A collection of thoughts from Dr. Kirstie Griffiths
Who is Dr. Kirstie Griffiths?
Q. Where was your hometown, and what was your favourite thing about it?
A. I spent the first few years of my life in a small town called Tottenham, Ontario. The best thing as a child was that there were many young families in the community so the street I lived on had other kids to make friends with. When I grew older I became eager to move to a large city and dreamed of the day I could set up in Toronto. Many years later, after spending three years studying chiropractic in Toronto, I missed and yearned for all of the things to appreciate about living in a smaller, close-knit community. Guelph is the perfect size for me, and I am so excited to be back here to grow my career!
Q. Why did you enter your field of practice?
A. I studied biomedical science at the University of Guelph knowing I wished to pursue a role in healthcare. In my fourth year, I completed research with Dr. John Srbely, a chiropractor and professor of human health at the university. We were studying pain mechanisms in patients with chronic pain, attempting to find a way to track brain activity to objectively measure the experience of pain. I was so inspired by our work with these patients that I began considering a career in manual therapy. Spending many years as a competitive dancer, I have always held a keen interest in biomechanics and the influence of movement on health. This field of healthcare has so much to offer, and I can’t wait to see what the future has in store for our profession.
Q. What is the most rewarding experience you have had in your practice?
I have had many meaningful experiences with patients that have left an impression on me. Nearing the completion of my intern year, I expected to feel relieved, excited, and ready to conquer what was coming next. Instead I was met with sadness. Greeting my final patient as a clinical intern, she asked me "so, how does it feel?" and I responded with "conflicting - I can't understand why this feels like sadness right now." And then she said something that served as a reminder that our patients in some ways help to heal us too. "You have spent the last 6 months getting to know your patients. These people aren't just "people" anymore, they are relationships. And how many relationships did you have to end today?" Saying goodbye to my final patient as intern was hard, but it was for exactly this reason that I felt so certain I had taken the first steps on an incredible path. We are invested in people’s lives and well-being and want to know that they are happy, and healthy, and taken care of. I have the privilege of calling my passion my job and that makes each day uniquely rewarding.
Q. What has been the best year of your life so far? why?
A. 2018 was life changing! Last year I had the opportunity to travel to the Dominican Republic on a volunteer outreach to treat patients with limited access to care. This was such a rewarding experience and assisted in sharpening my skills as a chiropractic intern. In June, I wrote my last board exam and walked across the stage to graduate with (what my husband and family are probably hoping will be the last one) a degree I worked so hard to achieve. A couple of weeks later I married my university sweet heart, and we took off on a honeymoon to travel Greece and Rome. I returned ready to get geared up to begin practice. 2018 was one of those years when all of the pieces finally come together and it is the most gratifying feeling in the world.
Q. What is your favourite pastime away from the clinic?
A. I have several hobbies that keep me busy when I am not in clinic. I would classify myself as a foodie and make a point of perusing TripAdvisor to try out the newest and best restaurants in town. My husband and I are both in love with our golden retriever Downie (yes, she is named after Gord Downie), and completely spoil her with affection and treats. I teach yoga in several locations around Guelph when I am not in clinic, and really enjoy sharing the bliss that the practice has brought me over the years.
Top 3 Objections to Exercising with Back Pain
Movement is medicine. Yoga has been studied extensively and has incredible success in the management of pain conditions. When my patients and I dialogue this, I see several common themes:
1) Back Pain patients are interested in togs but they are nervous about exercising; there is uncertainty surrounding their condition and what motion is safe versus harmful
2) Traditional gym/studio settings may not be the right fit; they are not prepared to commit to an annual membership, class sizes are large, and the instruction is too broad and geared toward many levels of fitness
3) They are concerned that their instructors may not possess the knowledge to appropriately modify and offer instruction that reflects their health condition
That is why I have designed a program that combines my expertise and passion for healthcare & yoga. My Yoga for Low Back Pain program is a 12 week program that combines education, movement, and meditation to give you the tools to get out of pain. Space is limited to 10 participants allowing for personalized instruction and the opportunity for hands-on assists.
This program offers much of the education and rehabilitation I offer my patients, but in a small group setting, providing an economical care option to those suffering with back pain.
Are Sit-ups and Supermans Causing your Back Pain?
One of the things we discuss in the Yoga for Low Back Pain therapy program is The Big Three.
