9 Steps to a Restful & Restorative Sleep

Sleep is supposed to be easy. We literally have to do nothing but lie down and close our eyes and yet 20-40% of people will experience insomnia this year. Lack of sleep increases the likelihood of chronic diseases including hypertension, diabetes, depression, cancer and obesity, as well as increasing mortality, and reducing quality of life and productivity. For athletes and those who exercise, sleep is vital for recovery. Without enough quality sleep, all the effort in the gym, money spent on supplements and time spent weighing chicken breasts is wasted. Sleep is something we’ve been doing our whole lives, it comes naturally to us and, therefore, most have never been taught “how” to sleep. Sleep hygiene is a term used to describe habits and practices that are conducive to sleeping well on a regular basis. I’ve organized a plethora of sleep hygiene topics into 9 general categories you can incorporate into your daily routines to foster a good night’s sleep. Sweet Dreams.

1. Make it a Routine

We are creatures of habit. Inconsistency can wreak havoc on our health when it comes to how and when we prepare for sleep. Our circadian rhythm, an internal clock that determines our sleeping pattern, is governed by a number of different hormones that can be influenced by our actions during the day. By hitting the sack and waking up at a consistent time each day, our body is able to regulate these hormones and prepare our body more efficiently for a good night’s sleep. Had a late night? It’s better long-term to wake up at your regular time and make up for it the following night.

In addition to sleep and wake times, our circadian rhythm and its associated hormones are also sensitive to our activities leading up to sleep. Simple routines like brushing our teeth or having a bath can tell our bodies to start preparing for sleep when consistently done before bed. As well, the rise and fall of temperature with bathing encourages the natural temperature drop we experience when sleeping. To take further advantage of our body’s affinity for habits and ease the transition from wake time to sleeping, we can start practising a regular relaxing bedtime ritual such as breathing exercising, mindfulness or meditation. These can help bring down our sympathic tone(the “fight or flight” excitatory division of our autonomic nervous system) and limit the secretion of the stress hormone cortisol, which increases alertness. If you tend to have an active mind and take your problems to bed, try writing them down and leaving them in another room before you start your nightly winding down routine.

2. Use Light to Your Advantage

Our circadian rhythm and the hormones that govern it are extremely sensitive to light exposure in ways that can affect our sleep both positively and negatively. Increasing light exposure during the day helps our body regulate the natural balance of hormones like melatonin, cortisol and adenosine. By taking breaks from life indoors to venture out into the sun, we encourage the natural rise and fall of these hormones to promote peaks at the most opportune times.

Inversely, too much artificial light in the evenings and bright phone and computer use before bed can negatively affect the same delicate hormone ratios. This tricks our body’s into thinking it’s still time to be awake and ready for action. Studies have found that the bright blue tones in our phones and computers have the most negative effect on our melatonin and cortisol levels by stimulating our pituitary gland (the connection between our nervous and endocrine systems that governs many of our hormones) into a more excited state. Avoiding screen use 30 minutes before bed is your best option to boost natural melatonin (a sleep promoting hormone) levels. If you have no other choice than to set your phone alarm or check your e-mail immediately before your head hits the pillow, then try an app like “Twilight” that significantly dims the screen and also shifts the screen color to the red end of the spectrum to limit the impact on the pituitary gland.

Hamster in bedFUN FACT: An Ohio State University study using hamsters found that four weeks of exposure to artificial light—the kind that stems from smartphones, laptops, tablets, and television screens—left the critters more lethargic and depressed than those that slept in total darkness.

3. Get Out of Bed

Bear with me. We can foster our sleep routine by avoiding spending time on the bed or in the bedroom for reasons other than sleep and intimate activities. Netflix binges and last minute work proposals should all be done outside of the bedroom. Keeping TV’s, computers and work materials out of the room will help strengthen the mental association between your bedroom and sleep and not other activities. By developing the bedroom into a fortress of solitude for sleep we can program our bodies to start preparing for bed just by walking into the bedroom.

