Move away from pain, move forward optimal posture and wellness.

We help each member of the family to relieve their pain or other symptoms, correct their posture and obtain optimal spinal function, and then to maintain optimal health through, amongst others, regular adjustments and physical activity.

From pain relief to optimal health

To be without pain… is this being cured? Of course not. In our society, little emphasis is placed on prevention. Yet everyone agrees that “prevention is better than cure”. Prevention is not only economical; it is also the best way to not lose valuable time on being sick.

1. Intensive initial care
If you suffer from acute pain, emphasis will first be put on relieving the symptoms. Your chiropractor will nonetheless do a complete health check and will also examine your spine and your posture during your first visit.

Pain that suddenly appears following for example, a false movement, is often the result of several months, even several years of poor function. It is essential that your chiropractor examine you thoroughly to detect all possible causes of your acute symptoms.

In addition to spinal “adjustments”, muscle work and other therapies performed during your first visits, your chiropractor will provide advice in order to quickly regain control over your acute condition.

2. Corrective care
During your third visit, your chiropractor will recommend corrective care. We will explain whatthis implies: the time required, the frequency of visits, the exercises to do and any recommendations that your chiropractor may give you in order for to you obtain optimum health.

Corrective care requires time. Posture disorders, misalignment of the spine and other disorders that your chiropractor will recommend correcting have settled slowly over the years. This is true, even if thepain has appeared recently due to something insignificant.

3. Preventive and periodic care
Once you have completed your corrective care, your chiropractor will usually recommend periodic preventive care, also known as wellness treatment. They have several objectives and benefits:

– Maintaining optimal function of your spine.
– Preventing relapses of acute injuries such lower back injuries.
– Early detection, before symptoms appear, of posture and spine disorders.
– Monitoring problems or discomfort you feel on a daily basis.
– Maintaining your current file at our clinic, in order to facilitate access to care, in case of an emergency or pressing need.
– Getting answers to your questions concerning your health from an available qualified Healthcare Professional.

Sports Chiropractic

Over the past 18 years, we have helped more than 4000 people to relieve their pain, correct their posture and find lasting solutions in order to maintain optimal health. Also, many athletes at all levels were able to resume competition and perform at their personal best, thanks to the diagnosis and treatment of musculoskeletal injuries we offer.

With the growing popularity of running, many of our patients practice this activity with passion and commitment. Dr. Lepage being a marathoner himself, our patients arevery confident in the diagnosis and treatment of injuries related to running, in the preparation forlong-distance events or simply to learn how to start running without injury.

Family Chiropractic

The clientele we serve is composed mainly of families whose members place health as their basic value, participate in regular physical activities and maintain good postural hygiene, as well as a healthy lifestyle.

We help each member of these families to relieve their pain or other symptoms, correct their posture and obtain optimal spinal function, and then to maintain optimal health through, amongst others, regular adjustments and physical activity.

family-kids-happy-people-46252

Exercise Is Medicine!

April 2021 Newsletter.

Source: Exercise is Medicine® Canada, exerciseismedicine.org/canada

Spring is around the corner.  Runners and cyclists are back in our streets.  Physical activity hasundoubted health benefits.  Being active for at least 150 minutes per week can help reduce the risk of premature death, heart disease, stroke, high blood pressure, certain types of cancer, type 2 diabetes, osteoporosis, overweight and obesity and can lead to improved fitness, strength and mental health (morale and self-esteem).

How often should I exercise?

To achieve health benefits, adults should accumulate at least 150 minutes of moderate to vigorous aerobic physical activity per week, in bouts of 10 minutes or more.  It is also beneficial to add muscle and bone strengthening activities using major muscle groups, at least 2 days per week.  More physical activity provides greater health benefits.

What about aerobic intensity and how can I assess intensity?

Light exercise will usually not cause adults to sweat and breathe harder. 

It is easy to have a conversation at this intensity. Walking is the typical example of light exercise.

