Oh Momma! Easing the Aches and Pains of Pregnancy (from Thrive 2017)
Facilitators: Dr. Carol Ann Weis, Dr. Crystal Draper, Dr. Nadine Ellul
CE Hours: 3.5
Prenatal and postpartum back pain is very common and can be moderate, severe or disabling. Treatment options are limited during pregnancy and many therapists are unsure how to effectively treat pain during this time. Workshop participants learned how the latest research and techniques could enable them to offer excellent prenatal and postpartum care, including spinal manipulation, taping and exercise.
- 25-90 of women report low back (LBP) and/or pelvic girdle pain (PGP). Pain is significantly correlated with sleep disturbances, use of pain medication and disturbances to activities of daily living such as child-rearing. Several factors have been implicated in pregnancy-related LBP including altered posture, hormonal changes, muscle fatigue and muscle imbalance.
- Unfortunately, women who experience LBP during pregnancy are frequently dismissed by their health care professionals, as it is not considered a serious health risk to the mother or fetus and treatment options are limited. Although most pregnant women will consult their primary care physician about questions regarding exercise, chiropractors are in a unique position to spend focused time addressing their back pain and treatment options.
- This workshop updated participants on the latest guidelines and trends in the literature on back pain during pregnancy and postpartum treatment options. It also assessed participants’ current level of knowledge regarding exercise and pregnancy guidelines.
This two-part workshop covered: chiropractic care treatments in part one; exercise and pregnancy in part two.
- Improve your understanding of current trends in the literature concerning chiropractic care among pregnant and postpartum populations.
- Learn how to observe and engage in hands-on treatment of pregnant women in therapies, such as SMT and taping.
- Discuss the current guidelines for exercise during pregnancy for the healthy uncomplicated pregnancy, including sedentary, recreational and active patients.
- Gain an understanding of how to use the health-screening tool, The Physical Activity Readiness Medical Examination for Pregnancy(PARmed-X for pregnancy), with pregnant patients in their practice.
Each part of the workshop included pre and post workshop surveys to measure outcomes. Pre-workshop surveys focused on participants’ patient demographics, their previous work with pregnant and post partum populations, comfort level and knowledge with current guidelines. Post-workshop surveys measured participants new comfort levels with implementing manual procedures to this population and their new level of knowledge.
- Part 1: Low back and pelvic pain in pregnancy and postpartum – Manual therapies (2.5 hours)
- Risk factors
- Treatment options
- SMT, Webster’s (please note: we will not be teaching the Webster technique, but will be discussing the literature about this technique)
- Taping options
- Low back (Erectors, SI Jt, H-Pattern)
- Abdomen (RA, EO, pubic symphysis, spiral)
- Part 2: Exercise in pregnancy and postpartum (1 hour)
- Safety in trimesters
- Pelvic floor
- Low back
- Postpartum breastfeeding postures
- Postural stretches
Dr. Carol Ann Weis, MSc, DC
Dr. Weis practices at two busy interprofessional clinics in downtown Toronto. She graduated from the University of Western Ontario with a Bachelor of Arts (Honours) in Physical Education (1992) and a Master of Science in Exercise Physiology (1997). In 2008, she graduated from the Canadian Memorial Chiropractic College (CMCC). In addition to her private practice, Dr. Weis is an Assistant Professor at CMCC where she lectures and conducts research on back pain and pregnancy. She has a number of peer-reviewed articles and has presented her research at various conferences. She is also co-author of The Athletic Mom-to-Be: Training your way into pregnancy and motherhood.
Dr. Crystal Draper, BAS, DC
Dr. Draper holds a Bachelor of Arts and Science Degree in Human Kinetics and Developmental Psychology from the University of Guelph and is a graduate of CMCC. She currently practices downtown Toronto at two interdisciplinary clinics, focusing on pregnancy and postpartum care. In addition to clinical practice, Dr. Draper is a faculty member and course coordinator for Clinical Diagnosis and teaches within the Chiropractic Techniques and Chiropractic Principles departments at CMCC. Her collaborative research on pregnancy and back pain was presented at the 2017 ACC-RAC and currently has articles in press.
