Movability - Wellness & Sport Sciences

Movability - Wellness & Sport Sciences Chiropractic, pelvic floor physiotherapy, acupuncture, massage, orthotics, naturopathic care, and rehab all under one roof.

We treat complex conditions through full-body assessment, root-cause care, and a collaborative, patient-first approach.

04/29/2026

Friendly reminder: chronic headaches are never normal.

There is a difference between expected and normal.

An occasional headache after dehydration, poor sleep, skipped meals, illness, alcohol, screens, or stress can be expected.

But headaches that keep returning should not be normalized just because your family calls them normal. Family history may explain the pattern, but it does not make chronic pain your baseline. Most people do not live with chronic headaches.

I ask patients: “How many headaches do you get per month?”
They say: “The normal amount.”
I ask: “What is normal?”
They say: “6, 8, 10, 15.”

The normal baseline is zero headache days.

Not because humans never get headaches, but because recurring head pain is a signal. It deserves a diagnosis and a plan.

Chronic daily headache means 15 or more headache days per month for over 3 months, but you do not need to reach that number before taking headaches seriously.

The root cause matters: sleep, hydration, food, hormones, migraine, vision, neck tension, jaw clenching, medication overuse, stress, environment, or another medical issue.

Sometimes context is part of the cause. I have seen chronic headaches improve after divorce or marriage counseling. That does not mean the pain was fake. It means the nervous system lives inside a real body, in a real life.

With children, I am even firmer: I do not normalize headaches in kids. A one-off headache with a clear cause can happen, but frequent, severe, new, or unexplained headaches deserve attention.

Track the pattern:
How many days per month?
Where is the pain?
What triggers it?
Nausea, light sensitivity, dizziness, vision changes, neck pain, jaw tension, numbness, weakness, or fatigue?
How often are you taking medication?

Get assessed if headaches are frequent, worsening, severe, different, affecting school, work, or sleep, or making you rely on meds often.

Urgent red flags: sudden or worst headache, head injury, fever or stiff neck, confusion, vision changes, weakness, numbness, or trouble speaking.

Headaches may be common.
Chronic headaches are not normal.
Expected does not mean normal.
Common does not mean healthy.
Pain is information.

Dr. Sina

04/26/2026

A positive nerve tension test does not tell you where the compression is.

That is one of the biggest mistakes I see with thoracic outlet cases. “TOS” gets used like a final diagnosis, when really it is just an umbrella term for neurovascular compression. The better question is: where is the system actually being challenged?

Is it above the clavicle?
Between the clavicle and first rib?
Or below the clavicle, under pectoralis minor?

That distinction matters because the symptoms can look almost identical. Tingling. Heaviness. Pain. Numbness. Fatigue overhead. A positive ULTT. Same presentation on the surface, completely different mechanical driver underneath.

Pectoralis minor syndrome is one of the most overlooked pieces of that puzzle. When pec minor becomes shortened or overactive, it can contribute to scapular anterior tilt and protraction, and reduce the space available for the brachial plexus as it travels beneath the muscle into the arm.

So a patient may be labeled with “TOS,” when the more clinically useful question is whether the dominant compression is actually infraclavicular, under pec minor.

That is why positional testing matters. If changing clavicular position alters symptoms, you should interpret the case differently than if unloading pec minor changes the response. This is not about finding one magic test. It is about using anatomy, symptom behavior, movement, tissue tone, and neural response to narrow the driver instead of guessing.

Good clinicians do not stop at “the nerve is irritated.” They ask where it is being irritated, what is mechanically feeding it, and which movement pattern keeps reproducing the problem.

At Movability, this is the level of detail we care about. We do a lot of work with pinched nerves and complex neck, shoulder, and arm presentations, which means looking past the label to find the anatomy and mechanics actually driving symptoms.

I go much deeper on this in the latest Movability Masterclass on Substack, where I break down the anatomy, exam logic, and decision-making process behind these cases.

Get the site right, and treatment becomes more specific. Specific care almost always beats generic care in complex cases.

04/22/2026

Spinal stenosis is not just a narrow canal.

The MRI can show anatomy, but it cannot tell you how much reserve the person has left.

At Movability, we look at stenosis through the Canal vs Capacity Framework.

The canal is the structural side: disc degeneration, facet changes, ligament thickening, foraminal narrowing, central canal narrowing, spondylolisthesis, and the compression story.

Capacity is the human side: nerve health, blood flow, strength, balance, hip mechanics, walking tolerance, sleep, blood sugar, smoking history, nutrition, and how much the nervous system can tolerate.

