Category Archives: Conditions, Injuries & Advice

The importance of choosing appropriate equipment for any athletic pursuit is of utmost importance in preventing pain and dysfunction. Whether activity involves a 30 minute walk in the park with your dog or a highly competitive game of tennis, choosing the correct equipment can be the difference between pain or gain. Equipment may range from simple footwear to more complex racquets or sticks; to expensive and highly sophisticated items such as bicycles and motor vehicles. Three major pieces of equipment play a major role in the development of sports injuries – footwear, racquets and bicycles. Over the past two decades running shoes have become increasingly more complex and specialised.   The assessment of foot type and function is imperative in deciding the most suitable shoe.  They must fit correctly and the laces must be firm enough for motion control.  Running shoes need to be changed every 1,000 km which is approximately every 6 – 9 months for runners and 12 months for walkers. The constructions of many types of football boots provide inadequate support for the lower limb.  They should be of adequate depth in the upper, have a rigid heel counter, sufficient forefoot flexibility and have a wide sole with ‘cleats’ placed to allow forefoot flexibility.  Netball and tennis shoes require support for sideways movement.  Wearing running shoes for these sports may lead to ankle sprains, while wearing tennis or netball shoes for running may lead to problems such as ‘shin splints’. Racquets are used in sports such as tennis, squash, badminton and table tennis.  The choice of a tennis racquet may be a contributing factor to ‘tennis elbow’.  Things that need to be considered include string tension, flexibility of the racquet, size of head, weight and grip size. Overuse injuries in cycling may be associated with incorrect bike set up.  Seat height, saddle position, handlebar position, pedal resistance and peddling technique if incorrect may contribute to musculoskeletal pain such as neck and back pain, shoulder and wrist pain and knee pain to name a few. When choosing any piece of equipment you need to get correct advice from a professional to avoid unnecessary pain and injury. By Melanie Roberts

Arthritis is a condition that affects millions worldwide. Osteoarthritis is a form of arthritis that affects the joints throughout the body. There is a layer of cartilage that lines the bones of our joints. As we age, this cartilage loses water and becomes less resilient and more susceptible to wear and tear. Once this cartilage layer starts to degenerate, bone becomes damaged beneath this cartilage and bone spurs bone may form causing pain, swelling and stiffness. Osteoarthritis is common in hands, feet, spine and especially weight bearing joints such as hips and knees. Symptoms of osteoarthritis include pain, stiffness and reduced mobility. Pain is often worse when it’s cold and when weight is put through the joint (ie: walking). In those with mild to moderate arthritis, the pain usually gets better after moving about or “warming up”.   Physiotherapy can help those suffering from osteoarthritis. While you cannot change the fact that the arthritis has developed, physio can help with the pain, lack of strength and reduced mobility that is associated with arthritis. ‘Hands on’ physio, such as soft tissue massage to the muscles about the affected joint, can help relieve any tightness and restore movement. Your physiotherapist can also provide you with some simple exercises to help strengthen the muscles around the joint to ensure that the joint is moving as freely as possible. These exercises are also important to strengthen those muscles to ensure there is enough strength to minimise any unnecessary strain on the joint in future. Physiotherapy can help delay the need for a knee replacement.   By Jessica Norton

Symmetrical squats are important and this means that when viewed from the side both kneecaps will end up in the same place – with good alignment, your bottom does not drop more to one side, your pelvis does not twist to one side or drop down and that if you have weights on your shoulder the bar does not lean over to one side. When viewed from behind the bottom will come straight back and not twist to one side on the way down or up.  Some of the below list may affect the symmetry of the squat. Ankle Dorsiflexion – this is to do with ankle stiffness.  Can you move your body over the ankle?  If the ankle is stiff perhaps from a past injury this will limit the amount that your body can move forward over the ankle unless you stand on a wedge. Knee Pain – when your knee goes into flexion especially if your body is coming over too far it will load the knee joint.  If you have some arthritis in the knee or the kneecap this may cause pain.  Also, any tears in the cartilage may also cause pain and therefore the weight bearing may not be even. Hip Pain – If you have a tear in the labrum (cartilage) or some anterior impingement in the joint it will affect the way you squat through the hip.  It may make you squat with your legs wider and turned out to avoid pain.  You could also weight bear less on this side. Groin Tightness – this tightness on the left side for example will cause the pelvis moving to the left in the bottom position. Piriformis Tightness – at the top of the squat this will make the left hip appear externally rotated if tight on the left side.  In the lower part of the squat it will make the pelvis move to the left, again causing asymmetry. Posterior Capsule Tightness – this will appear like the piriformis tightness but at the bottom of the squat the pelvis will move to the right not the left. Leg Length Difference – this depends on if the leg length difference is actual or apparent.  Both will have an effect on the symmetry of the squat but for different reasons. Scoliosis – this depends if it is structural (bony growth) or apparent due to asymmetry of muscles, that is, functional or apparent. Hip Muscle Strength – this can be due to muscle weakness – it may be in glut max where you will move to the stronger side or it may be in the quadriceps muscles which will show up especially in the up phase of the movement moving weight across to the other side.  There may also be some weakness in the deep pelvic stabilisers which may cause a pelvic drop on the opposite side. Upper Limb Tightness – tight latissimus dorsi or pect major will have an effect looking at the upper body and the way the bar moves (is it symmetrical through range?). By Melanie Roberts.

So what actually happens when we injure the soft tissues in our body? Understanding the processes and time frames involved can give you a basic idea of what to expect should you encounter an injury. Common soft tissue injuries involve structures such as muscles, tendons, and ligaments. The following three stages are how typical soft tissue injuries will respond: The acute stage usually lasts around 0-72 hours and involves local inflammation, bleeding and the initial formation of scar tissue. The repair stage begins on day 2 and can continue until week 6 and involves scar tissue being formed to ‘close’ the damage. The remodeling stage can begin after 4 weeks and can last up to 12 months. During this stage, the tissue slowly returns to it’s pre-injured state. The initial extent of the injury will influence the amount of scar tissue formed along with healing times. Muscles will lose strength in relatively short periods of time due to the inflammatory process and being immobilized. Scar tissue can be broken down effectively using soft tissue therapy techniques performed by a physiotherapist. This can speed up recovery time and promote muscle elasticity which can reduce the risk of re-injury. Each injury presents differently and although each injury will go through the above stages, the time frames can differ depending on the severity of the injury. By Todd Purser.

These days we worry about our family and their health, yet seem to neglect ourselves.  We often put things off in order to please others, especially our friends and family, and forget about doing things for ourselves.  We get busy in our work and home lives and forget about the simple things like going for a walk on the beach or having a massage for relaxation. If we have aches and pains, they are often neglected with the excuse that they will “go away”.  This is often not the case and in fact the opposite may occur, where adaptations and compensations develop to cope with the injury or dysfunction.  An example of this is with shoulder pain, which may be from a simple fall or lifting injury.  If left, compensations occur, as muscles or ligaments may be injured and prevent the muscle from contracting properly, due to pain inhibition.  This in turn means that other muscles must take over and work too hard, and therefore become tight.  The whole shoulder becomes dysfunctional and can then put extra strain on other parts of the body, for example, the neck.  This neck pain may in turn lead to headaches, and so on.  By leaving problems because you do not look after yourself as well as you would look after your loved ones may lead to a lot of long term unnecessary pain.  Think about it…if your child came home from school or footy and said that they hurt themselves, you would have them off to the doctor or physio the next day.  Take more time to love yourself, as you only have one body, so look after it! By Melanie Roberts

Hamstring strains are common in sports such as soccer, AFL, rugby league as well as common physical activities like running. The hamstring muscle group is comprised of three muscles which act to extend the hip and bend the knee. When the tension within the muscle is too high due to too much force or repetition then the muscle fibres tear. Hamstring strains commonly happen while running, just before the foot strikes the ground. In this position the hamstring is in a lengthened position and is required to produce a lot of force to prepare the foot for impact. Hamstring strains are graded 1-3 depending on their severity, with grade 1 being a minor strain with only a few fibres torn compared to grade 3 which involves over 50% of the muscle fibres being torn and may involve full rupture of the muscle. Signs and symptoms of a hamstring strain vary depending on the severity of the injury and may include pain when walking, pain on stretch, bruising, tightness and weakness. Hamstring strain recovery times also vary, with on average 6-8 weeks required for a grade 2 strain. Management includes soft tissue therapy and a gradual strengthening program to restore full range and strength. A return to sport program is important to ensure a smooth transition back to playing/exercising. Management also includes addressing any contributing factors such as weak glut and hamstring muscles, poor flexibility, inappropriate shoes, poor technique, unbalanced training program etc. Proper management of a hamstring strain is vital as inadequate rehabilitation leads to an increased risk of injuring the hamstring again.   By Jessica Norton  

Achilles tendinopathy is a common condition that results from degeneration of the Achilles tendon. The term Achilles tendinopathy means pathology within the tendon and has replaced the term tendinitis as research has found the condition to involve degeneration of the tendon, rather than an inflammatory response.  A tendons role is to transmit force from the muscle to bone as well as absorb any external forces from over straining the muscle. To achieve this, a tendon must have adequate strength, flexibility and elasticity as well as adequate recovery time. Achilles tendinopathy usually results from repetitive or prolonged activities such as excessive walking, running etc that overloads the capabilities of the tendon. Beginning an aggressive training program after being sedentary for a period is also seen as an aggravating factor for Achilles tendinopathy. As a result of aggravating factors, the tendon substance changes causing a reduction in tensile strength of the tendon.  Inflammation of the paratendon (sheath around the tendon) is occasionally seen. Signs and symptoms of Achilles tendinopathy include pain at the beginning and end of exercise with pain easing once warmed up. Stiffness first thing in the morning and after being seated for a period of time is also common. As the condition worsens, pain will be felt earlier into exercise or will not ease after warming up. Management of Achilles tendinopathy includes addressing all of the contributing factors which could be calf tightness, overpronation of the foot, inappropriate footwear, poor technique, muscle weakness and many more.  Since tendon repair and remodelling is stimulated by load, complete rest can be detrimental to Achilles tendinopathy. A period of ‘modified rest’ (Ie: rest from aggravating and painful activities) while completing a gradual strengthening program under the advice of your physio, is an important part of successful rehabilitation.   By Jessica Norton

Chronic shoulder injury is a common problem and not just for athletes.  Among the population day to day activities can produce pain.  Some activities may include hanging out the washing, gardening or working out in the gym.  Many people pile on the weight at the gym without paying attention to technique or balanced strengthening. The incidence of rotator cuff tears increases with age, with adults beyond the age of 50 most vulnerable.  Sports people in specific sports are at risk of chronic shoulder injuries.  These sports include swimming, tennis, cricket, javelin and baseball, all of which involve variation on the throwing action when the arm moves above the head. This action requires a large number of muscles and combines a large range of motion with high forces and speeds at the shoulder joint; especially in a repetitive motion. For the shoulder and arm to move efficiently there needs to be co-ordination of movement between the shoulder blade and upper arm.  If this pattern is disrupted due to poor posture or muscle imbalances injury and pain may result. An accurate assessment of your shoulder by your physiotherapist can address any tightness, weakness or poor co-ordination of muscles contributing to this debilitating condition. By Melanie Roberts

Sciatica is a term often used to describe any pain down the leg. However, there are numerous causes of leg pain and Sciatica is a specific diagnosis. The sciatic nerve exits the spine at the lower back level, runs through the buttock muscles and travels down the back of the leg, passes the back of the knee and ends at the back of the foot. Irritation of this nerve at any point along its path may cause leg pain, however true sciatica is caused by nerve root irritation as it exits the spine (termed radiculopathy). The most common cause of sciatic nerve root irritation, seen in those with true Sciatica, is a disc herniation. A disc herniation (also known as disc bulge) occurs when the inner ‘jelly substance’ of the disc is ‘pushed out’ of its normal boundaries and out through the outer fibrous ring. Nerve roots are closely situated to the discs and vertebrae so can easily become irritated during a disc herniation. Nerve roots can become irritated due to the inflammation and increased blood flow from the disc injury. However, nerve roots can also become irritated if the ‘jelly substance’ during the disc herniation compresses a nerve root.  A herniated disc may result from an acute incident, or more commonly, it occurs gradually over time with repetitive strain to the spine. Symptoms of sciatica include pain down the leg, weakness of the muscles of the affected leg, altered sensation (such as pins and needles, numbness). The pain is often described as a ‘shooting’ pain and may disturb sleep. Movements that aggravate sciatica are movements that increase the pressure on the disc herniation such as bending forward, sitting for long periods, driving, lifting. If you are experiencing any leg pain, please visit your physiotherapist. Your physiotherapist will first conduct an assessment to identify whether your leg pain is in fact sciatica or whether you are experiencing another cause of leg pain. Other causes of leg pain include facet joint pathology and piriformis syndrome. Facet joint pathology such as stiff and irritated facet joints as well as osteophytes (bone spurs seen in those with low back arthritis) can cause nerve irritation and leg pain. Piriformis syndrome is used to describe the compression of the sciatic nerve as it passes through the piriformis muscle (a muscle deep in the buttock). In a small percentage of people, the sciatic nerve passes in the middle of the piriformis muscle (instead of just below it) so if this muscle gets tight or spasms up, the sciatic nerve can get compressed resulting in leg pain. Physiotherapy can be very beneficial for the treatment of sciatica, as well as the other causes listed above. Treatment of sciatica may include soft tissue massage to any muscle spasm, joint mobilisation to restore full movement, posture advice and a home exercise program consisting of specific stretches and strengthening exercises to restore full strength and prevent further recurrences. By Jessica Norton

Clinical Pilates is an amazing treatment method that basically trains the muscles in the area where you have your injury. This will stabilise and balance your body and therefore support the movement and avoid your pain from returning. We are different to other physiotherapy clinics, because we strive towards making our clients well with treatments targeted at long term results. We will prescribe exercises that will stabilise and correct muscle dysfunction, so you can live your life painfree. WHAT IS CLINICAL PILATES? Clinical Pilates is one-on-one or small group Pilates with a therapist, training the core muscles around your spine. The focus is solely on you and we will make sure that you are maintaining the best technique possible, so you can recover from your condition as soon as possible. The Pilates exercises are aimed at the appropriate level for you and your pain and are progressed as tolerated. WHAT ARE CORE MUSCLES? The core muscles are the deep abdominal muscles that insert into the spine and are not visible. The core muscles are the closest muscles to the skeleton and it is difficult for a person to know if they are activating this group of muscles. Functional movements are highly dependent on the core, and lack of development can result in a predisposition to injury. Poor activation of your core will cause a loss of mobility and stiffness as the outer muscles of the back and abdomen brace to overcompensate, which may result in spinal stiffness as well as muscle fatigue. Research suggests people with chronic low back pain do not have a correctly functioning core and improved muscle stability of the spine is crucial for treatment of this condition. Having a developed rectus abdominis or ‘six pack’ does nothing to strengthen your back and does not mean you have a strong core. Sit-ups are commonly thought to assist in the strengthening of your core but this is NOT true and in fact may actually lead to an increase in back pain. Having a strong and stable core gives greater support and efficiency for most athletic endeavours, therefore, athletes and the general public alike can benefit from core strengthening exercises. A strong core assists with people’s posture especially those who work in a role that has a static posture such as an office job which can be a large cause of neck and back pain. By Melanie Roberts