During my athletic career, I was impressed by the knowledge and understanding of the physical therapists that helped me.  Unfortunately, I almost always had to be injured before I would benefit from their expertise.  It made no sense to me to wait until I was hurt before addressing my physical weaknesses ; I wanted something more pro-active.  Prehabilitation (prehab) is the act of applying rehab principles to healthy individuals in order to prevent injury and enhance physical performance.

Rehabilitative principles are applied in a step-by-step fashion, to ensure that the body is not forced to do anything that it is not ready for.  I will outline some of these steps, and give you examples of why each could be important to you:

Reduce Pain and Inflammation

Pain or inflammation in a joint causes key muscles to be deactivated, as well leads to patterns of avoidance.  Running with a sore back for instance can train key stabilizing muscles not to work, leading to instability of the back long term, and can cause you to adopt habits that could make you a slower runner in the long term.

Ensure Proper Joint Motion and Stability

Tight ankles, especially one sided, can cause rotation through the entire body, cause unequal wear and tear of joints, overuse of other joints, and poor balance.  Weak hamstring muscles can increase your likelihood of tearing ligaments in your knee.

Efficient Movement and Posture

Your technique when you exercise determines which muscles get strong, which ones stay long and supple, which joints get stressed, and how tired you get.  Anti-inflammatory herbs or medications may help for your knee pain, but if the cause of the knee pain is the way you walk or run, then your pain will always recur.

Notice that none of the above steps have much to do with general fitness; someone can be very strong or fit, and still fail some of these steps.  Every day, people are exercising or performing simple daily tasks with limitations in the above categories, and those seemingly healthy activities can be making them unhealthy.  Don’t wait until you are unsatisfied with your physical health; learn about your physical limitations and what you can do about them right now.

Take a look at this clip which highlights some of the exercises that Mike did during his recent visit with Dr Oughtred, in Vancouver, BC.

Professor Gilbert Welch, MD, wrote a very interesting article in the New York Times recently about the current state of preventive medicine and how it pertains to the US presidential campagnes.

Today, Preventive Medicine should really be called early disease detection.  People are encouraged to come in to see the doctor at various ages in order to make sure they don’t have an illness that they are unaware of.  This approach is effective at detecting some diseases before they are out of control, but it does little to prevent disease and it ends up costing us more money.

In contrast, health promotion prevents disease.  The best preventive medicine involves educating patients (the word doctor means teacher) about how to care for their bodies, eat properly, exercise properly, and encouraging them to adopt healthy lifestyle habits and a positive outlook on life.

So next time you hear someone talking about preventive medicine, you may want to clarify: are they talking about disease detection or are they talking about promoting health so that disease is less likely to occur.

At his medical practice at the Sage Clinic in Vancouver, Dr Oughtred emphasizes health promotion, disease prevention and the enhancement of athletic performance.

In the December 2007 issue of Scientific American, Body, there was an article titled, “The Ultimate Blood Test”.  The article was a review of a new blood test called the Biophysical 250, the most comprehensive blood test available to date.  I was intrigued, and eventually I decided to call Biophysical Corp to learn more about the test.  After a few conversations, I was convinced that this was a test that I would be comfortable offering to my patients.

It’s called the Biophysical 250, because it measures 250 things in your blood, all at once.  For those afraid of having blood drawn, you can rest assured that the test requires only 2 tablespoons of blood.  The test covers blood markers for cancer, heart disease, autoimmune disease, infectious disease, nutritional status, hormonal status, inflammation, blood diseases, osteoarthitis, and organ dysfunction.  Biophysical Corp does not advocate testing anything that there is no treatment for, so they don’t test markers for alzheimers for instance.  Biophysical reports that in a trial of 120 clients who received the Biophysical, 27 clients had a moderate health risk, and another 15 had a major health risk.  The Biophysical 250 can help discover problems before they become problems, and there are many markers that wouldn’t normally be tested for until the disease was already apparent.   Some examples are:

• H-pylori (a bacteria associated with stomach ulcers)
• Autoimmune markers (For lupus, scleroderma, or rheumatoid arthritis)
• Insulin (high insulin levels are thought to precede type 2 diabetes)
• Cancer markers (Breast, Prostate, Colon, Pancreas, Liver, Testicular)
• Ferritin (high ferretin can be assymptomatic, and represents high iron stores, which can be harmful to the body over time)
• Thyroid Markers (thyroid disease is common, and can go a long time before being diagnosed)
• Hepatitis markers

The trouble with waiting until you get a disease, is that you stand the risk of not being able to reverse the disease process once it is diagnosed.  Cancer and autoimmune diseases are classic examples of diseases that have much better outcomes if treated earlier.

