How Pelvic girdle pain is caused during pregnancy

July 30, 2021 Physio Insights 0 Comments

Pelvic girdle pain refers to musculoskeletal conditions affecting the sacroiliac joints, symphysis pubis and surrounding ligaments and muscles. It will affect about 1 in 5 Northern Beaches mothers but can also develop outside of pregnancy.[1]

The pelvic girdle is a ring of bones around your body at the base of your spine and when the three joints in your pelvis work together normally, they move slightly. Pelvic girdle pain is usually caused by the joints moving unevenly, which can lead to the pelvic girdle becoming less stable and more painful.

What does pelvic girdle pain feel like?

“I’m normally like a socially active person. It has made me the most miserable anti-social person. . .cos I’m in too much pain”

“Constantly feeling like your pelvis is going to fall off.[2]

Pelvic girdle pain used to be known as symphysis pubis dysfunction (SPD), but it still causes the same high level of pain it always did.

Pelvic girdle pain can affect your mobility and sharp pain when you are walking, climbing stairs and turning over in bed are common symptoms.

What are the symptoms of PGP?

Symptoms include:

pain in the pubic region, lower back, hips, groin, thighs or knees
clicking or grinding in the pelvic area
pain made worse by movement

However, early diagnosis and treatment can relieve your pain. Treatment is safe at any stage during or after pregnancy.

What causes Pelvic girdle pain?

As your baby grows in the womb, the extra weight and the change in the way you sit or stand can put more strain on your pelvis. You are more likely to have pelvic girdle pain if you have had a previous back or pelvis condition or have hypermobility syndrome; a condition in which your joints stretch more than normal.

What are my treatment options?

Your Fixio physio will be able to suggest the right treatment for your needs. This may include:

advice on avoiding movements that may be aggravating the pain
exercises that strengthen your abdominal and pelvic floor muscles and can help relieve your pain and allow you to move around more easily.
manual therapy to gently mobilise the joints and help them move normally again. This should not be painful.
warm baths, or heat or ice packs
acupuncture or dry needling. Women receiving acupuncture or physiotherapy reported less intense pain in the morning or evening than women receiving usual antenatal care[3]

Pelvis girdle pain is not something you just have to put up with until your baby is born. The outcomes for women with pelvic girdle pain during pregnancy are good, with 9 out of 10 of women reporting most symptoms subside after about 3 months of giving birth^.However, pelvic girdle pain frequently recurs in subsequent pregnancies, with the painful symptoms no less painful.

[1] Chou LH, Slipman CW, Bhagia SM, Tsaur L, Bhat AL, Isaac Z, et al. Inciting events initiating injection-proven sacroiliac joint syndrome. Pain Med 2004;5(1): 26e32.

[2] Clarkson, C. E., & Adams, N. (2018). A qualitative exploration of the views and experiences of women with Pregnancy related Pelvic Girdle Pain. Physiotherapy, 104(3), 338–346.

[3] Pennick V & Young G (2007) Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Sys Rev 2007 Issue 2. Art. No.: CD001139.

One on One Clinical Pilates at Fixio

April 10, 2020 Physio Insights 0 Comments

When Joseph Pilates created his new method of physical training in the 1920’s, he named it ‘Contrology’ due to the immense focus on control of the body and mind. The goal being to improve your balance, core stability, and posture while strengthening your muscles and increasing flexibility.

Pilates was developed over the course of many years, with a combination of anatomy training, acrobatics, Yoga principles, and ancient Greek and Roman methods of training all adding up to what we see as modern Pilates.

In the hands of a highly trained professional, it can also be used as a treatment for specific musculoskeletal conditions. Unlike Pilates for fitness, one-on-one sessions of Clinical Pilates Dee Why are used by qualified Physiotherapists who have completed extensive training to help treat:

Neck pain
Lower back pain
Pre and postnatal conditions
Prehabilitation and rehabilitation when surgery is needed
Shoulder pain
Hip and Knee pain
Arthritis pain
Poor posture

This is an unprecedented time for most Australians, but we have to remember we don’t have to do it all alone.

One-on-One Pilates instruction is safe and hygienic.

Since COVID-19 was officially declared a pandemic by the WHO on March 11^th, Governments have shutdown non-essential services, essentially halted the economy and implemented strict social distancing protocols.

Clinical Pilates sessions at Fixio on the Northern Beaches adheres to all of them.

Keeping our distance on your first visit we will:

Take you through a thorough, private assessment of your body
Assess your neuromuscular control and identify your natural movement patterns
Then, our trained physiotherapist will directly address your body’s imbalances through prescribed exercises.

Fixio’s One-on-One Clinical Pilates prescriptions are designed to:

Improve your flexibility and balance
Help you find your ideal posture and body tone
Strengthen important muscles during and post pregnancy
Improve your pelvic floor function

A one-on-one Pilates Dee Why class includes a full assessment so that our Physiotherapists can tailor an individual programme that targets your specific condition, needs, and limitations.

Clinical Pilates helps to increase Core strength and reduce back pain

Spine stabilisation and keeping a correct posture is essential to keeping recurring back injuries at bay.^[1] Strengthening your core is the key to ensuring this process is maintained regularly. During your one-on-one Clinical Pilates session at Fixio, your physiotherapist will focus on targeting those muscles that are most important, while bringing your attention to the control and feel of how the exercises affect your muscles to increase your own awareness of your body. Many people are not aware that core strength plays a large part in a number of everyday activities including: sitting for long periods of time, lifting weight, playing sports and even standing.^[2] The more you work on and are aware of your core the less pain will suffer.

One-on-One Clinical Pilates sessions may also be eligible for a rebate from your health insurer

Those looking for a one-on-one Pilates classes on the Northern Beaches can find them at our clinic. Our Sports physios are experts on how the body functions and moves, making Clinical Pilates safe for anyone of any age or fitness level.

Clinical Pilates sessions at Fixio Dee Why are designed and run by experienced physiotherapists, experts in musculoskeletal function and rehabilitation. Clinical Pilates at Dee Why has never been so personalised. Each session is conducted as an individualised program suitable for all ages and levels of fitness.

For more information on Pilates for your condition, give us a call on (02) 8964 4086 or book an appointment.

[1] Lis, A. M., Black, K. M., Korn, H., & Nordin, M. (2006). Association between sitting and occupational LBP. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 16(2), 283-98.

[2] Hsu, S. L., Oda, H., Shirahata, S., Watanabe, M., & Sasaki, M. (2018). Effects of core strength training on core stability. Journal of physical therapy science, 30(8), 1014-1018.

Junior AFL is beneficial for children in more ways than one

March 17, 2020 Exercise, Physio Insights 0 Comments

In previous blogs we’ve looked at some of the physical, psychological and social benefits that playing a team sport can have on children. Today we’re going to be looking specifically at Australian Rules Football (we’ll just call it AFL for ease of reading from here on in!) and some of the great effects it can have on kids’ physical and social development. As AFL continues to grow in NSW, so does physiotherapists’, Doctors’, psychologists’ and education expert’s knowledge of how AFL and other ball sports positively affect children and their development into young adults. Unfortunately my love of AFL can only be channelled through being able to support the physical needs of players and unashamedly cheering on the GWS Giants from the stands. Us sports physiotherapists aren’t much help to others when we’re injured, and I seem to be a target for big hits and big injuries (ask me any time about the number of surgeries I’ve been through).

This year I am going to be sponsoring the Balgowlah Suns Junior AFL Club and helping kids and parents to get a sports physiotherapists view of the biomechanics, preparation and recovery that go into every game. When prepared for properly, AFL is one of the safest sports children can play, with less physical contact than rugby league, more hand to eye co-ordination skills and more aerobic fitness. Getting kids into safe and fun sports is essential in combating childhood obesity and improving social development skills.

What are the physical benefits of AFL and programs like Auskick?

Children learn a variety of fundamental and advanced gross motor skills from kicking, handballing, catching, running, jumping and evading that will benefit them for future physical development and sports participation. Through regular training, children are also learning the basics of fitness conditioning and the basic principles and importance of health and nutrition.

Improved physical fitness
Increased hand-eye coordination
Better aerobic capacity
Strengthening muscles and bones

How does AFL improve psychological and social skills?

Children who play physically active team sports are more attentive, have a more efficient memory, enhanced creativity, better learning adaptability and problem solving and attitude regulations abilities.[1] AFL Juniors have to make rapid and complex decisions during the game while remembering certain structures of play and achieving pre-defined goals. This allows children to adapt to a variety of situations off the field more efficiently with the neuroplasticity of the brain creating new neural pathways at an astonishing speed in young kid’s brains. Yes, you read that correctly, football gameplay learning makes kids more adaptable. There’s more good news though.

Children who participate in team sports develop important social skills, a sense of belonging and camaraderie much faster than kids who don’t. The President of the International Council for Sport Science and Physical Education, Professor Margaret Talbot once stated ‘Sports and other challenging physical activities are distinctively powerful ways of helping young people learn to ‘be themselves’.[2] These benefits flow positively through children’s lives and the broader community is better for it too.

