About Sarah Jamieson

http://www.moveolution.com

Sarah is the owner and head movement coach at Moveolution; a Vancouver based consulting company focused on the integration of movement and recovery science. Bridging the gaps between the clinical and performance fields Sarah’s passion stems from lifelong passion of Yoga, Jujitsu, and Qi Gong; which she integrates into her coaching practice. She is a full time social change maker, a ‘run-a-muker’ of everything outdoors and repeatedly engages in random acts of compassion.

Posts by Sarah Jamieson:

Don’t Let Your Tissue Get Uptight:  Tone Vs. Tightness

Don’t Let Your Tissue Get Uptight: Tone Vs. Tightness

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As a movement coach, the question of “what is the difference, between tone vs tightness” is a common occurrence and one that is of significant importance to those who suffer the burden of chronic pain and compensatory dysfunction. To better understand, not only the difference, understanding how to identify the different are key factors that can make or break your intervention strategy.

First order of business is looking at the tools for assessing and screening dysfunction and compensatory movement:

The FMS and SFMA:

The FMS and SFMA protocols are tools used to capture movement dysfunction at the level of the pattern and then address whether the limitations are mobility, stability or motor control based. On average many practitioners often attribute “tightness” as a lack of muscle length or “weakness” to muscle inhibition like having “a weak core” or “weak glutes.”  Now, they would not be wrong in their conclusion, but this is not the be all and end all. It’s only one piece of the puzzle and the puzzle (your body) has many moving parts that work together to give you performance output and synergistic movement. Now, the SFMA is only used by clinicians, therefore, my form of screening, is more an overall postural screen, luckily working in an integrated model, allows me to refer to a physiotherapist or most often the initial functional assessment has already been performed… now, I just want to see the client move through my own lens.

Our first role is to demonstrate how your muscle acts in association with the connective tissue, the nervous system etc and then also address how perhaps glute weakness affects a movement pattern, increases tone, redistributes engagement to other muscles; which in turn causes compensatory movement and tone.

Through this protocol we can go through the body like a checklist of the many imperfections we all carry on a day to day basis, or we could try to discover each individual’s major dysfunctions so that we can remove these negatives to uncover our strengths.   Corrective intervention and a well-designed strategy is crucial for improvement, doing more of any exercise; corrective or other, can result in more pain if we do not address the full scope of limitations. If they could do more, they would, but most often pain is a limiting factor… and they can’t.

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The ASLR:

Let’s take the ASLR drill as an example of addressing the vast difference between tone vs tightness.  During the FMS Screen and Y balance tests I will be able to identify the largest area of need, and most often in new clients with or without pain, the shoulder mobility (SM) and active straight leg raise (ASLR) are the two most often needing corrective intervention. The ASLR is also most often the starting point for the discussion of tone vs tightness.

Depending on your scope of practice, if you work in a clinical setting  like in rehabilitation, you can apply a manual intervention, by mobilizing or manipulating  a joint or you could apply soft tissue work either with our hands or tools; like the foam roller or magic stick, or if you are an RMT, FST or KMI practitioner you could provide deep tissue work into the muscles or on the fascia. You might use needles to do a musculoskeletal technique called trigger point dry needling, like in IMS or Acupuncture. Or if you are a personal trainer or movement coach, hands on technique may not be in your skill sets; therefore, educating the client and using corrective intervention is where your path for this client starts.

Let’s break down the screen first. Let’s say I deduce that Mr. Smith has the following:

  • D/S (deep squat) – 2
  • H/S (hurdle step) – 2/2
  • In/L (inline lunge) – 2/2
  • ASLR (active straight leg raise) – 1/1
  • S/M (shoulder mobility) – 2/3
  • TSPU (trunk stability push up) – 2
  • R/S (rotary stability) – 2/2
  • Spinal ext. – clear
  • Spinal flex – clear
  • Impingement test – clear
  • Total: 13 out of 21 (no pain, but a lot of discomfort)

To see the ASLR test, please watch this video:

From the basic screen we can see that Mr. Smith has alright movement, but is lacking in some areas and exhibits a low score of 1’s in his ASLR and an asymmetry in his S/M.  I see a lot of athletes and clients that have discomfort and limitations, yet overall do not score too badly on the FMS. The question then becomes why? From here I would then want to clear the spine and take a deeper look at Mr. Smith’s lowest score and asymmetry. This will include what we call “clearing” the spine and active vs passive testing.

I first start with his ASLR. I know that he cannot reach optimal range on his own, which is a minimum of 70 degrees in the leg lift. Therefore, I test this passively by assisting him. If I can take that leg through a larger range of motion and reach a 2 or 3, most often this is a motor control issue, not lack of hamstring tissue length. If I cannot then it’s certainly mobility and leg length. Sometimes genetics and structural elements can play a role, but I work with a lot of clients who do not have a tightness issue – its tone and motor control. That is 1 part physical and 1 part neuroscience. Motor control is in the brain and we know that Mr. Smith has poor motor control’ therefore, what are our next steps?

We could have a certain degree of muscle atrophy. We could have uncoordinated muscle behavior. We could have increased tone. We could have residual trigger points. What we have to do is identify, What are those motor control and movement limitations? What are the problems with mobility and stability?

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What is Tone?

Let’s focus in on the tone. In physiology, medicine, and anatomy, muscle tone (residual muscle tension or tonus) is the continuous and passive partial contraction of the muscles, or the muscle’s resistance to passive stretch during resting state with a reduced range of motion in active engagement. Tone isn’t bad, but in excess it can limit mobility, stability and power output. When stretch occurs, the body responds by automatically increasing the muscle’s tension, which is ultimately, a reflex which helps guard against danger as well as helping to maintain balance. It helps to maintain posture and declines during REM sleep when that “alarm” of protection is somewhat shut off.

Tissue that has an increase in tone, can be known as hypertonia; which can present clinically as either spasticity or rigidity.

Spasticity is velocity-dependent resistance to passive stretch (i.e. passively moving a leg quickly, like the kickoff in football will elicit increased muscle tone, but passively moving the leg, like in the ASLR slowly may not elicit increased muscle tone). Spasticity can be in the form of increased resistance only at the beginning or at the end range of the movement.

Rigidity is velocity-independent resistance to passive stretch (i.e. there is uniform increased tone whether the leg lift is passively moved quickly or slowly).That sucker ain’t going anywhere. Rigidity can be of the stiff board, or the resistance to passive movement is in a jerky manner.

We must also take into consideration tissue contractures, adhesions, scar tissue and past injuries or structural concerns.

Getting back to Mr. Smith, I now know that Mr. Smith has tone in the ASLR and as an intervention I ask him to foam roll his posterior line (back, lats, glutes and calves), maybe even use a little magic stick). This also will tell me where he has trigger points and an increase in “whoa nelly” that’s the spot, discomfort or pain.

We then re screen his ASLR… and there is an improvement, but we know that this won’t stick. This is a great way to educate the client on the connection between the brain –to-muscle connection, but also the relationship of the fascia and nervous system in connection with the muscle-motor control arena.

To gain a deeper perspective and larger picture, I would also screen Mr. Smith’s spine, clearing the cervical in flexion, extension, lateral flexion and then the whole spine in flexion, extension, lateral flexion and rotation, as well as thoracic mobility. The spine plays a significant role in ASLR patterns, as does the thoracic spine. Most often if the ASLR, the shoulder’s and spine will offer us more information on a client’s motor control and integration of their nervous system and fascia systems functionality, but for the sake of this article, we will just use the ASLR as an example of tone vs tightness.

Corrective Intervention:

By rolling and applying soft tissue release, allows us to free up space and by moving those segments completely changes the neuromuscular support around that joint and associated joints. It will most likely also free up some muscle tone and allow you to move through your spine and lower quadrants a little bit better. This is still without suggesting corrective exercise as of yet, now it’s time to focus on the active part of the intervention strategy. This is merely “protective” not yet “corrective. “Protective measures keep you from getting worse, but may not make you better. Corrective measures actually work toward helping you foster or start the reset process yourself.” – Gray Cook

From this point forward, I will assign a few key corrective exercises for the client to perform on their own 1-2x per day, and will also offer  a sequenced set of mobility movements to either prepare the client for daily life and/or sport, as well as a decompression set of movements to be performed at the end of their day or sport. This program is under 20mins, so that it’s time efficient.

At the end of that, we should see an appreciable change in something we measured. Below is a short sequence I use for clients with increased tone and low ASLR score.

Video on the ASLR correction:

Start: Screen ASLR

Corrective #1: 5 mins of breathing: diaphragmatic strengthening to re-engage posterior diaphragm. Recruiting the diaphragm and mechanics of the breath lowers anxiety, and connects the nervous system to the tissue, as well as biochemically releases chemicals to release and relax tonic tissue.

Soft Tissue Release: 5 mins of soft tissue release; including, foam roller, magic stick and tennis ball

Mobility Sequence:

  • Quadruped spinal rolling (cats flow, with emphasis on spinal waving)
  • Side cats flow (variations on exploring range)
  • Lumbo Pelvic facilitation: supine pelvic tuck and tilt with bridge pattern rolling
  • Bilateral hip rotations with legs crossed (TFL, ITB, lateral line and ribcage)

Corrective #2: Upper and lower body rolling pattern (unassisted and assisted)

Corrective #3: Leg Lowering Pattern (PNF, leg lowering 1 and 2)

Corrective #4: Hip Flexor Stretch with core assist to free up anterior line

Corrective #5: ASLR with core assist to recruit trunk and connect shoulders to hips and trunk to pelvis.

Re Screen ASLR: improvement in screen

Decompression:

  • Repeat mobility sequence (keeps it easy for the first set of notes)

  • Add in Rib pulls or thoracic rotations for good measure – we could all use more of that.

This would then be the clients homework for the next 2 weeks, and each session we work together, I progress or regress as needed. It’s also important to move clients from primitive patterns to foundational patterns, especially if they train with a strength coach or an athlete. Grooving the hip hinge and addressing single leg stance is usually on my session roster with a client so that they can see the long term picture of where and when these corrective exercises can improve performance overall.

To learn more about the FMS and Corrective Intervention Tools feel free to visit our website at www.fittotrain.com or http://www.functionalmovement.com/

Fascia: Your Body of Water In A Flowing State of Movement

Fascia: Your Body of Water In A Flowing State of Movement

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A while ago I wrote a blog that looked at fascia and hydration, “Is Your Fascia Hydrated: H2O to Go,” but more from a runner’s perspective and why some runners/athlete’s experience cramps. Today, I want to feature more of the process of hydration in our fascia.

Water is essential to life – all life

Our bodies are up to 70 % water by weight and nearly all processes in the body require water for cellular function.  When we think of water there are two natural ways water flows through our bodies and it is a two part process involving the following;

  • Irrigation is your actual consumption of water and water dense foods in adequate amounts.
  • Hydration is the chemical process by which water molecules bind with proteins and other substances.

Water is a lifeline for health and well-being.  Hydration, the process through which the body moves water, continues to be explored today. Over the past decade there has been a growing exploration of the role of fascia in the human condition. And a new conversation has begun among movement practitioners, manual practitioners and researchers of the role of water and our fascia.

Hydration is controlled by the hypothalamus and the body will prioritize so that essential organs will remain hydrated. Connective tissue (including fascia and membrane) will be one of the first to dehydrate leading to adhesions and fixotrophia of the tissue. At the microscopic level fascia looks like little tubes that transmit nerve signals and nutrients, like water, so that it can move freely over muscles and flow (like water) with the state of movement of the human structure. A good note to self, is when you fee thirsty – you are already dehydrated. Same if you drink lots of water, and pee a lot, your body isn’t holding onto water, because you probably aren’t keeping it hydrated consistently on a regular basis – this all effects your fascia and your body’s systemic functioning.

When we look at fascia; hydration is a bio-mechanical, not a chemical process, because there needs to be movement for a reaction to occur. When we stretch the fascial tissues or palpate them, toxins are pushed out and released; which creates a space for fresh fluids to be reabsorbed – hence hydration of the tissue. The practices of Yoga postures (asana) and breathing (pranayama)  are bio-mechanical processes to cleanse our fascial tissues, as are structural integration and fascia stretch practical applications.

For a quick re cap of fascia and what it looks like, check out Gil Hedley’s Fascia and Stretching from the Integral Anatomy Series. It’s a great little video.

Fluid Dynamics and Fascia

In an article from the iroc yoga community I found an enlightening excerpt “ Water has continuously proven to be a fascinating substance. Dr. Gerald Pollack, a University of Washington professor of bioengineering , has developed new theories.  In his keynote address titled The Secret Life of Water: E = H2O to the 2012 Fascial Research Congress, he discussed a 4th state of water, which is “bound”. The bound state stands along side of the well known solid, liquid and vapor states we learned in school. It is in this 4th state that water is bound to the protein, collagen, creating special conditions within the fascia.  Pollack’s explorations include understanding how water in its “bound” state contributes to the flow of fluids through fascial tissue. We look forward to more application of Pollack’s work in the world of fascial research.”

Understanding that fascia is our biological fabric, our interconnected matrix to our nervous systems, our muscles, our joints and our organs; which ranges from the ropey tendons and ligaments, to the webbed like (but tough) visceral fascia that surrounds our organs, down to the delicate membranes that provide the ‘carpet-backing’ for your body’s other tissues.  Fascia has two main components – one is collagen protein and the other is a watery “ground substance” called extracellular matrix (ECM).

Movement Sophistication

Movement is THE most important factor (next to water) to keeping our tissue subtle and elastic. When we stop moving or practice postures that are negative on our structure, we can compensate and cause dysfunction and pain. The process of fluid flow in fascial hydration contributes to the feeling of pliability and suppleness; therefore movement is key.