The Biophysical 250 does not replace a comprehensive annual health screen with your physician, but for those who can afford it, it can be a great, low risk adjuct to a comprehensive medical assessement for the patient that wants to know more about their existing state of health.

To learn more about the test, visit: http://www.biophysicalcorp.com/ .  The company has also come up with an abreviated version of the test that is priced more competitively, and still screens for several of the same markers.

These food items are chosen to help you reach and maintain your healthy weight. Restaurants like salad bars or some sushi restaurants that have relatively consistent menu items can be viewed under the ‘Restaurant Types’ category. Restaurants and food establishments are grouped according to area. Feel free to post comments and suggestions at the bottom. Please check back, as more areas and resources will be added over time.

Downtown (Burrard and Robson)

Moxies Classic Grill (808 Bute St) www.moxies.ca

Appetizer

Glazed Wild Salmon
Crab and Scallop Cakes
Szechuan Green Beans
Skillet of garlic mushrooms

Salads

Tandoori Wild Salmon Salad (ask for no Naan bread)
Spinach Salad (ask for no fucaccia)
Club Salad (ask for no banana bread)

Entrée (ask for no starch, extra vegetables)

Roasted Chicken
Grilled Chicken Breast with pineapple salsa
Lemon Pepper Halibut
Maple Glazed Wild Salmon
Almond Crusted Wild Salmon

Earls (1185 Robson, 905 Hornby) www.earls.ca

Starters

Baby Calamari (ask to have it sautéed without breading, instead of deep fried)
Edamame Beans

Salads (add chicken to make it a meal)

Mixed Field Greens
Warm roased beet and spinach salad
Salmon Provencal Salad

Chicken

Oven roasted chicken (no roast potatoes)

Fish

Cedar Plank Salmon (no potatoes)

Sides

Seasonal Vegetables

Cactus Club (1136 Robson) www.cactusclubcafe.com

Start

Szechuan beans
Spicy chicken
Edamame

Salad

Kula Greens

Main (no rice/ potatoes, add extra veggies)

Oceanwise fish selection (BC aquarium approved)
Grilled Salmon
Chicken Creole

Thai House (1116 Robson) www.thaihouse.com
Although thai dishes are traditionally served with rice, you can have them without.

Salad

Yum Rommitr Ta Lay (#21)

Soup

Tom Yum Ta Lay (#31) (seafood)
Tom Yum Goong (#33) (prawns)
Tom Yum Gai (#34) (Chicken)
Tom Kay—made with coconut milk (order with chicken or prawn) (#35)

Main

All Chicken and Duck dishes ok!
(approx 8 dishes) (unless battered, or sweet and sour)
All fish and seafood ok (approx 10 dishes)
All vegetable dishes ok (5 dishes)

Savory Coast (1133 Robson) www.savorycoast.ca

Appetizer

Warm Goat Cheese Salad

Salad

Warm Chicken Breast Salad
Shrimp and Avocado Salad
Tuna Salad (ask for no potato)

Entrée (ask for no starch, extra veggies)

Grilled Wild Salmon
Cioppino salmon, halibut, tuna, prawns, bay scallops, mussels, clams, saffron fennel broth.
Herb Crusted Halibut

Italian Kitchen (1037 Alberny) www.theitaliankitchen.ca

Antipasto

Grilled Calamari Steak
Salt Spring Island Mussels

Insalata

Ahi Tuna, Grilled Fennel
Organic Beets, Baby Arugula
Sablefish crusted with sun-dried pesto, topped with Dungeness crab

Carne (ask for no starch, extra veggies)

Chicken Satimbocca with Proscuitto and Sage

Pesce (no starch, extra veggies)

