How Do You Roll?

By Jorg Patzer
These days, foam rollers are everywhere — the gym, your RMT, Physiotherapist, your living room and even your suitcase. Essentially, foam rolling is a form of self-myofascial release, or self-massage, that gets rid of adhesions in your muscles and connective tissue
Here’s a breakdown of three ways to improve the use of a foam roller:
#1: Don’t roll directly where you feel pain. 
When we feel pain, our first inclination is to massage that spot directly. However, this might be a mistake. Areas of pain could be the victim that result from tension/ imbalances in other areas of the body.
Let’s take the IT band, for example. While religiously rolling out your IT band might feel good but the idea that you are going to relax or release the IT band is a misconception. The phrase roll out your IT band itself makes it sound like you are rolling out a piece of dough, but your IT band is anything but pliable. It’s a remarkably strong piece of connective tissue and can not be “rolled out”. To have an impact on the IT band you would have to look into the muscles who attach to it.If you iron out areas of inflammation, you can increase inflammation. And if you are in pain, your body will be too stressed to repair itself, or is guarding the area which does not decrees the muscle tone.  
To improve: Go indirect before direct. If you find a spot that’s sensitive, it’s a cue to ease away from that area by a few inches or take off the pressure. Take time and work a more localized region around areas that feel sore before using larger, sweeping motions. For the IT band, work on the primary muscles that attach to the IT band first — specifically the gluteus maximus and the tensor fasciae latae (hip flexor).
#2: Don’t roll too fast. 
While it might feel great to roll back and forth on a foam roller quickly, you’re not actually eliminating any adhesions that way. “You need to give your brain enough time to tell your muscles to relax.
To improve: Go slower so that the superficial layers and muscles have time to adapt and manage the compression. Feel where the tender spots are with the roller, and use short, slow rolls or stop and let it “melt”. “There’s no reason to beat up the whole muscle if there are only a few sensitive areas. Less is more in my opinion. 
#3: Don’t spend too much time on those knots. 
We’re often told that if you feel a knot, spend time working that spot with the foam roller. However, some people will spend too much time at the same area and attempt to place their entire body weight onto the foam roller. If you place sustained pressure on one body part, your body start protecting and keeps the tension on that muscle to decrees further damage. 
To improve: Spend about 20 seconds on each tender spot then move on. You can also manage how much body weight you use. For example, when working your Quad muscle, plant the foot of your leg on the floor to take some of the weight off the roller or lean against a wall. 
Happy Foam rolling!

Stand More, Sit Less


If you work 5 days a week, for 8 hours a day, that adds up to 1920 hours of sitting in a year.  Studies show that:

  • 30 minutes of sitting causes compression and fatigue in your spinal muscles, discs and ligaments.

  • Excessive sitting contributes to a decline in heart health and an increase in risk of stroke, cardiovascular disease, diabetes and some types of cancer.

  • Key fat burning chemicals in the body turn off after 1 minute of sitting

  • 2 hours of sitting reduces blood flow, results in a blood sugar drop and a decline in “good” HDL cholesterol by 20%

And that is just at the office! The average person may also spend 1.5 hours sitting to watch TV, 1.5 on their lap top, 1 hour sitting to eat and depending on your commute to work, even more sitting. That is a lot of time on your backside, most of which is likely with unconscious posture.

Unfortunately, your well-intentioned time at the gym can’t reverse postural stress that accumulates during the day.  A 2014 study followed more than 82, 000 men for 10 years and showed that a regular fitness routine did NOT counteract the effects of prolonged sitting. Individuals who sat 5+ hours a day were still likely to have heart disease no matter how much they exercised in their free time.

The key to success is finding more ways to move during your workday and leisure time. This means convert sitting to standing time.  Did you know that replacing 3 hours of day of sitting with standing can make a huge difference in your overall health? In fact switching just 3 hours a day of sitting to standing time is the caloric and activity equivalent of running 10 marathons a year!

Here are some suggestions on how to do that:

  • Stand when taking on the phone

  • Eat snacks/lunch or drink coffee/tea standing up

  • Walk over to a colleague instead of emailing them with a question

  • Make your day harder by taking the stairs

  • Plan a walking/standing meeting to replace a sitting one

  • Actually schedule breaks during your day to move, stretch and breathe

  • Divide your lunch break in half with time to eat and time to take a quick walk

  • Pick a co-worker to be accountable to increase your chance of success

Even small breaks add up to 3 hours if done regularly. Why not start right now?  You can do it.

Questions about this article? Contact Dr. Berry at [email protected]

Knee Pain Vancouver

What is PFPS – Patellofemoral Pain Syndrome

By Brooke MacGillivery, Physiotherapist

Patellofemoral Pain Syndrome, commonly referred to as PFPS, is a syndrome characterized by diffuse pain/discomfort surrounding the knee cap. The pain can vary in intensity, location, and duration, and will commonly present after repetitive activities such as running, squatting, or cycling.

