Kyle Gosse
1147 Topsail Road A1N 5G5 Mount Pearl, NL, Canada

DO NOT AUTOMATICALLY ASSUME THAT YOU HAVE DONE SOMETHING WRONG OR THAT SOMETHING IS DAMAGED . When you begin to experience pain the number one variable you have at your disposal is modifying the amount of load you are performing on a weekly basis. In this context, the word load can mean something different to many different people. For some, it means reducing the amount of exercise they are doing for others it can mean decreasing how active they are at work or in the garden. ...In any of these instances, the solution very rarely is to stop the activity altogether. In many situations, this can make things worse, not better. However, many of you would be astonished about what a difference simply reducing the total volume activity can make towards the way you are feeling and the pain you are experiencing. . Helping you to modify your lifestyle and begin to instruct you on how to reintroduce the activities you want to be performing is one of our main responsibilities as clinicians! However, we can't promise you will beat the Lakers... #osteopathy #stabilityosteopathy #physicaltherapy #nbaplayoffs #stjohns #newfoundland

So true from @encompass.health I am always preaching to my clients to do the little things right before focusing on more grandiose rehab ideas. Pain more times than not is extremely multifactorial and involves more than just dealing with the biomechanics of why you might be uncomfortable. #osteopathy #physicaltherapy #painscience #stjohns #newfoundland

How do do you pick a service? As a person in pain it can be incredibly overwhelming when looking for help to choose between chiropractors, manual osteopaths, physiotherapists, athletic therapists, RMT’s, etc. Then you also have to factor in the noise from your friends and family who are aways happy to share their personal experiences on the topic. . So amongst all of this how do you pick which category is best for you? The simple answer is YOU DON’T. When you are choosing a ...clinician you are not picking their sub category of field you are picking THEM! There are many professions trained to handle a wide range of issues such as non specific low back pain, acute injuries, nerve compression, etc. When you are picking a clinician to help you, focus less of your attention on comparing the various sub categories and more attention to: - do you trust what the person is saying or do you feel as thought they are hiding behind jargon? - Do their practices seem current? - Are they empathetic? - Is there experience working with people who have similar symptoms to you? - Do they seem committed to your success as a client? - Do you feel as though you have stepped into into a follow up appointment factory with once weekly maintenance check ups? Or does the outlined timeline seem reasonable? - Have you been given exercise, lifestyle, and day to day modifications or are all the interventions passive (being done to you)? . When you focus on critical questions like this versus what subcategory of rehabilitation a clinician works in you are far more likely to find someone to help you. Also, don’t be afraid to speak to the person before booking an appointment. It is normal to want reassurances. #physicaltherapy #stjohns #osteopathy #newfoundland #rehabilitation

When watching the PGA championship this weekend I became extremely frustrated when one of the sports elite Brooks Kopeka was seen regularly receiving joint mobilizations on the ground throughout his round. The announcers would then without knowledge on the subject perpetuate the need for nonsense like this condoning it as some sort of miraculous idea. When in reality this was most likely one part of an extremely dynamic treatment model that encompassed many things such as loa...ded exercise, and swing modifications for weeks leading into the event (or at least I hope so, if not I hope he seeks new council) The fact that he was receiving these mobilizations during play would leave me to confidently speculate that he was most likely not completely rehabilitated and if it was a less important event and not a major like the PGA championship he probably would have skipped it altogether. . There is a place for interventions like this in the spectrum of treatment. Joint mobilizations can be extremely useful for managing discomfort in the short term in order to make the beginnings of long term adaptation easier. Unfortunately when this kind of thing is seen on TV average people and amateur athletes alike see it and instantly think that this is where they should be investing their rehabilitation time and dollars when in reality they don’t see that manual therapy is one tiny facet of what that professional athlete is most likely undergoing. . Popularization of things like this continuously sets back evidence based physical therapy and encourages practitioners to adopt simpler less encompassing models of treatment because the public has become so interested quick fixes. I can vividly remember seeing the same trend when Michael Phelps started showing up to the olympics covered in cupping marks. It suddenly became the thing that athletes should be doing even though the research on the subject overwhelmingly points to placebo. #physicaltherapy #stjohns #pga #osteopathy See more

