Category: News

By Celeste Langdon, ND (candidate) also ‘super summer student intern at THS!’ 

So, you went to your doctor about bloating, gas and abdominal discomfort. Chances are, you got diagnosed with IBS, or irritable bowel syndrome. It is of no surprise to know that one in eight Americans are diagnosed with IBS, as a large number of us experience these symptoms at some point in our lives, if not on a regular basis. Unbeknownst to most people is that there are four types of IBS: IBS-D (diarrhea predominates), IBS-C (constipation predominates), IBS-M (mix of diarrhea and constipation) and IBS- un-subtyped. 

       So we know how to diagnose it, but where exactly do these symptoms come from?

There are many different factors that come into play in order to narrow down the root cause of IBS. It can be as simple as a dietary change, or as complex as genetic predisposition. But the most recently found root cause of IBS is what is known as SIBO or Small Intestinal Bacterial Overgrowth. SIBO is just that – an overgrowth of bacteria, except the bacteria are growing in the small intestine as opposed to other areas of the gut where they would normally reside. These bacteria not only cause the IBS symptoms, but they also can cause nutrient deficiency, vitamin deficiency (including A, D and K), carbohydrate intolerance and systemic symptoms such as acne and brain fog.  SIBO can be found in as many as 84% of IBS cases, with a 75% improvement rate for IBS patients after treatment of SIBO. 

       Thinking you may have SIBO? Here are some of the top symptoms reported for SIBO: Intolerant to fiber or prebiotics, your symptoms are worse with probiotics and better with antibiotics, history of food poisoning or acute infectious gastroenteritis, celiac disease and chronic deficiency with no known cause. If these symptoms sound like you, and you want to find out more about your symptoms, you can get a breathalyzer test done which tests your lactulose and glucose levels in order to assess whether or not you have SIBO. Although this test works very well (specificity of 80%), most people opt not to do it due to the price. There is an alternative test though, known as the IBS check test which is simply a blood test which costs much less than the breathalyzer test. 

Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3155069/

In the manual therapy and rehabilitation world, there is an abundance of knowledge on injury management and best practice guidelines. Due to the availability of this information, you would typically receive similar treatments for certain injuries. Whether it is a physiotherapist, chiropractor, massage therapist, athletic therapist, etc., if you came in with shoulder pain and a diagnosis of rotator cuff injury, you’d most likely receive a treatment plan with some array of hands on therapy, modalities (laser, ultrasound, acupuncture, etc), and given exercises to do. Even though these treatment plans are typically successful if executed properly and based on the best guidelines, there are still those that go through the ringer of therapy with little to no results and may even get told to “live with it”. This is where I’ve found Neurokinetic Therapy to be extremely helpful in solving the complex cases or even expedite recovery in other cases.

The Neurokinetic Therapy™ corrective movement system protocol employs a system of precise muscle tests in order to gain the ability to change the programming of the Motor Control Center (MCC) in the cerebellum. The MCC coordinates all movement patterns in the body. It learns through failure. A good example to help understand this is a baby learning to stand. Through many attempts and failures the baby finally achieves success. But how? The MCC chooses the most successful attempts until standing happens without “thinking” about it.

Conversely, after an injury, the MCC adapts to a compensation pattern and holds that in its memory forever unless it is convinced to change. A good example is a whiplash accident in which the posterior neck muscles typically brace for weakened anterior neck muscles. This pattern can continue in dysfunction unless there is some intervention. In NKT, movement assessment and muscle testing protocols are used to discover and confirm compensation patterns such as the one mentioned above. Once these compensations are understood, specific therapy is performed to undo compensations and restore proper and desired movement patterns. After the balance is restored, the MCC is “reprogrammed” and recognizes the new pattern. The effects of a restored movement pattern can be almost instantaneous; which can leave a patient baffled and the practitioner feeling like a wizard! However, to complete the reprogramming, specific rehab exercises are assigned to “drive home” the newly learned functional pattern.

Neurokinetic Therapy™ is an effective tool in assessing and treating dysfunctions in the body. At its core, learning how to effectively assess dysfunction amongst muscles of the body with NKT can provide great insight for a practitioner. Further to this, NKT provides a plethora of assessment protocols that can detect dysfunction within joints, ligaments, scar tissue, and even dysfunctional relationships between all of the above. The intricacies the neuro-musculoskeletal system is truly astonishing.

As a user of NKT for the past 3 years of practice, I can attest to how valuable this protocol is to therapy. It helps to provide a complete clinical picture and clarity in cases that otherwise would have practitioners scratching their heads. Whether it is helping someone with their running, or taking away their chronic symptoms, NKT gives you the opportunity to do so much more for your patient!

