Chair Lower Back Stretches


Sitting for eight hours each day at work can be torture for someone with lower back pain. It’s important to stretch your back frequently even while at work. I have put together a video of lower back stretches that you can perform in an office chair. These stretches will ease your sore back.

Stretching Tips:

When you stretch, remember to move to a position where you feel a gentle pull. Don’t stretch as far if you feel any pain. Aim to hold each stretch for 30 seconds. Perform these lower back stretches several times per day at work and at home to get pain relief. Click to learn how to stretch your neck.

Standing Breaks:

Taking regular standing breaks every 30 minutes at work will help ease your back soreness during your work day. I recommend going for a 15 to 30 minute walk on your lunch break to help loosen your back. It is a good idea to discuss with your doctor any unusual back symptoms you may be experiencing. Avoid activities that increase your pain.

10 Tips For Recovering From Car Accident Injuries


Are you recovering from car accident injuries? It’s important that you take the appropriate steps to recover quickly. Too often I see people whose recovery has been drawn out needlessly over several years. It’s important to incorporate active rehabilitation when you can tolerate gentle movement. Performing light stretches, core exercises and simple strengthening exercises early on accelerates the rehabilitation process.

Avoid Activities That Increase Pain


I was speaking with a new client today. She, like other clients we work with had suffered whiplash from a car accident. She was struggling to perform yard work such as mowing the lawn and gardening owing to her neck pain. In the conversation, she revealed how she thought she was strengthening her neck when she was continuously looking down to power wash her driveway. She mentioned the power washing caused her neck pain to worsen but she continued to do it because she believed it was aiding her recovery. I explained that she was irritating her neck by looking down for long periods of time and that it was making her condition worse. Unfortunately, this was not the first time I have had clients make this mistake. Below is a list of activities that have the potential to aggravate an existing neck or back injury. It is vitally important to be aware of body positions or activities that worsen your symptoms. If possible, avoid activities that increase your pain.

Common activities with the potential to aggravate your symptoms:

  • vacuuming
  • washing the floor or a bathtub
  • mowing the lawn
  • gardening
  • prolonged texting
  • washing windows
  • lifting or carrying heavy groceries
  • using a laptop computer or tablet

Pace yourself

It may be impossible to avoid some of the tasks listed above. For example, if you do need to vacuum, try and break the task up. Take a rest break after every five minutes of vacuuming. During this rest break, perform stretches to ease your neck pain or low back pain. For a task such as window washing, you could pace yourself by washing a single window per day over several days.

Forget no pain, no gain

The take home message is that the “no pain, no gain” aphorism is counter productive. The bottom line is when an activity exacerbates your pain symptoms, you should stop the activity.

Dr. Karina Fuentes, Psychologist, On Chronic Pain And Anxiety Following A Car Accident


I had the pleasure of interviewing Dr. Karina Fuentes, Psychologist. Dr. Fuentes has a private practice in Port Coquitlam where she helps people with conditions such as chronic pain, anxiety and depression. She received her Ph.D in clinical psychology from the University of Victoria in 2001. She explains how therapy helps people with chronic pain and gives advice on driving anxiety after a motor vehicle accident.

What are the signs that a person who is suffering from chronic pain would benefit from seeing a Psychologist?

Some common reasons why people with chronic pain choose to work with a Psychologist include having difficulty overcoming a depressed mood, feelings of guilt about how their pain affects their family, feelings of anger, or difficulty coming to terms with how their pain limits them. Anxiety about doing things that are safe to do also suggests that support from a Psychologist could be helpful. For example, some people with chronic pain are afraid to exercise even though their doctors have said it is safe.

What advice would you give to someone who has been in a car accident and subsequently has anxiety with driving?

The least helpful thing you can do is avoid driving. Avoiding it will help you feel better in the short-term, but as more time passes it will become harder to overcome the anxiety. Having said that, you should not expect yourself to be able to immediately feel as comfortable as you did before with driving. A more helpful approach is to gradually get used to driving again. For example, you might start with short drives around your neighbourhood while practicing anxiety management techniques and then work your way up to more challenging drives.

Describe the impact that seeing a Psychologist can make in the life of someone suffering from chronic pain from an injury caused by a car accident?

Some examples of how a Psychologist can help people include finding different ways of managing their pain, overcoming anxiety about driving or being a passenger, rebuilding confidence, finding hope for the future, and focusing on abilities instead of limitations. Psychologists can teach specific skills for improving sleep, overcoming anxiety and negative thinking, resolving trauma, and learning how to relax.

Will ICBC cover the cost of treatment with a Psychologist?

