SOS Physiotherapy: Back Pain and Difficulty Walking

REFLECTING ON A YEAR OF HEADSPACE The Spinal Column The Newsletter About Your Health And Caring For Your Body

My mind kept wandering to things that I needed to do, flipping between conversations that had happened the day before, the dog barking outside, my to-do-list for the upcoming weekend, it was like standing in the middle of a highway with the all the cars whizzing by all around me. Well, this is meditation. The fact that I was just becoming aware of the different thoughts that I was having and developing the ability to identify the thought, label it as “unpleasant”, ”pleasant” or “neutral” and move back to focusing on my breath is the basic principal. The key, I was taught, is to think of it as if you’re sitting on the edge of the highway in a comfortable spot, watching the traffic sail by, as opposed to being caught up in the middle of it. These persistent thoughts are the cars on the highway. We want to simply be the observer at the side of the road and not caught up in our thoughts, or the rush hour traffic jam. After several months, it became easier. Some days were easier than others, but I found myself developing the ability to identify situations in my day-to-day life when I was caught up in my head instead of focusing on the conversation happening in the present. I could simply take a breath, label these thoughts and re-engage in the event that was unfolding in the present. I began to notice a difference in the things I was able to remember and felt like I was “reacting” less to stressful situations and stimuli, like my orthopedic manual therapy intermediate exam last April. Now even after a year, I’m not even close to being a meditation “master” or consider myself “enlightened”. I would however say I have noticed a change in my ability to be present, a decrease in “reactivity” on a daily basis and developed much more of an appreciation for time away from technology. I would encourage anyone who has every thought about meditation to give it a try. It’s not a mysterious as you may think and quite easy to implement. The evidence on its effectiveness is growing. According to a systematic review with meta-analysis performed by Hilton et. Al, (2017) there is evidence to suggest that mindfulness and meditation may be helpful in decreasing chronic pain, depression and improvement of overall quality of life. Go on, put your phone down, take a breath, pull off the highway and watch the traffic fly by. Adam Dafoe, PT

The practice of meditation and mindfulness has come to the forefront in the news and social media and has been growing in popularity for the past several years. We can thank some of the new meditation based apps like “Headspace”, “10% Happier” and “Calm” for making this practice easier than ever to access, learn and integrate into our daily lives. With the age of smartphones, social media, endless wifi hotspots and hectic work and household schedules, it has become increasingly more difficult to stop and be present within any given moment, completely free of distraction. How often are you involved in a verbal conversation with a family member, friend or colleague and not scrolling through your smartphone while talking? Or find your mind wandering through the list of hundreds of thoughts or tasks that you could be accomplishing instead of participating in this current conversation? This was a feeling that was becoming all too frequent for me and those that were close to me had started to make me aware of this observation. “I know you’re listening but can tell you’re not totally in the room.” Was one of the ways I felt it was best described to me. I decided to do some research late last December, into mindfulness and meditation. I had heard lots about it and was wondering if it might be helpful with this idea of “presence” or “focus” that seemed to be dwindling within my daily life. I came across an app called Headspace and began the 10 Day trial that they had to offer. I made it my New Year’s Resolution for 2019 to try to meditate for a short period (10-30min) a day, at least 5 days per week. As it turns out sitting and being “quiet” for 10min turned out to be a lot harder then I Imagined, especially for someone that is use to talking with people pretty much all day long.

INSIDE: • Walking Away From Back Pain • Fixing Your Stride • Healthy Recipe

• Exercise Essentials • Complimentary Physiotherapy Screen • Spring Training Focus on Exercise

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Walking your Way Pain Free Walking is a great form of exercise, but more than that, it is a necessity of life. When you can’t walk, even basic tasks become complicated. Getting out of bed in the morning, getting to and from work, moving your way around the office, and even spending time with family on the weekends all rely heavily on your ability to walk. When your back pain begins to interfere with your ability to move around freely, then you know it is time to start doing something about it. Conveniently, walking is more than a goal when it comes to back pain, it could be part of the solution. Working with a physiotherapist to develop improved strategies and techniques with your walking could help you to get back on your feet even sooner than you thought possible. What’s more, for those who are able to walk, getting on your feet more often with targeted exercises could help you find relief from back pain even sooner than expected. Look inside to learn more about our programs and say good-bye to your aching back.