Prior to coming in to see one of the chiropractors at Town Health Solutions, one of the questions we receive is ‘what is a first visit to a chiropractor like?’.  We are happy to tell you!

Based on where you are, you’ll be greeted by one of our friendly front desk staff, either Faith in Saint John, Raylene in Sussex, Brenda in Hampton, or the other Raylene in St. Stephen.  They’ll provide you with a short intake form so we can get some basic information about yourself.

At this point, you’ll meet the chiropractor who will be overseeing your visit.  The first visit takes approximately one hour, so we ask our patients to please plan their schedule accordingly.  Our staff being thorough is an understatement.  We don’t want to just help you feel better, we want to find out why you felt bad in the first place, and try to reduce the likelihood of it coming back.

A first visit includes the following:

Case history

We will spend approximately 20 minutes asking you not just about the where, what, and how, but also try to tease out the why.  We’ll be interested in your lifestyle, medical history, and anything that can help us help you.

Physical Examination

Here, your chiropractor will watch you move, perform orthopaedic and neurological tests, functional tests to evaluate how muscles and joints behave through different tasks, and also tests to ensure that you don’t have anything more serious that would necessitate a medical referral.

 Your chiropractor will perform a very thorough and complete physical exam

Report of Findings

At this stage, your chiropractor will explain everything they found in a very clear, concise, and understandable manner, without overusing too much technical jargon.  You’ll be told your diagnosis, functional findings, how your case history relates to your issues, and what the plan is including what treatment will include, and how many visits it will likely take (acute cases take between 8-12 visits).

 Everything will be clearly and simply explained.

Treatment

Your chiropractor is trained in many different strategies, that are applied uniquely to YOU, the individual.  There is no cookie cutter approach at Town Health.  Treatment may include soft tissue therapy, spinal or extremity manipulation, active exercise, nutritional recommendations, functional neurology, modalities such as shockwave or laser, and support on navigating your life for the next few weeks.

 Treatment is very specific to your particular needs.

So that’s your first visit!  We hope that it answers some of your questions and we look forward to being able to help you! 

It’s no secret that exercise is good for your health, but you may be surprised to learn just how far-reaching these benefits can be. We are all familiar with the classic gym stereotypes of toned muscles and trim waistlines, but there’s certainly more to it than just weight loss and physical appearance when it comes to physical activity. There is a wealth of scientific research supporting the notion that regular physical activity can have a huge impact on the prevention and management of many health conditions. These health conditions include diabetes, cardiovascular disease, high blood pressure, stroke, cancer, anxiety, depression, and many more.

Now, I’m sure each of us has been impacted in some way by one of the above conditions, so we would all be inclined to try and limit any further experiences with them, right? Of course, there is no way to guarantee a life free from illness and ailment there are certainly ways that we can better our odds when it comes to chronic illness. While each of the above conditions differs vastly in their symptoms, their prognosis and their anatomy and physiology, they do share a lot of common risk factors. Some of these primary risk factors include tobacco use, alcohol use, diet, and exercise, each of which are variables that can be changed and manipulated with the right guidance and effort. My hope in writing this week’s column is to better educate you on the positive effects and benefits that can come when we manipulate the exercise variable and move away from sedentary behaviour.

Here in New Brunswick, especially, we need to start heeding these warnings, acknowledging the risk factors, and then actually acting on them! In New Brunswick we have some of the worst health statistics in the country; we are over 5% higher than the national average when it comes percentage of the population living with obesity (20%) and high blood pressure (19.8%) and we are near the top of the list when it comes to the percentage of active tobacco users (21.2%). In line with our above average health statistics, we have an over-burdened provincial healthcare system with our hospitals and facilities consistently operating over their capacities.

But alas, exercise can help! As alluded to above, exercise can play a huge role in reducing risk for many chronic illnesses. Exercise has been proven to help lower and manage blood pressure and cholesterol levels, to help reduce body weight and body mass index (BMI) and to help prevent and manage diabetes. Exercise can also play a huge role in the prevention and management of psychological illnesses like stress, anxiety, and depression by creating chemical changes in the brain and the bloodstream. Reducing risk factors like high blood pressure, stress, and high cholesterol can then act two-fold by going on to further reduce your risk for stroke or cardiac events.

In summary, the benefits of exercise go far beyond strength gain and physique, rather it can also serve to improve and maintain your health and longevity. So, as a start point, I challenge you to enjoy this beautiful time of year and get outside for a 20-minute walk each day. Taking small steps like this for yourself and for your overall health can make a huge difference! Stop making excuses, stop putting it off, and please don’t wait until it’s too late to act; it’s easier to prevent than it is to cure!

