How do I know if I have suffered a concussion?

With winter sports like Rugby league, Rugby Union, and Soccer now in full swing, it’s the time of year that a potentially dangerous condition becomes more prevalent in the offices of Northern Beaches physiotherapists, doctors and emergency rooms – Concussion.

What is a concussion?

Put simply, a concussion is a mild brain injury that can happen after a person has suffered an injury to the head from a collision, falling, or being hit in the head with an object.

Thankfully our soft gooey brains are protected by a hard skull casing, but when the head or body encounters a hard impact, the brain can bounce up against the hard skull wall, and injure it.

How do I know if I have a concussion?

After a head knock in the NRL, you’ll see the doctor asking the player about their symptoms, their state of mind and performing a quick physical exam.

An incorrect response to any question on the tests such as the Westmead posttraumatic amnesia scale is considered a positive for cognitive impairment after head injury:

  • What is your name?
  • What is the name of this place?
  • Why are you here?
  • What month are we in?
  • What year are we in?
  • What town/suburb are you in?
  • How old are you?
  • What is your date of birth?
  • What time of day is it? (morning, afternoon, evening)

What are the symptoms of a concussion?

The symptoms immediately after and in the days and weeks following a concussion can be complex and vary between person to person.

The most common symptoms that can happen immediately after a concussion include:

  • Memory loss – People sometimes forget what caused their injury, as well as what happened right before and after the injury.
  • Confusion
  • Headache
  • Dizziness or trouble with balance
  • Nausea or vomiting
  • Feeling very tired and acting cranky, irritable, or not like themselves

Symptoms that can happen hours to days after a concussion include:

  • Trouble walking or talking
  • Memory problems or problems paying attention
  • Trouble sleeping
  • Mood or behaviour changes
  • Vision changes

How do I know if my concussion is actually something worse?

Because head injuries and concussions can be potentially life-threatening, they should be taken very seriously from the moment they occur.

You, or the person with you, should seek immediate medical attention if:

  • You vomit more than 3 times
  • You have a severe headache, or a headache that gets worse
  • You have a seizure
  • You have trouble walking or talking
  • Your vision changes
  • You feel weak or numb in part of your body
  • You lose control over your bladder or bowels

How is a concussion treated?

A concussion does not usually need treatment. Most concussions get better on their own, but it can take time. Some people’s symptoms go away within minutes to hours. Other people have symptoms for weeks to months.

When symptoms last a long time, doctors call it “postconcussion syndrome.”

After a concussion, it is important to:

  • Not drink alcohol while you are still having any symptoms of concussion
  • Rest your brain – Avoid doing activities that need concentration or a lot of attention if they make you feel worse.
  • Rest your body – Make sure to get plenty of sleep.

When can I play sports or do my usual activities again?

Prematurely returning to sports after a concussion is putting your health at risk.

It’s important to let your brain heal completely after a concussion. Getting another concussion before your brain has healed may lead to serious brain problems.

Do not go back to playing on the same day as your injury

With each concussion you suffer, the risk of future concussions increases.

For more information on concussions, how to treat them and how to return safely back to sport and work, give us a call to book an appointment.


How to avoid common causes of winter sport injuries

To some, winter means cold mornings and nights, shorter days and rugging up inside with a hot chocolate and some Netflix.

But to others on the Northern Beaches, it means Ski and Snowboarding season has begun. Whether you’re off to Thredbo, Perisher, Charlotte Pass, or somewhere else; it’s important to ease into it.

Statistically, sports injuries peak in the months of May, June and July.  This is not surprising because cold muscles, tendons and ligaments increase the risk of sustaining injury and team sports are in full swing.

Snowboarding and skiing might seem like a couple of fun activities to just ‘do’ on vacation, but they are also intense whole-body activities. This means they can be pretty hardcore to go gung ho straight into after a year of sitting at an office desk or working from home.

Don’t overexert yourself

One of the most common causes of injury during winter sports is overexertion.

While you’re out having a blast and full of endorphins, it can be hard to recognise how tired you are and miss the fact that your knees are burning or that your arm fell off on the last run.

