Alex Derksen- PT, CF-L1, FRCms

Alex Derksen- PT, CF-L1, FRCms Alex Derksen, Msc(PT), Bsc(Psyc), CF-L1, FRCms
Physiotherapist
Weightlifting Rehab & Performance Coach
Provider

Our adult playground workplace ๐Ÿ˜๐Ÿ”ฅ๐Ÿ’ช A one-stop-shop health & performance centre! From youth athlete development to adult ...
12/31/2022

Our adult playground workplace ๐Ÿ˜๐Ÿ”ฅ๐Ÿ’ช
A one-stop-shop health & performance centre! From youth athlete development to adult weekend warriors, we got you!
๐Ÿƒ๐Ÿ’จ๐Ÿ‹๏ธโ€โ™‚๏ธ๐Ÿคธ๐Ÿพโ€โ™€๏ธ
Vancouver Island just got leveled up ๐Ÿ’ฏ

๐—ช๐—ฒ ๐—ฑ๐—ผ๐—ป'๐˜ ๐—ฎ๐—น๐˜„๐—ฎ๐˜†๐˜€ ๐—ป๐—ฒ๐—ฒ๐—ฑ ๐˜๐—ผ '๐—ฑ๐—ผ' ๐˜€๐—ผ๐—บ๐—ฒ๐˜๐—ต๐—ถ๐—ป๐—ด:๐—”๐˜๐—ต๐—น๐—ฒ๐˜๐—ฒ ๐—˜๐˜…๐—ฎ๐—บ๐—ฝ๐—น๐—ฒ:โžก๏ธ Injury/discomfort is acute โžก๏ธ no real history or mechanism of ...
02/27/2022

๐—ช๐—ฒ ๐—ฑ๐—ผ๐—ป'๐˜ ๐—ฎ๐—น๐˜„๐—ฎ๐˜†๐˜€ ๐—ป๐—ฒ๐—ฒ๐—ฑ ๐˜๐—ผ '๐—ฑ๐—ผ' ๐˜€๐—ผ๐—บ๐—ฒ๐˜๐—ต๐—ถ๐—ป๐—ด:
๐—”๐˜๐—ต๐—น๐—ฒ๐˜๐—ฒ ๐—˜๐˜…๐—ฎ๐—บ๐—ฝ๐—น๐—ฒ:
โžก๏ธ Injury/discomfort is acute โžก๏ธ no real history or mechanism of injury โžก๏ธ red flags cleared โžก๏ธ been training really hard over the last block or two
๐—ฆ๐—ผ๐—น๐˜‚๐˜๐—ถ๐—ผ๐—ป:
โžก๏ธ 4 weeks of shaving off the top end of intensity and volume of the athlete's training and the aches and pains ended up dissipating.
โฐ By taking advantage of natural history, while continuing to train, it may allow you to continue to practice your skills, while simultaneously letting the body cool off for a period of time
๐Ÿง We are not trying to 'fix' anything. We are also not doing nothing. We are also not following a boom-busy cycle of discomfort. We are just shaving enough of the top end to allow your body adapt and thus create an opportunity to progress your training further for the long term.
๐Ÿ‘ด๐Ÿ‘ต Remember were trying to train for longevity not just your current 3-6 week block to try and hit a new PR. Don't be afraid to listen to your body and pivot. It may actually be what you need to see the gainz later on.
๐—ง๐—ฎ๐—ธ๐—ฒ ๐—ต๐—ผ๐—บ๐—ฒ ๐—ฝ๐—ผ๐—ถ๐—ป๐˜๐˜€:
โžก๏ธ Mother nature is a beautiful thing.
โžก๏ธ Addition by subtraction.
๐Ÿคท This is just one option. It may not work for everyone. But you also may be surprised by its positive effects.

๐Ÿคธ๐Ÿพโ€โ™€๏ธ Normal movement, normal healthy movement is thoughtless and fearless. Hence the major goal of the rehabilitation p...
01/11/2022

๐Ÿคธ๐Ÿพโ€โ™€๏ธ Normal movement, normal healthy movement is thoughtless and fearless. Hence the major goal of the rehabilitation plan.
๐Ÿคฌ I'm tired and fed up of the bull$hit, outdated and nocebic physiotherapy fad that is so 'body' focused on muscle 'imbalances' and 'correct' muscle patterning.
๐Ÿ™…๐Ÿป 99.999999% of the world doesn't think like this when they move, don't let a therapist tell you otherwise.
๐Ÿ‘‘ Listen to Louis. He knows a thing or two.

๐Ÿคธ๐Ÿพโ€โ™€๏ธ Normal movement, normal healthy movement is thoughtless and fearless. Hence the major goal of rehabilitation.๐Ÿคฌ I'm...
01/11/2022

๐Ÿคธ๐Ÿพโ€โ™€๏ธ Normal movement, normal healthy movement is thoughtless and fearless. Hence the major goal of rehabilitation.
๐Ÿคฌ I'm tired and fed up of the bull$hit, outdated and nocebic physiotherapy fad that is so 'body' focused on muscle 'imbalances' and 'correct' muscle patterning
๐Ÿ™…๐Ÿป 99.999999% of the world doesn't think like this when they move, don't let a therapist tell you otherwise
๐Ÿ‘‘ Listen to Louis. He knows a thing or two