For any feedback, questions, or topics you would like to see discussed please email me directly: nathan@thetownphysio.com

By Nathan Edwards, M.Sc.PT

My parents raised me to respect my elders and to appreciate and embrace their wealth of knowledge and experience. So, when I have senior citizens come into my office and define their injuries, their soreness, and their inactivity as “just part of getting old” I always revert back to my parent’s childhood advice and say, “you’re right, but…” In this weeks column I’d like to explain that “but” and get you comfortable with the fact that you DO have a say when it comes to joint pain, activity, fitness, and health as you age gracefully into your senior years.

There’s no doubt that with increased age we see a higher incidence of certain ailments, most commonly we think of arthritis, osteoporosis, diabetes, high blood pressure and heart disease. We certainly know that arthritis can mean joint pain with certain movements. We absolutely know that osteoporosis results in inherently weaker bones and can lead to higher risk of fracture. We are all familiar with examples whereby new stints of high intensity exercise have been a factor in cardiac events or heart attacks. With all of that stated it certainly stands to reason that a logical, albeit more traditional mindset might peg any of the aforementioned conditions as reasons to avoid activity as we age. Unfortunately, it’s my job to tell you that it’s actually in your best interest to defy the common wisdom and get busy moving and sweating as you age.

The first and foremost, as it pertains to physiotherapy and aging, has to be arthritis. There’s seldom an appointment in my office when that word isn’t mentioned, discussed, or given blame for pain and injury. Arthritis, defined loosely as joint inflammation, becomes far more prevalent as we age. As prevalent as it may be in senior citizens, the treatment methods and practices do not vary a great deal based on age alone; with movement being a major part of the answer for all ages. The science shows that movement in some capacity is crucial for joint health and mobility and can yield a reduction in pain and sensitivity. However, the exercise has to be appropriately suited and graded to the specific area of inflammation. Some arthritic joints may respond well to non-weight bearing activities like swimming or cycling, where as arthritic backs may respond well to brisk walking. Ultimately, the science says arthritis and movement must go hand in hand to maximize mobility and health, it’s just a matter of finding the right exercise, which sometimes takes a little bit of help and guidance from a healthcare provider.

The next major ailment when it comes to aging and mobility is osteoporosis. Osteoporosis is increasingly prevalent as we age, especially in women, and essentially translates into normal terms as porous bones; porous meaning lower in density and therefore weaker and more vulnerable to fracture. Our bodies, when healthy, are constantly remodelling our bones with steady loss and gain of tissue. Simply put, with osteoporosis our bodies are not replacing enough the bone tissue fast enough to keep up with the rate of loss, so we lose bones mass. A major factor for bone health is that our bones require weight-bearing activity, loading and stress in order to effectively maintain an adequate rate of loss and gain equal; our bones grow under compression and weaken when not used! Bone loading can happen with a number of activities, including walking, but we must minimize the risks for falls. Simple factors must be considered to minimize risks, like walking on even ground in a predictable environment and using a walker or a cane depending on your current level of mobility. Do not hesitate to contact a healthcare provider to evaluate your risks and determine an appropriate activity.

The last note for healthy aging comes back to some of our key chronic conditions, like heart disease and diabetes which both increase in prevalence with age. There is ample evidence out there to support that these conditions are absolutely impacted, mitigated, and managed by healthy levels of physical activity, but it must be with a wise and gradual progression to minimize your risks.

Ultimately, we are all aging and we will all continue to age, but when it comes to many aspects of your health YOU are in the drivers seat. There are exercise options out there for all of your needs that can truly stand to improve your pain, your health and your overall wellbeing. So, next time an ache stops you from getting out and doing something don’t sit back, accept it, and play the age card; old or young there are ways to get moving towards improvement! For more info on aging and wellness visit www.wellnessnb.ca/seniors for a host of great resources on getting active or speak to a health professional.

When it comes to the management of pain and injury we can learn a lot from our past! This week I would like to dive into the history a little bit and break down some of the most common injuries for us here in New Brunswick. We will look into where they happen, how they happen, whom they happen to, and what happens next if you are injured.