Better communication skills
Fosters a sense of self belief
Improves concentration and cognitive function
Increases teamwork skills
Builds a sense of mateship/belonging
Make a ton of new friends

Good preparation and recovery is vital

Preparation and recovery is much more than hitting the carbs the night before and a bottle of powerade in the morning (more on why you shouldn’t dose your kids with powerade in a following article). It is important to stay hydrated leading up to and on the day of the game and eating a balanced, nutritional diet is going to help keep kids fuelled up for the big game. Complete a warm up and cool down including stretching, slow jogging and running activities, with and without the football to minimise the risk of muscular and joint injuries.

Get a musculoskeletal screening test

Wouldn’t it be cool to be able to see into the future and prevent an injury before it happened? Musculoskeletal screening tests aren’t quite looking into a crystal ball, but they are becoming increasingly backed up by numbers and science. Do you think the pros step out onto the pitch and just hope that their body has it in it that day? They have an entire team of physiotherapists, sports scientists and strength and conditioning experts monitoring every step that they take. Musculoskeletal physiotherapists test a range of movements and take measurements to create a physical profile that will identify areas that may be more susceptible to an injury. Musculoskeletal screening tests have been shown to be an accurate and reliable indicator of specific injuries in AFL players.[3] Finding a Dee Why sports physiotherapy expert is crucial to ensuring any musculoskeletal screening tests are comprehensive and accurate, otherwise you may actually be putting yourself or your child at risk of suffering an injury.

AFL is an all round awesome sport for children to help grow and adapt so many skills that are going to benefit them in later life, not to mention they get a real kick out of it! If you have any questions about all sports physiotherapy or musculoskeletal screening tests for AFL or other sports, get in touch with us.

[1] Erwin H, Fedewa A, Beighle A, Ahn S. A Quantitative Review of Physical Activity, Health, and Learning Outcomes Associated With Classroom-Based Physical Activity Interventions. Journal of Applied School Psychology. 2012;28(1):14–36.

[2] http://www.icsspe.org/

[3] Reliability of common lower extremity musculoskeletal screening tests Belinda J. Gabbea, Bennellb, Wajswelnerc, Finch. Physical Therapy in Sport 5 (2004) 90–97

Photo: High five mum by Mike Hauser (2008) https://flickr.com/photos/35314767

Attribution (http://creativecommons.org/licenses/by/2.0/)

Why you should choose a Titled Physiotherapist

March 14, 2020 Physio Insights 0 Comments

With literally thousands of physiotherapists now at your fingertips and an infinite number of Google options to choose from, how do you know if the Dee Why physio you choose is appropriately qualified to treat your specific condition? Anyone who can legally call themselves a physiotherapist has studied for 4 years at university, covering multiple areas of practice including: Musculoskeletal injuries and conditions (joints, muscles, bones, tendons and ligaments,) Neurology (spinal cord and brain injuries) Cardio-respiratory conditions (heart and lungs) Paediatric issues (children). Fresh out of uni you could say a physio is a jack of all trades, but a master of none. It is after admission as a fully fledged physiotherapist that we can really delve into the more specific and advanced areas of practice and hone our skills to become experts in our field.

What is a Titled Physiotherapist?

If you think of a regular physiotherapist as a General Practitioner, a Titled Physiotherapist is the equivalent of a specialist. The Australian Physiotherapy Association (APA) defines a Titled Physio as “highly qualified physiotherapist with expert knowledge and skills”. That’s putting it pretty lightly. To be eligible to call yourself a “Titled Musculoskeletal Physiotherapist” you need to do your 4 years Bachelor of Applied Science (Physiotherapy), complete a 2 year Masters of Musculoskeletal Physiotherapy (making a substantial contribution to the field academically) followed by a minimum of 2 years full time clinical experience dealing primarily with musculoskeletal conditions. That’s nearly a decade of study right there.

What are the common areas of Titled Physiotherapy?

Sports medicine
Paediatrics
Animal physiotherapy
Musculoskeletal physiotherapy
Neurological physiotherapy
Gerontological physiotherapy
Cardio respiratory physiotherapy
Occupational Health and Safety
Continence and Women’s Health

What does a musculoskeletal physio specialise in?

Musculoskeletal Physiotherapists have expertise in the treatment of muscular and joint conditions. These rockstars have a comprehensive knowledge of anatomy, physiology, pathology, injury assessment and utilise up to date evidence based approaches to treating spinal and joint injuries. Musculoskeletal Physiotherapists are the experts in assessing the structures, contributing factors and mechanics causing your pain. Think of them as the pain doctors.

How musculoskeletal physiotherapy can help you.

Completely relieving or reducing your pain
Helping you to avoid future injury recurrences
Providing you with ongoing strategies and support to manage your injury or condition
Improving your flexibility, muscle strength, quality of movement and co-ordination
Enabling a quicker recovery and allowing you to your normal activities sooner
Assisting you to achieve your exercise or functional goals
Improving your fitness by structuring a personalised injury management training program
Prescribing exercises to do at home or in the gym to enhance your recovery

How common are Titled Musculoskeletal Physiotherapists?

Not quite as rare as hen’s teeth, but not far off. Did you know that less than 5% of physiotherapists attain the level of Titled Musculoskeletal Physiotherapist? Your local Dee Why physiotherapist, Damien Glover combines an expert understanding of anatomy and human biomechanics, the latest scientific methods and years of practical experience in the field to provide a multi-pronged program designed to combat a number of common musculoskeletal issues.

The multifactorial approach of a musculoskeletal physiotherapist to your examination allows us to accurately diagnose your condition or injury and highlight further influencing factors of what is happening with you. This deep dive into your physical health allows your Northern Beaches physio to design a bespoke rehabilitation program with short, medium and long term outcomes to ensure success and a pain free future.

Chronic neck pain: Physiotherapy treatments

March 13, 2020 Physio Insights 0 Comments

Are you suffering from a pain in the neck? I’m not talking about your latest electricity bill, or an annoying co-worker, I’m talking good old fashioned inescapable neck pain. Over the course of a lifetime there is a 50% chance you will suffer from neck pain at one point or another.[1] This risk can be heightened by a number of factors: your age (another great part of getting older), your sex (women are more likely than men to experience neck pain[2]) and the type of work you do (I’m looking at you, computer using people). For most Australians neck pain is something that usually lasts 6-8 weeks, but for around 30% of people, neck pain can become a chronic source of pain, limiting the activities you can take part in and disrupting sleep patterns which in turn can cause other problems.[3] Neck pain is one of the most common complaints physiotherapists deal with and there are a number of scientifically proven exercises and treatments to ensure your neck pain doesn’t turn chronic.

What are common symptoms associated with neck pain?

To put it simply, the spine and neck are very complicated regions of the body and can cause a variety of symptoms and finding the right Northern Beaches physio is essential to pinpointing the cause. In all there are seven cervical vertebrae acting as building blocks of the spine in the neck and surrounding the spinal cord and canal. Within the neck, structures include the neck muscles, arteries, veins, lymph glands, thyroid gland, parathyroid glands, oesophagus, larynx, and trachea. This means that neck pain can present a wide array of related symptoms, requiring a skilled musculoskeletal physiotherapist to identify the source. Neck pain can culminate in the following symptoms:

Headaches
Numbness, weakness and tingling in the arms and fingers
Surrounding muscle pain, commonly the shoulders
Fever
Stiff neck
Sore throat
Even loss of bowel or bladder control

What are some of the causes of neck pain?

Neck pain just doesn’t come about for no reason, it is usually related to a specific issue with another part of the body, or begins as a direct result of an injury or overuse problem. When you first discuss neck pain with your physio they will conduct an analysis of your body in order to pinpoint the root cause in order to create the most effective program to treat it. Musculoskeletal physiotherapists and General practitioners have highlighted the following as the most common causes of neck pain[4]:

Degenerative disc disease
Neck strain
Osteoarthritis
Cervical Spondylosis
Poor posture
Pinched nerve

Is your phone being a pain in the neck?

As more people spend their days scrolling mindlessly through Facebook, the average number of hours spent on our phones is increasing rapidly, with Australians clocking up 10 hours of mobile screen time PER DAY.[5] Did you know that within 5 minutes of waking up over one third of Australians have already checked their mobile phone at least once, not even dinner time puts the brakes on mobile usage with around 70% checking their phones while eating with family and friends?[6] They are some seriously crazy numbers. We’ve even had to give it a name, text neck. Staring down at your phone causes your neck extensors to stretch unnaturally causing them to weaken over time and can add nearly 30kg of pressure to the back of the neck. This unnatural forward head posture has also been shown to inhibit breathing capacity which can lead to migraines and cause brain fog throughout the day. If you also happen to have a job that requires you to stare at a computer screen or you spend a few hours a day watching television, your risk of suffering neck pain increases.