Moderate-intensity exercise will cause adults to sweat a little and breathe harder.

It is possible to have a conversation in short sentences.  On a scale relative to an individual’s personal capacity, moderate-intensity physical activity is usually 5 or 6 on a scale of 10.  Examples are brisk walking (as if you are late to get somewhere) and bike ride.

Vigorous-intensity exercise* will cause adults to sweat and be « out of breath ».  

It is difficult to have a conversation.  On a scale relative to an individual’s personal capacity, moderate-intensity physical activity is usually 7 or 8 on a scale of 10.  Examples are jogging, swimming laps, cross-country skiing and hiking on hills.

Moderate to Vigorous-intensity physical activity (MVPA)

MVPA is a combination of moderate and vigorous intensity activity.  This is what you’re aiming for to meet the guidelines!

And what about losing weight?  Improving fitness is more important than losing weight.  Low cardiovascular fitness is associated with a much higher risk of disease and death than being overweight.

Pick a time. Pick a place. Make a plan and move more!

  • Join a weekday community running or walking group.
  • Go for a brisk walk around the block after dinner.
  • Take a zumba or other class after work.
  • Bike or walk to work.
  • Rake the lawn, and then offer to do the same for a neighbour.
  • Train for and participate in a run or walk for charity !
  • Take up a favourite sport again or try a new sport.
  • Be active with the family on the weekend!

Now is the time. Walk, run, or wheel, and embrace life!

*You should see you health care professional before engaging in vigorous exercise. 

Piriformis Syndrome

March 2021 newsletter.

Text from “Running Doc’s Guide to Healthy Running”, from Dr. Lewis G. Maharam, MD.

Piriformis syndrome is – figuratively and literally – a pain in the butt, one that does an excellent imitation of the catchall ailment called sciatica.  This Pain can also show up in the lowermost portion of the back.  Therapy is possible but tricky.  Don’t try to diagnose and treat this one yourself.

Not long ago, for example, Paul, a 45-year-old patient of mine, came to me with what he described as a dull ache in the middle of one buttock.  It hurt him to run, and the pain was especially sharp as he was going up hills or even walking up stairs.  A string of doctors had pegged it as everything from a deteriorated spinal disc to that classic medical non sequitur, low back pain.  None apparently suspected the piriformis, one of the muscles deep in the rear of the pelvis that helps turn your leg outward and that runs alongside, and occasionally surrounds, the sciatica nerve.  Like any muscle, it can be overused and go into spasm, something that can also be triggered by tight hamstrings, prolonged sittings, or anything that twists the area.  When that happens – and especially when the sciatic nerve becomes involved – the pain is dulls, constant, and, it often seems, permanent.

Diagnosis is not difficult for anyone who has seen the condition before.  One or two simple exercises with the patient on a table can pinpoint it, and trained fingers can actually feel down to and sense the spasming muscle.  But diagnosis is only the start of treatment, and therapy is far from simple, news that is always a big disappointment to experienced athletes who are accustomed to being sent home with a list of simple stretching and strengthening exercises and a follow-up appointment. 

Paul, for example, listened to me for 20 minutes while I explained why he had to do exactly as I said.  Yes, there would be stretches, but they would have to be done […] the right way.  Other therapies, […] including a specialized technique called “transverse frictional massage”, in which the massage is applied opposite the alignment of the muscle and tendon fibers; ice; ultrasound. 

I heard from him nine months later when he called to tell me how disappointed he had been with my care.  Why?  Because he still hurt.  Of course, it turns out that once he knew what was wrong with him, he’d decided to skip all that therapy stuff, get some piriformis stretches out of a book and get to work on his own.

A condition that’s commonly not correctly diagnosed in the first place, that requires otherwise intelligent athletes to follow orders like robots, and that’s all but impervious to anything but the full galaxy of therapies is as close as one can come to a sports medicine physician’s nightmare.  But if you do what you’re told, it needn’t be our nightmare, too.

