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I have back pain, why are you asking about my bladder control?

Posted 6/14/2018

Have you ever gone to physiotherapy for back pain? Do you remember them asking you about if you had any problems with your bowels or bladder? Did you think it was strange? So why do we ask you this? We ask because of your cauda equina. Okay.....wait......WHAT????

What is the Cauda Equina?

The term relates to the lower end of the spinal cord, where the nerves fan out into a bundle of fibres that looks like a horse’s tail (‘cauda equina’ is Latin for ‘horse tail’). These nerve fibres leave the spinal canal through holes between each vertebra (the bones in your back). Some of the nerves join to form the sciatic nerve or nerves controlling the legs. Some also provide the sensation and control for the bladder, anal and genital regions.

The cauda equina lies behind the lumbar discs, in the spinal canal. These discs sit between the vertebrae (bones of the back) but can sometimes rupture (known as a large disc prolapse or ‘slipped disc’). This can happen quite suddenly, usually in younger people. When this happens, the nerves of the cauda equina can become trapped and squashed. In older people, it may happen gradually and be combined with other arthritic changes within the spine. The effects may be noticed more slowly, and even regarded as simply ‘part of getting old’. Any squashing of the nerves can cause pain, numbness and/or weakness of the legs, particularly the foot and ankle. It could also cause difficulty with bladder and bowel control, numbness between the legs or over the buttocks and difficulty with sexual function.

Some injuries to the back can cause Cauda Equina Syndrome. Pressure from structures in the back (such as a disc herniation) press on the nerves and limit their ability to work properly. This limited function can affect the structures that they control such as your bowel, bladder and genitals.

Our job is to help identify the cause of your concerns and direct you to the right place. So for that reason, we sometime ask questions that might seem intrusive and personal; so that we can rule out anything more serious. Now, we don;t want to scare you. Please be assured that cauda equina syndrome is RARE- I have seen one confirmed case and one case that I suspected but did not receive an update on in 24 years of practice. 


So, if it is rare, why do you worry about it?

Although rare, it can be serious and lead to permanent damage. It is usually requires immediate surgery and therefore, we want to get you to the appropriate health professional right away. Here is a great informatic of some of the possible symptoms of cauda equina syndrome. If you experience nay of these symptoms please speak to your health care provider. Many of these can be early signs, but if you experience loss of bowel or bladder control or if you have numbness in the perineum, please go to the closest emergency department. (That said.....keep in mind many of the symptoms below can be caused by author causes including medications so please don't panic.)



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The Tides of Change

Posted 5/20/2018

 So, here we are on the May long weekend and I made a quick trip back East. Although I love the mountains out West, the ocean holds and special place my heart.  This morning on my morning walk, a thought came to me. This was the beach today .......


And here is almost the exact same spot yesterday............


Such a huge difference isn't it? All too often we see patients expect this drastic of a change in their health. Unfortunately, more often then not, the change is much slower. 


Recovery from an injury takes time, especially if it is an older problem. Over time, an injury creates secondary effect which can affect the recovery. And it takes persistence and a team approach. Coming for your appointments once, twice or trice a week and not doing anything on your own may not be enough. What you do at home if often as important if not more important than what we do in the clinic. I recently saw a lady with a 40 year history of her injury. One her first appointment, I advised her that we would be looking for an improvement in her symptoms and an increase in her function, and the prognosis for a full recovery was guarded. She was so compliant with her home exercises and following the advice we gave her. Low and behold, to both of our surprise, she showed up for her second appointment feeling much improved. After about 5 or 6 weeks she was feeling such and immense improvement that we both felt she could continue on her own and self manage. What was responsibly for the drastic and unexpected improvement? Probably a little of what we did in the clinic and probably a lot of what she was doing at home. we were able to help guide her in the right direction, but she took the bull by the horns and ran with it. 


So, will you get better after one of two appointments? Probably not (although it does happen as noted above). The more expected progression is to see a little improvement after each visit and each week until we reach where we want to be. That might be 5 or 10% per week, or it might be 40 or 50% each week; it depends on the issue, the chronicity and what you are doing at home. Be patient, don't expect overnight improvement, but be pleased when you do improve at an accelerated rate. Do your exercises (and yes! we known when you haven't done them). Follow the advice of your therapist. Follow your treatment plan; the number and frequency of treatments recommended has been recommended to best help you. and last but not least, be patient - often recovering from an injury is less like the changes brought on by the ocean tides and more like a child growing. If you watch every day, you don't notice a child growing, but go away for a week and you will see a huge difference. 