Does going for a walk sound like a big pain in the back? For those who struggle with chronic back pain, even the basic task of going for a walk can be overwhelming and painful. Back pain can strike at any time. Whether in the upper back, surrounding the neck and shoulders, or in the lower back at the lumbar or sciatica, back pain is something that no one likes to deal with for too long. Relying on pain medications to help you overcome back pain will leave you disappointed. While pain medications are frequently helpful at alleviating the discomfort of your back pain for a short period of time, they are not capable of resolving the issue that is causing your pain to develop in the first place. The only thing that can actually fix your back pain is addressing the issue that is causing your pain head on. Physiotherapy is a great resource for addressing your back pain and can be a helpful tool in getting you back on your feet. So, whether it is following a sudden injury or a chronic issue that has developed over time, physiotherapy could be the answer to helping you enjoy life free of back pain. And the secret to success is learning to approach recovery one step at a time.

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When you are experiencing regular back pain—especially if you are experiencing back pain while walking—you should consider ways that you can reduce back pain by taking small steps to support your back. There are several things that you can do at home to improve your stride, which can make a significant difference when it comes to managing back pain day-to-day. Here are several ways that you can start taking care of your back with each step you take: 1. Make sure that you are wearing the right types of shoes. While the golden rule for walking is to wear sneakers, not all sneakers are created equally. You need to wear a sneaker that is going to provide you with the arch support that meets your individual needs. This may mean upgrading from your minimal support sneaker to something more athletically designed. 2. Try a custom insert in your shoe. Of course, you can’t wear sneakers all

the time. When you are at the office, professional footwear matters. You may find it helpful to have custom orthotics made for your work shoes so that you can have more arch support around the clock. 3. Work on improving your posture. If you are slouching when you walk, then that may be impacting the way that your back feels. Take a few minutes in the morning and again in the afternoon to stretch your back, and then make a point of keeping your shoulders square and your back straight as you walk. Simply standing tall may alleviate some of your back pain. Another way that walking can help alleviate back pain is by encouraging weight loss. Being overweight puts added pressure on your back, and this can contribute to increased back pain. Working with a physiotherapist to improve your walking technique can help you to overcome back pain one step at a time.

Exercise Essentials Try this movement if you are experiencing leg pain.

Greek Turkey Burgers with Spinach

• 1 cup frozen chopped spinach, thawed • 1 lb 93% lean ground turkey • ½ cup crumbled feta cheese • ½ tsp garlic powder • ½ tsp dried oregano • ¼ tsp salt • ¼ tsp ground pepper • 4 small hamburger buns • 4 tbsp tzatziki • 12 slices cucumber • 8 thick rings red onion (about ¼-inch)

Helps Relieve Leg Pain

HAMSTRING STRETCH Sit tall on the edge of a

table or bench. Have one leg outstretched straight, with the opposite foot in contact with the floor. Gently flatten the knee of the supported leg until you feel a comfortable stretch. Keep the torso tall and do not arch the back. Hold for 30 seconds.

Preheat grill to medium-high. Squeeze excess moisture from spinach. Combine the spinach with turkey, feta, garlic powder, oregano, salt and pepper in a medium bowl; mix well. Form into four 4-inch patties. Oil the grill rack. Grill the patties until cooked through and no longer pink in the center, 4 to 6 minutes per side. (An instant-read thermometer inserted in the center should register 165°F.) Assemble the burgers on the buns, topping each with 1 tablespoon tzatziki, 3 cucumber slices and 2 onion rings.


It's Maple Syrup Time!

Text Neck Saver

This month's exercise is another one of Adam's favorites. Its both a postural position and an exercise at the same time. The best part is, you can do it while texting and it will save your neck, work your postural muscles, core, deep neck flexors and glutes all at the same time! Lean into the wall and let it support you, including the back of your head. Bring your shoulders back and rest them against the wall. Engage your core and flatten the curvature of your back into the wall. Bring your phone up so it is in front of your eyes. Gently engage your core and squeeze your glutes as you nod your chin down. Hold this position for the count of 10 - 30 seconds as you are texting. Feel the burn between your shoulder blades!

The Elmira Maple Syrup Festival is Sat. Apr. 6th, 2019. Come and support the SOS "Flippin Physios" again at the pancake flipping contest and stop by the SOS Elmira Clinic for a warm cup of coffee.

Know Your Physio

Adam Dafoe, BA(Kin), MSc(PT), CSCS

Celebrating Over 25 Years of Healthcare Services! Belmont Clinic Belmont Centre for Physical Medicine 564 Belmont Avenue West, Suite 301 Kitchener, Ontario N2M 5N6 TEL: (519) 743-4355

Adam Dafoe is a Registered Physiotherapist and Certified Strength and Conditioning Specialist. He completed a Masters Degree in Physiotherapy at Queen’s University, an Honours Bachelor of Kinesiology at Wilfrid Laurier University and a Bachelor of Education from Western University. Adam started his physiotherapy career as a Varsity team Physiotherapist at the Trent University in Peterborough. Adam continues to expand his manual therapy and orthopaedic skills through the completion of his orthopaedic levels and is currently preparing for his FCAMPTexam in Fall 2019. Adam has also completed continuing education in Active Release Therapy (ART), acupuncture and dry needling, as well as exercise prescription. Hehasaspecial interest in identifyingandaddressingfaultymovement patterns that are often contributing factors to both chronic and acute injuries. Through corrective exercises, manual therapy and functional strengthening, he strives to both optimize your performance and return you to your activities as effectively as possible. In his spare time Adam enjoys strength training, snowboarding, golf and spending time with his family and dog Harper.