Seared Wild Spring Salmon
Crispy Mediterranean Branzino
Sauteed Jumbo Prawns

Saltlik (1032 Alberni) www.saltlik.com

Starters

Mixed Marinated Olives
Fresh Oysters
Dungeness Crab

This and That

Skillet Fired Mushrooms
Seasonal Vegetables
Grilled Asparagus
Shrimp Skewer

Rancher Salads

Steak Cobb Salad
Alotta Crab and Shrimp Salad

Mains (no starch, extra veggies)

Grilled Chicken Breast
Pacific Wild Salmon Filet
Rosemary Parmesan Crusted Halibut

The Keg (742 Thurlow) www.kegrestaurants.com

Appetizer

Shrimp Cocktail
House Salad

Entrée (ask for no starch, and add extra veggies)

Ahi Tuna Salad
Grilled Thai Chicken
Grilled Salmon

Joe Fortes (777 Thurlow) www.joefortes.ca

Appetizer

Iceberg Wedge
Shrimp Louie Salad (dressing on the side)
Cobb Salad
West Coast Salmon Trio
Jumbo Tiger Prawn Cocktail
Sauteed Cherry Stone Clams
Steamed West Coast Mussels
Maryland Blue Crab Cakes

Mains (ask for no starch, extra veggies)

Porcini Crusted Tuna
Cedar Plank Wild Salmon
Herb Crusted Halibut
Joe Fortes Classic Cioppino
Pecan Crusted Fresh Louisiana Catfish

Sides

Sauteed Mushrooms
Jumbo Tiger Prawns
Alaskan King Crab
Nova Scotia Lobster

Mosaic at the Hyatt (655 Burrard) www.vancouver.hyatt.com

Salads

Mesclun Salad

Appetizer

Crab Cake (sauce on the side)

Entrée

Three Egg Omelette (no toast or potatoes—ask for greens or sliced tomato
Albacore Tuna

Hotel Vancouver (900 West Georgia) www.fairmont.com/hotelvancouver
Griffins Restaurant

Salad

Cobb Salad (dressing on the side)
900 West Salad (no cranberries)

Entrée (ask for no starch, extra veggies)

Fraser Valley Double Chicken Breast
Wild BC Salmon
Dungeness Crab Cakes
Seafood Trio (Salmon, Halibut and Prawns)

900 West Lounge

Salad

Cobb Salad (dressing on side)
900 West Salad (no cranberries)

Lite

Edamame

Bar Bites

Ahi Tuna Tower (no chips)
Prawn Cocktail
West Coast Seafood

Grill

Wild Salmon (no starch, extra veggies)

Bacchus at the Wedgewood Hotel (845 Hornby) www.wedgewoodhotel.com

Appetizer

Fennel pollen dusted gulf shrimp
Salad of bib lettuce (easy on the cranberries)
Salad of roasted organic beets

Entrée

Bacchus cobb salad
West coast seafood salad
Grilled ahi tuna loin
Filet of queen charlotte halibut (substitute potatoes for veggies)
Herb crusted filet of British Columbia spring salmon
Lemon and rosemary roasted breast of grain fed chicken (no starch, extra veggie)

Bellagio Café (773 Hornby) www.bellagiocafe.com

Omelettes (until 2 pm), ask for sliced tomato instead of toast, and no potatoes.
Antipasto

Prawn Cocktail

Tapas

Spicy Chicken Cilantro
Garlic Mushrooms
Edamame

Insalate

Bellaggio Salmon Salad
Warm Seafood Salad
Greek Salad
Florentine Spinach Salad
Campagnola (no cranberries)

Pesce (no starch, extra veggies)

Fillet of Salmon
Mediterranean Salmon
Spanish Scallops and Prawns

Carne

Chicken Souvlaki (no rice, ask for extra veggies)

Don Francesco Restaurant (860 Burrard) www.donfrancesco.ca

Appetizers

Antipasto Della Casa
Fresh Oysters
Fresh Mussels Al Pesto Di Noce

Salad

Mixed Greens
Tomato Onion Salad
Baby Spinach Salad
Tuna, boiled egg and avocado salad
House Cured Wild Salmon Carpaccio

Entrée (ask for no starch, extra veggies)