It is up to your adjuster about whether or not they will provide funds for treatment. If you have a lawyer, you may wish to ask your lawyer to speak with your adjuster about the possibility of funding. Some Psychologists’ fees exceed what ICBC pays, so in that event you may be asked to pay for the difference.

When ICBC provides funding they typically will approve a set number of treatment sessions. Depending on what you and your Psychologist think is best, your Psychologist may submit a request for additional sessions. It is then up to ICBC whether or not additional funding will be provided.

How can family and friends support an individual suffering from chronic pain?

Be aware that although your loved one may look perfectly fine they may be struggling with pain. People with chronic pain are sometimes afraid of burdening friends and family, and they may try to hide how they are really feeling. Planning shorter activities or making sure your loved one can take breaks can be helpful in managing household tasks and social commitments. People with chronic pain usually don’t know how they are going to feel from one day to the next, so patience and understanding are key.

Elizabeth Esposito Speaks About Massage Therapy for Car Accident Recovery


Elizabeth Esposito, Registered Massage Therapist and owner of Esposito Massage in Port Moody, shares her thoughts on the ‘need-to-knows’ of massage therapy for car accident recovery. Elizabeth has been practicing massage therapy for the last decade. She is a member of the MTABC and CMTBC. She has a big heart and looks out for the best interest of her patients.

1) Can you explain how massage therapy can help someone who has soft tissue injuries from a motor vehicle accident?

Massage therapy can aid in decreasing the person’s pain perception, will help to increase their mobility and help them with their rehabilitation goals if pain plays a factor in activities that they are not able to accomplish.

2) What is an appropriate length of time to wait before attending massage therapy following a car accident?

I recommend patients come in as close to the date of their accident as possible. The sooner the patient has an intervention from an injury, the faster their recovery.

3) How often do you recommend a person received massage therapy in order to get the maximum benefit?

The severity of the injury determines how often a person needs to attend massage therapy to get the maximum benefit. If the injury and pain is severe, I will recommend twice a week for two weeks. Once the patient starts to notice a change in their body then I will recommend dropping to once a week for three weeks. At that point I will reassess where the body is at. If the person is still getting the maximum benefit then I will recommend to them to come in every other week for three weeks until we can stretch out the length of time between treatments to a few times a year.

4) Is a doctor’s referral required in order for ICBC to cover massage treatment? Is there a maximum amount of treatment ICBC will cover?

Initially there is no doctor’s referral required for the initial 12 treatments. After 12 treatments a doctor’s note is recommended for eight more treatments. After having 20 treatments in total the decision is then made by their adjuster if they will still cover treatment. ICBC only covers $23 of the treatment cost so there is a user fee that is required to be satisfied by the patient. User fees vary depending on the length of treatment, for example a 1 hour treatment costs $110, ICBC covers $23 so the user fee for the patient is $87.

5) What makes massage therapy unique compared to other types of treatment?

Massage is very hands on and your therapist is with you for the entire time. Massage therapy manipulates and works with the soft tissue of a person’s body. It’s very personal because the therapist is working on the patient’s tissue for the entire treatment.

6) Can you de-bunk a myth about massage therapy?

Massage does not get rid of toxins out of your body. The human body has it’s own filtration system through the kidneys and liver. Most people feel the urge to urinate afterwards because getting a massage is like a work out without working out.

7) What qualities should a person to look for when hiring a massage therapist?

What people perceive is a good massage therapist is personal. Sometimes years of experience plays a role, but honestly, there are some great new therapists entering the profession that are often better than an older therapist because they are new and want to impress. Not to say that older therapists aren’t, just sometimes older therapists get into a rut and miss things. It’s all about your relationship with your therapist and personality because getting a massage therapy treatment is very personal and intimate. It is very important to make sure you find a therapist that stays up to date on current research and continues to educate themselves as much as possible instead of what is required.

Stretches To Ease Your Neck Pain


Stretching Your Injured Neck

It is common for a person who has been injured in a motor vehicle accident to suffer from neck pain. Performing neck stretches two to three times per day can help ease your neck pain. Talk to your doctor or health care practitioner before starting a stretching program.

Benefits 

  • Reduced neck pain
  • Increased range of motion
  • Increased circulation
  • Reduced neck stiffness

Stretching Tips

Ideally your body should be warm when you stretch. Imagine your muscles are like a rubber squash ball. When the ball is cold it doesn’t bounce well but once it’s warm, it becomes more elastic. It is wise to have a hot shower or go for a walk before you stretch to increase your muscle temperature. Aim to hold each neck stretch for 20 seconds. Repeat each stretch two times on each side, left and right. If you have significant pain holding these stretches for 20 seconds, start by holding them for 10 seconds and work up to 20 seconds. It’s important to stop in a end position where you feel a very gentle stretch. Do not force the stretch. If you experience an increase in your symptoms, you need to lessen the stretch by not moving so far. In time, it will become less painful.

