Thank you for September.

We’re approaching Thanksgiving, so this post is about giving thanks.  More specifically, it’s about giving thanks to my team at work, who do such a great job and who I’m so grateful to have.

We have had a crazy month at Burlington Sports & Spine Clinic.  As you may know, our clinic is a part of the Complete Concussion Management national network of clinics, and as such, baseline concussion testing has become a big part of what we do.  For the last several years, that’s meant that we schedule a couple of September weekends dedicated to conducting pre-season baseline tests of hockey teams.  This year, that meant three full two-day weekends, and well over 400 baseline tests performed.  We collect valuable data on each player to compare against, should the player become concussed in-season, and this allows us to make safer, more reliable return-to-play decisions.  It’s a great program, and we’re happy to be involved with it, but the logistics are demanding, and that’s where the thanks comes in.  Thank you to Emilia, who kept this ship sailing with late Friday nights and long days on Sundays.  Thank you to Dave, who organized and planned and made this all happen.  Thank you to Amber, Kristy, Mike, Damian, and Britnie, who keep the clinic running smoothly while all this “extra” takes place every September.

A big part of my job, and one of the things I enjoy the most, is talking with my patients.  And what I hear again and again, are work stories that make people happy versus work stories that make people unhappy.  Work is a big part of many of our lives, and I’m ever so thankful that I’ve found a crew to make workdays fun.  They say that you’re the sum of the five people that you spend the most time with, and in September, I was the sum of the people at Burlington Sports & Spine.  Thank you for that.

I won’t bore you with the details of the other side of my life in September: the teacher/football coach husband, the back-to-school rush of two young kids, the puppy, and let’s throw a half marathon in there (bad idea), but I will say I’m thankful for it all.  I’m thankful for the choices I’ve made to get me to this point in life, the opportunities I’ve been given, and the luck that’s come my way.

And as I look towards October, I’m thankful for an under-scheduled Thanksgiving weekend and for the chance to restore some balance and take a breath.

thank-you-kids-ThankYou


The Overuse of Youth

Young athletes are a big part of my practice.  From sprained ankles to separated shoulders to low back pain, my goal with them, as with all my patients, is to decrease pain and increase function as quickly as possible.  But with young athletes in particular, I want to try to minimize the effect that an injury has on the rest of their body long-term.  Our bodies are masters of compensation you see, so if one area becomes weak or injured or dysfunctional, another area steps up to counterbalance.  And herein lies the problem: where did the injury start?  Can we chase the dysfunction throughout the body to find the initial culprit?

Troubling trends that I’m finding amongst these young athletes are overuse injuries.  Most often, these kids are playing their primary sport nearly year-round.  Summer hockey.  Winter ball.  Indoor soccer.  In 2016, the American Orthopaedic Society for Sports Medicine released an Early Sport Specialization Consensus Statement, which you can read by clicking HERE.

AOSSM

This is my favourite part:

“The primary outcome of this think tank was that there is no evidence that young children will benefit from early sport specialization in the majority of sports. They are subject to overuse injury and burnout from concentrated activity. Early multisport participation will not deter young athletes from long-term competitive athletic success.”

Please take a moment to read that again.  “No evidence” of “benefit” from “early sport specialization.”  And a whole lotta downside in the form burnout and overuse injury.

Make no mistake, I love youth sport.  I’m a huge competitor and I was raised playing every sport around, as do my children.  But remember, better movers make better athletes, and your child’s body will not learn to move well if it has only been expected to do the same thing over and over again.  Multi-dimensional.  Multi-sport.  Multi-movement.  That’s the key to a well-balanced athlete, and more importantly, a healthy human body.

If nothing else, I hope this post gives you some food for thought.  Parents have thousands of choices to make throughout their children’s lives, and this one is a big one.

hockey rules


Now, we know better.

This is a tale of my mom, and of advances in research and medical treatment.

know better do better quote

Maya Angelou famously said, “Do the best you can until you know better.  Then when you know better, do better.”  This statement can be readily applied to scientific advances in patient care, and in the case of my mother, low back pain.

In the 1980s, when my brother and I were very young, my mom suffered from chronic low back pain.  There was no incident that started her pain, per se, but it was a dull ache that developed into chronic pain over the years.  She was diagnosed with “degenerative disc disease,” and in 1988 had aggressive back surgery, whereby the surgeon fused four of her five lumbar vertebrae together via screws and an eight-inch metal rod.  I have vague memories of visiting her in recovery in an Edmonton hospital, a few hour’s drive from our tiny prairie town of Hughenden, Alberta.  My nine-year-old brain didn’t hold on to many of the details, just that she was in a hospital bed, and I’d never seen my invincible mother, well, not invincible.

She recovered well, and her low back pain was a thing of the past through my ego-centric teenage and young adult years.  And while her history of back pain and surgery didn’t play a conscious role in my decision to become a chiropractor, the irony is not lost on me that I treat patients like her pre-surgical self every day.  I could have helped her, and let me boldly state that she might have avoided back surgery.  You see, she had no radiculopathy (pain down the leg due to pressure on a lumbar spinal nerve), no indicators of disc bulges or herniations, and she was only 38 years old, coincidentally the exact same age that I am now.

However, her back pain is back with a vengeance now, thirty years later.  It’s worsened over the last several years, and she now has trouble being on her feet or sitting for prolonged periods of time, and struggles to lift much more than her youngest 21-lb granddaughter. It’s affecting her quality of life, despite regular rehab exercises guided by yours truly, ergonomic modifications, and other conservative treatment measures.  The thing is, for the last thirty years, her body has compensated for the lack of movement through her lumbar spine, and the segments above and below her fusion now show advanced degeneration.  Her movement patterns have changed, her core muscles have changed, her biomechanics have changed.  Her spine does not move well, and as a cumulative result, she is in pain much of the time.

She’ll tell you she feels lucky.  Lucky that her pain was mostly gone for the last thirty years.  Lucky that the post-surgical ramifications haven’t affected her much until now.  But I’ll tell you that I wish she didn’t have chronic low back pain in the 1980s, because the conservative management today would be far different.

Why do I tell you this?  Because now, we know better.  Now, we do better.  And we are really good at treating low back pain.

lumbar fusion

This is similar to my mom’s spinal surgery in 1988, although four of her five lumbar vertebrae are involved.

*** As an aside, I never use the term “Degenerative Disc Disease” as a diagnosis because I think the term creates fear-mongering and patient helplessness.  Words spoken by a medical professional carry power, a power that I do not take lightly.  Improved semantics = improved patient outcomes.  And might I remind you that there is not always a correlation between clinic imaging results and a patient’s symptomatology…..