So, where do we hurt? The most common injuries in New Brunswick come as a result of falls or as a result of motor vehicle accidents and include strains, sprains, cuts, concussions, and fractures. In New Brunswick, there are several factors that make us more or less likely to be injured, some of which may come as a surprise! Firstly is our gender, historically, New Brunswick males have a higher incidence of injury than females, and this trend stays true throughout the rest of the world. You may also be surprised to learn that socioeconomic status ($$) is correlated to incidence of injury, with the highest rate of injury occurring in the least affluent neighborhoods. Less surprising is that the incidence of injury is very closely related to age, with our youth (those aged 12-19) being the most frequently injured and our seniors (aged 65+) being injured the least. Of the injuries that occur, about one-third of them (29%) occur during leisure activities or sport and approximately 18% happening in the workplace.

One in twelve New Brunswickers reports having an injury within the past year that limited their ability to participate in their activities of daily life, one half of which sought medical attention within 48 hours of their injury. Our injury rate is actually higher than the Canadian national average, and with that comes a significant financial burden; the estimated cost of injury in New Brunswick is almost $500 million annually. While that large number may not seem all that significant to you, that breaks down to over $600 per resident per year from the provincial budget; and guess who pays that? Us. Despite the cost to the system, if you are injured, you need to seek appropriate medical care based on the severity of your injuries, whether that’s the Emergency room for head trauma, or visiting your Physiotherapist or Chiropractor for a muscle strain or joint sprain.

Of all of the above-mentioned injuries that occur in New Brunswick many of them are predictable and preventable. Whether it’s reducing falls risks in our senior populations, adopting safer driving habits, or simply ensuring you have appropriate safety equipment in your leisure activities, we can all play a small role in reducing injury risk and maintaining our well-being. I encourage you to visit the website listed below and learn how you can take some simple steps to reduce risk of injury for you and your loved ones.

www.nbtrauma.ca

Getting your Z’s has always been important, but new research suggests the benefits of good sleep habits are even more far-reaching than many of us would have suspected. Simply put, the latest research is suggesting that injury rates go down as your sleep time goes up; more sleep=less injury. So what does this mean in physiotherapy?

Sleep and injury is becoming a particularly hot topic in the sports world with big names like the NBA’s Steph Curry putting themselves under the microscope in order to gain a better understanding. The research seems to put 8 hours as the magic number, with those athletes sleeping <8 having a higher rate of injury; increasing up to almost double in some studies (1.7X). The same studies also show an improvement in athletic performance in those sleeping >8 hours.

The trends, however, are not limited to the athletic population. Several studies across the world show that in school-aged children, sleeping problems or low sleep duration are directly\ correlated to a higher incidence of accidental injury. Similar results are found in workplace studies, whereby lower reported sleep durations are significantly associated with higher risk of workplace injury.

The long story short: get your sleep! Good sleeping habits are essential for your body’s healthy function; this should not be new information. Adequate sleep improves mood, allows your body time to heal, replenish energy stores, helps to manage stress and lowers your overall risk for many chronic health conditions. And now you know, whether you’re a young athlete or a seasoned desk worker, appropriate sleep practices are essential when it comes to reducing injury risk and improving performance.

This article was published by Dr. Erik in the Telegraph Journal online and KV Style in early 2017.

New Brunswick is having some tough financial times, and it’s likely to keep going. Currently, of the 31% of the budget spent to run our health system, we pay $3,333 per New Brunswicker. Man, woman, and child. While we can currently support people’s needs, the baby boomers are aging and we are going to experience extreme price inflation in the cost of healthcare. We need to look at this as an opportunity to not just cut, but invest in areas that are going to support this demographic shift.

The current health system in the province, developed in the 1950s, was not designed to support these kinds of population needs including the longevity of life that we now enjoy. Born between 1947 and 1966 the oldest of the boomers are currently 70. According to the Canadian Institute of Health Information, Canadians aged 15-65 use $2500 per year in health services. By age 70, that number quadruples to $10,000 per person, per year. Octogenarians, in their 9th decade of life require health services costing $20,000 per year.

However, the folks who are now becoming seniors are hardworking people who have paid very high taxes, raised families, and contributed to society all throughout their adult lives. They deserve more than merely a discussion about numbers. They deserve dialogue on how we can do things better. I was raised by my grandparents and I cannot bear the thought of what will happen when we run out of options.

To use a baseball analogy, we’re currently tracking down a fly ball on the warning track, running at full speed toward that proverbial wall. The recent decision to not address the health system as part of the Strategic Program Review was short sighted. You can only cut the pen budget so much, and some of our health practitioners are being asked to bring their own pens!
New Brunswick is actually ahead of this silver tsunami with the second highest number of seniors over the age of 65 in Canada, making up approximately 16% of the population. The earliest of the baby boomers, THIS YEAR, will experience a 300% increase in their health expenditures on average. In ten years, that number doubles again. It is all well and good that those of us involved in healthcare can spout scary budget numbers that most people don’t really care about, however this is about people. The quality of life of parents, grandparents, and loved ones are all central to this issue.

