Shoulder Injuries in Tennis Players

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by Lisa Smuskowitz, Registered Physiotherapist

Overview: Shoulder injuries are repeatedly seen to impact the careers of tennis players at all levels of play. The shoulder complex comprises 4 different joints, each contributing to the great amount of mobility and stability seen during complex shoulder movements. When this delicate equilibrium between mobility and stability is compromised, the shoulder is vulnerable to injury.

Why is the shoulder so vulnerable to injury?

Large forces go through the shoulder joint during the tennis serve as energy is transferred from the ground up: ground reaction forces → legs/hips/trunk → shoulder/upper arm

*a break in a link in a proximal segment will create larger demand on the next segments, like the shoulder


What provides stability and mobility in your shoulder during movement?

Shoulder Mobility Shoulder Stability
Shoulder blade control is vital during the serving motion as it (1) provides a stable base for the arm, (2) rotates upwards to get it out of the way from the arm, (3) moves around the rib cage, and (4) provides a stable base for muscles in the shoulder and upper back Static stability: provided by your bones, ligaments (at end of range of motion), and joint capsuleDynamic stability: provided by your muscles (at the beginning of the cocking phase of the serve)

Milos Raonic

When is the shoulder vulnerable to injury?

There are five phases of the tennis serve: (1) wind up (knee flexion, trunk rotation), (2) early cocking, (3) late cocking (position of maximal demand on the shoulder as you reach up and back), (4) acceleration phase and (5) follow-through. During the late cocking phase, it is your rotator cuff muscles’ job to stabilize the shoulder while it is in a position of extreme range of motion. If your stability or mobility is compromised during this phase, you can develop impingement syndrome, which is one of the most common tennis injuries. Some even call it ‘tennis shoulder.’ Impingement syndrome can occur when lifting the arm between 60-120º of abduction (sideways lifting) or when the lifted arm is rotated inwards. The pain is caused by one of your rotator cuff muscles getting pinched and aggravated. Repetitive impingement can lead to structural damage (e.g. rotator cuff tears).

What are your treatment options?

  1. Conservative management, including physiotherapy will focus on correcting the anatomical, physiological and bio-mechanical systems at fault. Problem areas can include the kinetic chain, shoulder blade function, and the role of static and dynamic shoulder stabilizers.
  2. Modalities will help speed up the healing of injured tissues. In more acute injuries, ultrasound and high-power laser therapy can be useful. In chronic injuries, shockwave therapy can be more beneficial. Electro-acupuncture can also be used as a complementary therapy in both acute and chronic injuries.
  3. Plasma-rich platelet injection (PRP) is a biological treatment involving injection of a portion of the patient’s own blood consisting of a higher platelet concentration to promote healing of damaged tendons, ligaments, muscles and joints.
  4. Local anaesthetic and steroid injections decrease pain and inflammation (e.g. cortisone injection)
  5. Surgical intervention involving debridement of damaged rotator cuff tissue, subacromial bursitis, bone spurs and osteophytes, with repair of rotator cuff tears are typically used as a last resort.


  1. Ellenbecker, T.S. “The Relationship between Stroke Mechanics and Injuries in Tennis”. High Performance Coaching; The USTA newsletter for tennis coaches. 2006;8(2):2-10.
  2. Laudner, K. and Sipes, R. “The Incidence of Shoulder Injury among Collegiate Overhead Athetes”. Journal of Intercollegiate Sport. 2009;2:260-268.
  3. Mei-Dan, O. and Carmont, MR. “The Role of Platelet-Rich Plasma in Rotator Cuff Repair”. Sports Med Arthrosc. 2011;19(3):244-250.
  4. Kovacs, M. and Ellebecker, T. “An 8-Stage Model for Evaluating the Tennis Serve”. Sports Health. 2011;3(6):504-513.
  5. Van der Hoeven, H. and Kibler, WB. “Shoulder Injuries in Tennis Players”. British Journal of Sports Medicine. 2006;40:435-440.


BlackToe Running: June Running Program

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We are very excited to have partnered with one of our neighbours, BlackToe Running, to offer Totum Life Science Members 10 exclusive spots in BlackToe’s extremely popular June coached running program.

