of_chronic_pain.html

 

Sources:

Pain BC: http://www.painbc.ca/

Spruce Body Labs http://www.sprucebodylab.com/

Beverly’s on 4th: .http://spaon4th.com/

ABC.net: http://www.abc.net.au/health/talkinghealth/factbuster/stories/2013/06/11/3779124.htm

Part 2: A Hero’s Journey and Back from PTSD: Captain John Croucher, Platoon Leader of the PPCLI First Battalion

Part 2: A Hero’s Journey and Back from PTSD: Captain John Croucher, Platoon Leader of the PPCLI First Battalion

ENDURING FREEDOM

Officers endure 25 kilograms of body armor, a Kevlar helmet and a tactical vest gleaming with weaponry, heavy equipment on their backs, and regular army issue sunglasses and scarves pulled up over their faces to protect against the dust that seems to billow out of every crevasse; where our Canadians are deployed to the Afghan landscape, moving across the desert like sand-colored, camouflaged characters from a mainstream movie flick.

In 2006, the Canadian Armed Forces deployed approximately 2,500 Canadian Forces personnel to Afghanistan; of which 1,200 comprised the combat battle group. Platoon commander Capt. John Croucher — Captain John to his troops or simply “The Sir” was assigned to the the PPCLI First Battalion.

The Princess Patricia’s Canadian Light Infantry (PPCLI, generally referred to as The Patricias)  is one of the three Regular Force infantry regiments of the Canadian Army of the Canadian Forces. The 1st Battalion, Princess Patricia’s Canadian Light Infantry (1PPCLI) is a mechanized infantry battalion and uses the LAV III (light armored vehicle) as its primary fighting vehicle, used to patrol and survey. The battalion is made of four rifle companies, one support company and one command and support company.

I met Captain John Croucher in 2007, after his deployment as part of his rehabilitation treatment. It was a day I would never forget, and his personal story is one that I continue to carry with me. His bravery, courage and strength go beyond the call of duty and his ability to endure and persevere after severe injury and occupational stress are a tribute to what the make and model of a solider should strive to be. What always struck me the most was how humble he was, how open he was about his experiences, and how his thoughts were always for his men – their health and well-being, pre and post deployment – always for  his team, his platoon. He  put others first; it was and has always been one of his most endearing qualities.

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The Art Of War:

Most of what we know of war, what we “think” of war; is not what is all encompassing of war. For those of us who never step off the comfort of our own soil in our own backyard, our representation of combat is merely what we see in the news, in the media or in movies. We cannot fully appreciate what it truly means to go to war, what it means to lead men into battle, to be responsible for their lives and your own and more importantly, to put your life on the line for your country – for the security of your family. Yet, Captain Croucher does and during my year and half as his movement and rehabilitation coach; he confided in me several times about the war in Afghanistan, what it was like and his role as platoon leader.  I had always had a yearning to serve my country and have always respected and honored the code and community of our military and law enforcement officers, hearing these stories were at times comical – boys being boys, very GI Joe, and other stories of hardship. It is no easy take being a solider. It is a discipline and a family unlike any other. One routed in…  “one for all.”

Afghanistan has always been an ancient focal point of the Silk Road and a passage or  human pilgrimage, since the dawn of time. Three decades of war made Afghanistan one of the world’s most dangerous countries and with this comes a dangerous place for civilians and villagers as well to reside.

Captain Croucher’s duties; not only included platoon leader, but included communications, negotiations and meetings with district governors, village headmen and local police chiefs, when and if necessary and most often these took place in village mud huts, open orchards and the occasional office. However, I have been told these “offices”  are far and few between. The national drink of choice is chai or sweet hot Afghan tea, and by the sounds of it Captain Croucher drank a lot it on his deployment.

In a Globe and Mail Interview with journalist; Christie Blanchford, Captain Croucher confided;  that many elders are frightened of the Taliban, many villagers do not want trouble, and allow whomever to come into their houses late at night demanding food and shelter. They really have no say in the manner. This is no way for anyone to live. Any country where the lines between law and human rights are blurred, people live in fear, they are afraid for their lives and those of their families.

“Some of them might be sympathetic to the Taliban, but most of them aren’t on anyone’s side. These people just want to be left alone.” – Captain Croucher.

Canada in Afghanistan:

Canada has always been a strong supporter of the United Nations Peacekeeping, and has participated in almost every mission since its inception. These efforts are focused on four priorities: (1) investing in the future of Afghan children and youth through development programming in education and health; (2) advancing security, the rule of law and human rights, through the provision of up to 950 CF trainers, support personnel, and approximately 45 Canadian civilian police to help train Afghan National Security Forces; (3) promoting regional diplomacy; and (4) helping deliver humanitarian assistance.

Canada’s role in 2006 (and all deployments over-seas) is not always just combat related, but includes elements of peace keeping and supporting and protecting the civilians; their needs range from a new water well to such basic supplies as blankets and food. Reporting back the needs of the village was also part of Captain Croucher’s position; this helped to bridge gaps, keep the peace and formulate Intel.