Neck Stretches

Start with your head facing forward. Gently tilt your head towards your shoulder until you feel a light stretch. Hold this position for 20 seconds. Repeat the same movement with your head tilted to your other shoulder.

Look over your shoulder as if you are doing a shoulder check. Hold this position for 20 seconds before turning your head to the other side. When you are turning to look left, you should feel the stretch at the right side of your neck.

Begin looking straight ahead. Slowly lower your chin towards your chest. Stop when you feel a gentle pull at the back of your neck. Hold for 20 seconds. Return your head to the starting position.

Turn your head 45 degrees to the side and then lower your chin to your chest. Hold this position for 20 seconds before returning to the starting position looking forward. When you turn your head to your left side, you will feel a stretch on the right side of your neck.

Aquatic Rehabilitation


Aquatic rehabilitation…it’s not what you think it is. No flippers, swim cap or googles are required and you don’t even need to know how to swim! In aquatic rehabilitation your feet remain firmly planted on the pool bottom in the shallow end. Okay, at least one foot is planted on the bottom at all times and the side of the pool is within reach.

What is aquatic rehabilitation?

Aquatic rehabilitation or aqua therapy are terms given to describe active rehabilitation exercises performed in a swimming pool. It includes range of motion, strength and stretching exercises. The aquatic environment provides gentle resistance while the buoyancy supports your body weight making you feel lighter. All exercises can be performed in the shallow end of the pool. Individuals that are more comfortable in the pool, have the option of performing deep water exercises wearing an aqua therapy belt. The aqua therapy belt allows you to float similar to a lifejacket. Many community swimming pool have aqua belts that are available for patrons to use. By no means is it a requirement to be able to swim lengths using the traditional swim strokes like front crawl, back crawl, breast stroke or butterfly. Aqua therapy sessions are typically lead by a Kinesiologist or Physiotherapist at a community pool.

Who would benefit?

Aquatic rehabilitation is particularly beneficial to individuals:

  • who have high levels of pain from a soft tissue injury (such as from a car accident)
  • who have limited range of motion
  • who struggle with full weight bearing (ie standing and walking)
  • who are recovering from a joint replacement (as a hip or knee replacement)
  • who have chronic pain

Benefits of aquatic rehabilitation

  • increase in range of motion
  • increase in strength and function
  • cardiovascular improvements

What equipment is needed?

A swimsuit is the only prerequisite, however, I also recommend having sandals that you can wear on the pool deck. It is a bonus if you have access to an aqua therapy belt and a pool noodle.

Example exercises

Below is a list of rehab exercises that can be performed in the pool. This list is not exhaustive by any means. You can get really creative with using the pool noodle!

  • forward, side ways and backwards walking
  • bicep curls/tricep extensions
  • front and side arm raises
  • arm circles
  • squats
  • lunges
  • leg extensions/leg curls

I have received a lot of positive feedback from clients who have performed aquatic rehabilitation. They were able to perform an exercise routine in the water with less pain. Contact us to schedule an aquatic rehabilitation session. We offer this treatment in most cities across the Lower Mainland.

Interview with Gowri Atkinson of Active Living Physiotherapy


I spoke with Gowri Atkinson, Physiotherapist and owner of Active Living Physiotherapy in Coquitlam, British Columbia. She gave her expert opinion on how to recover from car accident injuries based on what she’s learned over the last 30 plus years as a Physiotherapist.

What led you to studying Physiotherapy?

I didn’t know for a long time which career to choose. Finally, I decided to try for physiotherapy. It would be a shorter route than medicine which would have been too long a haul. I like working with people.

What is your greatest professional accomplishment?

My 30 plus years of experience is my greatest accomplishment. If I’m not sure how to treat a particular problem, I go with my educated guess and gut feeling and it has always paid off. I am always learning about different issues and how to help patients.   

It is important to get the whole picture when assessing a problem. For example, for a patient with knee pain it is important to assess their back, hip ankle and feet. As one problem can cause other problems over a long period of time.   

Who has been your inspiration?

I’ve learned a lot from working beside other physiotherapists. They have influenced me in different aspects of physiotherapy.

What common mistakes do people make with their physiotherapy treatment that interfere with their recovery from a car accident?

Some people are under the impression that physiotherapy is a quick fix without them putting in any effort.