Whether you’re hoping to start running for the first time or to change your status from “Beginner” to “Non-beginner,” this program is for you! If you have been away from running or are looking to improve your speed at the 5km or 10km distance, this is also a great place to start — and a personal best may be in your future!


The BlackToe Running coaches are experienced runners who still remember those first few weeks when they took up the sport. They will make sure your transition is not only successful but fun as well.

The BlackToe Running Group meets at the store at Bathurst and King every Monday night at 6:30pm rain or shine. Your program will include:

  • A weekly group workout led by the BlackToe Running coaches. We set pace groups so people of similar fitness are developing together. We mix it up and make the workouts fun — and yes, there is some core work!
  • A weekly plan outlining your workouts for the coming week along with tips and suggestions
  • Guest speakers who have expertise that can help you understand biomechanics, nutrition and more
  • Proper pre-run and post-run warm-up and strength drills, all done in a group setting!
  • Access to your coaches via email or in person during the week as required
  • Discounts on BlackToe Running apparel
  • Advice on proper nutrition, gear and apparel
  • Tips and tricks on how to make running a regular part of your life
  • The support of your awesome teammates!


Cost is only $25 for the month of June
Sign up now. There are only 10 Totum spots available.
For more information and to sign up contact Mike Anderson / 416-577-7569

10 Simple Nutrition Tips

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by Tara Postnikoff

Help control inflammation through your diet. Face it: training is hard on the body with all that pounding our muscles, joints and ligaments face a lot of stress. Too much stress leads to inflammation in the body, which over time can lead to injury. Add anti-inflammatory foods to your diet daily, such as ginger, turmeric, pineapple, fish oil and garlic, to help keep your inflammation in check and your immune system strong.


Build a Better Breakfast. It’s important to eat a good breakfast daily. Aim to consume 20-25% of your daily calories at breakfast to keep you fuelled longer and help ward off evening eating excess. On days when you are not training first thing, try swapping out the oatmeal for some eggs and handful of nuts. Or have a protein rich smoothie with veggies, 1/2 an avocado and only 1 cup of fruit. Proteins and fats will give your body long lasting energy and make you feel more satisfied and reduce cravings later on in the day. If you are training first thing in the morning, easy to digest carbs are the way to go, as they digest quickly so you can get on with your workout.

“I Train To Eat!” Sound familiar? Well, training is not an excuse to eat whatever you want! The more stress you put on your body through training demands, the better your diet should be, not the other way around. Not only do you need to worry about the number of calories, carbs, proteins and fat — you also need to consider all the micro-nutrients such as vitamins, minerals, enzymes and bioflavanoids that your body needs increased amounts from to support your training. Focus on the more nutrient-dense, not calorie-dense foods, to offer you the most bang for your buck. Load up on veggies throughout the day, and say no to refined carbohydrates and processed foods.

Grocery Shop with a Plan! Wandering through the grocery aisles without a list will leave you open to poor food choices. Take 10 minutes before going to the store an plan out a few days worth of meals and then identify what ingredients you need and stick to the list.

Up your Omega-3! Fish with the highest amount of EPA/DHA omega-3s are salmon, mackerel and sardine. Other good sources include herring, anchovy, lake trout, rainbow trout and tuna. Seven to ten ounces of fish per week is a good start to reaching your omega-3 intake. Another type of Omega-3 is alpha-linolenic acid which is found in certain plants. There are fewer contaminants in vegetable oils. Flax is the highest source of alpha-linolenic acid, then chia seed, hemp seed, pumpkin seed and walnut.

Pack Snacks! If you are trying to stay healthy then plan ahead for daily snacks. Mixing veggies and protein or veggies and a healthy fat will provide an energy boost between meals, without a spike in blood sugar. Avoid breads and baked goods and try 1-2 cups of veggies and a 1/3 cup hummus or two hard-boiled eggs or 1oz of nuts. If you have a workout planned within 2-3 hours then add a piece of fruit.

Clean Up! Avoid refined, processed foods with additives, preservatives and chemicals such as artificial sweeteners, colourings, flavourings, as they will only deplete your body of nutrients. Read the ingredient list – if you don’t know what it is, don’t buy it!

Get Cooking! Try cooking foods more often so that you can control what goes in the meal. Home made foods are generally better for you. During the week plan for quick meals such as quinoa, chicken breast and a pile of bright vegetables that can be made in 15 minutes. Make a little bit extra for lunch the next day. When you have more time try making a larger portions of soup, chili or a roast that can be used over a couple days.

