Trish Trumper, RMT

03/24/2026

Most people look at this and focus on the timelines. 9 months, 12 months, 2 years. Nice and tidy. Real patients don’t follow that.

What matters more is what you actually see.

Adhesive capsulitis isn’t just a “stiff shoulder.” It’s a shoulder where movement is limited whether the patient tries… or you try. Active range is reduced, and passive range is reduced as well. That’s one of the key clinical signs.

If they can’t lift it, but you can move it further, you’re thinking along a different line. If both are restricted — especially external rotation — adhesive capsulitis moves higher up your list.

Now, risk factors.

This doesn’t just show up randomly. There are patterns. Diabetes is a big one. Thyroid disorders also come up regularly. Previous shoulder injury or a period of reduced use can trigger it. And then there’s age — most commonly between 40–60.

You’ll also see it more in females, and menopause likely plays a role here. Hormonal changes, particularly the drop in oestrogen, are thought to influence connective tissue behaviour and inflammatory responses. That can make the capsule more susceptible to thickening and stiffness. It’s not the only reason, but it’s part of the picture.

The inflammation point in this graphic is only part of the story. Early on, yes, there may be an inflammatory component. As it progresses, you’re dealing more with capsular thickening and reduced joint capacity. So it’s not just something that needs “calming down.”

And the stages? Freezing, frozen, thawing. Useful as a rough guide, but don’t treat it like a schedule. Patients don’t move through this in a straight line.

Management isn’t about forcing range back. It’s about working within tolerance, keeping the shoulder moving, and reducing sensitivity so the patient can actually use it again. Sometimes injections help, sometimes they don’t. There’s no one-size approach.

Bottom line:

If it doesn’t move when they try… and it doesn’t move when you try… pay attention.

03/24/2026

Every COVID-19 infection carries a risk of Long COVID - affecting the brain, heart, lungs, and immune system in ways that can last months or longer.

Prevention still works.

- Masking: Wear a high-quality mask (N95 or better) to reduce spread
- Ventilation: Bring in fresh air and use HEPA filtration indoors
- Distancing: Reduce crowding, use hybrid/remote options when possible
- Testing: Test early and often
- Vaccination: Helps protect against severe illness, especially with other measures

03/24/2026

Are you waiting for a medical imaging appointment(CT, MRI, ultrasound, bone density or bone scan)?

If you’re registered with MyHealth, you’ll get text/email notifications with your appointment details, preparation instructions, and appointment confirmation links!

There’s also a phone number for patient questions or cancellations: 250-370-8003

Patients can register for MyHealth by phone: 1-844-844-2219

Or in person at any Island Health lab, medical imaging site, or hospital admission desk.

Or online: getmyhealth.islandhealth.ca

03/22/2026

So, walking is great, but it isn’t going to maintain or build strength.

As we get older, strength training becomes more important for us, in order to keep being functional.

Things like climbing up or down stairs, lifting suitcases, moving furniture, carrying groceries, yard work, helping others, these all require strength.

Wondering where to start?

Have a look at this summary from the American College of Sports Medicine 2026 review of the evidence, and feel free to ask us any questions:

Happy strength training!! 💪🏼😊

03/19/2026

03/13/2026

Podcast Episode · The Dose · 2026-02-05 · 28m

03/13/2026

Wanting to learn more about menopause? Dr. Jen Gunter is a very well respected and reliable source...as well as a great speaker! Hope to see some of you there.

03/12/2026

For the 750 million people who hear a relentless ringing, buzzing, or hissing sound that no one else can hear, there has never been a genuine cure — until now. Northwestern University researchers developed a bimodal neuromodulation device that delivers precisely timed electrical impulses to the tongue and auditory nerve simultaneously, retraining the brain's auditory cortex to stop generating the phantom sound. After 12 weeks of daily use, a majority of participants reported significant and lasting relief. 👂

Tinnitus is not a problem in the ear — it is a problem in the brain. After hearing damage, the auditory cortex becomes hyperactive, firing spontaneously and generating sounds that have no external source. The Northwestern device exploits a neurological principle called spike-timing-dependent plasticity: by delivering two simultaneous sensory signals at precise timing intervals, it forces the overactive auditory neurons to recalibrate and dampen their abnormal firing patterns.