Scallopine of Chicken Breast
Prawns Provencale
Fresh Filet of Halibut all’Italiana
Half Chicken Broiled all Diavola
Wild Qauils Braised a la Piemontese
BC Salmon alla brace con salsa di cedro
Fresh fillet of trout alla brace con limone

Thai Food Restaurant (40-1170 Alberni St)

Satay fish and vegetable
Black pepper chicken
Cashew nut chicken
Shrimp with scrambled egg
Ginger black bean chicken

Joeys (820 Burrard) www.joeysmedgrill.com

Start

Green Salad
Chinatown Lettuce Wrap
Edamame
Ahi Tuna Salad

Entrée (no breads, rice, potatoes, ask for extra veggies)

Chicken Souvlaki
Rotisserie Chicken
Blackened Spiced Basa
Miso Glazed Salmon

Kimei Royal (#211-1030 W Georgia)

Ebisu (827 Bute)

Ichiban Ya (770 Thurlow)

Oysi Oysi (1136 Alberni)

Kimono (869 Hornby)

Tokyo Joes (955 Helmcken)

Sushi Maki (989 Hornby)

See my Sushi Restaurant Weight Loss tips article.

 

Downtown (Pender and Granville)

Malones Bar and Grill (608 West Pender) www.malones.bc.ca

Szechwan green beans
Creole Prawns
Mongolian Chicken Skewers
Antipasto platter (without bread)
House Salad
Oven roasted chicken (order extra vegetables without potatoes)

Kimono Japanese Restaurant (433 Granville)
See my Sushi Restaurant post.

Salad Loop – www.saladloop.com

Use your own dressing, maybe Annie’s green goddess if you like creamy dressings. Olive oil based dressings without sugar are best. Glass containers. Check out this post for more tips.

Take 5 Café (425 Granville) www.take5cafe.com

Chicken salads
Frittatas

Asian Grill (500 block Granville?)

You can make your own stir fry of veggies and choice of protein. Also has a salad bar.

Green Leaf Salad Bar (560 Bute)
See my Salad Bar post.

Aqua Riva (Canada Place way) www.aquariva.com

Salads

Baby greens
Sesame seared wild salmon salad
Grilled ahi tuna nicoise salad

Main Course (order no starch, extra veggies)

Grilled wild salmon
Spit roasted cumin rubbed chicken

Herons at the Fairmont (900 Canada place way) www.fairmont.com/waterfront

Appetizers

Spiced bouillabaisse
Celebration Greens

Mains (order no starch, extra vegetables)

Waterfront Cobb Salad
Seared Ahi Tuna
Steamed Saltspring Island Honey Mussels
Wild Sockeye Salmon

Metro (200 Burrard St at waterfront center) www.metrodining.ca
* Metro uses organic and local food whenever possible.

Appetizers

Harvest Vegetable Salad
Seafood Cobb Salad
Baby Romaine Hearts (Easy on the onion cream)

Dinner Mains are available at lunch (no starch, extra vegetables)

All mains are ordered by the ounce—3-5 ounces should be adequate.
Ask about aioli’s and other creams—get them on the side.
Sablefish
Salmon
Scallops
Halibut
Albacore Tuna
Spiny Lobster
Himboldt Squid

Lion’s Pub at Terminal City (888 West Cordova)

Salad

Wild gathered greens
Spinach salad
Greek Salad

Mains

Grilled Wild Salmon

After 2 pm

Veggie platter (easy on the dip)
Jumbo prawns (easy on the sauce)

 

Yaletown

Urban Fare (177 Davie St) www.urbanfare.com

Grilled tofu and Asian vegetable salad
Edamame salad
Build your own. Add one of:

Grilled salmon
Grilled chicken
Chicken Kebob
Roasted ¼ chicken (don’t eat the skin)

Add as many as want of:

Zuccini
Broccoli
Marinated mushrooms
Grilled vegetables (eggplant, peppers, zucchini, etc)
Other non-starchy veg list (see general salad bars list)
Cold items (already packaged)
Crudite and dip (easy on the dip)
Chopped garden salad
Spinach salad
Mixed Green salad
Prawn ring

HyRise Produce/Salad Bar (1155 Pacific Blvd)

See my Salad Bar recommendations article.