Another time to avoid the bed is when you’ve woken up in the middle of the night with a racing mind and are having trouble falling back to sleep. It may sound counterintuitive, but the pressure and concentration we use to force ourselves back to sleep may actually be keeping us awake. If after 20 minutes you’re not asleep, get out of bed, go to another room, and do something relaxing until you are tired enough to sleep. Make sure not to turn on any bright lights, the TV or computers during these times Read by candlelight, grab a glass of water, listen to relaxing music or just sit in a chair in the middle of a dark room like a horror movie villain. Whatever you choose to do, just get out of bed so your body doesn’t associate worrying and being stressed out with being in bed. Do your mind racing elsewhere until you are sleepy, then return to bed. It’s ok for this to happen multiple times during the night, don’t stress about it and try to maintain your regular wake time.

No napping either. Sorry. Many people struggling with sleep quality take naps in an attempt to make up for lost sleep. Although short naps have been shown to boost awareness throughout the day, prolonged afternoon naps may be one of the culprits for those having difficulty falling asleep or staying asleep at night. Because late-day naps decrease sleep drive, it’s better to keep them shorter than 45 minutes and before 5 p.m.

4. Environment is Key

Your bedroom should be as cool, dark and quiet as possible. A well ventilated room between 60 and 75°F is ideal to encourage the natural fall in body temperature we experience each night. Too hot or too cold and our bodies will take action to get more comfortable, which will probably involve waking you up.

Silence is best, but when it comes to sleeping, “quiet” can be relative. An ideal auditory environment isn’t so much perfectly quiet as it is consistent without loud spikes of noise to wake us up during the night. If you live in a busy city or close to potential noise generators it can be difficult to limit the outside noise completely. But, we can decrease the relative volume of outside noise by creating constant low-level noise with a fan or a “white noise” appliance.

5. Embrace the Darkness Within You(r Bedroom)

dark roomAs soothing as a nightlight may be if you’re 4 years old, all light sources can act as a powerful signal telling our brain that it’s time to wake up. Melatonin (our sleep hormone) levels can be significantly decreased by any artificial light sources throughout the night. Using heavy curtains, blackout shades, or, as a last resort, an eye mask to block light ensures our sensitive nervous and hormonal systems aren’t getting confused as we slumber. Additionally, turn the clock face away and do not check the time or your phone if woken up at night.

ASIDE: Pets – studies have shown benefits of sleeping with pets, however, an active pet chasing squirrels in their sleep can interrupt your sleep cycle. Try sleeping without Fluffy for a couple nights and you both may get a better sleep.

6. Lifestyle

There are many lifestyle factors that can affect the quantity and quality of our sleep but we’ll keep it simple:

  • Exercise – minimum 30 minutes a day to build up adenosine (another sleepy hormone) but not too close to bedtime to control cortisol levels, keep body temperature low and avoid putting ourselves into an excited state. Try to finish exercising at least three hours before bed or work out earlier in the day.
  • Avoid alcohol – although it has the ability to make you pass out(not a recommended sleep aid), the metabolism of alcohol actually decreases the efficiency of our sleep and interrupts our circadian rhythm
  • Avoid nicotine, heavy meals and excessive fluid intake after dinner – too much metabolic activity can rattle our cages and actually limit how restorative our sleep is.
  • Avoid caffeine after lunch – although helpful during the day to boost your metabolic rate and improve alertness, consuming it too late in the day can keep you revved up well past bedtime. Don’t forget tea, chocolate, cola, and some pain relievers can all be significant sources of caffeine, it’s not just the coffee keeping you wired!

7. Pillow talk

PillowsChoosing a pillow involves the consideration of a combination of factors including slеер posture (ѕіdе, ѕtоmасh, back etc.), age аnd body composition, hеаlth оf your musculoskeletal system, personal рrеfеrеnсеѕ (mаtеrіаl, comfort and style), and budget. Selecting the right pillow should be a trial and error process, testing variations of different factors in store or on lease from family or friends until you find the perfect fit.
In general, softer more malleable pillows or memory foams tend to be better for healthy adults. While a gооd соntоur ріllоw , ѕhареd tо еnѕurе neutral ѕріnаl аlіgnmеnt and hеlр relax muѕсlеѕ, may provide relief for those with neck or back pain. No two people are the same and the best way to find your perfect fit is to get out there and try as many different types as you can. The goal is to have your head and neck in a neutral position with weight еvеnlу dіѕtrіbutеd thrоughоut thе еntіrе ѕurfаce area avoiding pressure points or unsupported segments. Also consider using pillows in positions other than under the head and neck. A soft pillow between the knees in a side posture can help support the hips and pelvis, while a more firm pillow placed under the knees in a supine position can help take pressure off of the lower back.