At the young age of 33, confident and in peak physical shape; Captain Croucher seemed invincible and his team respected him highly. The name “The Sir” is a testament to that honor and respect. With considerable pride, John spoke with confidence, that he had been deployed with 38 guys, and with 38 he returned to the mud-walled compound every patrol that Alpha Company of the 1st Battalion, Princess Patricia’s Canadian Light Infantry they then called their home away from home. Day in and day out they would patrol. Captain Croucher would always say patrolling is a necessary evil, and IEDs are always on their minds. Officers know the danger, yet no matter how much training one undergoes to prepare for combat, you never really can prepare enough. Always be ready, always be on guard.

May 25, 2006:

May 25th 2006 was not unlike any other patrol day; the officers went through their daily checks, headed out, but it was on this day that Captain John Croucher’s world would change. On May 25th, Captain Croucher’s LAV was hit by an IED; which this would be the third to hit Alpha’s second platoon. This strike left Captain Croucher severely injured. His recount of that day are words I find it hard to read. This excerpt is taken from an interview with The Globe and Mail’s journalist Christie Blanchford (2).

“My first push with my arms immediately told me that I was getting no help from my legs. I pushed myself out and onto the back deck of the LAV.

“I was on fire, the right side of my body from toes to mid-body was on fire. I tried patting myself out when I noticed that my right hand was burned extremely badly. I was having no luck putting myself out, and knowing that the guys were on the ground, I rolled myself off the car, falling to the ground some eight feet, where the guys noticed me and started to put out the fire.

“The pain was incredible but the crew had a stretcher beside me in no time. Within seconds I was rushed back to the safety of cover behind a G-wagon, all the way demanding to know how many guys were hurt, very concerned about these numbers and the possibilities as I watched the vehicle go up in flames. The checks confirmed that everyone else was okay, non-life-threatening injuries only. My only thoughts were for my crew. Myself, I took the worst of it, but that’s the way every commander would want it: Keep the men safe.” 

Captain Croucher’s injuries included first- and second-degree burns from ankle to hip on his right leg and on his hand, as well as a broken fibula and tibia. His right ankle was literally a shattered mess, where he had to undergo eight surgeries at three different hospitals in three different countries; the first a Canadian-led base hospital at Kandahar Air Field, the second at a U.S. military hospital in Landstuhl, Germany, and finally the third in Canada at the University of Alberta, and to top it all off  a shattered heel and a large puncture wound from shrapnel; where 70% of his lower limbs had significant reduced motor control and atrophy after the long stint in the hospitals.

When I started working with Captain Croucher he had difficulty walking, and performing basic movement patterns like bending at the knees into a hip hinge, or rotational patterns that required the ankle, knee and hip to work together. The neuromuscular control had to be re built from the ground up and from the inside out. Restoration of muscular strength, stability of the neighboring joints, and mobility/ degree of freedom in lower quadrant was the primary focus of our rehabilitation.

As tough as a man is, no matter how resilient they are, that sort of traumatic experience can leave a any man scarred psychologically and Captain Croucher had a long road of recovery ahead of him. The physical trauma; albeit long and arduous for Captain Croucher, was not the major obstacle. Captain Croucher knew shortly after his injury that the major barrier would be overcoming the sheer horror of the experience and mentally and emotionally processing it all.

ptsd 1

The Nightmare of PTSD:

After a month or so from the attack, after the haze of pain killers started to wear off; Captain Croucher started to make a list of the “things to do” to get back to active duty. “The Canadian Armed Forces has screening protocol in place for post deployment, mental health screening. I knew a month or so after that I could be suffering from PTSD and I wanted to get the best treatment I could, so I could get back to active duty,” he said in a phone interview with me. “

Captain Croucher went on to say in our interview several weeks ago; “there is still a lot of stigma attached to being labeled with PTSD, and many officers do not come forward. The CAF (Canadian Armed Forces) were not ready for the amount of injuries coming back when we first deployed officers to Afghanistan, therefore we just  didn’t have enough professionals to go around. After 2006, the CAF implemented better strategies, mandatory post deployment mental health screening, and consult with leaders in these fields. ”

Captain Croucher had always been a step ahead of the rest; a loyal military and family man, a great friend, and someone who always stressed being proactive and diligent in the face of adversity.During the early stages of his treatment, Captain Croucher knew Vancouver had some of the top resources for treatment so he put in for a transfer.

After Captain Croucher’s transfer to Vancouver he started his treatment with a Vancouver based clinical psychiatrist, by the name of Greg Passey; who, Captain Croucher said was instrumental in his treatment and moving forward with overcoming PTSD. Mr. Passey has spent over 22 years in the Canadian Forces as a Medical Officer in Canada, Norway, the United States, and Rwanda, specializing in PTSD, occupational stress disorders/injuries.