With serious decisions facing the government and voters over the next year, ten years, and beyond it is important to have further knowledge into how our health system is delivered, administered, and managed in New Brunswick. Most people, including those who work in the system have little to no idea! We also should use issues facing us in this world to learn from as well.
Completing a four year term with the Horizon Health Network board, I have the unique insight from this experience and that of being a healthcare provider. In Dr. Erik’s Daily Apple I plan to share my thoughts on wellness matters, the business and politics of health, and other areas of importance that the reader is unlikely to get anywhere else. I hope you enjoy these thoughts, and I hope our ongoing discussion together will in some small way be part of a solution to a problem that only we the people can solve.

Dr. Erik Klein is a health policy expert, published author, and practicing Chiropractor in Saint John and Hampton. Dr. Erik is the CEO of Town Health Solutions with clinics across New Brunswick and a former member of the Horizon Health hospital board. He can be reached at 652-5222 or drerikceo@townhealthsolutions.com. For further information please go to www.townhealthsolutions.com or search us on Facebook.

This article was published by Dr. Erik in the Telegraph-Journal online and KV Style in early 2017.

You are probably receiving the wrong treatment for your low back pain

Chances are, the treatment you receive for your low back pain is probably not the right one.  This is because even with this common problem, scientists have yet to be able to agree on what works even after decades of trying to figure it out.  The reality is, there are commonly two huge problems, especially with therapists: too many hold old-school beliefs and choose not to further educate themselves.  On the other hand, others treat every patient pretty much the same way, seeing low back management with a catch-all solution. This is very concerning because getting people better is all that matters.  Full stop. Unfortunately, I see this go on every single day. The factors affecting low back pain are diverse and require full body biomechanical analysis, assessment of skeletal and muscular imbalance, work/home habits, diet, stress, and other emotional issues.  The American College of Physicians just released a brand spanking new guidelines and they recommend therapy before drugs. Below we discuss what you should and shouldn’t do.

Low back pain is most often temporary muscle or joint stress that is coming from some form of overcompensation.  Essentially an on-going issue that tends to rear its ugly head every once in a while. If you had a car where the strut was rusted out, would you continue to patch the strut and have repeated breakdowns, or would you fix the car so it worked optimally? Some of the most popular treatments are merely patches.  Getting ultrasound treatment, TENS, IFC, ice packs is effectively patching the strut. These passive modalities don’t fix any problems. Active modalities such as hands-on deep muscle work, the advice to stay active, spinal manipulation, and mindfulness/stress reduction DO fix problems. Mechanical spinal syndromes require hands-on, active solutions to return your body to optimal function.  Further, these strategies are proven to show more positive responses in the brain (vs. electronic tools like ultrasound). How the brain responds to the sensations you are experiencing is just as important as the problem itself, because the brain modulates how you feel pain.

Sometimes, when I am being asked for a second opinion, people want to know what to look for in a great therapist. There are a few simple guidelines: your therapist should apply active, hands on care and encourage you to keep moving.  Your therapist should understand the WHY of the problem and be able to explain it in simple, yet specific terms, what is going on, and how they are fixing your problem in a step by step fashion. For mechanical spine syndromes, if you’re under care at a clinic, you should see some symptomatic change by the third visit, and you should feel great by visit ten.  Even with sciatic problems, fifteen visits is all that should be required for acute flare-ups in most cases. If not, a referral is likely warranted. Finally, find out that your therapist is doing a TON of continuing education, continuing to build their skill sets and tool belts so they can help you be your greatest as quickly as possible. When you begin care, demand the best and if you aren’t improving fast, seek a second opinion.  

There really is a dog’s breakfast out there for options for low back pain, and much of it is frankly wrong because it’s easy or quick to implement and a lot of people can be covered in a short period of time.  Efficiency is frequently rewarded over results. With new guidelines though, we know better. Great clinicians dive deep in (both mentally AND physically) to unravel WHY this is happening and this takes attention and time, but the results speak for themselves and people see the difference.

Dr. Erik Klein is a health policy expert, published author, and practicing chiropractor in Saint John, and Hampton.  Dr. Erik is the CEO of ‘Town Health Solutions’ an award-winning network of clinics in Atlantic Canada.  He can be reached at drerikceo@townhealthsolutions.  For further information, please go to www.townhealthsolutions.com, or search on Facebook. Continue reading “You are probably receiving the wrong treatment for your low back pain”