8. You Sleep in the bed You’ve Made

Buying a new mattress can be compared to buying a new car. There are many different options with hundreds of factors to consider, you will be using it everyday and you will be spending a significant amount of your hard-earned money on it. Most people shop around for their vehicles and yet many don’t put the same effort into choosing their new mattress and often base their decision on price alone. Considering you will be spending one third of your life in it, I’d suggest giving your next purchase some serious thought. So when is it time to get a new mattress?

Experts suggest investing in a new mattress every 8-10 years. But a change may be needed sooner if signs of wear appear such as sagging in the middle, changes in density, musty odours that won’t wash out, or excessive noise production. After making the decision to buy a new mattress, its then time to find the perfect one. There are no stead-fast rules when it comes to selecting a mattress. General concepts can be applied such as even distribution of weight, appropriate spinal support and vibration and noise reduction, but inevitably it comes down to personal comfort preference. Similar to purchasing a pillow, there are hundreds of options and you’ll want to test out as many beds as possible. Don’t just test the firm ones or the soft ones because that’s what you’ve always gone with. As we age our body’s change and may require a different type of support as the years go by.

Attempt to test out the beds you are seriously considering for at least 15 minutes. Yes, lie on the bed, in the store, in front of strangers for 15 minutes. The sales-person will be very understanding and you’d be surprised how different a mattress can feel after a quarter of a hour. Finally, try not to mix and match mattress and boxsprings from different sets. Box springs are designed to support a specific mattress type and weight. Having an overwhelmed boxspring can result in a sagging or contorted mattress, resulting in a sagging or contorted you.

9. Last resort

sleeping pillsIf all other sleep hygiene modifications haven’t made a significant difference, consider using a natural sleep enhancing supplement like melatonin, California Poppy extract, Lemonbalm or 5HTP before resorting to
more powerful prescribed medication. Ambien, Lunesta, and other doctor-prescribed medications are highly effective sleep inducers, but they can also be habit-forming and come with a number of potentially dangerous side effects. Others, like Unisom, containing the sedating antihistamine doxylamine can help short-term, but can also cause fogginess during the day. Taking a more natural and less harmful option such as melatonin has been shown to help induce sleep and regulate circadian rhythm if the conditions are optimal, meaning, if all other factors of sleep hygiene are accounted for.

So there you have it! Thanks for investing in your health by reading and hopefully taking some steps to getting a more restorative sleep. Some of these practices and tips will be easier to include in your daily and nightly routine than others, but, if you give them a chance, the odds of achieving restful sleep will improve. Remember the most important factor or sleep is routine, so stick to it and reap the benefits.

When applying these tips it may also be helpful to consider recent studies showing that, individually, each specific component of sleep hygiene is related to sleep, however, addressing multiple individual components at once does not seem to make the same kind of significant difference. Therefore, it may be more beneficial to make changes one by one, incorporating a new component each week instead of all of them at once. Sleep is all about routine and by changing too much too quickly, we may be hindering the very thing we are trying to promote.

Finally, as much as these tips have the potential to help, remember, not all sleep dysfunctions can be improved with sleep hygiene alone. Significant sleep disorders such as sleep apnea, restless leg syndrome, clinical insomnia or narcolepsy are always a possibility and if sleep doesn’t improve through good sleep hygiene alone, you may want to consult your physician.

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Whiplash Causes & Syptoms

Whiplash is an acceleration-deceleration mechanism of energy transfer to the neck. It is caused by an atypical movement or force applied to the neck resulting in movement beyond the neck’s normal limit. It may result from motor vehicle accidents, sporting activities, accidental falls, repetitive stress injuries involving the neck, and assault. The impact may result in bony or soft tissue injuries, specifically to the ligaments, tendons, and muscles, which in turn may lead to a variety of clinical manifestations.

Signs and Symptoms

Whiplash, also called cervical sprain, cervical strain, or hyperextension injury, is characterized by a collection of symptoms that occur following damage to the neck.

Symptoms of whiplash may not present for 24 hours or more after the initial trauma. The most common symptom after a whiplash injury is neck pain or stiffness. People who experience whiplash may develop one or more of the following symptoms, usually within the first few days after the injury.