It is normal to feel stiffer after treatment or after a Yoga class. Why?

Your body works in phases, and as the space or phase a few hours after being stimulated your body is entering into the state of fascial hydration takes place. The “stiffness” is not due to shortening of the muscle tissue, but because our tissues are busy drawing in fresh fluids and are thus rehydrating.

Stiff & Tightness are not the same thing:

Tight fascia affects the whole organism, because it’s all connected. Structural imbalances can cause overall and specific increased rates of nervous stimulation; which when left untreated can cause increased muscle tonicity (not to be confused with tightness), trigger points and somatic-visceral referrals into the organs. Thus the body overall, and especially certain systems, will be tight and ischemic. This can reduce oxidation, hydration and blood supply to your muscles, and long term can result in chronic pain or motor control deficiencies.

Superficial fascia has a tensile strength of 2,000 pounds per square inch. It can entrap more nerve endings and blood vessels than any other tissue. By Hilton’s law of physiology, this will have a direct effect on the underlying muscles and joint proprioceptors. Something to thing about.

Thus the more you think of hydrating your fascia and understand the process of “bones should float” in the body, the more likely you are to not have mobility issues that stem from tightness of the muscles and fascia.

In next weeks blog we will look at tightness vs tonic tissue.

 

Sources:

* Sherri Leigh RMT:  http://www.sherrileighrmt.com/Sherri_Leigh_RMT/About_KMI_Structural_Integration.html

 

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

RECOVERY? ARE YOU GETTING IT? The Nervous System & Endocrine System Revealed

RECOVERY? ARE YOU GETTING IT? The Nervous System & Endocrine System Revealed

High Performance Training: Motor Skills

As our scientific understanding of movement, strength, even how to asses and screen for both injury and baselines  has evolved, so too has our movement capacity in sports and athletics.

Functional fitness means to restore and refine the balance of the human physique, as well optimizing homeostasis in the body through tissue restoration (ample recovery). For example, too much over-specialization on traditional strength models; like “body building” with pullups, pushups or squats creates a complementary imbalance in the functionally opposite direction which must be addressed, or we face first diminishing returns, then plateau, then regress, followed by pain and eventually injury. Like anything if you play that sport, you train for it, but if you do not, then you are ultimately not setting yourself up for success.

For most athletes the standards are higher; sometimes these standards come with playing for a high or elite level team, and some standards are the ones we place on ourselves , but most perform their cycles in spite of their fitness levels rather than because of them. They do well and survive because they had the passion and dedication to commit, but not always the right training. Even with effective preparation to perform at high intensity, does not give all athltes the ability to recover fast from high stress. Whoever recovers fastest wins, because if you do not – your risk for injury and possible your game/career ender sky rockets.

When we think of sports in essence we think about training the body, and in this, we think of only the musculoskeletal system (muscles) and the cardiovascular system, and neglect some of the other more important responses and adaptations in our body. Most sports require a variation of fine and complex motor skills performed at high intensity.

What happens when intensity increases?

How do our motor skills respond and adapt to high intensity training?

If you cannot answer these questions; you are setting yourself up for injury and possibly failure.

In high intensity training, you lose untrained, fine motor skills at approximately 65% heart rate maximum. (Heart rate maximum is 220-age). You lose untrained, complex motor skills at approximately 85% heart rate maximum.

You can increase how long you keep the skills, but with each new situation, a new stressor. You can only adapt to specific stress. So, you may be able to remain calm during “practice drills” but when game time hits, with another team you know little about, or perhaps embarking on an ultra multi day event, carrying 40kgs of equipment, to an unknown route, with unknown environmental factors, and if and when you are surprised, your chance of making mistakes increases substantially and the result is, you feel overwhelmed and do not operate at 100%. And much of this is also mental training, but I will save that for another article.  Whoever can recover fastest from surprise, mistakes and overwhelming odds… wins. That’s the paleo meat and hold the potatoes of it all.

Recovery = Systems Restoration

Notice, I did not just say “tissue;” much like the above, we need to start thinking of whole systems adaptation, not isolation of one system. Rest and recovery are critical components of any successful training program. They are also the least planned and underutilized ways to enhance performance. We must recognize that ‘Rest” is not the same as “Recovery,” just like “Mobility” is not the same as “Movement.”

“ Rest is relaxation, where there is an absence of activity. When you appropriately recover, you do not require or desire rest. See the difference. Rest should only be required when you do not sufficiently recover from excessive stressors, when you are under-recovered, you oscillate between excessive stress and forced rest; a common, viscous cycle in our industry. Traditional relaxation techniques become unnecessary if one fully recovers from excessive stress; relaxation is our natural state when our various nervous systems function as they should.”  (passage from my previous post of my “Movement Series”)

A great excerpt from Andrew Read; Master RKC and Endurance Trainer, in an article called7 Essential Elements of Rest and Recovery:

“ If you train for ten hours per week, you have 158 non-training hours or 95% of your time left for rest and recovery. Where is all of this “extra” time going and why do you walk into your workout dragging?

Training = Work + Rest.

It’s not. It’s multiplication. 

Training = Work x Rest.”

 

The Nervous Systems When Training:

Your nervous system cannot tell the difference between the physical threat and a mental or emotional threat.

Unfortunately, many athletes do not take advantage of this. Whoever endures, stays. But that is not TRAINING. That is merely WEEDING out those who are not yet trained for high performance stress. To TRAIN someone for stress, it must be woven into the conditioning. This isn’t a “sink or swim” approach.

The focus of the training must be upon how fast you can recover from a high intensity output so you can stay at your “A” game, both physically and mentally. “

Most often high athletes approach high level training preparation with a tenacity unlike any other, it is what makes them brilliant athletes, but the drawback is that they will push themselves beyond safety into over-training injuries and illness, and still keep going more with injury and while ill. We see this with retired athletes who no longer play at that level, but want to continue to train at that level because it recreates the same sense of glory on the field, court, track – whatever your place of sportage homage is.

The nervous system does not know the type of resistance, it only knows intensity. Your biomechanics do not know what kind of exercise you are performing; it only knows degrees, direction and load.  It only knows how much and how much stress. It cannot tell that the stress is from injury. It cannot say a broken shoulder is a different pain, than the pain of high intensity exercise like clapping pullups. It only knows the degree of stress. Therefore, your mental preparation and thought process tells the body – is this good stress or bad stress.

The body cannot tell the difference between heart rate maximum from exercise, and heart rate maximum from being shot at. It only knows heart rate maximum. Therefore, whoever recovers fastest from high stress in training without injury and illness, will be more operationally prepared to perform in high stress with injury and illness.

Do you see where we are going with this?

 “The first goal of training must be “do no harm.” This takes some mental paradigm shifting for many “hard-chargers.” I honor them for their willingness to sacrifice themselves, but they must not do this in training, so that they are able to be so honorable in combat.” – Scott Sonnon, Rmax International (TACTICAL MAGAZINE 2011)

Successful periodized sports specific programs include education behind how our body metabolizes and regulates stress and recovery. This boils down to two fundamental systems; the nervous system, and the endocrine system. If an athlete understand the biochemical responses, transmissions and transfers within their body; they will have greater success in energy output, intensity levels and when faced with unprepared game changing events; on and off the field.

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The Nervous System in a NutShell:

The human nervous system is composed of two parts: the central nervous system, which includes the brain and spinal cord, and the peripheral nervous system, which is composed of nerves and nerve networks throughout the body. The two main components of the nervous system, I have been especially interested in during my research into tactical training and response, is the somatic nervous system and the parasympathetic system, but let’s give you a run-down of the nervous system in its entirety.

The peripheral system (PNS) is composed of a number of nerves that extend outside of the central nervous system. The PNS can be further divided into two different systems: the somatic nervous system and the autonomic nervous system.

The autonomic nervous system is responsible for involuntary functions, as well as emotional responses like sweating or crying.

Somatic Nervous System: The somatic system transmits sensory communications and is responsible for voluntary movement and action. This system is composed of both sensory (afferent) neurons, which carry information from the nerves to the brain and spinal cord, and motor (efferent) neurons, which transmit information from the central nervous system to the muscle fibers. These are our transmission and communication highways.

The Sympathetic Nervous System: The sympathetic system controls the body’s response to emergencies.  Known as the fight or flight response, this system responds by preparing your body to either fight the danger or flee.

 The parasympathetic nervous system functions to counter the sympathetic system and restore the body’s functions. This system helps to calm the body, slows the heart and breathing etc.

How are the endocrine and nervous system linked? The brain structure known as the hypothalamus connects these two important communication systems together. The hypothalamus is a tiny collection of nuclei that is responsible for controlling an astonishing amount of behavior.  Yet, in most training programs the necessary education into the “why” we train and the “how” our body operates is still stuck in just the response and effects on the musculoskeletal systems, not how we internally respond, improve, degrade, progress, regress, etc. These two systems are paramount, and to be tactical operators and officers is a necessity.

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THE ENDOCRINE SYSTEM:

The endocrine system is a collection of glands that produces a wide variety of chemical messengers called hormones; which are necessary for normal bodily functions. These hormones regulate processes such as metabolism, growth, digestion, and response to stress. The glands release the hormones directly into the bloodstream where they are transported to organs and to tissues via our interconnected matrix highways. At these target organs and tissues, the secreted hormone evokes a specific, pre-programmed response from the targeted cells. . The specific functions of the endocrine system include:

  1. regulating the chemical composition and volume of the body
  2. regulating metabolism and energy balance, including digestion
  3. regulating contraction of smooth and cardiac muscle
  4. maintaining homeostasis even during crisis events
  5. regulating components of the immune system, and
  6. regulating the integration of growth and development.

Thus, appealing to the endocrine system is one way in which the body coordinates its actions with information collected from the environment. The endocrine system is responsible for teaching the body to react to the physical, emotional and mental stress around us.

ENDOCRINE ANATOMY:

While the endocrine system consists of several different glands that secrete over 50 different hormones, the hypothalamus and the pituitary gland control such a broad range of bodily functions that they are often referred to as the master control center. Here is a breakdown of the major operations:

Hypothalamus: The hypothalamus is located in the brain. It regulates many aspects of the body, such as heart rate, body temperature, water balance, and the amount of glandular secretions from the pituitary. It secretes hormones that help regulate the pituitary gland and also responds to their presence in a feedback mechanism.

Pituitary Gland: This small gland is tightly connected with the hypothalamus and secretes two hormones of particular interest to athletes. Anti-diuretic hormone( ADH ) promotes water re-absorption in the kidneys and is released from the pituitary when sensors in the hypothalamus determine that the blood is too concentrated, i.e., when dehydration occurs. For those deployed, away from water sources, or in hot climates, this could be critical. Adrenocorticotropic hormone ( ACTH ) stimulates the adrenal gland to produce cortisol; while the pituitary secretes numerous other hormones necessary for growth and survival. Because cortisol is secreted under duress; and your nervous system cannot differentiate between physical, mental or emotional stress; occupations that require higher stress overall means the secretion of this chemical could degrade function. When your immune system is working overtime, your body relies on that fight or fight response, which if cortisol gets to high  – remains turned on, like an alarm clock you can’t shut off. More on that in the adrenal gland section below.

Adrenal Glands: We have two adrenal glands, one on top of each kidney in the lower back. Each gland consists of an outer layer called the cortex and an inner core called the medulla. Secretion from the adrenal medulla is controlled via the nervous system, whereas ACTH controls secretion from the adrenal cortex. The major hormones produced by the adrenal medulla are adrenaline (also called epinephrine ) and a related hormone called noradrenaline ( norepinehprine ). These hormones cause the changes that occur during an emergency situation ( the fight-or-flight response ). Such changes include: increased heart and breathing rate, increased blood flow to muscles, cessation of digestion, and increased blood glucose levels and metabolic rate. The adrenal cortex produces two main classes of hormones: glucocorticoids and mineralcorticoids. The main glucocorticoid hormone, cortisol, promotes the breakdown of muscle proteins into amino acids that enter blood. The resulting increase in amino acid levels in the blood then causes higher glucose blood levels when the liver breaks down these amino acids. Cortisol also favors metabolism of fatty acids over carbohydrates. This hormone works in opposition to insulin, raising blood glucose levels. In a different mode, cortisol counteracts the inflammatory response that can lead to the pain and swelling of joints in arthritis and bursitis.

ENDOCRINE SYSTEM FATIGUE AND RECOVERY

The endocrine system can become fatigued just like a muscle that is continually overworked. At some point it just can’t produce the stress hormones as it should. A tired ( but not damaged ) muscle may recover in 24 to 48 hours, but it takes an overused endocrine system weeks to recover.

During high intensity training cortisol serves the body well by mobilizing energy stores and reducing inflammation. Afterwards, it temporarily blocks the desirable effects of insulin, and repair of the body is slowed. This is why recovery and recovery protocols, along with joint mobility is so important.

Even when the cortisol levels fall to normal after a few days, there are lingering effects from the disturbance of the endocrine system. If the body is called upon to respond to stress again, adequate levels of cortisol cannot be produced, resulting in a crash or hitting the way response. All motor control slows, along with mental fortitude.

The varied nature of these symptoms points to suppression at the level of the central nervous system hypothalamus/pituitary axis. That is, it isn’t just one gland that isn’t working right nor is it some simple nutrient deficiency.

In Closing:

When setting up a sports specific training program, or any program design for any client who is moderate to high activity;  these are two major systems you should consider educating your athlete or client on, so that you can fully understand the needs and requirements of your body moving into the phase transitions of your periodization. If your mentality is to “go hard, or go home,” you may very well be going home yourself, less one athlete, because that athlete in now spending the next 8-12 weeks with our physio team and in corrective movement.