I will give you an example of a lady who had received treatment from me. She had been in a motor vehicle accident.  She told me in the beginning that she did not do exercises. She had 10 sessions of physiotherapy and massage therapy and then quit because she thought she was better. But the pain started bothering her and she came to see me for more treatment. She wasn’t doing much in the way of homework. I tried to inspire her, educate and motivate her about the importance of the home program but I was unsuccessful.  Sometimes you just can’t win. It was very disappointing.

Patients have to be really motivated and be willing to sacrifice their time and put in a reasonable amount of effort on a regular and consistent basis to make a change for their improvement and a healthier life.

How soon do you recommend a person start physiotherapy after sustaining soft tissue injuries from a car accident?

I usually say immediately – sooner rather than later is much more beneficial.   

Some patients see me several months after an accident. They may have had other treatment, for example, massage therapy and/or chiropractic treatment prior to physiotherapy. By this time they have compensated for their problems and learned bad habits. This then becomes more challenging and takes longer to correct the poor postures they have acquired.

It is important to learn how to sleep and sit in the best positions with the least amount of pain and stress to the muscles, ligaments and joints. What can they do at home and at work to decrease their pain and stress levels? The sooner I can get them under my care, the more I can help them.

Guiding them on the right path from the beginning makes a huge difference.

Education from the beginning is a key factor on the road to recovery.

What modalities are particularly beneficial for someone who has sustained soft tissue injuries in a car accident?

Definitely ice and heat – one or the other or both. I like ultrasound. I think it works quite well for a lot of soft tissue problems. I also use the TENS and muscle stimulation machines. Manual therapy is an important tool I use.

What are the benefits of Physiotherapy that cannot be obtained from other therapies?

Every Physiotherapist does things differently. 

I listen to my patients and try to figure out their issues. It is often the little things they tell you that gives me a better insight into their problems. You have to be like a detective and figure out what they are doing wrong or what they can change to decrease their pain and increase their tolerance to a particular activity.

I think listening skills are very important for physiotherapists. I have learned to become a better listener over the years.

As a physiotherapist I strive to achieve long lasting results rather than a quick fix. Also I teach my patients how to manage their problems.

How has physiotherapy changed over the last thirty years?

Physiotherapy as a profession has changed so much. Physiotherapy has grown, diversified and specialized. When I started years ago, we did for example some of the work of kinesiologists, occupational therapists, massage therapists, etc.   

Many physiotherapists acquire specialized skills through further education, for example, vestibular rehabilitation.  I enjoy helping men and women with pelvic floor problems and working with the elderly (gerontology). I also assess and prescribe orthotics when appropriate.   

I had worked with premature babies in the intensive care nursery, with adults and children in the intensive care unit, sports injuries and ICBC patients.

What misconceptions do people have with Physiotherapy?

A lot of people think you need a doctor’s referral for physiotherapy, and that’s certainly not true. For ICBC, after 20 visits you need a doctor’s referral for more treatment to be funded.

Some patients are not quite sure what to expect, some expect a quick fix.

A question I am often asked is, “How long do you think it will take to get better with treatment?”  This is the million dollar question. Improvement is dependent on the patient’s level of motivation, on the extent of their injuries and their pre-injury fitness level. I believe that educating my patients is important as it empowers them to make choices.

What advice would you give to a person who has been injured in a car accident?

Make sure you get out checked out thoroughly by a physiotherapist as soon as possible.

Consult a physiotherapist – ‘your go to person’ – for musculo-skeletal issues.

Interview with Rebecca Stephens, Dr. TCM, R.Ac., B.Sc.


I had the pleasure of interviewing Rebecca Stephens, Registered Acupuncturist and Doctor of Traditional Chinese Medicine, who practices at Healing Cedar Wellness on St Johns street in Port Moody. In her practice, she helps people with musculoskeletal pain and injury, stress or women’s health issues. Rebecca is an instructor of Acupuncture at Boucher Institute of Naturopathic Medicine. Rebecca explains why acupuncture is a unique and effective treatment for musculoskeletal pain and injury.

What is acupuncture?

The textbook definition of acupuncture is: “The stimulation of specific anatomical sites on the body, called acupuncture points, to achieve therapeutic effect.  This is usually done by way of the insertion of fine sterile needles into the skin.”  Stimulation of these points is shown to affect the nervous, endocrine, and circulatory systems, and these effects can be used to address various health concerns. The complete scope of acupuncture therapy employs a few additional tools besides needles, such as cupping, tuina (acupressure massage), moxabustion (warming of an acupuncture point), and gua sha (a “scraping” therapy with similarities to Graston technique).

How can acupuncture help a person who is suffering from soft tissue injuries sustained in a car accident? How does acupuncture reduce one’s pain? 