What are the best treatments for neck pain?

Your Dee Why physio will most likely recommend a multi-modal approach to tackling your neck pain, with studies showing that a combined process is the most effective at shortening the duration and intensity of the pain.[7] A combination of strength and mobility exercises, postural and ergonomic changes, hands on treatment and dry needling have all been shown to be effective and are utilised by musculoskeletal physiotherapists around the world.

If you have been suffering from a sore neck, or any of the symptoms outlined above, you are only increasing your chances of your neck pain becoming chronic and affecting other areas of your body and daily life by not having it treated. It can be easy to shrug off neck, shoulder and back pain as a normal part of life, work and getting older, but nobody should have to put up with chronic pain. You might not be able to get rid of every pain in the neck in your life, but speaking with your Northern Beaches physio can certainly go a long way to getting rid of the actual pain.

[1] Hogg-Johnson S, Van der Velde S, Carroll L, Holm L, Cassidy D, Guzman J, Côté P, Haldeman S, Ammendolia C, Carragee,14,15 Eric Hurwitz E, Nordin, M, Peloso P. The Burden and Determinants of Neck Pain in the General Population: Results of the Bone and Joint Decade 2000–2010 Task Force on Neck Pain and Its Associated Disorders. Eur Spine J. 2008 April; 17(Suppl 1): 39–51.

[2] Ostergren PO, Hanson BS, Balogh I, Ektor-Andersen J, Isacsson A, Orbaek P, Winkel J, Isacsson SO; Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmö shoulder and neck study cohort. Malmö Shoulder Neck Study Group. J Epidemiol Community Health. 2005 Sep; 59(9):721-8.

[3] Mehanical Neck Pain and Cervicogenic Headache. Neurosurgery 2007: 60:S1-21–S1-27

[4] Bot SD, Van der waal JM, Terwee CB, et al. Incidence and prevalence of complaints of the neck and upper extremity in general practice. Ann Rheum Dis 2005:64(1):118–23.

[5] Australian consumers spending more than 10 hours of every day on their digital devices’, 2016, Ernst & Young, www.ey.com

[6] Mobile Consumer Survey 2017: The Australian Cut, Deloitte, https://www2.deloitte.com/au/mobile-consumer-survey

[7] William J. Hanney WJ, Kolber MJ, Schack-Dugre J, Negrete R, Pabian P, The Influence of Education and Exercise on Neck  Pain. Am J Lifestyle Med. 2010;4(2):166-175.

Injury Management: reduce your chances of an injury recurrence

March 8, 2020 Injury Prevention, Physio Insights 0 Comments

We’re an active bunch on the Northern Beaches and you’ll find that injury prevention and recovery are 2 major aspects of sports physio clinics in Dee Why. Chances are at some point you’ve experienced an injury, whether you tore an ACL, strained a hammy or twinged your neck and if you’re one of the unfortunate many you’ve probably reinjured it at least a couple of times. Recurrent injuries aren’t confined to AFL players and other professional athletes. Computer programmers are more susceptible to a recurrence of tennis elbow than tennis players, remember? Unfortunately prevention can’t always prevent a hammy strain, but once an injury has occurred you have the power to start the prevention cycle all over again.

There are a number of factors that influence the statistical probability of suffering an injury recurrence; if you watch a sport regularly you can probably name 1 or 2 athletes that seem to suffer the same injury over and over again. NRL player Tautau Moga for instance is only 25 years old and has torn his left ACL 4 times, having a full reconstruction and rehabilitation after each occasion. Researchers are getting better at injury prevention and management every day and sports and musculoskeletal physiotherapists are experts in getting to the things that increase injury recurrence:

Insufficient rehabilitation from previous injury

Call it youthful exuberance in wanting to get back into it too quickly, call it being lazy and not completing your full rehabilitation but one of the most common reasons for suffering a recurrence of an injury is failing to rehab properly. Overloading is a great short term principle and is part of effective programming to allow for super-compensation and increase fitness and strength, but IT DOES NOT APPLY DURING INJURY RECOVERY. Any professional level athlete in any sport will tell you their recovery is just as important as their training when it comes to performance. Failing to follow your physiotherapist’s full rehabilitation program for your sore hammy is only going to end one way. Your guessed it – a pain in the butt!

Neglecting symptoms of pain

Speaking of pain, one of the next most popular reasons people reinjure themselves is failing to heed your body’s best warning signal; pain. “I’ll just run it off” doesn’t cut it as an effective treatment strategy for managing most musculoskeletal injuries but it’s still one of the most common things that people like to do for some reason. Most chronic back, neck, knee, hip, groin, ankle and hamstring injuries will usually give you some warning sign before they completely give up. Don’t treat that shooting pain in your leg like the check engine light in an old car and just put some tape on it either. Strapping and taping is good in some instances, but it can’t keep a hamstring in place for long.

Poor conditioning or fitness

Coming back from long term injury can be tough and it’s common to let fitness levels slip while injured which can often lead to poor performance or additional musculoskeletal injury upon returning to physical activity. Every bit of physical activity outside of your physically repetitive job is going to lower your chances of suffering a repetitive strain injury as well. While you are recovering from an injury, try and do all you can to keep moderately active, whether it be short walks, dumbbell curls or simple sit-ups.

Poor technique and movement control

Poor technique and movement control are probably the 2 most important factors that cause injuries in the first place and they continue to play a part in injury recurrences. I don’t know how many times I’ve seen someone load up weights to the max at the gym, lifting far too much and trading technique for weight. This principle can be applied to most physical activities. Most injuries occur when you go too hard, are fatigued and are using movements that you are not at the unconscious competence stage of performing yet.

Poor or no warm-up/warm-down

Be honest, do you spend 10 minutes warming up and down every time before and after sport and physical activity? A well performed warm-up before a workout is going to dilate your blood vessels, ensuring your muscles are supplied with enough oxygen while also raising your muscles’ temperature aiding in achieving optimal flexibility and efficiency. Cooling down after physical activity is every bit as important as warming up. Stretching while you’re cooling down is the way to go because your muscles, limbs and joints are still warm. Stretching is going to reduce the build-up of lactic acid, which is the leading cause of muscle cramp and stiffness.

If you have suffered an injury, don’t shirk your recovery. Speaking with an expert in sports and musculoskeletal physiotherapy and undertaking a custom made rehabilitation program is going to shorten the length of your recovery, minimise your risk of a recurrence of your injury and also help provide you with the knowledge you need to continue to prevent injury independently.

The most common types of foot pain and what it means, and what you can do about it

March 7, 2020 Physio Insights 0 Comments

Your feet are full of bits and pieces that can cause plenty of pain. 26 bones, 33 joints and over 100 ligaments, nerves, muscles and tendons that are all capable of causing varying degrees of feeling from ooh that tickles to CALL THE AMBULANCE!!! Each foot is intricately designed to absorb the forces of walking, running and jumping, morphing to the shape of the ground and transmitting these forces through the ankle to the legs. When everything is going smoothly, this process is seamless and unnoticeable, when it’s not, it can affect your day to day life. According to the 2017 Healthy Feet Survey[1] around half of Australians experience heel/arch pain and 6% of people surveyed wake up every morning with foot pain. The same study also showed that despite having expert knowledge, musculoskeletal physiotherapists are only consulted by 5% of people suffering foot pain, with 80% heading to the GP for advice. GP’s commonly refer clients to musculoskeletal physios for foot and ankle pain, physios are really just doctors to manage and prevent pain.

So, what are the most common types of foot pain, and what do they mean?

Ball of the foot pain or Metatarsalgia

Pain and inflammation in the ball of the foot is referred to by physiotherapists as Metatarsalgia . Good news for people who are more active, you’re more likely to experience ball of foot pain due to your activities that involve a lot of running and jumping. It is also common for people to suffer Metatarsalgia due to the over-usage of improper fitting shoes.

Musculoskeletal physiotherapists recommend a number of conservative treatment methods for ball of the foot pain such as rest and ice therapy. It is also important to take an in depth look at your shoes. Ideally you participate in sports with shock absorbing arch supports or insoles to minimise future complications or recurrences of metatarsalgia. Signs and symptoms of ball of foot pain include:

Burning or aching pain in the ball of the foot
Pain around the big toe only
Worsening pain with weight bearing activities such as standing, running or walking
Numbness or tingling in the toes of the foot
The pain improves with rest

Plantar Fasciosis aka Plantar Fasciitis

“Plantar fasciitis” (a common misnomer as there is rarely any inflammation!) is one of the most common causes of heel pain characterised by pain in the plantar fascia, a thick fibrous band of connective tissue running from the bottom surface of the heel bone extending along the sole of the foot towards the toes. Have you ever jumped out of bed in the morning only to feel a stabbing pain in your heel with each step? That’s probably plantar fasciitis. Plantar fasciitis is most commonly found in impact and running sports but can sometimes feel like it just popped out randomly out of nowhere. People with poor foot biomechanics and those with flat feet or weak foot arch control muscles are more likely to suffer heel pain.