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What is foam rolling actually doing? In the fitness and rehabilitation world foam rolling and various other mobility implements have become extremely popular in recent years. It’s a common sight at fitness facilities to see people frolicking around on PVC pipe or various foam contraptions that could be mistaken as torture devices for durations of up to 30 minutes. . Words like release and break down of scar tissue have become associated with foam rolling but in reality th...e literature shows us that we cannot actually create enough shear and force using these devices to cause adaptation to muscles themselves. . But if my soft tissue is not actually changing, why do I feel better after doing it?Foam rolling of an area creates a temporary neurophysiological change to the area. In essence you are adding a new sensory stimulus to distract you from one you are already experiencing. Imagine shaking your arm really quickly or grabbing your elbow and squeezing it hard after you have banged your funny bone on something. It is the same idea. These perceived changes in mobility and pain/discomfort level can last short durations improving range of motion and comfort but there is window before it becomes counter productive. . So is it worth my while to still use foam rolling as part of my fitness/rehabilitation routine?Yes, when used appropriately foam rolling can be a good tool to have. If you are experiencing pain or tightness in a particular area and a quick roll of that area with a ball or tube can take that away and make you feel more confident in your movement it is clearly a benefit. However, it is important to utilize this new perceived mobility/stability improvement immediately after doing so so the new ROM becomes an adaptation and not just a temporary feel good. . Feel free to comment below if your guilty of doing way to much self massage!https://www.ncbi.nlm.nih.gov//www/pmc/articles/PMC4637914/ #osteopathy #physicaltherapy #myofascialrelease #rehabilitation #foamrolling #trainyourbrain #stjohns #newfoundland #stabilityosteopathy See more

The Biggest Squat Myths & Misconceptions Part 5 - Chest Up! At last we enter into the final portion of this series. If only I had a dollar for every time I heard this cue shouted from coaches, spectators, and gym buddies alike. Of course it always comes from place of wanting your friend or client to succeed but unfortunately from a biomechanics perspective it is not really helpful. * When we try to lift the chest up during the squat what we are really doing is lifting the ...ribcage away from the abdomen. This drastically reduces intra abdominal air pressure rendering our breathing and bracing pointless while also making the individual significantly less explosive out of the hole (bottom position of the squat). This also increases the amount of lumbar extension we have very often preventing a deeper squat as well as causing the hips to shoot back behind you and rise to quickly (I know many of you can relate to this). * What we should actually be striving for in the squat is a neutral ribcage and neutral spine position (not extended back) at all times. This will allow a deeper squat that allows you to stay more up right (relative to your personal limb length). And it will also make it easier on the way up to always have your hips travelling forward and not create a situation in which they are shooting behind you. * Hope you guys enjoyed these and were able to squat better because of them! #osteopathy #stabilityosteopathy #mobility #stability #squats #physicaltherapy #newfoundland #stjohns

Some times in rehab therapy patients and practitioners alike can get caught up in gimmicks and fads that keep going in product loops getting rebranded, rather than focusing on basics that are research proven. As a result of this people often feel like they have tried everything but in reality they have done everything except the basics. It always catches me off guard when clients are astonished by the fact that they got results from talking through their issue thoroughly, making lifestyle modifications, small amounts of manual therapy for acute pain management, and appropriately dosed exercise prescription in conjunction with a long term plan. #osteopathy #manualosteopathy #physicaltherapy #stjohns #newfoundland

The Biggest Squat Myths & Misconceptions Part 4 - Your weight should be on your heels It is not as simple as just putting all your weight on your heels. Frequently I hear people being told when squatting to sit back on their heels or to drive through the heels when coming up out of the bottom of the squat. This often leads to the toes and ball of the foot lifting off the ground when squatting causing the weight distribution to become very focused on the heel. ... Although this isn’t entirely incorrect as we do want the primary force production coming from the the mid foot to heel, what we actually should be striving for is three points of contact on each foot with the big toe, pinky toe, and heel. Maintaining these three points of contact will allow us to have the largest possible relationship with the ground. The benefits of this are including but not limited to the ability to use dorsiflexion (foot towards shin movement) effectively, increased firing of hip musculature from the big toe contact, more stability in the eccentric (downward) portion of the movement, and lastly a more efficient stacking of the knee over the foot. The knee travelling forward over the foot creating dorsiflexion is also an essential part of us being able to close the knee joint completely and achieve a deep squat. Here is a link of Quinn Henoch DPT reiterating some of these points with visual cues, and a tip you can try if you are having trouble feeling the ground with your feet:https://youtu.be/RjH5ZLP8p1A #osteopathy #stabilityosteopathy #mobility #stability #squats #physicaltherapy #newfoundland #stjohns

The Biggest Squat Myths & Misconceptions Part 3 - I have butt wink (lumbar rounding) at the bottom of my squat because my hamstrings are too tight I very frequently hear people talk about how they think their tight hamstrings are the culprit for their lumbar collapse at the bottom of the squat. Besides the fact that the hamstrings are a commonly tight muscle in most people and it usually has more to do with things such as neurodynamic tension and the fact that people do no...t perform movements that require overly flexible hamstrings at frequency which would allow them to be mobile. The muscular function of the hamstring is to create flexion (curling) at the knee, and extension at the hip (forward not backward tilt). When we squat we are moving the hips and knees more or less at the same time so the net effect on hamstring tension is almost nothing. To find out if you have enough hamstring mobility to squat, get on your back, flex your toes towards the shin and lift your leg straight into the air without bending your knee (active straight leg raise test). If your leg reaches 70 degrees this means you probably have enough hamstring mobility to safely perform a squat and you need to spend your time improving your position and mechanics not stretching your hamstrings. Hope you guys are enjoying these! Feel free to comment and let me know what you think #osteopathy #manualosteopathy #physicaltherapy #squat #stjohns #newfoundland