Hyperextension and Hyperflexion Whiplash

  • Neck pain and stiffness
  • Headaches
  • Dizziness
  • Pain in the arms, shoulders or between the shoulder blades
  • Low back pain
  • Altered sensation such as pins and needles or numbness
  • Weakness
  • Ringing in the ears or blurred vision
  • Difficulty swallowing
  • Difficulty concentrating or remembering
  • Irritability, sleep disturbances, fatigue
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Vancouver Sun Run, 10 Tips for Your Best 10k

The annual 10km Vancouver Sun Run is set for April 17th and thousands of runners will embrace the streets of downtown. The Sun Run is Canada’s largest 10km race. The beautiful scenery, well organized course and entertainment throughout are just one of the many reasons for its major success.  To ensure your personal success, whether it is your first time or your tenth time, check out the following tips.

  1. Train for the run! Many have ran a few kilometers, 5km or even a 10km in the past, but that doesn’t mean you are ready for the Sun Run. You should be training for the run at least 8-10 weeks in advance.
  2. Have a training partner. It makes it a lot easier to get out for a long training run if you have someone to go with you. If you don’t have a training partner, try to join a run group. Often shoe stores, gyms or independent trainers will host running clinics.
  3. Stretching. It is really important to keep your muscles limber throughout your training to prevent cramping and scar tissue build up. Never stretch cold muscles, so remember to do dynamic stretching before your runs and static stretches after your runs. (Dynamic means you are moving while you stretch and static means you hold the stretch for 30-45 seconds.)
  4. Foam Roll. Find a foam roller that you like (usually $25-50) and use this either before you run, after you run or ideally both. Foam rolling is very efficient for decreasing scar tissue build up and helps to maintain the elasticity of your muscles.
  5. Therapy. Some examples of what runners can benefit from at Alliance Wellness Clinic include: Deep tissue massage with a registered massage therapist, Active Release Technique/spinal adjustments from a chiropractor, muscle imbalance rehab on the RedCord/IMS from physiotherapist, supplement management from a naturopath, and overall health management with acupuncture, osteopathy and counseling.
  6. Hydrate. It is imperative to be well hydrated for all training runs and even more so for race day. Take advantage of the water stations and have some water along the course.
  7. Caffeinate. Consider a pre-workout or caffeinated beverage before your runs to give you a little extra energy. Remember that caffeine can be dehydrating, so drink more water. It would not be advisable to caffeinate before race day, if you haven’t in any previous training runs.
  8. Carbohydrate Loading. It is not essential to carb load the days leading up to or the night before the Sun Run. This is more important when training for longer runs such as a full marathon. Eat your normal meals, with a healthy balance of carbohydrates, proteins and fats.
  9. Keep Moving. During the Sun Run, you may experience some pain in your legs. This is completely normal and is just a build up of lactic acid. After you cross the finish line, it is a really good idea to continue walking for 15-20 minutes to help keep the blood flowing and speed your recovery.
  10. Ice. When you get home after the run, take a cold shower or sit in a tub with a few bags of ice for 10-15 minutes. This will really help with inflammation, pain and accelerate your healing and prevent delayed onset muscle soreness.

These are just a few tips to help make your Sun Run more comfortable and most importantly more fun! Good luck!

Vancouver Sun Run 2016 Race Details

Date: Sunday, April 17th

Start Times (PST):

  • Competitive wheelchairs: 8:40 a.m. Burrard & Georgia
  • Vancouver Sun Run (10K): 9:00 a.m. Burrard & Georgia
  • Shaw Mini Sun Run (2.5K): 8:00 a.m. @ Pacific Blvd (BC Place Stadium)

Download Sun Run 10K Course Map

For more information, check out:

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Preventing and Treating Spring Allergies

Spring brings warmer weather but for some people seasonal allergies as well.

One in six Canadians suffers from seasonal allergies. Allergy season can start in spring and last till late autumn depending on what people are allergic to. The symptoms of seasonal allergies are: itchy, watery eyes, runny nose, itchy throat and ears, sneezing and congestion. This differs from old or flu that tends to last less than 2 weeks and can have a fever and muscle aches.