As one of my mentors and friends; Carmen Bott, Performance and Conditioning Specialist at Fortius Centre in Vancouver; “Darwin was incorrect; it is not the survival of fittest who survive, it is those who adapt survive.”

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Quantum Consciousness: The Power of the Mind and Meditation

Quantum Consciousness: The Power of the Mind and Meditation

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When we talk about states of being, most of us think in terms of emotion or feeling (happiness, sadness); which falls under the category of biochemically, via our individual internal electrical neural networks. When we experience emotions, the longest an emotion can circulate, stay turned or coast (biochemically) within our systems is a mere 90 seconds. In order for that feeling to last longer, you have to practice mental fortitude, stay within the moment and practice sustaining that level of internal chemical reaction for longer periods of time.

In other words, paying attention to any specific neural connection and emotion keeps the associated circuitry open, dynamic, and alive. The nervous system has to be reminded to keep firing the same circuitry over and over again. The stronger the feeling, the greater the number of circuits simultaneously fired.  This can be done through visualization techniques, guided meditation or practice, makes perfect. Some call this the quantum zeno effect. I have studied quantum mechanics for nearly a decade, and founds it’s interconnected matrix fascinating. Therefore, relating this to how we feel and perceive emotion is merely one aspect of our “quantum” conscious efforts to live happier and more fulfilled lives. Understanding the role and biochemical role our emotions play, allows us to deeper understand how important they are in how we think, do and be … and relate to the world around us.

The quantum Zeno effect:

The quantum zeno effect is a situation in which an unstable particle, if observed continuously, will never decay. Frequently repeated observations or biochemical that produce feelings, stabilize a system and slow the rate of change or decay. Fewer, less frequent observations destabilize a system and increase the rate of change or decay (anti zeno effect). One can “freeze” the evolution of the system by measuring it frequently enough in its (known) initial state. For the sake of this article, I will filter our focus to that of the power of the brain. I have written multiple articles on the power of neuoplascticity in the brain, as well as brain entrainment to help decrease stress, help cure (dis)ease in the body, quite the mind and body and aid in recovery, as well as decrease chronic pain.

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Quantum biology:

Quantum biology refers to applications of quantum mechanics to biological objects and problems. Many biological processes involve the conversion of energy into forms that are usable for chemical transformations and are quantum mechanical in nature.

In an article written by, Dr. Kingsley Dennis, PHD, called;

“The human body is a constant flux of thousands of inter-reactions and processes connecting molecules, cells, organs and fluids throughout the brain, body and nervous system. Up until recently it was thought that all these countless interactions operated in a linear sequence, passing on information much like a runner passing the baton to the next runner. However, the latest findings in quantum biology and biophysics have discovered that there is in fact a tremendous degree of coherence within all living systems. It has been found through extensive scientific investigation that a form of quantum coherence operates within living biological systems through what is known as biological excitations and biophoton emission. What this means is that metabolic energy is stored as a form of electromechanical and electromagnetic excitations. It is these coherent excitations that are considered responsible for generating and maintaining long-range order via the transformation of energy and very weak electromagnetic signals.

Human thought in the twenty- first century needs to work towards a new model that immerses the human being within a vibrant energetic universe. However, this need not demand that we throw away what we already have; rather, we can expand upon the tools that have brought us to our present position. There is an eastern proverb that roughly translates as: “You may ride your donkey up to your front door, but would you ride it into your house?” In other words, when we have arrived at a particular destination we are often required to make a transition in order to continue the journey. In this sense we can be grateful to a vast knowledge base of scientific and religious thought for helping us arrive at the point where we presently stand. Yet it is now imperative that we move forward. As Deepak Chopra wrote his post “Consciousness and the End of the War Between Science and Religion” how we move forward is likely to be centered in our understanding of consciousness.”

This begs the question, if we know that the power of brain and thought has the power to cure out ailments, provide deep understanding and joy within us – can this also affect the world around us. The answer is yes, it can, and we have seen it done.

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Maharishi Effect:

A great example of this is the Maharishi Effect was tested between the years 1972-1978. The Maharishi Effect  was designed to be a phase transition to a more orderly and peaceful state of life in society as measured by decreased crime, violence, accidents, and illness, and improvements in economic conditions and other sociological indicators. The scientists who discovered this effect named it in honour of Maharishi Mahesh Yogi, who predicted it thirty years ago.

Maharishi had predicted that when a critical sub-population of individuals – 1% – experienced and stimulated the field of pure consciousness through the Transcendental Meditation Programme, a type of macroscopic field effect of coherence would occur in the society and the quality of life would improve.

The first experimental evidence for this phenomenon came in 1974 with the studies of Borland and Landrith (1976). However a trial run in 1972 was observed in 11 cities in the United States; in which 1% of the population was practising the TM-Technique. Then they looked at one major index of the quality of life in the cities – the crime rate – and compared it which the crime rate in 11 other cities matching for population and geographic location. They noted that when 1% of the town’s population practised TM technique and the trend of rising crime rate was reversed, indicating increasing order.

In 1974 a group of 7000 individuals meditating on thoughts of love and peace were able to radiate loving energy which reduced global crime rates, violence, and casualties during the times of their meditation over the course of 3 weeks by an average of 16%.

Suicide rates and automobile accidents also were reduced with all variables accounted for. In fact, there was a 72% reduction in terrorist during the times at which this group was meditation.

Almost 50 studies have been done further confirming the benefits of global meditation and its direct impact on everything in the world, even so far as to have the results published in the Journal of Crime and Justice in 1981. We know meditation has endless health and psychological benefits, but it is now being explored by politics and sociology because of its undeniable energetic impact. Everything is energy, including your thoughts.

In the movie “What The Bleep Do We Know;” by Mark Vicente, we see that there are an infinite amount of possibilities and that we are all connected to living things around us – because we are all energy. It unlocked the vast questions, many of us had about the universe and our place in it. We give and take energy endlessly, all the time.

As adults, we are not easily convinced of things we cannot see, or scientifically prove; this is have been an on going debate since the dawn of time. Yes, children, whose minds are still developing and are highly creative have the opportunity to re shape the very existence of our world for the next generations to come.  Many of the studies now being focused upon, are this effects and impact on the world when children practice harmonious thought, play and meditation.

Could we eradicate violence from the planet, if children are taught to live more peacefully, and to be more compassionate to all?

Could we end suffering and poverty, and living a more connected life if children were taught peaceful means of play, interaction and ways of life?

I would hope and continue to believe that the answer would be yes.

Sources:

Vedic Science: http://www.vedicsciences.net/articles/quantum-consciousness.html

What the Bleep Do We Know? http://www.whatthebleep.com/

Dubrovnik Project: http://www.dubrovnik-peace-project.org/sci/maharishi_effect.htm
http://maharishi-programmes.globalgoodnews.com/maharishi-effect/

The Compassion Nerve, The Wandering Nerve, The Vagus Nerve: It’s in our Physiology to Be Good

The Compassion Nerve, The Wandering Nerve, The Vagus Nerve: It’s in our Physiology to Be Good

Why do people do good things? Is kindness hardwired into the brain, or does this tendency arise via experience or perhaps through understanding great adversity? Is it inherited, or genetically encoded in our DNA? How do we, as humans, tap into our greatest compassionate selves?

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Compassion research is at a tipping point: Overwhelming evidence suggests compassion is good for our health and good for the world!  Last week I came across an article that showcased one of the leading authors behind the neuroscience of compassion, Dacher Keltner a director of the Social Interaction Laboratory at the University of California, Berkeley and it got me thinking about the brain’s connection, the neuroscience of what it means to be and do good in the world. The article was called “New Earth Physiology – Activating the Vagus Nerve” by Angela Savitri Petersen.

Keltner investigates these questions from multiple angles and often generates results that are both surprising and challenging. In his recent book, Born to Be Good: The Science of a Meaningful Life (W. W. Norton, 2009), and he weaves together scientific findings to uncover the neurological knowhow of human emotion’s innate power to connect people with one another. It is his believe that this lays the foundation towards leading a good life. Our research and that of other scientists suggest that activation of the vagus nerve is associated with feelings of caretaking and the ethical intuition that humans from different social groups (even adversarial ones) share a common humanity. People who have high vagus nerve activation in a resting state, we have found, are prone to feeling emotions that promote altruism – compassion, gratitude, love and happiness.”

You can see our natural connectivity and compassionate instincts in how our brains react to pain. Nerves connect all parts of the body to and from brain in order to improve immunological, physiological and hormonal functions of the body. Our nervous system is highly intricate and each and every nerve supply important sensory and motor information to the relay stations in the brain (neurons) to perform critical activities. The Vagus nerve is one of the most important nerves in the body with a number of functions and as it would seem when activated create results that are all encompassing – better for the world, and our humanity. People who have high vagus nerve activation in a resting state, we have found, are prone to feeling emotions that promote altruism—compassion, gratitude, love and happiness.

 

It’s in the DNA of the Brain

When we feel pain, or even see someone else in pain – we immediately empathize. This is the vagus nerve kicking in. We are hard wired to connect with others, even if in today’s world it might not seem so – we are.

And that’s not the only part of the brain that lights up when we see images of pain or suffering and distress. The amygdala—the brain’s threat detector—activates. This is the internal alarm system of the brain that turns on “fight” or “flight,” which is no surprise because we are also hardwired for survival.

When these two area’s are activated, and in highly compassionate people, there’s another area of the brain that Keltner has found lights up, a very old part of the mammalian nervous system called the periaqueductal gray; which is located way down in the center of the brain. This region is associated with nurturing behavior in mammals. We don’t just see pain or distress or suffering as a threat. We also instinctively want to alleviate that suffering through nurturance; whether that be our own or nurturing of someone else.

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What exactly is the Vagus Nerve?

The vagus nerve is a bundle of nerves that originates in the top of the spinal cord, near the cranium and it is better known in Latin as the “wandering” nerve, because it wanders from the cranium, all the way down the spinal cord, to your lungs to help you breath and control heart rate, and into your spleen and digestive system.  It activates different organs throughout the body. When active, it is likely to produce that feeling of warm expansion in the chest—for example, when we are moved by someone’s act of kindness or when we appreciate a beautiful piece of music or visual landscape. This makes the vagus nerve one of the great mind-body links in the human nervous system. Every time you take a deep breath, your heart rate slows down, you can control your body’s function by connecting the mind-to body… via activating your vagus nerve.

In an article dated a couple years back by Scientific America “Forget Survival of the Fittest: It Is Kindness That Counts” David DiSalvo (the journalist) had a close encounter with Dacher Keltner, on an interview DiSalvo asked; “One of the structures in our body that seems especially adapted to promote altruism, is the vagus nerve, as your team at U.C. Berkeley has found. Tell us a bit about this research and its implications?

Keltner replies offering kudos to another top rated scientist;  “Neuroscientist Stephen W. Porges of the University of Illinois at Chicago long ago argued that the vagus nerve is [the nerve of compassion] (of course, it serves many other functions as well). Several reasons justify this claim. The vagus nerve is thought to stimulate certain muscles in the vocal chamber, enabling communication. It reduces heart rate. Very new science suggests that it may be closely connected to receptor networks for oxytocin, a neurotransmitter involved in trust and maternal bonding.”

Arizona State University psychologist Nancy Eisenberg has found that children with high-baseline vagus nerve activity are more cooperative and likely to give. This area of study is the beginning of a fascinating new argument about altruism: that a branch of our nervous system evolved to support such behavior.

 

Stress and the Vagus Nerve:

Your nervous system cannot differentiate between mental or physical stress – it just feels stress. The body’s levels of stress hormones are regulated by the autonomic nervous system (ANS).  The ANS has two components that work to balance each other; which are the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).

The SNS activates or turns on your nervous system. It helps us handle what we perceive to be emergencies, when there is a threat, and is in charge of the flight-or-fight response.

The PNS aims to turn off the nervous system and helps us to keep the systems relaxed and calm. It promotes relaxation, rest, sleep, and drowsiness by slowing our heart rate, slowing our breathing, constricts the pupils of our eyes, decreases muscular contraction and relaxes tissue. Acetylcholine; which the nervous system uses as a neurotransmitter is responsible for learning and memory. It is also calming and relaxing, which is used by vagus nerve to send messages of peace and relaxation throughout your body. As we get older, our connective tissue starts to become more stiff and our bones more brittle, we stiffen up and your immune system produces more inflammatory molecules, thus our nervous system turns on the stress response, promoting system breakdown and aging.

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Vagus and Inflammation

New research has found that acetylcholine is a major brake on inflammation in the body and understanding how to consciously refine the benefits found in meditation and therapeutic movement, like yoga and flow state energy work can help activate the vagus nerve – which leaves you not only relaxed, but more joyful and thus compassionate.

A ground breaking piece of research by Kevin Tracey, director of the Feinstein Institute and Professor and President of the Elmezzi graduate school of molecular medicine in Manhasset, New York, has been knee deep in research for, what seems like ions on how the nervous system (the vagus nerve) controls inflammation in the body, now known as ‘The Inflammatory Reflex’. Inflammation is one of the major contributors to aging of the body and plays a key role in illness and disease. Tracey’s studies on inflammation, and the physiological and immunological response to infection and injury has been instrumental and he has worked on the mechanism by which neurons control the immune system; which he relates much success and reverse engineering disease in the body by activating the vagus nerve!

Inflammation isn’t always bad either; the vagus nerve is the brake on inflammation throughout the body. Once the vagus nerve senses that there are enough inflammatory substances (the chemicals of inflammation) following an injury it sends a signal to the immune cells that make those chemicals and tells them to turn off production, without it – we might literally burst Much like applying a break to your car, so the car can stop at the red light.

Studies have shown that there is a great link between inflammation and pain AND compassion. Seems logical enough. Studies have shown that those who show high vagal tone, have less disease, rake high on the healthy scales, and are – you guessed it – compassionate and inflammation free.