๐Ÿ”ฅ๐—ง๐—ผ๐—ฝ ๐Ÿญ๐Ÿฌ ๐—ž๐—ฒ๐˜† ๐—ฃ๐—ฎ๐—ถ๐—ป ๐—–๐—ผ๐—ป๐—ฐ๐—ฒ๐—ฝ๐˜๐˜€๐Ÿ”ฅ๐Ÿฅ‚Because it's NYE and we all like a Top 10 before a new year.๐Ÿญ. ๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ถ๐˜€ ๐—ป๐—ผ๐—ฟ๐—บ๐—ฎ๐—น, ๐—ฝ๐—ฒ๐—ฟ๐˜€๐—ผ๐—ป๐—ฎ๐—น ๐—ฎ๐—ป๐—ฑ ๐—ฎ...
12/31/2021

๐Ÿ”ฅ๐—ง๐—ผ๐—ฝ ๐Ÿญ๐Ÿฌ ๐—ž๐—ฒ๐˜† ๐—ฃ๐—ฎ๐—ถ๐—ป ๐—–๐—ผ๐—ป๐—ฐ๐—ฒ๐—ฝ๐˜๐˜€๐Ÿ”ฅ๐Ÿฅ‚Because it's NYE and we all like a Top 10 before a new year.
๐Ÿญ. ๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ถ๐˜€ ๐—ป๐—ผ๐—ฟ๐—บ๐—ฎ๐—น, ๐—ฝ๐—ฒ๐—ฟ๐˜€๐—ผ๐—ป๐—ฎ๐—น ๐—ฎ๐—ป๐—ฑ ๐—ฎ๐—น๐˜„๐—ฎ๐˜†๐˜€ ๐—ฟ๐—ฒ๐—ฎ๐—น.
โžก๏ธ All pain experiences are normal and are excellent, though unpleasant response to what your brain judges to be a threatening situation. All pain is real.
๐Ÿฎ. ๐—ง๐—ต๐—ฒ๐—ฟ๐—ฒ ๐—ฎ๐—ฟ๐—ฒ ๐—ฑ๐—ฎ๐—ป๐—ด๐—ฒ๐—ฟ ๐˜€๐—ฒ๐—ป๐˜€๐—ผ๐—ฟ๐˜€, ๐—ป๐—ผ๐˜ ๐—ฝ๐—ฎ๐—ถ๐—ป ๐˜€๐—ฒ๐—ป๐˜€๐—ผ๐—ฟ๐˜€
โžก๏ธ The danger alarm system is just that- there are no pain sensors, pain pathways or pain endings.
๐Ÿฏ. ๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ฎ๐—ป๐—ฑ ๐˜๐—ถ๐˜€๐˜€๐˜‚๐—ฒ ๐—ฑ๐—ฎ๐—บ๐—ฎ๐—ด๐—ฒ ๐—ฟ๐—ฎ๐—ฟ๐—ฒ๐—น๐˜† ๐—ฟ๐—ฒ๐—น๐—ฎ๐˜๐—ฒ.
โžก๏ธ Pain is an unreliable indicator of the presence or extent of tissue damage- either can exist without the other.
๐Ÿฐ. ๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ฑ๐—ฒ๐—ฝ๐—ฒ๐—ป๐—ฑ๐˜€ ๐—ผ๐—ป ๐˜๐—ต๐—ฒ ๐—ฏ๐—ฎ๐—น๐—ฎ๐—ป๐—ฐ๐—ฒ ๐—ผ๐—ณ ๐—ฑ๐—ฎ๐—ป๐—ด๐—ฒ๐—ฟ ๐—ฎ๐—ป๐—ฑ ๐˜€๐—ฎ๐—ณ๐—ฒ๐˜๐˜†.
โžก๏ธ You will have pain when your brain concludes that there is more credible evidence of danger than safety resulted to your body and thus infers the need to protect.
๐Ÿฑ. ๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ถ๐—ป๐˜ƒ๐—ผ๐—น๐˜ƒ๐—ฒ๐˜€ ๐—ฑ๐—ถ๐˜€๐˜๐—ฟ๐—ถ๐—ฏ๐˜‚๐˜๐—ฒ๐—ฑ ๐—ฏ๐—ฟ๐—ฎ๐—ถ๐—ป ๐—ฎ๐—ฐ๐˜๐—ถ๐˜ƒ๐—ถ๐˜๐˜†.
โžก๏ธ There is no single 'pain centre' in the brain. Pain is a conscious experience that necessarily involves many brain areas across time.
๐Ÿฒ. ๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ฟ๐—ฒ๐—น๐—ถ๐—ฒ๐˜€ ๐—ผ๐—ณ ๐—ฐ๐—ผ๐—ป๐˜๐—ฒ๐˜…๐˜.
โžก๏ธ Pain can be influenced by the things you see, hear, smell, taste and touch, things you say, things you think and believe, things you do, places you go, people in your life and things happening in your body.
๐Ÿณ. ๐—ช๐—ฒ ๐—ฎ๐—ฟ๐—ฒ ๐—ฏ๐—ถ๐—ผ๐—ฝ๐—น๐—ฎ๐˜€๐˜๐—ถ๐—ฐ.
โžก๏ธ While all protective systems can become turned up and edgy, the notion of bioolasticity suggests that they can change back, through the lifespan. It is biologically implausible to suggest that pain can't be changed.
๐Ÿด. ๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ถ๐˜€ ๐—ผ๐—ป๐—ฒ ๐—ผ๐—ณ ๐—บ๐—ฎ๐—ป๐˜† ๐—ฝ๐—ฟ๐—ผ๐˜๐—ฒ๐—ฐ๐˜๐—ถ๐˜ƒ๐—ฒ ๐—ผ๐˜‚๐˜๐—ฝ๐˜‚๐˜๐˜€.
โžก๏ธ When threatened the body is capable of activating multiple protective systems including immune, endocrine, motor, autonomic, respiratory, cognitive, emotional, and pain. Any or all of these systems can become overprotective.
โคต๏ธ Continued below:

โŒStop with the silos.โŒ๐Ÿ™…๐ŸปWe do NOT need to dichotomize rehab and training.๐ŸถMy pet peeve is an athlete coming in with page...
12/22/2021

โŒStop with the silos.โŒ
๐Ÿ™…๐ŸปWe do NOT need to dichotomize rehab and training.
๐ŸถMy pet peeve is an athlete coming in with pages of 'rehab' exercises that a clinician prescribed with the perception that they need to do it before they can train.
๐ŸคฏIt doesn't need to be that way.
๐ŸคRehab and training can be integrated.
๐Ÿ’ช๐ŸปRehab can look like training. Rehab can feel like training. Rehab can be your training.
๐Ÿ”ฅ"ExRx is just a method to elicit adaptations in an individual. Know the constraints that injury or disease impose but implement interventions based on exercise science just like you always would"
~Scot Morrison

๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ง๐—ฟ๐—ฒ๐—ฎ๐˜๐—บ๐—ฒ๐—ป๐˜ ๐—ง๐—ผ๐—ผ๐—น๐Ÿค•Pain is all about context. We must rethink pain. Shifting our idea of pain from a measure of the sta...
12/22/2021

๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ง๐—ฟ๐—ฒ๐—ฎ๐˜๐—บ๐—ฒ๐—ป๐˜ ๐—ง๐—ผ๐—ผ๐—น
๐Ÿค•Pain is all about context. We must rethink pain. Shifting our idea of pain from a measure of the state of tissues to something your body is doing to protect you...so therefore EVERYTHING matters.
๐Ÿ”ฅThe concept of The Protectometer and DIMs and SIMs help people in persistent pain identify potential contributors to their pain state and plan their road to recovery
๐Ÿ›ก๏ธIt helps reconceptualize pain from the false belief of a 'damage' meter to that of a PROTECTOR.
๐ŸคนThis Protectometer is in a constant state of judging whether something seems DANGEROUS or SAFE
โš ๏ธA DIM (Danger in Me) is anything your body perceives as dangerous to your tissues, life, livelihood, job, happiness and day to day function.
๐ŸฆบA SIM (Safety in Me) is anything that your body perceives as safe to make you stronger, healthier, happier and more confident.
๐Ÿง Our body concludes it will have pain when there is more credible evidence of danger in me (DIM) than there is credible evidence of safety in me (SIM)
โคต๏ธ How to use this device:
๐Ÿ‘Š๐ŸปFirst step- look for anything that the body may see as credible evidence of 'Danger in Me' (DIMs) which tells it that it needs protecting and anything that the body may see as credible evidence of 'Safety in Me' (SIMs) to help decrease your protective behaviors like pain.
๐Ÿ‘‡๐ŸปExamples:
โžก๏ธThings you hear, see, smell, tough
โžก๏ธThings you do
โžก๏ธThings you say
โžก๏ธThings you think and believe
โžก๏ธPlaces you go
โžก๏ธPeople in your life
โžก๏ธThings happening in your body
๐Ÿชฃ Final step- modify and remove DIMs and strengthen and gather SIMs.
๐Ÿ‘€The beauty of this- we have so many options for recovery! It's just hides in difficult to spot places. It lives in the biopsychosocial factors that make us human.
๐Ÿƒ๐Ÿผโ€โ™‚๏ธIf you've been experiencing persistent pain, reflect and give this exercise a try! (Had to throw in 'exercise' somewhere ๐Ÿ˜‰)
โค๏ธRemember: "for there is nothing good or bad, but thinking makes it so."
~ Shakespeare

๐—œ๐—ฑ๐—ฒ๐—ป๐˜๐—ถ๐—ณ๐˜† ๐—˜๐—ป๐˜๐—ฟ๐˜† ๐—ฃ๐—ผ๐—ถ๐—ป๐˜๐˜€ ๐˜๐—ผ ๐—ž๐—ฒ๐—ฒ๐—ฝ ๐—Ÿ๐—ถ๐—ณ๐˜๐—ถ๐—ป๐—ด!๐ŸคŸ๐Ÿป๐—ฃ๐—ฎ๐—ฟ๐˜ ๐Ÿฏ- ๐—ฃ๐—น๐—ฎ๐—ป ๐—ผ๐—ณ ๐—–๐—ฎ๐—ฟ๐—ฒ ๐—ฏ๐—ฎ๐˜€๐—ฒ๐—ฑ ๐—ผ๐—ป ๐—œ๐—ป๐—ถ๐˜๐—ถ๐—ฎ๐—น ๐—˜๐—ป๐—ฐ๐—ผ๐˜‚๐—ป๐˜๐—ฒ๐—ฟ (see prev posts)๐ŸคฌYou're injured ...
12/04/2021