Have more questions about your recovery and treatment plan? Feel free to ask your therapist! 

Bring on Spring!!!!!!!

Posted 4/28/2018


Itching to do some gardening? The sunshine sure has given us Spring Fever! Remember, the secret to a healthy garden is a healthy gardener. Gardening can cause muscle strain to the lower back, shoulders, knees and arms. And since we usually jump into it after a winter away from the action and positions required, gardening injuries are not uncommon.

Follow these tips and enjoy the fruits of your labour. Don’t be limited by the aches and pains!


Stretching helps you to move more easily, increased the blood flow, keeps your muscles flexible and relaxed, your joints mobile and relieves tension and strain.

Do some shoulder circles, gentle trunk rotation, and heel/toe stands. Go through the movements you will be doing while unloaded. Don’t forget to stretch your wrists and forearms as gardening tools require a lot rasping tasks.


Keep weights and activities close to your body. Move with your work; keep your work in front of and close to your body to avoid reaching and twisting. Imagine yourself ‘dancing’ with the rake. Lift with your knees bent, keeping your back straight. Keep the weight against your belly button; this will remind you to bend with your legs and to move your feet instead of twisting your back.

Be realistic! Your body can only perform at the level of effort and endurance it is accustomed to. Don’t try to get it all done in one day. You wouldn’t go to the gym for 8 or 10 hours after a 6 months break would you?


Standard safe lifting loads are 64 lbs. (about 29 kg) for middle-aged men and 28 lbs. (about 13 kg) for women, but a ‘safe’ lift is less than this when the load is difficult to reach or an awkward shape. Now, those are just guidelines and your ability may be more or less. Always test the load first and if you think it is too heavy ASK FOR HELP from a spouse, children, neighbours, heck even ask a stranger walking down the street!


Take a break, spread tasks over a period of time, and take time to recover between projects. Again, just like in the gym, you would take a break between sets so remember this in the garden.


Avoid over-use injuries by doing different activities throughout the day to reduce strain on major muscle groups and joints. Start with some raking, and then maybe re-arrange some flowers.


Gardening tools and equipment are meant to ease work, not cause additional strain. Take measures to fit the tools to you, not you to the tools. Keep your supplies within easy reach.

Use tools to reduce work; a wheelbarrow to transport supplies or an extended handle to reduce the reach. There a lots of tools with good grips or ergonomic handles available; USE THEM!


Keep your tools close to your body and your back straight to reduce strain. Have a little ‘dance’ with your rake!


Squat or kneel on a kneeling pad. If you have difficulty getting up, use a kneeling pad / bench with a support handle for assistance.

Give your back, legs and knees a break from stooping and kneeling by using tools with long handles to help with the weeding.

Squat or sit on the ground to trowel, rather than bending over.


Insert the head of the shovel vertically into the ground and step on the blade.

Lift small amounts at a time. Keep your back straight and bend at the knees. Avoid twisting.


Know your body’s abilities and lift properly; bend your knees, not your back, keep the load close to your body and do not twist. Always test the load first and if too heavy – GET HELP!

Use a wagon or wheelbarrow to transport supplies and/or to move or carry heavy items.


Tools with larger, padded handles are more comfortable for gardeners with painful or arthritic hands. You can enlarge tool handles yourself with grip-tape or foam tubing purchased at a hardware store.

Gardening gloves can protect your hands and joints.

Keep tools (such as your pruners) sharp to make cutting easier.



Physiotherapists are healthcare professionals who help people of all ages and lifestyles gain and maintain their desired level of active living and physical mobility. With their understanding of the human body in action, physiotherapists are able to help you increase your mobility, relieve pain, build strength and improve balance and cardiovascular function. Physiotherapists not only treat injuries, they also teach you how to prevent the onset of pain or injury that can limit your activity. Don’t let an injury get in the way of your beautiful yard; if you have an injury starting treatment early can help speed your return to activity. Book your appointment today. 403-945-0227


The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. got into a car accident......Now What?

Posted 4/19/2018

Being involved in a car accident. You have injuries, your car is damaged, you have no transport, you are upset and frustrated......and now you have to navigate the insurance system to figure out what to do.

Stay calm, there is plenty of help. 

Make sure you exchange information with the other driver. If  there are any injuries, damage exceeds $2,000, if any driver does not have documentation such as a driver’s licence, registration or insurance, if one or more of the vehicles isn’t drivable or you are the victim of a hit and run make sure you contact the police. If there are no injuries and damages are minor, exchange insurance information and contact your insurance provider. 