Dr. Stu McGill is a world renowned professor at The University of Waterloo and is a wizard when it comes to spinal mechanics. He integrates the use of three specific core exercises that are particularly useful in the rehabilitation of back pain.
Spinal stability can be improved during postures and movements by isolating the deep abdominal muscles, specifically transverse abdominus and multifidus. These form a myofascial corset around the waist and provide support during spine loading.
The issue with traditional core exercises we employ such as Sit-ups and Supermans is that they produce very high compression levels in the spine that can cause tissue damage.
If you experience back pain, consider swapping out your current ab routine with The Big Three:
1) Bird Dog - This exercise is pictured above and trains transverse abdominus, spinal extensors and multifidus. Emphasis on neutral spinal alignment in this position is key.
2) Modified Curl Up - Effectively trains rectus abdominus but minimizes lumbopelvic flexion compared to full sit ups to reduce the risk of disc herniation.
3) Side Bridge/Plank - Activates quadratus lomborum, obliques and transverse abdominus while minimizing spine loading.
Training for health is different than training for performance, and this is one of the driving factors behind behind the development of my clinical yoga program “Yoga for Low Back Pain”. In the world of rehabilitation, less is often more.
It Begins with Listening
When I was in the third year of my Biomedical Sciences degree, I worked up the courage to apply for medical school. I wrote about it the day I went out to buy the MCAT prep book. “All or those mistakes and wrong turns were worth it, just to experience the satisfaction of scraping the dirt off your flesh, looking the world dead on, and saying ‘maybe I can actually do this.’ Dream big.”
Then life happened, my dreams were redirected and one year ago today, I walked across the stage as Dr. Kirstyn Ross, Doctor of Chiropractic. It’s been a year. One of making mistakes, having uncertainties, feeling like it is impossible to learn as much as I want to, but also one of growing, learning as much as I could, and experiencing a fulfilling bliss that I would not replace for anything.
On the days when I feel the experience the greatest doubt, I remember the oath I took, 365 days ago. “I will at all times stand ready to serve my fellow people, without distinction of race, creed or colour, in my lifelong vocation of preventing and alleviating human suffering, wherever it may be found.”
Some days that means getting the diagnosis right. Other days it means providing a safe space. If there is one thing I have learned for certain, it is that healing takes on many forms and usually begins with listening.
Chiropractic Myth Buster
“I’m not sure if I want to see a chiropractor - I’ve heard once you go, they tell you you have to keep going. Is that true?”
This isn’t the first time I have heard these concerns, oftentimes they come directly from my patients on their first visit.
So here is my truth. I want you to come and see me because you want to be here. Because you value your health and you have some degree of optimism that I can provide guidance in assisting you with your goals. In the report of findings I explain to patients that one of three things tends to happen while you are under care:
1) You don’t respond to treatment - this is rare, but it does happen. We need a few treatments to have enough data to draw conclusions about how things are progressing but if there is no change, I don’t try to convince you to keep coming. I will refer you to someone who may be better able to assist.
2) You improve - this is the majority of cases I have seen in practice. Sometimes it takes one treatment, sometimes it takes many. We check in at the start of each visit and I ask you how things are feeling. We do objective tests so we can track your progress along the way. The path is not a linear trajectory and that is ok as long as it is trending toward recovery.
3) You recover. I am as excited as you are when this happens because I have observed the incredible work you have invested in this journey.
While there are some risks, it is very rare that receiving treatment will make things worse for you. My patients choose to return because treatment feels good and it suits their lifestyle of prioritizing their health. Maintenance care is a perfect way to touch base every once in a while to receive some feel good care, review exercises, and create space to dialogue questions that have come up along the way.
So while I do have patients that keep coming to see me even when they no longer have pain, this is not driven by the idea that if they stop coming, they will deteriorate. There is so much more to the therapeutic relationship than treating pain.
I have heard so many translations and extensions of this phrase over the eight years that I have exited practice rooms.
“I bow to you”
“The divine light within me honours and bows down to the divine light in you”
“My soul recognizes your soul”
Tonight in my class, it revealed a depth that I have never experienced.
Tonight’s class was themed around the throat chakra, inspired by a screw up in my workplace today (more on this later). I opened my class by talking about my missteps. I dialogued how I would do things differently in the future. And then we went on to flow and breathe together in a practice that felt viscerally deep.
