My Turn At Fans Of The Hip

Finally my turn at this course. I've been looking forward to going for this since last year when Gino attended it last February. Even though he has shared what he has learnt, nothing beats learning from Michael.

We always want to become better physiotherapists, so we get better at treating our patients.

Some thoughts on the tilting of the pelvis.

Here's a really fascinating picture of the fascia and intermuscular septum in our legs.

Back to work in the clinic next week while Gino go for the next course.

 

Wi-Fi Lowers Your Chances Of Having Children

Straits Times article on 0202519

My "caveman" husband Gino didn't have a permanent mobile number until 2009 when he left the then Singapore Sports Council (now Singapore Sports Institute) to work in Physio Solutions. Yes, he was that adverse to technology and being contacted (so he could train in peace).

When he was traveling with the athletes, or competing overseas himself, he will often just get a prepaid line so I can contact him. No one else has that number except the athletes and I.

And for the longest time we didn't have a broadband connection in the house, only a dial up  connection. When we finally started having a broadband connection, he'll turn it off every night before we go to sleep. This was way before the generous amounts of data offered by the telcos for your mobile line.

Now that may have turned out well as a new study found that exposure to Wi-Fi connections lowers male fertility rates. So couples' chances of having kids are reduced since the electromagnetic waves kill sperms.

All the male participants in the study were previously involved in IVF or artificial insemination procedures. They averaged 38.4 years old and were divided into three groups.

A control group whose sperm samples were not exposed to electromagnetic waves from the Wi-Fi device. The shield group, whose sperm was protected by a small Wi-Fi shield that intercepts electromagnetic waves (EMW). The exposed group whose sperm was exposed to EMW.

The sperm were exposed to EMW for 30, 60 minutes, two and 24 hours and sperm motion was then tested. In the exposed group, the men had a pocket Wi-Fi router, similar to how a mobile phone would be carried in a man's pants (see picture below).

Oops, not the best place to put your phone

There was little difference in sperm motility rates across the groups for 30-60 minutes. After two hours, motility rate in the control group was 53.5%, shield group 44.9% and 26.4% in the exposed group.

After 24 hours, dead sperm group of the control group was 8.4%, shield group 18.2% and exposed group significantly higher at 23.3%.

Though the Wi-Fi shield offers some protection over a short period of time, the study shows mounting evidence on the harmful effects of EMW on sperm. The longer the exposure, the higher risk for potential negative effects.

If you look at the number of people over the next few decades using devices that rely on Wi-Fi connection, impact would be huge when it comes to fertility rates.

The article can be found in page A14 under the World section in today's Straits Times.

The study headed by researcher Kumiko Nakata (above) is being presented at the ASPIRE 2019 conference from 2-5 May, 2019.

Even if we turned off our Wi-Fi router now, there are heaps others surrounding us (picture above). Look at your own phone to see the available connections.

Fans Of The Hip, Fans Of Learning

It's the the turn of the 3 amigos again this time since Rachel and I went previously to the Anatomy Trains course. Yes, we take turns to go for courses so we get better at treating you. We always want to be better physiotherapists. That makes us fans of lifelong learning.

I took a peak at Gino's notes. Here's how you may get sciatica resulting from your piriformis muscle and not from a prolapsed disc even though your MRI scan suggest so.

I'm looking forward to picking their brains through our own sharing session soon. Stay tuned.

Sharing What We've Learnt

Team huddle 

After Rachel and I did the Anatomy Trains course just under 2 weeks ago, Reggie, Ting Jun and Gino had their arches and legs course just after us.

To consolidate what we've learnt, we set aside time and spent this morning reviewing what we've done. It was very helpful to bounce ideas/ observations and suggestions of we've seen with patients so far.

Yes, we spend lots of time refining our techniques so we can get our patients better quicker. We don't take short cuts or use treatment techniques that don't get results.

Ride (to) Port Dickson

We even came up with our own mnemonic for remembering a certain technique.

Just trying our best to become better physios.

Our Turn At The Anatomy Trains Course

After seeing Reggie, Gino and Ting Jun attend the previous Anatomy Trains courses, we definitely wanted to go and learn too. Especially since I was told it really ties in very nicely with many of the treatment strategies we already do, especially with fascia.