Water Up! Make sure you start all workouts in a hydrated state. When dehydrated you can’t perform at their best and you increase risk for injury, such as muscle tears or strains. Consume 2-4 cups of water in the 2-4 hour window leading up to your workout. For workouts lasting longer than 60 minutes make sure you carry water and consume 1/2 to 1 cup of water every 15 – 20 minutes to prevent dehydration.


Eat your Veggies! Do you get the 7-10 servings of vegetables that an active individual needs per day? Vegetables are dense in nutrition but low in calories. They offer lots of fibre, vitamins, minerals and bioflavanoids. It’s important to eat a variety of them from all colour groups to increase your nutrient spectrum.

Running and Winter

Do They Belong in the Same Sentence?

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by Dr. Brittany Moran, Chiropractor

Going for a run can be an intimidating prospect in the best of weather. Living in Canada, we are obviously faced with at least a few months of “less than ideal” outdoor running conditions. In this article I am going to discuss running safely and effectively in the winter months.

First we are going to put to rest a winter running myth. You are not going to freeze your lungs if you run in the winter! By the time the cold air hits your lungs it has warmed up. I have run in some very cold weather and lived to tell about it. So no excuses!

The key to having a successful run in the winter is having the proper gear. In the winter, it’s all about layering. We will walk through how to layer up and still be able to move for your run.

The trick to determining how much to wear when heading out for a brisk winter run is to add 10 degrees to the outdoor temperature and dress for that temperature. This represents your body temperature, and so it is how you should dress. Also, taking note of how cold it was outside, what you wore and how you felt on the run is a good habit to form so you have a better idea of what to wear. You should feel a little cold at the beginning of the run then as you start working harder, your body will heat up to a point where you should be comfortable.


For your upper body the first layer should be tight-fitting and moisture-wicking. Not cotton…cotton is rotten and will stay wet when you sweat. The second layer is one you can play around with to best suit the temperature: a T-shirt, a looser fitting dry fit or even a sweatshirt if it is very cold. The last layer I recommend is a jacket that is going to cut the wind. If you have something that gets rid of the wind chill, it will make a big difference.

On your lower body, you definitely want to be in pants — Spandex, yoga style or even a nylon pant will do, just make sure you can move in them. You can put a second layer on your lower body when it’s really cold. I usually always wear at least tight shorts under my pants.

Be sure to cover your hands and ears as well. Your extremities will get especially cold in a colder temperature. Proper gloves and a toque or headband are an absolute must. It may also be warranted to get some warmer winter running socks to keep your toes warm.

Now that you are dressed and ready to take on the great outdoors, another thing you need to consider is the slippery conditions of the sidewalk. Ice can be hard to spot, so make sure to watch out for it. Try to avoid routes that not well kept and potentially very icy. And if this is not avoidable, run with a wider stance and slower pace as this is more stable.

Since it’s cold outside, it’s important to ease into your run — or better yet, do a warm up pre-run. You do not want to step outside and start out at a fast pace, as your muscles will be cold. So start off easy and let your muscles warm up.  Then you can increase your pace.

Another thing to consider with winter running is the lack of daylight. Be sure to have something that lights up or is reflective on while running in these conditions. Cheap Toronto car rental Also be sure to check before crossing roads because you are harder to see in the dark.

A few local areas that I have found that are well maintained throughout the winter are the Lakeshore trail and Mount Pleasant Cemetery.

If you absolutely must do a run on the treadmill due to a blizzard…this is the only acceptable circumstance. Put the incline to 1.0 — this makes the effort level more comparable to outdoor running.

Lastly, set a spring time goal! It’s really hard to stay motivated in the winter, so I advise everyone to sign up for a race in the spring time. That way you have to keep training and running through the winter months. There are a lot of great races in the Toronto area in the spring, so check them out. All this winter running makes you way tougher for these spring races.

See you out on the roads….Stay warm and happy running!

Dr. Brittany Moran

Offseason Game Plan: Addressing Injuries Before they Happen

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by Lindsay Scott MScPT
Registered Physiotherapist – Totum Life Science


I am a cardio junkie. I will gladly run for hours at a time, and I truly believe that there is no better way to start a day than a sunrise run along my favourite path. I also have a tendency to avoid strength training at all costs.