Why does PFPS occur?

In order for the lower extremity to function optimally, the ankle,

knee and hip joints must have functional ranges of motion. The muscles surrounding each joint must be strong and balanced as well. Due to the nature of most jobs, the majority of us sit for a better portion of the day. Sitting for prolonged periods can inhibit the posterior chain (glutes, hamstrings, calves), which can lead to weakened muscles. Anytime a muscle group is weakened, the body develops compensatory patterns to achieve a given movement pattern. If the glute muscles are inhibited while climbing stairs, the body will recruit surrounding muscles to get the job done (cue tight hip flexors and quads). The body can tolerate repetitive movements, but only when all the muscles involved are doing their fair share. Tight quads and hip flexors can pull on the knee cap, forcing it to track improperly which can contribute to PFPS and other conditions such as IT Band Syndrome.

There are a number of different factors that can contribute to PFPS, not just the mechanisms listed above. The good news is that by determining any muscular imbalance or mechanical impairments, a treatment plan can be devised to correct imbalances and decrease the stress on your knees.

If you find you have diffuse knee pain that affects your daily activities, seek out a physiotherapist to assess your mechanics. Simple things like foam-rolling your quads, and doing glute-activation exercises prior to a run can decrease the stress on your knees.

Tennis Elbow – Vancouver

By Lindsay Farr, Physiotherapist

Lateral epicondylalgia (LE), more commonly referred to as tennis elbow, refers to pain on the outer side of your elbow.

This pain is usually worsened with gripping and repetitive activities such as typing, mousing, lifting objects with an outstretched arm, and opening doors. It is typically considered a tendinopathy of the extensor carpi radialis brevis muscle, however evidence shows a relationship between the neck, the radial nerve, and LE. Historically this condition was treated with non-steroidal anti-inflammatories (NSAIDs), ice, and rest.

Current evidence suggests there may not actually be an inflammatory component to this condition and studies have shown that physiotherapy combined with a home exercise program is more effective than ice or NSAIDs.

Studies have started to investigate the role of posture and the nervous system in the development of LE and have shown positive correlations. There is a greater prevalence of neck pain in patients with LE versus age matched controls (Berglund, Persson & Denison, 2013) and individuals suffering lateral elbow pain are more likely to test positive for radial nerve sensitivity (Coombes et al., 2013). Sitting at a desk for prolonged periods of time can lead to a chronic “head forward posture,” as pictured below.

Tennis Elbow 1

This position compresses the joints in our neck and narrows the space through which our nerves pass. Chronic poor postures can lead to compression of nerves, such as the radial nerve, which supplies muscles in our lateral elbow. When our nerves are compressed information moving through those nerves is restricted and slowed and this puts structures innervated by those nerves at risk for injury. Where our muscles would normally be able to withstand the repetitive daily tasks such as gripping and opening doors, nerve compression and irritation has limited their tolerance and so they breakdown sooner and start emitting pain signals. This is when we feel “tennis elbow.”

Here are some helpful tips for those of you who are “9-5 desk sitters,” or anybody struggling with lateral elbow pain:
Adjust your desk station: try to attain posture as shown in this image. If you are unable to adjust your station yourself, speak with your manager and ask to have an ergonomic assessment of your desk station

Tennis Elbow 2

Move: set a timer for 45 minutes. Whenever that timer goes off adjust your position. Lean back over your chair to stretch your chest muscles, stand up and walk to the printer/cooler, twist left and right in your chair.

Tennis Elbow 3

Stretch: use these basic neck and arm stretches daily to avoid tight muscles and relieve pressure on the nerves

Tennis Elbow 4

Posture: try to maintain a posture where your head rests over your body. Shoulders should be slightly back, lengthen the back of your neck and gently nod your chin “yes”. Your ears should nearly align with your shoulders when viewed from the side.

Tennis Elbow 5
See a Physiotherapist: if your symptoms persist and are becoming limiting to simple daily activities you should seek medical advice from a physiotherapist who can instruct you on more specific treatment methods and exercises.

What is Chiropractic today?

with Dr. Nina Foot,
and Dr. Chelsea Berry

Chiropractic medicine has a rich history and many incarnations. New school chiropractic care involves not only adjustments but also:

  • Soft Tissue Therapy
  • Exercise Prescription
  • Nutritional Advice
  • A.R.T – Active Release Therapy
  • Modalities such as Cold Laser Therapy.

Our chiropractors follow up to date research guidelines and current scientific evidence to provide the best possible care.

Have you ever wondered what chiropractic care is all about? Whether you’ve heard information from friends or online, initially, chiropractic can be a bit mystifying.

