Save the Date! April 11, 2018 Fitness Presentation

On April 11th, Moira will be making a presentation in Lunenburg at the Chowder Club luncheon, located in the St. John’s Parish Hall beginning at 12:00pm. Entitled “Change Your Body, Change Your Brain: the Neurological Effects of Exercise”, Moira will cover some of the adaptations exercising your body can have on both your physical and mental well-being. She’ll also provide suggestions on how to get started if exercise isn’t currently “your thing”.

Attendance is $10, which includes lunch - fish chowder, rolls, tea, coffee and cookies.  Save the date and come join us!

Fluid Motion partners with the Saltbox Brewery

Finally, Moira’s two passions - physiotherapy and beer - will converge. On Friday, March 29th, Mahone Bay’s Saltbox Brewery will feature a beer brewed specifically for Fluid Motion Physiotherapy. Aptly titled “Feel No Pain”, the beer will be an amber ale with a hint of mango. Brewed in a “firkin” (a small cask), it will be tapped for tasting by the general public starting at 4pm Friday afternoon.

Come and sample this brew and chat with Moira over a pint. It’s all about community and celebrating local business owners and the customers who support them.

Feeding your Fight Against Colds & Allergies

You know those drug advertisements for “aching pain, sniffling and sneezing”?  While I’m not completely averse to the intermittent use of over-the-counter cold, flu or antihistamine products to control discomfort, fighting your symptoms with good food is under-rated.  Most often cold and allergy symptoms are associated with increased amounts of inflammation in your body – which causes your immune system to kick into overdrive.

Below are a few food tips that reduce inflammation and can help to improve your overall well-being:

1.        Start by reducing the amount of pre-packaged or preservative-laden foods you eat.  These types of foods are often high in sodium or hidden sugar – both causes of inflammation in your body.  Check out the nutrition label the next time you buy pre-packaged food and see what percent of your recommended daily allowance is represented by sodium and/or sugar.  Then look at the number of ingredients that have words you can’t pronounce.  Many of those can trigger an inflammatory reaction.

2.       Drink tea:  steam from the tea can open up your nasal passages.  Moreover, tea contains “polyphenols” which are a plant-based form of antioxidant that helps to reduce inflammation.

3.       Eat soups that contain antioxidant rich vegetables, e.g., carrots, onions, tomatoes, spinach, and kale.  These all contain vitamins that can help to ease respiratory allergy symptoms.

4.       Add fruits to your salads or yogurt:  berries (raspberries, blueberries, blackberries) cherries, and grapes contain an antioxidant (quercetin) that helps to prevent the release of histamines.

5.       Eat foods that are high in Omega 3 Fatty Acids:  salmon is usually the go-to foods one hears about in this category.  But any “fatty fish” will do – e.g. sardines, mackerel, or tuna.  You might be surprised to know that “grass-fed” beef also contains some Omega 3s.  The differences between grass-fed and corn-fed beef are significant (and worthy of a separate article), but suffice it to say that when possible, get your Omega-3s from whole, real food sources…that means local farm-raised, grass fed beef and wild-caught seafood.  Other easy Omega 3 additions include walnuts, flax seeds, and chia seeds.

6.       Include “probiotics”:  these are healthy bacteria that help to strengthen the immune system.  One of my favourites is sauerkraut…put that on a sandwich at lunch.  You can also find probiotics in yogurt or kefir.

Including these foods in your diet will not only boost your immune system and reduce inflammation, it will improve your overall sense of wellness by reducing joint pain, improving your mood, and stabilizing your blood sugars.  So, get off the pills and get onto some fairly simple, natural food remedies to help your body help itself.

Exercise and Hockey Players

I recently treated a young patient with a groin injury who is a competitive hockey player.  Apparently this was not the first time he pulled his groin muscle while skating.

Groin injuries in hockey players are well-documented.  And most of these injuries don’t involve contact,  mostly due to the excessive amount of force generated during the acceleration and deceleration phases of skating.1   A study by Emery et al found that the recurrence rate of this type of injury was 23.5%.2That’s what we in the healthcare industry call a “chronic” problem.

What’s interesting about these groin injuries is that it doesn’t seem to be related to “tightness” of the groin musculature (known as “adductor” muscles).  Research focused on elite NHL players with a history of groin injuries found that these adductor muscles are weak, particularly in relation to the opposing “abductor” muscles on the outside of the leg.3

If you’re interested in the root cause of this muscle imbalance and want to read more about it, there’s a really nice article that can be found on the blog of Mike Reinold’s website (   Mike is a physiotherapist and athletic trainer who treats professional athletes, and is a great online educational resource of mine.

For those of you who are hockey players – or any other athlete who may want to avoid a groin injury – here are a few suggested exercises to incorporate into your workout to address a possible muscle imbalance around the hips/thigh area.

Odds are, as an athlete, you spend a lot of time with your hips flexed (the “athletic stance”).  Over time, this will cause the pelvis to rotate forward – lengthening your abdominal muscles in the front of your body, and the hamstring muscles at the back.  So, anterior and lateral core work, and glute/hamstring strengthening are critical to restoring neutral alignment of the pelvis. 

Start with mobility exercises or myofascial release with a foam roller to open up the hips.

