About Us
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What is myoActivation?
myoActivation® is a methodology used to assess and treat chronic pain conditions. It combines releasing muscles in sustained contraction, fascia under tension and relevant scars with the aim of resolving pain.
Dr. Greg Siren based the myoActivation® system, on the trigger point needling technique developed by Travell and Simons in the 1960s. It is detailed in their book, Myofascial Pain and Dysfunction: The Trigger Point Manual.
myoActivation® uses specific trigger point and other needling techniques, e.g. scar release. These protocols are based on years of experience. Dr. Siren and his colleagues have had 50,000+ encounters using myoActivation®.
To ensure quality assurance, myoActivation® has been trademarked and myoActivation® training is now delivered through the Anatomic Medicine Foundation, a BC non-profit society. You can take a look at the foundation’s website to locate other physicians in Canada that have been trained or for more information: anatomicmedicine.org.
What is a trigger point injection? (TPI)
TPI is the insertion of a needle into trigger points, fascia (the membrane that envelops muscles) and scars. We usually inject tiny amounts (micro aliquots) of 0.9% saline, a physiological solution - meaning it matches your tissue concentrations. The type of needle we use (hypodermic) have a cutting tip which creates a trauma response in the tissues. This causes muscles and fascia to release and a healing response to be launched.
We use saline rather than other medications such as lidocaine or steroids to reduce possible side effects and reactions. There is evidence that saline injections have effective outcomes in pain reduction. We also want to be able to assess whether release happened so do not want the area ‘numb’.
What can I expect during a myoActivation Trigger Point Injection treatment?
Your doctor will examine your posture and ask you to do a series of movement tests. This is to get your baseline ranges, check for asymmetries and see which movements create discomfort or pain. The doctor will release the points they identify as causing the problem using a needling technique.
Very often the treatment site is not where pain is felt. For example, lower back pain often comes from trigger points in the abdominal wall rather than the back. The body is all connected!!
After TPI, you may feel achy and tired. This can take a day or for some, a few days to recover from. It depends on your individual sensitivity, but as the body releases, ranges of motion generally increase, become more symmetrical and pain decreases. Usually range of motion will improve before pain. Initially, as tension lines start to change it may feel achy in areas that are different from your original complaint or symptom, this is not unusual and we see it as a positive sign.
Check out our video on how to prepare for your first appointment.
Consultations
Once we receive a referral from your physician, we will book your first appointment. This appointment will last 30 minutes and includes a consultation with the doctor and a treatment trial if that's right for you.
Before the appointment starts, we will review an Informed Consent Form with you and ask you to sign it once we have answered any questions you may have. We will only treat you after you have signed this form indicating that you consent to treatment.
You will meet with your doctor who will ask you about your medical history and do a physical exam.
Please be ready to discuss:
injuries and illnesses since childhood, including past trauma
surgeries
any scars on your skin
The physical exam includes testing ranges of motion and palpation of painful areas.
If appropriate, the doctor will give you a treatment trial. Most people do receive treatment during their initial consultation.
Our Origins
Dr. Greg Siren is known as the founder of the myo Activation style of trigger point injections. Although he is no longer seeing patients in the clinic, he has been working hard to make myo Activation more accessible to health care providers across BC and Canada.
He obtained his medical degree from the Royal College of Surgeons in Ireland in 1987. He is a Certificant and Fellow of the College of Family Physicians of Canada and holds a Bachelor of Science degree in Physiology from the University of Toronto.
Greg founded The myo Clinic in 2010, and co-founded the CHANGEpain Clinic in Vancouver in 2013.
He first learned about trigger point injections while working in an urgent care setting in Oregon. He was impressed how the technique quickly reduced pain for his patients with low risk side of effects.
It was in 2008-2009 when Greg was the physician on board oil rigs being relocated from Texas to South Africa where he had the opportunity to see the results over time, while living with oil rig workers with significant musculo-skeletal pain issues due to their work.
Greg observed the extent these workers became happier and more social after getting sustained resolution to their pain. It was then he decided to open the myo Clinic to continue the rewarding practice of helping people living in pain get back to their lives.
Greg’s vision from the start was that people should have early access to pain care in their own communities through primary care. Over the years he developed a methodology, trademarked as myoActivation, so that other clinicians can deliver the same techniques with consistent results. Greg has been teaching other clinicians informally since 2010. In 2019 the Anatomic Medicine Foundation was established a non-profit organization with a faculty consisting of multiple clinicians and practitioners that delivers training and support to clinicians in standardized formats. There are currently 4 levels of myoActivation training. There is active development of new courses for example the new course aimed at emerge doc’s.
Currently, Greg is Director of the Anatomic Medicine Foundation, where he and a team develops and delivers certified training courses to teach physicians, nurse practitioners and other licensed practitioner to deliver myoActivation.
Greg continues to be involved in a number of committees and working groups with the Doctors of BC and various health authorities.
Our Team
Liesl Roome MB ChB CCFP
Dr. Liesl Roome is the current owner and Medical Director of The myo Clinic - Brentwood Bay. She began general practice medicine in 2002 in La Lucia, Durban, South Africa. After moving to Canada, she had a full-service family practice in Parksville, BC, before moving to Victoria in late 2016.
In early 2017, Liesl started transitioning to work at the myoClinic and by September 2018, she was full-time at the Tyee Road location. She felt that there was a huge need for more options for people in chronic pain, and myoActivation® offered a non-pharmaceutical, effective treatment. Seeing people emerge from pain and being able to regain functionality in life was extremely rewarding for her.
She is part of the Clinical Faculty for the Anatomic Medicine Foundation, and recently also became a faculty member at UBC Department of Family Medicine, which is why you can find medical residents coming in to observe at the clinic from time to time.
Dr. Roome also works with the Anatomic Medicine Foundation as one of the instructors, delivering myoActivation training to physicians and nurse practitioners from around the province.
Dr Francois Oosthuizen (MB ChB CCFP)
I began my general practice medicine journey in Canada in 2003 when I moved from South Africa to Northern Alberta. After spending several years there, I relocated to the beautiful city of Victoria, BC in 2015.Currently, I maintain a full family practice in Victoria, where I have the privilege of serving a diverse range of patients. In addition to my family practice, I am proud to be a part of the esteemed team at the myo Clinic. Initially, I started as a patient in the clinic, witnessing firsthand the benefits of the treatments. This inspired me to undergo training courses over the past couple of years, equipping me with the expertise to offer this treatment option to my own patients.To ensure efficient patient care, I dedicate a day and a half per week at the myo Clinic, helping individuals achieve optimal wellness and improved quality of life.
Shani
Shani is a Patient Care Coordinator and Clinical Chronicler, who started working at the clinic during spring 2021.
Shani completed school in South Africa, then completed her diploma in modern applied psychology. She immigrated to Victoria and attained her Canadian citizenship in February 2021.
Shani is planning to complete studies and become a physician in the future.
Miya
Miya is a Patient Care Coordinator and Clinical Chronicler who started working at The myo Clinic in Fall 2021.
She finished her first year at Mount Royal University in the Bachelor of Science program majoring in Biology and plans to finish her degree at the University of Victoria.
She enjoys painting, camping, and spending time with her friends and family. Her future plan is to attend the University of British Columbia to become a dentist.
Riaan
Riaan has been a Patient Care Coordinator and Clinical Chronicler since 2022. His interests include anatomy, dancing, and injury management. He is pursuing a career in nursing.
Chloe
Chloe joined The myo Clinic team in 2023. She doubles as a licensed Emergency Medical Responder in BC. Her end goal is to become an Advanced Care Paramedic in Canada so she can work and travel around the world.
Kate
Kate is a Patient Care Coordinator and Clinical Chronicler who started working at the myo Clinic in May 2023. Kate finished her bachelor in Psychology and Behavioral science in Ukraine and worked in a research institute in Switzerland for 1 year. She is planning to continue study either neurobiology or microbiology in future. Kate enjoys singing, traveling and hiking.
Marilyn
Marilyn graduated from medical school in Georgia and is planning to pursue her residency in psychiatry. She has a strong interest in mental health and enjoys traveling, hiking and baking in her free time.
Kari
Kari is a Patient Care Coordinator and Clinical Chronicler who started working at the clinic during Fall 2024.
She is currently a biology student at the University of Victoria and plans on pursuing her MD at a Canadian medical school in the near future.
Kari enjoys reading, playing guitar, and olympic weightlifting.
Careers
Patient Care Coordinator and Clinical Chronicler
Currently these positions are filled.
This job is suited to a person who is seeking a clinical career and would like experience directly supporting physicians during clinical encounters. Our regular hours for these positions are Monday to Friday from 8:00 am to 4:00 pm.
You can indicate your interest in this position for future competitions by completing this form. Thanks!