There are many ways to treat and help prevent seasonal allergies:

  • Pollen counts are highest between 5-10 AM and on dry, hot and windy days. Try to limit time outside during these times.
  • Keep house and car windows closed.
  • Wear a hat and large sunglasses while outside to prevent pollen from getting stuck on hair and in your eyes. Hair gel makes more pollen stick to hair and if not rinsed off can end up on your pillow. Brush off your hat before coming inside and rinse glasses off after use.
  • Shower and change/wash your clothes after coming in from outside to avoid spreading pollen through your home and onto your bed.
  • Nasal irrigation with a sinus rinse or neti pot to clear nasal passages of pollen and other allergens when you come inside for the day.
  • Line your mattress and pillows with dust mite covers as the bed contains the highest concentration of mite allergens.

These are all ways to prevent pollen from triggering an allergic reaction. Naturopathic medicine works on regulating your immune system so that it doesn’t form an allergic response to something the body normally would not react to in an allergic manner.

Diet and intestinal integrity play a huge role in allergy control, the immune system and inflammation. Food sensitivity testing can test your blood for antibodies that your body produces towards foods. This test will determine how your diet affects your immune system and thus your antibody and histamine production. If you also have the symptoms of gas and bloating than fixing your “leaky gut”, can be a factor in your allergies. There are many herbal or nutritional treatments that can be tailored for your individual allergy and health concerns.

Please consult Dr. Seto, ND for a personalized health and allergy treatment plan.

Dr. Stella Seto, ND is a licensed naturopathic physician with a special interest in clinical nutrition/food sensitivities, sports and pain management and hormone balance.

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Shin Splints Symptoms & Treatment

What are Shin Splints

Shin Splints is an overuse condition commonly caused by running and other weight-bearing activities. There are two varieties of shin splints, posterior and anterior. This condition is caused when the tibialis anterior muscle or tibialis posterior muscle respectively become tight and pull on the connective tissue (Periosteum) lining the tibia or shin bone. This tension creates a painful inflammation along the shin between the knee and ankle that is made worse with activity and contraction of the involved muscles.

What Causes Shin Splints

When someone over-pronates or pronates too rapidly, either or both of these muscles may be called upon to work harder than normal. As a result, fatigue sets in, leading to inefficient force production which leads to micro-tearing of the soft tissue and therefore an inflammatory reaction.

What are Shin Splints Signs and Symptoms

  • Tenderness over the inside shin area (may start as a dull ache and progress to a sharp pain)
  • Pain starts with activity and then seems to disappear, but may return at the end of activity, as shin splints get worse the pain may last longer
  • May see lower leg redness (rubor)
  • Lower leg swelling
  • May feel a lump or bump on the lower leg
  • Pain with toes or ankle pointed downwards

Risk Factors

  • Running on uneven surfaces
  • Running downhill
  • Resuming activity (exercise) after a period of no or reduced activity
  • Weak muscles in the front of the leg (stronger muscles in the back of your leg)
  • Over-pronation (when your foot rolls to the inside and your arch flattens)
  • Wearing inappropriate shoes (worn-out or incorrect for your foot type)
  • Training too hard too soon (not increasing your activity gradually), because muscles that fatigue
  • quickly lose their ability to absorb shock and therefore more stress is placed on the bones


First, rest and ice to decrease damage being done and inflammation. Following the acute phase, orthotics are prescribed to reduce the over-pronation and help take the load of the muscles that will be over-worked if the pronation is not controlled.

Not sure which professional to see or which treatment will be best for you? Call 604-737-1177 to schedule your free consultation or book online

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Knee pain

Knee pain can have a variety of causes and presentations. Here is a list of common causes of knee pain including a description, common causes and risk factors.

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS), is caused by chronically tight and overused muscles in the thigh pulling on the knee cap. This condition caused when a tight and inelastic IT Band (the connective tissue band that runs down the outside aspect of the thigh from the hip to just below the lateral knee) and the lateral quadricep muscle (vastus lateralis) pull on the outside aspect of the knee where it attaches to the bone and knee cap (Patella). In general patellofemoral pain syndrome occurs when the patella does not move or ‘track’ in a correct fashion when the knee is being bent and straightened. This movement can lead to damage of the surrounding tissues, such as the cartilage on the underside of the patella itself, which can lead to pain in the region. Pain is increased with activity and deep knee bending on the affected side.