Two people can have similar MRI reports and completely different lives because capacity changes everything.

This is why our stenosis work at Movability is not just “stretching the back” or chasing pain.

Our physiotherapy team has extensive experience with stenosis patterns, especially cases where walking tolerance is dropping, symptoms flare with standing, cycling feels easier than walking, or the person has tried injections, meds, or generic rehab and still feels stuck.

The goal is not to force movement into a system that cannot tolerate it. The goal is to rebuild capacity intelligently.

That can mean flexion-friendly strategies, walking exposure, cycling conditioning, hip and trunk strengthening, balance work, gait confidence, nerve-resilience considerations, and red flag monitoring.

Smoking, diabetes, neuropathy, poor sleep, alcohol use, B12 deficiency, vascular issues, deconditioning, and fear of movement can all make stenosis feel worse or decline faster.

A strong plan has to understand which layer is driving the symptoms.

This week’s Movability Masterclass article is a full Root Cause Breakdown on spinal stenosis, why some people decline faster, what makes symptoms worse, and how we think through these cases clinically.

If you or someone you know has been told “it’s just stenosis,” this will give you a clearer way to understand the pattern.

Read the full breakdown on Substack: Movability Masterclass. Link in bio ⬆️

And if this sounds like the case you are dealing with, Movability is built for complex movement problems like this.

Dr. Sina

04/19/2026

Not every head-turn dizzy spell is “just the inner ear.”

Sometimes, the neck position is not only triggering symptoms.

Sometimes, it is changing blood flow.

That is the core idea behind Bow Hunter syndrome, also called rotational vertebral artery syndrome.

In this condition, a specific neck position, usually rotation or extension, can mechanically narrow or occlude a vertebral artery.

In neutral, the artery may look fine. Turn into the wrong position, and blood flow to the posterior circulation can drop in real time. Return to neutral, and symptoms may ease.

That is why this diagnosis gets missed.

Most testing is static.

But the problem is dynamic.

Symptoms can include vertigo, lightheadedness, blurred or double vision, tinnitus, imbalance, presyncope, syncope, and in serious cases, TIA or posterior circulation stroke.

The big clue is not dizziness by itself.

It is the pattern.

Same head direction.
Same threshold.
Same symptom.
Relief when the head comes back to neutral.

Most dizziness with movement is not Bow Hunter syndrome. Vestibular and cardiac causes are far more common. But when the pattern is mechanically precise, repeatable, and tied to neck position, we have to stop thinking in symptom buckets and start thinking in mechanisms.

This is exactly why I wrote the full Root Cause Breakdown on Substack (link in bio):

“Bow Hunter Syndrome, The Vascular Diagnosis Hiding Inside Cervicogenic Dizziness”

Inside the article, I break down the systems map, anatomy, biomechanics, dynamic testing logic, management options, escalation criteria, and the clinical pivot most people miss.

This is why root-cause thinking matters.

The body often tells the truth in patterns.

You just have to ask the right question in the position where the problem lives.

Read the full article on Substack, Movability Masterclass.

Subscribe there for complex case breakdowns that connect pain, movement, neurology, and physiology.

Educational only, not personal medical advice. If you have sudden weakness, speech changes, vision loss, severe imbalance, fainting, or new neurological symptoms, seek urgent medical care.

Dr. Sina

04/14/2026

TMJ OR MIGRAINE?

Most temple headaches are not mysterious, they are mis-sequenced.

One of the biggest mistakes I see is this: people ignore the jaw and call every temple headache a migraine, or they blame every click and pop on TMJ. Both mistakes miss the real question:

Is the jaw actually driving the pain?

What matters is not just where the pain lives. What matters is causation.

A jaw-driven headache often shows up in the temple, around the ear, or in the chewing muscles. It may come with jaw tightness, clenching, pain with chewing, morning stiffness, or symptoms that get worse after talking, yawning, gum, or opening wide.

Try this short self-check at home, gently, not aggressively:
1. Temple pressure test:
Place 2 fingers on your temples and press gently. Does it recreate your familiar headache, not just soreness?
2. Jaw movement test:
Slowly open and close your mouth 3 times. Then move your jaw side to side. Does your familiar temple pain increase?
3. Chewing test:
Chew something soft for 30 to 60 seconds. Does the headache get worse during or right after?
4. Pattern check:
Do you wake up with jaw tightness, catch yourself clenching, or feel worse after chewing, talking a lot, or yawning?