Thai Urban Bistro (1119 Hamilton) www.thaihouse.com

Also see Chilli House (1018 Beach) - similar menu and great selection.

Salad

Yum Rommitr Ta Lay (#21)

Soup

Tom Yum Ta Lay (#31) (seafood)
Tom Yum Goong (#33) (prawns)
Tom Yum Gai (#34) (Chicken)
Tom Kay-made with coconut milk (order with chicken or prawn) (#35)

Main

All Chicken and Duck dishes ok! (approx 8 dishes) (unless battered, or sweet and sour)
All fish and seafood ok (approx 10 dishes)
All vegetable dishes ok (5 dishes)

Nuba (1206 Seymour and 322 W. Hastings) www.Nuba.ca

Mezza (Appetizers) – ask for no pita
Chicken shish tawook
Lamb kafta
House salad (ask to add chicken)

Yopo (1122 Homer St) www.yopocafe.com

Vegetable Dishes (no rice) (add non-deep fried chicken)

Mixed vegetables (steamed)
Garlic broccoli
Garlic green beans

Seafood

Mixed seafood with vegetables (steamed)
Sauteed prawns with snow peas

Soups

Mixed Vegetable soup

Milestones (1109 Hamilton) www.milestonesrestaurants.com/yaletown

Appetizer

South East Asian chicken skewers

Salads (add chicken, salmon, or prawns)

Milestones garden greens (add prawns)
California spring salad
Grilled chicken salad

Entrees (all entrees, order extra veggies and no potatoes/ rice/ pasta or yams)

Fire grilled salmon (aioli/ sauce on side)
Portobello mushroom chicken
Roasted half chicken (take some to go, no need to eat it all)

Goldfish (1118 Mainland) www.goldfishkitchen.com

Small plates

Seafood Chowder
Wild BC Salmon Gravalax

Salad

Butter lettuce

Sides

Sautéed mushrooms
Asparagus

Large Plates

Maple soy chicken breast
Pan Seared Arctic Char (easy on the pears)
Pan Seared Ling Cod
Wild BC Salmon
Mussels (ginger with coconut curry)

Hamilton Street Grill (1009 Hamilton St)

Starter

Black and Blue Ahi tuna (easy on the mayo)

Main

Hamilton Street Cobb Salad (easy on the bacon)
Grilled BC Salmon (sauce on the side, extra veggies, no starch)

Sides

Garlic sautéed prawns (easy on the butter)
King crab
Garlic Sautéed mushrooms

Browns (1165 Mainland) www.brownssocialhouse.com

Bowls-these are rice bowls, but you can ask for extra veggies/ no rice with the following:

Chiva som bowl
Ahi tuna bowl
Penang prawn curry

Salad (do not add crispy chicken to salads)

Ahi tuna salad
Cowboy salad

Entrée

Pan seared halibut (no risotto, cream sauce on the side, extra veggies)

Starters

Edamame
Szechuan beans

Sides

Seasonal veggies
Crisp coleslaw

Rodney’s Oyster Bar (1228 Hamilton) www.rodneysoysterhouse.com

Oysters (all)
House Salad
Shrimp Cocktail
Mussels (no cream sauce or bread)
Crab
Grilled Halibut (no rice, extra veggie)

Cactus Club (357 Davie St) www.cactusclubcafe.com

Start

Szechuan beans
Spicy chicken
Edamame

Salad

Kula Greens

Main (no rice/potatoes, add extra veggies)

Oceanwise fish selection (BC aquarium approved)
Grilled Salmon
Chicken Creole

Yaletown Brewing Company (1111 Mainland) www.drinkfreshbeer.com

Start

Chicken Satay
Edamame
Fire Cracker Green Beans

Salad

Green Salad
YBC Chopped cob salad
Greek Salad
Wild Salmon Spinach Salad

Main

Chinatown greens and tofu (ask for no rice, extra greens)

Player’s Chophouse (808 Beattie St-at BC place) www.vancouverchophouse.ca

Starters

Crab Cakes
Pacific Yellowfin Tuna
Shell Fish Pot
Jump Chicken

Salads

Romaine Hearts
Baby Mixed Greens
Players Chophouse Salad

Seafood (ask for no starch, extra veggies)

Market Fresh Fish
Pan Seared Tuna
Sautéed Jumbo Gulf Shrimp

Entrees (no starch, extra veggies)

Free Range Chicken Breast

Sides

Sautéed Mushrooms
Asparagus

 

South Granville

Bogarts (1619 West Broadway) www.bogartschophouse.com

Small Plates

Jumbo Prawn Cocktail (easy on the cocktail sauce)
Grilled Marinated Calamari (easy on the aioli)

Salad

Cobb
Nicoise
Baby Spinach and Jicama Salad

Earls (1601 West Broadway) www.earls.ca

Starters

Baby Calamari (ask to have it sautéed without breading, instead of deep fried)
Edamame Beans

Salads (add chicken to make it a meal)

Mixed Field Greens
Warm roasted beet and spinach salad
Salmon Provencal Salad

Chicken

Oven roasted chicken (no roast potatoes)

Fish

Cedar Plank Salmon (no potatoes)

Sides

Seasonal Vegetables

Cactus Club (1530 W Broadway) www.cactusclubcafe.com

Start

Szechuan beans
Spicy chicken
Edamame

Salad

Kula Greens

Main (no rice/ potatoes, add extra veggies)

Oceanwise fish selection (BC aquarium approved)
Grilled Salmon
Chicken Creole

Joeys (1424 W Broadway) www.joeysmedgrill.com

Start

Green Salad
Chinatown Lettuce Wrap
Edamame
Ahi Tuna Salad

Entrée (no breads, rice, potatoes, ask for extra veggies)

Chicken Souvlaki
Rotisserie Chicken
Blackened Spiced Basa
Miso Glazed Salmon

O Thai (1626 W Broadway) www.othai.ca
* This restaurant is probably a good choice for allergic types, as they used very little extra sauces, etc. Everything is made in-house.

Salad

Mixed Seafood

Entrée (Ask for no rice)

Sautéed Vegetables
Garlic Chicken
Cashew Chicken
Chicken in Tamarind Sauce
Minced Thai Basil chicken
Mixed Seafood With Thai Basil
Red or Green Chicken Curry

Rangoli (1488 West 11th) www.vijsrangoli.ca

Lamb Kebabs
Spicy Pulled Pork on Sauteed Greens (no chapatti)
Yoghurt and Tamarind Marinated Grilled Chicken (no Naan)

Meinhardt (3002 Granville) www.meinhardt.com
There is a deli section to this grocery store with prepared foods on display.

Display case

Fish Cakes
Grilled Chicken breast
Beet Salad
Grilled Salmon
Turkey Breast
Pickles
Edamame Salad
Garlic Prawns
Seaweed Salad
Olives

Café Barney (2975 Granville)

Salads

Mixed Green
Cobb Salad (ask for vinaigrette dressing instead)
Warm Spinach Salad
Spicy Thai Chicken Salad

Tapas

Mussels (no baguette)
Seafood Skillet
Omelettes
No Hash browns, toast – ask for sliced veggies or salad on the side instead. Easy on the cheese

Red Door (2996 Granville) www.reddoor.ca

Small Plates

Lettuce Wraps
Chicken Satays
Tom Kha Kai (Thai coconut soup)
Edamame
Tuna Sashimi
Wok Fired Sambal Shrimp

Chicken

Dragon Fire Chicken
Orange Peel Chicken
Kung Pao Chicken

Seafood

Orange Peel Shrimp
Red Curry Shrimp
Coconut Masala Shrimp

Vegetables

Buddhas Feast
Thai Jungle Curry

Ouisi Bistro (3014 Granville) www.ouisibistro.com

Start

Baton Rouge Greens
Vert et Bleu
Cajun Style Crab Cakes

Entrée

Jackson Square (poached eggs on crab cakes-order sauce on the side)
Egg on me (Poached egg with cheese, tomato, cucumber, sprouts-ask for no toast)

West End

Raincity Grill (1193 Denman) www.raincitygrill.com

Appetizer

Mixed Winter Greens
Salad of Smoked Langley Trout
Albacore Tuna Tartare

Main

Salt Spring Island Mussels (no bread)
Organic Ocean Wild Salmon (no potatoes, extra veggies)