One of the most important aspects of treating and preventing a recurrence of plantar fasciitis is assessing and correcting any issues in your foot and leg biomechanics, sporting technique and your shoes. Not all Dee why physio clinics are experts in foot control assessment and its dynamic biomechanical correction. After an initial in depth physiological assessment, your physiotherapist will likely prescribe manual therapy techniques such as joint mobilisations, soft tissue massage or release, muscle stretches for flexibility, foot taping and lower limb strengthening exercises.

Achilles Tendinopathy

Characterised by pain in the Achilles tendon or its covering, Achilles Tendonitis is an overuse injury that is most common in joggers, jumpers and other activities that require repetitive actions. Tendons are tough fibres that connect your muscle to bone but they are susceptible to overuse and injuries are usually caused by a number of micro tears occurring over a period of time. Common causes of Achilles tendonitis include:

Tight hamstrings and calf muscles
Walking on your toes (or excessive high heel wearing)
Overtraining and failing to warm up or down
Poorly supportive footwear

Foot pain is a common issue for Australians to put off until recovery includes being totally laid off your feet. It can be easy to write off foot pain as simple pain but it can also be caused by fractures, nerve compressions, loss of blood supply to the bone and even problems stemming from the lower back. The best way to pinpoint and treat foot pain is to undergo a full body analysis with your local physio. The good news if you are suffering foot pain is that research has shown that physiotherapy is effective management and will get you back to playing the sports and doing the activities you enjoy, free from pain.

[1] https://www.myfootdr.com.au/wp-content/uploads/2017-Healthy-Feet-Survey-by-My-FootDr-Balance-Podiatry_web.pdf

Why do some children get Sever’s Disease and how is it treated?

March 2, 2020 Injury Prevention, Physio Insights 0 Comments

Sever’s disease, aka calcaneal apophysitis to musculoskeletal physiotherapists is the most common cause of heel pain in growing athletes. Sever’s Disease isn’t really a true disease per se and was actually first identified by Patrick Haglund in 1907[1], but it was James Sever’s characterisation of the disease in 1912 that led to it being named after him.[2] Maybe it just had more dramatic ring to it? Sever’s disease is the inflammation of the calcaneal apophysisa, located on the heel close to where it connects into the Achilles tendon. Sever’s Disease most commonly occurs before or during a child’s peak growth spurt and is often seen when they begin a new sport or footy season. It is most common in boys between the ages of 8 and 12 and quite frequently in girls between the ages of 8 and 10 years old who are also active in sports.

How is Sever’s Disease diagnosed?

For your physio to find the cause of your child’s heel pain and rule out more serious conditions, they will ask some thorough questions about their medical history and ask questions about recent activities or injuries. There is rarely the need for any blood tests or x-rays, your physiotherapist will perform what’s called a squeeze test and some other tests to confirm the diagnosis of Sever’s Disease. During the squeeze test (which is exactly what it sounds like) if the child’s medial and lateral sections of the heel are tender and there are no symptoms such as red skin or swelling, almost always indicates a diagnosis of Sever’s disease.

Symptoms include:

Pain in the back or bottom of the heel
Limping
Walking on toes
Difficulty running, jumping or participating in usual activities or sports
Pain when the sides of the heel are squeezed
Tiredness

What causes Sever’s Disease?

When children (especially boys) are going through a growth spurt, the bones will grow first and the muscles and tendons can take a while to catch up. In Sever’s disease, the area around the heel bone can become quite sore and swollen where the Achilles tendon attaches to it. Children who participate in running and jumping sports such as AFL, soccer, Basketball and athletics are more likely to end up with Sever’s disease. Research has also shown that wearing boots with studs or spikes increases the risk of developing Sever’s disease.[3]

Factors contributing to Sever’s Disease in children include changes to:

Height and weight – high BMI children have higher rates of the disease
The frequency of physical activity – AFL carnivals over a few consecutive days
The type of physical activity – Changing sports or starting new ones eg. Netball, gymnastics
Shoes and equipment – Many football boots have a lower heel that can add pressure to the apophysis by stretching the Achilles tendon slightly. Lots of barefoot running and even walking in thongs on the soft sand at Dee Why can cause the same increased load.

How is Sever’s Disease treated?

As with most soft tissue injuries, in the first stages of recovery your physio will recommend the R.I.C.E method – Rest, Ice, Compression, and Elevation. Unfortunately, no one treatment method has been definitively proven to be better than others in the long-term management of Sever’s disease. During the early phase your child will probably be unable to walk pain-free, so the first aim is to prescribe your child with some active rest activities and keep away from pain-provoking activities for the time being. Your physio will use and teach your child a range of pain relieving techniques including joint mobilisations for stiff ankles and give the area a good massage in order to restore full Range of Motion, reduce pain and regain full foot biomechanics. A good musculoskeletal physiotherapist will also want to see your child’s biomechanics and technique in action and if they have injured themselves playing AFL or another sport, getting your physio to check it out will help reduce flare ups in the future.

How does Sever’s Disease affect my child’s sport?

Sever’s disease is a self-limiting condition and will fully heal with the right treatment. The first important step is to seek treatment when early signs of Sever’s become apparent. Sub-optimally treated Sever’s disease can cause a permanent bone deformity at the rear of the heel bone which can be painful and annoying. For the time being, seeing a physio will be be helpful to learn ways to stretch the Achilles tendon and keep pain under control. Limit your child’s sport load during the initial period and monitor their return to sport closely afterwards.

If your child is between the ages of 8 to 12 and is complaining of heel pain with no exterior causes, you should suspect Sever’s disease until proven otherwise. Sever’s Disease is a common issue seen by your local Dee Why physio due to the high number of active kids on the Northern Beaches (a positive and a negative there) and they are the best people to speak to if your child is complaining of a sore ankle.

[1] HAGLUND P: Ueber fractur des epiphysenkerns des calcaneus, nebst allgemeinen bemerkungen ueber einige

aehnliche juvenile knochenkernverletzungen. Archiv fur

klinische Chirurgie 82: 922, 1907

[2] SEVER JW: Apophysitis of the os calcis. N Y Med J 95:1025, 1912

[3] Sever’s Disease: What Does the Literature Really Tell Us? Rolf W. Scharfbillig, PhD* Sara Jones, PhD† Sheila D. Scutter, PhD May/June 2008 • Vol 98 • No 3 • Journal of the American Podiatric Medical Association

4 common treatment techniques used by musculoskeletal physiotherapists

February 10, 2020 Physio Insights 0 Comments

Physiotherapy is a broad and multi-dimensional treatment process designed and ever expanding to treat a huge number of conditions. While physiotherapy mostly focuses on the diagnosis and rehabilitation of musculoskeletal and circulatory system issues, a growing number of practitioners also treat conditions like sports injuries, various forms of arthritis and respiratory problems such as cystic fibrosis. From bone breaks to bursitis to Temporomandibular Joint Pain, physiotherapists have a special knack for canvassing the human body for the cause of pain and dysfunction and getting it back to full performance using a number of high-tech and low tech treatment options. For all the technology in the world, a musculoskeletal physiotherapist gets the best results with their hands.

Below are the 5 most common treatment techniques used by physiotherapists every day in order to get their patients back to optimal health and performance, free of aches and pains.

Physical examination and assessment

The first and most important step in the treatment process is the physical examination and assessment your physiotherapist will complete on your first visit. Expect to have a real deep and meaningful chat with your physio where they will ask you a number of detailed questions about your general health, activities and how your aches or pain came about. It’s at this point a good physio becomes a bit like Sherlock Holmes, sometimes it takes a bit of sleuthing to get to the bottom of some injuries and pain as they can be the result of an injury that starts in another area of the body.

Following the getting to know you part, your physio will begin to lay out a treatment plan personalised to your current situation. Depending on where you are on the injury and pain scale, the first course of action might be a prescription for some recovery and icing of the affected area before moving forward with physical therapy.

Joint and soft tissue mobilisation

Joint and soft tissue mobilisation techniques are forms of manual therapy that have been tried and tested over decades. When joints and other soft tissue become painful due of trauma, overuse or disuse, they can become dysfunctional and unable to perform the movements they were designed for. Soft tissue injury is an umbrella term used to describe injuries affecting your muscles, tendons, or fascia that usually occur as a result of sprains, strains, contusions, tendonitis, bursitis and stress injuries. Soft tissue mobilisation has also been called therapeutic massage and has been designed to relax a patient’s muscles and reduce swelling in certain areas, making it a perfect treatment for relieving pain associated with sporting injuries.