Captain Croucher also received support and treatment through the 39th Brigade, composed of Canadian Forces (CF) and Primary Reserve units, all of which are at the 39 CBG Headquarters located at the Jericho Garrison on West 4th Avenue. For his physical treatment and rehabilitation, I was honored to support Captain Croucher with weekly movement and yoga classes, and he continues to be a good friend and someone I admire greatly.

Now, more than ever Canadian soldiers are coming forward to make claims for psychiatric disabilities, such as post-traumatic stress disorder. Captain Croucher noted that there has also been a large concern within the military on officers claiming to have PTSD and associated stress disorders for disability insurance. Since mental health is subjective and we do not yet have wide spread standardization for screening, treatment etc it can be difficult to navigate the system on your own and it can also be hard for professionals to diagnose.

Back in the Trenches:

Today, Captain Croucher is back in Edmonton with the PPCLI officer working at 1CMBG;  in the light infantry battalion, they are trained in a variety of insertion methods (parachute, helicopter, vehicle, boat, and most importantly by foot) and in a variety of complex terrains (e.g. urban, mountains) that would prove difficult for mechanized forces. Most recently, Captain Croucher was deployed a little closer to home –  to Calgary to help support rescue and emergency response during the latest flood.

cfa

For those who struggle with significant life challenges, who have seen and experienced beyond the normal range of trauma, those who live each day with chronic pain – there is hope. If you are a returning vet or a family member of a returning vet  I would encourage you to ensure there are no mental health risk factors. This can be performed with a professional or you can take the self-test located (here), through the PTSD Association.  The stigmatization and labels that come attached to “the invisible wounds” are of immense magnitude. Unfortunately we live in a society that does not acknowledge the deep wounds that cannotbe seen. But this is changing as rapidly as the numbers of people with PTSD are increasing and more people are speaking out and telling their stories. Hero’s like Captain John Croucher.

Happy Canada Day!

 

Sources:

(1)     Canadian’s In Kandahar – National Post

(2)     “Absence from his men adds salt to his wounds;” by Christie Blanchford, Globe and Mail on July 14 2006 http://www.theglobeandmail.com/news/national/absence-from-his-men-adds-salt-to-his-wounds/article1106075/ Christie Blanchford: cblatchford@globeandmail.com

(3)   The book “Fifteen Days” by Christie Blanchford

(4) PTSD Association – http://www.ptsdassociation.com/about-ptsd.php

Fall in Love with Flying at che baba’s Yogasilks!

Fall in Love with Flying at che baba’s Yogasilks!

Recently, I had the outstanding pleasure of attending a 2hr Sunday session of “Yogasilks” at che baba, yoga and cantina, 603 Kinsgway in Vancouver. It was the most fun I have had in a yoga class since I tried my first partner yoga class last year and got the taste for “flying” poses.

And fly you will! Led by the uber-talented kiwi-born Vancouver teacher, Yogasilks founder and long-time yogi, Ross Howatson, this class hosted 10 fresh-faced and excited beginners to Yogasilks and we had an absolute blast.

Suspended from “silks” – think: long, stretchy, silky sheets tied at two corners –  suspended from the ceiling, students are led through a series of yoga poses ranging from Warrior 1, Trikonasana, hip openers, heart openers, core strengtheners to breathing exercises, relaxation and gentle inversions.

With an adventuresome group ready to take on the thrill of the silks, we were challenged with a few fun and crazy cirque-de-soleil-esque moves: fallen angel (sees you threading through and dropping out of the silks – safely though!), handstand (with legs threaded through the silks – what an amazing experience!) and a few more inversions (think Sukasana, easy pose, but upside down and dangling). Ending class coccooned sweetly in the silks with a guided relaxation, I left feeling settled and grounded. Not to mention, my hips, legs and back felt amazing all week!

Ross did a brilliant job of encouraging, humouring and challenging the Yogasilks students. I would strongly recommend this 2hr workshop to anyone who loves hanging around, playing, having fun and trying something new in your yoga practice.  I fully intend to be back on a regular basis!

After the workshop, the participants all enjoyed tapas at the attached cantina. The food is simply incredible. A sweet little spot, che baba was started by a young local couple, Allison and Stephan, who love sharing yoga, great food, and creating community.

Try Yogasilks. Seriously. Bring your friends. You will fall in love with Ross, the silks, che baba and the whole experience.

Che baba runs 2hr workshops on Sundays (first two weeks of August cancelled for trainings), which are a great introduction for beginners. The studio runs a regular Yogasilks drop-in class during the week, which will start back in the fall. In the meantime, che baba also touts a full drop-in schedule of other classes, which would be a great excuse to do some yoga before enjoying a meal at the cantina!

Love the idea and want to get teaching it? Yogasilks classes are currently in development at other studios and teachers will be needed! Che baba only has a few spots available for Yogasilks Teacher Training, Aug 11-12, 9am-5pm (delicious lunch provided by the cantina), $640+hst. For more information please contact Ross Howatson at yogasilksinfo@gmail.com.

Make time for Yogasilks in September and enjoy flying and hanging around! Please comment below if you have already attended a session and let me know about your experiences!

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