 

Brain Wave Frequency and Clearing the Mind

Another benefit to activating the vagus nerve is the connection with brain wave frequency and brain entrainment. When we calm the mind, the brain can make the transition to delta, theta and even gamma waves; which can be extremely beneficial for those who have sleep deprivation, or sleep disorders, as well as those in high stress occupations. Research has found higher levels of gamma brain waves and thicker brain cortexes (the areas associated with higher brain function) in people who meditate or perform slow energy work.

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It shouldn’t seem unnerving that tapping into our vagus nerve increases compassion; and with that being said increases the sustainable benefits towards positive change for our planet and our humanity overall – Ketlner thinks so, and I would agree.

 

Sources:

RUN4MOM: Break the Silence. End the Violence 57km Supporting Battered Women’s Support Services & CMHA North Shore

RUN4MOM: Break the Silence. End the Violence 57km Supporting Battered Women’s Support Services & CMHA North Shore

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VANCOUVER (July 21, 2013) – On July 28th  starting at 0700hrs,  Sarah Jamieson, a local Vancouverite will embark on a 57km journey – to honor the memory and spirit of her mother’ Nora Lynn Donnelley, who passed at the age 57 in her North Vancouver home on July 31, 2008.

A run to break stigma, break personal barriers and bring awareness and much needed support and end violence against women.  This non-sanctioned event aims to pay tribute to those families who endure and dedicate their lives to surviving stigma, to surviving violence and to those who have the courage to break the silence.

RUN4MOM is a 57km run that honors every year Sarah Jamieson’s mother was alive. It is during this run she pays tribute to her mother’s courage, strength, worthiness and compassion.

RUN4ACAUSE exists to challenge the community to better understand, accept and work towards an inclusive society by empowering ourselves and our community to break the silence. It is on this day we celebrate the courage, strength and beauty of all those who struggle with significant life challenges. We celebrate those who have taken that next step for the betterment and opportunity of their future, and we offer a call to action for those victimized – let us stand together to end violence and stigma.

SUPPOTING BATTERED WOMEN’S SUPPORT SERVICES:

For over 30 years BWSS has been working to end violence against women and girls. Battered Women’s Support Services provides education, advocacy and support services to assist all battered women in its aim to work towards the elimination of violence and to work from a feminist perspective that promotes equality for all women. In 2010 we launched they launched The Violence Stops Here campaign recognizing the role men play in eliminating violence against women.

THE FACTS:

  • 1 in 4 women will suffer violence at the hands of another at some point in their lives
  • 1 in 3 Canadians will experience or be connected to a mental health problem.
  • 66% of all female victims of sexual assault are under the age of twenty-four, and 11% are under the age of eleven. Women aged 15 to 24 are killed at nearly three times the rate for all female victims of domestic homicide.
  • Immigrant women may be more vulnerable to domestic violence due to economic dependence, language barriers, and a lack of knowledge about community resources
  • On any given day in Canada, more than 3,000 women (along with their 2,500 children) are living in an emergency shelter to escape domestic violence.

Surviving Child Abuse: My Personal Account of

“I was 6 years old the first time, my mother’s second husband hit me.  I had left an empty popsicle wrapper on the table, and forgot to put it in the trash. These memory of how this event shaped is still fuzzy, but what I do remember was my first real and raw understanding of what fear, anxiety and no longer feeling safe feels like. What I do remember is hearing screaming behind me as I ran up the stairs blindly grabbing at the carpet, as he dragged me back down – kicking and screaming.  Being thrown into the spare bedroom, it was dark, a chill in the air. He scrambled on the bed and my own screaming for my mother was deafening. She cried in the corner of the doorway, begging him to stop. Then I felt something hit the side of my head, sending me flying off the bed and into the side wall. I remember tucking myself into the fetal position, my face hot, I was sweaty, shaking, my head pounded and I could taste iron – my own blood. He left, closed the door and told me, lights off and to not come out until I was ready to be “good.” 

 

I stayed in that room for what seemed like hours, laying on the floor, trying to understand what had just happened. Trying to understand why someone who said they loved me and my mother would cause such pain and fear. At the age of 6 – nothing, none of this makes any sense and it re defines, it re shapes how you see the world and your place in it. From that moment on, I slept with a night light on, I had a backpack ready by my bedroom window, a crayoned route to my biological father’s house and I slept with that widow cracked open in case my cat and I had to escape. No child should ever have an escape route from their own home.

After that day, the abuse, the anger would continue. I would witness him hit my mother, fight with her, knock her down; physically, psychologically and spiritually. Over the years she became less and less the strong, vibrant mother I knew – and more of a woman fighting for her life. He controlled her actions, she lost friends, she rarely went out, she drank, he made her do cocaine with him. He was a sexual predator. For 9 years, I was slapped, spanked, whipped with a belt and even up to the age of 12 I remember being stripped naked and “disciplined.” At the age of 14 when we lost our home to debt, I convinced my mom to leave him. I got 2 jobs in high-school, she got a restraining order and when the divorce was finalized – the healing began. The long road of recovery, begins with a single step.”

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I tell this story in detail because stories, like mine, need to be told. They need to be heard and the silence needs to be broken. Abuse is what started the downward spiral of my mother’s mental illness – a two decade long battle with her demons, her manic depression – later turned- bi polar disorder and addiction.

For me – I turned to running as a way to process and understand “what the F*** had happened to me.” In all our trauma, my mother never got angry with me, she was always loving and even at a young age, I knew I was the glue that had to hold it all together. This burden turned out to be my most valued lesson.  In my mother’s passing from accidental suicide; I have learned that in my own silence there can be no full healing. I choose to not only speak for myself, but to pay tribute and honor to my mother’s memory by telling her story of courage.

As an adult, I have had decades of therapy to better understand the long term effects of my childhood abuse and chronic pain has been one of them. I have suffered from back pain for nearly a decade. The reasons why some children experience long-term consequences of abuse while other’s emerge relatively unscathed are still not fully understood. The ability to cope, and even thrive, following a negative experience is what we call “resilience.”

Resilience comes from really owning your sh*t, really accepting the cards that we are dealt and more importantly, accepting that your future, the life you wish to lead, the legacy you wish to leave behind – can only be chosen by “YOU.”  The right to choose is the most important rights we, as a human species can harness.

For years I struggled to understand why some people who survive trauma – be it combat, violence, sexual or physical abuse, neglect or isolation – exhibit tremendous resilience and lead full, loving lives; while others become defined by their trauma. For years, I stood somewhere in between. Someone who couldn’t fully accept her past, but someone who wasn’t about to be defined by it either.

Over the last year, I have been knee deep, head down, rolling around in every leader, TED Talk and podcast I could my hands on that deals with; wholehearted living, defense against the dark arts, vulnerability, cognitive behavioural therapy, superhero movies – you name it, I am researching it.

One of the turning points for me was the talks, and associated books by Brene Brown, specifically, her book called “Daring Greatly,” where she discusses “Gremlin Ninja Warrior Training.” Shame derives power from being unspeakable – from being silent. It’s easy to be silent, because they do not have to risk judgement, ridicule or criticism. To be vulnerable, to let ourselves be seen – is a scary place.

Daring greatly requires worthiness and much like those manipulative “gremlins” from the 1984 Steven Speilberg movie; shame is that booming voice that self sabotages our efforts to move forward, it numbs us from feeling. I don’t want to feel hurt anymore, I don’t want to be angry anymore – but at the same those gremlins numb us from feeling love, connection, trust and joy. We cannot NOT feel. It is that voice that says…. “You’re not enough,”  You don’t have a degree,” Your past is less than exceptional,” “Your still single,” and so on and so on and so on.

Roosevelt once said; “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat.”

The answer is shame resilience. Resilience is about moving from shame to empathy. When we share our story with someone or a group who responds with empathy and understanding, and we practice self-compassion – shame cannot exist. Gremlin Ninja Warrior Training has four elements:

  1. Recognizing same and understanding it’s triggers.
  2. Practicing Critical Awareness – Give yourself reality checks
  3. Reaching out – Own your sh*t and share your story.
  4. Speaking Shame – talk about how you feel

RUN4MOM is all about putting one foot in front of the other; both metaphorically and physically. This is first year where I am focusing the majority of my acceptance, advocacy and awareness on surviving child abuse and sharing my mother’s story of domestic and family violence. Battered Women’s Support Services has been an expert on providing women-centered, anti-oppression training for more than two decades. They provide several training programs for women and front line workers across BC, as well as programs, services and crisis intervention for women and children who struggles with significant life challenges, to help them end violence.

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SUPPOTING BATTERED WOMEN’S SUPPORT SERVICES:

For over 30 years BWSS has been working to end violence against women and girls. Battered Women’s Support Services provides education, advocacy and support services to assist all battered women in its aim to work towards the elimination of violence and to work from a feminist perspective that promotes equality for all women. In 2010 we launched they launched The Violence Stops Here campaign recognizing the role men play in eliminating violence against women.

One of the key programs, I feel needs to be recognized is the Advancing Women’s Awareness Regarding Employment program; which  is one of the many ways that Battered Women’s Support Services works to eliminate all forms of violence and abuse against girls and women.  Their specialized employment program includes:

Recognizing, Understanding and Overcoming the Impact of Abuse (RUOIA)

Workshops related to personal development and employment related skills

Career Exploration including informational interviews, job search skills, volunteer work experience

Information and referrals to educational and training.

Since 1979, Battered Women’s Support Services has provided education, systemic advocacy and support services for girls and women, who have experienced abuse and/or violence.

 

Critical and Essential Services:
Battered Women’s Support Services responds to over 8,000 direct service requests, in 2008:

  • Over 5460 women called our Crisis Line
  • Over 1300 women accessed Crisis Support and Accompaniment
  • Over 2304 women accessed Counselling
  • Over 3650 Counselling sessions were provided
  • Over 980 women accessed Support Groups
  • Over 1,200 women who were starting over received clothing and/or household items

Diversity:

  • Percentage of women who self identified as recent immigrants: 42%
  • Percentage of women who self identified as Aboriginal, Indigenous, First Nations, Native, Indian or Métis: 18%
  • Percentage of women who self identified as refugee: 2%

For more information on BWSS: http://www.bwss.org/

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MY SISTER’S CLOSET:

Women are the experts of their experience and their healing journey. BWSS has numerous programs to help women establish better connections and healing along their journey. Everything from crisis line support, to counseling, to legal advocacy, to youth programs, to a social enterprise called “My Sister’s Closet.”

One of the many BWSS meet the needs of women in our community is through social enterprise. This includes a Retail Program and a thrift boutique, My Sister’s Closet.

Social enterprise — also known as business with a social purpose — makes up a third sector that is quickly gaining importance in the overall economy. Social enterprise is way of describing how non-profit organizations have engaged in the trade of goods or services over the past century. Though not really new, the concept has emerged in British Columbia and other parts of Canada as a “new” concept with its own lexicon, leaders, investors, and entire organizations devoted to the exploration and development of social enterprise.

Since the early 1990’s BWSS has offered women the opportunity to be social entrepreneurs; at first through the marketing and skill-based counseling training programs then later through the opening in 2001 of the My Sister’s Closet Thrift Boutique on Commercial Drive in Vancouver. In 2006 they opened their second location of My Sister’s Closet at 1092 Seymour street in Vancouver. Having grown to fully realize what it means to be successful social businesswomen and we work to ensure that our business model:

  • Is consistent with our organizational mission
  • Promotes and mentors women-ist leadership
  • Fosters women-ist teamwork, collaboration and partnership
  • Embraces change, respects what is working, and integrates new learning
  • Reflects our commitment to delivering results in this critical area
  • Views problems as opportunities

My Sister’s Closet: http://www.bwss.org/services/programs/social-enterprise/my-sisters-closet/

Join us for RUN4MOM ON July 28th and why not stop by and support BWSS, CMHA and Sarah J on July 26th for our RUN4MOM Pre race event party!

 

RUN4MOM Pre Race Event @ My Sister’s Closet

Date: Friday July 26th

Time: 7pm – 9pm

Location: 1092 Seymour Street, Vancouver

Come and join Sarah Jamieson for the RUN4MOM pre race party. This is a great opportunity to connect and meet the women and supporters of BWSS and SHOP at My Sister’s Closet. This is a free event, and all refreshments can be purchased by donation.

HOW CAN YOU SUPPORT?

  1. Join me on RUN4MOM. Walk with me on my run route – from Ambleside to Dundarave @9am on July 28th
  2. Donate to either one of the charities and take a stand against violence and stigma. Donate here: http://www.canadahelps.org/GivingPages/GivingPage.aspx?
  3. Share RUN4ACAUSE and help break the silence at www.sarahmjamieson.wordpress.com

 

Chronic Pain Series Part 4: Bridging the Gap Between Childhood Abuse & Adult On Set of Chronic Pain

Chronic Pain Series Part 4: Bridging the Gap Between Childhood Abuse & Adult On Set of Chronic Pain

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Living with chronic pain can be a highly frustrating, confusing and stressful experience; which can ultimately to lead to psychological distress, a higher risk of mental health factors and lower quality of life overall. Although bio-medical factors set in motion initial pain diagnoses for treatment, it is clear that psychological factors, our mental state and our past experiences around pain can significantly contribute to the development, exacerbation, and process/ pathway pain takes in our mind and body. Thus it also goes without saying that the maintenance and potential treatment paths must also take into account the biochemical, bio-mechanical and bio psycho-social models as well  to adequately offer clients with chronic pain the availability for recovery from chronic pain.

Over the course of the last several weeks we have looked at chronic pain and the associated links with mental health. Looking at a broad scope of potential risk factors in an attempt to better understand how we diagnose, the metrics we currently use and where we might bridge gaps in our systems, and offer people in pain more availability to resources and community support.

