Find Freedom in Movement
Alison Coupe, Registered Physiotherapist
BScPT, MCPA, C-AFCI, C-GIMS, Vestibular
Ali has over 2 decades of experience in post-graduate physiotherapy, initially studying anatomical sciences at the University of Victoria before graduating from the Faculty of Medicine in Rehabilitation Sciences at the University of British Columbia in 2001.
Ali has had a varied career in Manual (hands-on) orthopedic physical therapy from an On-field Sports trainer with rugby and football teams to working in specialized hand therapy. Her post-graduate training continued into Acupuncture --- taking full credentials in both traditional acupuncture and medical acupuncture with the Acupuncture Foundation in 2003.
Early in her career, Ali was very privileged to mentor with Dr. Chan Gunn at the Institute for the Study and Treatment of Pain. Dr. Gunn of Gunn-IMS UBC is the mastermind of Intramuscular Stimulation (IMS) also often referred to as dry needling or Trigger Point release. His research and treatment methods earned him the Order of Canada and development of his technique has been pivotal in treating varied conditions from muscle and joint related conditions, nerve injury, sports injury and chronic pain syndromes.
Ali is also certified in Vestibular Therapy (including vertigo and BPPV) and has worked with athletes of all ages in multiple sports. She continues to always strive for further professional development opportunities and appreciates solving a good client “puzzle”.
What is Intramuscular Stimulation (IMS) / Dry Needling?
Intramuscular Stimulation (IMS) is a widely-researched medical system for the diagnosis and treatment of pain. This includes local pain in muscles/joints but also neuropathic pain when nerves malfunction following injury or tissue irritation resulting in nerve pain and/or muscle tig
What is Intramuscular Stimulation (IMS) / Dry Needling?
Intramuscular Stimulation (IMS) is a widely-researched medical system for the diagnosis and treatment of pain. This includes local pain in muscles/joints but also neuropathic pain when nerves malfunction following injury or tissue irritation resulting in nerve pain and/or muscle tightness leading to subsequent joint compression.
IMS uses acupuncture needles to penetrate deep within muscle tissue, specifically targeting muscles that have contracted and become shortened from supersensitive nerves.
While IMS may create some muscle soreness during treatment that may last 24-36 hrs, it is followed by significant muscle relaxation of trigger points (“knots”), improved mobility and reduction of pain.
PAIN is an entity that is commonly misunderstood. There are three distinct categories of pain:
Nociception, Inflammation, and Neuropathy
· Nociception: The immediate response conveyed to the brain via the spinal cord, signaling tissue injury (noxious input). An example is a response from a slap to the skin.
· Inflammation: A local response to cellular injury resulting in redness, swelling, heat, pain and sometimes loss of function, serves as a mechanism to facilitate healing.
· Neuropathy or Radiculopathic Pain: Ongoing pain with no obvious signs; caused by a disruption in the peripheral nervous system, leading to hyper-sensitivity in the pain sensory system.
Neuropathy specifically refers to any functional disturbances or pathological changes in the Peripheral Nervous System (PNS). The central nervous system (spinal cord and brain) is well protected by the skull and the spine, unlike the overlooked PNS, which is much more vulnerable to damage and denotes the greatest number of ongoing pain cases.
Medical professionals are apt to treat pain in the first two categories but are perplexed by pain that shows no sign of tissue damage or inflammation. Long-term pain can exist in ongoing acute pain/inflammation such as a fracture or rheumatoid arthritis (treated with surgery or anti-inflammatory drugs), or most commonly in neuropathic pain (explained further below).
Neuropathic pain has several indicators: There is a pain in the absence of ongoing tissue damage; there is a delay in the onset of pain after a precipitating injury; Mild stimuli are very painful; Pronounced summation and after-reaction from stimuli (i.e. the pain gets worse with exercise because the nervous system is already in a hypersensitive state).
This explains why you might feel fine immediately following a car accident, but a week later complain of symptoms of whiplash. The most common cause of neuropathy is everyday wear and tear or overuse. The significance of this being that such disorders as low back pain, whiplash, frozen shoulder, tennis elbow, fibromyalgia, myofascial pain, and Achilles tendinopathy are all physiologically caused by the same mechanism.
Neuropathy
A common form of neuropathy is myofascial pain. The clinical features of myofascial pain are:
· Continuous, deep, dull aching pain.
· Tender spots (trigger points) in muscles.
· Relief by deactivating trigger points.
· Restricted range of motion in muscles.
· Muscle twitch with trigger point stimulation.
Summary
IMS can benefit many conditions related to musculoskeletal, inflammatory and nerve-mediated dysfunction both acute and chronic. This ranges from sciatica to osteoarthritis, tendonitis such as tennis elbow, chronic or acute generalized low back or neck pain and beyond.
What is Physiotherapy? And how does it relate to Health and Wellness?
