Patient safety and comfort is of utmost importance. The therapists use proper table height and supports to ensure that the patient and the fetus are both safe and comfortable. Most treatments performed on pregnant patients are performed in a side lying position as this position decreases the risk of compressing the aorta and inferior vena cava against the patient’s spine which could disrupt blood flow. The patient may also be positioned semi-reclined to decrease the compression of abdominal contents on the diaphragm and help the patient to breathe better.

The massage therapy treatment approach to pregnancy differs from individual to individual taking into consideration the patient’s health history and symptoms. The therapist takes extra care with patients with conditions such as Pregnancy Induced Hypertension (also known as pre-eclampsia) and Gestational Diabetes

Here are some of the common complaints associated with pregnancy and how massage therapy helps:

Lowback Pain, Pelvic Pain: Due to increased joint laxity, the muscles in the surrounding area are over stressed to keep the joints stable. Massage therapy helps by releasing unnecessary muscle tension and improving muscle strength in areas that need to be well supported.

Edema/Swelling: Often experienced in the legs and arms, edema can compress into surrounding tissues, nerves and blood vessels that may lead to carpal tunnel syndrome, piriformis syndrome and general discomfort. Massage therapy helps by promoting lymph drainage and improving circulation to get rid of excess fluid.

Breast tenderness: In preparing a woman for breast feeding, the breast tissue might feel swollen, tender and over sensitive. Massage therapy can help by reducing congestion, promoting drainage and relieving the pressure in the area with the use of hydrotherapy and manual lymph drainage techniques.

Insomnia/Restlessness: With the emotional and physical stress of pregnancy and the stress of anticipating a child, most mothers-to-be have sleep problems. Massage Therapy helps by inducing relaxation and sleep.

Constipation: Progresterone causes smooth muscle relaxation and therefore lessens bowel movement. Massage therapy helps by promoting the movement of the bowels by manual stimulation, and relieving stress in the surrounding muscles.

The above symptoms may linger even after the birthing process. Massage therapy will also assist in post-surgical recovery and overall stress reduction.

Pregnancy can be the most dramatic and transformative event in a woman’s life. Massage treatments performed by the registered massage therapists at the clinic will help women enjoy this experience and provide them with a supportive environment as they anticipate the coming of their child.

I attended the Living-With-Living-Well education session “Wake Up: Sleep has an impact on your health!” put on by Toronto Rehab. This session covered a number of topics including obstructive sleep apnea (OSA), narcolepsy, insomnia and how these conditions can affect your health. People with conditions such as these have disturbed sleep and often have excessive daytime sleepiness as well as other health concerns. For example OSA can cause elevated blood pressure. The repetitive periods of waking at night are related to an increase in adrenaline levels in the body, which raises the blood pressure throughout the day. Many people with OSA are often not aware that they wake up at night, and they might not even feel tired during the day. High blood pressure itself usually has no symptoms, but can lead to many health problems over time such as heart disease or stroke.

The physical signs and symptoms associated with obstructive sleep apnea (OSA) include restless sleep, high blood pressure, night time chest pain, large neck (>17” circumference for men, >16” for women), excess weight, morning headaches and having to go to the bathroom several times during the night.

Another interesting aspect of sleep disturbances that was mentioned was the link between sleep and pain. Though the mechanism is still not fully understood, some studies have shown that individuals with disturbed sleep, particularly those with chronic pain (e.g.: fibromyalgia), may experience an enhanced perception of pain. Of course, in some cases it may be the pain that causes the sleep disturbance in the first place, thus potentially leading to increased daytime pain and a vicious cycle. This can make teasing out what is causing what more challenging. In addition to affecting pain sensation, poor sleep can have an impact on a number of other areas of our lives: mood, personality, concentration, memory, thinking, and even libido to name a few.

Identifying the presence of a sleep disorder is the first step in tackling it. If you do have excessive daytime sleepiness, the first thing to ask yourself is whether you are getting enough sleep. Keep in mind that “enough sleep” for one person may not be the same for another. You might also find that your sleep needs change, as you grow older. An easy test to see if you are getting enough sleep is trying to sleep longer and seeing if you feel more rested. If you still feel tired talk to your doctor: he/she will be able to assess whether you might benefit from a thorough sleep assessment to rule out a more serious cause such as OSA. You could see a complementary health care professional, like a naturopath, to see what non-medical strategies there are to help sleep. Seeing a chiropractor is of course another option. Although treatment of a sleep disorder is not in a chiropractor’s scope of practice in Ontario, they treat injuries, relieve pain and tension, and give some recommendations (for exercise, sleep hygiene, weight loss, and other lifestyle advice), all of which may help improve the quality of your sleep.