If you answered yes to 2 or more, your jaw deserves a real evaluation.

That does not automatically mean it is just TMJ. Migraine can coexist. Tension headaches can overlap too. The point is not to self-diagnose. The point is to stop ignoring a major driver.

Red flags matter: sudden severe headache, facial swelling, fever, vision changes, numbness, new neurologic symptoms, or severe jaw locking need proper medical assessment.

I broke the full root cause framework down in my Substack, Movability Masterclass.

Article: TMJ Headache Symptoms: How to Tell If It’s TMJ, Migraine, or Tension Headache

Send this to someone who keeps calling every temple headache a migraine.

If the headache changes when the jaw works, the case changes. That is why chasing only the symptom often fails. You can temporarily quiet the pain and still miss the driver. For the full systems map, exam logic, and what I rule in first, read the full breakdown on Substack. Link in bio ⬆️

Dr. Sina

04/08/2026

“Do you know what idiopathic means? It means the doctor is an idiot and can’t figure out the pathology.”

One of my mentors, a surgeon, told me that years ago in his thick Russian accent, and I’ve never forgotten it.

Because when it comes to idiopathic intracranial hypertension, too many people still talk about it like it’s random, or like it’s just stress.

It’s not random.
And stress is not the diagnosis.
But stress is physiology.

IIH is not just a headache disorder. It is a pressure regulation disorder.

The real question is:
what is loading the pressure system?

Venous outflow.
CSF dynamics.
Sleep apnea.
PCOS.
Androgen signaling.
Anemia.
Connective tissue disorders like hEDS/EDS.
Autonomic dysfunction.
Grief.
PTSD.
Burnout.
Adrenal dysregulation.

Not because every one of these “causes IIH” in a clean, simple way.
But because each one can change the terrain: vascular tone, venous return, sleep architecture, breathing patterns, inflammation, hormone signaling, and pressure tolerance.

That is why symptom chasing fails.

If you only treat the headache, you can miss the pressure story.
If you only focus on weight, you can miss the airway, endocrine, and venous story.
If you only hear “stress” and stop there, you can miss the physiology.

And a lumbar puncture?
That’s a snapshot, not the whole movie.

Some cases are obvious.
Some are fluctuating, transient, subclinical, or mixed high and low pressure.
Those are often the ones that get mislabeled first.

I go much deeper into this in my new Substack article:
When IIH Isn’t Random

Inside I break down the full systems map, the anatomy, the physiology, the diagnostic traps, and how I actually sequence these cases in real life.

If you’re a clinician, or just someone who refuses surface-level explanations, this one is for you.

Read the full Root Cause Breakdown on Substack, Movability Masterclass. Link in bio.

What have you seen get mislabeled as “just stress” when there was clearly more going on?

Dr. Sina

04/04/2026

If the grocery store makes you feel drunk, panicked, visually overwhelmed, or like the floor is moving, that is not “just anxiety.”

The grocery store is not the diagnosis. It is the stress test.

It exposes a breakdown in your orientation system, the network that helps your brain know where your head, eyes, and body are in space.

When that system is strained, normal environments stop feeling normal. Shelves feel aggressive. Patterned floors look like they move. Checkout lines feel worse than walking. Scrolling and driving suddenly become exhausting.

This is where people get misled. They keep looking for one owner of the symptom.

They blame anxiety.
Or the inner ear.
Or the eyes.
Or the neck.

But in complex cases, especially after whiplash, concussion, cervical overload, hypermobility, migraine, viral illness, or long periods of stress, the real issue is often a mismatch between systems that are supposed to work together.

Your eyes have to team and track.
Your vestibular system has to stabilize vision in motion.
Your neck has to tell your brain where your head is in space.
Your autonomic nervous system has to keep you regulated and upright enough to tolerate all of it.

When those signals stop syncing, the brain gets conflicting input. That is when people say:
“I feel dizzy, but not spinning.”
“The store makes me feel unreal.”
“I can walk, but I fall apart in line.”

This is how I think through complex cases: which systems lost synchrony, what is driving that loss, and what is still keeping the pattern alive?

That is why symptom chasing fails.
Glasses alone may not fix it.
Neck treatment alone may not fix it.
Vestibular rehab alone may not fix it.

Sometimes it is binocular vision dysfunction.
Sometimes it is vestibular migraine.
Sometimes it is PPPD.
Sometimes it is dysautonomia or POTS.
Sometimes the neck is contributing through cervical sensory mismatch.
And sometimes it is not one diagnosis. It is a stack.