Joint mobilisation is a technique used by physiotherapists by performing a back and forth oscillation of the joint in order to restore full range motion and limit pain. Joint mobilisation is helpful in cases where pain and joint tightness limit motion such as frozen shoulder. Joint mobilisation treatment varies depending on your circumstances but will generally include gentle joint mobilisations, joint manipulation and none of the old school snap, crackle and pop techniques that have little long term benefit.

Acupuncture and Dry Needling

Dry needling and acupuncture are two of those treatments that always raise my patient’s eyebrows. At first, not many people are keen on the prospect of being jabbed with tiny needles, it sounds counterproductive to kicking pain doesn’t it? But after one session, they’re converts.

Contrary to popular belief, dry needling is not the same as acupuncture, although there are similarities between the techniques. The main difference between dry needling and acupuncture is found in the theories behind why each of the techniques works. Dry Needling focuses on the reduction of pain and restoration of normal function by releasing myofascial trigger points in muscle. In contrast, acupuncture is dedicated to the treatment of medical conditions via the restoration of the flow of energy (chi) through key points in the body to restore balance.

Ergonomic, biomechanical and sports specific technique correction

If your visit to the physiotherapist was brought about by suffering an overuse or acute injury at work, during sport or just by living your normal life, you’re really doing yourself a disservice and increasing your chances of re-injury if you don’t take adequate steps at changing your movement patterns or technique. Poor technique and posture are two of the most common sources of repeat injury observed by physios. Biomechanical assessment, technique observation and diagnostic skills are all part of the skill set of your musculoskeletal physiotherapist and allowing them to observe you in your environment or using your regular physical techniques will ultimately help you to avoid musculoskeletal and sports injuries in the future.

Think of your local musculoskeletal physiotherapist as a pain doctor, or body mechanic. They have at their fingertips a range of tried and true methods of getting you back into 100% health and kicking that pain to the curb. If you are experiencing any muscular, joint or physical pain don’t hesitate to make a booking at your local 5 star rated physiotherapist on the Northern Beaches. Your body won’t regret it.

Back to school tips to help children stay active and healthy

January 24, 2020 Physio Insights 0 Comments

It’s that time of year again, the school holidays are over and that means heading back to school or heading to school for the first time for kids all over the Northern Beaches. The start of the school year can be filled with excitement or dread for both parents and kids. Going through booklists, getting all the right uniforms and planning getting everyone to school are all important parts of the new school year, but it can cause some other areas to be overlooked.

The start of the school year usually brings an increase in child patients in physiotherapist’s office across the Northern Beaches as a number of factors create the perfect storm for injuries and pain to arise.

Following these tips will help you and your child get through the back to school period as happy and healthy as possible.

Focus on good nutrition and hydration

Children are balls of energy at most ages, and balls of energy require the right fuel to keep them healthy and going throughout the day. Playing outside in the heat of the day dehydrates children faster than adults and without good hydration habits, kids can end up with heat stroke pretty quickly. Eating a good healthy breakfast and lunch will help your child to concentrate throughout the day as well.

Find the right backpack

Do you like the idea of carrying around an uncomfortable backpack filled with heavy objects that might as well be rocks? Try running and jumping with them on as most children do. The wrong school bags filled with heavy books and lunches are a prime cause of back pain in children and can even lead to long term damage and malformation of the bones. Usually this is due to inappropriately sized bags, not carrying the bag correctly (on one shoulder like the cool kids) and too much weight.

How do I choose the right backpack?

Forget good looks, put comfort and fit at the top of the priority list
Make sure the backpack is properly sized – no wider than your child’s chest
Choose a backpack with broad, padded shoulder straps

Once you’ve found the right backpack:

Place the heaviest items at the bottom, close to the spine for better weight distribution
Don’t overload the backpack – moderate weight IS NOT harmful to your child’s back
Don’t let your child sling the backpack over one shoulder
Any waist straps are there for a reason – use them!
Don’t wear the backpack any lower than the hollow of the lower back

Make sure your child has comfortable shoes

Good shoes for your child are just as important as getting good tyres for your car! The average kid spends over 1500 hours per year in their school shoes, running, jumping, and playing sport on hard surfaces. That’s a lot of time to be spending in shoes that are unsupportive or that are incorrectly sized for your child. Children are susceptible to ankle injuries while their bones and joints are strengthening and shin splints are no fun for anybody! Some tips to look out for when picking shoes for your child include:

Make sure they fit correctly – too much or too little space affects comfort and can potentially cause blisters or the foot to move too much within the shoe
Make sure the shoe has a firm heel counter to hold a firm support around the ankle
Make sure the shoe bends at the toes where the foot naturally bends to avoid extra stress underneath the foot

Limit time on electronic devices

Research shows that spending too much time on iPads, phones and other touchscreen devices could lead to the muscles and bones of young children not developing properly. A Curtin University study conducted in 2016 showed that poor neck posture with little neck movement and decreased physical activity could lead to neck pain and under-developed muscles and bones.

Outdoor games are not just a fun way for children to exercise with their friends – getting outside like the good old days, away from the iPad, will help children develop their bodies, sleep better and keep them active while also having fun. Which is the best part of being a kid!

Winsome Baker

07:20 30 Aug 18

Damien has treated me periodically for two years for various musculo skeletal complaints . The reason I choose Damien is because his approach and techniques with treatment tick all boxes that I consider make an excellent specialist generalist physio.When I visit a physio I expect to have the pain relieved, know what I have done and how long the recovery is expected to take .He is a good listener, great diagnostician and he really cares about his patients. Importantly he researches and participates in ongoing training to ensure he uses the latest evidence based techniques in his treatment. The home exercises he recommends are well explained and achievable. His treatment results are excellent and if the healing is not progressing well Damien does not hesitate to suggest an appropriate alternative health practitioner. He is such a good practitioner I have encouraged my daughter in law to visit him about her shoulder. She too is delighted with the treatment. "

AhrikaBean Kelly

02:17 02 Sep 18

I haven’t written many reviews but I feel compelled to spread the word. Finally a physio that listens, doesn’t give ridiculously complicated exercises (I had a maximum of 3 exercises which changed throughout the rehab) and I know that he genuinely cared about my outcome and what my individual goals were. I was really nervous before going as I have had a couple of bad experiences with chiropractors before but I was instantly at ease with the warm welcome, calm demeanour and professional yet likeable nature of my physio, Damien. Anyone on the Northern Beaches with back pain needs to call The Beaches Sports Physio because he is the best in the business! Thanks for getting me walking again!

Kate Kelly

07:28 11 Aug 18

Damien is an excellent physio who looks after our whole family - from the teen sporting injuries to the middle-aged twinges and every postural issue in between. He has excellent diagnostic skills and always takes a sensible holistic approach. He is willing to adapt his treatment regime to what works best for the client and is responsive to feedback. Highly recommended!

Joanne Gilmour

06:48 14 Aug 18

Damien is a down to earth, trusted, and knowledgeable physio. He is thorough in his assessment and provided me with knowledge about my injury, so I can better understand the mechanics of my body. Damien is empathetic in his approach (but to the point!) and I find him easy to talk to which makes his ability to assess me much more individualised and holistic. I would recommend Damien to any of my friends with 100% assurance that he would provide the best service and care in the industry.

Jesse Jia

01:42 13 Aug 18

I don't often write reviews but I wouldn't want anyone to miss out this great Physio. My personal experience with them has been great, especially with Damien who I have known for over 3 years. Back in 2015 I sprained my ankle but I didn't pay much attention to it. The injury then got old and worse and couldn't heal itself. Luckily, my doctor referred me to Damien and he's been taking care of me ever since. He managed to release me from pain and even put me back in basketball court in just a few weeks. He also taught me how to protect the ankles so I haven't got any issues since. Over the last few year I also had back pains for a couple of times and Damien and his colleagues have been taken care of me with 10/10 satisfaction. They are simply so professional, flexible and friendly.

Rosemarie D'Aspromonte

10:14 17 Aug 18

My experience with Beaches Sports Physio was extremely helpful and lifesaving. I was very distressed when my x-rays revealed that I had arthritis in my lower back. I thought this was the end of my busy life. So, I was referred to the Beaches Sports Physio, and to my surprise the physiotherapist, Damien, was so helpful in explaining that this was normal for someone my age, and that with exercise I would get better. I admit, I was sceptical and very anxious at first, but Damien was able to calm me down. He was very patient, friendly and knowledgeable. The Beaches Sports Physio was a pleasure to visit and I have no hesitation referring my friends here.

Roshan Ramoo

01:49 26 Jul 18

I cannot recommend The Beaches Physio enough. I needed physiotherapy services for my shoulder which has a history of dislocations, and the staff I encountered were all highly knowledgeable, professional and super friendly.The advice I received was super easy to understand, and this was really important for me given that I am not very medically savvy. With great encouragement from the staff, I am performing my exercises, and am on the road to recovery.An easy decision to award 5 stars!