Physical Therapy encompasses a multitude of “tools” by which we help clients set goals to achieve a return to the activities/livelihood that creates their best sense of wellbeing without being limited by circumstance, injury, surgery, or conditions/disease of any severi
What is Physiotherapy? And how does it relate to Health and Wellness?
Physical Therapy encompasses a multitude of “tools” by which we help clients set goals to achieve a return to the activities/livelihood that creates their best sense of wellbeing without being limited by circumstance, injury, surgery, or conditions/disease of any severity.
Physical Therapy can include a broad range of individualized treatments from Manual (Hands-On) orthopaedic techniques your therapist does with you, mobilizing joints, releasing soft tissue tension, stability taping or bracing all the way to acupuncture and dry needling, education for self-management or the development of a strength, flexibility or balance program.
What Is Acupuncture? How East meets West.
Acupuncture is a safe and effective complementary treatment for many musculoskeletal conditions that physiotherapists encounter every day in practice. It is especially helpful for treating physical disorders accompanied by pain and inflammation.
Within acupuncture itself, there are different areas
What Is Acupuncture? How East meets West.
Acupuncture is a safe and effective complementary treatment for many musculoskeletal conditions that physiotherapists encounter every day in practice. It is especially helpful for treating physical disorders accompanied by pain and inflammation.
Within acupuncture itself, there are different areas of access to neural/energy systems in the body. Meridians of Chinese Medicine can be correlated with the recognized anatomical nerve pathways of the human body.
Acupuncture is effective for treating soft tissue damage to muscle, tendons, ligaments, fascia and joint capsules. Needling has multiple benefits: First, needling increases the local circulation of blood in the injured area. With increased circulation, damaged cells are removed and healing is accelerated. Studies show that the blood flow to injured areas is greatly impaired when the supply is blocked by muscle spasm, contractures or inflammation. Almost immediately, acupuncture brings the supply of both white blood cells to heal tissue and fight the risk of infection, and red blood cells to generate new tissue growth.
Secondly, needling decreases muscle tension and the tightness of connective tissue. Spasms and contractions can be relieved. A natural splinting or muscle-guarding takes place following an injury (a stiffening of surrounding tissue). This protection is beneficial at an early stage but often impedes healing if it persists too long. Acupuncture helps to relax this reflex. Dry needling (or intramuscular stimulation) can also be used for this purpose especially if the tension is chronic (of a long duration).
Acupuncture can treat various kinds of disorders including musculoskeletal, neurological, hormonal, inflammatory, respiratory and most importantly in physical therapy — pain-related conditions, new or longstanding. The emphasis of scientific investigation thus far has shown that acupuncture has effects on the pain control systems of the body. Pain relief is initiated by
acupuncture stimulus of the small-diameter nerves in muscles, which send impulses to the spinal cord.
The spinal cord and the brain are then activated to release chemicals such as endorphins. This mediates natural opiate-type pain relief within the body. Short-term relief of pain using acupuncture can enable painful joints to be mobilized and/or exercised and be incorporated into an active program.
Research studies have been done on the efficacy of using physiotherapy and acupuncture in conjunction for the rehabilitation of many common disorders including osteoarthritis
What Is Vestibular Therapy?
The vestibular system includes the parts of the inner ear and brain that process the sensory information involved with controlling balance and eye movements. Common vestibular disorders may include:
Benign Paroxysmal Positional Vertigo (BPPV);
Labyrinthitis or Vestibular Neuritis;
Meniere’s Disease;
Age-Related
What Is Vestibular Therapy?
The vestibular system includes the parts of the inner ear and brain that process the sensory information involved with controlling balance and eye movements. Common vestibular disorders may include:
Benign Paroxysmal Positional Vertigo (BPPV);
Labyrinthitis or Vestibular Neuritis;
Meniere’s Disease;
Age-Related or Neck-related Dizziness or Imbalance;
Trauma or Head Injury including Concussion;
Acoustic Neuroma
Vestibular therapy is the terminology for treatment focused towards resolution and/or management of many vestibular conditions. Physiotherapists who practice in vestibular rehabilitation have undergone advanced training to assess and treat clients with dizziness, vertigo or disequilibrium concerns. Treatment and intervention is individualized and may include:
Canalith Repositioning Maneuvers (ex. Epley);
Reflex and Balance Exercises including Falls Prevention
Joint Mobilization, Stretching and Strengthening Exercises
Physiotherapists may also incorporate additional treatments and patient education to provide an all-inclusive approach to each patient’s condition and needs.
Registered Physiotherapist
BScPT, MCPA, C-AFCI (Acup),
C-GIMS (Dry needling), Vestibular
Copyright © 2022 Flow Physiotherapy and Wellness, Vernon, B.C. - Ali Coupe Physio - All Rights Reserved.
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