PFPS is often confused with another condition known as Chondromalacia Patella. This is damage to the cartilage which lines the underside of the knee cap. CMP can be a result of PFPS, although it can also occur independently, usually due to damage from an impact.

Patellofemoral Pain Syndrome


  • Aching pain in the knee joint, particularly at the front, around and under the patella.
  • Tenderness along the border of the kneecap.
  • Swelling sometimes occurs after activity.
  • Pain is often worst when walking up or down hills or stairs.
  • A clicking or cracking sound may be present on bending the knee.
  • Sitting for long periods may be uncomfortable.
  • Wasting (atrophy) of the quadriceps muscles in prolonged cases.
  • Tight muscles including calf muscles, hamstrings, quadriceps (especially vastus lateralis on the outside) and iliotibial band.

Risk Factors/Contributing Factors

  • Lack of proper stretching pre/post exercise
  • Weak medial thigh muscles (vastus medialis and adductors)
  • Long-distance running
  • Running uphill
  • History of a previous knee dislocation
  • Overloading – Bending the knee increases the pressure between the patella and the femur. Thus sports such as running, where repeated weight-bearing occurs, may result in PFPS.
  • Over pronation- Pronating sometimes exhibited as ‘flat’ feet lead to an increased biomechanical stress on the knee joint. This may affect the alignment of the patella particularly during movement.
  • Q-angle – Some people have a larger than normal femoral angle (known as the Q-angle) resulting in a ‘knock-kneed’ appearance (genu valgum). When the person straightens their leg when weight bearing, the patella will be forced to the outside of the knee. With repeated bending and loading, this motion may lead to damage of the underlying structures and cause pain. A larger Q angle is common in women due to their wider pelvis. This is why more women suffer with this condition than men. Strengthening the abductors (Gluteus Medius, Minimus and Tensor Fasciae Latae) and lateral rotators (Gluteus Medius and Maximus) of the hip can be beneficial when a wide Q angle is thought to be a contributing factor.


The knee and ankle are common locations for sprain and strain injuries. These types of injuries are often seen in sports such as football, hockey and soccer. They are also common in slips/trips when out walking and running. A sprain is damage to a ligament that supports a joint. These include the medial and lateral collateral ligaments (MCL/LCL) and the anterior and posterior cruciate ligaments (ACL/PCL) in the knee. In the ankle, the most commonly injured ligaments are on the outside aspect of the ankle and includes the anterior talofibular ligament, calcaneofibular ligament, talocalcaneal ligament, posterior talocalcaneal ligament and the posterior talofibular ligament. A strain, on the other hand, is a damage to a muscle in the affected area. Both strains and sprains can range from mild tearing to complete rupture and often need to be differentiated from a fracture by a healthcare provider due to trouble weight bearing, excessive swelling and bruising to the area.


Knee Sprain

  • Swelling ranging from mild and localized to severe with a larger area affected
  • Possible bruising also ranging in severity
  • Pain with active motion
  • Pain with passive motion
  • Pain with walking and weight-bearing
  • Sense of instability or “giving out”


  • Blunt trauma to the area (ie tackle, impact)
  • Tripping or stumbling
  • Falling
  • A quick pivot and change of direction in sport
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Piriformis Syndrome

The Piriformis muscle is a small muscle (3-5cm) located in your buttock. It runs from the bottom of the spine to the top of the hip. Its function is to help the leg rotate outwards.

Piriformis syndrome occurs when the piriformis muscle becomes tight, usually from overuse. Other problems, such as a burning sensation down the back of the leg, may occur when this tight muscle compresses the sciatic nerve which may run above, below or right through the piriformis muscle.

Signs and Symptoms

Piriformis Syndrome

  • Sitting tolerance is limited to 15-20 mins before onset of pain
  • Pain, numbness or tingling down the back of the leg
  • Tender area in the buttock region
  • Difficulty walking due to pain


Risk Factors

  • Trauma, Muscle spasm or muscle imbalance
  • Overuse
  • Improper sitting posture or abnormal walking patter

If you are experiencing the symptoms of Piriformis Syndrome, Call 604-737-1177 to schedule a free consultation or book online

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Carpal Tunnel Syndrome

Carpal tunnel syndrome is pressure on the median nerve – the nerve in the wrist that supplies feeling and movement to parts of the hand. It can lead to numbness, tingling, weakness, or muscle damage in the hand and fingers.


