Understanding ACL injury and management options

The anterior cruciate ligament or ACL is a key ligament in the inside of the knee that helps to stabilise the knee joint. Injuries are common, especially among athletes involved in sports that require sudden stops, jumps, and changes in direction. On injury it can be partially torn, or totally torn, called a complete rupture.  Injury can occur at any age. 

An ACL injury is a significant injury. It can result in significant pain, lack of stability in the knee, and decreased ability to partake in activity and sport.

Accurate diagnosis is essential for effective rehabilitation to take place. Previously ACL reconstruction in surgery was the next step. However we are increasingly seeing that there are successive non operative options available. If you suspect an ACL injury it is essential you see a health practitioner. As sports physios we will be able to assess your knee.

Causes and Symptoms of ACL injury

ACL injuries can result from various mechanisms, including:

1. Direct Impact: A blow to the knee can stretch or tear the ligament.
2. Non-Contact Injuries: These occur when no contact with anyone else is involved. This commonly occurs when an athlete changes direction rapidly or lands awkwardly from a jump.

In this blog, we hope to bring you the latest research about frozen shoulder and how physio can help.

Frozen shoulder or “adhesive capsulitis”

Frozen shoulder or “adhesive capsulitis” is the development of a very stiff shoulder which can be very painful in the initial stages.  It typically affects those in there 40’s-60’s.  As yet an understanding we don’t totally understand how frozen shoulder occurs.  The capsule around the shoulder becomes highly painful and then contracts to become stiff.  

Contributing factors to the cause of frozen shoulder

These include:

genetics, 

aging (from 40s-60s) 

lifestyle (there are strong links to adiposity, meaning increased body fat)

metabolic (there are strong links with diabetes, thyroid and hyperlipideamia)

How do you know if you have frozen shoulder?

If you have any of the above contributing factors then this places you at great risk of having frozen shoulder.  Typically the condition begins with considerable constant shoulder pain.  The actual reason for the pain remains unclear. The shoulder becomes restricted in movement as the capsule contracts, typically in movements reaching the arm outwards, behind you or overhead. This is known as the “freezing phase”.

Over many months the shoulder will become less painful but remain very stiff and restricted in movement – this is know as the “frozen phase”.  Over yet more months the shoulder will slowly improve with the range coming back, know as the “thawing phase”.

Diagnosis of frozen shoulder can be confirmed on imaging, together with your symptoms and the range of movement you have available in the shoulder joint.  Xray can be a very useful scan to have to rule out several other possible causes of your shoulder pain.

Need to become more active?  Know you should become more active? Injured? Just cant get motivated? At Physiologix we are here to help. With an amazing team of Physios, massage and Pilates experts we would love to work with you and support you to get more active.  So how can your physio help you get active?

The World Health Organisation (1) shows 1/3 of adults (1.8 billion) do not meet recommended levels of physical activity (2). So number 1: you are not alone!

Activity is key at Physiologix

At Physiologix much of our work with people focuses on advice and education. The other key component of our success with our clients is our focus on exercise.  Exercises are not just about an injury or issues someone may have but also on exercise, or activity, for general health.

It is simple.  Whatever you might be interested in or maybe like to do, we will use that as our base and start there.  Being a little fitter means you are a little more healthy, not just physically but also mentally.  It doesn’t take much to go a long way.  

We help many clients at Physiologix with back and neck pain using clinical Pilates.  There is an overall lack of clear evidence in the literature that Pilates can help prevent back pain so why is it that we have such success with our clinical Pilates?

There is slowly emerging research about Functional Behavioural Therapy and its clear benefits in treating low back pain.  We take many of the components of this therapy and use it within our clinical Pilates.

You work in a small group, this is fun, social, gives you a chance to chat to others going through similar issues.

Your program is designed individually for you, in conjunction with a physio.  This allows us to help you learn to move safely again. As you gain confidence we can start to help you return to tasks you previously believed you had to avoid or could not do.

Persistent pain, particularly in relation to the back and neck is a big problem for a lot of people.  The struggle individuals cope with is often disabling and depressing.  The cost to our economy is huge.  So what does this mean for someone struggling with long term back or neck pain?