If this made something click, save it and share it with someone who was told it’s all in their head.

I broke the full pattern down in my Substack, Movability Masterclass:
“Why the Grocery Store Becomes Impossible After Neck Injury”

Dr. Sina

03/31/2026

In my previous video, I showed you a woman leaking cerebrospinal fluid out of her nose.

And that is exactly why this conversation matters.

Because most people hear “CSF leak” and think of one thing, fluid dripping from the nose. But that is only one version of the story.

There are two major categories.

A cranial CSF leak is usually a skull-base barrier problem. That is the type that can show up as clear watery drainage from one side of the nose or ear, often changing with bending, pressure, or position, and getting mistaken for allergies, sinus issues, or ear problems.

A spinal CSF leak is different. Many spinal leaks do not visibly leak outside the body at all. They are often internal, and they show up more like a pressure and posture problem. Worse upright. Better lying down. Neck pain. Nausea. Dizziness. Tinnitus. Visual changes. Brain fog. The late-day crash that nobody can explain.

Same family of problem, very different surface story.

This is one reason these cases get missed so often. People are trained to look for the loud, textbook version.

But not every cranial leak has an obvious taste.
Not every spinal leak has a perfect orthostatic headache.
Not every MRI is positive.
And not every leak is dramatic.

Some are slow.
Some are intermittent.
Some are low-volume.
Some are tied to trauma or surgery.
Some spinal leaks are caused by calcified disc spurs or osteophytes that physically tear the dura.
Some patients also sit inside a connective tissue story, including hypermobility spectrum disorders or EDS, which does not diagnose the leak by itself, but does change the terrain.

And this is where people get misled by internet myths.

Taste is not a diagnostic test.
Smell is not a diagnostic test.
Glucose strips are not reliable.
The halo sign on paper is not reliable.

Pattern first. Then the right testing for the right type of leak.

And this is not harmless. Cranial leaks can raise the risk of meningitis. Spinal leaks can lead to serious long-term complications if they are missed.

I wrote the full article, “CSF Leak Symptoms: How Cranial and Spinal Leaks Get Missed,” on my Substack, Movability Masterclass.

Link in bio

Dr. Sina

03/26/2026

This is brain fluid leaking out of her nose… and multiple doctors told her she was fine.

(Shared with patient consent)

Here’s what actually happened:

Over a year before the leak was finally diagnosed, she had a hard head injury.
Her nose ran that same day when she bent forward… then it stopped.

She didn’t think much of it, no headache, no neck pain, and she felt completely fine the next day.

No one later asked her about prior trauma.

Then later, after a severe blood pressure episode, she started using a rebounder for exercise.

That’s when everything changed.

She suddenly developed clear, water-like fluid dripping from ONE nostril and it continued for 8 months.

Right side only.
Clear like water.
Worse bending forward.
Worse with pressure and position changes.
Pooling into her throat when lying down.
New headaches starting around the same time.

She saw ENT, told there was absolutely nothing wrong with her sinuses.
She saw an allergist, kept getting allergy medications.
Nothing worked.

She was dismissed by multiple doctors and hospitals while this continued for 8 months.

Then she came to see me.

During the exam, I watched clear fluid drip rapidly from her right nostril with head movement and forward flexion.

That is not normal.

Clinical pearls:

Unilateral + clear + positional rhinorrhea should always raise concern for a CSF leak
8 months of persistent leaking is not “just allergies”
Failure of allergy treatment is a major clue
Ask about prior trauma, even if it seemed minor, caused no lasting symptoms, and happened long before the leak became persistent
Symptoms that change with bending, straining, jumping, or movement matter
A “normal sinus exam” does NOT rule this out
You cannot diagnose this from a video, it requires proper testing

I wrote directly to her physician and urgent care to ensure she would not be dismissed again.

Beta-2 transferrin: POSITIVE
Imaging: skull base defect confirmed

Read that again:

Unilateral. Clear. Positional.

That is NOT “just a runny nose.”

If you want me to do a full deep dive on CSF leaks and build out a Movability masterclass on Substack, comment “CSF”.

Dr. Sina

03/25/2026

If you constantly feel a lump in your throat, but doctors keep telling you everything looks normal, read this.

That feeling has a name: globus sensation.

And no, it is not automatically anxiety.
And no, it is not automatically reflux.

This is one of the most misunderstood symptom patterns in health because people keep chasing one explanation for a problem that usually lives across multiple systems.