Gino has shown us stuff that he has learnt from the same course, but the actual presenter would definitely have a few more pearls of wisdom.

So Rachel and I will be attending this very same course over the next 3 days so that we too can be able to treat our patients better.

Being the guinea pig

BPPV

Inside the inner ear

BPPV stands for benign paroxysmal positional vertigo and that's what I had recently.

It can be quite quite scary if you don't know what it is. We had just changed rooms to sleep and all four of us (husband and the two boys) started sleeping together in the same room. I woke up one morning and on trying to get up had the sudden sensation that the inside of my head was spinning (or otherwise know as vertigo). There was a period of fairly intense dizziness too.

Other symptoms can include a loss of balance or unsteadiness, nausea and even vomiting which I did not have.

BPPV is usually triggered by specific changes in the position of the head. And it can occur when you move your head up or down, rolling over in bed, or when you turn over or get in and out of bed in a certain way.

How is this so you must be wondering? Well, inside our ears is a tiny organ called the vestibular labyrinth. It has three semi circular canals that contains fluid and fine hair like structures that gives you information about that position of your head.

Otolith organs inside your ear monitor up, down, left, right etc movements of your head. They also contain calcium carbonate crystals (or otoconia) that make you sensitive to gravity.

These otoconia can become dislodged and when they happen to move into one of the semi circular canals when you are lying down. When too much otoconia accumulates in one of the canals, it causes the semi circular canal to become sensitive to changes to the position of our head, sending false signals to the brain. And this is what makes you dizzy or your head to feel like it is spinning.

When the dislodged otoconia moves into a semi circular canal, the eyes can move in a specific to and fro manner called nystagmus. I didn't have any nystagmus on testing but if you do that can be scary.

Other than being scary if you don't know what's happening, BPPV can increase the chance of you falling.

Medication will not help BPPV although in some cases it does resolve on its own after a while.

BPPV can sometimes be misdiagnosed by general practitioners who are not familiar with the testing or treatment of BPPV. The impact can be mildly annoying to highly debilitating and can affect function, safety and risk of falling.

How did I get better? Well, fortunately Gino knew how to treat BPPV using the Epley Manoeuvre. He treated me once and I was much better after that.


Reference

Fife TD et al (2008). Practice Parameter : Therapies For Benign Paroxysmal Positional Vertigo (An Evidence-based Review) : Report On The Quality Standards Subcommittee Of The American Academy Of Neurology. Neurology. 70: 2067-2074.

No Prizes For Guessing Who Got New Shoes (Again)

The most recent footwear Gino reviewed was the Earth Runners/ Huraches. Previously, he also got 3 pairs of Nikes.

Well, today he came home with not one but 2 new pairs of Under Armour running shoes to review. The UA Speedform Slingshot and the UA Charged Bandit 2.

Also have a read here. Stay tuned for his review.....

Can Antiperspirants Or Deodorants Cause Breast Cancer?

A few nights ago, Gino sent me an article warning that underarm antiperspirants or deodorants can cause breast cancer. Specifically aluminium ones. He suggested that I maybe I shouldn't be using them. I replied that I've used aluminium free deodorant for years.

Why aluminium ones you must be wondering?

Some scientists have suggested that there may be certain ingredients in underarm aluminium deodorants or antiperspirants related to breast cancer since they are applied frequently to an area next to the breast.

The articles have suggested that these aluminium filled products contain harmful substances which can be absorbed through the skin or enter the body through nicks caused by shaving.

Once absorbed, it can cause estrogen (hormonal) like effects. Since estrogen has the ability to promote the growth of breast cancer cells, some scientists have suggested that aluminium based compounds in deodorants and antiperspirants may contribute to development of breast cancer.

There is also research showing that the number of breast cancers diagnosed in the upper, outer area of the breast (which is the part closest to the armpit) is on the rise (Darbre at al, 2013).

I do not know of any local studies done so far but Both the American Cancer Society and the National Cancer Institute say there is no evidence directly antiperspirant/ deodorant use to cancer.

The research does not proof that antiperspirant causes breast cancer although some researchers who studied the chemicals are questioning if aluminium in combination with all the other compounds found in the antiperspirants/ deodorants (and many other personal care products we use) could add up to something harmful.

Many questions remain unanswered, but you cannot rule out the idea that these complex chemical mixtures could cause or contribute to the development of breast cancer.