Despite the huge increase in imaging and treatment options, the problem is not improving, rather growing. However, recently a few studies are coming through with much more positive outcomes.

Pain Does Not Equal Damage

Pain, we are coming to realise, is far more complex than we previously realised.  In short, pain does not equal damage.  In fact pain can be caused by many things not related to damage at all.  Fear of movement, apprehension, stress, poor sleep, childhood abuse are just a few of the things linked to persistent or chronic pain. 

It’s the New Year – many of you are keen to get fit.  But this is also a time we see a spike in injuries.  This blog is to help give you a few top tips to avoiding injury as you get into the fitness in 2024.

Below you can read about some top tips specific to avoiding injury at the gym. And also how to reduce injuries getting fit running.  We look at Pilates, an amazing way to get fit, or to keep you strong and help keep injuries at bay. And lastly we look at some simple ways you can watch your technique as you exercise.

It’s the lead up to Christmas! A very Exciting and Busy time of the year. At Physiologix we know this time can also be quite stressful, especially if you’re carrying an Injury or living with a long-term condition. So here are 4 simple, FREE, easy top follow tips to keep pain free this Christmas

Tip 1 To Keep Pain Free This Christmas - Sitting

Over the Christmas period there is a lot of socialising. Whether it’s Christmas parties/ work do’s, catching up with friends and family, Driving or Flying to see our loved ones. 

Spending longer periods of time sitting can lead to pain in your buttock/ hips and/ or back.

Ankle sprains are one of the most common injuries in court and field sports.  There is a very high incidence of ankle injuries in children and adolescence. Interestingly this is an injury that is twice as likely to happen in females than males. We belive in good physio intervention from the start - but why is this so important to get right?

The problem is this. Ankle sprains have the highest recurrence rate for any lower limb injury, meaning that having happened once it is the most injury to happen again. As a result, chronic ankle problems are common to occur. In fact, between 46% to 70% of those who had an initial ankle sprain will then go on to develop ankle instability.  Ankle instability is what many of our patients would describe as “unstable ankles” or “weak ankles” or “an ankle that might go again”.

Chronic ankle injuries are then at a much higher risk of going on to develop early ankle arthritis. 

What is Oncology Massage?

Oncology Massage Therapy uses gentle therapeutic touch to help support patients with cancer. Research shows that Oncology Massage Therapy can reduce the side effects from conventional treatment of cancer and improve the quality of life for someone undergoing cancer treatment or with a history of cancer. It's a gentle and safe method to release muscle discomfort and body tension during and after cancer treatment.

What are the Benefits of Oncology Massage

Oncology massage is used to help decrease the side effects of the treatment, improving sleeping patters and reducing pain and nausea.  The massage techniques used are gentle and slow and induce deep relaxation in the body which also helps to calm the mind. Oncology massage can also help to treat and manage some of the side effects of cancer treatments such as neuropathies, lymphoedema, cording, scar issues. It can also help improve movement when there is restricted range of motion.

You might have recently found yourself in an: injured –> rest –> rehab –> return to sport –> injured, cycle lately and wondered – what am I doing wrong?

Have you considered if your technique and injury are related?

There’s nothing more frustrating than finding yourself re-injured after a long stint of rehabilitation. Though regardless of whether you’ve been injured before or not, looking into the biomechanics of how you’re moving could be incredibly useful to help manage and rehabilitate your injury.

Neck pain is unfortunately something we treat a huge amount of at Physiologix.  The focus of the Physiologix Physios is good education, self management strategies and exercises. With this most people can learn to manage their neck well reducing their symptoms and occurrence of symptoms considerably. Good neck pain relief can then be achieved. 

What are some of the common symptoms of neck pain

Common symptoms of neck pain include:

• Pain that's often worsened by holding the head in one place for long periods, such as when driving or working at a computer
• Muscle tightness and spasms, felt in and around the neck muscles
• Decreased ability to move the head, such as problems turning
• Headache

In less common situations vision can be distorted and people might feel like they are on a boat – this differs from vertigo where you feel like the whole room is actually spinning. 

Pain is usually localised to the neck but can refer down the arms, into the upper back or up into the head created a headache.

What treatment is best to reduce neck pain

Lets start by saying that you can have either of these and not be a golfer or a tennis players.

