Does it hurt? Will I be sore afterwards?
The treatments often involve strong pressure but it is always expected that it will not hurt. I test you with gradually increasing pressure to make sure it is not too much. Sometimes there is soreness afterwards as the tissues get used to the new position but, because of the number of safety tests that are used, this is very unlikely to represent any harm. If any other joint becomes sore (for instance, if your knee becomes sore because the foot is now sitting differently), we have to then go treat the joint that revealed itself to us. At no time will you see a “no pain, no gain” mentality.
How long does it take?
The treatment methods are very swift. If the joint is out of position, it can be mobilized or manipulated, often in only one session and the improvement holds as we go on to another part that needs care. Treating the entire limb or the vertebral column involves a complex series of joints which interact and is somewhat more detailed, by which I mean two or three sessions.
Generally the joints need to be corrected first and see if the muscles accept the new range of motion. The muscles that do not accept it require their own treatment, which would add a bit of length to the treatment time. Most people with back or neck pain are done with treatment between five and seven appointments although some chronic conditions like arthritis or fibromyalgia require tuneups. Because the treatments are aiming to be corrective and not just soothing for the symptoms, I find people have a good length of time (usually six months or so) before the tuneups are required. Of course if there is an injury, you should come in sooner.
Baby torticollis can be treated manually, safely, with a very light touch. The joints are soft, so a gentle touch in the right direction is all that is needed. A few seconds. The joints can get pressed into awkward positions from pressure during birth, not always the muscle concept that you find commonly written about (rarely, in fact).
Is there any risk?
Because I use many safety tests which have been designed by the Canadian Physiotherapy Association and because the treatment is always approached in gradually increasing increments, the risk is absolutely minimal. I take note of your precautions when you arrive and refer to them regularly. The safety procedures are even more detailed with the neck and the treatment techniques are exceedingly light. For best safety, I do not use rotational techniques in the neck. Any treatment that is physically uncomfortable will be toned down because better results are achieved with a painless technique anyway.
Do I need an x-ray?
Rarely is an x-ray necessary and rarely are they useful in my context. Please do not feel that you need one before you start physiotherapy. I treat the soft tissues, for instance pinched nerves and muscles spasms, which can't be seen on x-ray anyway.
I have degenerative disc disease; can anything be done about this?
Degenerative discs are discs that got thinner due to age or injury. It’s not actually a disease, just a bad name. A very important point -- hard to believe -- is that thinned discs do not hurt. The thinning is not a painful condition. Sometimes, the thinning allows the bones to settle closer together and if there's already something wrong with the area, then it will become more apparent. If joints are maltracking or if the muscles are creating a great deal of compression, the thinner discs may become just the final straw. It does not change anything that is done with the treatment except that I may emphasize stretching a little bit more. A person whose back has this one stroke against them should take more care of the back rather than avoiding treatment. No, the discs do not plump up again and, no, the degeneration does not get less, but by the time the nerves are un-pinched and the muscles are un-spasmed, almost everyone achieves reasonable or good relief (see next question).
What if I don't get better?
There are backup plans for people who did not respond to treatment. It doesn't happen often though, because the techniques are customized to you. I have a particular interest in chronic pain and have learned a number of techniques suitable for long-term conditions. For years I have liaised with acupuncturists, massage therapists and naturopathic doctors and have learned many other ways to treat pain.
Dietary control can be very important for some people; for instance, caffeine, aspartame and MSG can all excite the nervous system and increase a painful state. Sometimes this causes the pain in the nerves to “cascade” into a self-perpetuating cycle. Hydration matters. Vitamin C matters. Magnesium really matters. Elastic K Tape is very ice for putting stressed tissues on slack for relief and it helps take the attitude out of chronic pains. There are many avenues to consider, not all of which are mechanical treatments, so I refer to specialized practitioners once I suspect a problem needs a different type of help.
Does the improvement stay forever?
It can. If the problem is a joint that has been maltracking or put askew because of an injury then, yes, this sort of thing can be corrected and you are back to your usual self. The things that tend to recur very quickly are usually due to abnormal pulls from the soft tissues or because the body is trying to keep pressure off a sore area that has not yet been identified. If I see recurrences like this, I search the body further for why the improvement is not holding. Because people tend to have the same postural habits and do the same activities using the same office chair, they tend to pick up the same conditions again and again. This does not represent something ”not holding well” but rather a whole new episode and perhaps needing some fundamental change to ergonomics or habits.
I can help you with your ergonomics, correct your body's alignment, check if orthotics might be suitable, and educate your body how to move differently using neurological reprogramming. I can do specific nerve releases with techniques to free up nerves that are bound down making guarding of the muscles in the area. This is called dermo-neuromodulation (DNM), blended with osteopathic procedures.
Some people who regularly exceed their body’s abilities but are not able to change their activities may just need to return to treatment for me to pick up the pieces now and then.
What do you mean by neurological re-programming?
People without an actual neurological problem like cerebral palsy or stroke, do not realize how much they could benefit from a nervous system tune-up. There are a number of fundamental programs that exist in our brain stem and mid brain giving us automated actions that we don’t have to think about. These are called reflexes. For instance if you put the flat of your foot to the ground, your leg muscles are activated to turn your leg into a pillar. If you are tilted forward, one leg comes out to start the walking motion to stop you from tipping over. These “families of movements” can be easily examined in newborns, as reflexes exist in us before we are born. (There are approximately seventeen known major reflexes in the newborn, although everyone agrees that there are probably more). Reflexes are the fundamental patterns that we use our whole lives.