Last update: January 7th, 2021, 7 am.

Important Message

On January 6th, 2021, the Québec government has announced that all non-priority commercial enterprises throughout Québec must stay close from from January 9, 2021 up to and including February 8, 2021. However, professional healthcare services including chiropractors are not covered by the closings and can pursue their activities. Our clinic will be open during the months of January and February.

Elodie Desprez, massage therapist, is also working at our clinic as usually.

A stringent health protocol has been in place at our clinic since the end of March and will be maintained until further notice. You also need to go through the Covid-19 questionnaire (see below).

Once at the clinic, we ask you to wear a mask, disinfect your hands when you arrive, and keep a distance of two metres between yourself and our reception staff and other patients. If you have your own mask, please wear it. If not, we can provide one. You must also come to the clinic alone if possible, and leave your personal effects in your vehicle. 

Your chiropractor and all our staff will continue to comply rigorously with current health directives for private healthcare clinics.

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Covid-19 pre-consultation questionnaire:

1- Did you test positive for Covid-19 in the last 21 days or waiting for your test results?

2. In the past 14 days have you returned from travel outside Canada?

Do you have any of these symptoms?

3- Fever (>38°C);

4- Recent onset of cough or worsening of an already existing cough;

5- Difficulty breathing;

6- Loss of taste;

7- Loss of smell;

8- Muscle aches, headache;

9- Sore throat;

10- Diarrhea;

11- Have you been in close contact (at least 15 minutes within less than 2 meters) with someone diagnosed with COVID-19 without adequate personal protective equipment?

If you answered yes to one the the questions 1, 2, 3, 4, 5, 6, 7 and 11 or if you answered yes to two of the questions 8, 9 and 10, you cannot be seen by one of our chiropractors. 

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For information and appointments:

  • Phone: 450-455-9822
  • Email: info@drlepagechiropraticien.com
  • Messenger: click here
  • Text message (please mention your name): 514-705-9470

Tips for Buying a Mattress (And Sleeping Well)

February 2021 newsletter.

Text from: Canadian Chiropractic Association.

Consider the importance and value of a good night’s sleep (beyond the price tag) when you are looking for a new mattress. Your back will thank you!

Lack of sleep can have a significant impact on your quality of life, social interactions, and even your mood. Sleep deprivation can also cause a decrease in your work productivity, the greater number of sick days used, and result in increased injury rates due to poor response time and accuracy.

A 2011 study by the British Chiropractic Association (BCA) reports that 41% of women and 36% of men claimed their back pain was exacerbated by a poor night’s sleep2. The pain can often be attributed to the firmness, size, or the offered back support of the mattress. If you’ve ever woken up with a sore neck or back, you may want to evaluate the quality of your mattress. Your mattress can play an important role in maintaining your musculoskeletal (MSK) health. Here is what to keep in mind when making a purchase.

 

When to replace your mattress

Waking up from slumber with a sore back on repeated occasions can be a sign that it is time to switch to a newer mattress. Typically, it is said that after 10 years, the bed will begin to deteriorate, which is the best time to consider buying a new one.

Current research suggests that:

  1. Medium-firm mattresses can be beneficial for individuals with chronic mechanical low back pain and are considered more comfortable compared to soft mattresses. They also have been shown to improve sleep quality by 55% and decrease back pain by 48%.
  2. The standing posture of an individual’s spine should be similar to their sleeping posture. Since standing posture varies from individual to individual, mattresses that are custom made may be more beneficial in reducing pain.
  3. Using an adjustable bed based on individual preferences is associated with increased sleep quality.
  4. Mattresses that promote skin warming may improve sleep quality by reducing early morning awakening and enhancing deep sleep.
  5. Soft mattresses decrease excessive compressive forces on your joints, however, mattresses that are more firm help to maintain proper sleep posture as they prevent sagging of the hips.