What is Tennis Elbow

Tennis elbow is the term used for pain felt over the outside of the elbow.   Medically this is referred to as “Lateral Epicondylalgia”. This is caused by pain from the tendons of the extensor muscles of the forearm and where they attach to the bone. These are the muscles that run up the back of the forearm and cause the wrist to bend backwards or “extend”.

Causes of Tennis Elbow

The tendons can compress against the bone at the outside of the elbow where they attach eventually resulting in pain.  Typical reasons this may happen include:

• A sudden increase in use of the muscles.This may be from heavier use as well as longer use, or more frequent use
• Return to activity after a break
• Doing too much too quick
• Lack of recovery time between use of the muscles

Avoid prolonged sitting

With long car journeys and lots of functions coming up, many of us find ourselves sitting for hours, flaring up pain either at the time of the next car.  Try to pick seats where your hips are slightly higher than your knees.  Try to sit well in your seat and not spend too long leaning forward talking, or crossing legs. Keep getting up regularly.  At Physiologix we sell ‘Pressure Relief Cushions’ ideal if the pressure of the seat is what you feel the problem in. ‘Wedge Cushions’ are another wonderful way of helping to sit keeping your hips higher than your knees. Cushions are cheap, can go anywhere, and can help reduce hours of pain – well worth trying out!

Running injuries can occur in different areas of the leg and can vary from a muscle strain, to tendinopathy, to a bone stress fracture……and they don’t always mean you have to stop running. Despite the odd ankle sprain, the majority of running injuries are due to overload. Overload means doing more than your current capacity can cope with.

Why do Running injuries occur?

Spikes, or sudden increases in training loads are usually the culprit in causing running injuries. Understanding what load means in the running context is important if you are to manage your running program well and run pain free.

Running Injuries and load increase

What is an increase in load? This may be

• a sudden increase in pace or doing more speed training,
• adding hills training,
• starting to run with a running partner (who runs faster than you, which you make you push your training harder),
• new shoes,
• returning from a break with no running such as holidays or if recovering from an injury or illness.

KEY POINT: Any changes in your running program or how you run need to be done slowly and progressively, to avoid a running injury.

Most of us love a good massage. But how do you know what is good?  Trying to find a high quality remedial massage in Brisbane is no easy task.  Here are some guidelines to help you.

Does your Remedial Massage Therapist in Brisbane have “the touch”?

No pain, no gain – this is a saying often used with hands on therapists. Safe to say, for most people, this is rubbish. In fact, for most of us, looking for a massage to help an injury, or to help reduce the muscle ‘tightness’ brought on by stress, more aggressive massage is likely to just leave you feeling worse.  In you are in pain, muscles change how they work around the injury to protect you. Aggressively manipulating them will often just make the body more fearful of what is going on, and most likely, the muscles will just become more sore and more “tight”.  In the case of “stress” tightening everything up – an aggressive massage is just more “stress” to the body.  Again the system needs calming, safety, an ability to be able to feel at ease – aggressive massage is definitely unlikely to create this affect.

Work with your Remedial Massage Therapist

Work with your therapist, and have you therapist work with you.  When having a session with your Remedial Massage Therapist should be constantly checking that the pressure and techniques they are using are good for you.  You must say at any time if you are unhappy, that you respond better to more pressure, or less pressure.  Likewise, don’t feel pushed into having certain massage techniques.  And if something doesn’t work on one occasion, for example, maybe you are treatment sore afterwards for a prolonged period, or the post massage soreness is too much for you, make sure your therapist is able to utilise a wide repertoire of skills so that they can change what they do to work for your body.

Shoulder pain? Find a shoulder physio in Brisbane who can help.

Do you struggle with shoulder pain, or more precisely pain over the outside of the upper arm?  Does your pain bother you reaching overhead or behind you, for example to the back seat of the car? Do you struggle to lie on your shoulder to sleep at night?  You may be suffering from “Rotator Cuff Related Shoulder Pain - RCRSP”.  And for a shoulder physio in Brisbane, Physiologix is here to help

Your shoulder physio will help you understand why you have pain

Your rotator cuff muscles help to hold and control the ball of your shoulder joint in its socket. Issues can arise either with a sudden traumatic onset or just gradually build up with no set cause. Sometimes symptoms occur after you have been doing less for a while (you might have been ill, or away on a holiday) and then you get back to your previous activities, or from a sudden increase in use (for example doing a whole lot more around the house or garden or increasing your arm exercises).  Onset we know can also be linked with you doing the same level of activity but being run down, for example if you haven’t been sleeping well, from increased smoking, or from other increased stress.