JD Kato is a chiropractor and clinical exercise physiologist practicing at the Rosedale Natural Health Clinic. If you would like to contact him, to schedule an appointment or to learn what other services we offer, please call 416-926-0084 or visit www.rosedalenaturalhealth.com

Pain due to poor posture is experienced by many Torontonians that have a sedentary occupation and lack physical activity. These are individuals whose work requires them to maintain a static posture for more than 6 hours a day and those who do repetitive activities. Eventually, poor posture slowly becomes the new “normal” for the body.

Lack of movement can diminish the ability of your body to distribute nutrients to the affected areas resulting in diminished tissue health. The most common symptoms are tension headaches, neck and shoulder stiffness and pain, difficulty breathing and decreased range of motion usually in the cervical spine. Others experience carpal tunnel syndrome and numbness and tingling down the arms. We often ignore the pain and tolerate it as much as we can and wait until it gets debilitating before we get help. At this point, corrective action must be taken to restore the body’s natural alignment and function.

Massage therapy treatment for postural dysfunction aims to be progressive, not aggressive. The therapist works on the patient’s main complaint while addressing compensatory structures at the same time.

The treatment goal is to relieve pain, improve tissue health, eliminate trigger points, decrease muscle tension, improve muscle length, strength and flexibility, and restore normal range of motion. In addition to this, patients improve breathing, build up confidence, stamina and exhibit a healthier posture.

First the short and tight muscles of the affected areas are slowly stretched back to normal length, to allow more room and less resistance. Examples of tight muscles are the pectorals, scalenes, sternocleidomastoid, suboccipitals, upper traps, hip flexors and hamstrings. The treatment includes progressive passive stretches on the upper chest, neck and shoulders combined with joint mobilizations in these areas and also on the elbows, wrists and the small joints in the hands. The therapist may also use friction technique on areas with adhesions and muscle stripping on the intercostals and rhythmic mobilization from the cervical spine down to the sacrum.

Then the therapist works on the lengthened and weak muscles, stimulating the muscle fibers to rebuild its strength and tone. Some of these muscles are rhomboids, levator scapula, erector spinae and gluteus maximus. The therapist uses fast and heavy tapotement to wake up the tired muscles of back and shoulders. Hydrotherapy may also be incorporated using heat to improve blood flow in tight muscles, and cold hydrotherapy to reduce swelling. The therapist encourages strength training exercises for the back and shoulder muscles to slowly build normal strength and function.

Maintaining a proper posture during work is a constant effort. It has become a very difficult task especially with the lack of proper ergonomics in the work space. It is highly advised to stay conscious of your posture at all times. Take short breaks occasionally, stand up take a deep breath and stretch your entire body by reaching up with your arms and then bending forward touching your feet with your hands. And when you get home at the end of the day, have a warm bath with Epsom salts and immerse yourself in rest and relaxation.

If you have any questions about how massage therapy can help with work related pain or postural dysfunctions, please give us a call at 416-926-0084.

Are you happy?

10 suggestions to help you achieve happiness:

1. Bring passion back. Learn something new. Whether it is an art, cooking, writing, running, salsa dancing, horse back riding, or photography. Find something you truly enjoy. Learning activates passion and passion is power – in fact it is one of the strongest forms of energy that we can generate within our body. Passion leads to a sense of accomplishment and a feeling of purpose in life.

2. Live on a day-to-day basis. Learn from the past. Live for today. Hope for tomorrow. Don’t let your life slip through your fingers by living in the past or for the future. Living one day at a time will ensure you live every day of your life. Use your resources and past learning experiences to deal with the challenges of day-to-day living. When faced with a challenge, remind yourself of past challenges and how you made it through them, and will do so again.

3. You always have choices. Your greatest power is the power to choose. At different times in our lives, we may say to ourselves that we don’t have a choice. However, there are always different avenues that can be explored. If you feel stuck right now, step back, view the situation from a different angle, identify your choices, and select one. By not making choices and staying stuck, you are making the choice to stay stuck!!

4. Surround yourself with love. Surround yourself with people who have your best interest in mind. Choose friends that make you feel loved and want to improve your life. We all have an innate need to belong. Wouldn’t you rather belong to a group that supports and encourages you than a group that does not?

5. Teach those around you that you are worth something. We teach people how to treat us. By taking care of yourself and your needs, you are modeling to others that YOU ARE IMPORTANT. By taking care of ourselves, we start to feel that our needs are being met, and we can let go of any resentment we feel towards others. Remember if we harbor bitterness or resentment, happiness will dock elsewhere.

