Author Archives: drparenteau

The Most Common Type of Dizziness

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The most common form of dizziness (i.e.: vertigo) is a form of peripheral vertigo known as Benign Paroxysmal Positional Vertigo (BPPV). Symptoms of BPPV include:

– nausea and sometimes vomiting
– a form of dizziness that, to the sufferer, feels like a spinning motion
– dizziness brought on by sudden movement (often getting up from laying down)
– vision blurriness
– eyes spinning (nystagmus)
– quick bursts of dizziness that last only seconds (although BPPV can also last several minutes) Continue reading →

The Newest Neck Injury: Text Neck!

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In our modern world of mobile devices, a new neck injury has arisen. Referred to as “text neck,” it results from the forward flexion of the cervical spine as you look downwards on your mobile device. As you can see in the above picture, the individual’s neck is bent forward as he or she spends hours per day perusing work emails, apps, games and social media. This places the spine in a position that is unnatural and places undue pressure on the spinal discs as well as the muscles running from your upper back to your neck and skull. Evenutally one or both of these systems will begin to be symptomatic.

As you can see below, the natural position for the neck is straight, with a slight backward curve. This allows the muscles to be in a normal position and the right amount of pressure to be placed on the discs. Think of text neck as essentially a slow motion whiplash. And if left unchecked, it can result in an unnatural loss of curvature in the cervical spine as well as disc bulging and nerve impingement.

 

 

Symptoms of text neck include:

  • burning sensation in the upper back or base of neck
  • pain in the base of the skull
  • tingling in the forearms and hands
  • headaches and/or nausea

There are ergonomic ways to use your mobile devices and you should be well versed in them.

If your pain is not subsiding, see a professional that understands how to treat text neck. Treatment should include:

  • electric stimulation of neck muscles
  • ultrasound
  • myofascial release therapy
  • and perhaps even manipulation

Don’t wait for the problem to worsen, get diagnosed and treated and change your habits. You don’t want a serious neck condition in 5 to 10 years!

If you’re in pain, we can help

Call us!

250-589-6325

Ankle Sprain or Peroneus Tendonitis? How To Tell

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First things first, let’s show you where the peroneus longer and brevis are (peronei tendons). See the picture below. The two tendons come down the outside of your calf and ankle and are tucked behind the big ankle bone that sticks out on the outside of your ankle. As you can see, they then travel down in an L shap and plug into your foot bones. On the other hand, the ligament involved in an ankle sprain is the anterior talofibular ligament. It is right in front and below the big ankle bone.

So, if the pain is not in front of the outside ankle bone, it can’t be a peronei tendonitis. 

Now, the way in which you hurt your ankle also tells you what’s going on.

If you hurt your ankle by rolling it, most likely you have a sprain AND the pain is right in front and below the big outside ankle bone, you most likely have a sprain. It is possible to strain the peronei with an ankle roll, but much less likely. When rolling the ankle affects the peronei and not the ligaments, the pain is usually where it plugs into the bone of the foot (see pic above). This will not be right next to the big ankle bone, but in the tip of the bone of the foot.

Most of the time you have a proper peronei tendonitis is when you didn’t hurt yourself instantly, but started developing pain for no known reason. And the pain will be behind the ankle bone and sometimes even up the outside of the calf.

How you treat the injury depends on what the injury is. So make sure to have your ankle region pain properly diagnosed!

 

 

 

What Does A Chiropractic Adjustment Even Do?

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“Doc, what does an adjustment do?”

I have been asked this a thousand times, so I am going to give you, the would-be patient, a quick low down on joint manipulation.

First, much like medicine, nutrition and chemistry have been with us for thousands of years, so has joint manipulation. For example, the ancient Chinese used it to correct for pain and inflammation. As humans are wont to do, if something works we keep doing it.

And we perfect it.

Over the millennia we have scientifically understood and improved spinal manipulation. Modern day chiropractic is not the chiro of one hundred — or even twenty — years ago.

“What is a joint manipulation?”

Easy answer: unlocking a locked joint.

When we suffer an injury — either a sudden injury, or a slow, over use injury — the sophisticated neuro-muscular system will use postural and structural muscles to lock a joint down. Preventing full and free motion.

Unfortunately, the body tends to over do this response. As a result, other nearby joints suffer as well and the problem can grow. For an easy demonstration try walking around without bending one of your knees. You will be forced to change how the whole body chain works in order to compensate for one single locked joint.

Likewise, when a spinal region is locked down, the problem affects secondary regions, making pain and dysfunction grow. A practitioner identifies the affected region and delivers an accurate and quick (but gentle) manipulation to make the joint move through its full range. By sneaking up on your body, your brain doesn’t have the chance to prevent this motion. And this proves to your Central Nervous System (CNS) that the motion is not only possible, but safe and pain free. This retrains your neural pathways and removes the “lock down.”

It can take a few visits to properly retrain the brain, but it is highly effective. And in some conditions (e.g.: facet imbrication) it can even be accomplished in a single visit.

Manipulation also breaks down scar tissue in joint capsules and surrounding soft tissue. Further enabling proper, fluid motion. For a real look at our manipulation practice, click the video below:

“How many people need manipulation?”

Most people will encounter an issue in their life time that will greatly benefit from joint manipulation.

Headaches: According to the American Headache Association, tension-type headaches are, by far, the most common form of headaches. They can be as debilitating — and even more so — than standard migraines. Fortunately, most tension-type headaches are due to tension and restriction in the neck region of the spine. As a result, manipulation is an integral part of treatment for this ailment.

Low back pain: One in four North Americans will suffer a bout of lower back pain in their life time. And low back pain is the most common cause of worker’s disability for those under the age of 45.

Several government studies over the past few decades have shown joint manipulation to be superior to surgery, injections and prescription medication for treatment of low back pain. The Agency for Health Care Policy and Research (AHCPR) of the US Department of Health and Human Services released a 1994 study stating that joint manipulation was a safe, inexpensive treatment that was more effective than standard medical approaches. It was not done by a chiropractic association but by a government assembled panel that included 23 diverse specialists comprised of medical doctors, chiropractic doctors, nurses, experts in spinal research, physical therapists, an occupational therapist, a psychologist, and a consumer protection rep.

The Ontario Ministry of Health (government) commissioned study is the largest standing study on low back pain treatment. Dubbed the “MANGA Report” it made the bold statement of recommending chiropractors as the first line of care ahead of medical doctors!

Several other studies have been done, nearly all of which have come to the same conclusion: for certain injuries, manipulation is the least expensive and most effective treatment.

Now, that being said, not all ailments require manipulation. For these other injuries and pain conditions we use a variety of physiotherapy techniques as well as exercise-based solutions and soft tissue treatments. You need your practitioner to think outside the box and apply the treatment best suited for your problem.

If you’ve tried everything else but have yet to have joint manipulation, please give us a call. And we can discuss whether or not an adjustment would be beneficial for your condition:

250-589-6325

To see the wide ranging services we provide, click on the image below for our YouTube Channel:

How I Overcame Two Significant Injuries – Including A Neck Disc Injury

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As a former wrestler and commercial fisherman, and now a forty-something jiu jitsu competitor and weight lifter I have had many opportunities to wreck my body. Somehow I avoided injuries that could side line me for more than a couple weeks for the past 10 years. Except for moderate to minor rib cage and ligamentous injuries, I have been pushing my body fairly hard despite my age and the much younger age of my competitors and training partners. Continue reading →

Knee Stability Exercises – Level 2

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**Do not start this program without first being examined and prescribed a beginner program. This is NOT a beginner program.

Stabilizing the knee via exercises is an important injury prevention technique that most people do not incorporate enough into their routine. Many sports place strain on the knee and therefore can cause injury. You cannot strengthen ligaments or joint cartilage. It simply is what it is. However you can strengthen tendons and muscles and improve flexibility and co-ordination. There is no better injury prevention for the knee than a 2 to 3 times per week stability program.

Here are the goals with knee stability programs:

Increased flexibility of:
1. Hips (internal, external rotation)
2. Quadriceps
3. Hamstrings
4. Inner thigh muscles
5. Calves

Increased co-ordination of:
1. Ankles
2. Core
3. Hip & knee movements

Increased strength of:
1. inner thighs
2. hip muscles
3. hamstrings

 

We cannot ignore any aspect of the leg structure, from the core down to the ankles, as they all have an impact on the efficacy of knee movement. Please do these exercises after a proper warm up (e.g.: 5 minutes on the eliptical).

 

1. Foam Airplanes
– stand on foam board (without shoes)
– arms out in “T” formation (do not let arms drop throughout exercise)
– lift one leg off
– keeping chest over hips (straight back), bend one “wing tip” down to ground by moving hips NOT arms
– then reverse movement and bring other “wing tip” towards ground
2 sets of 8 on both sides

 

 

2. Balance & Pass Medicine Ball
– balance on an exercise ball with your knees (feet OFF ground)
– stand erect, chest over hips, arms out, one hand holding med ball
– pass ball back and forth (see video below)
2 sets of 10 passes (5 to each hand)

 

