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Migraines are a highly prevalent neurological condition that can significantly impair quality of life for many. They include symptoms such as severe headache often behind one eye along often with an aura that may include flashing lights, blind spots, blurry vision or other visual impairments. This 2023 study systematically reviewed randomized controlled trials (RCTs) to assess the durable effect of acupuncture in adults with episodic migraines- these are migraine attacks occurring intermittently but not chronically.

Methods

  • The researchers included 15 RCTs encompassing 3,035 participants.
  • Acupuncture interventions were compared against:
    1. Sham acupuncture (placebo control)
    2. No treatment or waitlist control
    3. Pharmacological migraine prophylaxis (e.g., flunarizine, metoprolol)
  • Outcomes assessed 3 months post-treatment included:
    • Number of migraine days per month
    • Number of migraine attacks per month
    • Pain intensity, measured using the Visual Analog Scale (VAS)

Findings

  • Acupuncture vs. sham: Acupuncture significantly reduced both migraine frequency and migraine days at 3 months post-treatment.
  • Acupuncture vs. no treatment: Acupuncture showed a clear benefit in reducing migraine frequency and intensity compared to the waitlist.
  • Acupuncture vs. preventive medication: Acupuncture performed comparably to pharmacologic prophylaxis, with some measures favoring acupuncture.
  • Adverse events were generally mild (e.g., minor bruising or localized pain at needle insertion sites). No serious adverse events were reported.

Should you try it?

  • Acupuncture appears to provide a sustained therapeutic effect for episodic migraine that persists at least three months after the treatment period.
  • This finding is clinically relevant because conventional preventive medications typically lose efficacy once discontinued.
  • However, evidence beyond three months is limited, making long-term durability uncertain.

Questions?

If you would like to try acupuncture, feel free to let us know or book online HERE. Physio Sayaka offers it at the clinic if you would like to discuss more before booking!

A new study in the European Spine Journal looked at how often people develop a herniated disc in the lower back and what increases the risk. A lumbar disc herniation happens when one of the discs between the bones in your spine bulges or breaks (i.e. the inner jelly protrudes through the outer fibrous layer). They can cause pain locally, or even down the leg at times in the form of sciatica if the nerve roots are being pinched.

The study reviewed many past papers and found that the problem is fairly common, especially in adults between 30 and 50 years old. It is less common in younger people but can affect anyone. How often it happens depends on how it is defined. Only a few people per thousand each year need surgery, but many more have milder symptoms that do not require it.

Several clear risk factors were found. Smoking and being overweight both make the spine weaker over time. Health issues like high blood pressure, high cholesterol, and diabetes also raise the risk. People who often bend forward, lift heavy objects, or sit for long hours at work are more likely to develop disc problems. Vibration from heavy machinery, night shifts, and high stress at work may also contribute, especially for women.

The good news is that most of these factors can be improved. Staying active, keeping a healthy weight, and using proper lifting and posture techniques can help protect your spine. Managing overall health, especially heart and blood pressure, is important too.

Tips to Protect Your Back

1. Don’t smoke, as it reduces blood flow and weakens the discs.
2. Maintain a healthy weight to lower pressure on the spine.
3. Stay active with regular walking and core strengthening.
4. Use good lifting form – maintain a neutral spine
5. Take breaks from sitting and set up your workspace properly.
6. Manage your blood pressure, cholesterol, and blood sugar.
7. Reduce stress and get enough sleep to help your body recover.

If you have more questions about your back pain, feel free to contact us or book online!

Our awesome physio, Sayaka, is expecting her second child and needs help keeping her patients strong and healthy!

Sayaka works with a diversity of patients ranging from Parkinson’s rehab, surgical rehab all the way to strength training for athletes. We are looking for somebody who works with a strong emphasis on strength work/ rehab- we want to put that gym space to use!

Some general facts about the job:

  • Flexible hours
  • Expected duration: 1 year
  • Part-time or full time- we will take what we can get if the practitioner is a good fit!
  • Your own treatment room and access to gym space
  • Jane practice software
  • Patient- focused, evidence-based work environment
  • Plenty of parking with store front entrance into the clinic
  • Reception coverage for 40 hours/week with the option to work outside of those hours

There’s always the option to work beyond the locum if it makes sense for all, but for now the focus would be on maintaining Sayaka’s patients and other new physio patients that come into the clinic.

E-mail seandelanghe@gmail.com if you want to learn more!