We closed our class as a collective and when the room had emptied, one of my students stayed behind and said some version of this to me:
“We are so blessed that you bring your stories into your teaching and live this practice off of your mat. Your vulnerability is truly your gift; every time I come into this room, I am taken on a journey and I leave here feeling like a freer person then when I arrived - As if I am floating. You are a star that burns so brightly and asks for nothing in return. I am so grateful for your offerings”
All of that expansion in the throat cultivated in our practice; a feeling bubbled up directly from my heart, rose to the surface and released itself from that place of expression. With absolute safety and comfort, I started to cry.
I see you. I see myself in you, because in this space, we are the same. I feel your pain and your gratitude and everything in between, because we are one. With recognition that our souls are inseparable, I bow to you; Namaste
The Body Keeps the Score
For my first few months in practice I suffered from persistent headaches that were intensified by stress. I began a ritual of carving out care days where I set one day of the month aside to totally step away from my business and take care of my mind and body. It turns out you can never really totally step about from your business, my practice is such a real part of me and it shows up regularly on my off days.
So once a month on a Thursday, I indulge in yoga, steam room, hot tub and sauna, and schedule my back-to-back (haha) massage appointment and chiropractic treatment. During one of these appointments, I engaged in a wonderfully deep conversation with my colleague at the clinic. At the close of the hour, she handed me this book.
This was two months ago. Truth be told, I hadn’t opened this yet because of the sheer volume of the text. But this book kept showing up for me in life and I took it as a sign to crack the front cover and dive in. I’m 38 pages in and the author is putting the essence of my practice into words in a way I didn’t know was possible.
“The brain-disease model overlooks 4 fundamental truths:
1) our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring well-being.
2) language gives us power to change ourselves and others by communicating our experiences helping us to define what we know and finding a common sense of meaning.
3) we have the ability to regulate our own physiology, including functions of the body and brain through such basic activities as breathing, moving, and touching
4) we can change social conditions to create environments in which people can feel safe and thrive”
You had me at number one
Your Pain is Real
Pain is subjective; we experience it in different ways, at different times, and for different reasons. As a chiropractor, that makes our job difficult sometimes. When a patient comes to see me with a sore neck because they slept funny the night before, I know exactly what to do to help that problem; an adjustment has a high probability of alleviating the pain.
But when someone comes to see me with back pain that has persisted for many months, back pain that has completely changed their quality of life, back pain that has instilled fear and frustration and despair; to live that experience is an important distinction.
Central sensitization is a process that describes how the brain can become sensitized to an area of initial pain and create a heightened response. This pain can persist even once the injury has resolved and there is no lingering tissue damage. The reason for this is because pain is a construct of the brain.
To put this into perspective, there is a condition that demonstrates this phenomenon called Phantom Limb Pain. It describes how a person who has had an amputation of a limb can still feel pain associated with that limb long after it has been disconnected from the physical body. The brain has mapped the pain; the brain sees the limb as being present and the pain is as real as ever.
When a patient comes to me with a long history of pain, my treatment approach is different. It is education. It is teaching the difference between pain that reflects a danger versus pain that is a construct of the mind. It is training my patients how to understand these subtle differences in their own bodies, and invite feel-good pain-free movements back into their routine in an attempt to override the system. It is taking back control of your pain and ultimately taking back control of your life.
So, to those of you who are dealing with chronic pain and all of the challenges that come with it - I see you. Your pain is real. I am on your team. It may take some time, but I will do everything I can to help you get back to living.
Let's Clear the Air
How many of you are nervous about seeing a chiropractor because you have heard horror stories from people being told they need treatment several times per week for what seems like an eternity, and if they do not comply, the condition will worsen? I meet new patients every week who come in telling me that they have reservations about seeing a chiropractor because someone they know had a negative experience and they are not quite sure what it is I do and whether or not it works. My hope is to use this platforms to speak truth to create a clearer picture of how we serve as healthcare practitioners.
I practice an evidence based model of care, meaning when I develop a plan of management, I combine information from scientific studies, professional experience, and the values, preferences and circumstances of the specific patient in front of me. Different people are different and for that reason my treatment plans morph over time and bodies to suit the needs of the patient. Some general rules of thumb that guide my suggestions for treatment:
1. Chronic pain takes longer to resolve compared to acute issues; the problem did not appear overnight, so it requires some time invested for correction.