Take time to try out the bed before you buy and see if it’s right for you. There are many options to consider when it comes to purchasing a mattress. Make sure to take the time to explore and do your research, especially if you are looking for specific features to meet your needs. A good night’s rest is important for your MSK health and ensures you can continue doing your daily activities. Consider these tips for your next mattress—your back depends on it!

Muscle knots (Everything you need to know + tips for relief)

November 2020 newsletter.

Text from: Canadian Chiropractic Association.

Muscle knots are typically found in your back, shoulders, and neck. They are stiff bands of muscle that have a hard knob in the centre, which is known as a trigger point. The pain can either pop up spontaneously (active) or when the trigger point is pressed (latent). But in all cases, muscle knots cause pain to radiate beyond the trigger point into the surrounding muscles.

 

What causes muscle knots?

Muscle knots, also known as myofascial trigger points, are complex and have a variety of possible causes. There is a lot more research to be conducted on the matter, but the best available evidence suggests that muscle knots are the result of overuse such as heavy lifting or repetitive activities. Other causes may include: psychological stress, poor ergonomics, bad posture, fatigue, dehydration, sleep disturbances and joint problems.

Trapezius muscle trigger points and their referred pain areas.
 
What are the symptoms of muscle knots?

Pain is the primary symptom of muscle knots. Most people agree that muscle knots feel swollen, tense, or bumpy, and cause an aching sensation. Depending on where in the body the muscle knot is located, it may cause seemingly unrelated pain in other areas. For example, a muscle knot in the neck can send pain into the base of the skull, causing a tension headache.

How are muscle knots diagnosed?

Diagnosing a muscle knot requires a physical examination by an experienced professional such as a chiropractor. The examiner will assess the area of concern for three things: a taut band of muscle, a tender nodule, and the reaction of the patient to physical pressure.

 

How are muscle knots treated?

There are several options, but the most common include stretching, chiropractic care, exercise, massage therapy and ultrasound therapy. Whichever option you choose, the main goal is to release the trigger point to reduce pain and increase mobility by breaking up the knotted tissue and calming inflamed nerves.

 

How can you prevent muscle knots in the first place?

  • Improve your posture by sitting in a relaxed position, with your shoulders back and down. Try your best not to slouch.
  • Take opportunities throughout the day to rest and incorporate exercise into your routine.
  • If your job requires you to sit for most of the day, take regular stretch breaks to prevent your muscles from getting too tight.

 

Can you treat muscle knots at home?

While we recommend seeking the advice of a spine, muscle, and nervous system expert, there are some cases where you can massage the sore muscles yourself. Try following this simple technique: 4

  • Locate the knot in your muscle and, using your fingers, gently massage it out.
  • Focus on loosening the tight muscle by pressing down firmly and making small circles.
  • If you’re finding it difficult to reach the muscle knot in your back, neck, or shoulders, you can try using a tennis ball or foam roller to apply pressure to the knot. Slowly and gently move back and forth to relieve the tension.

Muscle knots in any area of the body are painful and frustrating. Now that you know what they are, what causes them, and how to treat them, we hope you’ll find relief and get back to enjoying your everyday activities.

If you have a persistent muscle knot that is interfering with your quality of life, make an appointment with a chiropractor today.

Shovel light

December 2020 newsletter.

Source : Canadian Chiropractic Association

During the winter months snow shovelling can be a pain, considering that each shovelful of snow weighs about six pounds. That’s a lot of repetitive lifting, and wear and tear on your back. These back health tips will ease the hassle of clearing your driveway and help keep your back in shape.

Warm-up  Before tackling any strenuous activity, a quick 10 minute warm-up such as a walk around the block will kick-start your muscles for the activity ahead and help prevent injury.