I am also a physiotherapist who is passionate about helping runners get back to crushing their running goals, being stronger than ever and staying injury free.

Unfortunately, I am well aware of the fact that those two identities are somewhat ironic.

For a long time, I was delighting in tracking my ever-increasing mileage each week, ignoring the advice that I gave to clients on a daily basis about the importance of strength training, and signing up for every race that I could manage to squeeze into my schedule.

So began my seamless transition into injury.

As a physio, I knew that I was on the fast track to disaster, yet I felt invincible. Perhaps it’s more a question of being lazy. Either way, I was not impressed as it became increasingly apparent that my bad habits were catching up to me.

Hobbling into the off-season with aches and pains, I vowed to finally address the underlying factors that had been contributing to the injuries that I was fighting through. Focusing on strength and mobility throughout the quieter months meant that I could attack the following season healthier, faster, stronger and more in love with running than ever before.

Whether your goal is to get through next season without injury, to finally snag that PB or to up your game with some longer distance races, planning your off-season appropriately is an essential first step in setting yourself up for success.

Here are a few pointers that I frequently share with my clients (and even adhere to myself!):

1. Give yourself some time off

  • Sleep in on the weekend, grab a beer with friends, dust off your cross country skis, and enjoy the entire stack of pancakes with extra maple syrup.
  • Don’t worry about running for a while, but when you do lace up, wave to every single runner who you pass along the way and leave that Garmin at home. After a season of following training plans, it’s liberating to run at whatever pace suits you that day and for whatever distance seems right just because you feel like it.
  • Try something new that forces you to move in different ways. Most runners move in the same plane of motion over and over again. Humans are built to move in multiple directions, and when we don’t, the result is often injury.


2. “Prehab” to avoid rehab by strengthening

  • While there are numerous muscles that play a role in maintaining great running form, the most common culprits that we see are:

1. The core. Think of the glutes, lower back muscles and deep abdominals as the foundation for all movement. As you run, energy travels through your body as a result of the impact of your foot on the ground and your muscles contracting to propel you forward. Your core acts as a hub for transferring that energy. If a runner’s core is weak, that energy transfer becomes less efficient. In addition to slowing you down, inefficient motion can cause another body part to receive more than its share of energy, or load. This can lead to injury as those tissues are not designed to withstand that excess demand. Injuries can also develop when a runner’s movement patterns change as a result of asymmetrical transfer of energy. With a strong core, we are able to transfer energy efficiently, ultimately creating a faster, more powerful gait pattern that is less prone to injury.

2. The hips. The main stabilizer of your leg when standing on one leg is the gluteus medius. When you run, you’re essentially landing and balancing on one leg thousands of times in a row. If this hip stabilizing muscle is not strong enough, there is often a huge amount of stress on your knee, ankle and foot, ultimately leading to injury.

In 2007, Dr. Reed Ferber of the Running Injury Clinic at the University of Calgary completed a study of 284 runners complaining of a wide variety of knee, ankle and foot injuries. He found that 93% of participants had weak hip muscles. Impressively, 90% of those runners were pain free following a six week targeted strength program. Strength training works!

  • Try to incorporate strength training 2 times a week, focusing on multi-joint, body weight exercises such as lunges, squats, and planks. Build gradually, and remember that simplicity is often the best policy.



3. Check your gait

  • Get an analysis early in your training. Unless you understand your movement patterns, it is impossible to properly address any limitations to your strength, mobility, flexibility, and ultimately, your performance.
  • Don’t forget how valuable running drills can be in cueing a proper gait pattern. Even the best runners in the world do drills on a daily basis in order to remind themselves not to reach too far in their stride, teach their bodies to land below their centre of mass and keep their cadence up. Some good examples include: strides, high knees, skipping, side shuffling, and butt kicks.


4. Focus on and plan for just one or two goals for next season

  • Meb Keflezighi won the Boston marathon last spring. The guy runs for a living and has a whole team of coaches, medical professionals and sponsors behind him. How many marathons did he run last season? Two! This is a good reminder that our bodies need time to recover. If a pro runner has only one ‘A’ race to focus on at a time, how can those of us who are not training as a full time gig expect to be racing hard all season while still avoiding injury and exhaustion? Pick a goal or two that you’re really excited about, and base your season, including your off-season, on whatever you need to do to help you to achieve that goal.