๐—œ๐—ฑ๐—ฒ๐—ป๐˜๐—ถ๐—ณ๐˜† ๐—˜๐—ป๐˜๐—ฟ๐˜† ๐—ฃ๐—ผ๐—ถ๐—ป๐˜๐˜€ ๐˜๐—ผ ๐—ž๐—ฒ๐—ฒ๐—ฝ ๐—Ÿ๐—ถ๐—ณ๐˜๐—ถ๐—ป๐—ด!
๐ŸคŸ๐Ÿป๐—ฃ๐—ฎ๐—ฟ๐˜ ๐Ÿฏ- ๐—ฃ๐—น๐—ฎ๐—ป ๐—ผ๐—ณ ๐—–๐—ฎ๐—ฟ๐—ฒ ๐—ฏ๐—ฎ๐˜€๐—ฒ๐—ฑ ๐—ผ๐—ป ๐—œ๐—ป๐—ถ๐˜๐—ถ๐—ฎ๐—น ๐—˜๐—ป๐—ฐ๐—ผ๐˜‚๐—ป๐˜๐—ฒ๐—ฟ (see prev posts)
๐ŸคฌYou're injured or have a tissue irritation. It sucks. I've been there. But you can keep lifting!
๐Ÿ’ช๐ŸปYou just need to identify the entry points to training:
โžก๏ธThis will increase load tolerance and capacity in specific positions.
โžก๏ธMinimize deconditioning
โžก๏ธContinued skill practice
โžก๏ธMinimize apprehension to movement and compensatory avoidance patterns
๐ŸŽš๏ธThere are many constraints to employ to get the you back training. We can turn the dial up or down on any of these. These are based on the buckets of need, boundary conditions and prior training history & data:
๐—˜๐˜…๐˜๐—ฒ๐—ฟ๐—ป๐—ฎ๐—น ๐—Ÿ๐—ผ๐—ฎ๐—ฑ: Find threshold. Adjust weight
๐—œ๐—ป๐˜๐—ฒ๐—ฟ๐—ป๐—ฎ๐—น ๐—Ÿ๐—ผ๐—ฎ๐—ฑ: Find threshold. Adjust proximity to failure
๐—ฉ๐—ผ๐—น๐˜‚๐—บ๐—ฒ: Find threshold. Adjust sets/reps or frequency
๐—ฅ๐—ฎ๐—ป๐—ด๐—ฒ ๐—ผ๐—ณ ๐— ๐—ผ๐˜๐—ถ๐—ผ๐—ป: Find threshold. Modify portion of the lift
๐—ง๐—ฒ๐—ฐ๐—ต๐—ป๐—ถ๐—ฐ๐—ฎ๐—น ๐—ฆ๐˜๐—ฟ๐—ฎ๐˜๐—ฒ๐—ด๐˜†: Adjust shin angle, stance, grip width, back angle, pelvic tilt, shoulder rotation, etc.
๐—ฉ๐—ฒ๐—น๐—ผ๐—ฐ๐—ถ๐˜๐˜†/๐—œ๐—ป๐˜๐—ฒ๐—ป๐˜: Modify speed with tempo or isometrics
๐—˜๐˜…๐˜๐—ฒ๐—ฟ๐—ป๐—ฎ๐—น ๐—•๐—ผ๐˜‚๐—ป๐—ฑ๐—ฎ๐—ฟ๐˜†: Constrain task to build up load tolerance, ROM, or desired bucket of need etc.
๐—ฉ๐—ฎ๐—ฟ๐—ถ๐—ฎ๐˜๐—ถ๐—ผ๐—ป: Substitute for different movements temporarily (top-down approach: next most specific variation to the primary lift)
๐Ÿ‹๏ธโ€โ™‚๏ธExample (see previous posts):
Powerlifter with left sided LBP when deadlifting
๐Ÿ”ฅBoundary Conditions:
โžก๏ธ Exam Findings: Symptoms with end range lumbar flexion and hinge forward
โžก๏ธ ROM Threshold: off floor in deadlift
โžก๏ธ Load Threshold: ~75% current RM
โžก๏ธ Positional Intolerance: split stance RDLs and back extensions
๐Ÿชฃ Bucket 1= Deadlifts with ROM boundary and load threshold
๐Ÿชฃ Bucket 2= Unilateral left quadrant LB constrained loading
๐—˜๐—ก๐—ง๐—ฅ๐—ฌ ๐—ฃ๐—ข๐—œ๐—ก๐—ง๐—ฆ:
Day 1:
โžก๏ธSingle Leg Hinge w/ tempo 2-2-2 (KPI)
โžก๏ธ Deadlift: ROM constrained, load focused (KPI)
Day 2:
โžก๏ธ Back Extensions off GHD w/ tempo 2-2-2 (KPI)
โžก๏ธ Deadlift: Full ROM, tempo and load constrained (KPI)
๐Ÿ‘‡๐ŸปMore below!๐Ÿ‘‡๐Ÿป

๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ถ๐˜€ ๐—™*๐—ฐ๐—ธ๐—ถ๐—ป๐—ด ๐—–๐—ผ๐—บ๐—ฝ๐—น๐—ฒ๐˜…!๐ŸคฏThe possible factors of why someone may experience pain are endless (as shown) so it is truly i...
11/22/2021

๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ถ๐˜€ ๐—™*๐—ฐ๐—ธ๐—ถ๐—ป๐—ด ๐—–๐—ผ๐—บ๐—ฝ๐—น๐—ฒ๐˜…!
๐ŸคฏThe possible factors of why someone may experience pain are endless (as shown) so it is truly impossible to know the exact reason why someone is in pain and therefore know the exact process to get them out of pain
๐Ÿ˜ŽWith that being said we tend to think about pain from a biopsychosocial lens, which helps gain an understanding of the person and their subjective experience (taking it in from a holistic perspective)
๐Ÿ•ธ๏ธThese biological, psychological, and social factors were intended to have an interconnected, non-linear, dynamic relationship with the pain experience.
๐ŸงThis means that small things can give large effects, but also large effects in one area may have no effects in the targeted area. And that there are so many interactions occurring that can affect each other that the same treatment may give rise to positive or negative outcomes dependent on the current state of the person
๐ŸŒBy looking at it from this perspective, we are able to zoom out to encompass all of the factors that may be at play for the person and can consider the person and their engagement and embodiment in the world
๐Ÿ‘“This shifts the lens from pain arising from a body region or the brain, and instead to it being an experience that emerges through a person, which is inseparable from their mind, body, and world.
๐Ÿ”ฅBPS helps to understand patients, their lives and contexts.
๐Ÿค–We are not linear machines and therefore we cannot separate someones pain experience to 1 causal factor. We cannot โ€˜find painโ€™, but instead it presents itself through the person in a lived experience as the person makes sense of the world, with it shaping them
โค๏ธMaybe instead, this BPS lens can help treat PEOPLE, rather than pain. Which can lead to greater reductions in suffering, disability and quality of life to improve overall patient care.

๐—œ๐—ป๐—ถ๐˜๐—ถ๐—ฎ๐—น ๐—˜๐—ป๐—ฐ๐—ผ๐˜‚๐—ป๐˜๐—ฒ๐—ฟ ๐˜„๐—ถ๐˜๐—ต ๐˜๐—ต๐—ฒ ๐—•๐—ฎ๐—ฟ๐—ฏ๐—ฒ๐—น๐—น ๐—”๐˜๐—ต๐—น๐—ฒ๐˜๐—ฒ: ๐—ฃ๐—ฎ๐—ฟ๐˜ ๐Ÿฎ:๐Ÿชฃ๐—•๐˜‚๐—ฐ๐—ธ๐—ฒ๐˜๐˜€ ๐—ผ๐—ณ ๐—ก๐—ฒ๐—ฒ๐—ฑ๐Ÿชฃโžก๏ธ We established the current boundaries of the athl...
11/17/2021

๐—œ๐—ป๐—ถ๐˜๐—ถ๐—ฎ๐—น ๐—˜๐—ป๐—ฐ๐—ผ๐˜‚๐—ป๐˜๐—ฒ๐—ฟ ๐˜„๐—ถ๐˜๐—ต ๐˜๐—ต๐—ฒ ๐—•๐—ฎ๐—ฟ๐—ฏ๐—ฒ๐—น๐—น ๐—”๐˜๐—ต๐—น๐—ฒ๐˜๐—ฒ: ๐—ฃ๐—ฎ๐—ฟ๐˜ ๐Ÿฎ:
๐Ÿชฃ๐—•๐˜‚๐—ฐ๐—ธ๐—ฒ๐˜๐˜€ ๐—ผ๐—ณ ๐—ก๐—ฒ๐—ฒ๐—ฑ๐Ÿชฃ
โžก๏ธ We established the current boundaries of the athlete in Part 1, so what does the athlete need to get back too (and within that what do they need)?
๐Ÿ‘‡๐ŸปExample:
โžก๏ธ Powerlifter with intermittent left sided low back/SIJ pain after Deadlift day 16 weeks ago which flares up periodically with deadlifting and hingy related movements.
๐Ÿ”ฅBoundary Conditions:
โžก๏ธ Exam Findings: Concordant symptoms with end range lumbar flexion and hinge forward. Load tolerance threshold during Mid Thigh Pull Test (using hand held dynamometer)
โžก๏ธ Range of Motion Threshold: off floor in deadlift
โžก๏ธ Load Threshold: ~75% current RM (in last 16 weeks)
โžก๏ธ Positional Intolerance: Symptoms intensified further with L foot forward split stance RDLs at end range and GHD back extension at initial concentric portion and after holds in either position at ~10 seconds.
๐Ÿชฃ Bucket 1= Deadlifts with range of motion boundary and load threshold
๐Ÿชฃ Bucket 2= Unilateral left quadrant constrained loading through hingy based exercises and constrained extensor exposure exercises to overall nudge the symptoms and build tissue tolerance to position
๐Ÿ’ช๐Ÿป What does the plan of care/programming look like? Stay tuned for ๐—ฃ๐—ฎ๐—ฟ๐˜ ๐Ÿฏ: ๐—œ๐—ฑ๐—ฒ๐—ป๐˜๐—ถ๐—ณ๐˜† ๐— ๐—ฒ๐—ฎ๐—ป๐—ถ๐—ป๐—ด๐—ณ๐˜‚๐—น ๐—˜๐—ป๐˜๐—ฟ๐˜† ๐—ฃ๐—ผ๐—ถ๐—ป๐˜๐˜€ ๐˜๐—ผ ๐—ง๐—ฟ๐—ฎ๐—ถ๐—ป๐—ถ๐—ป๐—ด!
๐Ÿ“š Adapted from CALU (2021)- ExRx Considerations through a BPS Lens with Quinn Henoch

๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ถ๐˜€ ๐—ป๐—ฒ๐˜ƒ๐—ฒ๐—ฟ ๐—ท๐˜‚๐˜€๐˜ ๐—ฝ๐—ต๐˜†๐˜€๐—ถ๐—ฐ๐—ฎ๐—น!๐Ÿ’ฏ Pain is filtered through your limbic system (your emotional center), cerebral cortex (resp...
11/12/2021

๐—ฃ๐—ฎ๐—ถ๐—ป ๐—ถ๐˜€ ๐—ป๐—ฒ๐˜ƒ๐—ฒ๐—ฟ ๐—ท๐˜‚๐˜€๐˜ ๐—ฝ๐—ต๐˜†๐˜€๐—ถ๐—ฐ๐—ฎ๐—น!
๐Ÿ’ฏ Pain is filtered through your limbic system (your emotional center), cerebral cortex (responsible for thoughts), and prefrontal cortex (regulates attentional processes)...100% of the time.
โžก๏ธ Meaning pain is never purely a physical experience- it is always both physical and emotional.
๐ŸŽš๏ธThink of your central nervous system like a pain dial that controls pain intensity. The volume can be turned up and down by many different factors such as stress, anxiety, mood and attention.
๐Ÿคนโ€โ™‚๏ธ Because of its multifactorial nature and how it is influenced by thoughts, emotions, behaviours and lifestyle factors we have so many options to get back to doing what we love!
๐Ÿ‘Š๐Ÿป So if your pain experience is getting in the way of your meaningful activities- I challenge you to ask yourself, what can I do this week to lower my pain dial?
โค๏ธ Last thing- you pain experience is ALWAYS real.

๐—˜๐˜€๐˜๐—ฎ๐—ฏ๐—น๐—ถ๐˜€๐—ต๐—ถ๐—ป๐—ด ๐—–๐˜‚๐—ฟ๐—ฟ๐—ฒ๐—ป๐˜ ๐—•๐—ผ๐˜‚๐—ป๐—ฑ๐—ฎ๐—ฟ๐˜† ๐—–๐—ผ๐—ป๐—ฑ๐—ถ๐˜๐—ถ๐—ผ๐—ป๐˜€:= Establishing where the athlete is currently at and when they feel their 'ting...
11/10/2021

๐—˜๐˜€๐˜๐—ฎ๐—ฏ๐—น๐—ถ๐˜€๐—ต๐—ถ๐—ป๐—ด ๐—–๐˜‚๐—ฟ๐—ฟ๐—ฒ๐—ป๐˜ ๐—•๐—ผ๐˜‚๐—ป๐—ฑ๐—ฎ๐—ฟ๐˜† ๐—–๐—ผ๐—ป๐—ฑ๐—ถ๐˜๐—ถ๐—ผ๐—ป๐˜€:
= Establishing where the athlete is currently at and when they feel their 'ting' (sensitivity, limitation, etc.)
โžก๏ธ ๐—˜๐˜…๐—ฎ๐—บ ๐—™๐—ถ๐—ป๐—ฑ๐—ถ๐—ป๐—ด๐˜€: ROM for task limitation, HHD testing- load tolerance finding, motor control/stability limitation, training history- acute or chronic spikes or dips in load etc.
โžก๏ธ ๐—Ÿ๐—ผ๐—ฎ๐—ฑ ๐—ง๐—ต๐—ฟ๐—ฒ๐˜€๐—ต๐—ผ๐—น๐—ฑ: At __ weight or % RM =feeling 'ting'
โžก๏ธ ๐—ฉ๐—ฒ๐—น๐—ผ๐—ฐ๐—ถ๐˜๐˜† ๐—ง๐—ต๐—ฟ๐—ฒ๐˜€๐—ต๐—ผ๐—น๐—ฑ: faster speeds or increasing intent= feeling 'ting'
โžก๏ธ ๐—ฃ๐—ผ๐˜€๐—ถ๐˜๐—ถ๐—ผ๐—ป๐—ฎ๐—น ๐—œ๐—ป๐˜๐—ผ๐—น๐—ฒ๐—ฟ๐—ฎ๐—ป๐—ฐ๐—ฒ: shin angle, torso angle, hand position, foot position= feeling 'ting'
โžก๏ธ ๐—ฅ๐—ฎ๐—ป๐—ด๐—ฒ ๐—ผ๐—ณ ๐— ๐—ผ๐˜๐—ถ๐—ผ๐—ป ๐—ง๐—ต๐—ฟ๐—ฒ๐˜€๐—ต๐—ผ๐—น๐—ฑ: At bottom of squat= feeling 'ting'
โžก๏ธ ๐—ฃ๐—ฟ๐—ผ๐˜…๐—ถ๐—บ๐—ถ๐˜๐˜† ๐˜๐—ผ ๐—ง๐—ต๐—ฟ๐—ฒ๐˜€๐—ต๐—ผ๐—น๐—ฑ: with repeating exposures, near fatigue threshold or during fatiguing sets= feeling 'ting'
๐Ÿ”ฅWhy Establish Current Boundary Conditions?๐Ÿ”ฅ
โœ… They become KPIs (measureables) for tracking purposes to know if we are moving in the right direction and progressing towards the lifter's goals
โœ…Informs training for current available movements:
โžก๏ธ ๐—ฃ๐—ฟ๐—ผ๐—ฐ๐—ฒ๐—ฒ๐—ฑ ๐˜„๐—ถ๐˜๐—ต ๐—–๐—ฎ๐—ฟ๐—ฒ ๐—Ÿ๐—ถ๐˜€๐˜: Mindful of how we dose their boundary condition(s)
โžก๏ธ ๐—™๐˜‚๐—น๐—น-๐—š๐—ผ ๐—Ÿ๐—ถ๐˜€๐˜: don't affect the ting. Go for it.
โžก๏ธ ๐—ก๐—ผ-๐—š๐—ผ ๐—Ÿ๐—ถ๐˜€๐˜: *temporarily* have to remove it.
๐Ÿ“š Adapted from CALU (2021)- ExRx Considerations through a BPS Lens with Quinn Henoch