Now you know.


Reference

Darbre PD, Mannello F and Exley C (2013). Aluminium And Breast Cancer: Sources Of Exposure, Tissue Measurements And Mechanisms Of Toxicological Actions On Breast Biology. J Inorg Biochem. 128: 257-261. DOI: 10.1016/j.jinorgbio.2013.07.005.

Jones J (2000). Can Rumors Cause Cancer? J Nat Cancer Insti. 92(18): 1469-1471.

Can Drinking Lemon Water Help You Lose Weight?

Now that's a big piece of lemon

Paris Hilton, Beyonce, Miranda Kerr and other celebrities all drink hot water with lemons saying it aids weight loss.

Gino even put lemon slices in his filtered water on his long Saturday bike rides. But this is purely because he likes a bit of taste in his water. He also likes to add lemons and especially limes to his drinking water at home but again purely for how it tastes. He doesn't drink it to lose weight for sure.

Limes or lemons is much better for him I reckon. Gino used to drink lots of Coke and other sodas but has since stopped after his bike accident. He doesn't drink sports/ isotonic drinks while riding especially since they really cannot replace the sodium levels he loses during exercise.

Is it that simple and too good to be true?

Lemons are acidic and contains both citric and ascorbic acid, an acid believed to have antioxidant properties. They are also a good source of Vitamin C, alkalizing minerals like calcium and potassium.

As such, some dieticians suggest that lemon water can have an alkalizing effect on the body or at least help the digestive system stay in a more ideal alkaline pH level. There is however insufficient published data indicating this.

That's what drinking filtered water is supposed to do as well.

You will probably get lots of Vitamin C while drinking lemon water which many studies have shown to have immune boosting properties. The hydrating effects of water will also be beneficial to you.

Well, drinking water with lemons does not cause you to lose any weight by itself. However, if your lemon water is replacing a coffee or soda that you normally drink that has more calories and that results in a calorie deficit then you can lose weight.

Drink lemon water if to hydrate yourself and for the Vitamin C. But remember to rinse your mouth as the acidic levels in the drink can wear out the enamel in your teeth.

Gino's all ready for his bike ride with his lemon water

Will Running With A Stroller Cause Injuries?

Good o' running days with Marlene, Mia and Dean

Back when Dean was younger, I tried running with him sometimes. Yes, him in a stroller with me pushing. Sometimes alone, sometimes with Marlene.

Hence, it was with great interest when I came across the article which investigated if running with a stroller impacted your running form or more importantly, whether it caused injuries.

It started when the author (a physiotherapist and 2:44 hour marathoner) started running with a stroller so he could train without having to leave his infant daughter. (That's a way of multi tasking too). He couldn't find any research on how running with a stroller may impact his form so he conducted his own research with a couple of colleagues.

The researchers studied a group of runners who had not ran with strollers in the past year. They ran in an indoor track both with and without a stroller at their own comfortable pace. The stroller weighed in at 22 pounds (about the weight of an average one year old with stroller).

The results show that while running with a stroller, the runners had a forward lean of 6.7 degrees more than running without. There was a reduction in trunk rotation of 11.4 degrees and an average of 2.9 degrees reduction in trunk side flexion running with the stroller. There was also an increase in pelvic tilt of 2.8 degrees while hip extension was reduced by 3 degrees running with the stroller.

All in all, although running form changed slightly, the changes were small and probably will not affect runners who want to regularly run with strollers.

The authors concluded that the change in form was due to runners pushing the stroller with both hands. Running with both hands pushing the stroller caused the increase in forward lead while reducing the rotation brought about by arm swinging normally. As a result, the authors suggested running with just one hand on the stroller to allow at least one arm to swing.

The researchers concluded that there was absolutely no reason not to run with a stroller. They also recommended some mobility work to stretch the hip flexors and trunk rotation and extension.

I found the forward leaning actually helped make the run faster although it was easier to run with only one arm on the stroller. The lean was exactly what Gino teaches in his pain free running technique for our patients to run without pain. If I ran with just one arm on the stroller, I found that I could not maintain my normal running pace. It was also a struggle to run up hills without the leaning.