Where and what will hurt?

Pain usually is felt around the outside of the upper arm.  It is often irritated with certain activities and better with rest.  Pain and or weakness is often found with doing activities, overhead or out to the side in particular.

As Leading Shoulder Physios in Brisbane, Physiologix is here to help

Find a Physio for Achilles Tendinopathy in Brisbane

What is the best treatment and how do you find a physio for Achilles tendinopathy in Brisbane?  Look no further. Gabriel Fernandes is your man.  For the last few years Gabe has made this condition his obsession and passion, embarking on a Ph.D. looking at the topic. 

What is the Initial best treatment for Achilles Tendinopathy

Initial best treatment for Achilles Tendinopathy is conservative management.   This means trying to get your pain better without injections or surgery.  So what treatments would we use in physio for Achilles Tendinopathy?

Load management is key, thus, advice and education form a large part of your first session.  Why might your condition have developed? Have you had a sudden increase in what you are doing? A sudden change in your activity levels that uses the tendon too quickly without enough time to adjust to demand, or without enough time for recovery might be linked to the onset of your pain.  

Or might it be related to something else?  These include other medical reasons that your physio will ask about.

Find a How can Physio for Achilles Tendinopathy help me recover?

What can you do to help the pain? This is another common question people ask of their physio for Achilles tendinopathy.  Firstly we will look at things you can do immediately to reduce pain. This might be around changing what you do, how you do it and how much you do.   The current up to date research guidelines about what medications might help reduce pain and considerations when you take pain relieving medications can be discussed. Ways to self massage your lower leg muscles, but not your tendon, may also help you reduce your pain. Remember do not rub your tendon, it does not help, and it can actually make pain worse. Exercises are an important part of your recovery road from Achilles tendinopathy.

Looking for access to online Pilates Classes?

Access these great online pilates classes:

• Safely from Home
• As often as you want for a week (although time periods may vary)
• When you want

Join Moira, one of our highly experienced, accredited pilates instructors, for either or both of these 2 at home pilates workouts.

Functional Fitness
Focus: functional movements, all over body workout, balance, bone density, fun movement, weight bearing, no floor work.
Needed equipment: chair, theraband, 1 heavy weight (2-5kg, or a 2l carton of milk, or laundry liquid), and a set of small hand weights (0.5kg or 1kg, or a pair of canned goods).

Matwork Pilates
A more traditional floor-based workout.
Focus: mobility, abdominals and continuous movements. Moving the spine in every plane of movement, a good abdominal workout and feel-good movements
Equipment needed: none. Just a mat and a towel (as an assist).

It was recently world osteoarthritis day, a great time to be discussing what is the latest in the best treatment for osteoarthritis.

Osteoarthritis, often known as OA is a condition that affects our joints, where two bones meet. Any joint may be affected and here at Physiologix we see almost any area of the body can be affected.  The cartilage that protects the joints is the area that becomes affected.

There are many risk factors.  Age is relevant, but it is not just older people that can develop OA.  There can be a genetic factor, but not always.  Obesity, a sedentary lifestyle, being female, and previous joint injury are also all risk factors.

So what then is the best treatment for osteoarthritis? 

In the case of hip and knee OA, exercise has been shown to be the best initial treatment intervention.  But many people hurt when they exercise so what then? Understanding positions that you can work in, with good technique are the starting point.  Working into a little pain is safe to do as long as the pain settles quickly after and isn’t worse that night or the next day. 

At Physiologix, your physio will assess you to gain better understanding of what you can do and what, initially, is best to avoid.  They will guide you on how much, how often. The importance of rest days is essential to allow the body to recover, but you also need to be doing enough to be effective.  Your physio can also talk you through other things you could be doing to help such as support braces and seeing the GP for medications for pain relief. 