Hip Flex/Hip Rocking

Foam Rolling Hip Flexors

Then add:
Rotational Core Strengthening:

and Glute, Hamstring, Adductor Strengthening:

Supine Bridge with weight (hip thrusts)
Bilateral or single leg RDL:
Abductor Side Bridging


1.       Sim FH, Chao EY.  Injury potential in modern ice hockey.  Am J Sports Med 1978, (6)378–384

2.       Emery CA, Meeuwisse WH, Powell JW.  Groin and abdominal strain injuries in the national hockey league.  Clin J Sports Med 1999, July 9(3): 151-6

3.       Peter Nelson, Groin Injuries in Hockey Players,

Benefits of Strength Training for Women

When I ask my female clients if they work out with weights, I either get a blank look or a reply like, "I don't want to get too bulky".   There are a lot of myths around strength training, and women "bulking up" by lifting heavier weights is one of them.  I recently came across a great website that breaks down these strength training myths.  Take a look at Seven Strength Training Myths Women Should Know

And if you think you're too old to reap the benefits of strength training, ladies, listen to Ms. Willie Murphy, who started strength training at age 73 and is now a competitive dead-lifter at 77.  You may not be as lean and keen as Ms. Murphy at 105 pounds.  But her comments about having no trouble lifting her grandchildren or pushing her car out of the snow are just a few of the benefits you reap by incorporating some resistance training into your daily life - at any age!

And it doesn't mean you have to buy expensive equipment, or go join a gym.  It’s more about engaging in more strenuous activity when you exercise.  It’s picking up heavy things (e.g., pushing a heavy wheel barrow while gardening; carrying your kids on a hike; exercising with your our own body weight by doing push ups or lunges; taking a walk with a small weighted back pack).

Incorporating strength training into your exercise routine can reap a myriad of benefits.  Here are just a few to consider:

  1. It enhances bone density in women and reduces the risk of fractures (especially important in post-menopausal women)
  2. It boosts your metabolism (a must if you want to burn off that fat)
  3. It helps you develop better body mechanics (balance, flexibility and posture all tend to improve)
  4. It reduces your risk of developing Type 2 Diabetes
  5. It boosts energy and reduces stress by elevating "endorphin" production (a natural opiate produced by the brain)

If you're not sure how to get started, seek advice from your local physiotherapist or fitness expert.  Incorporate strength training as a fitness objective - it's a great natural anti-depressant, can help you burn the fat off, sleep better, and improve your overall quality of life.

Ice versus Heat

This was one of the first questions that came up in physiotherapy school.  And with recent research, I can’t say that the answer is much clearer all these years later.  However, here are the basics:

In the initial stages of a muscle or joint injury, there is an increased activation of white blood cells in the area.  These cells play a critical role in triggering the healing process by “eating up” dead/damaged tissue and releasing “cytokines” that regulate the behaviour of other important cells in the body needed to help recovery.  The increase in white blood cells is what causes an inflammatory response (i.e. swelling and/or pain) with an injury. 

Cold Therapy

Ice is used primarily to decrease inflammation.  The application of a cold compress reduces blood flow, thereby reducing swelling and inflammation.   In addition the cooling of the skin affects the sensory nerve endings, acting as a secondary pain reliever.  The application of ice to treat an initial trauma (muscle strain, sprain, or contusion) is based on the notion that, aside from being painful, too much swelling can induce secondary tissue damage to healthy cells around the area of injury.

However, this must all be taken with the proverbial “grain of salt”.  Animal studies have shown a potential for cold-induced tissue damage if the ice is applied for too long, or is too cold.  There have been case reports of burns, nerve injury and frost bite if cold is applied for prolonged periods.

A general rule of thumb is, use ice only in the first 24-72 hrs after an injury.  Apply for 10-15 minutes, then wait 90 minutes before re-applying.  If a person is elderly, the duration of time to apply the cold compress should be limited (less than 10 minutes) and monitored to avoid tissue damage.

Heat Therapy

The application of heat (e.g., hot water bottles, heating pads, hot packs, hot baths) increases blood flow, metabolism, and elasticity of connective tissues.  Increasing the temperature of body tissues is thought to promote healing by increasing the supply of nutrients and oxygen to the site of the tissue damage.

Research (which includes several randomized control trials) suggests that the use of heat is best for acute and subacute low back pain and/or muscle soreness from overexertion.  Moist heat (versus dry heat) seems to be the most effective for reducing pain.  Apply for 15-20 minutes, every 4 hours.

Again, there are some precautions associated with applying heat to an injured area.  Specifically, people with altered nerve function or decreased sensation need to be closely monitored.  This would include those with multiple sclerosis, poor circulation, diabetes, spinal cord injuries, or rheumatoid arthritis.

The Bottom Line:

If you have an acute injury with swelling (e.g., a ligament sprain or muscle strain), apply ice during the first 48 to 72 hours.  After 72 hours, there is little demonstrated benefit.  Moist heat is the preferred application for acute low back pain or muscle soreness.  Use it when you feel muscles are tight or aching.

Treatments for Osteoarthritis of the Knee

I’m often asked by patients if there is anything in addition to physical therapy that may help to address the symptoms of osteoarthritis (OA) in the knee.  A number of studies are being conducted in the medical field to determine if injections into the knee joint can address the problem.  A recent synopsis of studies in the Advanced Clinical Evidence (ACE) Review looked at the effectiveness of platelet rich plasma (PRP) to treat degeneration of the knee.

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Use it or Lose it

Most of us have found that as we age, we lose muscle mass.  Historically, researchers thought that loss of muscle starting around the age of 40 was part of the normal aging process.  However, more recent research suggests that “typical” loss of muscle has more to do with lifestyle changes - like becoming less active – than with aging.

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