The Boathouse (1795 Beach Avenue) www.boathouserestaurants.ca

Salad

Seafood Chop Chop Salad

Appetizer

Lobster Kebobs
Bucket of Peeled Shrimp
Oysters and Steamers (no bread)

Mains (no starch, ask for extra veggies)

Jumbo Prawn Skewers
Boathouse Seafood Grill
Jumbo Prawn Skewers
Boathouse Seafood Grill
Grilled Salmon
Miso Crusted Halibut

Milestones (1210 Denman) www.milestonesrestaurants.com

Appetizer

South East Asian Chicken Skewers

Salads (add chicken, salmon, or prawns)

Milestones garden greens (add prawns)
California spring salad
Grilled chicken salad

Entrees (all entrees, order extra veggies and no potatoes/ rice/ pasta or yams)

Fire grilled salmon (aioli/ sauce on side)
Portobello mushroom chicken
Roasted half chicken (take some to go, no need to eat it all)

Banana Leaf (1096 Denman) www.bananaleaf-vancouver.com

Appetizers

Chicken Skewers
Steamed mussels or clams
Seafood (choose from 8 different seafoods and 12 different sauces!)

Vegetables

Sambal green bean with shrimp and tomato
Fried eggplant in chilli garlic dried shrimp paste
Spicy spinach in dried shrimp paste
Sambal chilli fried okra, eggplant, and green bean

Meat

Nyonya boneless curry chicken
Nyonya style kong pow boneless chicken

Central (1072 Denman) www.centraleurobar.com

Three Egg Omelettes (ask for no toast, substitute mixed greens for hash browns)

Forest mushroom and cheddar (easy on the cheese)
Egg White Omelette

Brunch Classics (Substitute toast and hash browns with greens)

2 Free Run Eggs
Organic Turkey Sausage and Eggs
Central’s Chicken Hash

Lunch Type Stuff

Summer Greens
Central Cobb Salad

During my 7 years of competition with the Canadian alpine ski team, I experienced several injuries, the most frustrating of which were the insidious injuries that seemed to appear out of nowhere. These injuries could last for months to years, and usually required multiple treatments to heal. Because one treatment alone was rarely effective, I began to think that there was more than one cause for these problems. It was for this reason that I decided to become an integrated health care professional, utilizing expertise from several different areas to help people experience better health.

Many chronic problems have more than one cause: type 2 diabetes, heart disease, autoimmune disease, asthma, headaches, overuse injuries, back and neck pain, irritable bowel, PMS, and psoriasis, are all examples of problems that have more than one cause or contributing factor. Common sense dictates that the assessment and treatment of such problems should be multifactoral. For example, an integrative assessment of the patient with chronic headaches would consider the following factors:

• Inactivity or obesity

• Overweight individuals that don’t exercise experience more health problems, including headaches

• Blood pressure

• High blood pressure or sudden changes in blood pressure can increase your likelihood of head pain

• Hormonal imbalance

• Migraines occur more in women, and they will often notice their pain fluctuates with menses

• Blood sugar imbalance

• Fluctuations in blood sugar can lead to the vascular constriction or dilation that is often associated with headaches

• Stress and cognitive influences

• Those who experience anxiety or depression, experience more headaches

• Neck problems

• The upper two vertebrae in your neck can cause an increase in head pain when they are dysfunctional

• TMJ problems or dental problems

• Food sensitivities

• Environmental sensitivities

• Poor posture and work position

• Poor vision or eye problems

• Infection or cancer

• Drug interactions

• Inflammatory disease

• Past trauma/ accidents

A multifactoral assessment allows the health provider to look at your health from a ‘bird’s eye view’, and focus treatments on the areas of your health that might contribute to your pain. Treatments could include physical therapies, supplements, therapeutic exercise, specific herbs, a special diet, or cognitive behaviour therapies. However, without an integrated assessment of your health, your treatment may be one sided, and may fail to address weaknesses in your complete health picture. It is for this reason that I recommend an integrated approach for your chronic problems, the prevention of disease, and for the pursuit of your optimum health status.