Take regular breaks, drink lots of water, eat a good healthy lunch and keep an eye on your energy levels, if you start to feel fatigued – call it a day.

What are some common winter sports injuries to look out for?

The knee is the most commonly injured joint by skiers due to the increased twisting and turning demands. In particular, ACL, MCL, PCL and LCL injuries can occur due to a sudden twisting movement at the knee with your foot planted, along with a lovely popping sound which may or may not be followed by extreme pain and instability in the knee.

Head, neck, shoulder and wrist injuries also commonly occur as a result of falls, which tend to be more common among snowboarders. In particular, wrist sprains, clavicle fractures, shoulder dislocations, whiplash, and concussions are common.

If you have had winter sports injuries in the past, or have some current niggles then it would be a good idea to consult your physiotherapist before you go and hit the slopes.

A musculoskeletal physio will be able to give you the right piece of advice to avoid recurring injuries in the future and tips on how to properly warm up and warm down.

If you’re concerned about injury during the winter sports season and would like to find out more about injury prevention Call Fixio today on 8964 4086 or Email to organise an appointment with one of our Physios.


Why physiotherapy is important in the treatment of diabetes

Diabetes is a worldwide epidemic. According to the International Diabetes Federation, over 450 million people worldwide are living with diabetes, including 1 in 5 of those aged over 65.[1]  An estimated 1.7 million Australians are currently living with diabetes. The proportion of people living with type 2 diabetes has been steadily increasing in Australia and diabetes related complications (even though many are preventable) are a serious problem.[2]

What is Type 2 diabetes?

People with diabetes have an abnormally high or low blood sugar level.

In Type 2 diabetes, the body either fails to produce enough insulin, or can’t use that insulin properly. Insulin is the hormone in our body that allows the sugars from the food we eat (glucose) in the blood stream to enter our body’s cells, where it is converted into energy.

What are the symptoms of diabetes?

Many people with type 2 diabetes display no symptoms.

Because type 2 diabetes tends to be diagnosed at a later age, some of the warning signs can be dismissed as a part of ‘getting older’. In some cases, by the time type 2 diabetes is diagnosed, the complications of diabetes may already be present.

Common symptoms include:

  • Excessive thirst
  • Passing more urine
  • Feeling tired and lethargic
  • Always feeling hungry
  • Having cuts that heal slowly
  • Itching, skin infections
  • Blurred vision
  • Gradually putting on weight
  • Mood swings
  • Headaches
  • Feeling dizzy
  • Leg cramps

If untreated or not properly controlled, diabetes can damage blood vessels, nerves and organs such as the kidneys, limbs or the eyes, leading to serious problems. However, with a healthy lifestyle and the right treatment people with diabetes can lead full and normal lives.

Who is at risk of developing type 2 diabetes?

People are at a higher risk of getting type 2 diabetes if they:

  • have a family history of diabetes
  • are over 55 years of age – the risk increases as we age
  • are over 45 years of age and are overweight or have high blood-pressure
  • are over 35 years of age and are from an Aboriginal or Torres Strait Islander background
  • are a woman who has given birth to a child over 4.5 kgs (9 lbs), or had gestational diabetes when pregnant, or had a condition known as Polycystic Ovarian Syndrome.

While there is currently no cure for type 2 diabetes, the condition can be managed through a number of lifestyle modifications. Effectively managing diabetes is the best way to prevent diabetes-related complications.

How can physiotherapists help those with diabetes?

Exercise plays a key role in preventing or delaying the onset of Type 2 diabetes by improving blood sugar metabolism, reducing body fat, increasing muscle mass and improving cardiovascular fitness.

Physiotherapists can do more than assess, diagnose, treat, and manage musculoskeletal manifestations and complications of type 2 diabetes.

Physiotherapists play a key role in the design, delivery and implementation of exercise programs for the management of type 2 diabetes and can also counsel patients in physical conditioning and active, healthy living.