Globus sensation can be driven by laryngeal hypersensitivity, vagus nerve signaling, upper esophageal sphincter dysfunction, hyoid and laryngeal mechanics, jaw and TMJ tension, cervical spine structure, breathing pattern, autonomic overload, and sometimes structural issues like cervical osteophytes. In some people, especially those with hypermobility, hEDS, or HSD, the terrain is even more complex.

That is why so many people get dismissed.
They are told it is just stress.
Or they are treated like it is just reflux.

But a lump in the throat is not the same thing as true dysphagia, where food or liquid is actually getting stuck. That distinction matters. The driver matters. The perpetuators matter too: throat clearing, voice load, shallow upper chest breathing, jaw clenching, poor sleep, and nervous system amplification.

So when I look at globus, I do not flatten it into one cause.
I ask:
Is this a sensation problem or a transport problem?
Is there a red flag?
Is the lead driver irritation, sensitivity, mechanics, or motor control?
What is keeping the loop alive?

If you have progressive swallowing difficulty, painful swallowing, aspiration, weight loss, coughing blood, persistent hoarseness, or a neck mass, get evaluated.

If this is the first explanation that actually made sense, save it, share it, and send it to someone who keeps being told nothing is wrong.

Full breakdown on my Substack, Movability Masterclass:
“Globus Sensation (Lump in the Throat): Root Causes, Differential Diagnosis, and Systems-Based Care”

Link in bio.

Dr. Sina

Your dentist is often the first one to see the signs in your mouth:flattened teeth,worn enamel,small chips or fractures,...
03/22/2026

Your dentist is often the first one to see the signs in your mouth:
flattened teeth,
worn enamel,
small chips or fractures,
sensitivity,
and a jaw that has clearly been working overtime.

What a lot of people miss is this:
clenching and grinding are common,
but they are not always just teeth problems.

By the time it shows up in the mouth, a lot of people are also dealing with jaw clicking, headaches, neck pain, facial tension, or poor sleep, and they never connect those things back to the same pattern.

As a TMJ chiropractor who works on these cases alongside dentists, I am not just thinking about the teeth.
I am thinking about what may be driving the pattern in the first place:
stress load,
sleep and breathing patterns,
jaw and neck muscle tension,
postural strain,
medications,
nutrient deficiencies,
and the list goes on.

That is why a night guard can help protect the teeth,
but still not fully solve the issue.

The grinding is common.
But many times it is the effect,
not the root cause.

Sometimes the jaw is just where the body shows strain first.

What tipped you off first, jaw pain, clicking, headaches, neck pain, poor sleep, or worn teeth?
And if there is a TMJ topic you want me to cover next, drop it in the comments.

Dr. Sina

03/21/2026

Pain between your shoulder blades is not always just a muscle knot.

Sometimes a small nerve called the dorsal scapular nerve can be part of the problem.

This nerve starts from the C5 nerve root in the neck, passes through the side of the neck, and travels down toward the muscles between the shoulder blade and spine, especially the rhomboids and levator scapulae.

When that nerve becomes irritated, people may feel:
• pain between the shoulder blades
• a deep ache or sharp pain along the inner edge of the shoulder blade
• tightness that keeps coming back
• neck stiffness
• pain when turning the head or moving the shoulder blade

This is one reason some people keep stretching, massaging, or foam rolling the area but the pain keeps returning.

In some cases, the nerve is part of why that area stays sensitive.

In this reel, I’m showing a simple dorsal scapular nerve glide that may help calm the area down and improve movement.

A few important points:
Move slowly.
Stay in a comfortable range.
You should feel mild tension, not sharp pain.
Start with 8 to 12 smooth reps.

Not every case of pain between the shoulder blades is coming from this nerve, but it is one of the patterns that gets missed.

If you keep getting the same pain between your neck and shoulder blade, this is worth looking at.

At Movability, we focus heavily on identifying and treating nerve-related drivers like this when they’re contributing to persistent pain.

Save this for later, and send it to someone who always says they have a knot beside their shoulder blade.

Dr. Sina

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What Makes Us Unique

Movability was created to fill a void in the healthcare world. We noticed a lack of truly custom and comprehensive care, we knew we had to be different to provide the best possible treatment. We set out to create a unique therapeutic experience built on empathy, trust, and unparalleled attention to detail. We spend the time to get to know the real you, your goals, dreams and expectations because you are much more than just a diagnosis. We work with you to create custom treatments that meet those expectations. At Movability there’s no such thing as one size fits all. Experience the difference for yourself.