Keep your run to an hour or less. My son starts getting unhappy beyond that. Here's another tip, have a toy in the stroller for you to help distract them. Make sure the toy is attached, if not you'll find yourself retrieving the toy from time to time.

Running to a playground or park and stopping for a while will make the run more fun for your child. It disrupts your run but the smile you get makes it all worth it.

Don't assume cars will give way to you on the road. On the contrary, be more cautious.

Reference

O' Sullivan R, Kieman D and Malone A (2015). Run Kinematics With And Without A Jogging Stroller. Gait and Posture. http:dx.doi.org/10.1016/j.gaitpost.2015.10.001.

Teaching the Kinesio Taping Level 1-2 Course

Gino spent the last two days teaching the Kinesio Taping Level 1-2 course @Progress Healthcare (tape distributor).

Attending the course were physiotherapy students, sports science students, local and foreign physiotherapists, an occupational therapist and a sports doctor from Indonesia too.

Day 1 consists of theory and concepts of Kinesio taping along with facilitation and inhibition of muscles. Day 2 allows the participants to learn mechanical corrections, fascia and space correction and other corrective techniques.

Here are some pictures taken from the course.

Showing the "weave" and the "wave"

What's with the pink tape?

Jon's push-up position taping 

Ram's head?

Also have a look more pictures here.

Another Surprise For Gino

Guess what came in the mail for Gino today? Have a look here.

2 Years After Gino's Horrific Accident

My 3 boys

We remember this day 2 years ago when Gino was in an accident. Yes, it has been a long 2 years. 

A truck took him down when he was cycling.He suffered skull and spinal fractures.

It is in our past. But we remember this day purely to see how much we've grown as a couple, as a family and as individuals. 

Borrowing the words of a wise friend, "Healing isn't a bed of roses, it isn't a fluffy fairytale. It is tiring, gruesome and painful." So true! We are very grateful that all has healed well. 

The positives that have come out of this experience are many. Firstly, Gino is back riding his bike.
Secondly, we have become lots more aware of what we eat as a family and how nutrient dense food is like medicine to the body. Thirdly, we saw how our families and friends rallied around us. Lastly, we learnt tremendously as physios in the rehab of an individual with spine and skull fractures.

Oh yes! And our precious gift of a second son early this year.

We are grateful everyday for our lives, our health and each other.

Raining, But We Were Cycling

After falling while running at the green corridor  on Monday with  a few abrasions  and received quite a few scoldings, decided not to run in the rain this morning.

Went cycling instead. Indoors of course, at Sports Solutions. Got a few stares from cars and people walking by at the two of us riding furiously away to nowhere. Gino was reading and listening to his iPod as well as cycling, he's a master at multi tasking.

Exercise done for the day.

3 Pairs Of Oakleys

Guess what, first he got 3 pairs of Nikes, now he's got 3 pairs of Oakley sunglasses. Yes, you read right he got 3 new pairs of sunglasses from Oakley today.

Gino got a pair of the Radarlock Path 30 Years Sport Special Edition. Oakley is celebrating three decades of making sports performance sunglasses. This special Heritage Collection brings back 3 favourite vintage designs with colours from the era that started this for a limited time. The top edge of his Radarlock frame has a printed stripe reminiscent from Oakley's original eyewear collection 30 years ago.

Well, Gino Has been wearing Oakley sunglasses since he was sixteen.

Top edge with a difference

He also received a pair of Frogskins and the Chainlink. All the names may sound strange to you, but the sunnies are anything but strange.

Frogskins and  Chainlink

Looks like I have to "borrow" at least one of them permanently.... wonder what he's gonna get next.

ST 180514 Today's Sunday Times Article

Gino was quoted in today's Sunday Times on page 17 under the Home section for his views on the Vibram Five Fingers lawsuit. He has actually written about it way back in 2012.

He also shown them his version of his minimalist running shoes, a pair of Fei Yue's that his brother bought for $RMB30 (or S$6) as compared to $149-$209 for a pair of Vibrams here in Singapore.

Gino's $6 version of Vibram's

Like what we've always told our patients, it your running technique that is critical, not your shoes. Also have a read here.

You've Come A Long Way Baby!

He ain't heavy, he's my son

Here we are. A year later. Boy am I grateful that Gino has returned to work, got back on the bike and is able to carry our son if he wanted to, among so many other things that we took for granted before the accident.