2. More treatment up front can be helpful to correct a problem rapidly, especially if the issue is an acute pain such as waking up after a night of sleeping in an awkward position.
3. Lastly, this idea of “maintenance care” - this was a term that frightened me as a student. If you are being treated for upper back pain, you may start feeling better very quickly and cease care. This is what I would have done if I were in your shoes a few years ago. Oh, how things have changed! The issue here is if you work at a desk 40 hours per week and are subjecting your spine to the same stressors and risk factors for back pain day in and day out, that pain has a very good chance of settling back in. Regular treatment can help to prevent recurring issues from recurring, and I am excited to say this is supported by the research.
Yoga is a Bridge
A regular yoga practice has the power to transcend our mats and show up for us in other areas of our lives. Time invested on the mat allows us to become aware of the inner workings of our minds. It can shape them to become less reactive. It can assist in shifting our perspective out of our own stories.
Our history and experiences create bias, often setting us up to misinterpret the actions of others in a negative light. Previous instances of hurt and loss collect in our subconscious, building walls of defence from which to seek shelter behind in current moments of challenge. Yoga cultivates a sense of objectivity and oneness, allowing us to peer out from behind our walls.
When we look beyond ourselves, we see parts of ourselves in others, and parts of others in ourselves because we are universal. Yoga creates a bridge between us and the rest of the world, so that with every interaction, we develop the ability to break down our walls, cross the threshold, and land softly on the other side.
DR Outreach Anniversary
One year ago today, I was pulling on scrubs, preparing for my first morning of treating patients in the Dominican Republic.
It is hard to look at photos of this girl and believe that this was only one year ago. So much has shifted. So many challenges have been met. So many elements of my life have blossomed.
I remember sitting down at the end of this day, soaked through with sweat, facing an exhaustion I had never known. So many things about that first day were difficult - the language barrier, the sheer patient load, the inescapable heat, and the overwhelming reminder that I still had so much to learn.
It has been one year and I now take comfort in knowing I will always have so much more to learn. That quest for knowledge and better patient care keeps me inspired, while the unanswered questions keep me grounded.
I am forever grateful to have been gifted with this opportunity to travel to another country and treat patients that would otherwise have limited access to care. These beautiful people reinforced the greatest lesson I have learned in practice; that love is a universal language and that as chiropractors, our hearts together with our hands have a great capacity to heal
You Will Always Be Welcomed Here; Come As You Are
In tonight’s yoga class, I introduced the idea of our external environment shaping our internal architecture. I talked about how these stimuli have the potential to shape our mood and how we have some element of control over many of these inputs.
And then I talked about the things we can’t control. What do we do when we can’t limit our exposure to the things that do not serve us?
We may not be able to eliminate the bad altogether, but we can choose to turn the volume up or down. And when our environment is not nurturing us, that is the best time to turn the attention inward and go deep.
As instructors, we tend to teach what we need or offer up to the universe the lessons we have earned from surviving all sorts of mistakes along the way. We sprinkle this with good intention on our students but we are sometimes unsure of how it lands.
So when one of my students approached me after today’s class with gratitude and tears in his eyes, expressing that this class was particularly significant - when a student reciprocates with this level of connection - that is my affirmation that we must continue teaching with our hearts first. That is a reminder to me, of the importance of providing a safe space and repeating this offering until it is engrained in body and mind;
You will always be welcomed here. Come as you are.
Mental Health is Health
I want to talk about “mental health” for a moment. We have a tendency to frame mental health in a way that makes it seem separate from the rest of us; as if there are two separate boxes, one for mental health and the other for physical health, more commonly referred to simply as “health”. I would like to paint a picture of the oddity of this using an example that is easy to wrap our heads around.
This would be like saying there is “health” and then there is “heart health.” Imagine someone arriving to their doctor’s office having difficulty breathing. Any number of things can cause this symptom, but imagine for a moment that this person knows they have heart failure and they leave this out of the discussion with their doctor because they are coming in with a lung problem, and lungs are separate from the heart. We know these physical systems are intimately connected. We can picture how a heart problem with its network of vessels supplying the entire body could have an impact on another organ.