Dr. Nadine Ellul, MHSc, DC
Dr. Ellul is a graduate of CMCC and later earned a master’s degree in Health Studies from Athabasca University. For the past 10 years, she has run a family-based practice. Since 2012, she has been a CMCC faculty member teaching chiropractic technique, clinical diagnosis and simulation case scenarios. Most recently, she has been involved in original research exploring the implementation of force-sensing technology into the classroom environment. Her other experiences include teaching for Seneca College and most recently joining Durham College’s School of Business, IT and Management as a full-time faculty member.
Managing Concussion and Post-Concussion Syndrome (from Thrive 2016)
Facilitator: Dr. Cameron Marshall
CE Hours: 3.5
This workshop was designed to provide participants with essential knowledge and hands-on clinical training for treatment of concussion injuries. Dr. Cameron Marshall, the founder of Complete Concussion Management Inc., covered the latest concussion information, including basic pathophysiology, risks/red-flags and assessment and management. The workshop also included three hands-on breakout sessions to learn rehabilitation and treatment techniques firsthand. After this workshop, it was expected participants would be able to provide proper guidance and successful treatment and rehabilitation for your patients.
- Gain confidence in your diagnosis and treatment for concussion patients
- Enhance your knowledge of concussion and post-concussion syndrome with the most up-to-date evidence
Part 1: Lecture on Pathophysiology & Management of Acute Concussion
- What happens inside the brain? How much force is required?
- What are the Red Flags and when should I refer out?
- What are the steps for returning someone back to school, work, or sports?
Part 2: Lecture on Pathophysiology & Management of Post-Concussion Syndrome (PCS)
- Key theories behind chronic symptomatology
- Learn the evidence behind effective treatment/management strategies in PCS
Part 3: Assessment & Rehabilitation of Post-Concussion Syndrome (Practical/Hands-on Breakout Sessions)
- Learn how to properly conduct a well-known vestibular and visual assessment and apply the appropriate rehabilitation techniques for the most common PCS dysfunctions
- Session A: Vestibular-Oculomotor Assessment (VOMS)
- Session B: Visual Rehabilitation
- Session C: Vestibular Rehabilitation
Dr. Cameron Marshall
Dr. Marshall is a Fellow of the Royal College of Chiropractic Sports Sciences as well as the founder and current president of Complete Concussion Management Inc., a clinical network of medical facilities for the purpose of concussion diagnosis, management, and rehabilitation. Dr. Marshall has conducted research in collaboration with the University of Buffalo concussion research team and has trained over 400 physicians, chiropractors, and physiotherapists on the diagnosis and management of concussion injuries. Dr. Marshall is also a treating clinician at LiveActive Sport Medicine at the MasterCard Centre in Toronto.
Managing Chronic Pain in Older Adults (from Thrive 2018)
Facilitator: Dr. Carlo Ammendolia
CE Hours: 3.5
This workshop focused on managing chronic pain and chronic pain syndromes in older adults. The prevalence, challenges and approaches to managing multiple co-morbidities, poly pharmacy and declining physical and cognitive function were covered. The workshop was designed for chiropractors to leave with practical and proven strategies that they could implemented immediately, to help improve the overall health of their older patients with chronic musculoskeletal pain.
- Learn the prevalence, burden and common etiologies of chronic pain syndromes in older adults.
- Understand how co-morbidities, polypharmacy and psychosocial barriers impact recovery in chronic pain.
- Learn a comprehensive approach for managing chronic pain and maximizing function in older adults regardless of pain location.
- Demonstrate how this approach can significantly improve outcomes in degenerative lumbar spinal stenosis.
- Demonstrate that chiropractors have the necessary skills and knowledge to successfully manage chronic pain in older adults.
