Archive for the ‘ Newsletter ’ Category

Stretching Tips / Osteoarthritis of the Hip

May 24th, 2015 by admin

Stretching Tips.

While there are many benefits to be gained from effective stretching, employing an improper technique can actually result in injury. Here are some tips and guidelines for you to follow when stretching:

  • Ideally warm up first with an activity such as walking (at least 5 -10 minutes).
  • Stretches should be pain-free. You should only feel tension or a tight feeling when stretching. If you feel a sharp pain, this means you’re stretching too far and should ease back a little.
  • Don’t hold your breath while stretching; keep breathing to ensure the muscle tissues remain oxygenated during the stretch.
  • Stretch both sides. But, if one muscle is tighter than the other, focus on it more until they’re both in the same range. Perhaps start and finish with a stretch on the tighter side.
  • Avoid bouncing at the end of the stretch because it may lead to injury.
  • Hold stretches for 20-30 seconds, if not longer. A 10 second stretch is not enough to achieve a lasting effect.
  • Repeat the stretch 3-5 times with intermittent rest periods in between.
  • Make sure your body is aligned properly and observe good posture.

When to Stretch?

Traditionally, stretching has been encouraged before and after any kind of physical activity. However, recent studies show that there is no discerning difference between whether you stretch before exercise/sports or not, both-in terms of performance and injury prevention. In some cases, researchers say that it’s okay to omit the pre-event stretch, (so long as you do a thorough warm up) since the post-event stretch is much more beneficial.

Some of our everyday postures and activities can lead to certain muscles becoming tight while the others sit in a lengthened position. These habitual postures lead to muscle imbalances that then become more and more difficult to correct over time. Many therapists will suggest that stretching all muscles generically isn’t as beneficial as identifying which of your muscles are abnormally tight and developing a targeted stretching regime.

Talk to your therapist for advice regarding the best stretching program for your body type, posture and activity levels.

Osteoarthritis of the Hip

What is Hip Osteoarthritis and how does it occur?

Hip osteoarthritis (also calledDegenerative arthritis of the Hip) is one of the most common types of osteoarthritis. Osteoarthritis occurs as the cartilage of a joint, a soft tissue that provides cushioning and a smooth surface for joint movement, begins to degrade due to wear and tear caused by mechanical stress. As the cartilage breaks down and is worn away, the joint begins to function abnormally and small bony deposits can form around the joint. As this process progresses, movement of the joint begins to be painful and can eventually lead to significant disability.

As we age, our cartilage often loses quality and elasticity – resulting in an increased likelihood of degeneration as we age. However osteoarthritis is not limited to the elderly and young people can be affected, although much less frequently.

While there is no single identified cause for osteoarthritis, there are known risk factors that make a person more likely to develop the condition.

These risk factors are increasing age, a family history of osteoarthritis, previous injury to the hip joint, obesity, improper formation of the hip joint at birth (a condition known as developmental dysplasia of the hip), genetic defects in the cartilage and, activities that put extra stress on the hips.

What are the signs and symptoms?

The most common symptom is pain, followed closely by joint stiffness. The location of arthritic pain is usually around the hip joint but it can also appear in the groin, buttocks, thigh or knee. Other symptoms include a grating or cracking sensation with joint movement, tenderness around the joint, and swelling.

Pain is most noticeable with weight-bearing activities such as walking, running or negotiating stairs. After a period of prolonged rest, the arthritic joint will often feel quite stiff. This can be particularly noticeable in the morning with many people reporting feeling stiff for 15-20 minutes after waking.

How can therapy help?

Physical management for osteoarthritis of the hip will usually include stretching, exercises and joint mobilization to increase the joint’s mobility, as well as strengthening exercise to the muscles surrounding the hip, allowing them to better support the joint.

Many other factors may help with arthritic symptoms such as appropriate rest, weight loss, physical activity and environment modification, mobility aids, NSAIDS, or natural anti-inflammatories such as Metagenics Kaprex, Arthrex or Glucosamine Intensive Care. For some people with severe osteoarthritis, the best course of action is a surgical joint replacement, which can have great outcomes when coupled with effective preparation and rehabilitation.

None of the information in this newsletter is a replacement for proper medical advice. Always see a medical professional for advice on your individual condition.

Therapy Vs Surgery? / Frozen Shoulder

April 24th, 2015 by admin

Therapy vs. Surgery?

For many patients, deciding to have surgery following an injury can be incredibly difficult. The thought of surgery can be daunting, yet ensuring the best outcome for their injury is also important. Here we take the time to weigh up a few of the factors that might influence this decision.

Sometimes the decision can be simple. In the case of severe injuries, surgery is often universally acknowledged by all parties to be necessary for successful healing. Similarly, minor injuries can often be treated successfully with therapy and without complication.

At other times, the decision can be more difficult, particularly when treatment with conservative therapy is not guaranteed to work. Surgery can seem like the fastest and most certain solution. Some people, including sports stars, elect for surgery as the quickest route back to competition even though the injury could be managed with therapy over a longer time frame.

The level of function you require is also a factor. Those whose work has high physical demands may choose surgical intervention, whereas an office worker with the same injury may not. This is a very personal aspect to the decision and is largely influenced by your individual goals and values.

In some cases, taking six to twelve weeks to trial therapy prior to surgery is the safest course and is frequently recommended by surgeons. This allows the body a good chance to heal without invasive interventions.

Also to take into consideration is the fact that many surgical procedures will still require weeks of rehabilitation with a therapist after the operation to ensure complete success. Furthermore, the risks of surgery, though rare, can be serious including infection, scarring and even more serious complications due to undergoing anaesthesia.

Other factors that should be considered before deciding to undergo surgery include:

  • Age
  • Pre-existing health conditions or risk factors like heart problems, Diabetes Mellitus, obesity, etc.
  • Allergy to medications
  • Severity of pain
  • Emotional condition
  • Social/family resources necessary for the aftercare
  • Religious belief

Before making any major decisions, it is important to consult medical professionals to ensure you are well educated in all the risks and benefits of your decision.

Frozen Shoulder


Frozen Shoulder (also known asAdhesive Capsulitis) is a condition that affects the shoulder joint with no apparent (idiopathic) cause. It is characterised by severe pain and stiffness of the shoulder. The shoulder capsule thickens due to lack of synovial fluid, which leads to tightness and stiffness. Frozen shoulder occurs most frequently between the ages of 40-60 years old and affects more women than men.


The cause of Frozen Shoulder is still unknown, however some risk factors have been identified that increase your chances of developing the condition including diabetes mellitus, stroke, shoulder injuries and immobilization.

The hallmark sign of Frozen Shoulder is being unable to move your shoulder even with the help of other people. This is particularly noticeable when moving the arm away from the body. Physicians may ask you to undergo investigations such as X-ray and MRI, however frozen shoulder doesn’t tend to show up on imaging. Our therapists can diagnose frozen shoulder with a thorough examination.

Frozen Shoulder has three stages:

  1. Freezing (Painful stage) – lasts from six weeks to nine months; patient has a slow onset of pain (usually pain at rest), and the shoulder starts to experience limitation of motion
  2. Frozen (Adhesive stage) – lasts from four to six months; pain begins to diminish (the shoulder is still usually painful with movement), of the shoulder getting stiffer, and activities of daily living are affected).
  3. Thawing (Recovery stage) – last six months to two years; shoulder’s normal range of motion is slowly returning to normal


Though Frozen Shoulder is a self-limiting condition, an important part of management is the prevention of related neck and shoulder issues secondary to the original problem. As you can imagine, frozen shoulder can be extremely debilitating and many adaptations occur in the surrounding musculature. Therapy also acts to reduce pain throughout phases one and two, while restoring joint movement as the joint moves through the painful phase.

This is done through a variety of treatments, including heat, stretching, joint mobilisation, range of motion exercises to improve the shoulder’s motion and resistance exercise to strengthen, you will also be given a home exercise program. Recovery time varies with every patient. If you’re working hard to regain your normal shoulder function, you’ll be rewarded with a faster recovery.

Medical management includes medications and corticosteroids, an injection procedure called a hydrodilatation, joint manipulation while under anaesthetic and/or surgery. In our experience, the most successful management is a hydrodilatation combined with physical therapy.

None of the information in this newsletter is a replacement for proper medical advice. Please see one of our friendly practitioners for advice on your individual condition.

Pain and your Brain / High Ankle Sprains

March 22nd, 2015 by admin

The Relationship Between Pain and Your Brain

For someone suffering from pain, to be told “It’s all in your head” can be a frustrating experience. It is also a poor explanation of what is going on. What many people don’t understand is that pain is a complex process and the mind plays a role in the perception of pain for everyone.

All pain, no matter the cause, must be recognized by the brain and processed for you to be aware of it. Pain is actually an important part of human survival, letting you know which activities are dangerous and encouraging you to rest and in many cases to protect damaged tissue. When the body loses the ability to perceive pain, this can lead to further injury and even death.

There is a famous condition where people don’t feel any pain at all, known as “congenital analgesia”. This is actually a very dangerous condition and these people are at risk of dying young. They have no warning system letting them know that they need to seek treatment. It can be hard to get your head around the idea that pain helps you survive, but it really is an important strategy of our bodies to keep us protected.

Pain isn’t always associated with tissue damage.

Even though pain is an important part of human survival, sometimes things go wrong. A famous example of this is phantom limb pain, where amputees continue to have severe pain, sometimes for decades after the limb has been removed.

Sometimes pain can even be felt on the injured side when looking at a mirror image of their uninjured limb moving!!

The amount of attention you give to pain and how you feel about it will also change how severely you experience that pain.

Have you ever noticed a bruise and couldn’t remember how you got it? That is an experience of tissue damage without much pain. On the flip side, if you have suffered recent emotional trauma or are grieving you might find a small injury very difficult to deal with. Some people believe the best way to deal with pain is to ignore it and push through with all activities. Other people believe that the best treatment for all pain is to rest and stop all activities.

What you believe about pain and how you react to it can have a big effect on how your brain interprets pain signals. Feeling in control of your pain is also very important. For people who are experiencing pain for long periods of time without any way to reduce symptoms this can be very distressing, particularly if this pain is impacting their ability to participate in activities.

Your therapist is trained to help you deal with pain in the best way possible. This may involve counselling and education about how to deal with your pain and not just physical treatment of your injury. Don’t hesitate to ask us more next time you come in.

High Ankle Sprains


The ankle consists of three bones, the tibia, fibula and talus, all held together by thick fibrous ligaments. At the bottom of the leg they form a mortise or hinge joint with the foot. The bottom parts of the tibia and fibula join together and surround the talus in such a way that it is able to hinge forwards and back while providing stability and restricting the side-to-side movements.

Syndesmosis describes the ligaments holding the tibia and fibula together and a high ankle sprain is a tear of these ligaments. A normal ankle sprain is a tear of the ligaments lower in the ankle, and this is why we refer to a syndesmosis tear as a “high” ankle sprain.


These injuries usually occur through twisting of the ankle during sport, however they can also happen with day-to-day activities. The foot is typically pushed back and rotated outwards, putting excess pressure on the ligaments keeping the lower leg bones together. This force can cause the syndesmosis to tear resulting in a gapping of the two bones, which can lead to significant instability of the ankle.


High ankle sprains are much rarer than lower ankle sprains, accounting for only 1-11% of all ankle injuries. It can be very difficult to tell the two injuries apart. To complicate things, a fracture of the ankle will also have similar symptoms. Your physiotherapist will have a set of physical tests they can perform if they suspect a high ankle sprain. Ultimately imaging may be required to confirm the diagnosis.


High ankle sprains can take up to two times longer to heal than normal ankle sprains and require more immediate attention. Syndesmosis tears that are left untreated can result in chronic instability and pain, making them vulnerable to further injury in the future.


Severe and unstable tears may require surgery and most syndesmosis tears will need to be put into a supportive boot for 4-6 weeks. Following this period a rehabilitation program of strengthening, mobilization, balance, control and agility will need to be commenced before your ankle will be at its pre-injury function. Cortisone injections may be recommended in some cases and have been shown to have good results, when accompanied with proper rehabilitation program. Speak to your physiotherapist for more information.

None of the information in this newsletter is a replacement for proper medical advice. Always see a professional for advice on your individual injury.

Chronic Pain / Rotator Cuff Tears

February 14th, 2015 by admin

Understanding Chronic Pain

Many people use the term Chronic to convey just how excruciating a pain is. However, what the term really means is simply that the pain has been there for longer than three months, even if it’s not very bad. The distinction is made after three months because most injuries to tissues, either muscle, bone or joint have had a chance to heal and resolve by this time.

Why make the distinction?

The difference between pain that has just happened and pain that has been there for a long time has implications for treatment and the way you approach it. Chronic pain requires different management and is likely to be caused by more than one thing where as short-term pain (also known as acute pain) often has a distinct cause, such as a fall or sudden force.

What are some examples of acute conditions?

A sprained ankle, torn muscle, a bruise and even a broken bone are all examples of injuries that occur suddenly and usually follow a typical pattern of healing. They usually go through an inflammatory reaction with the area being red, hot, swollen and painful to touch. This period usually lasts for a few days and is a normal part of the healing process as the body works to remove damaged tissue and bring important cells into the affected area. Different tissue types take varying amounts of time to heal. The severity of the injury will also affect healing times.

Some acute injuries can become chronic if something goes wrong in the healing process, and some are so bad they won’t heal without medical care. For example, fractures need to be kept as still as possible to allow the broken bones to heal together in the correct position.

Some pain and illnesses develop over time and are chronic in nature, usually starting insidiously and becoming progressively worse. Osteoarthritis, multiple sclerosis and rheumatoid arthritis are all examples of chronic conditions that cause chronic pain.

For some people, even though their injury has healed and no significant cause can be found, pain persists. This type of pain can be particularly distressing and requires a holistic approach to treatment, particularly addressing the emotional costs that come with suffering from long-term pain.

Certain factors will predispose someone to developing this type of pain including recent or past emotional trauma, anxiety and depression. Unfortunately chronic pain often causes people to adopt a vicious cycle of rest and inactivity, which causes more weakness, stiffness and pain, which then leads to more pain and so on.

Your therapist is well trained to help you cope with chronic pain and get you back to a more functional level and doing the things you love.

Sometimes the internet can be a confusing place, full of misinformation, particularly from people trying to sell you things. A recent website developed by the Department of Health in Western Australia aims to provide evidence-based support and education to pain sufferers.

Have a look here

Rotator Cuff Tears


The rotator cuff refers to four small muscles in the shoulder joint that connect the shoulder blade to the upper arm. They stabilize the shoulder joint, keeping the joint where it is and also act to rotate the shoulder inwards and outwards.

The muscles attach at different points around the shoulder blade and attach as four tendons into the top of the humerus (upper arm bone).


These tendons are commonly injured through a fall onto an outstretched arm. However, they can tear from seemingly harmless movements of the arm repeated over a long period of time if the tendons are weakened. This is often referred to as ‘repeated microtrauma’. Tears occur most commonly at the point where the muscle turns into tendon, called the musculotendinous junction.


What to expect after a rotator cuff tear depends on how bad the tear is. It is possible to tear the tendon completely in two, which usually requires a surgical repair and subsequent rehabilitation. Partial tears can heal with therapy and rehabilitation and the length of time required will depend on the severity of the tear.

Unfortunately, while many rotator cuff tears are resolving and healing, secondary complications begin to occur. The shoulder girdle is a very complex and flexible part of the body and as such is quite vulnerable to pain caused by poor movement patterns.

Many people move differently when they have pain. They might tend to elevate the shoulder blade, move their neck less to that side or simply move that arm less.

A common condition associated with rotator cuff tears is shoulder impingement, which is where, due to poor muscle control, structures within the shoulder joint are compressed and irritated as the arm is lifted. Another is adhesive capsulitis, or “frozen shoulder” as it is often called, where the capsule of the shoulder becomes stiff and inflamed.


Treatment is an important part of the rehabilitation process of rotator cuff tears, including those both surgically and naturally repaired. Your therapist will help to prevent secondary neck and shoulder problems and give you a strengthening program to restore you to your previous function. For the best outcomes it’s important to seek treatment as soon as possible and get started on your rehabilitation program. Often the longer you wait, the worse the situation.

None of the information in this newsletter is a replacement for proper medical advice. Always see a professional for examination and advice on your individual injury.

Healthy New Years Resolutions/Growing Pains

January 28th, 2015 by admin

Five Healthy New Year’s Resolutions

Need some inspiration for a worthwhile New Year’s Resolution that you might actually keep? Here are a few recommended resolutions that will act as investments in both your short and long term health.

1. Sit Less:

New studies showing just how bad sitting is for your health are starting to really convince us that a lifestyle change is in order. Limit your sitting to four hours a day, set an alarm to remind you to get up every hour or invest in a standing work station. Any way you can find to do it, this is one great investment in your long term health.

2. Find a physical activity that you actually like:

Too many of us fail to stick to an exercise program because we don’t choose the right activity. The gym isn’t your only option. This year, try to find an activity that you really enjoy. It can be anything from laser tag, to dancing, to rock climbing. It doesn’t matter what the activity is as long as it gets you moving.

3. Drink more water:

Are you getting your recommended eight cups a day?

If not, this is an easy resolution to keep that can make a surprising difference to your overall wellbeing. Staying hydrated has been shown to help with concentration, fatigue and even reducing pain.

4. Get that niggling pain or stiffness treated:

Perhaps you might feel a bit self indulgent if you visit a therapist for a problem that really hasn’t been bothering you much. However, most chronic health problems start out as something small. They are also much easier to treat in the early stages . Invest in your body now and treat niggles or stiffness before it does get in the way of your day to day activity levels.

5. Learn how to strengthen your pelvic floor correctly:

Pelvic floor weakness is a common problem that affects both men and women, often resulting in incontinence and pain. The good news is that most pelvic floor disorders can be treated with specific exercises. Unfortunately, many people actually do these exercises the wrong way, making the problem worse. Speak to your therapist to find out how they can help ensure you have correct technique.

Growing Pains


The short answer is that yes, growing pains are real and usually a harmless part of childhood. Though poorly understood, they are recognized as a common phenomenon occurring most often between the ages of 3 and 12. The pain is commonly felt in both legs, particularly at night with no clear cause of pain. As yet no one is able to explain why they happen but growing pains are thought to be a normal response of a growing body as it adapts to new heights, sizes, strengths and skills.


Not so fast. While growing pains are harmless and usually transient, there are many childhood illnesses and conditions that do require professional assessment and, if left untreated, can cause serious harm. These include but are not limited to;

Juvenile arthritis

Childhood cancers (which often first present as knee or jaw pain)

Developmental hip dysplasia (abnormality of the hip joint)

Perthes disease

and a variety of other musculoskeletal disorders.

While it’s true that children are generally more resilient and heal well, they are also vulnerable to injuries just like adults. All serious strains and sprains should be rehabilitated correctly to ensure no long-term problems occur down the track. Many childhood pains can be relieved with therapy in the short term, even if the child will eventually grow out of the pain in the longer term.


Unfortunately, unless you are a trained professional you won’t be able to tell. If there is any doubt in your mind, always contact a therapist or doctor. Many clinicians have great respect for a parent’s intuition and acknowledge that parents are usually very good at knowing if something is wrong with their child.

Even if you feel sure nothing is wrong, there are a few signs and symptoms that you should take particular notice of.

Pain that is severe, pain that occurs suddenly without obvious cause, pain that is one sided, pain that affects your child’s activity levels, causes a limp or is associated with signs of general illness/fever, or persisting night pain.

Constant, severe and unrelenting pain is a serious sign that should be investigated at any age.


The first step is to consult a therapist or general practitioner. They can help to either reassure you that your child’s pains are harmless, or recommend further investigation and treatment.


December 29th, 2014 by admin

Physiotherapy And Injury Healing

There is no doubt that the human body can be very resilient. Short of regenerating new limbs, the body is capable of recovering from amazing amounts of damage, including broken bones. Many people may feel that physiotherapy treatment will only speed up recovery, and that if they are not elite athletes then simply letting nature take its course is the best, and most cost effective choice for them.

Speed of recovery, however, is only one very small measure of physiotherapy success and fails to fully represent how important proper treatment is. Here are a few things about injury healing you may not have been aware of.

1. Scar Tissue is more likely to form without treatment.

Scar tissue can cause ongoing pain and stiffness in skin, muscles and ligaments. Physiotherapy can prevent excess scarring through advice regarding movement, massage and other hands on treatment.

2. Your ability to sense the position of your body, known as proprioception, is often damaged after an injury and can be retrained.

Impaired proprioception is a major factor in reinjury. If you’ve ever heard somone say “my knee/ankle/shoulder still doesn’t feel 100%” then this could be why. Physiotherapy treatment will aim to restore proprioception as a part of standard rehabilitation.

3. Once healing has finished, your body may not be exactly the same as before.

Ligaments may be looser, muscles and joints may be stiffer and almost always weaker. While the pain may be gone, there may still be some issues that need to be addressed to prevent ongoing and more complicated issues in the future.

4. You may have picked up some bad habits while waiting for the injury to heal.

While in pain, we often change the way we do things, this can lead to the development of poor movement patterns and muscle imbalances. Even though the pain has gone, these new patterns can remain and create further problems down the road.

5. Injuries don’t always heal completely.

On rare occasions, circumstances may prevent an injury from healing fully. The most serious example of this would be a fracture that cannot heal if the bone is not kept still enough. Other factors that may prevent an injury from healing include poor circulation, diabetes, insufficient care of the injury and poor nutrition.

Your physiotherapist can assess your injury and develop a treatment plan that will both restore you to the best possible function and prevent further injuries.

Focus On….Carpal Tunnel Syndrome


Carpal Tunnel syndrome is a progressive disorder caused by compression of a key nerve in the wrist. The carpal tunnel refers to a space or “tunnel’ at the front of the wrist where tendons and nerves pass from the wrist to the hand. The median nerve is most commonly affected. This nerve controls sensation to the palm, side of the thumb and fingers, (excluding the little finger). The median nerve also sends impulses to some of the small muscles that allow the fingers and thumb to move.


Symptoms usually begin gradually with frequent burning, tingling or itching/numbness in the palm of the hand and fingers, especially the thumb, index and middle fingers. Your fingers may feel fat and swollen, even if they aren’t. Symptoms are often relieved by shaking of the wrists, even if only temporarily.

These symptoms may show up during the night as many people sleep with their wrists bent. Gradually, tingling symptoms may increase and grip strength may begin to weaken, which can affect your ability to form a fist, grasp small objects or perform other manual tasks. Left untreated, carpal tunnel syndrome can result in permanent nerve damage.


Because this tunnel is made from the ligaments and bones of the hand, it is quite rigid, and any thing that causes the narrow space to be taken up can compress the structures that sit within. Often the tendons that pass through the carpal tunnel will become thickened or swollen through overuse, resulting in compression of the median nerve. People who suffer from thyroid or pituitary disorders, rheumatoid arthritis, diabetes, wrist dysfunction, work related stress or use of vibrating tools are more likely to develop this disorder.

Women are three times as likely to develop carpal tunnel syndrome as men, this is thought to be due to smaller wrist dimensions.


Your physiotherapist can diagnose carpal tunnel syndrome with specific tests. Neck pathology can mimic carpal tunnel syndrome and it is important that a correct diagnosis is made. In many cases, symptoms can be resolved with physiotherapy, and you may be advised of rest, wrist splinting, exercises, manual therapy, dry needling and postural changes to prevent further injury.

Physiotherapy treatment is almost always recommended before considering other treatments such as surgical release or cortisone injection and is often very effective, particularly in mild and moderate cases. For more information, don’t hesitate to ask your physiotherapist.

Jumping For Healthy Bones

Here’s a quick and easy way to help combat osteoporosis.

New research has found that premenopausal women who jumped as high as they could were able to actually increase their bone mass while women who didn’t exercise lost bone mass during the same time frame.

The study recommended jumping as high as you can, ten times with a thirty second rest, twice a day for best results.


November 16th, 2014 by admin

Degenerative Disc Disease

Between adjacent vertebrae sit flexible discs that provide movement and shock absorption in the spine. In the thoracic region these are completely fibrous while the discs in the lower back and neck are filled with a jelly like substance and surrounded by protective, fibrous rings. The discs of the lower back are the largest as they need to transmit higher loads through the spine.

As we age, these discs lose hydration, height and elasticity. Unfortunately, this also means that the discs are unable to provide the flexibility and support they previously did. Like any form of soft tissue, discs can also become sprained and are able to heal. It is also possible for these discs to bulge and even have the jelly contents spill out into the surrounding region.

You may have heard people talk about having a slipped disc, however this is a misleading expression as discs almost never slip out of place and are very securely attached to the bones above and below them.


When these discs first begin to degenerate, abnormal stress is placed on the surrounding joints and muscles of the spine. Facet joints and the vertebrae themselves can also degenerate and produce small bony outgrowths called osteophytes, although these can occur independently of disc degeneration. During this period people may notice feeling stiff and sore at regular intervals. Symptoms are usually located in the neck and lower back.

As the degeneration progresses and the discs become less functional, episodes of pain will often be more frequent and more severe. Many people describe pain with prolonged sitting or standing, along with pain radiating into the hip or buttock region. Pain will often be relieved by changing positions, lying down or walking. Pins and needles or numbness may occur when the spinal nerves around the affected disc become irritated.

Disc degeneration is considered to be a normal part of aging, however research on twins has shown that a genetic predisposition to degeneration is the most accurate predictive factor. Smoking, poor nutrition, posture and biomechanics may also increase your chances of suffering from disc degeneration.


Your therapist can diagnose this condition clinically with a thorough examination, including careful questioning and in depth assessment. In many cases imaging is not required, however if you have had previous medical imaging please bring this to your initial appointment.

An important thing to note in spinal pain is that many people can have severe back pain without an obvious finding on their imaging and other people have no pain with very significant structural changes in their back. Some people have even had their discs rupture and heal without realising it!


Treatment of any spinal disorder is often complex and your therapist will tailor your management plan to suit you. Many people respond well to specific strengthening exercises, particularly Pilates style exercise. Trigger point therapy or dry needling can help to relax muscles that are often abnormally tight, therefore reducing pain. Your therapist is also trained to safely mobilize the spine, which allows the back to move with improved range and reduced pain.

Your therapist will have a great deal of advice and education for you to assist in managing your symptoms. Diagnosis of a condition such as degenerative disc disease can be daunting, however it doesn’t have to be a life sentence of pain. For more information, speak to one of our friendly, experienced therapists about treatment options.

Cauda Equina Syndrome

Cauda equina syndrome is a rare condition that you may not have heard of, however it can have catastrophic consequences if it is not recognized and treated quickly. This condition occurs in about two percent of cases of herniated lumbar discs, causing loss of lower leg function, incontinence and lower back pain. It is one of the few medical emergencies related to back pain and can be devastating if symptoms persist.


At the end of the spinal cord there is an area of spinal nerves arranged together in a bundle that looks a little like a horses tail. (In Latin horses tail is cauda equina). These nerves are encased in the spine at the lumbar region.

If for some reason these nerves are compressed, nerve signals to the bowel, bladder and lower extremities can become disrupted. Left untreated, this compression can cause permanent paraplegia and incontinence.

Common causes of compression are disc herniation associated with disc degeneration, tumours, inflammatory disorders, spinal stenosis or complications from surgery. Trauma-related cauda equina syndrome from knife wounds or motor vehicle accidents can affect people of all ages.


This disease is difficult to diagnose because its symptoms mimic many other conditions. However, there are a few symptoms that health professionals know to take very seriously. These include:

  • Sudden loss of reflexes in the legs
  • Unusual and rapid onset of Bladder/bowel incontinence or sexual dysfunction
  • Pain in one or both legs
  • Motor and sensory loss
  • Tingling or numbness in the saddle region (Groin and inner thighs)
  • Bilateral sciatica

These symptoms may be associated with severe low back pain and if you suddenly experience more than one, particularly incontinence, contact a health professional immediately.


Treatment will depend on the severity and cause of the syndrome. However, most of the time cauda equina syndrome requires decompression surgery as soon as possible to relieve pressure on the nerves. The longer the period between symptom onset and surgery, the less likely it is for a full recovery. Most patients will need physiotherapy, pain management and counseling even if their condition is treated quickly. Recovery time is based on the amount of damage to the nerves.

While this a very rare condition, public education is important, as rapid treatment is vital to prevent permanent damage.


October 14th, 2014 by admin

October 2014 Newsletter

Sunshine and Your Health

With so much public education about the dangers of sun damage, the last thing you’ll be expecting to be told is that you’re not getting enough sunshine. However, in Australia up to 30% of the population have inadequate vitamin D status, increasing to more than 50% in women during winter and spring.

What does vitamin D have to do with sunshine?

Also known as the “sunshine vitamin”, vitamin D is essential for your health. With a typical western diet, most people will get about 10% of their daily vitamin intake through food and the other 90% is actually processed by the body through exposure to sunshine.

Why is it important?

Vitamin D is essential to maintain bone health and muscle function. Deficiencies in children can cause rickets, and over time it can cause osteoporosis in adults. It is also a predictor of falls, due to reduced muscle strength, which coupled with osteoporosis can lead to complicated fractures. Depression has also been linked to vitamin D deficiency.

Think you get enough sunshine?

You might be surprised at how much sun exposure you actually need to make enough vitamin D. Unfortunately the answer isn’t straightforward. During winter you’ll need to be in the sun for longer, and the further from the equator you are, the more sun you’ll need. Fair-skinned people are better adapted to process vitamin D and as such need to spend less time outside.

People who tend to avoid the sun or dress very modestly might be surprised to find that they are vitamin D deficient, along with office workers and those who spend a lot of time indoors, particularly the elderly who are in care.

Being overweight can also put you at risk of being vitamin D deficient as fat cells absorb vitamin D and prevent it from being released in a way that can be used by the body.

Vitamin D deficiency can be diagnosed with a simple blood test. To find out more about how much sun you should be getting and how to balance sun exposure with skin cancer risks go to….

Achilles Tendinosis

What Is It?

Achilles tendinosis is an overuse injury of the Achilles tendon, most commonly affecting runners between 30 to 40 years of age.

The term tendonitis is often used in place of tendinosis, however this is not strictly accurate as most terms that use ‘-itis’ describes an inflammatory condition and inflammation has been shown to be largely absent in tendon overuse injuries.

Tendinosis is instead due to repeated microtrauma as heavy, sudden or repetitive loads are applied. Tendon tissue typically has poor blood supply which means it is often unable to heal adequately before the trauma is applied again, resulting in a damaging cycle that eventually leads to the breakdown of collagen fibers. It is these fibers that provide a tendon with most of its strength and flexibility. The end result is a degenerating tendon containing damaged and disorganized collagen fibers. As the tendon degenerates it is able to support increasingly smaller loads, adding to the cycle of damage and degeneration.

Tendinosis can be a difficult condition to treat and can take anywhere between six weeks to six months to resolve. Untreated tendinosis can even increase the risk of tears and complete rupture of the Achilles tendon. To aid in treatment, the condition is often classified as either acute or chronic depending on the duration of symptoms, and insertional or non-insertional depending on location.

What are the symptoms?

Pain, stiffness and weakness are the primary symptoms of tendinosis, with many people experiencing intense pain when they take their first steps out of bed in the morning. Many people notice swelling and thickening over the tendon, which may be tender to touch. More chronic conditions will give a ‘creaking/cracking’ sensation when the affected area is pressed.

Typically these symptoms will begin gradually with the onset of exercise or activity and fade as the exercise progresses. As the condition progresses the pain will become more constant, last longer and be triggered by lighter stress. It is important to note that tendinosis can be asymptomatic, only becoming painful when the condition is already quite advanced.

How can treatment help?

Physiotherapy treatment for tendinosis is targeted towards breaking the cycle of injury and stimulating healthy collagen production. This means identifying factors that increase tendon stress, such as training errors, biomechanical faults and poor footwear, while prescribing appropriate rest from activity. There are many manual treatments which have been shown to be very effective along with a specific exercise program involving eccentric exercises. Ultrasound, extracorporeal shockwave therapy and dry needling are helpful treatments that may also be used.

For more information, don’t hesitate to ask your treating physiotherapist.


September 22nd, 2014 by admin

Think FAST To Save A Life.

Stroke is a leading cause of death worldwide. For stroke survivors, the long-term effects can be devastating for both them and their family. Disturbingly, over the past few years, the rate of stroke among young adults and children has grown rapidly. One of the biggest concerns is that most people having a stroke don’t recognize the symptoms and miss out on medical treatment when it can be most effective.

It’s important to identify the warning signs of stroke and act fast. The sooner you receive medical care, the higher your chances of recovery are. Stroke can rob a person of both their physical abilities and their personality. The faster you take action, the more of the person you save.

Signs and Symptoms

The signs of a stroke vary from person to person and they usually occur without warning. Common symptoms include the inability to write or understand spoken language, numbness/weakness in the face, arms and legs, double vision, headaches, vertigo, and an inability to recognize faces.

To help recognize a stroke quickly the acronymFAST is used as an easy reminder of the most common stroke symptoms. The letters stand for;

Face: Check their face – has their mouth drooped?

Arms: Can they lift both arms?

Speech: Is their speech slurred, do they understand you?

Time: Is critical. If you see any of these signs call 000 straight away.

Why Is It So Important To Recognize A Stroke?

Recognizing if someone is having a stroke and receiving emergency medical treatment are important for three main reasons.

  1. Only a doctor can decide if you are having a stroke.
  2. Some treatments must be given within three hours of the stroke starting.
  3. They will need to be assessed by a doctor who will look at treatments to prevent another stroke.

Because every person and every stroke is different it’s important to seek treatment, even if you’re not sure. For more information visit the stroke foundation’s website.

Focus on…

Shin Splints

What Are Shin Splints?

Also known as Medial Tibial Stress Syndrome (MTSS), this common injury usually affects runners, dancers and people who engage in sports that involve jumping and running. While shin splints can seem harmless, if left untreated they can really impact your ability to keep up training and even interfere with your daily routine. The good news is that you can prevent and treat shin splints quite easily.

Shin splints are a common overuse injury that causes pain along the inside of the tibia (shin bone). As with most overuse injuries it is caused by an inability of the structures around this region to cope with the demands of training. The pain can be coming from injury to the muscles surrounding the tibia, the structures that attach these muscles to the tibia or the tibia itself.

Signs and Symptoms

Shin splints often start as a dull pain around the inside of the shin, usually around the middle third of the lower leg.

You may feel pain before, during, or after activity. The affected area may be sore and tender, with some swelling and often both legs are affected. Pain often begins gradually and in the beginning it may come and go, however as the condition progresses pain can be present all the time.

How Does It Happen?

The exact cause of shin splints is often difficult to pinpoint, however as with many overuse injuries, dysfunction at another site can cause tissue to take on more stress and begin to breakdown. Below are some common factors that may increase your risk of developing shin splints.

  • Training errors, increasing intensity too quickly.
  • Pronating feet or uneven leg length.
  • Running uphill or on hard surfaces.
  • Unsupportive footwear.
  • Gluteal weakness and pelvic instability.
  • Reduced muscle strength and flexibility

How Can Treatment Help?

Many other conditions can mimic shin splints so it is important to visit your therapist who can diagnose your condition correctly and advise suitable reductions to your training program. Furthermore, left untreated, shin splints have been known to develop into stress fractures or compartment syndrome.

While rest and ice will help to settle symptoms quickly, your therapist will be able to identify the factors most likely to be contributing to your pain and assist with correction of any muscle imbalances, joint stiffness or training errors. For further treatment options and advice on managing your shin splints, don’t hesitate to ask your therapist. We can help you!!


August 30th, 2014 by admin

Hydrate For Better Health

We all know the importance of drinking more water in warmer months, however as the weather turns colder, it’s easy to forget to keep up your water intake. Hydration is essential to keep your body functioning properly as water enhances nutrient absorption, maintains skin elasticity, and regulates pH balance. It also helps prevent muscle spasms and lubricates your joints. Getting enough water is essential to having enough energy and staying healthy.

Hydration and Treatment

If you are currently receiving treatment you might be surprised to learn that keeping properly hydrated can speed up your recovery and help you to feel better overall. One reason for this is that keeping hydrated can soften tight muscles and reduce pain. Drinking enough water also helps to minimize lactic acid buildup, which is produced by your muscles as you exercise and significantly contributes to post-exercise stiffness and soreness.

Your body is made of up to 70 percent water, and staying hydrated keeps your blood pressure within a healthy range, stabilizes body temperature, and supports kidney function. It also aids in digestion, improves mental focus, and boosts your immune system.

The benefits of hydration are huge and can greatly assist your treatment and your overall wellbeing. So for better health, don’t forget to drink more water, even though you might not feel as thirsty. For optimal results, drink pure filtered water or herbal tea.

Focus on…

MCL Sprains


The medial collateral ligament, or MCL, is a thickening of the fibrous capsule that surrounds the knee joint. It is located on the inside of the knee and provides stability from side to side movements, which would damage the joint. When subject to strong forces the ligament can tear, leading to pain and instability of the knee.


MCL tears typically produce a very specific pain on the inside of your knee. In the first 48 hours after the injury the inside of the knee will appear red, hot and swollen with possible bruising. Many people report hearing a ‘pop’ or ‘clunk’ at the time of injury and may feel as though the knee is about to give way.

The knee is usually painful to put weight on and may feel unstable. This instability may be more noticable in the days following the injury, after the swelling has subsided. Some people note pain at night while lying on the painful side and with activities that involve bending the knee.


MCL tears can happen in a variety of ways, but the most common is where the foot is fixed and the knee is twisted inwards, usually while the knee is also bent. This can happen from something hitting the knee from the outside, such as during a rugby match when someone is tackled around knee height or when their foot comes out of their binding while wakeboarding or snowboarding.


There are a variety of clinical tests that determine if an MCL tear is the cause of pain and the degree to which this has caused the knee to be unstable.

An MCL injury is usually graded by it’s severity from grade I to III. A grade I tear will only involve a few ligament fibres and will heal well within a few weeks. A grade II tear is more severe and will lead to some knee instability, however a grade III tear involves a complete rupture of the ligament. Grade II and III tears will usually require bracing but only in very severe cases, surgery.

More severe tears can be accompanied by other injuries such as cruciate ligament tears or meniscal tears. If either of these are suspected an MRI scan or specialist opinion may be needed.


The first 48 hours after an injury are very important and a physiotherapist can assist with first aid, advice on injury management, the use of ice, braces, taping and early exercises. Rehabilitation of MCL tears focuses on keeping the ligament safe and stable while it heals. Therapy can actually speed up the healing process with manual techniques such as massage, ultrasound and dry needling.

Major consequences of a serious knee injury are loss of muscle strength, balance and control, which can leave the knee vulnerable to reinjury. Rehabilitation aims to restore the knee to its previous state.

For more information don’t hesitate to ask your therapist.

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