Ryan Oughtred

Injury to the lower back is one of the more common injuries incurred by the alpine skier. Waiting for back problems to happen before doing anything about them is probably a bad idea; the discs and bones of the spine generally only have nerves on their outermost portions, which means that damage to the inner portions of the vertebrae and discs can occur without experiencing any pain at all. The spine can degenerate ‘from the inside out’ for many years without any warning signals, and by the time an athlete is 26 years old-in the peak of a career-the spine can have significant amounts of permanent wear-and-tear. Here are the 5 most important preventive measures I think athletes and support staff can take to prevent back problems:

Build progressions in training schedules:

1. The risky forces for the spine are flexion, rotation, compression, and sheer; all of which are involved in skiing. Because avoidance of these risky forces is not possible, the athlete must be exposed to them gradually over time. Both on-snow and dry-land training should gradually involve progressions in both volume and intensity of activities that involve bending forward, twisting, weight lifting, and eccentric loading.

2. The adolescent spine may be especially vulnerable because the growth plates of the vertebrae are softer than in an adult, making them more prone to injury from compression and sheer forces.

Sit less, and never lift heavy after sitting:

1. Any time the spine is flexed forward for a period of time, such as with sitting, a phenomenon called ‘creep’ occurs in the tissues. The tissues are melded toward a shape that is different than normal. Heavy lifting or other compressive activity (such as ski racing) should be avoided immediately following a prolonged period of sitting or forward bending.

2. To combat the effects of creep from sitting on planes, in cars, or on chairlifts, athletes can perform extension exercises like McKenzie press-ups or other extension movements any time they have been prolonged to excess flexion.

3. When traveling – I would never allow athletes to lift heavy bags immediately after riding in a van or on a plane for hours. Stand up, walk around, and maybe bend the spine back a couple of times before lifting anything heavy.

4. When riding the chair lift – athletes should take time after every chair lift ride to stand up, bend back a little, and warm up before diving into another race run. While riding the chair, a relaxed upright posture is probably best.

Compress and twist the spine judiciously:

1. Twisting while you lift heavy weight doubles the load through the back. Athletes should be taught to never twist while they are lifting, unless it is an exercise specifically designed to prepare them for skiing.

2. Discourage athletes from packing heavy bags, and encourage them to share the work of lifting with other people.

Keep your spine neutral and stable:

We know that stability of the spine will prevent injury, but applying that to practice is not a simple task.

1. Maintain a neutral spine as much as possible when training, especially when lifting heavy weights or twisting.

2. Focus on endurance of the spinal related muscles, not just strength.

3. Integrate components of instability, unpredictability and precision into dry land training.

4. Full body exercises are probably better than isolated muscular activities. Even if the athlete feels like the exercise is too easy, it is still doing something for them.

5. Make sure athletes can breathe evenly throughout entire exercises.

6. Encouraging the athlete to lightly draw in their tummy, or ‘feel like they are stopping a pee’ while working out, might add to their spinal stability. Train everything. All the muscles of the core probably contribute to injury prevention in some way, as does the lower body and upper body. Search for balance, find weaknesses and eliminate them.

Proper biomechanics-the earlier better:

1. Taking the time to consult with someone who understands normal spinal mechanics and how to assess it could be a valuable investment.

2. If one area of the spine is not moving well, other spinal regions may be forced to work too hard, or in an unbalanced fashion. Detecting these kinds of imbalances early in a career may prevent future injury or even enhance athletic performance.

The field of low back problems is a difficult area. I have done my best to consider some of the evidence so far, and apply it to the ski racing athlete. I hope it was helpful!

Ryan Oughtred

More to read:

• Panjabi MM. The stabilizing system of the spine. Part 1. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 1992; 5(4):383-9

• Richardson CA, Jull GA, Hodges PW, Hides JA. Therapeutic exercise for spinal segmental stabilization in LBP: scientific basis and clinical approach, Edinburgh: Churchill Livingstone; 1999

• McGill S. Low back disorders: evidence based prevention and rehabilitation, Champaign, IL: Human Kinetics Publishers, Inc.; 2002

• N. Bogduk, B. McGuirk. Medical Management of Acute and Chronic Low Back Pain. An Evidence Based Approach. Elsevier Science. 2002