Recommendations from my Physio

Every month I visit my Physiotherapist to have my mobility assessed and to have my soft-tissue myofascial pain treated using Intramuscular Stimulation (IMS). Currently I receive IMS in both my upper trapezius, as they are extremely tight, and in my SI joints.

IMS was developed by Dr. Gunn while he was a physician at the Worker's Compensation Board of British Columbia in the 70's, where he investigated the large number of mysteriously stubborn cases after frustration with the ineffective modalities at his disposal. The treatment, which utilizes acupuncture needles because they are the thinnest implements available that are designed to penetrate deep within muscle tissue, specifically targets injured muscles that have contracted and become shortened from distress.

IMS relies heavily on a thorough physical examination of the patient by a competent practitioner, trained to recognize the physical signs of neuropathic pain. This physical examination is indispensable since chronic pain is often neurological as opposed to structural, and therefore, invisible to expensive X-rays, MRI Tests, Bone and CT Scans. Failure to recognize these signs will result in an inaccurate diagnosis, and thus, a poor starting point for physical therapy.

During my visits, I ask a lot of questions about how to continue safely participating in CrossFit without aggravating my AS. There is concern for people with AS about exercises which compress the spine (overhead press), have a hinging motion at the hips (back extensions or deadlifts), or engage the SI joints in some way (i.e. a wall squats or wall balls). Because of the chronic tightness (and resulting severe pain) in both my traps, my physio has suggested that I avoid exercises which involve sustained contraction of these muscles (i.e. holding a weight overhead for any continuous length of time).

Ankylosing spondylitis (AS) is a chronic systemic rheumatic disease that mostly affects the sacroiliac
joint (SI) and vertebral column. The thoracal and spinal joint and ligament involvement in AS lead to
decreased spinal mobility in every direction, and people with AS are at risk of spinal fractures due to osteoporosis related to the mechanics of the disease. This disease can lead to permanent spinal deformity and postural disorder during the later stages so it's very important to reduce episodes of joint inflammation and to practice any activity in a safe manner.

I am working to educate my coaches about my disease so that they can better understand what I am able to do and where I have physical constraints. Because my physical abilities may change hour-by-hour and day-by-day, it's important for me to know that they understand when I need to scale back a bit on something I was previously able to do.

It is important to provide your coaches and trainers the necessary information they require to plan safe exercise routines for you. It's a partnership, so keep those doors of communication wide open.