6. Get what you want! Do you expect your friends/family to be mind readers? Do you expect your partner to know what you need from them? How do you expect them to know if you haven’t told them? So tell them! Take charge of yourself! Help those around you understand what you need, rather than expecting them to know it at all times. Be explicit rather than implicit.

7. Stop worrying. Can’t change a situation? Stop worrying about it. Rumination and constant thoughts of things we can’t change are a waste of our precious energy. Remind yourself only to concern yourself with those things you can change.

8. Stop self-pity. If you’ve been taking rides on a runaway train called “self-pity”, perhaps you may want to get off at the next stop. We can become addicted to self-pity! We may look outside of ourselves and place blame on everyone and everything around us. We may believe we are the victims of daily punishment, which leaves us feeling out of control and angry at the world. When you are feeling angry, and find yourself pointing and blaming others, say the word STOP and do something nice for another person. How could you think about giving to someone else when you are angry at the world? Try it. Try to help someone else even if it is just smiling at a stranger that passes by. The kindness you share will be returned.

9. Cultivate gratitude everyday. Much like fire and water, gratitude and anxiety cannot occupy the same space. What are you grateful for? Write down things, people, etc. you are grateful for. See if you can be grateful for them before they happen, and for any challenges you encounter.

10. Adopt a virtue. Someone once told me that in order to grow spiritually, we can focus on one virtue at a time and all the rest will come. If I focus my attention on the virtue of “Patience”, and truly dedicate my life to becoming that patient person, I will need to practice other virtues as well: kindness, love, justice, forbearance etc. One cannot forget the power of spiritual growth in the search for happiness.

REMEMBER: If you always think the way you have always thought, you will always feel the way you have always felt AND if you always feel the way you have always felt, you will always do what you have always done AND if you always do what you have always done, you will always get what you have always gotten.

If there is no change, there is no change.

With multi-million dollar salaries given to the most gifted athletes in the world, there is a huge pressure to win and perform at their very best. In order to do this, today’s professional athletes are subjected to heavy training schedules. With the help of sports massage, these athletes will be able to keep performing at their very best. However, you do not have to be a professional athlete to be a patient of sports massage therapy. With today’s focus of being active and living a healthy lifestyle, more and more physically active people are discovering the merits of sports massage.

Essentially, sports massage uses massage techniques that are modified—but still very similar to traditional Swedish massage—to address the effects of exercise on the body with regards to training, game-time performance, and healing from injury.

With constant training and little time to rest, recovery from training sessions can sometimes be difficult. What sports massage can do is help decrease the body’s recovery time from training workouts. For instance, after a hard training session, it is not uncommon for the body to experience stiffness or tightness in the muscles for the next couple of days after their workout. It is believed that this stiffness and tightness is caused by microtears to the muscle fibers. A simple massage immediately after the workout, coupled with some stretching, can help manage the stiffness and tightness that is experienced after workouts. What massage does is that it helps improve blood circulation and relaxes the muscles that are being worked on. Massage helps to reduce the already heightened tone of the muscle to a more normal level.

Aside from recovery from workouts, sports massage can also prepare the mind and body for workouts and competitions. In this situation, the massage is quick, brisk, and is performed just before a major competition or practice. It can serve as a passive way to warm up. The massage usually lasts no longer than 15 minutes. No oil is necessary and the therapist uses brisk techniques, muscle squeezing, and rhythmic joint movements to prepare the body for the demands of the workout or competition. The main goal of the massage in this situation is to warm-up the body by improving blood circulation to the working muscles, loosen the joints, and to increase the arousal levels of the nervous system to a more heightened state. This is all done to prepare the body of the athlete to deal with the demands of the sport in which they are to engage in and to avoid injuries.

All athletes will suffer some sort of injury during their athletic endeavors. Depending on the injury, sports massage can help athletes recover faster from their injuries and get them back to their sport in a timely fashion. Just about all soft tissue injuries such as muscle strains, sprains, contusions, and tendonitis, can be treated with sports massage.

Most athletes are on the lookout for ways to train more effectively, improve performance, prevent injury, and recover quickly. With heavy training schedules and little time for rest, athletes have recently been among the biggest users of massage therapy services. Sports massage can definitely help all athletes in Toronto, regardless of their level of performance, to reach their athletic goals in a safe and effective manner.

Do you feel tired all the time? Are you oversleeping often? Are you irritable and not sure why? Are you avoiding social situations? Do you have difficulty concentrating? Has your energy decreased?