Lindsay Scott is a physiotherapist at Totum Life Science. She is currently training in Advanced Orthopedic Manual Therapy through the Canadian Physiotherapy Association. A passionate runner and triathlete herself, Lindsay has a particular interest in working with athletes of all levels to identify and address underlying factors contributing to injury. She can be reached at

Client Success Story — Robert Grabel

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March, 2013 was one of the toughest periods I have gone through in my life. Heads up: nothing tragic here — my health, my family and the things that matter most to me were all intact. However, it was during this time I had a meeting with a physical therapist that changed my life — and not for the better. The conversation went something like this:

Physical Therapist: How old are you?
Me: 48 (wondering why he’s asking this)
Physical Therapist: Great, then you’re young enough to find a new sport – now go find it!

My “old sport,” long distance running, was the reason he was examining me. Plantar fasciitis, heel spurs and more….I had the complete list.

I caught the running bug at 41 and became your classic compulsive runner. I completed 11 marathons, 20 half marathons and many others. I typically ran 7 days a week and often twice a day. My work even involved running: Inspired by a program I saw while running the Philadelphia Marathon, I started Teens Run Westchester, a non-profit that utilizes distance running to teach teens about goal setting and healthy lifestyles. But now according to a top sports doctor, my running days were over. I didn’t have a counter-argument. My days alternated between agonizing and miserable pain in both heels. And I had no one to blame but myself. Too much of a good thing is dangerous.

Fast forward to July 2013. I’ve moved from New York to Toronto as part of a work relocation with my wife. I’ve accepted my post-running life and even started to enjoy long bike rides. I had also taken up ice hockey (when in Canada…). And then I had the good fortune to tear my left ligament while playing hockey. Since we lived right across from Totum, I figured what could be easier than doing my recovery work close by? So I started working with Dr. Pete Kissel simply to strengthen my ankle post-injury.

running_shoes_QAWhile working with Pete, I shared my history and sadness over the end of my running. As both my feet started to get stronger from our work, he suggested that maybe my running days weren’t over. After about two months of sessions, which included lots of stretching and strengthening exercises, Dr. Kissel commented that while I might never “win a marathon,” he could definitely see me getting back to it. I was always a runner that enjoyed the scenery (I’m not speedy) so I was thrilled with the prospect.

I started off slowly. During those first few days of running I was fearful that the pain would return. It didn’t return and I was able to return to a much healthier three days per week of running, which I alternated with cycling or spinning. I ran in the Fort Lauderdale Half Marathon in February and in the Yonge Street 10-K this past April.

I’m incredibly thankful to be sharing this story in 2014. Thanks to Dr. Kissel, I am training for my twelfth marathon, which I will be running on my 50th birthday this December. I was lucky to learn so much from him, including the value of stretching and strengthening exercises (still doing it), moderation (something I struggle with!) and the simple appreciation for getting back something I love. I would also extend my thanks to the leaders at Totum. Part of my moderation approach includes trying for improvement in my cycling, and I loved participating in Amy’s Friday morning classes along with Tim Irvine. While we’ve moved back to NYC, I will always appreciate my time and experience at Totum.

Roll Out: Self-Massage Tips

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by Melissa Doldron

In between Massage Therapy treatments, I always offer clients some self-massage tips/techniques that they can do at home to help reduce tight muscles. There are many tools on the market that can help you roll out like a pro at home. Three tools I have in my arsenal that I love to use are a Foam Roller, Yoga Tune Up Balls and Massage Bar.

Self-massage can be great for specific myo-fascial release of Trigger Points or to work with your current stretching program. Rolling out helps increase circulation, restore length and balance to your fascia and muscles to improve your range of motion. Great for recovery days, it can also be used as a warm-up or cool-down to any physical activity.

rollerI love using the Foam Roller for larger areas, like the IT band, thoracic spine, calves and lats. The Massage Bar or Stick is great over sensitive areas, like your quads and adductors, where you can more easily control the pressure. For those that like a little DIY, I’ve seen some runners use an old school rolling pin!