By: Sayaka Thiessen, Waterloo Physiotherapist

I am sure most of use have experienced a muscle that feels tight and stiff. Most people immediately think to stretch the affected area, but is that always the solution? 


If you have stretched to the ends of the earth but you still feel tight, it might be time to change the approach and try to strengthen it. The sensation of “tightness” doesn’t always mean a short muscle. It could, in fact, mean that the muscle is weak or that a joint lacks motor control and needs to be trained. 


Getting assessed by a healthcare professional, like a physiotherapist, you can determine if stretching, or strengthening, or a combination of the two is the way forward. 

Looking for a physiotherapist in Waterloo? Sayaka might be a good fit for you, read more HERE.

Exercise is always better with friends, which is why we are excited to formally offer individual and small group workout sessions guided by Physio Sayaka!

Strength is a key component of any good rehab program, and is invaluable for staying healthy, regardless of if you are an athlete or not. Plus, we all know there are many ways to go wrong when trying to implement it, so why not get work with a regulated health practitioner to make sure you are doing things the right way!


These one-hour exercise sessions are tailored to your group’s needs, such as:

  • prehab for your sport or everyday activities
  • prenatal/postpartum rehab and strengthening
  • peri/post-menopausal strengthening
  • maintaining fitness in a safe environment with consideration for your previous injuries

Sessions are scheduled in advance to reserve the same time every week. We’re flexible on the duration, but 4 weeks minimum is usually a good place to start.

COST: 
Cost will be scaled to the size of the group:

Prices for the group session:

  • 4 people: $68 per person/session
  • 3 people: $78 per person/session
  • 2 people: $93 per person/session
  • Solo: $124

Covered under your physiotherapy benefits!

Note: Anyone looking to claim this under their PT benefits will need to come in for a short assessment to ensure we are delivering appropriate care for your PT goals. 

Reach out today if you’re interested! sayaka.physio@gmail.com

We’re excited at the clinic that we’ve decided to take on the Run Waterloo Grandway 5K as a team!

Completing 5Ks isn’t just about racing to your limit- conquering it in any capacity can do wonders for your health. Here at the clinic we all have all different goals for this event depending on factors like family, work schedule and our fitness starting point. Here is how everybody hopes to do and how they are going to prepare!

Dr. Sean

GOAL: Something that’s less than 2 minutes slower than my personal best- anything faster than 17:30.

TRAINING GOAL: I hope to run 50-60K/week most weeks with 1 interval workout and one longer run most weeks.

Chiro Intern Taylor

GOAL: Finish without walking! Anything under 40 would be great.

TRAINING GOAL: 1 run/week (3-5 km), 1 distance walk/week (3-5km), carrying around my 10-month old all the time otherwise!

Physio Sayaka

GOAL: To come in around 22:30 give or take 10 seconds. 

TRAINING GOAL: Run 3x/week and nail the weekly H+P interval workout. 

Karen Kennedy

GOAL: Why is Sean making me do this?

TRAINING GOAL: Walking 3x/week.

Jackie Hergott

GOAL: To complete the race with a brisk walk, and not be worn out when done.

TRAINING GOAL: Walking 2-5x/week, 3-5K total!

Lance Dawson

GOAL: Under 25minutes, enjoy the race.

TRAINING GOAL: A mix of cardio and weights every week. Playing in my band and drinking teas with 4-7 sugars.

Meet our Waterloo Chiropractor and Physiotherapy Team

Our team of Waterloo Chiropractors, physiotherapists, and registered massage therapists are here to help you get out of pain, and back to the life you enjoy as soon as possible. We use only the necessary treatments, nothing more.

We always take the time to conduct a full history and physical exam to identify exactly what is causing your pain. You will always be provided with a precise diagnosis, an explanation of your injury, a variety of treatment options, and a prognosis so that there are no surprises.

We are Evidence-Based

Our treatments are based on what only the newest and best scientific research is showing- you do not have to be concerned with pseudoscience or poorly understood concepts.

Dr. Sean Delanghe & Dr. Rebecca Blackburn both graduated from the most highly regarded chiropractic school, CMCC.

We strive to prevent recurrence

Our goal is not only to help you become pain-free, but also to stay pain-free.

With every injury, there will always be an option for different interventions to help prevent your injury from returning. This may include options ranging from ergonomic training to custom exercise plans.