1. Don’t let snow pile up.  If the weather report calls for several days of snow, frequent shoveling will allow you to move smaller amounts of snow after each snowfall.
2. Pick the right shovel.  Use a lightweight push shovel. If you’re using a metal shovel, spray it withTeflon, so snow won’t stick to it.
3. Push, don’t throw.  Push the snow to the side rather than throwing it.This way you avoid lifting heavy shovels of snow, and abrupt twists or turns that may result in injury.
4. Bend your knees.  If you need to lift shovels of snow bend your knees, and use your leg and arm muscles to do the work, while keeping your back straight.
5. Take a break.  If you feel tired or short of breath, stop and take a break. Shake out your arms and legs to recharge.
6. Keep comfort in mind.  Layer your clothing so you can adapt to changing temperatures. If you become too warm while outdoors, simply remove a layer or two to maximize comfort.

7. Stay hydrated.  Even though it’s cold outside, your body still needs plenty of fluids. Be sure to drink lots of water or fruit juice before, during and after shoveling. Remember – if you feel thirsty, you are already dehydrated.

8. Take it slow Rest when you feel tired or short of breath. Stop shoveling if you experience sudden or prolonged joint or muscle pain.

9. Cool down After you’ve finished shoveling cool down by taking a walk and stretching out tense muscles.


 

Cuboid Syndrome

October 2020 newsletter.

Text from: Running Doc’s Guide to Healthy Running, Lewis G. Maharam, MD and http://www.footvitals.com

Summary: Cuboid syndrome is a subluxation (partial dislocation) of the cuboid bone in the foot.  The cuboid bone essentially moves out of place due to ligaments weakened from repetitive inversion (the foot repeatedly turning inward while running).  The pain goes right up under the arch of the foot.  It mimics plantar fasciitis but doesn’t go away with standard treatments.  X-rays and MRI are usually not useful because they are normal.  An examination with tenderness on this bone makes the diagnosis.  Treatment is conservative, normally involving manipulation and then strapping with tape and/or employing an orthotic with a cuboid pad to hold the bone in place as the ligaments heal.

The cuboid bone is located roughly at the midpoint of the outer side of the foot, and together with the other tarsal bones, it forms the arch of the foot. Other structures that may be involved in the injury include the calcaneocuboid joint and the surrounding ligaments.

IMAGE FROM FOOT VITALS WEBSITE.

What Causes Cuboid Syndrome?
Typically it is athletes who develop cuboid syndrome, either after an injury, or as foot pain that appears without a noticeable injury. One study showed that as many as 80 percent of cuboid syndrome patients also have pronated feet (flat feet). Cuboid syndrome is often associated with repetitive movement of the foot, such that which occurs during running or dancing.

Signs and Symptoms.  Cuboid syndrome may cause pain in the lateral midfoot and under the arch of the foot, especially when walking.  Patients may avoid putting weight on the affected foot.

Diagnosis.  Cuboid syndrome can be difficult to diagnose — and may be misdiagnosed — partially because it is not well understood, but also because there are often no physical findings on an x-ray, CT scan, or MRI.

  • Pain: Palpating the area may be painful for the patient; some swelling can be present. Hopping on the affected foot may also be painful.
  • Decrease in motion: Patients with cuboid syndrome may find inversion ankle movement to be painful.
  • Uneven gait: Patients with cuboid syndrome may exhibit an antalgic gait — i.e., they seek to avoid putting weight on the affected foot. Pain during walking may occur as the foot pushes off the floor.


Treatment
Manipulation: Treatment of cuboid syndrome involves manipulation of the cuboid.  After manipulating the cuboid bone, the clinician may further manage the patient’s discomfort with massage, cryotherapy (ice), non-thermal ultrasound, or electrical stimulation. In some cases, manipulation may need to repeated.

Padding and taping: Supporting the cuboid bone with padding or a wedge may help prevent recurrence. Taping may also be used to support and stabilize the bones of the midfoot.

Orthotics: Because many people who develop cuboid syndrome also overpronate, orthotics may be useful in preventing recurrence.

Exercise: The clinician treating the cuboid syndrome may prescribe some exercises that can help with symptoms and prevent the injury from occurring again. These exercises could include stretching the ankle up and down or in and out for a number of repetitions several times a day.