Like stress, like emotions, like thoughts, like mood, like hunger....the list goes on. It's a part of the human experien...
11/07/2021

Like stress, like emotions, like thoughts, like mood, like hunger....the list goes on. It's a part of the human experience.
โžก๏ธ How we interpret pain, and how we react to pain have very powerful effects on its expression and it's outcome
โžก๏ธ This is influenced by what someone heard from those around them and what they read and hear from various forms of media
โžก๏ธ I take great responsibility with how I communicate and educate a person on their pain experience. What we as clinicians say or do can powerfully influence the person's response.
โžก๏ธ It's time to rebalance management goals from pain relief dominated to a heavier emphasis on confident movement, reduced disability, and guidance toward their functional goals- so that individuals live fitter more fulfilled lives

๐Ÿค” Have you ever booked in with a PT, Chiro, Doc, etc. for some sort of ni**le or injury and they tell you to stop doing ...
11/02/2021

๐Ÿค” Have you ever booked in with a PT, Chiro, Doc, etc. for some sort of ni**le or injury and they tell you to stop doing the thing you love for 6 weeks?
๐Ÿคท๐Ÿปโ€โ™‚๏ธNo? Lucky you.
๐Ÿ™๐Ÿป Most of you will say yes. And to you- I apologize on behalf of the profession.
๐Ÿ™…๐Ÿป They don't understand athletes. They don't understand your love for the sport. The meaning, connection, and empowerment it gives you. The social connection it provides. The outlet and space it brings for your overall health and wellbeing. It's more than just the physical qualities it provides.
๐Ÿ’ช๐Ÿป Find someone who understands both athletic performance and sports medicine & rehab. A coach or healthcare provider who ๐˜„๐—ฎ๐—น๐—ธ ๐˜๐—ต๐—ฒ ๐˜„๐—ฎ๐—น๐—ธ.

๐Ÿ‘‚Someone who listens to you and your goals and provides you a practical framework to keep you doing your thing, while helping guide you back to your end point!
๐Ÿ‹๐Ÿปโ€โ™€๏ธIn need of some guidance and you're a barbell athlete--weightlifter, powerlifter, or CrossFit athlete with barbell goals? Reach out! I would love to chat.
๐Ÿ˜ As you can tell- I love barbells!

๐™„'๐™ข ๐™—๐™–๐™–๐™–๐™–๐™–๐™–๐™–๐™˜๐™ !โค๏ธ๐Ÿ’ช๐Ÿป๐Ÿ‹๐Ÿปโ€โ™€๏ธIt's been a minute. But it was needed.Burnout was a thing.Now a fire is lit inside of me.Paused....
11/01/2021

๐™„'๐™ข ๐™—๐™–๐™–๐™–๐™–๐™–๐™–๐™–๐™˜๐™ !โค๏ธ๐Ÿ’ช๐Ÿป๐Ÿ‹๐Ÿปโ€โ™€๏ธ
It's been a minute.
But it was needed.
Burnout was a thing.
Now a fire is lit inside of me.
Paused.
Reflected.
Ready to make change.
Let's go!
๐๐“ ๐’๐ญ๐ซ๐จ๐ง๐ 
๐˜Œ๐˜ฎ๐˜ฑ๐˜ฐ๐˜ธ๐˜ฆ๐˜ณ ๐˜ต๐˜ฐ ๐˜–๐˜ท๐˜ฆ๐˜ณ๐˜ค๐˜ฐ๐˜ฎ๐˜ฆ

Happy Physiotherapy Month my Canadian PT buds ๐Ÿ‡จ๐Ÿ‡ฆ Just wanted to give y'all an update and let you know that I'm still her...
05/06/2021

Happy Physiotherapy Month my Canadian PT buds ๐Ÿ‡จ๐Ÿ‡ฆ
Just wanted to give y'all an update and let you know that I'm still here! Life has been pretty crazy balancing Acute Care, Private Practice, and Weightlifting Coaching. But I feel damn grateful to be serving during this wild ride โค๏ธ
Stay Strong everyone ๐Ÿ’ช๐Ÿป