Hydrotherapy, exercise in water, has been shown to be beneficial in helping with OA. At Physiologix we will design a program specific to you that you can then do in a pool yourself. We also will give you a home program, or look to provide you with a gym program for those that attend the gym, or to set you up with a Pilates program here in our fully equipped pilates rehab area.  Throughout the year Physiologix also offers the GLAD program, a comprehensive program including education sessions and OA specific rehab classes for those with hip and knee OA.

Running is ranked as one of the top 3 activities that adolescents (10-19 year olds) partake in.  There is a lot known about running related injuries in adults, but unfortunately often this research is then applied to running injuries in adolescents. Yet they are very different to adults and need to be treated as a specialist subgroup.

One of the problems is that “maturation” needs to be considered rather than age. You can have two 14 year old’s whose bodies are at two very different points of development – specific questioning will help your professional gauge where they are at in this maturation process - the outcome of this can mean quite different management.

Overuse injuries rank highly in running injuries in adolescents, particularly to the bone and soft tissues (eg tendinopathies) in this age group. Boys and girls can differ slightly. Girls can be more prone to bone stress related injuries – image and weight can put external pressures on girls and increased training loads in an undernutritioned state can cause major issues.

A key issue in this age-group can be growth.  Growth spurts mean bigger, heavier, longer bones. 

When can I return to running after pregnancy?  As a keen runner and mum of two, this is information I wished I could have had.  I want to know facts when deciding what is best for my body….there is too much “fake news” floating around there.  Not running, when it is integral to my life, is not something I am willing to give up unless there is extremely good reason….and even then I have to have a goal for when I can get back, and a program starting now that I can work on to get there!

Running is not just important for your physical health, it is also important for your mental health…..and having just had a child you really need to look after both of these! Running is also cheap, its easy and you can fit it into any timeslot…..and do all of this with your child.  So this makes it a great choice of exercise at a tricky time in life.

But we need to consider return to running after pregnancy just as you would returning after an injury.  Things take time to heal and recover and to do too much too soon just ain’t good!

Lets get a few straight facts here:

What are some important tips and tricks about nutrition for kids playing sport - here are some great, simple ideas to help ensure your kid, and their team is training, recovering and performing to the best of their abilities! 

It’s no secret that the food and fluid we consume greatly affects our ability to train, play and recover well. Not only does food provide our muscles with fuel, it also provides key nutrients for growth, recovery, cognition (our ability to think well and make decisions) and our immune system. 

In considering nutrtion for kids playing sport, here we will focus on what the most beneficial pre-game foods and snacks are to maximise energy and performance! The main nutrient we want to focus on for fueling performance is carbohydrates. The majority of carbohydrates should come from nutrient-rich foods, such as:

• Grains and cereals(rolled oats, quinoa, breads, wraps, crackers, rice, pasta, noodles,etc.)
• Fruit (all fresh, frozen, canned and dried fruit, fruit and grain bars, 100% fruit juice, etc.)
• Vegetables and legumes(potato, corn, sweet potato, baked beans, lentils, chickpeas, etc.)
• Dairy products(plain and flavoured milks, yoghurt, fortified non-dairy products, etc.)
• Extras - carbohydrate snacks(muesli bars, fruit buns, fruit loaf, smoothies, banana/carrot cake, etc.)

Typically, our first opportunity to fuel for our games starts with breakfast. If you are having a mid-morning game you should be aiming to have breakfast around 2-3 hours before start time. Focus on getting a good source of carbohydrate, some protein and of course, remember to hydrate!

Jaw pain or tempomandibular dysfunction (TMD) can occur for many reasons, one of the big ones being stress and jaw clenching – so the “festive season” seems to be an apt  time to be discussing this topic given so many of us are under enormous stress levels at this this time of year (top tips to deal with this later in the article)!

TMD is a term used to describe pain and dysfunction of the muscles that move the jaw) and the tempomandibular joints (TMJ) (joint which connects the jaw to the skull). 

Symptoms of TMD include – full or blocked ear sensation, clicking, sand paper sounds, headaches, difficulty chewing, yawning and pain.