This breakthrough matters enormously for quality of life. Tinnitus is the leading cause of disability among military veterans, affects 15% of adults globally, and has strong links to sleep disorders, depression, and cognitive decline. Current "treatments" — white noise machines, counseling, hearing aids — manage symptoms at best. This is the first therapy that appears to address the neurological root cause directly. 🔬

The device, called Lenire, is already FDA-cleared and commercially available in the US following the Northwestern trials. For millions, a silent night is now medically achievable for the first time in years.

Source: Northwestern University, Nature Reviews Neurology, 2023

03/11/2026

03/11/2026

Just today, I was talking to a patient about **whole-body DEXA scans offered by private clinics** versus the **bone density (BMD) tests done in hospitals**. They sound similar, but they are used for *different purposes*. Here’s a simple breakdown.

# # # Whole-Body DEXA Scan (Private Clinics)

**What it measures**

* Body fat percentage
* Lean muscle mass
* Fat distribution (visceral vs subcutaneous fat)

**Advantages**

* Detailed breakdown of **body composition**
* Can help athletes or people working on **fitness, muscle gain, or fat loss**
* Very low radiation exposure

**Disadvantages**

* **Not designed to diagnose osteoporosis**
* Not typically used in medical decision-making
* Usually **not covered by provincial health plans**

**Typical cost**

* About **$100–$200 per scan** in most private clinics

# # # Bone Density Test (Hospital or Imaging Clinic)

**What it measures**

* Bone mineral density at the **hip and spine**

**Purpose**

* Diagnoses **osteopenia and osteoporosis**
* Helps estimate **fracture risk**
* Guides treatment decisions (medications, supplements, lifestyle)

**Advantages**

* **Medically validated test** used worldwide
* Results interpreted using standardized scoring (T-scores)
* **Covered by provincial health insurance** in many cases when medically indicated

**Disadvantages**

* Does **not provide body fat or muscle composition data**
* Requires a referral from a healthcare provider

**Typical cost**

* Usually **covered** when ordered for appropriate medical reasons
* If paid for privately, at a hospital facility, typically **$100–$150**

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# # # Key Point

If the goal is **checking bone health and fracture risk**, a **bone density test ordered through your doctor** is the appropriate medical test.

If the goal is **tracking body composition for fitness or training**, a **whole-body DEXA scan** may be useful—but it doesn’t replace medical osteoporosis screening.

---

✅ **Bottom line:**
These tests use similar technology, but they answer **very different questions**.

If you’re unsure which test is appropriate for you, speak with your family physician—we can help determine whether bone density screening is indicated based on your **age, fracture risk, medications, and medical history**.

03/04/2026

Tendon failure as … a drug side effect?

In early 2024, I partially ruptured my triceps tendon while doing something EXTREMELY athletic: standing up from my office chair. 🙄 Sheesh.

Reckless, I know. Ironically, I was standing up to do one of my many daily “movement snacks” — an injury prevention strategy!

Guess I should have stayed put.

I’m hardly alone. I’ve heard many stories of tendons that ruptured with little provocation: Stepped off a curb. Reached into the back seat. Caught a falling coffee mug. Sneezed hard.

Partial ruptures like mine are probably even more common, but often undiagnosed. It was less dramatic than a full rupture, of course, but I could feel it tearing, an awful sensation: a wet, shuddering GIVING WAY. It felt just like the last time I definitively tore some connective tissue (coracoclavicular ligament rupture, a sports accident in the mid 2000s). A memorable sensation.

I didn’t curse. I just groaned and rolled my eyes and sighed the sigh of the defeated. I have already endured so many insults like this, what’s one more? But perhaps I should have cursed, because it turned out that this injury was probably the tip of a much more disturbing iceberg.

THIS tendon tear was — drum roll please — quite possibly a DRUG SIDE EFFECT.

Say what now? Yes, you heard that right: tendon rupture as the side effect of a medication. A side effect which I had never heard of before, despite my expertise — despite even knowing about OTHER drugs that do this.

This is a complicated and fascinating topic, and I really went way down the science rabbit hole. NEW POST, a hefty one, about a 20-minute read, heavily referenced (some big footnotes), with a long audio version for members:

PainScience.com/blog/tendon-failure-as-a-drug-side-effect.html

~ Paul Ingraham, PainScience.com publisher