Successful management of chronic pain depends on a multidimensional assessment, taking into account both the objective and subjective metrics of analyses. To increase the likelihood of successful treatment outcomes, it is important to understand, assess, and treat contributing factors to the development of chronic pain disorders, and potential barriers to recovery of function – all to improve their quality of life.

In today’s post we look at the 4th installment of this Chronic Pain Series which looks to briefly link chronic pain in adults and the linkage to childhood abuse and neglect.  While the association between abuse in childhood and adverse adult health outcomes is well established, this link is infrequently acknowledged in the general medical literature.

Child Abuse: It’s in the Stats

  • 1 in 3 females and 1 in 6 males in Canada experience some form of sexual abuse before the age of 18.
  • 80% of all child abusers are the father, foster father, stepfather or another relative or close family friend of the victim.
  • 35% of girls and 16% of boys between grades 7 – 12 had been sexually and/or physically abused
  • Among girls surveyed, 17-year-olds experienced the highest rate of sexual abuse at 20%

The impact of child abuse is often discussed in terms of physical, psychological, behavioural and societal consequences. However, in reality it is impossible to separate them completely. The impact of physical consequences can result in trauma or injury to the brain, and psychologically, abuse can result in cognitive delays or emotional difficulties. Our experiences as children shape our belief systems and how we start to understand our place in the world, When violence is a part of this belief system, it alters our growth and development – both from the point of view of the biopyschosocial model, but that of our internal representation in the world.

There are a number of pathways by which early life abuse, neglect and maltreatment could contribute to the development of pain disorders in adulthood. For instance, abusive childhood experiences can often manifest in high risk behaviors and can contribute to the development of negative psychosocial characteristics (depression, anxiety, anger, and social isolation). These in turn can lead to long term physical health problems like; cancer, diabetes, sexually transmitted disease, alcohol or drug abuse, eating disorders, mental illness – the list is endless.

Battered Women's Support Services Logo

Battered Women’s Support Services Logo

Surviving Child Abuse: My Long Road to Recovery

“I was 6 years old the first time my mother’s second husband hit me.  I had left an empty Popsicle wrapper on the table, and forgot to put it in the trash. The memory of how this event shaped is still a bit fuzzy, but what I do remember was my first real and raw understanding of what fear, anxiety and no longer feeling safe feels like – the only word that comes to mind is the word “shattered”. What I do remember is hearing screaming behind me, anger I had never known and as I ran up the stairs blindly grabbing at the carpet, he dragged my 6 year old body back down the stairs – kicking and screaming, my body flailing.  I remember being thrown into the spare bedroom.  It was dark, there was a chill in the air, I was hot, the salty taste of my tears and my body shaking uncontrollably.

I scrambled on the bed, the screaming was deafening, not sure if it was my screaming, or my mother’s as she knelt in the doorway pleading with him to stop, or it was the rage of my step father that was deafening. All time seemed to slow down and stop.  Then I felt something hit the side of my head, a hit hard enough to send me flying off the bed and into the side wall. I remember tucking myself into the fetal position, my face hot, on fire, sweaty, shaking, my head pounding, my heart beat in my ears – it’s too loud. I could taste iron – was that what blood tastes like? The screaming, it wouldn’t stop. Then he left; and told me, lights off and to not come out until I was ready to be “good,” he left. I was alone, I could hear my mom sobbing. I felt shattered. That day forever changed our lives and it was not the last of it’s kind. I felt alone. I became silent. The child in me was no longer present. I was split in half. 

Needless, to say, I no longer enjoy orange Popsicle’s. 

I stayed in that room for what seemed like hours, laying on the floor, trying to understand what had just happened. Trying to understand why someone who said they loved me and my mother would cause such pain and fear. At the age of 6 – nothing, none of this makes any sense and it re defines, it re shapes how you see the world and your place in it. From that moment on, I slept with a night light on, I had a backpack ready by my bedroom window, a crayoned route to my biological father’s house and I slept with that widow cracked open, even in the winter in case my cat and I had to escape. No child should ever have a mapped out escape route from their own home. 

After that day, the abuse, the anger would continue for 9 long years. I would witness him hit my mother, fight with her, knock her down; physically, psychologically and spiritually. Over the years she became less and less the strong, vibrant mother I knew – and more of a woman fighting for her life, running from her demons. He controlled her actions, she lost friends, she rarely went out, she drank, he made her do cocaine with him, watch porn. I was 12, these are not journal entries a 12 year old child should every write. I should be writing about boy crushes, girl guides or sleep overs with friends, but even though all those things happens, I would write about this f***ed up stuff. Because it is – my life’s diary of endless ramblings. He was a sexual predator. For 9 years, I was slapped, spanked, stripped naked, whipped with a belt. My mother screaming as he “disciplined” me. He would come into the bathroom, when I was showering or bathing. He let his friends hit on me and womanize my mother and I.  At the age of 14 when we lost our home to debt, I convinced my mom to leave him. Him or me. I became the parent. I got 2 jobs in high-school, she got a restraining order and when the divorce was finalized – the healing began. Humpty Dumpty sat on a wall, Humpty Dumpty had a great fall. All the kings horses and all the kings men, couldn’t put Humpty Dumpty back together again. Where does one find the strength to go on? to move forward? to have faith that yes, life can be better? These were my ramblings from a therapy session as a youth. I was 16.” – Sarah Jamieson

Triumph Over Tragedy:

I tell this story in detail because stories, like mine, need to be told. We cannot sugar coat them. They need to be heard and the silence needs to be broken. Abuse is what started the downward spiral of my mother’s mental illness – a two decade long battle with her demons, her manic depression – later turned- bi polar disorder and addiction. For me – I turned to running as a way to process and understand “what the F*** had happened to me.” In all our trauma, my mother never got angry with me, she was always loving and even at a young age, I knew I was the glue that had to hold it all together. This burden turned out to be my most valued lesson.  In my mother’s passing from accidental suicide; I have learned that in my own silence there can be no full healing. I choose to not only speak for myself, but to pay tribute and honor to my mother’s memory by telling her story of courage.

As an adult, I have had decades of therapy to better understand the long term effects of my childhood abuse and chronic pain has been one of them. I have suffered from back pain for nearly a decade. Most of my therapy has been a combination of therapeutic movement found in Yin Yoga, Fascial Stretch Therapy, SomaYoga, Osteopathy, IMS and my appreciation of both running and flow state martial arts and strength training. The real healing comes from the self discipline of re defining and re connecting with loving yourself, trusting yourself and the process and as Brene Brown called it “Gremlin – Ninja-Warrior-Training” to “Dare Greatly.” 

The reasons why some children experience long-term consequences of abuse while other’s emerge relatively unscathed are still not fully understood. The ability to cope, and even thrive, following a negative experience is what we call “resilience.” I feel fortunate that I had a number of protective and promotive factors that contributed to my ability to hold my sh*t together. My resilience – I can only say is part of my DNA. My father has always been instrumental in my life and my mother even at her worst, loved me unconditionally. My psychological body (for the most part) seems to be intact, but my physical body has always had pain (understanding that in essence these two are not separate at all). It is a continued journey I walk every day, there are good days and bad days, there are still nightmares, but also memories of love. It is a life long journey of understanding and acceptance and I find solitude in service to others.”

Study by Arizona State University: 

Evidence suggests that childhood abuse may be related to the experience of chronic pain in adulthood. In a study performed by Arizona State University, the group used meta-analytic procedures to evaluate the strength of existing evidence to showcase the association between self-reports of childhood abuse and chronic pain in adulthood. Analyses were designed to test the relationship across several relevant criteria with four separate meta-analyses.

Results of the analyses are as follows:

(1) Individuals who reported being abused or neglected in childhood also reported more pain symptoms and related conditions than those not abused or neglected in childhood. When a child has broken bones, fractures, are shaken (as in shaken baby syndrome) it changes the physiological nature of growth and development. Scar tissue can build up, resulting in altered biomechanics later in life etc.

(2) Patients with chronic pain were more likely to report having been abused or neglected in childhood than healthy controls. A variety of somatic symptoms are consistently found to be higher in adults with a history of physical or sexual abuse compared with those without an abuse history.

(3) Patients with chronic pain were more likely to report having been abused or neglected in childhood than non-patients with chronic pain identified from the community.

(4) Individuals from the community reporting pain were more likely to report having been abused or neglected than individuals from the community not reporting pain. Results provide evidence that individuals who report abusive or neglectful childhood experiences are at increased risk of experiencing chronic pain in adulthood relative to individuals not reporting abuse or neglect in childhood. (1)

Adult Onset of Chronic Pain Shows Links to Childhood Abuse:

How specific types of abuse alone or in conjunction with other variables may lead to any of these conditions is unknown, although measurable abnormalities in major physiological regulatory systems (hypothalamic-pituitary-adrenocortical axis and autonomic nervous system) have been found in some adults with a history of abuse.

Fight or flight; are our natural survival mechanics of the human species. Childhood abuse can showcase severe deficiencies in the ability to effectively self-regulate emotion resulting in inappropriate perceptions of threat and exaggerated fight-or-flight responses and this alarm can stay on from childhood to adulthood. Much like the alarm of chronic pain – the nervous system and pain receptors just won’t shut off.  Many studies have reported de-regulated neuroendocrine responses in abused children and adults with a history of childhood abuse. When these self-governing pathways are disrupted they can promote pathophysiology in the body; which increases the vulnerability to the development of a chronic pain disorder and potentially interfering with recovery, and/or prolonging the process.

Childhood abuse survivors reported more adult traumas, and demonstrated greater neuroendocrine stress reactivity, suggesting physiological sensitization to stress and higher risk of stress-related illnesses.

In a publication called “The Long-Term Health Outcomes of Childhood Abuse;” at “The National Center for Biotechnology Information” states childhood abuse has been associated with a plethora of psychological and somatic symptoms, as well as psychiatric and medical diagnoses including depression, anxiety disorders, eating disorders, posttraumatic stress disorder (PTSD), chronic pain syndromes, fibromyalgia, chronic fatigue syndrome, and irritable bowel. Compared with non-abused adults, those who experienced childhood abuse are more likely to engage in high-risk health behaviors including smoking, alcohol and drug use,and unsafe sex; to report an overall lower health status; and to use more health services. Viewing these various health conditions and behaviors as the outcome and abuse in childhood as the exposure, many of the criteria for a causal relationship are met.

This publication found that in at least 3 meta-analyses on the effects of childhood sexual abuse find clear and convincing evidence of a link between such abuse and a host of adult psychological symptoms. Retrospective studies also show that childhood abuse has consistent effects on first onset of early adult psychopathology. For example, performing structured interviews in a random community sample of 391 women, Saunders et al. found that 46% of those with a history of childhood sexual abuse, compared with 28% of those with no abuse, had experienced a major depressive episode. Women with such abuse also had significantly greater lifetime prevalence’s of agoraphobia, obsessive-compulsive disorder, social phobia, sexual disorders, PTSD, and suicide attempts than women without such abuse. MacMillan et al., in a community survey of 7016 men and women, examined lifetime psychopathology risk in adults who experienced either sexual or physical abuse as children and found anxiety disorders and depressive disorders to be significantly higher in both men and women with a history of either physical or sexual abuse.  (3)

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Our Healthcare System: Bridging the Gaps

The need for more visible research that will reach physicians who provide the bulk of front line health care is underscored by failure to give even passing mention to the well-documented link between adult depression and childhood abuse in a recent review on depression in the New England Journal of Medicine. (3)

In Canada, 18% of women over the age of 12 experience chronic pain, as compared with 14% of men.34 Chronic pain is one of many serious long-term health consequences of intimate partner violence (IPV). British Columbia plays a significant role in research and development outlining the current scope of these linkages from chronic pain, trauma and abuse (both childhood abuse and partner/ family violence).  A publication in the Journal of Pain, Vol 9, November 2008 in an article called “Chronic Pain in Women Survivors of Intimate Partner Violence “ found that according to the national prevalence survey of women’s experiences of specific acts of physical and sexual violence by a male partner,  30% of Canadian women are affected in their lifetime. These stats have not changed much in the last 5 years. Domestic violence and abuse still affects 1 in 4 women in North America and according to police statistics more than 60% of daily calls are domestic abuse related.

Chronic pain can affect people of all ages. In Canada, one in five people suffer daily from chronic pain. It is a ‘silent epidemic’. As a member of the board at Pain BC, a local non-profit organization based in Vancouver BC, our role in the community is to help bridge these gaps and to empower both patients and our health care providers and healthcare system to make chronic pain a higher priority on our national agenda. We do this through fostering an inclusive community and educating on the multi tiered scope of chronic pain. We have a shared passion for reducing the burden of pain and for making positive change in the health care system in British Columbia. If you’d like to be part of reducing the burden of pain in BC, get involved.