Acupuncture is a wonderful tool to address pain and dysfunction sustained from injury.  As mentioned in the last point, acupuncture can have effect on 3 major systems of the body, which in turn trigger cascades of effects that can regulate and decrease the body’s production of inflammatory and pain chemicals, as well as increase blood flow to an injured area.  Stimulation of specific points on muscles can help regulate muscle tone, which can greatly improve functioning and range of motion. Acupuncture is also very helpful to the healing process, and has been shown in studies to promote tissue regeneration.

What makes acupuncture different from other treatments?

Acupuncture has both differences and similarities compared to other therapies. With this treatment, the goal is to address the chief complaint while also taking into consideration the state of the whole body.  The thought is a more balanced body is less prone to problems, and can heal itself more efficiently. Acupuncture is different from conventional pain treatments in that it aims to achieve similar effect of pain/inflammation reduction either without the use of, or with reduced use of pharmaceuticals.  It also typically targets much smaller regions on the body (the acupuncture points) than other treatments to achieve the same effect of treating the larger area. You may notice that some of the points used seem similar to target areas used by other modalities, and some points are quite different.  The main differences are the technique and tool used. Overall acupuncture is meant to be a gentle therapy, and is considered very safe with little or no side effects. It is commonly used alone or in conjunction with other therapies.  Most patients report feeling very relaxed and a bit sleepy after treatment.

How often do you recommend a person receive acupuncture treatment in order to get the maximum benefit?

I will usually tell my patients to first try at least 3-4 treatments, to see if acupuncture is going to have an effect.  Then treatment frequency is then dependant on severity of symptoms.  More severe symptoms may be treated 2-3 times per week initially.  Moderate symptoms can be treated 1-2 times per week.  Once improvements are seen, treatments are spaced out accordingly.  It is hard to give an average course of treatment as all problems are different, but courses ranging from 6 – 24 treatments are not uncommon.

At what point in time after a car accident, is it beneficial to begin acupuncture treatment for a soft tissue injury? 

As acupuncture therapy can be applied indirectly (i.e. not at the actual site) to treat an injury, technically it can be started soon after the incident has occurred.  Direct treatment is usually only considered a minimum of 1 week after the injury, and is not typically applied to severely bruised or swollen areas.  Personally, I usually tell my patients to wait at least a week before coming in, to allow the body to rest.

What qualities to look for when hiring an acupuncturist?

Acupuncture in BC is a regulated profession.  Acupuncturists should be regulated with the College of Traditional Chinese Medicine Practitioners (CTCMA) of Canada, and have the designated title of R.Ac. (Registered Acupuncturist), R.TCM.P (Registered TCM Practitioner)., DrTCM or DTCM (Doctor of Chinese Medicine).  This ensures they have the necessary hours of training (3-5 years) and have passed the Provincial CTCMA Board exams to become registered. When seeking treatment for soft tissue injury sustained in a motor vehicle accident, it is helpful to seek out a practitioner with experience in this area.

Do insurance companies typically fund acupuncture treatment?

Yes, most health insurance plans cover some acupuncture treatments.  It is best to check with your individual plan to determine your coverage.  MSP may also cover a portion of treatment price for certain eligible individuals.

Is Your Mattress And Pillow Working For You?


Do you experiencing significantly more neck and back pain upon waking than you do later the day? This could be a sign that your mattress and pillow are not doing their job.

It’s your mattresses role to support the curves of your spine, thereby, allowing your tired spinal muscles to relax and recover at night. If your mattress is on the hard side, so much that is resembles a plank of wood, there will be gaps where your spine doesn’t come in contact with the mattress (because of your spinal curves). The muscles that run down your spine will have to continue working at night to maintain the natural curves where the gaps are. In contrast, a proper mattress supports the spinal curves allowing your back to rest. It’s a good idea to replace your mattress at least every ten years if not sooner as mattress wear out.

Do you spend the first part of your day stretching out the tension in your neck? Your pillow makes all the difference. I speak from experience. Have you every gone on a holiday and forgot to bring your pillow? You wake in the morning and your neck muscles are tense after using a luxury pillow which is more like two pillows stuck together. The pillow I recommend is a water pillow. The outer plush material of a water pillow resembles a traditional pillow; however, there is a badder inside the pillow. It’s recommended you fill the pillow with two or more litres of water by opening the valve and using a funnel that comes with the water pillow. For a better night sleep and less neck discomfort in the morning, try using a water pillow.

Whether you are recovering from soft tissue injuries or suffering from chronic pain, determine if your mattress and pillow are working for you.