3. Face-the-wall Squats
– face wall, feet wide apart
– have chair behind you to catch you if you fall
– toes turned outward 45 degrees and toes one inch from the wall
– pull chest “back” by pinching shoulder blades together and keeping ears over shoulders (head back)
– hands between your legs (finger tips against wall)
– squat down as low as possible while maintaining proper technique
2 sets of 15

 

 

4. Hamstring “pops” on exercise ball
– lay on back, feet on ball
– arms at your sides, palms down for support
– lift buttocks off floor and lift on leg up in air
– simultaneously roll the ball towards your buttocks and elevate the leg towards ceiling (see video below)
2 sets of 8 each leg

Nurse performing body-hamstring proprioceptive strength rehab

A post shared by Dr Emmanuel Parenteau (@drparenteau) on

 

5. One-legged Quarter Squat with Ball and Foam Board
– pin ball between wall and buttocks (NOT low back)
– place both feet on foam board (NO shoes)
– chest out, arms out (do NOT lean forward)
– lift one leg in the air
– drop into a controlled, quarter squat (NO further, too much pressure on PCL)
– press back up and repeat (see video below)
– make sure foam pad is far enough away so that at bottom of quarter squat your knee is not shifting forward
2 sets of 8 each leg

Knee Stability Squats – only quarter squats or less (otherwise hard on PCL and knee in general) 2 sets of 8 each leg

A post shared by Dr Emmanuel Parenteau (@drparenteau) on

 

6. Hip Circles
– Lie on your side.
– Bend bottom knee.
– Point toe of top leg.
– “Draw” as large a circle as you can by moving leg in a circle.
– Go as far UP and BACK as possible.
– reach forward lay forearm flat on ground to keep pelvis from leaning back during exercise
Do 2 sets of 10 on each side

 

 

7.  Single Leg Pot Stirs on Exercise Ball
– lay on ground
– one leg on ball
– lift pelvis slightly off floor
– palms down on floor for support
– “stir the pot” with foot on ball
2 sets of 8 “stirs” for each leg

 

Self Questionnaire Flow Chart for Future Care

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Patients often ask me “when should I come back to see you?”

This is a difficult question to answer. In order to help patients self evaluate for their needs of future care, I have developed the following flow chart. Feel free to use it for your own purpose.

please review this Pain Sensation Chart before using the flow chart.

CLICK TO CALL:
1-250-589-6325

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Sciatic Nerve Pain

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Many patients who have pain in the hip will immediately claim “I have sciatica!” Often this is not the case. This blog entry will help you differentiate between hip pain and true sciatica.

The sciatic nerve is made up of the peripheral nerves L4, L5, S1, S2 and S3. Somewhere near the buttocks these 5 nerves combine into one “hose” of nerves and we call this bundle the Sciatic Nerve.

The sciatic nerve then weaves its way through the muscles of the back of the hip (buttocks region) in order to run down the leg. One of the big muscles that can put pressure on the sciatic is the piriformis muscle. Although any muscle can irritate the sciatic, it is typically the piriformis. This is why pressure on the sciatic nerve is sometimes confused with piriformis syndrome, a condition in which the piriformis is injured or strained and emits posterior hip pain but does not necessarily impact the sciatic nerve. Buttocks or hip pain without pain going down below the knee region is not sciatica.

Interestingly, the sciatic nerve often has two branches before combining into a single branch below the buttock and one or both of these branches can run over, under or through the pififormis muscle. Either way a tight piriformis will pressure the sciatic nerve and cause symptoms all the way down the leg because that is exactly where all these nerves end up.

A single nerve — such as L4 — only “feels” a small section of skin sensation down your leg, so if you are pinching the L4 nerve, only the stripe of skin innervated by L4 will be numb, in pain or give a burning sensation. But because the sciatic nerve contains several nerves combined into one large bundle, the skin region affected by sciatic nerve pressure covers larger areas of skin (sometimes most areas) than a single nerve would. So, often, most of the leg is affected and undergoes changes in region and sensation.

So, if you can check off the following, you may be suffering from sciatica.

1. pain in the back of the hip (buttocks)

2. pain, numbness or burning sensation travelling farther down than the knee region

3. pain, numbness or burning sensation that covers a large area of skin (e.g.: both sides of calves/foot/thigh)

 

If you suspect you are indeed suffering from this condition the clinician you visit for confirmation and treatment should apply the following:

1. active release to the hip muscles to break down scar tissue and loosen the muscle(s) off the sciatic

2. PNF stretching of the posterior hip muscles to loosen the muscle(s) off the sciatic

3. teach you proper lifting/sitting ergonomics to keep the hip muscles from tightening up again.

4. prescribe home exercises and therapies to keep the hip muscles from re-aggravating the sciatic nerve.

 

Best of luck!