I'm so curious to see just how his lumbar spine fracture has healed. CT scan this week.

In hindsight, so many good things came out of this that it outweighs the bad.

1. It sure gave Gino a break from work. I definitely would have preferred us to go away on holiday for 6 months but hey! it takes something this serious to force him to take a breather.

2. All that time at home gave our son precious time with his dad. Their relationship has evolved to a whole new level since.

3. It made me read voraciously on how to help Gino heal as best as possible. And this made us change our eating habits and we are still improving it as we learn new things about food.

4. Gino has been a patient before with numerous knee procedures. But never at this level where his spine and his skull were fractured. We may have become the best physiotherapists in recovery after a spinal fracture!

5. We emerged stronger as a family. Getting through a difficult situation almost always does that.

At the end of the day. I am thankful. So very thankful. For health, for family, for good friends.

Green Juice

Sorry Gino, the bigger glass is all mine

Have you had your green juice today? 
I'd like to share what went into our green juice this morning. 
Bok Choy, brocolli, cucumber, 1 lemon, 1 lime and mint leaves.

Can you eat all these raw?

I always feel so satisfied just looking at the amount of greens that I could
consume so easily. If you drink your green juice on a empty stomach, your body 
just absorbs the micro nutrients like a sponge! Just imagine, all your cells getting the
goodness it needs to be healthy just like that!

We have not always been this watchful about our nutritional habits. It went to a whole new level after Gino's accident in April this year.

Incidentally because of his accident we also found out that Gino has osteopenia. This means that he has a lower bone density than a male his age. It is a level better than osteoporosis but hey we were still concerned because Gino had been very active all his life.

After numerous tests to ascertain the cause of lowered bone density, his endocrinologist concluded that his was due to genetics as everything else came back negative.

At first all I wanted was to ensure that Gino got good nutrition to give his body the best chance of healing well. This got me reading and cooking and watching many documentaries on food, sparking an interest in good eating practises. 

I had adopted a gluten and dairy free diet for almost 2 years now. Besides green juice, we eat very little refined and processed food. We make an effort to eat less meat. Gino has stopped drinking Coke and other soft drinks. Caffeine reduces bone density so Coke was the first thing to go! Plus too much sugar can also cause diabetes.

It is work in progress. We take it one meal at a time. In the end it is rewarding to feel better in our bodies and to see our son adopt some of our good eating practises :)

Is Laughter The Best medicine?

Gino was described as a skeptic in today's Mind Your Body section of the Straits Times when he was asked by the journalist regarding the aerobic effects (or whether it can make you fitter) of laughter yoga.

The main muscle used when breathing is your diaphragm. And exercising your diaphragm can help with improving aerobic performances although devices like the Power lung are more commonly used.

I remember when Gino used to race he did a bit of inspiratory muscle training. Besides working full time as a Physiotherapist at the Singapore Sports Council, he was also a carded athlete receiving some support for his training. So like some other carded endurance athletes, he had access to a Power lung. I remember he used it while we were watching television at home occasionally.

There are also many studies supporting the use of power lung or similar models from other brands for inspiratory muscle training. Bear in mind the studies are on inspiratory muscle training and not the brand of the product used.

The respiratory muscles like your diaphragm, intercostals and abdominals are definitely used with laughter yoga. There may also be some benefits like decreasing stress and anxiety. There is an abstract of a research paper found in Pubmed on laughter yoga. This was done on patients awaiting organ transplant, none so far found on improving your aerobic capacity. You can see the abstract here.

The article is found today's Mind Your Body section of the Straits Times on pages 10-11.

Playing Football At 11 Weeks After His Accident

Goal bound

Not so fast....

This is Gino. At exactly 11 weeks after his accident where he fractured his skull and lumbar spine. He's playing football with the kids at Botanic Gardens. How's that for recovery?

I had to yell at him to stop running when he tried to run after the ball. My heart skipped a beat each time he broke into a run, but at the same time I was really happy to see the progress he's made.

When I asked him why he ran, he said, "no pain what".  Well, that's Gino for you, always willing to push his timelines limits. Try telling him something cannot be done and he'll try to prove you wrong.

By the way, Dean and his cousins were just as, if not more competitive, at wanting to win.

Let's see how his CT scan looks in 2 weeks.