- Part 1: Introduction to etiologies of chronic pain syndromes in older adults and barriers to recovery. (1.5 Hours)
- Part 2: Learn approach for managing chronic pain and improving function, including its impact on lumbar spinal stenosis. (1.5 Hours)
- Part 3: A review of the skill and knowledge chiropractors have for managing chronic pain in older adults. (1 hour)
Dr. Carlo Ammendoliat, DC
Dr. Ammendolia is the Director of the Spine Clinic and the Spinal Stenosis Program at the Rebecca MacDonald Centre for Arthritis and Autoimmune Diseases at Mount Sinai Hospital in Toronto, Canada. He received his MSc degree in Clinical Epidemiology and Health Care Research and his PhD in Clinical Evaluative Sciences from the University of Toronto. Dr. Ammendolia is an Assistant Professor in the Institute of Health Policy, Management and Evaluation, the Department of Surgery and the Institute of Medical Sciences at the University of Toronto.
Dr. Ammendolia has been in clinical practice for more than 36 years and now combines clinical practice, research and teaching in the areas of non-operative treatment of mechanical, degenerative and inflammatory spinal disorders with a special interest in degenerative spinal stenosis.
Getting to Zero: Tapering Off Opioids (from Thrive 2018)
Speakers: Kirk Foat and Anna Foat
When opioids first arrived on the health care scene as a reasonable treatment option for immediate pain management, there was little to no foresight on the impact of high opioid dosages and the inexorable reliance patients would have on them. Today there are hundreds of thousands of Canadians seized by the scourge of opioid dependency. In many cases there are alternatives to opioids in treating non-cancer pain, accompanied by recovery success stories.
Kirk Foat is one of these success stories. Introducing Kirk, a man who suffered a traumatic ordeal while on vacation in the Caribbean; his badly injured hand was saved through surgery, but unknown to him at the time, his real challenges were just beginning. After years of taking OxyContin and Pregabalin for pain as prescribed, the side effects became more of an issue. Kirk’s incredible journey of recovery will have you on the edge of your seat – evidence that life is possible after opioids.
Kirk’s journey focuses on how he was successful at getting to zero opioid use, how he navigated the health care system and shocked his doctors by formulating an opioid tapering plan.
Even with Kirk’s own personal success in tapering off opioids, nobody should have to go through such a challenge on their own. By sharing his story with doctors, health care professionals and government policy makers he is educating care providers on how to support patients like him to reduce or stop taking opioid medication.
What Participants Could Expect
Kirk Foat shared his compelling story, accompanied by his wife Anna Foat, for Thrive’s 2018 keynote address to OCA members and special guests. Through sharing his experience in rehabilitation and years of addiction to high dose opioids, Kirk believes he can provide lessons for positive change that will help inform health care practitioners, as well as give hope to patients.
As part of the presentation, there was an interactive, moderated Q&A at the end, facilitated by Dr. Raquel Marques; a chiropractor who has worked with patients like Kirk, at Centres for Pain Management (CPM) in Scarborough. With a decade of experience in chronic pain management, she has collaborated with physicians and anesthetists who also specialize in this area. Dr. Marques’ role as a moderator was designed to help to unlock insights into how chiropractors can be a vital support to patients using opioids from a multidisciplinary perspective of pain management.
Kirk is a patient with a story to tell about how tapering off opioids and getting to zero is possible, even after years on a high dose. He believes that he can provide lessons and lived experience to effect positive change for health care practitioners, as well as give hope to patients.
Kirk works at University Health Network as a patient reviewer of medical papers. He has had the honour of speaking at Queen’s Park to the Deputy Health Minister, LHIN CEO’s, to Health Quality Ontario and numerous nurse practitioners.
Kirk is a graduate from the University of Western Ontario (sociology/psychology), and a peer educator for South West Self-Management Pain Program.
Anna loves the power of possibility and the passion of entrepreneurs. She’s worked at a startup, grown with one of the most famous Canadian scale-ups (and subsequent crashes), and now works for a major financial services firm in Canada, advising the chief transformation officer on digital transformation. She earned a BA in English Literature from the University of Waterloo and now teaches Design Thinking at the University of Western Ontario.
As Kirk’s wife, Anna’s contribution to his journey highlights the importance of support and involvement of family and friends.