Dean Richter

12:49 01 Oct 18

Damien was extremely thorough in his analysis of my knee problems that occur while I am running. He tested strength, flexibility in all of my related joints, muscle tightness, running technique and did a video analysis of my running style. I now have a really good plan for improving my running technique and eliminating the pain in my knees.I was extremely impressed with Damien's professionalism and depth of knowledge. I have no hesitation in recommending him to anybody who is after some great personal attention and expert help.

Michelle Leotta

23:33 04 Oct 18

Damien is a highly knowledgeable, accommodating and personable physio. He is an effective communicator and provides ongoing support to clients, checking in on the them regularly to see how they're progressing. Damien was able to quickly address pain in my lower back, providing me with exercises that rectified the pain within a matter of days. I've been a client of Damien's for the past three years, and despite relocating to an area that's further away from home I'm more than happy to travel over 40 minutes to visit him simply due to his high level of professionalism.

Julie Barnett

06:56 10 Oct 18

Damien will help you achieve a higher quality of life by addressing your pains and discomforts with his simple, yet highly effective, treatment plans. He is passionate, highly professional, thoughtful and down to earth. I appreciate his honesty and candidness, which has built trust between us knowing he will look after my best interests.

Trent Cripps

01:55 12 Oct 18

I highly recommend Damien as a Physio, he has treated me several times and I have seen significant progress in my condition. I have been to many Physio's over my life and I appreciate a Physio that takes the time to understand your concerns and treats you manually rather than simply hooking you up to a machine and walking away to treat another patient. Damien's experience and commitment to getting results with his patients gives me confidence to recommend him to anyone looking for results from an excellent Physio.

Sarah Mattern

22:38 07 Nov 18

I highly recommend Damien at The Beaches Sports Physio. I had been dealing with neck pain and stiffness for several months and after only a few sessions with Damien, I could finally turn my head with significantly less neck pain--and the pain and range of motion is steadily improving with each visit. Damien is very knowledgeable, professional, and personable. He listens intently to your concerns, asks questions, and performs a diagnostic exam in order to diagnosis the underlying issue(s). He explains the issue in understandable terms, and discusses a healing protocol, aiming to ensure that it's practical and actionable for you. In addition to in-office treatments, Damien gave me simple, yet effective, exercises and stretches to do at home in order to facilitate the healing. I believe that the healing process is a collaborative effort between the practitioner and the patient, and I found that his style is in line with this philosophy. Damien is passionate about his profession and sincerely seeks to help his patients heal and thrive in their lives.

Emma Thuell

02:17 05 Dec 18

I highly recommend Damien at The Beaches Sports Physio. I have been a client of Damien's for a number of years and I find him very knowledgeable, professional, and friendly. My first encounter with Damien was when I tore my ACL over 5 years ago. He listened to my concerns and explained the treatment in simple terms. We then worked together to create a program that had me back playing hockey within 9 months. When my Dad needed physio after his knee replacements, Damien was the only physio I recommended to him. My dad went on to have great success with his recovery. Damien is truly passionate about his profession and strive to help his patients in anyway he can to improve their lifestyle.

Anubhav Kapoor

03:41 13 Dec 18

Damien was absolutely amazing! I injured my lower back in the gym and literally could not get out of bed in the morning. Damien quickly identified the problem and fixed it in less than 4 weeks. I feel great now and the gym is going awesome! Thanks Damo

Em McLeod

07:06 13 Dec 18

Damien saved my back! 10/10 I was suffering from ligament laxity, which needed attending to quick smart. I first saw him when I was recommended to him by a friend, who knew I really needed to see someone as soon as possible for my back, during pregnancy. This was causing me to walk with a skewed spine, and causing major back spasms which were excruciating. It was hard to get in and out of the car, in and out of bed and even sitting in a chair was difficult. The only relief was laying on my back. Damien fitted me in to his schedule that very day, and once I walked in, he greeted me with a welcoming smile, took one look at me and knew what he needed to do. I explained my situation, and he explained every detail about what was going on with my body during pregnancy. My pelvis was moving, which is normal during pregnancy, and because of that, the ligaments in my back were “loosening” causing my muscles around it to tighten up to protect my back. He worked out that even though my pelvis would move only under a centremetre throughout pregnancy, it was actually twisted at the same time. He straightened it out, as well as my hips, and had me walking around a lot better than when I came in. He gave me a few simple stretches to do at home, which were easy enough to do on my back, which was the only position I could get relief from. Damien was extremely reassuring. I basically told him that it was something I think I’m just going to have to deal with for the next however many weeks/months, and he said “no, this shouldn’t be something you should have to suffer throughout your pregnancy. I’m going to help your situation and give you some relief so you don’t have to live suffer with this”, and that he did with flying colours! I was so scared I’d have to deal with this pain every day, but he has definitely helped me be able to walk properly again, and be able to do more daily activities. He also explained how to deal with my situation, and that my subconscious was telling me one thing, which actually helped me to better understand how I was going to get through this mentally. The body does amazing things, but the mind can also tell us how to work our bodies. And if we can understand how to train our bodies with our brain, the physical pain can be treated more easily. Damien has a great sense of humour, highly professional in asking me questions and finding out the problem, and made me feel extremely comfortable and totally reassured that he was confident he’d be able to help! Thanks Damien! 10/10 !

Emma Neighal

05:07 17 Dec 18

I highly recommend any one with any injury not just sports injuries to visit Damien at The Beaches Sports Physio.I first met Damien a few years ago with a severe ankle injury from a horse fall. After a couple of months of his treatment and the education he gave me on helping strengthen my ankle I had no pain and full range of movement and still have no troubles to this day with that ankle. Even after doing numerous kilometres of running training for the half marathons I now compete in.I am now returning to seek Damien's advise with a running injury I have sustained on my other foot. After one treatment I can notice the change in the range of movement and know exactly what I have to do to help the injury mend.Damien's passion to explain how the body moves and what can cause certain areas to be under pressure is inspiring. I enjoy his energy, happy, friendly nature and consider him very much a friend and not just a therapist.I look forward to my journey back to great physical help and know I am in good hands when I'm under the guidance from Damien.I encourage any one who has an aching back from sitting too long behind the computer, any mum with sore hips, shoulders and back from lifting the kids or any enthusiast runner with aching knees and ankles to drop in and have a consultation with Damien, you will be thankful that you did.

Rezida Nurislamova

21:24 19 Dec 18

“Thank you so much for looking after my low back pain! I had done something to it when I was working in early November. I had been advised to go to a different physio originally which I did. I felt extremely rushed with them, they didn’t explain anything to me and I just felt like I was just another number to them. Then my amazing doctor recommended that I go to The Beaches Sports Physio. I am so grateful that she put me in contact with them. Damien went to great lengths to make sure that I understood everything that was going on, he helped relieve my pain with his expert hands and he gave me really easy to remember exercises for home which we put on video so I could not forget. This was the most important part for me, that nothing was complicated, that there was a really simple process that he went through and that in the end I understood what would happen. I even got given a rehab plan that was specific to me at the beginning of the first session. I have just finished up treatment at The Beaches Sports Physio and I feel really confident in my lower back. I have been recommending Damien to everyone that I know because it is so evident that he authentically cares about people and you can see with his interactions with all of his patients that he will do everything he can to help them. Thanks again!! Rezida

Xara Roznerski

01:25 04 Jan 19

Damien is a Godsend! Since having my daughter 2.5 years ago I’ve been struggling with uncomfortable pain that no one was able to get to the bottom of. I’d tried everything! Finally I googled sports physio and ended up in his office. Stoked with the results, within one session I was able to get some relief. It was good to feel heard and Damien didn’t jump to conclusions and was better at investigating the pain than anyone else I’ve seen. Found it! Relieved it! Now I feel confident with his help I’ll be able to keep it at bay.

Illyane Lera

07:03 13 Jan 19

Damien is not your traditional physiotherapist. He puts his knowledge, experience and desire to help you in every interaction. He also helps our community by offering free consultation during beach volleyball competitions. His great attitude and experience makes a big difference. Thank you!

Simona Sekulova

09:38 17 Mar 19

I have seen Damien for multiple injuries (shoulder, knee, ankle) over the last 2 years. He is friendly and professional, extremely knowledgeable and took the time to understand the background behind my injuries. Given that I had played a Division 1 Volleyball in the USA for 5 years, understanding that some of my injuries are from overuse and building a specific rehab programs so that not only I can recover and get back on the court but also strengthening the muscles around. Damien plays volleyball himself, so it’s so much easier to explain how some injuries have occurred and what my limitations in trainings are while doing the rehab. In addition, due to my busy schedule he made himself available outside of normal business hours. I would highly recommend Damien to anyone looking for an awesome physio!