  • What do Doctors of Chirporactic do?
  • What conditions do they treat?
  • Is it effective?
  • Is it safe?

Our chiropractors at Qi have special training in the sought-after soft tissue therapy known as Active Release Technique (ART ®) and are trained to treat musculoskeletal conditions and injuries throughout the whole body, not just the back. They also incorporate:

  • Personalized exercises
  • Stretches
  • Postural advice to get you back to feeling your best as quickly as possible.

In truth, there are many types of chiropractic care to choose from. Most chiropractors use adjustments to mobilize the joints of the body and restore full movement and function.

There is an overwhelming amount of evidence to show that chiropractic adjustments are safer and more effective than medication or general medical care for managing low back pain.

Dr.Nina Foot is inspired to treat children, pregnancy, and any other client who would benefit from Chiropractic.
Dr.Nina Foot is inspired to treat children, pregnancy, and any other client who would benefit from Chiropractic.







Today, thousands of chiropractic studies have been published on various conditions, such as:

  • Headaches
  • Neck pain
  • Tendonitis
  • Disc herniation
  • Scoliosis
  • Sciatica
  • Shoulder injuries

just to name a few.

If you are suffering from sports injuries or joint pain, or if you are interested in learning about ways to improve your spinal health, book a free 15 minute consultation with Dr. Berry or Dr. Foot today.

We warmly invite you to join our free seminar, How to Heal Naturally, to learn more about how we practice and what we offer: Wednesday March 4th 12:00pm-1:00pm or Thursday March 5th 6:00-7:00. Call and speak to our front desk team to reserve your spot.

Manga, Pran; Angus, Doug; Papadopoulos, Costa; Swan, William. “The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low- Back Pain.” Richmond Hill, Ontario: Kenilworth Publishing, 1993

Haldeman, Scott, et al. “The bone and joint decade 2000–2010 task force on neck pain and its associated disorders.” European Spine Journal 17 (2008): 5-7.

Why do my knees hurt when I run?


  By Brooke MacGillavery, MPT, BSc, CAFCI, CSCS

Ever wonder why your knees hurt when you run? Or why you can’t quite achieve a perfect lotus position in yoga?

As a physiotherapist, I will assess your posture and overall mechanics to determine what can be done to eliminate pain and improve your daily life.  Pain and loss of function can develop from a trauma, or something as simple as repetitive postures like sitting at a desk all day.
My goal as a physiotherapist is to help people realize their full physical potential – whether it be training for a marathon, perfecting squat technique, or simply having pain-free neck range of motion.
As a physiotherapist at Qi, I feel my tools are all the more useful when paired with other services such as Pilates for core strengthening, or massage to decrease muscle tension and increase flexibility or range of motion. To start the new-year off right, ask yourself if you have any goals you’re having difficulty achieving due to physical limitations or pain; physiotherapy can help!

The bridge is an excellent exercise to start with:

  • With a neutral pelvis, bend knees

  • Feel the feet, arms and shoulders firm on the floor

  • lift hips and hold

  • Focus your breath into your low abdomen

  • Keep thighs engaged

  • Knees in line with your ankle and large to

  • Hold for 30 seconds

Perform 3 sets ensuring no back or knee pain.

To book in with Brooke call us at Qihealth # 604-742-8383

Why Functional Medicine?

with Dr. Erika Kubanek,

There is a lot of buzz about functional medicine these days. I get calls and emails quite frequently from some who have heard about this progressive approach to medicine. Never heard of it? Check out the Institute for Functional Medicine. So, you may ask, what is all the excitement about? Functional medicine is very much akin to naturopathic medicine – one of our core principles is to discover the so-called ‘root cause’ of illness and disease.

“Imagine a world in which medicine was oriented towards healing rather than disease, where doctors emphasize prevention above treatment.” – Andrew Weil, MD

With our conventional medical approach once we are ‘diagnosed’, that is the end of the investigation, answer is found and all we need is a drug or surgery to fit that diagnosis and relieve symptoms, often without treating the underlying dysfunction.

With naturopathic, not to mention functional medicine, a diagnosis is merely the start of our investigation.

In my practice I am continually asking the question ‘why’. Why has this condition developed? Why are these symptoms present? Why has this lab test deviated from optimal? And with these questions we search for the root causes of disease. Naturopathic medicine is uniquely positioned to be at the forefront of the functional approach to health care.
Our belt of therapeutic tools is not only huge:

  • nutrition
  • vitamins
  • minerals
  • phytochemicals
  • botanicals, to name a few

It is also also safe when prescribed by your expert in natural medicine.

Visit to book in with Dr.Erika Kubanek or to learn more about her approach visit

Using Acupuncture to Treat Residual Pain After an Injury

I get this question time and time again –

How does an acupuncture needle help get rid of my pain from an old injury?