Another fantastic self-massage tool is the Yoga Tune Up Ball. This little dynamo is fantastic for releasing tension from your feet (hello runners!) and hard to reach areas like your hip rotators and glutes. You can roll on it while on a yoga mat, or standing against the wall. It’s small and easy to travel with! Roll the ball between your shoulder blades for a great release after a long day on the computer!

Using your body weight roll slowly over those areas and feel for any tight spots. You can press your body weight into those areas or roll over them a few times for a nice release.


  • Be patient and relaxed and practice some quality breathing when rolling, do not hold your breath!
  • You should not feel any sharp pain, but more of a deep pressure that relaxes as your tissue releases.
  • Explore each area that you are rolling, paying attention to restrictions in your tissue.
  • Speed determines intensity. The more slowly you roll, the more intense the sensation.


The Benefits of Acuball

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Acuball, by Lindsay Scott

acuballMost people, myself included, wish that they could have their massage therapist, physiotherapist, or chiropractor on call throughout the day. If you are one of us, the acuball could be a versatile and cost effective solution for you. While the acuball certainly can’t compare to the skills of your therapist, it can certainly go a long way with respect to maintenance between sessions.

We are often asked why the acuball, or other tools such as the foam roller, are so good for you? Do they actually help? Though there are a number of theories as to what is likely happening that creates that oh-so-good feeling when you are done, truthfully, the scientific research in the area is limited. That being said, most clinicians agree, based on clinical experience and several theories that have been proposed, that these tools are essential components of maintaining a healthy active lifestyle that is injury free.

Here’s what happens: The acuball is a form of self myofascial release, which works to improve performance by restoring muscle elasticity and allowing tissues to rebound to their natural state by increasing blood flow, improving oxygen usage and decreasing muscle adhesions, or knots.

Most tissues, when healthy, should glide in relation to other nearby tissues and bones. Most tissues should also be somewhat elastic, like a bungee cord, where they can be stretched and then return to their original shape as you move. Inelastic tissues are more like a rope; the muscle loses its ability to lengthen and recoil with movement. Inactivity, overtraining, poor hydration, and even the demands of daily life (hello, hours sitting at a computer or crawling through traffic) can all lead to adhesions, or knots, in the muscle and surrounding tissues so that they no longer glide smoothly relative to one another. When this happens, you lose the ability to function efficiently.

Like any other form of massage or soft tissue mobilization, self myofascial release is also believed to create a chemical input. Initially, this may create discomfort, but the ultimate response is a healing one. When the tissue is disrupted, it produces the substances that facilitate healing.

Self myofascial release before exercise is believed to:

  • increase tissue tolerance to movement
  • increase blood flow
  • restore elasticity
  • increase efficiency of movement
  • increase force output of muscle contraction
  • decrease heart rate
  • prepare muscles to tolerate the upcoming demands of exercise


Self myofascial release after exercise is believed to:

  • increase blood flow, which theoretically flushes out toxins
  • re-establish elasticity
  • relieve muscle tension
  • speed up the recovery process and decrease DOMS (delayed onset muscle soreness), that sore feeling that causes you to cringe as you get out of bed the day after a really good workout
  • restore range of motion


Keys to self myofascial release:

  1. Don’t forget to breathe! Take deep slow breaths through the nose to relax your muscles, increase oxygen uptake and improve circulation.
  2. Slow down. We recommend 1-3 minutes on each muscle group that you are working in order to be effective.
  3. Stay Relaxed. It’s hard – we know! The muscle group being released must stay relaxed to get the most out of rolling. At first, you might experience mild to moderate discomfort. As you continue to work at those knots in your muscles, that discomfort should decrease.
  4. Movement. After working a specific muscle group, walk around or move that muscle group gently through it’s full range of motion to circulate more blood to the area.
  5. Regularity is key!


Who’s training your brain?

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by Rob Peach, MSW RSW

We don’t think twice about investing our time and energy into developing workouts designed to optimize our physical health and wellbeing, but it often doesn’t occur to most us to make the same sort of investment in our mental and emotional health.

Traditionally, while mental health professionals recognized the psychological benefits of physical activity, there hasn’t been a lot of attention paid to the relationship between exercise and our capacity for emotional regulation. The good news, however, is that is changing!