Evo Hristov

01:15 27 Mar 19

I went to see Damian due to a flaring up of a problem I’ve been neglecting for years. I was almost paralysed, shuffling my feet and supported by my wife. I was very pessimistic, filled with gloom, the only hope were the words of a friend, “I know a really good physiotherapist.”Three days and two sessions later, I was back to my normal. Less than two months later, I’m much better than what was my normal for years, my range of motion improved, all the pain and fear of doing more challenging stuff are gone.Damian is very knowledgeable, kind and passionate. Because he delivers on his promises, he fills you with confidence.Now, I can also say with utmost certainty, “I know a really good physiotherapist!”

Sarah Rathmell

21:06 29 Mar 19

I had been to another physio for years but with new staff i wasn't getting that genuine caring experience. That's when I was lucky to find The Beaches Sport Physio and Damien, who i call the Fixer. He is very thorough, experienced and honest. If you are after someone who genuinely cares and helps fix your injures, Damien's your man.

Harrison Jacob

05:10 01 Apr 19

I have written just one other review in my life but this will be by far the most important. Damien has showed me care that is rarely seen in practices these days. When I walk in through the door I feel like I’m being invited in to see an old friend. Most importantly though, Damien is a very thorough and knowledgeable physiotherapist. Whatever your issue he will be able to help. Honest, genuine and an outstanding physio!

James Martin

10:55 01 Apr 19

Damien does simply amazing work and helped me with shoulder rehab following surgery for a broken clavicle. I was given an estimated 12 weeks by the doctors for full recovery, but had full range of motion within 4 weeks and was almost back to 100% within 8 weeks thanks to Damien. His punctuality and communication was excellent throughout the process and I can't fault anything with his service!

Unknown

01:48 16 Apr 19

Where do I start, firstly as soon as I walked in I knew I was in safe hands due to Damien's professional mannerism. I had been experiencing back pains for quite some time prior coming to this establishment, and after my first session with Damien I had already made leaps and bounds over my previous treatment which I had been going to for nearly a year. Ever since then I have been making a full recovery on all fronts and in such a sort time compared to the other treatment. I found with my previous treatment (at a chiropractor) the treatment would only last for a certain amount of time before the pain would come back. I do not find this with Damiens treatment as I go days without any form of pain and when it does come back it is much more bearable. AlsoMy back had been keeping me up at night due to the pain levels, but after seeing Damien sleep has been absolutely blissful and I no longer struggle in that department. Great location with easily accessible parking spots and Damien really makes the time fly with the conversation. Overall 10/10I would highly recommend this establishment with anybody in need of a physiotherapist

10:41 17 Apr 19

Where do I start, firstly as soon as I walked in I knew I was in safe hands due to Damien's professional mannerism. I had been experiencing back pains for quite some time prior coming to this establishment, and after my first session with Damien I had already made leaps and bounds over my previous treatment which I had been going to for nearly a year. Ever since then I have been making a full recovery on all fronts and in such a short time compared to the other treatment. I found with my previous treatment (at a chiropractor) the treatment would only last for a certain amount of time before the pain would come back. I do not find this with Damien's treatment as I go days without any form of pain and when it does come back it is much more bearable. AlsoMy back had been keeping me up at night due to the pain levels, but after seeing Damien sleep has been absolutely blissful and I no longer struggle in that department. Great location with easily accessible parking spots and Damien really makes the time fly with the conversation. Overall 10/10I would highly recommend this establishment with anybody in need of a physiotherapist

Tom Downie

10:20 02 May 19

Damien brings a whole new level of professionalism and dedication to the physiotherapy profession. He really connected with me and made a massive difference to my condition. I can't recommend him highly enough!

Romy Hengeveld

07:05 25 May 19

Damien is extremely good in what he is doing. Very passionate, highly professional, humble and very involved. He genuinely cares about you and your recovery. After every session I feel a relieve in pain and he helps me reaching my goals. His punctuality is outstanding. I am continuing on going treatment with Damien for the next year and I highly recommend his services! 100/10

Rebecca Naughton

21:51 28 May 19

I would highly recommend booking an appointment with Damien! I'm grateful Damien worked at a fast pace to squeeze all of the advice and instructions he gave in to one session (which is all I was able for), I feel else where it could have been multiple sessions. I left with a complete 6 week rehab program. 5 weeks in I feel confident my ankle has and will continue to be as good as it was before. He is one of those healthcare professionals that is a special find and I have already recommended him to various family and friends. He is a lovely, friendly and genuinely caring physio!Thank you Damien!

Vince Paciullo

10:10 19 Jun 19

I went to Beaches Sports Physio presenting with a grade 2 hamstring tear I sustained during MMA training. Initially I was a little hesitant in getting treatment but my job is very physical so I thought I'd get it looked at. And I'm SOOO glad I did! I was greeting by friendly, professional staff and made to feel very comfortable. I was given absolutely every piece of information I needed and got a strategy together for recovery. As the weeks went by, the intensity of the physiotherapy progressed accordingly. I went from barely walking to being back at the gym in a matter of weeks doing what I love!!! I can't thank Damien enough, he is a great guy and very knowledgeable. Highly recommend!

Maddie Hobbs

03:09 21 Jun 19

So lucky to have found these guys after tearing a muscle in my back! Damien has an incredible wealth of knowledge and worked with me to not only get my back, back to 100%, but to also empower me with the tools to prevent this injury from recurring. As a Mum, I appreciated the holistic approach to my treatment, including the simple yet effective rehab exercises I could do at home while still minding my toddler. The wind range of hours offered by the Beaches Sports Physio made it easy to choose an appointment time that worked for me. The warm, inviting atmosphere created by the friendly staff made me feel welcomed right from my first visit. I would highly recommend this place!

Timothy O'Leary

03:05 26 Jun 19

What makes Damien excellent is he challenges himself to solve problems that other physios can't. I absolutely love swimming but I've had a shoulder issue since high school. In my first session Damien identified a torn labrum. I wanted surgery when I first heard those words but through Damien's intervention, I've become optimistic that I don't need surgery. He took the time to listen and understand my story. When he showed me the rehab exercises, he analysed my technique to ensure I knew what I was doing before I left the door. He is an effective communicator and his likability is a lucky bonus. Most significantly Damien has helped me with the mental approach to rehab. He has shown me how to set clear, simple goals and establish checkpoints, which manages my hopes and expectations. This has made all the difference in my rehab. I've kept a swimming logbook and my distances for swimming have steadily improved. Last night I swam 3km for the first time in four years.

Gorana Kljajic

08:05 04 Jul 19

My daughter now 13 has been playing tennis since she was 3. At around the 10 year old mark she started to get tennis elbow. After years of treatments and multiple physio's the condition kept returning and even when her elbow wasn't painful she couldn't play without an elbow brace until we saw Damien. He was the first physio to ask to see her racket and assess her grip, he is wonderful with kids and Anastasia absolutely loves going to see him, she trusts him! I trust him! It has now been 6 weeks of absolutely no pain and no need for an elbow brace for the first time in 3 years! Thank you Damo!!! You're amazing! Highly Recommended!!

Raj Singh

08:01 25 Jul 19

Jordan has so much knowledge and his process of diagnosing the problem is very thorough. He doesn't assume anything and ensures that enough "homework" is given to the patient for a speed recovery. Along with that, I got regular follow up calls to check on my progress. Highly recommend their practice.

Sophie Murray

22:40 14 Aug 19

Feeling grateful to have made an appointment with Damien after my partner saw him a few months ago. after only two sessions i have almost no pain in my shoulder which has been giving me grief for about a year and flared up 1 1/2 weeks ago. My rehab in my own time is simple and manageable. Damien has such a friendly manner and is easy to talk to in the appointments. I'd highly recommend him to anyone. Thank you Damien :)

Rebecca Rodda

07:15 15 Sep 19

Three weeks ago I thought all hope was lost for me, and I resigned myself to the fact that I would have to live with pain for the rest of my life...... but then I found Beaches Sports Physio!I had a fall down 14 steps 18 months ago, which left me in a lot of pain. I tried everything to relieve my pain but I was not a “physio person” so kept saying no when people would suggest that option.How wrong was I. Not only after just three sessions did Damien relieve my pain immensely, I was able to sleep on my back for the first time in 18 months.Thank you to Damien and Jordan at Beaches Sports Physio for helping me and putting me on the right road to recovery!

Vittoria Clerici

08:33 17 Sep 19

I can highly recommend The Beaches Sports Physio Dee Why. I started going there 3 months ago for a painful knee injury after a skiing accident and am so pleased I found it. Jordan was very thorough in explaining the specifics of my injury and the recovery required, including some exercises. I noticed immediate improvement after the first visit and have been improving ever since. He is really very knowledgeable and also really genuine, committed and cares about helping you. I am so glad to be feeling so much better after my visits.