Campus Clinic University of Waterloo Student Life Centre

200 University Avenue West Waterloo, Ontario N2L 3G1 TEL: (519) 884-0767

Elmira Clinic Behind Wellness Centre (Clock Tower) 3 Wyatt Street East, Suite 2 Elmira, Ontario N3B 2H4 TEL: (519) 669-1212

ACHES AND PAINS STOPPING YOU FROM GETTING IN THE GARDEN THIS SPRING? May is National Physiotherapy Month and we want to do something to celebrate! On Wednesday, May 1st, 2019 SOS Physiotherapy is offering a FREE 1-on-1 Discovery visit with a physiotherapist! We want to say THANK YOU to our valued clients, your friends, family and colleagues who have chosen physiotherapy in the past.

This “mini assessment” will give you the chance to discuss how physiotherapy can help “Move YOU to better health” this spring!

Bring in This Coupon Today For A Free 1-on-1 Screen! Complimentary Physiotherapy Screen

Not sure what’s causing your pain? • Talk about your joint pain • Receive a “mini assessment”

Call Today!

For use at Belmont location ONLY

Belmont Clinic Belmont Centre for Physical Medicine 564 Belmont Avenue West, Suite 301 Kitchener, Ontario N2M 5N6 TEL: (519) 743-4355 Campus Clinic University of Waterloo Student Life Centre 200 University Avenue West Waterloo, Ontario N2L 3G1 TEL: (519) 884-0767 Elmira Clinic Behind Wellness Centre (Clock Tower) 3 Wyatt Street East, Suite 2 Elmira, Ontario N3B 2H4 TEL: (519) 669-1212

MY PATIENT STORY “I injured my back lifting my dog into the car, and suddenly I was taken down with Sciatica. I had never had it before, and I had never had a problem like this where painkillers did not help. I couldn’t walk upright without extreme pain and I was in a really bad state. Andrew is a knowledgeable,

caring and patient Physiotherapist. I am so grateful for his help. He provided manipulation and acupuncture twice a week, which got me going in the right direction. The exercises that Andrew suggested were exactly what I needed to continue improving throughout the week. Now it’s almost three months since I hurt myself. I am walking like a normal person, except that I am walking on air because of the relief from pain and delight to have an active life again.” - D.H. | Feb 4 2019


With the spring weather arriving, we all begin shedding our heavy winter gear and boots for shorts, t-shirts and running shoes. The sunshine and warm breeze tells us it’s time to get outside and get moving! Whether it’s dropping a few pounds to get ready for the beach, training for that 10km that we’ve always wanted to do, or just getting stronger for the summer yard work ahead, we often return to our fitness programs and clear the laundry off the weights in the basement. Here are a few exercise staples that you maybe doing wrong! These are all what we call “compound” movements. They are exercises that involve the coordination of several muscle and joints all at the same time to perform them correctly. Because of this, they offer a “best bang for your buck” calorie burn wise and if done correctly, can help build functional strength. The Modified Squat: DO THIS: Chest up, back straight, butt back, knees behind toes, core and glutes engaged. The Front Plank: DO THIS: Elbows under shoulders, flat lumbar spine, head, shoulders, pelvis in straight line, core and glutes engaged, hold for 10 - 30 seconds. The Standing Row: DO THIS: Chest tall, Butt back, knees slightly bend, shoulders relaxed and pulled back, engage core, bring shoulder blades back and pull elbows to sides, hold for the count of 3.


The Modified Squat

The Front Plank

The Standing Row

These exercises can be performed in sequence to create a circuit for 3 rounds. Rest 1-2 minutes in between sets. Check with your physiotherapist to review your technique before attempting them of course!

Belmont Clinic Belmont Centre for Physical Medicine 564 Belmont Avenue West, Suite 301 Kitchener, Ontario N2M 5N6 TEL: (519) 743-4355

Campus Clinic University of Waterloo Student Life Centre

Elmira Clinic Behind Wellness Centre (Clock Tower) 3 Wyatt Street East, Suite 2 Elmira, Ontario N3B 2H4 TEL: (519) 669-1212

200 University Avenue West Waterloo, Ontario N2L 3G1 TEL: (519) 884-0767

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