About 20-30% of the adult population are affected by some degree by TMD and usually affects people between the ages of 20-40 years of age. It is more common in females than males. It is the second most common cause of orofacial pain after dental pain. 

What is osteoporosis: osteoporosis is a bone disease which weakens bones and increases the risk of fracture. This occurs when bones lose more minerals such as calcium faster than the body can replace them. Bone is in a constant state of regeneration, removing old bone and replacing it with new bone. As we get older the body’s ability to replace bone slows down, therefore bones become weaker and thinner. The most common bones affected are the hips, spine and wrist. 

Who is affected – although more prevalent as we age, this is a condition that can affect all ages.  Certain other groups can also be affected, such as those with absorption issues, for example Crohn’s and celiac disease.  Young female athletes are at particular risk due to the hormonal affects that heavy training can create.  

Bone density is therefore a life-long commitment. From childhood, through adolescence focus needs to be on performing regular exercise that includes impact loading, such as gymnastics or squash. If neither of these appeal then impact aerobic based exercise is good such as step or grit classes run in many of the gyms.

As we go through our 20s, 30s and 40s it is important to continue with this regular impact loading.  It should be noted that running is not considered a high impact activity.  It does indeed have a greater osteogenic (bone creating) affect than walking, but it is not as good as jumping related activity.  

Got hip or pelvis pain?

3 years in the making, hippainhelp.com is a website, that Kirsty and 2 of her colleagues, Dr Alison Grimaldi and Sharon Hennessey have put together. This is a one stop shop to learning all about issues around the hip and pelvis, their potential causes, and the treatment options available with best current research evidence. 

The site was born out of the frustration of clients coming to us having been told many incorrect things, "fake news", about their injury and its management

Not due for official launch until mid November, the website is now live and freely available to the public. If you, friends or family suffer from hip or pelvis pain, we would really love your feedback.

Jump on and take a look at hippainhelp.com

Physiologix and our staff remain at the cutting edge of all the latest research, treatment techniques and technology in the management of hip and pelvis pain.  We hope this is a site that helps better guide the general public about the whats, the what nots and the how tos of hip and pelvis pain.

Headaches are very prevalent worldwide and often come at a high cost personally, financially and socially, having a significant impact on quality of life for many people. At Physiologix, we have a Musculoskeletal Physio (with a special interest in treating spinal issues, including neck pain, headaches and dizziness) tells us a bit more about that thing that plagues so many of us, HEADACHES.

Treating headaches is complex. There a many different types of headaches which can be categorised into three main groups. Primary headaches are caused by what is know as 'independent pathology'. This includes migraines, tension type headaches and cluster headaches. Secondary headaches are caused by another disorder known to cause headaches. This includes trauma, meningitis, medication overuse and musculoskeletal disorders of the neck. Lastly there are cranial neuropathies/other types of headaches that do not fit into the previous two classifications.

Physiotherapy is known to be effective in managing headaches caused, or contributed to, by musculoskeletal disorders of the neck: these are known as "cervicogenic headaches".

However all the different types of headaches (primary, secondary and neuropathy/other) can cause neck pain. Although you may suffer from, for example, primary headaches such as migrane or tension type headache, these can result in a dysfunction in the neck, which in turn may contribute to your headache. Treating this dysfunction can help to reduce your headaches. Current research suggests that this neck dysfunction can even be a trigger for the onset of migranes, an added reason why it is so important to have the neck checked no matter what type of headache you suffer from.

Physiotherapists are experts in identifying and managing musculoskeletal dysfunction. Here at Physiologix, our physios performs a thorough assessment to enable them to determine the origin of your headache/neck pain, and to identify if a neck musculoskeletal dysfunction is contributing to your symptoms. This assessment is essential in determining the optimal treatment pathway for you.

Dizziness is one of the very disabling conditions that at Physiologix, unfortunately, we all too often treat.

Dizziness is a common problem and may have numerous different causes some of which can be helped with physiotherapy.

The most common cause of dizziness is from dysfunction within your inner ear (vestibular system) such as benign paroxysmal positional vertigo (BPPV). Common symptoms include dizziness when changing position like rolling in bed, bending forwards or turning your head. This dizziness usually subsides quickly.