Couldn’t agree with this sentiment from @strengthcoachtherapy more. You don’t need to lose sight of your long term goal because you are working at home. High intensity intervals are fine as a concept but they aren’t your only option for what you can do at home. Don’t forget about the muscles. Full body cardio high intensity workouts are fine.... . They’re absolutely better than nothing. . But they don’t build muscle. . If you want to build muscle at home, take advantage of challenging exercises. . Think large mechanical disadvantages, long lever arms, and more muscle isolation. . Load them any creative way you can, using backpacks, books, suitcases, manual resistance, or even family members. . And then make them harder: use tempo, pulses, holds, rest pause sets, drop sets, supersets, high repetitions, and high volume. . I’ll be the first person to tell you that in order to maintain your squat you have to squat, that’s not what I’m saying. There will be effects of changing your training. . But progressive overload still works at home. You can still challenge your muscles and make your workouts feel like lifts and not orange theory classes. . #StrengthCoachTherapy See more

This post hits particularly close to home for me as it has become increasingly frustrating to watch some portions of people across all forms of physical therapy professions divide into two camps of either manual therapy/modality elitism and those who oppose the point of it altogether. I still strongly believe the evidence shows us manual therapy does have a place in pain treatment models. However, we should not be basing our entire treatment plan around these interventions or... frame it in a way that makes clients psychologically dependant on it. The two work together very effectively if clinicians can come to a middle ground and start using semantics more effectively with clients. Thanks @drjarodhalldpt The topic of manual therapy is one that is complex and often emotionally charged as anyone should expect with such an entity that has garnered as much money, time, prestige, perceived value, and ascribed self-worth as that of manual therapy prowess and skill. . Traditionally narratives around manual therapy are often steeped in biomechanical rationales that place the clinician at the center of fixing the patient. This view of MT is highly corrective. These narratives make many unfounded claims about manual therapy with minimal or even no evidence. . Looking at the evidence (check out some of the work of Joel Bialosky) MT doesn’t appear to actually be able to break down scar tissue, put bones back into place, release tissues, align organs, stimulate or speed up healing, reduce inflammation, increase blood flow in any special way, reduce delayed onset muscle soreness in any appreciable way, release repressed emotions in the fascia, alter connective tissue length, accurately assess or correct accessory joint glides, or fix people all on its own. . So....what is it that manual therapy does/can do (based on current evidence): Manual therapy does stimulate sensory nerve endings, cause spinal interneuron gating, induce a placebo effect/meaning response, provide a sometimes-novel stimulus to alter perception, facilitate relaxation, feel good and create short term relief from pain, provide non-threatening physical contact, meet expectations (that we likely set ourselves - more on this later), create an opportunity human to human contact (social grooming as it has been referred to), temporarily alter symptoms to prove to people they can get better. . Manual therapy also provides the opportunity to convey narratives of the body as a machine, increase passive care-seeking, influence a person to believe they need another person's hands to fix them, create a strong mode of sunken cost fallacy influenced thinking by those that have been trained in a certain flavour, and creates potential to get stuck in "manual therapy" jail where a person is in an endless loop of coming to get their symptoms modulated with no real long term change See more

The Biggest Squat Myths & Misconceptions Part 2 - Chest Up! Thanks @squatuniversity for photos This is a cue I have heard shouted from coaches and instructors a like for years now, and although I am sure it is coming from a well intentioned place the motion itself only has negative implications for multiple reasons. ... Firstly, when you drive the chest upward on the lowering portion (eccentric) of the squat what you are actually doing is lifting the ribcage up off the abdomen and causing the low back to arch more or increase its lordotic curve (also known as an anterior pelvic tilt). When the pelvis becomes rotated into this position one of the consequences is that the edges of the hips (pelvis) are now pushed towards the knobby heads of the thigh bone (femur). Due to this, as you lower yourself before you get as deep as you want they will contact each other leading to a phenomanon known as butt wink. This is a term used to describe the low back collapsing and rounding in the bottom of the squat. So it is actually quite ironic. The attempt to lift the chest and be more upright is actually what is causing your torso to be more pitched forward as well as causing rounding in your low back. Secondly, one of the most important aspects of squatting is abdominal bracing (intra abdominal pressure). When you are in this chest lifted position where the ribs are being forced upward causing them to be no longer flush with the stomach you are actually making this area more unstable putting your body in a less safe position under maximal loads. You will also be weaker out of the bottom of the movement when you are changing direction taking away explosive energy. Lastly, even if you do everything perfectly on the way down, if you are battling with the weight on the way back up to the top you should still NOT lift your chest as all this will cause is your hips to rise behind you forcing you to do some weird hybrid good morning (back extension) due to your legs already being straight. We see mechanic very often in those new too squatting. In summary, when performing the movement focus on the ribs being flat to the stomach not the chest being up. The three pictures below show what this looks like in order! See more