When patients ask this question they are not looking for the Traditional Chinese Medicine explanation, they are looking for some scientific proof.  A recent article written by Helene M. Langevin provides research-based evidence on how connective tissue is related to post-injury pain and how acupuncture can be used to treat the pain.

Connective Tissue and Scar Tissue


Connective tissue and scar tissueConnective tissue supports and connects all the bones, muscles, organs, blood vessels and nerves in the human body. It’s what holds all the parts of our body in place.  Connective tissue creates a link between our head, arm and foot.

Scar tissue forms in the body after there has been trauma to a tissue. Various cells are recruited to deposit collagen and contract the tissue back together, but in doing so they form a dense matrix known as scar tissue.

Why is there pain after the injury has healed and scar tissue has formed?

If the previous injury becomes irritated and inflamed, the cells are signalled to deposit excess collagen.  This will subsequently increase the tension and contraction in the tissue,which limits range of motion leading to pain. One of the reasons that pain can be difficult to manage is that many people do not have a detectable malformation.

So how do we deal with the Scar Tissue?

Static stretchingAcupuncture can help relax the tension in the connective tissue. How does it do this? When an acupuncture needle is inserted into the skin and rotated, the connective tissue actually becomes attached to the needle causing it to stretch and change shape1. The tissue continues to remain stretched as long as the needle is in the skin and the changes occurring in the tissue are related to relaxation of the tissue.  The restructuring of these tissues is a slow process therefore it is important to be patient as it may take a few treatments to feel the results.

Learn how acupuncture can be used to treat your lingering pain.

Jessica Zerr is a Registered Acupuncturist at Qi Integrated Health

To learn more about Jessica visit Jessica Zerr Acupuncture


  1. H.M. Langevin et al., “Mechanical signaling through connective tissue: A mechanism for the therapeutic effect of acupuncture,” FASEB J, 15:2275-82, 200


I Have Pain In My Shoulder – What’s Wrong?

Often I see patients in my clinic at Qi Integrated Health who have suffered from debilitating shoulder pain that has been ignored or inappropriately treated. Desperate for results, some of these people have progressed to the point where something as simple as getting a mug out of an overhead cupboard, or putting on a jacket, becomes impossible. While a seemingly minor complaint at first, shoulder pain can progress secondary to altered kinematics, leading to muscle imbalances, instability, additional pain, and ultimately, loss of function.

As one of the most intricate joints in the body, obtaining the correct diagnosis and beginning an appropriate treatment regime requires a thorough clinical examination. Given the complexity of the shoulder, it’s easy to appreciate the number of causes for shoulder pain, so today we will focus on the rotator cuff.

The Rotator Cuff – What is it?

Supraspinatus Muscle

The rotator cuff is made up of 4 key muscles that are responsible for – as you guessed it – providing rotation and movement of the shoulder joint, but more importantly, dynamic joint stabilization. One of these four muscles is called the Supraspinatus. It is also the muscle most prone to injury.

Where is the Pain?

The supraspinatus muscle sits in the supraspinous fossa, or above the boney ridge on the shoulder blade. It attaches to the head of the humerus and is responsible for ABDucting the arm, or moving your arm straight out to the side. An injury to the supraspinatus may cause pain directly at the shoulder, or the pain may be referred down the front or back of the arm, sometimes even as far as the wrist.

Common Causes

There can be several different causes, but some of the most common include:

  • A fall on an outstretched arm
  • Sports that involve repetitive, strenuous movements of the shoulder such as baseball, softball, tennis, volleyball, and swimming.
  • Household chores such as washing windows or painting.
  • Degeneration associated with advancing age.


My Treatment Approach


One of the reasons the supraspinatus muscle is difficult to treat is that it sits below the trapezius muscle.  Acupuncture is a great way to treat this injury because it can target specific points deep to the trapezius muscle that things like massage cannot reach as well. For all you acupuncture buffs, SI12 is one of the key points.

Activity Modification

Activity will likely only aggravate the muscle and slow the healing process. Trying to limit the activity that causes pain, as difficult as that may be for some, it is very important.

 Rotator Cuff Exercises

Rehabilitative exercises for the rotator cuff muscles that are gentle and controlled will help with the recovery and prevent the formation of scar tissue.


Stop guessing what’s causing your pain, and hoping it will disappear. Speak to an acupuncturist trained in musculoskeletal health, and see what acupuncture can do for you.

Jessica Zerr Acupuncture

Study: Is Barefoot-Style Running Best?

Barefoot-running enthusiasts long have believed that running without shoes or in minimalist footwear makes running easier, speedier and less injurious. But a surprisingly large number of new studies examining just how the body actually responds when we run in our birthday shoes or skimpy footwear suggest that for many people, those expectations are not being met.


Read the article here: