Real Pain

Global Year Against Pain in Women


The International Association for the Study of Pain(IASP) has declared 2008 the Global year Against Pain in Women.



This is an effort to draw attention to the siginificant impact chronic pain has on women, since chronic pain affects a greater number of women than men around the world. However women are less likely to receive treatment.

IASP has promoted the Global Day and Global Year Against Pain for a number of years now primarily to raise awareness of pain worldwide. 2007 focused on pain in older pesons and 2006 focused on pain in children. The Global Year, is a year-long event held to raise awareness of the different aspects of pain.

Why the need to focus on pain?

Pain, particularly chronic pain, can significantly impact on quality of life and can continue to do so as the average lifespan increases. In developing countries there are several serious diseases that can cause severe pain for which there is often little or no pain relief available.

The IASP believes it is important to raise the profile of pain and promote the recognition of chronic pain as an important health concern. Few people die of pain, but many people die in pain and even more live in pain.

You can find more information at the IASP website. In your own area you may be able to contact a physiotherapist who could link you with a session(s)on chronic pain.

Post Noel Storm

As kayakers we spend a lot of time weather and wave watching. Tropical storm Noel looked like it's influence had the potential to reach Newfoundland. Indirectly it did. Mostly, residents and families who live near the coast are only to happy to be passed over by any storm, since in the past wharfs have proven difficult and costly to replace.

Early Sunday November 4 I was out to Outer Cove and Middle Cove assessing the waves and post storm serge as a result of tropical storm Noel.

Rain, fog and heavy winds were all present but wave action was minimal.

It appears from all the reports that the Nova Scotia coast and New Brunswick got the worst of the storm.

Photo contest submission

Recently I submitted this photo to the KNL photo contest. It was shot in Spaniard's Bay(Newfoundland) in early May. I recall leaving St.John's - it was cold, rainy, foggy and we almost turned around. But in this area it was a beautiful day and only the two of us kayaking at that time.

Check out the KNL website: www.kayakers.nf.ca
to view the photo of the month for October - a spectacular image taken by D McQuiod of Chris Buchanan going down a scary(to me) section of Little Harbour River.

Tennis elbow

From time to time I am asked to provide some assistance in dealing with the problem
commonly referred to as tennis elbow. Usually, the inquiries are from my baseball playing son after an intense game where he has taken on more of pitching job than his arm anticipated.


What is tennis elbow?

The official diagnosis is: lateral epicondylitis. These terms serve to identify the outside of the elbow as the region involved and inflammation of the common wrist extensors as the primary source of the problem. The condition is almost entirely an overuse syndrome. The onset with tennis players can usually be traced to a technique change or alteration in their backhand stroke, where intermediate players for one reason or the other "break the wrist" and repeatedly extend the wrist rather than keep the wrist straight and part of and extension of the arm and racquet.

For the rest of us - any repeated extension of the wrist may be enough to set off this condition. For example, hammering, computer work and with the recent election excessive hand shaking. The borrowed picture below, shows where the wrist extensors take their origin. When excessive tension is applied there can be quite a reaction at the bony attachment.

Some controversy exists regarding the pathology of tennis elbow. While largely thought as a musculotendionous disorder, the lateral elbow pain can arise from intra-articular, tenoperiosteal causes as well as from radio-humeral bursitis, radial nerve entrapment or in some cases be referred from the cervical spine.
















Common treatments:
1. as shown in photo below, some find using an epicondylitis clasp provides relief - much like grasping or holding the muscle to reduce it's pull on the bony attachment.
2. cryotherapy - ice to the region (with caution), usually an ice pack over a moist cloth for 8 minutes can be very effective.
3. stretch the wrist extensors gently(by bending the wrist) - hold for 20-30 seconds, repeat 4-5 times
4. strengthen the muscles - use a small weight(4-5 lbs). place wrist over knee and lower the weight slowly, use the other hand to bring the weight back to the start position. repeat 6-8 times 3 sets
5. ice again
6. modify what you do and how you do it.














For some, the use of acupuncture has been a great addition to the overall treatment -exercise and technique correction. Acupuncture as it relates to relevant anatomy of the region appears to have a sound rationale. The radial nerve is a continuation of the posterior cord of the brachial plexus and receives contributions from C5, C6, C7 and C8 nerve roots. On entering the forearm the radial nerve and it's divisions are in close contact with the radio-humeral joint.

The anatomy slide shows a point in the forearm, between the radius and ulna that stimulates the extensor muscles and the radial nerve. There are three points in the forearm that can be used for tennis elbow and three near the muscle attachment at the elbow.


































If you are a tennis player the force to serve or return a serve as a ground stroke, either forehand or backhand can be substantial - consider the following:
1. grip size - is it accurate for you? too little and too big can both promote excessive wrist extension.
2. head size - while oversized raquets are popular and can be very effective they may not be for everyone, especially since the added torque is significant if your shots are off centre.
3. tension on the strings - high tension can increase vibration and torque and these forces can be transmitted through the racquet to your arm.

Bay Bulls

Bread and Cheese Point





Pulpit Rock within Useless Bay



heading in around the sea stack Pulpit Rock






The Flats




Grass Cove











Bay Bulls is just a 30-40 minute drive from St.John's. Paddling here is an opportunity for a quick workout and a good opportuntity to see some nice coastal features.
There is a public wharf beside O'Brien Whale Tours.
Across the bay there is small beach where you could launch or at least land for a break if needed. This is home to the Gatherall's Tour group.
The north shore was where we wanted to go for some pictures, particularly of the Pulpit. The east coast trail meanders from the end of the paved road just past Bread and Cheese B&B, named for Bread and Cheese Cove - to the light house and beyond to the Spout.
The area here is quite well known as an early settlement dating back to the late 1700s. Useless Bay is the interesting and fairly accurate name given to a stretch of coast in this area. It seems this name was given out of a sense of frustration; apparently for the inhospitable natural design of the shore for the building of stages and wharfs. There are many descriptions of the area since small settlements were located between the lighthouse and the main community. It is worthwhile reading some of these as you paddle along or hike the equivalent on shore.
While hugging the shore it is sometimes difficult to paddle due to the sea state - a combination of swell, wind and wave action it gives a good glimpse of the landscape and an appreciation of how and what fishermen must have coped with years ago.
In the off season or when you can't get out in a kayak the Spout hike is worth the 6 -7 hours it takes. In 1794 it was described as one of the most singular natural curiositys in Newfoundland. Thanks to the work and preservation efforts of the East Coast Trail association it remains an amazing site.

Judo

Judo
Uploaded by ValeTudo

This is not what we do as beginners but this video highlights extremely well coordinated movements that come with practice, body awareness, core stability and control.

There are highlights from elite competition as well as the refined practice called Kata.

To run click the highlighted word Judo, to enlarge click zoom.

Ferryland

A group of paddlers waiting to go around Spurwink Island in Aquaforte.



One of many keyhole entries along the shore in Aquaforte.





The top of Aquaforte - exit of the river and near the beginning of the East Coast trail in this area.




Stored crab pots on the wharf in Ferryland. A view from the water.





Paddling in Ferryland, launch from the small park by the archaelogical dig.








Lighthouse on the headland of Ferryland
















Back at the park and site of the dig.










Ferryland is a fantastic spot to spend some time on or near the water. We started with a hike around Aquaforte. A favourite paddle at the end of the season for the club but a frequent destination throughout the year for paddlers. Once you exit Aquaforte paddling to Ferryland is quite easily managed - but the swell may not be for everyone, especially heading around the lighthouse. It is a spectacular view which I have paddled, but not today.

Today, the goal was to hike to the lighthouse and have a picnic courtesy of Lighthouse Picnics. See:http://www.lighthousepicnics.ca/
This was a perfect day to soak up the sun, have a gourmet picnic and by chance watch four humpbacks just off the coast.

We finished the day by kayaking around Ferryland. After packing and loading up the gear we dropped into the Ferryland Cafe for a coffee and chat with Rhonda and managed to get an invite for the Christmas Eve coffee and drop in.

Core strengthening

Prevention and rehabilitation of the spine by physiotherapists has for years focused on strengthening of the abdominals and back muscles. In addition, it made sense to strengthen hip, lower leg and shoulder muscles so that secondary stress wasn't transferred to pressure sensitive more inert structures in the spine.

The biggest myth, with all the new marketing and promotion, is that core training or core strengthening is just about the abdominals. Not true. Many injuries can be caused by hip tightness and resultant muscle imbalance in the hip and pelvis region. And since functionally we don't just isolate one group of muscles in an activity, it is not a good training strategy to minimize the lower extremity workout.


For kayakers a reasonable training circuit in addition to paddling might include:
1. aerobic training - 30-40 minutes/day of walking/jogging , biking, swimming or elliptical trainer

2. stretching - forward, backward lateral lunges, hamstring stretches(the yoga sun salutation is a good series of stretches that may be a good basic foundation)

3. strengthening - transversus abdominal tightening(key to many standing and stabilizing movements), plank position from yoga, side bridge, pushup, bridge, on floor mini crunch, mini squats, physio ball exercises - crunch pushup, seated on ball arm curls, shoulder/hip exercises using theraband.


For core stability a key concept in almost every movement is that you contract isolate the lower abdominals making sure you can activate the transverse abdominal muscle that crosses like a wide belt from one side of the pelvis to the other.


Cueing this muscle to work is best achieved by lying on your back:














If lying on the floor/mat: think of bringing the belly button straight down by tightening the lower abdominals(the horizontal band going from one side of the pelvis to the other). Hold and breathe. After several attempts move on to using light weights and curling the arms while tightening. Another option is lift one knee up towards your chest all the time activating this muscle group or slowly lower(straighten) one leg to the floor.














Provided you contract the tranversus(TrA) abd muscle at the same time use a ball as a bit of a challenge. Keep the hips and knee slightly flexed to minimize risk to the lumbar spine. We introduce this concept in judo classes by having the kids pass the ball using their feet to hold onto the ball. A simple and functional way of activating the stabilizers in preparation for snowboarding, martial arts and kayaking.




















You can use the ball if this is comfortable or lie on the floor with the knees bent. Keep the head and neck in neutral.















Progressions include: rolling side to side, roll to the side, stabilize while lifting 1 arm, alternate lifting of 2 arms, lift/extend one leg.
















In kayaking the obliques factor into the stroke as well as the hip extensors, hip abductors and adductors - so doing training on the ball, is a very useful and effective means of promoting the strength in these muscles.

There are numerous strategies - these days a dizzying array of options. You can keep it simple though. For conditioning, walk, run or swim. Work yourself up to the amount of time that is comfortable for you. There is a range of arm and leg exercises you can use including yoga moves and or taichi martial arts movements or you can hit the weights. Weight training with free weights and theraband is a bit different from the stationary machines we see in the gyms today. They are convenient but a few are not designed for the average user. More on specific exercises later.

Gull Island, Witless Bay

Today we headed out of Witless Bay beach to Gull Island looking for whales. We had heard a number of whales had come into Witless Bay on the hunt for the last of the capelin. It seemed a worthwhile venture heading out to see if we could get a couple of photos. Launching from the beach and exiting out from under the bridge was a bit tricky as the swell resulted in quite a breaking surf, squeezed into a fairly narrow entry way.

There were no whales today but the bird show made up for the absence of the whales.

The paddle out to Gull Island is fairly quick - we enjoyed a well spaced but hefty swell. Amongst the rolling waves were scattered groups of puffins who seem to take turns heading back to guard their nests from predatory gulls. At one point their postures almost reminded me of mini penguins. Another photo at a low point on the cliff appeared to capture a Northern Fulmar.

We got close to the island but didn't attempt to land as that might be too disturbing for the birds and is not permitted as the island is a bird sanctuary.

Puffins were constantly taking off from the water often appearing too full from feeding, to take off very far off the surface.

On the return, the long cumulative waves provided a bit of an opportunity to practice for bracing skills.

Trinity Bay

At this time of year Trinity draws lots of folks to the community to see all the talented atrists and actors/actresses. A number of us attended a great pageant presentation this year and stayed at the Peace Cove Inn in Trinity East.

The other great local experience is the Skurwink Hiking Trail. Just a short walk from the Inn and a beautiful coastal trail - eagles are often seen perched in the tall trees. The beaches viewed from the trail can be accessed by kayaking around the headland.

If the winds are up, stick to the inside of Trinity Bay and explore the rock outcroppings and putter among the sea stacks. Trinity East is an easy paddle from Trinity and just around the corner is a large mussel farm located in God's Cove - where else would you farm for mussels?

Darren and Jill run Trinity Sea Kayaking.They launch their excursions from the public beach near the Dock Marina, just a stone's throw from the laundry scene in the pageant. If you want to join in a professional safe tour - give them a call. On Thursday I joined them for their morning run and everyone thoroughly enjoyed themselves - what better way to prepare for a business meeting the next day, than run out to Trinity and paddle the bay? On the return to the beach we ran into a swarm of moon jellyfish - a rather incredible, almost unnerving site to paddle through thousands of these creatures.

Conception Bay Workout

The other night we attempted to launch from Outer Cove and Middle Cove - the fog was so dense we couldn't see beyond twenty feet from of shore. The likelihood that the fog would lift here was limited so we changed plans and drove to St.Philips where a large bank of fog was slowly receding.
The water was oddly flat calm and we moved on quickly to Topsail Beach noticing an osprey as it scanned the water looking for small ocean perch or other dinner items.
The oil rig in the distance was in the process of being serviced by supply ships otherwise we could have easily made a run over.

Night paddle

On Saturday evening 20 of us gathered at the public wharf in Avondale for a night paddle under the leadership of Alex. Aside from all the usual gear,kayakers packed or wore a headlamp or waterproof flashlight and used glow stick on the stern. We only used the headlamps when boaters came close. As a result everyone's night vision quickly heightened. The big draw at this time of year was the phenomenom commonly seen in ocean waters at night called bioluminescence. We weren't disappointed. How Alex got all these sea creatures to cooperate we never found out. But at various times along the coast when we dipped our paddles deep we stirred up quite a brilliant display. Occasionally what appeared to be solid fistfuls were caught up in the wake of the paddle stroke from the kayak ahead.

Apparently bioluminescence is the result of a chemical reaction between a protein (luciferin) and an enzyme (luciferase) in the presence of oxygen. Most lightsources radiate heat, but not in sea creatures. One reference describes this phenomenom as 'cold fire'.The production occurs in photogenic cells called photophores.

As we paddled around we discussed what creatures had this ability - it turns out there are a number of sea animals capable of this feat ranging from one celled animals like planktons, dinoflgellates to jellyfish, squid and bacteria < 1 mm in length.

There may be a number of reasons for this occurrence, including environmental.Some species utilize bioluminescence to facilitate finding potential mates.It seems many creatures increase the frequency and intensity of bioluminescent displays during their mating period.

We spent a good bit of time investigating one of the whaling shipwrecks in Conception Hr, one protrudes well beyond the surface the other can be seen below the surface of the water with a strong waterproof flashlight.

On the return trip back we took a break and made a great landing in a small cove and beach - no small feat with only glow sticks and a couple of headlamps.