Learn More: Some of my Top Support Links

More information on how to recognize abuse and to report suspected abuse, and a range of child-welfare and child-protection resources can be found at: www.mcf.gov.bc.ca/child_protection/index.htm

Battered Women’s Support Services: http://www.bwss.org/home/contact-bwss/

Kids Help Phone: http://www.kidshelpphone.ca/Teens/InfoBooth/Violence-and-Abuse/Family-abuse/Links.aspx

 

Sources:

(1)    Are Reports of Childhood Abuse Related to the Experience of Chronic Pain in Adulthood? A Meta-analytic Review of the Literature  by Debra A. Davis MA, Linda J. Luecken Ph D*, and Alex J. Zautra Ph D at Arizona State University – http://resilience.asu.edu/pdf-files/zautra3.pdf

(2)    Preventing Childs Abuse is Everyone’s Responsibility:  BC Newsroom, April 5, 2013: Sheldon Johnson, Ministry of Children and Family Development http://www.newsroom.gov.bc.ca/2013/04/preventing-child-abuse-is-everyones-responsibility.html

(3)    “The Long-Term Health Outcomes of Child Abuse;” by The National Center for Biotechnology Information: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1494926/

(4)    “Chronic Pain in Women Survivors of Intimate Partner Violence;”  http://www.ucp.pt/site/resources/documents/ICS/GNC/ArtigosGNC/AlexandreCastroCaldas/13_WuMeFoLeVaCa08.pdf The Journal of Pain, Vol 9, No 11 (November), 2008: pp 1049-1057

(5)    Canadian Children’s Rights Council – http://www.canadiancrc.com/Child_Abuse/Child_Abuse.aspx

(6)    Pain BC – www.painbc.ca

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: [email protected]

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

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

Chronic Pain Series Part 3: Disarming PTSD & Occupational Stress Injuries

Chronic Pain Series Part 3: Disarming PTSD & Occupational Stress Injuries

 

li-soldier-ptsd

What is subjectivity? 

Subjectivity, is a term used to determine a person’s perception, experience, feelings and beliefs. Most often, when it comes to chronic pain and mental health screening the “subjectivity” and indicators of risk, are still a large grey area and can be “subject” to interpretation.  Why? Because the reality is – the only person who can truly know 100% how you feel, how an experience has affected you – is you, and you alone. The rest is objective; as health care providers we make the most appropriate call we can based on our assessment; and this is where the grey area resides.  As much as subjectivity is a process of individuation, it is equally a process of socialization, taking into context the cultural environment, and the experience of interaction with people, places, and events.  These things change a person, and the debate on the best way to form a SOP (standard operating system) for diagnosis, treatment, prevention and programs is one hot topic that continues to be an on going theme in my research.

Over the last several articles,  introducing chronic pain, we have used the term `biopsychosocial model;` (bio) means biological, psycho (means psychological) and social (means environment); all of which refers to the body`s physiological, adaptive response to fear, pain and our environment. This model is the cornerstone of my research and although some of us may be born with a biologically determined, heightened sensitivity to stress, this fact alone is insufficient to create an anxiety disorder or even a precautionary risk factor for occupational stress indicators. Yet, it can give us great insight into being more receptive to persons who many be at risk. For instance someone who has had a long standing degree of child abuse, may be greater risk for depression or PTSD if he or she takes on a role involved with law enforcement, social work or combat… or on the flip side, it could be a leading reason they excel at these professions if they have the right coping strategy and insight. Again… there’s that grey area again. There has not been enough data collection to support either side.

Let’s review that model again’ the psychological factors in the biopsychosocial model refer to our thoughts, beliefs, and perceptions about ourselves, our experiences, and our environment. These cognitive patterns affect our perceived sense of control over our environment, and affect the way we assess and interpret events as either threatening or non-threatening; which are highly subjective.

Chronic Pain & PTSD:

Chronic pain and mental health screening, diagnosis, and pathways to direct treatment, are not yet fully standardized in our medical system, but, we have made much progress over the last decade with more health care providers looking at the integrated approach towards programs and services for people living with pain and people with dual diagnosis with mental health or trauma.

In an article written at the United States Department of Veterans Affairs, titled “ The Experience of Chronic Pain and PTSD: A Guide for Health Care Providers,” states a current PTSD prevalence of 35% was seen in a sample of chronic pain patients, compared to 3.5% in the general population. Trauma is not just physical or mental, it is both; all encompassing.

The human body and brain are one of the most complex and quantifiable conundrums, because there is still so much we do not yet understand about why one person can experience chronic lasting pain and another does not. Or, for the purpose of our discussion topic day; why one person can experience a traumatic event and suffer from PTSD, while another does not. It is a question that remains unanswered.

What is PTSD & OSI?

PTSD (Post Traumatic Stress Disorder) is a serious potentially debilitating condition that can occur in people who have experienced or witnessed a natural disaster, serious accident, and sudden death of a loved one, war, violent personal assault such as rape, or other life-threatening event. It can leave the person feeling intense fear, anger, and hopelessness.

Operational Stress Injury (OSI) is best described as any persistent psychological difficulty resulting from operational duties performed while serving in the Canadian Forces or in law enforcement or any emergency response profession. Difficulties may occur during combat duties, after serving in a war zone, in peacekeeping missions, or following other traumatic or serious events not specific to combat.

While it is considered normal to experience some form of distress after being exposed to a traumatic event, for some individuals, the symptoms persist. The long-term consequences can include, but are not limited to problems with interpersonal functioning, cognitive and biopsychosocial functioning, mental health  disorders, as well as substance abuse disorders, affective disorders, anxiety disorders, eating disorders, and conduct disorders.

More importantly, for those in professions where high stress is part of the nature of the job, like in military or law enforcement, coming out and saying “I may have PTSD” can seem like a great blow to the ego. Much like mental illness or chronic pain… PTSD comes with a label and the stigmatization attached to that label.

PTSD-Infographic

The Multi-Method Model: Screening 101

Psychologists and Psychiatric doctors are taught early in their training that assessment of human behavior and emotion is best done within a “multi-trait, multi-method” model.  The bases for this model are (a) the human condition, and (b) statistical limitations on measurement. As care providers we have a difficult time ascertaining the accuracy of patients’ pain severity, because of the nature of subjectivity. This can include chronic pain or mental health indicators. The body’s pain receptors or neuroplasticty just feels pain… it cannot differentiate between physical or mental always.

How do we really know when someone has an occupational stress injury or PTSD? We know that chronic pain, mental health and possible disability that often comes with it can lead to a cognitive reevaluation and reintegration of one’s belief systems, values, emotions, and feelings of self-worth and self responsibility , more importantly,  how one feels about the capability of performing their job and living their life.

Assessing PTSD can be tricky and it takes time and patience.  Measures vary in their sensitivity, specificity, and clinical utility for different settings and populations. Time permitting, the use of both self-report and interview-based assessments is recommended.  Health care providers generally assess by administering cognitive and physical examinations, having patients perform various tasks, if chronic pain is an indicator they could include exercises that help the provider evaluate the patient’s strength, flexibility and reflexes. When it comes to assessing mental health or PTSD risk factors, these exercises can range from one on one interviews where the professional looks for behavioral markers, assesses mental acuity, emotional triggers and cognitive thought processes.

Despite all of our understanding thus far on both chronic pain and mental health, the relationship between traumatic event exposure and adverse emotional or mental triggers/ affects remains still a very large grey area. Despite efforts to fully understand the relationship between traumatic event exposure and adverse mental health outcomes, our ability to quantify why only some trauma-exposed individuals become emotionally affected remains challenged.

Canada Steps Up:

Canada has some of the top tiered standard operating systems in North America, yet as a whole we can only train our officers so much, we can only prepare them so much and it is only until they are placed in real life situations can we truly know if PTSD or mental health risks will be a factor. Over the course of the last half decade Canada has been recognized as a world leader in fighting stigmatization and raising awareness of mental health illnesses.

In fact, through the Canadian Armed Forces, we have the greatest ratio of mental health care workers to soldiers in NATO, however most of what we now know and have implemented has been post deployment and is still a work in progress

Historically, PTSD has been associated with military personnel and the traumatic experiences involving combat and warfare situations, as well as emergency responders such as law enforcement and fire and rescue, but this can occur in any individual who suffers some form of trauma. The prevalence of PTSD is substantially elevated in patients with chronic pain, which is no wonder, as we know the nervous system cannot differentiate stress from the mind or body, all it feels is pain and stress. Officers that are on the front lines, are injured in battle or have had to be deployed for long periods of time have a higher degree of risk for both PTSD and chronic pain. Combat changes people, and pain changes people.

Many officers in law enforcement who are involved in confrontation, who have to work long shifts, operate on little sleep and have to deal with the worst of people’s worst days, day in and day out, also have a higher risk because of the nature of the job. This is not rocket science; and even though it has been very slow, the government is finally recognizing the need for greater resources and prevention nationwide.

The Canadian Armed Forces: Standing at The Front Lines

The first Operational Traumatic Stress Support Centre (OTSSC) opened in 1999. “ Lessons learned about psychiatric casualties from World War I (shell shock) and World War II (combat exhaustion, which comprised up to 25 per cent of all casualties in the Italian campaign) had been forgotten by the Canadian Forces (CF) by the time they were engaged in the first Gulf War in 1991.” Wrote Greg Passey, MD, CD, FRCPC  (1)

Canada’s role in the Afghanistan War began in late 2001; where we sent first Canadian soldiers secretly in October 2001 from Joint Task Force 2, and then the first contingents of regular Canadian troops arrived in Afghanistan in January–February 2002.  At the height of the war, during 2006, the high level of casualties and injured troops was overwhelming. Since then, the Canadian Armed Forces has made leaps and bounds in providing officers with necessary resources; however, many say there are still not enough professionals to go around. Even though all recruits must undergo rigorous screening both physically and psychologically prior to and post deployment, there are not enough operational stress injury clinics outside of the main facilities.

In 2011, the Canadian Forces released a study noting that of 2,045 randomly chosen personnel who served in Afghanistan between 2001 and 2008, eight per cent were diagnosed with mission-related PTSD. An additional 5.2 per cent were diagnosed with Afghanistan-related mental health disorders other than PTSD, like depression. (1)

In an article written by CTV news, dated July 20th 2011; by Dr. Greg Passey, who is a trauma psychiatrist and a former military medical officer, says the situation (PTSD and suicide) is all too common.  He says despite all the progress that has been made in raising awareness of PTSD, the stigma is still there and is a huge obstacle to overcome for many people in and out of the military.

“There remains a lot of misperception and ignorance within the military in regards to issues like post-traumatic stress disorder. They’re often viewed as people who are disciplinary problems,” Passey told Canada AM in this article.

Even the term ‘mental health issues,’ is stigmatizing, because it doesn’t speak to the severity of the illness, nor does it produce metrics to use for treatment. The brain is a physical organ. It has physical abnormalities and diseases processes and injuries. And so we should be talking about brain disorders. While they’re in the military, the resources aren’t too bad. The difficulty is once they’re released. And the reservists who have to depend on civilian resources; they can get lost.” (2)

He goes on to say that even with the recent recognition of PTSD, there are still not enough psychiatric resources and professionals to go around. The situation can become worse once a soldier retires or is discharged because they leave the support system.

In 1991, the majority of military psychiatrists at that time were centralized at the National Defence Medical Centre in Ottawa. Members of the military requiring assessment or treatment had to travel to Ottawa, which added to the stigma of mental health diagnoses. However, since 2006, the CAF has structured operational stress injury clinics all over Canada, all of which provide assessment, treatment, prevention and support to serving CAF members and Veterans. Each OSI clinic operate on an outpatient basis only and include one-on-one therapy sessions and group sessions to address PTSD, and mental health indicators and other issues that are occurring as a result of experiencing one or more traumatic events. Even though the CAF has made many changes and additions to support their troops; there needs to be a higher political agenda pushed forward and pushed up the food chain at the health care systemic level. (1)

Law Enforcement:  In The Line of Duty

At the JIBC (Justice Institute of British Columbia), all new recruits undergo block training where they prepare for the stressors and are offered courses/materials to better understand the complexities they could encounter on the job. They offer classes like; critical incident and stress, acute reactions to trauma and grief, incident reduction, front line workers guide and a all supported by the Public Safety Library. This relates to both law enforcement and fire and rescue candidates.

All new recruits with the Vancouver Police Department (VPD) are offered a health and wellness workshop style day at Copeman Healthcare, one of Vancouver’s leading private healthcare facilities; and home to my employer with Fit to Train.

New recruits come to Copeman Healthcare center and are offered preventative tools to ensure their optimal physical and mental health are looked after. Speakers from the physiotherapy and Kinesiology department, as well as the medical and psychology fields speak on topics related to long term health and law enforcement. Dr. Mackoff; a Registered Psychologist consults to a number of police departments both in Canada and internationally. As a psychologist Dr. Mackoff treats individuals experiencing difficulties with anxiety, trauma, depression and relationships. Dr. Mackoff has an interest in providing psychological assistance to individuals who are coping with health related difficulties

The RCMP’s Occupational Health Services, have specialized health practitioners who screen and monitor all members to identify mental health risks, as well as OSI clinics all over Canada, close or within detachments. RCMP officers have direct access to Canadian medical and psychological practitioners of their choice; inclusive of general physicians, psychiatrists, and community-based psychologists; asll of which fall under the RCMP’s Health Care Entitlements and Benefits Programs.

In October 2012; the Ontario Ombudsman released a report, “In the Line of Duty” in which was an investigation into how the Ontario Provincial Police and the Ministry of Community Safety and Correctional Services have addressed operational stress injuries affecting police officers; where 34 recommendations were outlined.

Much like the RCMP the OPP found that one of the obstacles facing police is that the force has not done any significant research into the OSIs among its officers, that the periodic screening is voluntary and there is a high level of stigma associated with OSI.

In the BOLC “Badge of Life Canada” online blog; they featured 2 of those recommendations (3) :

Recommendation 1:

The Ontario Provincial Police should take additional steps to reduce the stigma associated with operational stress injuries existing within its organization, including:

  • conducting a comprehensive review of its education, training, peer support, employee assistance and other programming related to these injuries

Recommendation 2:

  • consulting with experts, police stakeholders, the Canadian Forces, Veterans Affairs Canada, and other police organizations
  • researching best practices relating to addressing operational stress injuries in policing; and
  • developing and implementing a comprehensive and co-ordinated program relating to operational stress injuries. Subsection 21(3)(g) Ombudsman Act

Furthermore, a study from Carleton University found that officers in Canada are facing greater pressures at work that may be taking a greater physical and mental toll on police than previously believed.

