Vacation time

We have two excellent Registered Massage Therapists at the St. John’s Back Pain Clinic. One of our therapists, Crystal North will be on an extended holiday until September 22nd, 2014. Judy Batten will be continuing her usual hours during that time and is happy to see any of Crystal’s existing clients. Feel free to call or use our appointment request feature to book your appointment today.

My strength training is cardio

People at the gymI’ve had this conversation with numerous patients. We talk about the need for strength development and their response is “I go to the gym already”. I ask them to describe their work out and its something along these lines “20 minutes on the treadmill, 20 minutes on the elliptical and 10 minutes on the stepper”. I’ve come to learn that its a common assumption that anything that happens within gym walls will make you stronger. Here are some key concepts I pass along to patients:

1. Time under Tension

Tension is a major stimulator for strength changes. Enough tension in a focused period of time produced through a muscle contraction and you’ll get a cascade of events that lead to larger muscle fibers. The right amount of tension varies for every muscle and every movement but here is a simple rule of thumb.

With appropriate tension it should be challenging to complete an exercise 10 times

It can be that simple. From the opening example 20 minutes on the treadmill gives about 2000-4000 footsteps (people range from 100-200 steps per minute). To accomplish 2000 steps your body is generating far less muscle tension than is required to stimulate growth and your body uses many passive spring like tissues to supplement the muscle work.

2. Muscles become fuel

A very relevant point about cardio focused training is that if you calorie intake is less than your workout demands you will start breaking muscles fibers down to fuel the run. In a pinch proteins from muscle will give you about the same energy as the same volume of carbs. Once you burn up those energy reserves you’ll switch to a catabolic state when muscles are broken down for fuel rather than built up for strength.

3. Range of motion

The last point about strength is range of motion. Even if we ignored the effects of tension and muscle catabolism, cardio moves you through a very specific motion. If strength gains could be made they’d only apply to that movement meaning it won’t make you stronger to lift that box on to a shelf or smoke someone in a pushup contest.

That’s the usual discussion. If we have time I’d certainly expand on why strength is essential to good musculoskeletal health and the basics of a gym training program.

Heat or ice for back pain

heating padThis may be the most common question that comes up during a new patient visit. So doc, should I use ice or heat on my back when it hurts? My answer, with consideration of the literature that has been published over the last few decades, my clinical experience and the understanding of patient preferences is to use heat for diffuse muscular stiffness and ice for sharp localized pain.


How does heat help 

Heat is a natural by-product of muscle activity and the support systems for that muscle (blood/oxygen supply, nerves, lubricants, hormones) act differently to help as the heat rises. Heat opens blood vessels which means more blood carrying oxygen and nutrients to fuel and rebuild injured muscle as well as take away toxins and damaged tissue. A warmed muscle is more able to slide along muscles/bones/tissues in the area giving you decreased resistance or stiffness. Much like a warm up for sport heat can help bring muscles to a point where the muscle contraction and release is more efficient, bringing relief to that sense of stiffness.



How does ice help

Ice is very effective as a numbing agent to reduce localized pain, especially near the skins surface. Rather than popping pain killers and waiting, ice can often provide immediate pain relief to superficial regions like your tail bone. Opposite to heat, ice encourages blood vessels to constrict and reduce blood flow which can be valuable if swelling or bruising is an issue.


effective delivery

Your body is excellent at regulating its temperature. So that hot water bottle may bring your skin temperature up but an inch below the surface that extra heat is dissipating quick. The same idea applies for ice. If your target is superficial an ice or heat pack will work well with continuous heat for up to 30 minutes or ice applied in intervals of 10 minutes on, 10 minutes off. If the target is deeper or thicker tissue you may want to drive up your whole body temperature with a hot shower.


Quick summary

Heat works well for diffuse muscle stiffness when used for up to 30 minutes continuously.
Use heat packs for smaller superficial areas and a hot shower for deeper/thicker muscles.

Ice works well for superficial sharp localized pain.
Use ice packs in intervals of 10 mins on, 10 mins off for pain relief and to reduce swelling/bruising.

Always be cautious applying extreme temperatures directly on your skin.


Updated: Snowfall Warning for January 29, 2014


3:00 PM: We will be closing the clinic at 5pm. Those will appointments after 5pm will be contacted personally to reschedule. The storm should clue up overnight and we will be operating as usual tomorrow, January 30th. The roads are slick and a heavier snowfall is expected after 4pm. Drive safe.

11:00 AM: Skies are clear and winds are under control. Most weather centers are predicting heavy snow by 4 or 5pm. We will provide another update at 3pm.

After weeks of rain mother nature has dropped her temperatures to bring back winter. We’re expecting a heavy snowfall later in the afternoon on Wednesday January 29th, 2014. We’re planning to open in the morning before the potential storm. An update will be made at 11am and if necessary again at 3pm regarding afternoon and evening appointments. Those with affected appointments will also be contacted personally.