For myself, I know that after I hit a huge back squat during an early morning workout, nothing I encounter during my day seems as overwhelming or unmanageable as it might have otherwise felt.

Moreover, the same cognitive skills I use to hit that back squat, including being present in the moment, being aware of my thoughts and carefully monitoring my body’s response to the stress of the lift, are the same skills I apply to the challenges I encounter trying to balance an often hectic schedule.

By being mindful, or focusing on our thoughts, emotions and sensations as they occur, we are better able to be both intentional and purposeful in our actions and better able to understand and manage our emotions, rather than feel controlled by them.

Relationship issues, problems with mood and anxiety and difficulties with the use of alcohol or other substances can get in the way of you developing the capacity to achieve a sense of wellbeing in your life.

While we know that these issues can negatively impact our ability to perform optimally at work, at home and in the context of meaningful relationships, we often forget how damaging they can be on our levels of activity and health.

Having a trusted therapist can help you to feel less alone with your feelings, to develop the capacity to control and regulate emotions and to feel more confident in talking with others about your struggles.

Moreover, in therapy you can further develop your ability to diffuse difficult emotions, to manage thoughts, urges and feelings that are not consistent with your goals and values and increase your capacity to be fully present to experience each moment of your life.

Intentional, purposeful and mindful approaches to emotional wellness can translate into increased satisfaction with your physical activity. Improved physical wellness can result in an increase in your ability to manage stress, more satisfying relationships and your ability to connect with what you value most in life.

Have you been struggling with difficult emotional issues? Have they been affecting your motivation or ability to engage with others in a meaningful and authentic way? Do you feel ‘trapped’ by your thoughts and emotions, rather than able to manage their impact on your life?

If you find yourself saying ‘yes’ to any of these questions, then therapy might be right for you. Contact me today to talk about setting up an individualized treatment plan to support your capacity to achieve your optimal levels of physical, mental and emotional wellness.

Rob Peach, MSW RSW
416 795-7299

Soccer Cross-Training

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The World Cup may be over for another few years, but we have the rest of the summer to get out on the field and enjoy ourselves. Below, sport specialist chiropractor Dr. Jaclyn Kissel outlines the benefits and how-tos of cross-training for soccer players and other athletes.



  • Two or more types of exercise are performed in one workout or alternated in successive workouts
  • Engaging in an activity that is different from the main sport you participate in
  • Example:
    • A marathon runner who does upper body weights 2 times per week to prevent upper body fatigue during a run
    • A soccer player who does yoga weekly to keep leg flexibility to help prevent injury



1)     Avoid Overuse Injuries

  • Repetition = GOOD   Too much repetition = BAD (INJURY)
  • Athletes get injured due to overuse of the same muscles without allowing sufficient healing time
  • Cross training distributes the force to many areas of the body, therefore one specific area does not get too much abuse


2)      Develop your entire body (muscle balance = less injury)

  • Many sports or activities actually need more than 1 physical attribute
  • Soccer provides little development of muscle size (due to constant running)
  • Muscle strength important for:
    • i. bone strength
    • ii. balance
    • iii. protection against injury
    • iv. speed development
    • v. power development


3)      Can keep training while injured

  • If have a soccer injury, many athletes will stay fit through cross training by cycling, swimming, aerobic machines (elliptical), strength training (weights),  Pilates, yoga etc. to prevent worsening of the problem


4)      Adds variety to your workouts

  • Avoids over-training
  • Keeps training interesting
  • Well-rounded athlete



  1. Start slowly:  Start 15-20 min of the new activity
  2. Don’t just add another training day to your soccer schedule (must be integrated)
  3. Avoid exercises that aggravate existing injuries
  4. Try to match the length and intensity of the new workout with what you are used to with a soccer practice
  5. If you are feeling tired or fatigued while cross training, STOP!

Pick activities that will help enhance your soccer performance:

  • Cycling: builds your endurance and quad endurance without the load experienced during running
  • Resistance Training: decreases muscle fatigue, prevents injury, decreases HR, increase power and speed
  • Deep Water Running: mimics running stride, less body abuse, good if can’t run
  • Cross Country Skiing/Rollerblading/Snow Shoeing: great cardiovascular workout, less body abuse, works glutes (helpful for kicking)
  • Swimming: good for heart, increases flexibility, and gives running muscles a rest