 

A PTSD Mobile Coach:

The use of technology has also been a great turning point in chronic pain and mental health. The new OSI mobile app is a new channel for Veterans and serving personnel in the Canadian Armed Forces and the RCMP to get information and resources on operational stress injuries.

The PTSD Coach Canada app is designed to help you learn about and manage symptoms that can occur after trauma. Features include; reliable information on PTSD and treatments that work, tools for screening and tracking your symptoms, easy-to-use tools to help you handle stress symptoms, direct links to support and help and is always with you when you need it. Form more information please visit this (link).

Canadian_Forces_2009_12034

A Local Hero: Captain John Croucher, PPCLI officer working at 1CMBG

This is a story that deserves its own headliner, its own article. Captain John Croucher’ otherwise known as “The Sir,” to his men served in Afghanistan in 2006. The platoon captain of the 1st Battalion, Princess Patricia’s Canadian Light Infantry; who on May 25th, 2006 was severly injured after an he and his 20 officers, and their LAV was struck by an IED. The third to hit Alpha’s second platoon, or the 1-2 as it’s called; Capt. Croucher underwent eight surgeries at three different hospitals in three different countries, first in Afghanistan at the Canadian-led base hospital at Kandahar Air Field, then at the U.S. military hospital in Landstuhl, Germany, and finally in Canada at the U of A.

In 2006 Cpt. Croucher came to Vancouver to receive treatment for PTSD and further rehabilitation and I was the lucky Movement Coach who was given the privilege to work with Captain Croucher weekly for nearly 2 years. He remains one of my dearest friends and is one of my hero’s.

Next week hear Captain Croucher’s story and his first hand accounts of overcoming injury, breaking the stigma of PTSD and his role back in active duty, as well as some of the positive changes our government is making in OSI standardization, as well as some of the gaps that may still need bridging.

June is PTSD National Awareness Month, let’s support our troops!

 

Sources:

Chronic Pain Series Part 2: Mental Health & Chronic Pain

Chronic Pain Series Part 2: Mental Health & Chronic Pain

Mental Health and Chronic Pain:

Mental health and physical health are fundamentally linked; there can be no denying that people in pain, feel stress and it is this cycle of stress that leads us to consider our mental health. People living with chronic physical health conditions experience depression and anxiety at twice the rate of the general population.

Living with chronic pain every day puts a strain on your psychological well-being. Keeping the mind healthy while the body struggles to finds ease is not always easy, but it plays a huge role in coping with day to day pain. It is a perpetual cycle that acts as a feedback loop in both the brain and the body.

On the flip side, it also goes without saying that people living with a serious mental illness are at higher risk of experiencing a wide range of chronic physical conditions.

 

Depression:

It is no secret that there is a link between chronic pain and certain mental health concerns, like depression. This can be extremely frustrating during the diagnosis stage, because of the dual diagnosis of chronic pain. In fact, depression is often one of the first conditions that doctors try to rule out when diagnosing chronic pain. As many as 50% of people who suffer from chronic pain also have recurrent clinical depression. Billions have been spent on healthcare per year, yet chronic pain is still not high on the medical agenda.

So what is Clinical Depression? Clinical depression is more than a feeling of sadness or low, down and out mood. It is a psychological state that causes fatigue, lack of motivation, appetite changes, slowed response time and feelings of helplessness, inability to partake in the things you love, which is doubled by the pain of……pain. Depression has physical symptoms as well, including aches, pains and difficulty sleeping. Does this not sound familiar? Does this not sound a lot like many of the same symptoms of chronic pain? YES.

Depression is more than a side effect of chronic pain: the two diagnoses are often so interwoven, that they can be difficult to separate the two for proper treatment and resources. Chronic pain can keep people from doing the things they love. Pain changes how our body’s move, and how we relate to the world. It changes our mood; therefore, it’s safe to say that people who have chronic pain tend to be less active than those who are healthy, because their minds and bodies cause them to slow down and the anticipation of pain receptors leave little room for getting excited to move around and be merry. Again, we see this constant cycle of anxiety around pain.  Not feeling happy with your quality of life is often an emotional drain. With few outlets available for stress relief, it is easy to fall into a downward spiral that leads to depression.

In the Vancouver Sun on April 15, 2013 there was an article “Chronic pain: Managing it, living with it: Health system lags in chronic pain treatment,” outlining the need for chronic pain to be higher up on our medical systems agenda.

 “Depression can make people’s pain feel more intense as it can potentially stop them from feeling hopeful and they can lose motivation to do the work of recovery, which adds up to more pain, she says.

Diagnoses related to chronic pain are therefore difficult. Complex pain is a biopsychosocial issue as opposed to acute pain,” says Squire. “So that means we’re never just assessing the painful part, we’re assessing somebody’s mood, usually their sleep. It has cognitive effects, so they’re quite complicated assessments.”

We still do not have enough data metrics and research to support the proper pathways to treat people with chronic pain, but there are many organizations that are coming together to change this. Two of those organizations are PainBC and Change Pain Clinic, located right here in VancouverBC, but we will get to them in just a mere moment. Let’s look at the cycle of stress.

pain_cycle

The Cycle of Stress:

Pain activates the areas of the brain that respond to stress; through pain receptors. This is one of the body’s coping strategies for dealing with acute pain and for protecting us from harm. It is a survival mechanism that’s been encoded in our DNA since the dawn of time. When the brain gets the signal, the brain reacts by sending the body into high sensory overload and overdrive, to prepare for fight or flight. When the pain goes away the signals are supposed to stop.

However, we see with chronic pain, the fight or flight signals don’t turn off, and the nervous system stays in a constant state of high alert, like an alarm in the morning that won’t shut off. You can imagine how annoying and frustrating that would sound like; at some point all you want to do is throw the freakin’ alarm clock against the wall and drop “F”bombs right, left and center.

Now imagine that constant alarm in your body 24/7. It can feel debilitating, maddening and deafening. The body does not get a break from the brain’s stress chemicals and too much stress without time off eventually wears the body down, which can leave you vulnerable to depression.

Stress management can be complicated and confusing because there are different types of stress,  each with its own characteristics, symptoms, duration, and treatment approaches.

Now, not all stress is bad, but when we do not know how to cope or adapt to the changing landscape, it can do more harm to us, then we realize. In most psychology journals, psychologists describe four types of stress – hyopstress, eustress, episodic acute/ hyerpsress and chronic/ distress:

 

  • Hypostress: insufficiently low stress
  • Eustress: sufficient, adaptable stress, positive stressors
  • Episodic Acute /Hyperstress: recoverable, high stress, “A” type stress
  • Distress: excessive, unadaptable stress, inability to recover or cope

 

The emotional trigger and response is critical in establishing greater levels of resilience, in hopes of instigating more positive coping strategies that can greatly improve ones ability to cope under stress.  These include options such as; gentle and restorative yoga, breathing classes, meditation, music therapy, light movement classes, even brain entrainment. All of which have shown to be successful when applied to their treatment and personal coping strategy. Of course, none of these alone will do the trick, but an integrated system designed for YOU  – can offer you renewed HOPE.

 

The Biopsychosocial Model:

The biopsychosocial model (abbreviated “BPS”) is a general model or approach positing that biological, psychological (which entails thoughts, emotions, and behaviors), and social factors, all play a significant role in human functioning in the context of disease or illness. Indeed, health is best understood in terms of a combination of biological, psychological, and social factors rather than purely in biological terms The biological component of the biopsychosocial model seeks to understand how the cause of the illness stems from the functioning of the individual’s body. The psychological component of the biopsychosocial model looks for potential psychological causes for a health problem such as lack of self-control, emotional turmoil, and negative thinking.  (Wikipedia)

Rather than offer you a full synopsis on this model, it can be best viewed in this riveting presentation featured in April via Pain BC:

For those of you interested in the cross pollination of these fields, I highly recommend you take the time to view this presentation.

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Renewed Hope

Our community mental health sector, as well as our community in chronnic pain management, is undergoing a province-wide transformation. Many organizations, including local branches of the Canadian Mental Health Association, grassroots organizations in pain specialties have received new funding for service enhancements over the past several years; however it is not enough. Policy making and governance are high on the agenda to support long term, sustainable change at the higher levels. With new policy and adequate funding this can offer those patients with pain who may not be able to afford services and programs new hope in optimizing their health and wellness.

PainBC and teams like Change Pain Clinic are two pioneers in the areas of chronic pain who are paving the way for a renewed sense of dignity and hope for those who live with chronic pain and dual diagnosis in mental illness.

Last week we looked at PainBC, but I wanted to draw your attention to the previous “Empowering Self Management of Pain” webinar series. A series of webinars that aired in May brought forth the power of how innovation and technology can bring people with pain together to better understand their conditions and the power they have to take charge and manage their own personal health and wellness. In case you missed them please watch them all here – http://www.painbc.ca/sessions/past

Change Pain Clinic:  

A passionate team about leading health care system change for everyone burdened by pain. Since it’s fruition in 2009, founders Brenda Lau, Greg Siren and Judy Pryce have been collaborating on ideas on how to improve the lives of pain patients and pain practitioners. An integrated team of clinicians and health practitioners brings together the necessary skill sets to truly revolutionize how we look at, deal with and treat people in pain.

More importantly, a team readily open to put themselves on the line to change agenda, governance and policy within our medical system. Word on the street is Fit to Train Human Performance Systems may just be combining forces and joining this revolution. I feel honored to be part of this team and part of this revolution.

Not Myself Today: Partners in Mental Health

In January, a major step forward was taken with the launch of a National Standard for Psychological Health and Safety, which promotes good mental health and prevents psychological harm in the workplace. This is an important start.

The Not Myself Today campaign was created to proactively deal with our mental health. Every one of us has had a day when we don’t feel like ourselves. Now, imagine living with those feelings not just one day, but many days – and the shame, discrimination and lack of treatment and support that goes with it. This is especially critical at work – where so many of us spend so many hours a day. This campaign is designed to better understand and break the stigma around mental illness. As we know much like chronic pain, the stigma is the same. If you can’t “see” it…how do we tell others about how we “feel.” This campaign aims to change that and to bring people who feel miss understood…together to join forces… so they CAN and WILL be understood.

 

stock-footage-healthy-life-d-highway-exit-sign

The moral of this story, is that there are those of us who understand, who are here to help and offer support. There is hope and dignity in this struggle and as we continue to forge forward, more and more options are available to those who live with chronic pain and mental illness. I would like to close by offering you a fan-freakin-tastic quote, by one of my mentors, who has undergone his own transformation with chronic pain, injury, being stigmatized with labels; a man who is a fighter and has come out on the other side stronger and more resilient. This is quote from one of his blogs titled “Strive but do not Identify with the Struggle.” Enjoy….

 

 “What you fight for, and what you refuse to struggle against, defines who you are. Fight for your values, but do not live in strife. You can do a thing, without becoming a thing, just like you can face defeat, but not be defeated. Stop keeping track of the mistakes you’ve made, the fights you’ve faced and the defeats you’ve suffered. You will again, but you will not become them by doing do; only by thinking you are.

Focus your attention on the right decisions you’ve chosen, the flow you’ve facilitated and the triumphs you’ve allowed. Steel against the negative until you no longer need to direct your mind, and you have trained yourself to be free of judgment at all. Judging a person doesn’t define who they are, but who you are; judging yourself is the same. The process of judgment limits us by the boundaries of its definitions.

Do not identify with the discord, even when life surrounds you with a cacophony. Remain in harmony with the melody of your soul despite the noisy world, and you give everyone with whom you harmonize, a chance to tune in to their own melody as well.” 

– Scott Sonnon

 

Next week we look at chronic pain and PTSD in our military forces. Serving those who serve and protect.

 

Sources:

 

CHRONIC PAIN: STRENGTH IN NUMBERS

CHRONIC PAIN: STRENGTH IN NUMBERS

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“Chronic pain had been a part of her life for as long as she could remember. Pain that stemmed from her back, pain that seemed to turn on and off like a light switch, progressively worse during times of high stress and seemed to manifest for no reason at all. Some days it felt debilitating, burning deep inside, referring down her leg, up her entire back, into her digestive track, some days it seemed like too much energy to get out of bed. A deep dark abyss of unanswered questions, a chase for time, where the doubts, those shadowy parts of oneself that reside in all of us from time to time…lay  just behind your every step forward and seem to start catching up to you, and it is exhausting work; the continued work to bury them deep down inside. Why me? Why Now? Have I not lived through enough? What if it’s cancer?  Is it left over trauma for a decade of child abuse? Is it all in my head? Her mother had bi polar and suffered from chronic pain, could it be genetic? Where ARE the answers? The questions are exhausting.

 For years, she did not speak of it, she would say.. “oh it’s just an injury from running,” .. “it’s nothing major,”…. but then those deep dark questions would rise back up like a tidal wave.” – Sarah Jamieson

This was a passage from one of my journals when I turned 30, 2 years after the passing of my mother and the beginning of telling my personal story, my journey through chronic pain, mental health and surviving trauma. Spending the last 2 decades in silence on a personal path of recovery and meaning to better understand why and how “pain” exists in the body and mind, and to find out if there is a connection between onset of chronic pain and those who survive childhood trauma. The silence is no more. For those of us who have survived trauma, we each have a story to tell, and we must find strength in speaking out.

For today’s post I would like to limit my scope to an introduction to chronic pain to give you a better idea of some of the positive points of interest I am engaged in.

I share this with you because as a medical community, there is so much we still do not understand about the human psyche and about chronic pain overall, but many of us; patients and medical staff alike, are coming together to try to offer better diagnoses, treatment and services to those who suffer every day with chronic pain. More importantly, for people like me, I tell my story, so that we can build better awareness around chronic pain, break the stigma attached to it and provide a beacon of hope for those to stand tall and who can see a quality of life they wish to live and lead in the future.