By: SAYAKA TIESSEN, HONS. BKIN, MSCPT

Book here

Ankle sprains, AKA rolled ankles, have got to be one of the most common injuries out there. They can happen in the most innocuous situations, like stepping on an uneven surface, or during sports that require cutting and landing. The words “walk it off” are synonymous with ankle sprains. Get up. It’s nothing serious. Back to business.

I get the sense that most people that sustain an ankle sprain do not seek any guidance from a physiotherapist. It might swell up nicely for a day or two, but then you limp around and manage to get on with your life. What you might not appreciate though, is that ankle sprains have a high recurrence rate due to the residual effects of the initial injury. Things like ligament laxity and damage to the neural and musculotendinous tissue around the ankle can inhibit complete recovery. This can present as weakness, poor balance, and slower muscle response to load. You might not notice these deficits when you are walking around, but they do make you susceptible to re-injuring the area. This is why I always advocate for getting any old rolled ankle assessed by a physiotherapist.

I often prescribe a blend of resistance and balance training for my ankle sprain patients. But if you are super crunched for time, is there one that is more efficient than the other?According to a 2021 study, although resistance training and balance training on their own improves strength, hopping (explosiveness and control), and dynamic balance, if you had to pick one, balance training takes the edge. This is likely due to the high training load used in the study (20-30 second holds, 10-20x, 3-5 sets over multiple exercises), and the fact that you need to be strong and coordinated to balance well, and strictly strengthening will not challenge your proprioception (balance-ability). Time to get your Karate Kid on.

Want to know what kind of exercises are appropriate for you? Or have you sprained your ankle before and feel things are not quite right? You can book an appointment with me here!

We’re back again for the latest in my series on strength training for endurance athletes!

I’ve written previously about how and when strength training should be used in a nuanced way- it’s not as simple as ‘strength is always good!’ Check it out: here, here, here and here.

Now, the next question: is there a downside to strength training? Time costs aside, are there risks or detrimental aspects to including strength training in your quest to be a better endurance athlete? That is what I am taking a quick look at in this article.

Muscle hypertrophy:

First and foremost, based on my previous articles, we know the goal of strength training is to improve our running economy without losing any other components of why we run well. However, it’s not as simple as ‘build power, go faster;’ it’s about how you maximize your power-to-weight ratio.

The other consideration is that if you put on muscle mass, the ratio of the density of blood vessels carrying oxygen to the muscles vs. the volume of muscles they supply goes down – once again, hurting endurance performance.

The key with this is that higher rep, lower weight exercises don’t seem to give the same boost in performance that high weight, low rep strength work does. The flip side to this is that low rep exercises are what builds mass – something we don’t necessarily need to be faster. So, what’s the balance?

CLICK HERE to read the rest in the Run Waterloo Magazine.

Welcome back to my series on strength training and endurance sports. My last article looked at strength work and cycling economy- which was way back in June. I have a good excuse though: the birth of my daughter, Adeline Delanghe!

I would like to say “now that her sleep is normalizing blah blah,” but that simply is not the case. Instead, I’m just getting better at squeezing stuff in, which hopefully will result in more science of training articles for you all!

In any case, if you haven’t already, please review the first three articles in this series. The idea is not to give you a cookie-cutter, magical answer on how endurance athletes should utilize strength training. Instead, this is meant to introduce you to some of the nuances in the science, and how to decide if, when, and how much resistance training you should do.

Strength training 101: Impact on V02Max
Strength training 102: Impact on Running economy
Strength training 103: The impact of cycling economy

To add to the above, today’s article will take a look at another parameter of endurance performance- lactate threshold.

Strength Training and your Lactate Threshold (LT)

What is your LT? This is essentially the exercise intensity at which lactate accumulates in the blood faster than it can be removed. This is the “breaking point” so to speak between low and high-intensity work.

While V02max is important, having a high lactate threshold is crucial in endurance performance. The higher the lactate threshold is as a % of your V02max, the harder the effort you will be able to sustain for long periods of time. We don’t race at our V02max, but we do spend lots of time in and around our lactate threshold!

While V02max is a popular thing to measure and be proud of, as we have noted before, somebody with the highest V02max doesn’t always win the race, especially in running. As we discussed, this is in large part due to exercise economy. However, this is also seen when somebody has more effectively trained their lactate threshold despite not having the same max oxygen-consuming ability. In other words, having a slightly lower V02max that’s good enough, and a very highly trained LT can allow you to beat a competitor with a higher V02max.

V02max is the ceiling, and we want to max it out, and then get our LT as close to it as possible to be at our best!

CLICK HERE to read the rest on the Run Waterloo Blog.

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