The median nerve provides feeling and movement to the “thumb side” of the hand (the palm, thumb, index finger, middle finger, and thumb side of the ring finger).

The area in your wrist where the nerve enters the hand is called the carpal tunnel. This tunnel is normally narrow, so any swelling can pinch the nerve and cause pain, numbness, tingling or weakness. This is called carpal tunnel syndrome.
Carpal tunnel syndrome is common in people who perform repetitive motions of the hand and wrist. Typing on a computer keyboard is probably the most common cause of carpal tunnel. Other causes include:

  • Sewing
  • Driving
  • Assembly line work
  • Painting
  • Writing
  • Use of tools (especially hand tools or tools that vibrate)
  • Sports such as racquetball or handball
  • Playing some musical instruments


  • Numbness or tingling of the palm of the hand
  • Numbness or tingling in the thumb and next two or three fingers of one or both hands
  • Pain extending to the elbow
  • Pain in wrist or hand in one or both hands
  • Problems with fine finger movements (coordination) in one or both hands
  • Wasting away of the muscle under the thumb (in advanced or long-term cases)
  • Weak grip or difficulty carrying bags (a common complaint)
  • Weakness in one or both hands

At Alliance Wellness, we will help you manage pain associated with Carpal Tunnel Syndrome and increase your ranges of motions. Call 604-737-1177 to book your free consultation.

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Iliotibial Band (IT Band) Syndrome

Iliotibial band syndrome is a common conditions which usually presents as pain on the outer side of the knee. The IT Band is a thick band of connective tissue that crosses the hip joint and extends down the outer thigh and attaches just below outer side of the knee. IT Band syndrome is caused by excessive friction at the distal portion of the IT Band as it rubs over the outside portion of the knee. This is most common in runners and cyclist, but also other sports that involve repetitive knee bending because it leads to inflammation in this area.

Signs and Symptoms

Iliotibial band syndrome

  • Sharp or burning pain at the outside of the knee
  • Swelling or thickening of tissues in this area. Snapping or popping sound when bending the knee
  • Pain during or after activity, that is aggravated by running downhill and by prolonged sitting with knee bent


Risk Factors

  • Tight IT Band, Hip muscle weakness or imbalance
  • Very prominent lateral femoral epicondyle (bony structure on the outside of the knee)
  • Sports with repetitive knee bending, such as running and cycling, running up and down hills
  • Recent increase in track or interval training, Crowned running surfaces
  • Internal rotation of legs, Bowlegs

At Alliance Wellness, we will help you manage pain associated with Iliotibial band syndrome and increase your ranges of motions. Call 604-737-1177 to book your free consultation.

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Benign positional vertigo is a condition in which a person develops a sudden sensation of spinning, usually when moving the head. It is the most common cause of vertigo.

Causes, and risk factors

Benign positional vertigo is due to a disturbance within the inner ear. The inner ear has fluid-filled tubes called semicircular canals. The canals are very sensitive to movement of the fluid, which occurs as you change position. The fluid movement allows your brain to interpret your body’s position and maintain your balance.

Benign positional vertigo develops when a small piece of bone-like calcium breaks free and floats within the tube of the inner ear. This sends the brain confusing messages about your body’s position.

There are no major risk factors. However, the condition may partly run in families. A prior head injury (even a slight bump to the head) or an inner ear infection called labyrinthitis may make some people more likely to develop the condition.


People with this condition feel as though they are spinning or moving, or that the world is spinning around them. They may experience:

  • Nausea, vomiting, hearing loss, and a loss of balance
  • Vision problems, such as a feeling that things are jumping or moving

The spinning sensation:

  • Is usually triggered by moving the head
  • Often starts suddenly
  • Lasts a few seconds to minutes

Most often, patients say the spinning feeling is triggered when they roll over in bed or tilt their head up to look at something.

Our doctors will help to diagnose if this is the cause of your symptoms and rule out other possible causes including ear infections and other inner ear disorders. Treatment consists of a maneuver designed to reposition the calcium deposits thus eliminating the vertigo sensation.

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