So what about the brain? Why is it as relevant to disclose to your chiropractor a history of a mental health condition as it is to disclose a history of repetitive ankle sprains? Because mental and physical health can not be separated into two boxes. A new picture must be painted demonstrating the connection between mental processes, the physical body and how we experience pain. Conditions including depression and anxiety have a bidirectional relationship with chronic pain meaning depression and anxiety can increase the risk of developing chronic pain and enduring chronic pain increases the likelihood of developing anxiety or depression. This relationship is so strong that antidepressants are often prescribed for chronic pain in the absence of depression. Your history of emotional trauma may alter our approach to care given that our main therapeutic modality includes physical touch and hands on work.
Your mind matters.
Your mental health is health.
We honour this.
Yesterday’s home practice did not go as planned.
After a busy day of connecting with lovely humans and running errands, I thought it might be relaxing to roll out my mat for a little Vinyasa before getting ready for my meditation class. Relaxing was not necessarily the word I would use to describe the practice that unfolded; instead it was a perfect example of the necessity to be flexible (body and mind).
So here is my dog Downie; trotting all over my mat, leaving her little paw prints as evidence of her presence. Over the course of this one hour flow, I created a chair barricade, moved her bed three times, and tried my very best to ignore her. She wasn’t having any of it.
But my day had been too bright to be frustrated by this. So we flowed together. I pet her in between asanas. I laid in stillness as she licked my hands looking for treats. I giggled in savasana when she dropped her toy on me as a gesture to be playful.
A reminder to be playful
To not take yoga too seriously
To be open to experiencing life exactly as it comes.
Puppy Vinyasa; filing this away as a future business idea after Yoga for Low Back Pain
This is Your Journey
Every day is not perfect, but if you ask my patients, this is generally the level of enthusiasm I bring to our encounters. I love being a chiropractor, I feel privileged to be a part of this profession and I aim to use to platform to spread truth about what it is we do and why we do it.
Your initial appointment is intended to be for information gathering, building the foundation for a trusting doctor-patient relationship, and addressing any questions you may have. I conduct a thorough health history and physical exam to understand what is causing your pain in order to map out a plan of management. As part of this discussion, I will ask you about your goals; as important as it is to determine the cause of your pain, I feel it is more important to understand what your motivation is for seeking out care. How is it impacting your life? What effect is it having on your mood and state of being?
After our first visit, I sit down and write out your Report Of Findings which is shared with you on your second visit. I outline the information you have shared with me, the findings from the physical exam, the diagnosis and the recommendations for treatment. These extend beyond the adjustments and soft tissue work we do in the clinic, and are reflective of your personal picture. If your pain is affecting your sleep, we look at strategies to improve it. If your pain is amplifying stress, we look at ways to reduce it. I use yoga therapy as part of my treatment plan, building a personalized routine to suit the needs of the person before me, breaking down postures one at a time at each visit. We discuss mindfulness and how it can be cultivated to increase your awareness of pain triggers to give you a greater sense of control over your condition.
This is all to say that we typically spend 1.5 hours together before we begin the hands-on treatment you are seeking. This time is so vital for ensuring that you are receiving the most appropriate care that is congruent with your goals, and creates space to establish a trust that is necessary for a therapeutic relationship.
This is your journey; and I am here to support you on it.
Is Yoga the New Food Guide?
Not exactly, but hear me out on how yogic philosophy has trickled into this new set of recommendations put forth by the Canadian Government.
I spent some time today appraising these new changes with a skeptical eye, and I must say; Canada, you have made me proud. This is a program I can get on board with. This is a program reflective of how I approach diet with my patients. This is holistic nutrition presented in such a way that respects the research while simultaneously feeling intuitive.
The most exciting updates to the food guide surround the psychology and sociology of eating. They acknowledge that food intake for Canadians goes beyond four food groups. The what, why, when, where, and how often’s of eating involve culture, technology, and arguably above all else, the mind; and this is such an important place to start.
So the scientist and yogi in me beamed in unison when I came across “mindfulness” “eating for enjoyment” and “eating with others” as critical updates to this plan. This is paired alongside practical recommendations such as swapping out store bought dressings for homemade olive based ones, drinking water with meals, and incorporating plant based proteins for their added nutritional benefits.
Now is as good a time as any to bring health back to what we eat, and it simply starts by paying attention. May we let go of the unrealistic limitations we place on diet that lead to guilt and anxiety. Turning off the phone at meal time, connecting with other humans over food, savouring and enjoying every last bite; this is where we begin.