November is National Bladder Health Month

If your bladder needs a tune-up, the physical therapists at CTS can help. Call for more information: 858-457-8419
The legalization of medical and recreational marijuana in California has brought with it an avalanche of questions to our clinic. Medical marijuana has been touted to treat chronic pain, inflammation, anxiety, spasticity, and much more. All of this excitement can also bring some confusion. Who is it right for? Where can it be purchased? Is it safe? Understanding the terminology alone can be challenging.

Let's start with some basic facts and definitions:
  • There are three primary cannabis species: C stativa, C indica, C ruderalis. C stative and C indica are species that contain active byproducts used in medical marijuana. C stativa produces a more euphoric psychotropic high whereas a C indica produces a more calming high. Hybrids, a combination of stativa and indica are also available.

  • The marijuana plant has up to 100 active compounds known as cannabinoids. The two most relevant cannabinoids are THC and CBD.

  • THC is the active component that produces psychotropic effects.

  • CBD alone does not produce psychotropic effects. Instead it is said to address pain, inflammation, spasticity, seizures, etc.

  • CBD derived from hemp is legal in all 50 states. Cannabis species that have little or no active effects are known as hemp.

Methods of ingesting:
  • Smoking - Smoking marijuana has fast acting results that allow the user to feel the effects within minutes. This can make titrating dosage a little easier as patients need only wait a few minutes to assess if the amount ingested is providing desired effect. Smoking can be contraindicated for those who have lung issues such as asthma and COPD as it introduces harmful products into the lungs.

  • Vaping- Smoking through a vaporizer releases medicinal properties and eliminates the hazards associated with inhaling combusted irritants associated with the burning of the plant. The effects are otherwise similar to smoking.

  • Edible marijuana- When ingested, edible marijuana takes a long time, an hour or so, to realize its effects. When digested, effects also last for a longer period of time and can create a more systemic experience.

  • Topical preparations- Properties are absorbed into the skin in the form of a lotion or salve for a primarily local effect. This is most often used for localized pain and/or inflammation relief.

  • Sprays/ Tinctures- Taken orally and sprays and tinctures are absorbed through mucosa lining of the mouth. This route of administration results in feeling the effects in about 10-15 minutes.

Medical marijuana is increasingly a topic of conversation within the medical community. This post is not intended to advocate for nor argue against the use of medical marijuana. Rather, this post is intended to put forth some basic information on the subject. It is advised that anyone considering the use of medical marijuana should contact his or her physician for a physical examination to determine if it is appropriate for you as well as direct you to safe and effective products if deemed appropriate.

Charles D. Ciccone; Medical Marijuana: Just the Beginning of a Long, Strange Trip?, Physical Therapy, Volume 97, Issue 2, 1 February 2017, Pages 239-248,
Anne Shea, DPT
The joys of holiday travel can be overshadowed by the 'pain' of hauling excessive luggage, sleeping in a different bed and extended periods of sitting. Here are our favorite tips to keep you feeling your best while traveling so you can enjoy your destination.

Take breaks while driving
Every hour or two, stop and walk for a few minutes. It's also not a bad idea to do some standing back extensions. Sitting places your spine in a flexed position, so moving it the opposite direction can prevent pain.

Support your back
If you're going to be sitting for extended periods, like on an airplane, using lumbar support can keep you more comfortable. A lumbar roll, or small pillow works well placed between the seat and the small of back. Using a rolled jacket or blanket is another good option.

Choose the right luggage
Suitcases with wheels let you avoid lifting and carrying. If you're flying, check your bags to avoid the overhead lifting. A backpack that can be worn on both shoulders makes a great carry-on, easier to handle than a bag you can only use one hand on.

Dress to move
Comfortable shoes and clothes let you walk when you have the opportunity. If you have down time, like waiting at the gate at the airport, or waiting for your hotel room to be ready, use the opportunity to take a walk instead of sitting.

Pillow talk
If you have a long flight, train or car ride where you plan to sleep, use a neck pillow. This helps you avoid sleeping with a twisted neck, then waking up in pain. If you're worried about the comfort of the pillows at the hotel, don't be afraid to bring your own.

Listen to your body
Vague discomfort is often a warning sign that you need to move!

Don't take a vacation from exercise
Maintain your usual activity level. Research local exercise facilities before you head to a new town, take your running shoes, and travel with your theraband and foam roller. The more you can maintain your activity level, the less likely you are to end up in pain.

With these tips, you should be able to arrive at your destination feeling ready to enjoy your time with your family instead of in pain, stiff, or sore.
Jill Menefee, PT