What is chronic pain?

It seems like an easy question, yet in fact it is not. In medical terms the distinction between the terms “acute” pain and “chronic” has been by determining an arbitrary interval of time from onset, usually using markers for acute pain lasting 3 months and chronic pain lasting longer than 6 months.

According to WorkSafeBC policy, chronic pain exists when two conditions are met:

  • The pain is still present six months after an injury or an occupational disease;
  • The pain is present beyond the usual recovery time for the injury or disease.

WorkSafeBC identifies two types of chronic pain:

  • Specific pain — pain related to a physical or psychological cause.
  • Non-specific pain — pain that exists without a clear medical reason.

Answering the question “what is chronic pain” is difficult, because it manifests uniquely in each person, it is not easily diagnosed, and it is not easy understood by our medical community and for many who live with chronic pain. For many who live with this day in and day out there is a giant pink elephant in the room called – stigma.

Chronic pain is under-recognized and most often under-treated and it has reached epidemic proportions in this country, affecting almost six million Canadians.

Did you Know: “That means more than 1 in 5 British Columbians are living with chronic pain; which results in the daily suffering, the breakdown of family and other relationships, the potential for addiction as a way to cope, the loss of productivity and purpose, the risk of becoming impoverished.”   – Pain BC

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Chronic pain needs more of an agenda in our medical and therapeutic communities and many are starting to come forward to ensure chronic pain is not just on our local agendas, but provincially and federal agendas as well.

One of these organizations is called Pain BC, a local non profit organization formed in 2008.

Who is Pain BC?

Pain BC is made up of patients, health care providers, and leaders from academia, members of relevant non-governmental organizations and others, who share a passion for reducing the burden of pain and for making positive change in the health care system in British Columbia. I joined this board only a couple months ago and over the next 2 years my plan is to be a strategic part in raising the awareness of chronic pain and changing current landscapes of how we diagnose, treat and offer services to patients with chronic pain.

A dedicated group of well-educated, compassionate and appropriately resourced health care providers are essential allies for people during their journey with pain. Equally important is providing people in pain themselves with the education they need to become actively involved in their pain management, and giving patients a renewed sense of control and ownership over their lives and health.

Pain BC aims to deliver practical education sessions, providing assessment and other tools to guide and streamline practice, and continue to build partnerships to help advance systemic improvements, are all key to ” helping the helpers” improve the lives of people living with pain.

 Did you Know: Despite its prevalence, a recent survey demonstrated the lack of public awareness and education around chronic pain. Twenty-one percent of respondents indicated they suffered from chronic pain while only 47 per cent of Canadians surveyed “fully believed that chronic pain is real.” Chronic pain is under-recognized and under-treated. Chronic pain affects people of all ages. In Canada, one in five people suffer daily from chronic pain. It is a ‘silent epidemic’

 

 

The Canadian health system is operating on an outdated understanding of pain. Growing awareness of the human and financial costs of chronic pain has catalyzed an international movement to address the needs of people living with pain. Pain BC is adding our voice to others around the world calling for improved pain management. It’s time for a change.

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Pain BC’s Vision:

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.

Self Management Support:

One of the key components of Pain BC, is the opportunity to empower patients to become leaders in their own lives. Self management and strategies are key to any successful endeavor, it is a critical piece of the chronic pain management puzzle. Research has shown that self management of chronic pain can significantly improve people’s quality of life. We all want to be leaders in our own lives, do we not?

Self Management Programs are collaborative partnerships between those suffering from chronic pain and health care professionals.

For more information: http://www.painbc.ca/content/self-management-support

 

Resources for Health Care Providers:

Health care providers treating patients with chronic pain are presented with unique challenges. Pain BC’s mission includes educating those health care providers and providing them access to the best resources available so that they may help their patients as effectively as possible.

To that end, Pain BC has compiled information on Assessment Tools & Clinical Guidelines,  Clinical Resources, Conferences and Training, Program Design and Operation, a directory of Pain Clinics and Services, as well as a list of Links of Interest. As part of our continued work in supporting health care providers, we also provide unique memberships FOR healthcare providers to get more engaged in chronic pain; and this includes everyone from doctors and nurses, to physiotherapists, chiropractors and anyone offering skill sets in pain management and therapeutic modalities.

Pain BC provides brochures and information at your finger-tips to help better serve your community.

 

What Makes Pain BC Unique?

Apart from it’s partnerships and integral work behind the scenes, Pain BC offers innovative ways for patients and practitioners to get involved. The list below is just a snippet of what is offered and what is in the Pain BC pipeline for 2013/2014:

  • Pain Waves Radio: Pain Waves Radio is a call-in internet radio show created by non-profit society Pain BC, where listeners can listen to, and interact with, leading chronic pain experts as they discuss the latest pain management research, tools, and trends. For more information: http://www.blogtalkradio.com/painwavesradiobypainbc
  • Salons: a workshop style evening, that explores the art of public conversation.  An enhanced dialogue where speakers are chosen to present on a theme, and the flow of the event is not dictated by a regimented set of parameters, but around organic dialogue. It is meant to be interactive in an atmosphere of free flowing idea generation that is goal oriented and builds awareness on the topic at hand.  
  • National Pain Awareness November 3-9th 2013 A national conference focused on addressing chronic pain across the country. For more information please visit : http://www.canadianpaincoalition.ca/index.php/en/national-pain-awareness-week/about
  • Become a Member or a Volunteer: Pain BC needs you to get involved and take action on chronic pain. In order for us to break the cycle of pain and stigma, we as a community need to work together. Benefits of membership include a subscription to Pain BC’s e-newsletter, eligibility to attend education sessions and conferences for free or at reduced rates, and participation in networking events and discussion forums.
  • Be involved in Research: If you are over 15 years of age and would like to participate in a Chronic Pain Survey, the CIRPD is seeking input from people with chronic or persistent pain to better understand what types of information resources are being sought.

Chronic pain still has a long way to go to be understood, but the more we continue to bring interested parties together, the more impact we can make and the more we can shrink that pink pachyderm, in the room. There is hope for those living with pain, it does not have to be a way of life. Being a leader in your own life, starts here.

Sources:

Pain BC: http://www.painbc.ca/

Canadian Pain Coalition – http://www.canadianpaincoalition.ca/

 

UnCovering & UnCooking the FMS Model: Primitive Patterns, Myths & Strategies

UnCovering & UnCooking the FMS Model: Primitive Patterns, Myths & Strategies

Last week we taught an FMS Level 1 and Level 2 (Advanced Corrective Exercise) combo course at Copeman Healthcare to a sold out room of 29 eager students, coaches, trainers and clinicians. Over 130,000 + health professionals have joined the legion of FMS certified coaches around the world, and I felt very proud to be one of the assistants to one of the few teachers in North America who teaches the level 2 course. Behnad Honarbakhsh is one of Vancouver’s leading physiotherapists who specializes in not only traditional physiotherapy, but also, acupuncture, IMS (intramuscular stimulation), NLP, energy work, and soon to be Osteopathy. People have coined his sessions as “miracles” or “voodoo,” and I would be agree being a patient, as well as an employee and friend.  There is a vast wealth of knowledge and experience in our team at Fit to Train Human Performance Systems.  Now, enough of tooting the FTT horn… onwards to the main component of this article.. Uncovering the FMS model: Primitive Patterns, Myths and Strategies for corrective movement.

As Fit to Train’s only Movement Coach, new FMS professionals come to me with questions to learn more about how to apply this new tool and the corrective exercises into their current scope of practice. Many of which are strength and conditioning coaches and personal trainers who find it overwhelming with all of the information to then make the transition from doctrine to strategy. My response is always the same: Keep.It.Simple.

 

KEEP IT SIMPLE:

Modern fitness and training science has bestowed upon us the ability to create strength and power in the presence of extremely poor dysfunction. This dysfunction means that fundamental movement patterns are limited, asymmetrical or barely present. Just because we can make people bigger, faster and stronger on top of this does not make it right. Seated, fixed-axis equipment perpetuates the illusion of fitness without enhancing functional performance. And what about “weak core” or “weak glute medius,” these are the two biggest myths in our industry. Number one, how can you tell it’s a weak core or weak glute med? How can you tell if a client is “firing” it. Answer – is you can’t. One muscle does not make the human body move properly. For active clients and even well trained athletes, it will be inhibition of sequential movement that results in poor tissue movement and tissue health. This falls into 3 categories (1) mobility (2) stability or (3) motor control, and most often because joints have a relationship with it’s neighbor and neighboring quadrant, you see all 3 scattered in different interactions between joints, tissue and posture positions.

Utilize all of your tools to uncover an individual’s dysfunction and then work to correct it. The result will be an individual who moves more efficiently, thereby creating a foundation for more effective strength, endurance and power training.

1.  THE TOOLS : The FMS Screens (which includes the FMS, SFMA for clinicians and the Y Balance) are all just screens to offer you a baseline on a clients strengths and compensatory movement.

2. THE SCORE: work on one asymmetry at a time, as you we see changes in them all. Use the breakout tiers  provided on the most asymmetrical score (ASLR, shoulder mobility, primitive patterns etc).

3. THE STRATEGY: Corrective movement exercises  are designed to “prep” the body for movement, any movement that the coach has prepared for that particular client. Your role in your warm up is to assess risk, remove negatives and prepare the client for the session.  If you are a trainer, corrective movement can be the first 10 mins of the hour. Like all else, what the client does on their own is part of the overall strategy of personal goal attainment. Ensure you offer them guidance and encourage them to perform their specific corrective exercises at home between your sessions.

The “Core” is the Foundation to Primitive Patterning: Gray Cook; Sequence of Core Firing Video: 

MOVEMENT COACHING:

As a Movement Coach, I have the opportunity to spend an hour or more with each client and coach them on these fundamentals. Corrective movement is a modality within the health and wellness realm; which we like to call the “transition zone.” Corrective movement opens the door for coaches and professionals in the fitness industry to screen, assess and correct breakdowns in a client or athletes movement mechanics.

In my practice I use this style o f training to (a) pre screen a client who may need to see a physiotherapist or medical professional or (b) the client has been referred by a physiotherapist or medical professional and thus, my role is to “transition” the client from the clinical to the coaching again. This work compliments the work of most trainers and coaches, as it allows them to maximize their role with an athlete or client. There is no competition between myself and other trainers or coaches, because what I mainly teach is the technique and how cleaning the slate, removing negatives etc, applies to all areas of the athlete or clients life; while at the same time reinforcing the coaches strategy. An integrated team approach.

Even in the strength and conditioning realm, I have the opportunity to teach or in some cases re teach the fundamentals of lifting and transitioning. As the body becomes more efficient in mobilization, stabilization,  and neuromuscular adaptation they will ultimately be stronger and more fluid in movement. With this comes a risk of injury if we, as coaches, do not properly teach those new fundamentals the athlete or client are experiencing.

Video: Asymmetry in Movement (DVD Key Functional Exercises You Should Know): 

UNCOVERING THE FMS MODEL:

The following video selections are favorite videos I have chosen from the FMS library for you to be become more familiar with Corrective Movement, common mistakes and myths in the industry and the written portions of the article is direct excerpts from Gray Cook’s website and movement book.

Movement Competency: The ability to employ fundamental movement patterns like single-leg balance, squatting, reflex core stabilization and symmetrical limb movement.  This can also include basic coordination with reciprocal movement patterns like crawling and lunging. The central goal is not to assess physical prowess or fitness, but to establish a fundamental blueprint and baseline of quality not quantity.

Physical Capacity: The ability to produce work, propel the body or perform skills that can be quantified to establish an objective level of performance. If movement competency is present at or above a minimum acceptable level of quality, deficits in physical capacity can be addressed with work targeting performance. If movement competency is not adequate, it would be incorrect to assume that a physical capacity deficiency could be addressed by working only on physical capacity.

Growth and development follow the path of competency to capacity, but how many fitness and athletic programs  parallel this time-honored gold standard of motor development? If screens and standards for movement competency are not employed, we are programming on a guess. Furthermore, if our testing does not clearly separate movement competency tests and physical capacity tests, we exchange a guess for an assumption.

 VIDEO: Applying the FMS Model (6 min from the DVD Set “Key Functional Exercises You Should Know”):

COMMON MISTAKES & MYTHS:

Exercise professionals too often overlook the fundamental movements because highly active individuals can often perform many high level movements without easily observable deficits. The Functional Movement Screen was first introduced to give us greater relative insight into primitive patterns by identifying limitations and asymmetries. The FMS screen is a way of taking it back to the basics and recognizing that these patterns are fundamental; a key factor is that they are common during the growth and developmental sequence, and thus taking it back to primitive movement, we may be able to overcome some of these common compensations.

 VIDEO: Gray Cook:  Common Mistakes Made in Corrective Movement vs Strength Movement 

PRIMITIVE PATTERNS: 

Consideration of primitive patterns can help make you a more intuitive, and intelligent exercise professional. Very often we become experts in exercise without considering growth and development, which is where the fundamentals of movement were first established. As explained in this video, these fundamental movements include rolling, pushing up, quadruped, and crawling. This foundation is often neglected in the approaches we take to enhance function and/or performance through exercise programming.

The first rule of functional performance is not forgetting fundamentals. In order to progress to movement we first learned to reflexively stabilize the spine, in order to control movement more distally in the extremities, this happened naturally during growth and development. However, many individuals lose the ability to naturally stabilize as they age due to asymmetries, injuries, poor training or daily activities. The individuals who do this develop compensatory movements, which then create inefficiencies and asymmetries in fundamental movements.

VIDEO 2: Gray Cook and Lee Burton: Secrets of Primitive Patterns:

Sources:

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