๐—•๐—– ๐—ช๐—ฒ๐—ถ๐—ด๐—ต๐˜๐—น๐—ถ๐—ณ๐˜๐—ถ๐—ป๐—ด ๐—ฃ๐—ฟ๐—ผ๐˜ƒ๐—ถ๐—ป๐—ฐ๐—ถ๐—ฎ๐—น๐˜€!๐Ÿ‹๐Ÿปโ€โ™€๏ธ๐Ÿ”ฅ Congrats to PT Strong Weightlifter .hartley (and better half of PT Strong๐Ÿ˜‰) on quali...
02/27/2021

๐—•๐—– ๐—ช๐—ฒ๐—ถ๐—ด๐—ต๐˜๐—น๐—ถ๐—ณ๐˜๐—ถ๐—ป๐—ด ๐—ฃ๐—ฟ๐—ผ๐˜ƒ๐—ถ๐—ป๐—ฐ๐—ถ๐—ฎ๐—น๐˜€!๐Ÿ‹๐Ÿปโ€โ™€๏ธ
๐Ÿ”ฅ Congrats to PT Strong Weightlifter .hartley (and better half of PT Strong๐Ÿ˜‰) on qualifying and competing in the BC Senior Provincial Championship!
๐Ÿ˜ She went 6 for 6 (again!)! Once officially judged and reviewed she will be Provincial Level 1 Ranked in her current 76kg weight class
๐Ÿ‹๐Ÿปโ€โ™€๏ธ Sn**ch: 61kgโ˜‘๏ธ, 63kgโ˜‘๏ธ, 65kgโ˜‘๏ธ
๐Ÿ‹๐Ÿปโ€โ™€๏ธ Clean & Jerk: 81kgโ˜‘๏ธ, 84kgโ˜‘๏ธ, 86kgโ˜‘๏ธ
๐Ÿ‹๐Ÿปโ€โ™€๏ธ Total= 151kg
๐Ÿ’ช๐Ÿป Currently she is smack in the middle between 71kg and 76kg weight classes - so we will make a decision when the time comes before the next comp. For the last 2 completions we had ~6 weeks to prepare each: so our main goal was to get used to a pressured weightlifting environment, be at a normal/consistent/enjoyable weight and just have fun throwing down some heavy weights!
๐Ÿ˜ญ So flippin proud of her for all the hard work, time, and consistency she has put into this sport since transitioning from CrossFit in 2018! Especially over the this past year with the pandemic hitting, moving across the country back home, leaving the barbell crew and our OG coach and then trusting me with coaching and programming since June 2020
๐Ÿค It ain't easy coaching your partner and vice-versa, but we have managed to create a solid system that I'm sure will continually adapt and emerge with time...perhaps another post on this!
๐Ÿป Time to celebrate and enjoy this moment with .hartley over a couple wobbly pops and homemade plant-based cinnamon buns, covid style (๐ŸŽตJust the Two of Us๐ŸŽต)
๐Ÿ—ฃ๏ธ๐Ÿ“ข Another huge shoutout to for pivoting to be able to host the competition!

๐—ฃ๐—ฟ๐—ถ๐—ป๐—ฐ๐—ถ๐—ฝ๐—น๐—ฒ๐˜€ > ๐— ๐—ฒ๐˜๐—ต๐—ผ๐—ฑ๐˜€๐Ÿ™…๐ŸปThere is no perfect treatment and there is no specific method that everyone has to use๐Ÿ–คIf someone ...
02/25/2021

๐—ฃ๐—ฟ๐—ถ๐—ป๐—ฐ๐—ถ๐—ฝ๐—น๐—ฒ๐˜€ > ๐— ๐—ฒ๐˜๐—ต๐—ผ๐—ฑ๐˜€
๐Ÿ™…๐ŸปThere is no perfect treatment and there is no specific method that everyone has to use
๐Ÿ–คIf someone tells you a black or white answer- then they truly don't understand the grey scale of human experience (but they probably have 1 million followers because we are drawn to a quick solution and instant gratification)
๐ŸŒIf you take a macro view at different rehab methods or even training methods out there you will see that the commonalities between each of them. Remember "there are many ways to Rome."
๐Ÿš‘Establishing principles can protect you from confirmation bias and emotional influence, leading to improved reasoning behind the decisions you make
๐Ÿ”จThe individual who lives by methods can become dogmatic because they only know one way and thus are susceptible to blind spots
I.e. if all you have is a hammer, everything looks like a nail
๐Ÿง  The answer is not to acquire more tools (like many of us do when we are uncertain), but rather have a principle led approach to guide and organize when and how to use these tools/apply specifics more effective to take advantage of your skills
๐ŸคฏAs humans we are well known to be biased organisms when attempting to make accurate decisions. We are muddied by current trends (that latest greatest method), expectations (from yourself or another stakeholder), emotions (fear, insecurities), beliefs (what you previously learned), etc. This has even been shown to change day to day and moment to moment.
โœŠ๐ŸปTo compensate for our human flaws and unleash our creative abilities we must be grounded in a process that has been constructed on principles. This will allow for more consistent and accurate decision making and help us analyze successes and failures to be less wrong and increase the rate and quality of our learning
Swipe for an Example:
โžก๏ธ These principles of rehabilitation have no specific method or technique attached on how to manage the rehab process. But you can categorize basically every rehab method out there into one of these categories for how they pragmatically work (although they may claim an alternative, but unproven solution)
โค๏ธ Principles > Methods

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