Other disorders of the vestibular system include vestibular neuritis caused by inflammation of the nerve that supplies the inner ear. This causes dizziness that does not subside. Meniere’s disease is dizziness usually secondary to recurrent ear infections and can result in fluctuating hearing loss.

Dizziness can also arise from neck problems. Symptoms of neck related dizziness include neck pain, light-headedness, increased dizziness in prolonged head positions such as poor posture sitting at a computer.

Dizziness could also indicate dysfunction in other body systems such as the cardiovascular and neurological systems or can occur following head injury/concussion.

The cause of dizziness can often be difficult to diagnose and requires thorough examination. Physiotherapists use several tests that can help with diagnosing and directing treatment.

Physiotherapy has proven to be a very effective form of treatment for many of the above causes of dizziness. At Physiologix, we have staff that are a Musculoskeletal Physiotherapist, with a special interest in the spine (necks and lower back), headaches and dizziness.

To mark World Continence Week, Megan Bergman, our physio working with Women’s and Men’s Health brings you 3 great tips on a subject that affects a huge number of the population, from elite teenage athletes to the more mature members of our community.  

Top Tip 1:  Healthy Bladder Habits

These are some easy habits to practice that help to avoid issues with continence throughout your life.

1. Drink enough water. 1 to 1.5L per day and more if you are exercising 
2. Eat well. Good bowel function goes hand in hand with healthy bladder and avoiding too many processed foods keeps the bladder happy
3. Sit on the toilet in the correct position ensuring your tummy completely relaxes and never strain to empty
4. Avoid just in case wees... Void volumes should predominantly be between 350 to 500mL for most wees.
5. Exercise regularly to maintain ideal body weight

And finally ….

6. Do pelvic floor exercises regularly to keep the muscle strong and active

TopTip 2:  Pelvic floor

We know that pelvic floor exercises are important in helping maintain continence, particularly as we age…. but how do we do them, when do we do them and how many and for how long??

Find out how Luisa found pilates as a client, then went on to become and instructor........ and her own journey with injury and illness and the role pilates has played for her and can play for us all.

Watch this great Video to find out more

Pilates - why do it

With the start of the new year and then new term I am sure you are being bombarded by information and trying to decipher what is relevant and what is not.  

But 4 out of 5 primary school aged Australian kids are not doing the minimum recommended amount of exercise, an hour of moderate to vigorous physical activity a day; fewer still are doing any strength of weight based activities (1).

Its the start of the new school year and thats the perfect time to start new routines.

So what you may ask. Yet physically active kids have been shown to be more social and therefore better equipped for school. They are less susceptible to depression and anxiety and they display better memory and thinking skills.

Physically fit kids have been shown to have greater volume of grey matter in the brain, important for mastering the skills that help us get things done, learning, motor skills and visual processing (2).

Osteoarthritis (OA) is the most common lifestyle disease in individuals 65 year of age and older, but can also affect individuals as young as 30 years of age. It can begin for no obvious reason and the symptoms vary over a number of years. OA effects the joints wherein the cartilage on the ends of the bones degrade and thin. It most commonly affects the knee, hip and hands. People with OA of the hip or knee may experience the following symptoms and difficulties with activities of daily living:

• Knee pain and/or stiffness with weight-bearing.
• Crunching or clicking noises in the knee
• Difficulty walking up stairs or getting up from sitting. 
• Hip pain located outside the hip or deep in the groin
• Difficulty getting in and out of the car, putting on socks or picking things up from the floor. 

OA was previously thought of as a “wear and tear” and that the joint was worn out. This led many people to believe they cannot and should not be physically active with OA. This is not correct!! In fact, many studies have shown that cartilage actually needs moderate load through physical activity to regenerate itself. Exercise will make you feel better. 

The current national and international clinical guidelines recommend patient education, exercise and weight loss (if needed) as first line treatment for OA.

Good Life with OA in Demark (GLA:D) represents a nationwide evidence-based initiative that follows the current guidelines for best treatment of hip and knee OA . Research from the GLA:D® program in Denmark found symptom progression reduces by 32%. 

Other outcomes include a less pain, reduced use of joint related pain killers, and less people on sick leave. GLA:D® participants also reported high levels of satisfaction with the program and increased levels of physical activity 12 months after starting the program. 

This program is unique in that the education and exercises provided can be applied to everyday activities. By strengthening and correcting daily movement patterns, participants will train their bodies to move properly, prevent symptom progression and reduce pain

The program includes an assessment and physical tests performed by a trained GLA:D Physiotherapist, patient education sessions and a Physiotherapist supervised group or home exercise program performed twice per week over 6 weeks. The exercises are designed specifically for people with knee and hip OA with many level and progressions based on your level of pain and function. The idea is after 6 weeks you have the movement, quality and control needed to continue and become a part of your every day life. 

When you first hurt yourself, known as acute pain, the focus of your Physio treatment will be to reduce the pain at that location using a barrage of techniques that we know will help. However once you have had pain over several months, known as chronic pain, things change considerably.  The local area you first hurt, although still feeling painful, actually often has very little to do with why you feel that pain. This may sound very complicated, however, it is actually a survival evolution. Our brains develop a “protective” pain memory. Unfortunately this is often movement related, so exercises you did initially, in the acute phase, when the hurt area was letting you know it was first injured, often down the line can become pain causing, simply because the brain’s protective shield it trying to now stop you moving at all for fear maybe you might get hurt again, not because you have actually damaged anything.

Osteoarthritis (OA) is the most common lifestyle disease in individuals 65 year of age and older, but can also affect individuals as young as 30 years of age. It can begin for no obvious reason and the symptoms vary over a number of years. OA effects the joints wherein the cartilage on the ends of the bones degrade and thin. It most commonly affects the knee, hip and hands. People with OA of the hip or knee may experience the following symptoms and difficulties with activities of daily living:

• Knee pain and/or stiffness with weight-bearing.
• Crunching or clicking noises in the knee
• Difficulty walking up stairs or getting up from sitting. 
• Hip pain located outside the hip or deep in the groin
• Difficulty getting in and out of the car, putting on socks or picking things up from the floor. 

OA was previously thought of as a “wear and tear” and that the joint was worn out. This led many people to believe they cannot and should not be physically active with OA. THIS IS NOT CORRECT!!! In fact, many studies have shown that cartilage actually needs moderate load through physical activity to regenerate itself. Exercise will make you feel better. 

The current national and international clinical guidelines recommend patient education, exercise and weight loss (if needed) as first line treatment for OA.

As they grow, many children will experience an aching in their legs otherwise known as "growing pains". Little is known about why this occurs. It is often at night and on days following excessive activity such as jumping and running. The typical areas to be affected by the front and back of the thighs, the back of the calves and the back of the knees. On these occasions heat and massage coupled with stretching can be very effective.

What we must be careful not to miss is apophysitis. Immature athletes differ from mature athletes because of their open growth plates in their bones. These don’t fuse until into their teen years. The apophysis is a point of bone where the tendon attaches from the muscle to the bone. Repeated traction caused by the contraction of the muscle as the child exercises can pull on this bone attachment site. Rather than the tendon or the muscle being affected, the bone is affected. Tenderness is felt over the bony point but can also spread in a wider area around this point, making differential diagnosis from general growing pains difficult.  Stretching and heat on this occasion can be the worst thing to do.  This is when an assessment with a physio is beneficial. They will help to diagnose the cause of the problem and on some occasions imaging may be warranted.

It is very common to have apophysitis where the calf muscle attaches to the heel. This is called “Sever’s”. The problem can also be seen around the knee in Osgood-Schlatter’s- this is where the quadriceps tendon attaches to the tibia, or shin bone 

Concussion is a traumatic brain injury. More severe injuries include skull fractures and bleeding on the brain. Concussion may be more mild but should not be underestimated.  It is an injury sustained by a blow to the head, in Sport or play, usually from the blow with another persons head or the ground. The forces are transmitted to the brain, in a way stunning the nerves and thus affecting the ability of the brain to work.

Concussion in children generally must be treated differently to that in an adult. Children’s brain are growing and developing. They have a need to continue to learn and aquire knowledge. As such the priority is to see them back to full school capacity before returning to sport. Because concussion can affect your child’s ability to learn and interact in the classroom, medical clearance should be sought to ensure your child has no ongoing concussion effects and can return to school.