Injury, lack of oxygen, high fevers and toxic compounds (large doses of strong medications or toxins such as alcohol or adrenalin) can corrupt reflexes. If corruptions happen, your body has to compensate somehow and this is one of the ways people acquire spasms and hardened muscles. This type of compensation is a large source of the persistent muscle tone in the neck muscles after whiplash.
Fortunately, the corruptions can be “overwritten” to remind the brain stem of what the movement patterns (reflexes) looked like before the corruption happened. This is a technique that has been in use in Europe for more than two generations on handicapped children, but turns out to have a lot of application for normal adults as well.
Only with this method have I ever seen the removal of face tingling and tics, the resolutions of even a very severe scoliosis or disappearance of blotchy purple rings from the hands. Some reflexes can create super sensitivity and pain syndromes if they are corrupted; many create excess and abnormal muscle tone. Some corrupt reflexes can undo the balance. Many confuse the eye tracking and can create dizziness.
In spite of all this, if your nervous system was previously normal, these reflexes can be quite easily “re-installed” by refreshing the memory of them in your brain stem. The patient’s body is shaped into the exact position that a newborn’s body would take while performing the reflex. This is done in slow motion and the patient is asked to help act out the position as well.
Meanwhile, we create whichever stimulus it is that helps to act as a cue to the brain stem, for example: placing something in the hands if trying to restore the grasp reflex. When the reflexes are fully re-installed the muscle tensions acquired as compensation are no longer needed by the body.
Reflexes overlap with many brain functions and are used in Europe to treat ADD and learning disabilities. ADD can come from bodily discomfort and “spluttering” reflex programs. Many different learning disabilities have poor eye tracking as a common denominator. A proper grasp reflex is instrumental in hand coordination, minimizing writer’s cramp, tired shoulders, and typing errors. With good eye tracking and proper muscular control, your body feels lighter and your mind feels quite a bit more alert, able to process information more readily.
Each reflex takes between five and fifteen minutes to "install", and most people seem to need about twelve of them re-installed. I have found that approximately three-quarters of my patients respond with a strong benefit and I have found the results to be almost permanent. Allergies and improper brain chemistry seem to throw it off, though.
This process is often called Sensory-Motor Integration of Retained NeoNatal Reflexes. It can also be called Primitive Reflex Integration.
What if I have a medical condition?
That is not a problem. If I know what your condition is, I am able to work around it. Even conditions that absolutely cannot be touched (and I can hardly think of any right now), would still benefit from a home-use anti-pain device (TENS unit) that can be purchased for comfort even in the absence of hands-on treatment.
Am I allowed to have physiotherapy if I am pregnant and my back hurts?
Yes, certainly. There are many techniques that are suitable for pregnancy. Because the ligaments are getting softer during pregnancy, muscle balance (to hold you together) becomes even more important. Joints can maltrack more easily while ligaments are soft but they are also much easier to correct. Pregnant ladies get light techniques done on them and, fortunately, that's all they need at this time. Pelvic braces can be very useful and I can also instruct you in how to use a TENS unit during labour and delivery; that is a wonderful thing. In case it is needed, I also can treat baby torticollis ( a bent neck that sometimes occurs from getting born).
What is the cost?
I book patients on the hour anticipating approximately 45 minutes of examination and treatment. This is $130, cash or cheque. $160 for motor vehicle, which includes reports. THERE IS NO SWIPEY MACHINE. Longer appointments can be made for a proportionate price. I do not do half hour bookings but if an appointment is very brief because of the nature of the condition, then I modify the price. The appointments will not be broken up into smaller chunks to fit into your insurance coverage.
Will my private health insurance cover the cost of my treatment?
Your best course of action is to personally call your health insurance company and find out the particulars of your policy as each one is different. There's a toll-free number on your handbook or card. What is the percentage covered? Sometimes it is a percentage of an amount they choose, not what is actually charged. Do you have to share the physiotherapy allowance with another form of treatment? Ask what are the daily and yearly limits. Do you need a prescription?
Do you direct bill?
Direct billing is something I've chosen not to do as the submissions from the provider (me) are time consuming. The receipts are honoured by the insurers. Most plans need you to submit your receipts no later than 90 days after the turn of the new year i.e. end of the next March.
The charts are kept in a filing cabinet in a back office in my home. I have a trusted assistant that does some filing. I liaise with other professionals when I refer patients to them, with your consent. The treatment room is private and there is only one patient at a time. You may bring anyone with you and there is a sofa for them.
What is your consent policy?
Consent cannot take place until the patient understands thoroughly what is proposed as the treatment. For this to happen, they need a full examination and explanation, then (this is the most important part) the patient is put through the exact treatment in ultra slow motion but with the full pressure so they can feel what the treatment would involve. If the proper technique was chosen, the slow-motion treatment would be painless. I wait for any delayed reactions and if there are none then we are sure that the procedure is safe. When the patient feels they understand what is going on then they can choose to give consent or not. There's usually a plan B and a plan C. Rarely do you have to take it or leave it.
I have a consent form that explains these things but it does not override your verbal consent or withdrawal of consent. A person has a right to say no to any treatment at any time, even if I believe that saying no would cause them harm.