If you have been injured in an automobile accident in Alberta, you are entitled to accident benefits coverage regardless of whether you were at fault for the accident. The benefits you receive depend on the type of injury you have and here is where we can help. It is relatively simple to navigate the injury benefits, although with all the medical jargan and other things you are dealing with, it can seem daunting. 

We will give a little run down on the process, but remember we have dealt with many car accident claims in the past and we can help guide you through the process. We will try to keep it as simple as possible:


Within 90 days from the date of accident - Protocol coverage

The coverage you are entitled to depends on your diagnosis; but don't you worry about that. We will do the assessment and fill out the paperwork required. You will need to fill out an Notice of Loss and Proof of Claim Form - but we have them on hand at the clinic. You do not have to wait for the insurance company to send you your paperwork. Most injuries fall under the WAD (Whiplash Associated Disorders) classification which is a classification system that categories injuries based on severity/symptoms. But don't worry, we can help you out with that!

  • If your injury is a soft tissue injury, you are entitled to 10 (WAD1) or 21 units (WAD2) of treatment without the need for prior approval from your insurance company. This coverage is legislated, which means we do not have to wait for an insurance company to approve this. This was implemented to allow patients to commence treatment earlier as early intervention has been shown to have positive effects on recovery. 
  • If your injuries fall outside of the of a WAD1 or WAD2 classification, approval is required form your insurance provider.
  • With any injuries, all the necessary paperwork must be submitted to 'activate' the injury claim. Physiotherapists are Primary Care Providers and as such are able to make the diagnosis and complete the necessary paperwork required.
  • If you have commenced treatment elsewhere, either at another physiotherapy clinic or with a chiropractor you will need to advise other healthcare providers so that 1) they can coordinate treatment and 2) your insurance company only covers ONE ASSESSMENT fee and treatment with a different provider may result in an assessment fee that you are responsible for. 
  • You are entitled to up to $160 in necessary supplies to aide in your recovery.

After 90 days from the date of accident (or after your 10/21 units - Section B coverage

  • Prior approval is required for all injuries after 90 days, WAD1 and WAD2 injuries after the 10 or 21 units or for any injuries that do not fall in the WAD1 or WAD2 classifications. Again, don;t worry about that, our assessment will help determine where you fall. 
  • For any injuries outside 90 days, WAD1 and WAD2 injuries after the 10 or 21 units or for any injuries that do not fall in the WAD1 or WAD2 classifications, your extended health care must be exhausted prior to your car insurance coverage. 
  • After 90 days, WAD1 and WAD2 injuries after the 10 or 21 units or for any injuries that do not fall in the WAD1 or WAD2 classifications there are some 'absolute' limitations that are available through your car insurance unless you pursue legal action.
  • Once your extended health care insurance in exhausted, your car insurance will cover treatment, if approved, and up to  limits that are set forth by legislation. For example, under Section B coverage, you are entitled to a maximum of $250 for massage and $750 for chiropractic care. Physiotherapy has no set limit.

This and That

  • Insurance coverage is for treatment of injuries sustained as as result of the car accident in which you were involved only. We can not bill your car insurance for any injuries which are not a result of the car accident. 
  • Insurance benefits are non-transferable; we can not bill your insurance provider for treatment obtained by anyone other that yourself. 
  • Everyone loves massage! While massage can be an important part of your treatment program, please ensure you are following the recommendations of your primary care provider, be that a medical doctor, chiropractor or physiotherapist, and attending you other treatments as well. 
  • If you are attending treatment at multiple clinics, please let us, and the other clinic know. This is important so that we can all work together to ensure we are working towards the same goals. 
  • We will do our best to help you keep track of your insurance coverage, but ultimately the responsibility to track this coverage lies with you. 

You have the right to choose where you want to receive your treatment. If you have been attending another facility and want to move to a new one to continue treatment you must inform your adjuster of your wish to do so. You will need to inform the new clinic you are attending how many treatments you have received. You may also have to pay to have your file transferred depending on the policy of the clinic you were previously attending.  Any costs you incur that a third party funder will not cover are your responsibility to pay.

Please note: This information is NOT a legal advice and does NOT modify or replace your automobile insurance policy.  For more information on your specific situation, speak to your insurance agent, broker, company representative or contact legal counsel. 


Hmmmmmmm, so it is harder to explain than we thought. Do you have more questions? Did we miss something? Feel free to comment below, email us or call us to see how we can.


Here are some links for more  information:

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