If you answered yes to any of the above questions, you may be suffering from seasonal affective disorder (SAD) often referred to as winter blues or winter depression. SAD is a mood disorder. People that experience SAD in the winter months usually experience normal mental health during the rest of the year.

Common symptoms of SAD include:

• tired all the time
• oversleeping but not feeling refreshed
• needing a nap in the afternoon
• can’t get out of bed in the morning

• uncontrollable food cravings
• unexpected change in weight

• irritable often and not sure why
• depressive thoughts
• feeling guilt, anxiety, despair, misery
• difficulty concentrating
• “fuzzy feeling” in the head
• lack of desire or enjoyment

• avoid company
• loss of libido
• loss of feeling
• feel unsociable

• energy level down
• too tired to cope
• everything feels like an effort
• joint pain
• stomach problems
• lowered resistance to infection

• change in routine
• absenteeism from work

Animals react to the changing seasons with changes in mood, metabolism and behaviour. Look at the bear – he hibernates. He doesn’t want to look for food when it is blistering cold outside and the snow is blowing so hard he can’t see 20 feet in front of his face. Don’t most of us feel like hibernating at times? We want to crawl into bed, cover our heads with the covers, and stay there till spring. Many people find they eat and sleep slightly more in winter months and dislike the dark mornings and short days. However for some, changes in their mood, behaviours, and eating patterns are severe enough to disrupt their lives and to cause considerable distress.

So what do researchers say is the cause of “winter blues”?

Researchers say the changes stem from the lack of bright light in the winter months. It has been shown that bright light influences brain chemistry. Researchers aren’t sure why some people suffer and others don’t. What they do know is that our nerve centres, found in our brain, control our daily rhythms and moods. These nerve centres are stimulated by the amount of light entering our eyes. For example, as night falls and less light enters our eyes, our pineal glands start to produce a hormone called melatonin. Melatonin’s job is to tell our body to slow down and get ready to rest. So…on dull wintery days when the sun is hiding behind the snow clouds, our body continues to produce melatonin preventing us from waking up. Researchers have also linked the hormone serotonin aka “the feel good drug” to light. Therefore in the winter months with minimal exposure to light, the “feel good drug” is produced in small quantities and depression like symptoms are experienced.

Since we can’t shorten our winters, what can we do to make ourselves feel better?

Ideas to help feel better:

• live in rooms full of light;
• put in full spectrum light bulbs;

• eat a diet high in protein and low in carbohydrates;
• moderate alcohol consumption;
• eat regular meals;

• regular physical exercise during the day, not before bed; preferably outdoors in the morning hours (especially on sunny days);
• listen to music;

• go to bed at a regular hour most nights;
• make sure your sleep environment is comfortable;
• avoid caffeine, stimulants, or alcohol after 3 pm;
• avoid napping during the day;
• relax for an hour before bed;
• try to rise at a similar time each morning feeling rested or not;
• take a warm bath at bedtime;
• fight insomnia with gentle rocking or sound of water running;

• a counselor will help you change the negative thoughts and behaviours that are associated with the winter blues. Psychotherapy has been shown to have lasting positive effects and prevent a relapse of SAD symptoms the next winter;

Lastly, speak to your healthcare provider about other alternatives. Carefully timed supplementation can help beat the winter blues.

Suggested reading:
WINTER BLUES By: NORMAN ROSENTHAL, E.

The first major snowfall of the season left areas of Toronto with 20-30 cm of snow. This fantastic amount of snow in such a short period of time had some residents spending up to 5 hours digging their buried cars out after the snowplows cleared the roads. As many people know, snow shoveling carries with it a number of risks to one’s health including back injuries.

As with any activity, if you are not accustomed to it you are more likely to get injured. However, in the case of snow shoveling the repetitive heavy lifting and twisting motion further increase the risk of injury. These factors combined with the cold, the slippery ground, and the fact that many people are deconditioned because of a sedentary lifestyle lead to many back injuries showing up at the chiropractor’s office.

However, there are simple precautions one can take to help prevent these injuries. The following are safety tips to get you through the snow without injuring your back.

• Dress properly for both the weather and the activity. This includes layering your clothing, as this traps air and slows heat loss. These layers should include a synthetic fabric layer such as polypropylene (not cotton) next to your skin, which will wick the moisture away keeping you warmer. Do not expect to stay dry though, you will probably be sweating but you want to minimize the risk of being cold from being wet. The second layer should be an insulating layer like wool or a fleece. And finally the top layer should be a windbreaker/light jacket with a zipper to let the heat out if you do start to get hot from shoveling. These layers will help keep your muscles and joints warm in the winter air. Warm muscles and joints are less likely to get injured.
• Make sure you have the proper footwear with good traction. In fact, I even suggest removable accessories that you can put on the bottom of your shoes to help grip in the snow and ice (either metal “cleats” or coils). There are a number of products that you can find at most sport shops. I find them very useful in all sorts of winter activities.
• Ensure that you warm up before you shovel. Try going for a short walk to get the blood moving. As I said before, warm muscles and joints are less likely to get injured.
• Avoid snow shoveling soon after getting up in the morning, and after periods of sitting. The ligaments and the disks between the bones in your back can be more easily injured after waking or with prolonged sitting. This is another reason for your warm up walk before shoveling.
• Vary they way you work. This ensures you do not use only the same muscles until they are tired or overworked. For example if you are used to using your right side, give it a break and use your left for a while.
• Do not twist your back. Twisting decreases the stability of the disks in your spine and puts more wear and tear on your back. It is better for your spine if you pivot through your hips than twisting your back.
• Pace yourself. Instead of trying to do it all at once, take rests. Fatigued muscles do not work well and can lead to overuse injuries.
• Minimize the workload. Try pushing the snow instead of lifting it. And do not use a huge snow shovel; use a smaller one so that you are pushing less snow all at once.
• If you have had an injury in the past get someone else to do it. Perhaps you could give a few bucks to the neighbourhood kid to do it. Although this may seem like a cop-out it is not worth the risk of putting yourself out of commission for the holidays because you re-aggravated an old injury. You can always rehabilitate your back to minimize the risk of injury in the future, but right now it just in not worth it.

Remember also that risk of injury can be minimized if you exercise year round to maintain a decent level of fitness and muscular strength as well as regularly engaging in spinal stabilization exercises before the winter season begins. That way your back is stronger and you are in better shape if you do have to shovel the snow.I hope you find these tips helpful. Happy Holidays.

JD Kato is a chiropractor and clinical exercise physiologist practicing at the Rosedale Natural Health Clinic. If you have questions or comments about this article, or you would like an appointment you can contact him at (416) 926-0084 or jdkato@rosedalenaturalhealth.com

The biggest concern with osteoporosis is weakened bones that are prone to fracture. These fractures most commonly occur in the spine, the hip and the wrist. In addition to your nutritional status and hormone levels, the amount and type of physical activity or exercise you do affects bone strength.

The reason why exercise builds bone is this: the cells living in bone reside in small pockets, which are connected by tiny canals. These canals allow fluid to move within the bone. When the bone is loaded in the right way, such as with certain exercises, the fluid is squished through the canals. The cells can detect this fluid movement, which stimulates them to deposit more bone. Much research in the field of exercise physiology has been conducted to learn what kind of movement and exercise are the best to stimulate this bone growth to improve the strength of bone and help prevent osteoporosis.

The other benefits of exercise for those with osteoporosis are muscular strength and balance. As many people with osteoporosis are over fifty years of age, strength and balance become important issues. It is about this time in life that people begin an accelerated loss of muscle. Over time this loss can make people unsteady and increase the risk of falls that might fracture a bone. This reduced muscle mass is also linked to slower walking speeds which also plays a role in susceptibility to falling. Restoring some of the muscle bulk lost can also act as “padding” to protect the bone if the person does fall. Furthermore, many older adults become afraid of falling and limit their physical activity; this causes deconditioning, which will lead to frailty and loss of independent living.

A clinical exercise physiologist can identify those who have multiple risk factors that make them more likely to develop osteoporosis, make lifestyle recommendations to optimize bone strength and minimize fracture risk, and prescribe exercises that improve bone strength, balance and confidence. They have in-depth training in the science of exercise, and its prescription for those who are “healthy” and those with medical conditions. If you would like to discuss prevention or management of osteoporosis with an exercise physiologist or additional information about exercise physiology, please call the Rosedale Natural Health Clinic at 416-926-0084.

The best thing you can do after crossing the finish line of any race is to keep moving. Walking will help you cool down, maintaining the much needed blood flow to the heart as it slows down (especially after a sprint to the finish line), and prevent muscles from seizing up. You should then follow this with some gentle stretching and make sure to ice sore muscles and joints immediately. Even with the best post-race treatment, it is common to experience soreness that goes away after a few days. However, if these aches and pains persist it is important to seek professional care. Proper assessment and treatment can target restricted joints, tight muscles or muscle imbalances and reduce inflammation, allowing you to recover and resume training for the next race.

If you think you have acquired an injury from running, or any other repetitive activity you can contact the Rosedale Natural Health Clinic for evaluation, treatment, and prescription of rehabilitation exercises.