Exercise and a healthy diet are recommended both for prevention and for people already diagnosed. People with diabetes often have other medical problems or risk factors for ill health, such as heart disease, high blood pressure, a history of stroke or obesity. Physiotherapists are able to take into consideration these conditions and tailor a bespoke treatment plan to your needs.

For more information on how physiotherapy can support those with Diabetes, give us a call or send an email.





How to make sure you get the best recovery after a muscle injury

Skeletal muscles make up nearly half of our total bodyweight, so it should be no surprise that muscle injuries are amongst the most common occurring in sports. Some of the Northern Beaches’ most popular pastimes are muscle injury magnets, with rugby league, AFL, volleyball and surfing making up the bulk of culprits.

Muscle injuries are either ‘indirect’ or ‘direct’

A direct muscle injury is caused by an external blow or force, commonly during a collision with another person (think a tackle in rugby league) or by being struck with an object like a cricket ball. Direct injuries can cause dislocations and bone fractures and usually leave clues like haematomas and bruises to gauge how serious they are.

An indirect injury does not result from physical contact with an object or person, but from internal forces commonly caused by over-stretching, poor technique, fatigue and lack of fitness.

What do I do if I suffer a muscle injury?

The immediate management of muscular injuries during the acute inflammatory phase is very important for successful rehab.

First aid for muscle injuries follows the RICER principle. The objective of RICER is to stop the injury-induced bleeding into the muscle tissue and thereby minimise the extent of the injury.


  • R for Rest
  • I for Ice
  • C for Compression
  • E for Elevation
  • R for Referral

If you follow the RICER method, you’ll go a long way to:

  • preventing further tissue damage
  • minimising swelling
  • easing pain
  • reducing the formation of scar tissue
  • reducing the time needed for rehabilitation.

What shouldn’t I do if I have a muscle injury?

During the first 48–72 hours after an injury there are certain things that must be avoided.

These include:

  • Applying heat to the injury – No hot rubs, saunas and or baths
  • drinking alcohol
  • partaking in more physical activity or
  • a massage.

All of these actions will increase blood flow, and therefore bleeding and swelling. [1]

Don’t immobilise the affected area for too long

A few days of immobilisation to limit haemorrhage and oedema formation can provide time for your muscles to heal and regain strength for your rehab.

Prolonged immobilisation, while it might feel ‘comfortable’ at the time, could alter the biomechanical properties of the muscle-tendon unit, shrink healthy muscle fibres and substantially delay recovery of the injured skeletal muscle By restricting the length of immobilisation to a period of less than a week, the adverse effects of immobility per se can be minimised.[2]

If you still feel like you can’t move properly after a few days, it’s time to bring in your local physio.

How do muscles heal?

Injured skeletal muscle heals by a repair process as opposed to fractured bone heals by a regenerative process. This means that when muscle tissues are being repaired, they will heal with a scar, which replaces the original tissue, whereas when a bone regenerates, the healing tissue is identical to the tissue that existed there before.[3]

The healing of an injured skeletal muscle follows a fairly constant pattern irrespective of the underlying cause and musculoskeletal physiotherapists are the experts in rehab after a muscle tear.

Avoiding re-ruptures is one of the most important concepts of rehab and it has been shown that re-ruptures are actually the most severe skeletal muscle injuries causing the greatest amount of time lost from sporting activity.

If you have a muscle injury or pain, don’t walk it off; give us a call on give us a call on (02) 8964 4086 or book an appointment at




[1] Jarvinen M & Lehto MUK. The effect of early mobilization and immobilization on the healing process

following muscle injuries. Sports Medicine 1993; 15: 78–89.

[2] Järvinen TAH, Järvinen TLN, Kääriäinen M, Äärimaa V, Vaittinen S, Kalimo H, Järvinen M. Muscle injuries: optimising recovery. Best Pract Res Clin Rheumatol. 2007;21(2):317–31.

[3] Jarvinen TAH, Jarvinen TLN, Kaariainen M et al. Biology of muscle trauma. American Journal of Sports

Medicine 2005; 33: 745–766.

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