Bursting Your Understanding of the Brain

Here are three things I enjoy in life:

1) The brain

2) Art

3) Shattering the outdated veil of misconception and radically redefining what we thought was, to being one step closer to what actually is… Or in other words, bursting bubbles.

Well today is my lucky day, because I get to indulge in all three! What’s even better, I don’t have to do all the work myself!

Below is a link to one of my favourite TEDtalk videos. Have no fear, it’s short, entertaining and full of silly drawings. It addresses a common misunderstanding of left / right brain activity, and enlightens us to a more accurate micro / macro perspective of brain function.

So sit back and enjoy. As for me, I’m going to make myself a cappuccino, which is number four on my list of things I enjoy in life. Then I’ll watch this vid again. Hey, my brain needs bursting now and then too.

TEDtalks: THE DIVIDED BRAIN

– Jesse

THE NEWEST MEMBER TO “THE DREAM TEAM”

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Don’t we look so professional???  

Growing up on a farm two hours west of Toronto, I was raised to be a hard worker, a caring  person and compassionate towards others. Being a bit of a free spirit,  i had difficulty finding that “perfect fit” career.  After graduating from high school I traveled  for about 5 years, lived in numerous countries, experienced different ways of life and living and finally returned home. Upon my return to Ontario I decided to enrol in school and study to become a Registered Massage Therapist. RMT was the perfect fit for me; the ideal way to make a living while doing something i am passionate about doing; helping others. After graduating as an RMT, I started my own practice in my hometown.  Although I enjoyed having my own clients and owning my own business,  felt like there was something missing, and that there was more I could do and learn to better my practice.  

This past January I moved away from my small town to Toronto and was excited to learn more, experience new things and to challenge myself.  I had heard about Aim2Walk from a massage client of mine who is also a patient at the Aim2Walk clinic. Conversations about the Aim2Walk clinic intrigued me, so I decided to check it out. As soon as I walked into the clinic I knew that many of my ideals and passions were housed within the walls of the Aim2Walk clinic. Alternative therapies, multi-faceted professionals collaborating for the greater good and healing of people in need. A dream team and I wanted the chance to be apart of it.  A lot to learn about neurological disorders, but I looked forward to the challenge that this posed. 

Starting at the clinic, i often asked myself, how, specifically, can I as a massage therapist help those with neurological disorders.  There are many reasons why people should consider massage to be an integral piece of their health and wellness plan. Here are a few common issues seen with neurological disorders and how massage will assist in management of there disorders.

Muscle Spasticity (muscle tightness and/or stiffness) – With the spasticity comes along pain, decreased joint flexibility, decreased circulation and edema.  Massaging the tissue helps maintain the life of the tissue. Creating circulation to and from the tissues, helps decrease edema, and creates blood flow to carry nutrients to the tissues to repair the damage. Massaging the tight muscles helps soften and lengthen the shortened tissue while promoting more flexibility and allowing for the joints to move more freely. 

Scar Tissue – Scar tissue can be and is often very painful.  This happens because the scar tissue is adhered to the underlying tissues and when stretched or lengthened the tissues will pull and sometimes tare causing extreme pain.  Scar tissue also decreases range of motion in the tissues as well as the joints.  By breaking down the scaring with massage this will help improve the range of motion and flexibility as well as decrease pain.  

Muscle Pain – Many clients complain of muscle pain due to the spasticity, stress of the disorder, and change in the body structure. Massage releases  endorphins and amino-acides that function as the bodies “natural pain killers”. In turn these “feel good” endorphins cause a sense of well being while decreasing pain. 

Problems with Digestion – I have had numerous patients who present with pain as a result of abdominal bloating. This is often seen in people affected by neurological disorders because of restricted body movement and for those who spend a large part of their day sitting in a wheelchair. This can lead to issues going to the bathroom and passing gas. Intestinal massage can help release the pressure and let the gas escape. Although possibly a bit foul smelling, the pain relief is there! 

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Massage has an enormous amount of positive effects on the human body, specifically the bodies of people with neurological disorders. At Aim2Walk clients are treated as individuals and their cases are treated individually because no disorders transpire identically in people. Although treatments are very personalized and dynamic, personally my main focus is to improve quality of life for my clients and to help them achieve the highest level of recovery possible. 

Cheers, 

Michelle Wolfe, RMT

 

Rehab to Live or Live to Rehab?

I recently had a conversation with a patient who has been coming to our clinic for a number of months for therapy. Since her stroke several years ago she has returned to work and much of her normal household and social activities. She hasn’t put much of an emphasis on rehabilitation until she came to Aim2Walk. Since she is right-handed and her stroke resulted in limited function in her left hand, she has learned to adapt to doing many of her daily tasks one-handed. Now she is attending therapy three times a week and working towards her goal of increased movement and function in her left arm and hand. She sometimes wonders whether she should have been more focused on her affected side in the early stages after her stroke, rather than making it a priority to learn new ways of doing things and compensating for her injury. She summed it up quite well when she asked “Do I rehab to live or live to rehab?”

I have been thinking about the implications of this question ever since. Is it better to focus therapy on getting someone back to her everyday life, even if that means she will have a non-functional arm? Or would it be more beneficial to undertake a program trying to regain the normal movement of that arm- even if that required the patient to ‘live for rehab’ and have a slower return to independent living. This is not a new debate, and is reflected in two different approaches to stroke rehabilitation. The compensatory and restorative approaches are not exclusive of each other, but they do reflect differing philosophies.

The goal of the compensatory approach is not to restore or improve the movement or function of the affected side, but to teach new skills and adaptive techniques to allow the patient to achieve tasks required for daily living. For instance, the compensatory approach would encourage a patient to learn to button her shirt with one hand if that was the most efficient means to achieve independence quickly. This approach would also include adaptive equipment, such as foot splints or AFOS, and mobility aids. The benefit of a compensatory approach can be greater independence. For instance, if a person is unable to restore her original walking pattern, using a cane for compensation can help to improve her mobility so that she can walk to her mailbox and get her own mail. The concern with this approach is learned non-use. Learned non-use is the therapy term for the ‘use it or lose it’ concept. The longer a patient goes without using the affected limb, the more permanent or pronounced those deficits may become. While the compensatory approach may achieve better short-term results, it may deny the patient the opportunity for long-term restorative gains.

The goal of the restorative approach is restore the stroke patient’s lost physical functioning as close to normal as possible. Techniques such as neurodevelopmental training (NDT) and motor learning are used to encourage recovery of as normal a pattern of movement as possible. Compensatory movements that may potentially inhibit a return to normal neurological functioning are discouraged. Using the restorative approach, the patient would be encouraged to learn to button her shirt using two hands the way she would have prior to her stroke. Another technique used in this approach is forced-use or constraint induced therapy (CIT). This technique tries to combat learned non-use by actually forcing the patient to use her affected hand by preventing her from using her intact hand, usually by wearing a special mitten. The benefits of a restorative approach are decreased learned non-use and a return to more normal patterns of movement. However, the restorative approach can lead to longer recovery times and less independence in the interim.

Luckily, a therapy program doesn’t have to choose just one of these therapy approaches. Reviews of research have shown that using a mix of components from different therapy approaches is effective and that no one therapy approach is superior to another. There are also a number of personal factors that each patient must consider when deciding on how much of their therapy will be focused on compensation and how much will be restorative. Limited access to therapy, living alone, and returning to work may all be reasons that someone needs a more compensatory approach to therapy. A patient that is highly motivated and has the resources for more intensive therapy may decide on a more restorative approach. Finding a good balance between the two approaches can help find that middle ground between life and recovery.