Jayden Malala

00:55 24 Sep 19

I'm going to start this review by saying I 100% recommend The Beaches Sports Physio to anyone who wants to see extremely fast results. Back in April I sustained a knee injury (What I thought might have been a partial dislocation) and needed to book in to see a Physiotherapist. My first phone call was to The Beaches Sports Physio and was told that unfortunately they were all booked out. I received a phone call later that day from a guy by the name of Damien, who said he was willing to stay back an hour after work to assess me. The guys who work here aren't just friendly and professional. You can walk in knowing that whatever it is you have done to yourself, they know exactly how to find and treat it. Thank you Damien and Jordan!

Alexandre Cayuela Jiménez

23:22 28 Sep 19

Couple of months ago, I suffered of a bad back injury (first time). Couple of people from Manly suggested me to go to The Beaches Sports Physio and they did well. Jordan was my Physio, on top of being very friendly, he's really good on his job. I recovered very quickly thanks to his valuable advice and massages.Thanks for everything, highly recommended ! All the best to both of you guys !

Sandro Haag

01:25 22 Oct 19

Found this place based on Google Reviews, and honestly, this place is amazing. Damien is a great guy that knows what he's doing, and he's been helping me a lot.I've been to many different physios over the years and Damien is by far the best. Strongly recommend.

James Pysar

06:42 10 Nov 19

I saw Jordan for tennis elbow related to over use at golf. As I am a mad keen golfer I was concerned that I might have to rest for a while. Jordan was very thorough in his review of my injury and its' cause and very good at explaining the issue in simple terms. He gave me a very simple exercise program to follow and allowed me to continue golfing! It's been 4 days since I saw him and the exercises are making a positive difference already. I would highly recommend Jordan to anyone with a sports related injury.

Bishi Tancev

08:16 17 Nov 19

I was seeing a physio for a month as i was getting severe headaches which were affecting my care for my kids and making it near impossible for me to do anything in a day. I was popping painkillers daily. I wasn't getting the results i wanted fast enough and i was due to go back to work after mat leave in a couple of weeks. I was upset and disappointed i hadn't made any good progress so i sought a new physio. From the first point of contact, Jordan was very professional and thorough in understanding my situation. He then referred me to Damien as my problem area was one of his expertises. Within 2 weeks of treatment, my headaches were gone and i felt fixed already! Damien is very friendly, down to earth and knowledgeable and knew exactly how to fix me and gave me exercises very specific to my problem area. During my sessions, i didn't feel rushed and i was paid proper attention to. The boys are doing a fantastic job and i would easily recommend them to anyone without hesitation. So so happy with my results!

Gerard Homan

06:04 23 Dec 19

Fixio is a great team. They achieved wonders with my broken leg. After 2 operations and no walking for 4 months they got me back up and walking quickly and inspired me to get back surfing and running. Great job and thanks Fixio.

Phil Dawson

09:30 08 Jan 20

Professional personal and results driven. Damien goes the extra mile to ensure you are on the road to recovery and is my go to for any niggle big or small. Highly recommend.

Jonathan Couper

10:40 30 Jan 20

Damien is a professional physiotherapist and very personable in his approach. Following a sports injury, in what has been a difficult recovery process, my treatment to date at Fixio has been excellent and the established professional relationship and link in that Damien has maintained with my surgeon working out of the new Northern Beaches Hospital has greatly assisted my rehabilitation. I recommend Fixio to anyone seeking a committed physiotherapist that will assist you in achieving your health goals following injury.

Phil Mullins

21:57 14 Mar 20

I went to Fixio after suffering from a series of elbow, chest and shoulder injuries for a period of 6 - 12 months. I had tried a number of treatments, none of which had provided sustained relief.I found Damian to be professional, friendly and exceptional at what he does. His treatment plan has helped me recover quickly and, 3 months on, I'm without pain and making great progress in my training. I would highly recommend Fixio as they really deliver results!

Pete Sutton

01:01 29 Feb 20

Damien and the team at Fixio are some of the best physios on the northern beaches. I had been to a few prior to treat patella tendinitis but wasn’t making much progress. Since being treated by Fixio, I have significantly less pain, more mobility and can train with freedom. It’s a fun and friendly experience every visit and I can recommend with confidence.

Taniya CBTB

23:15 21 Feb 20

I had a sore back from surfing. I booked an appointment next day with Courtney and she helped me relieve the pain and gave me helpful exercises. I recommend her as she was highly professional and friendly. Very considerate and she knew her stuff!

Luisa Scenna

22:04 04 Mar 20

I can highly recommend Damien at Fixio, super professional and knowledgable, he's a pretty good bloke too!He genuinely cares about your progress and well being. I've dealt with chronic pain since 2014 and finding this is so rare. Damo took the time initially to fully understand my problem and I have been in good hands ever since, his holistic approach is fantastic too.The pilates sessions with Damien and Courtney are great, I'm feeling the strongest I have in ages and my body is moving so much better. It makes the world of difference to my quality of life. Thanks team!

Julian Sawicki

22:38 26 Feb 20

I have been a active person all my life. Recently I had severe pain in my shoulders and left arm. This pain prevented me from sleeping properly or undertaking any exercise. I attended Fixio (Damien) who sat down and analysed the problem (muscle inflamation) and also discussed with me what I wanted to achieve. My goal was to return to an active life of regular jogging, swimming and the gym. Damien informed me that it would take approx 12 weeks to reduce the inflamation and the pain, and that it would require a team effort with my part of the deal being to diligently perform a range of exercises and stretches at home.The combination of his expert deep massage and manipulation and my exercising at home saw a steady improvement leading to a full recovery.Damien is a very personable professional interested in how I was feeling and going with my recovery process. I valued the concept that recovery would be a joint effort which was aimed at achieving my personal goal - to get back to pain free exercise activity.Feeling good now and back to an active life style; I am happy to recommend Fixio to people with muscle problems.

Bob Alessi

07:19 14 Apr 20

Fixio was recommended to me to treat chronic Achilles pain. The team were very professional and friendly and devised am effective treatment program and on going exercises. I am now pain free and can comfortably enjoy long bush walks. I highly recommend them.

Nik Q

02:12 04 May 20

So glad to have found Courtney at Fixio. She listened to my story of chronic pain and set up a plan for what I wanted to achieve. We're progressing to strength work now as Courtney is addressing all my back and nec issues expertly and getting my joints moving again. Highly recommend.

Robert Davidson

05:12 21 Apr 20

Well what can I say, I went to Fixio over a year ago with debilitating back pain that had been on and off since an initial injury about 5 years ago. After seeing multiple physios and an osteopath with little success over this period, I saw Damien who has helped me immensely both physically and mentally in treating this injury. While I am not completely pain free, I am on the right path, and cannot thank him enough. Would highly recommend to anyone.

Sarah Inman-Rollin

05:37 18 May 20

I started getting knee pain (Patella Maltracking) at the beginning of the year, and after posting on Facebook, I was recommended Fixio in Dee Why (Northern Beaches). After reading Fixio's reviews I booked my first appointment. I was very impressed with them straight away as for every new client they allocate extra time to ensure that they can diagnose the problem correctly (this is so different to other experiences I have had where I have felt completely rushed in and out)! I have now been going to Fixio since January, and I cannot recommend it enough! What I love about Fixio is that you don't just get a textbook program to follow - everything is completely tailored to you. After each session I have left feeling really positive about recovery and I have actually enjoyed the process. Both Damien and Courtney are absolutely amazing at what they do - i'd trust them both with any injuries of mine. If you want a physio that is going to go above and beyond every time, and you live near Dee Why, Northern Beaches, then this is the place for you (and even if you don't - they are worth the drive)!!! I am now 5 months into my recovery and I have come so much further than I ever expected and it's all thanks to Fixio! Thanks guys!!!

Cris Nunes

10:25 19 May 20

I highly recommend Damien Glover's work. He is caring, knowledgeable and also firm when he needs to be as he understands our limitations and is not afraid to let us know what we can or can't do. Damien prepared a detailed plan to assist me with my shoulder injury recovery.

Kelley Ayers

08:18 20 May 20

I’ve had ongoing back pain for the last couple of years & so made the decision this year that I needed to get this issue resolved before it got any worse. It’s been slow progress but week by week I can feel things improving. Damien is excellent to work with & makes each appointment a bit of fun, & my weekly Pilates class with Courtney is hard work but also enjoyable. They make a great team.

Spencer Connell

04:53 20 May 20

I was referred to Damien over a year ago now after an accident which resulted in a double spinal fusion. I have learn't many things from him and we have come a long way together in my rehabilitation.In a few simply words he listens, he cares and he will work with you to get you where you need to go.No simple fixes, It's not easy...- It requires a lot of hard work and personal dedication.- There is a lot of pain but you need to know pain to get better.- Lots of compassion and also laughter.Thanks for everything you have done giving me my life back.

Jonathon McMullan

04:08 25 May 20

Great experience. Had a knee issue which caused major problems with my running form. Consultation was very professional and engaging. I was back running the next day and my treatment plan steadily improved my form until it was better than prior to my injury. Would highly recommend.

Eamon MacDermott

06:41 28 May 20

I very nearly had to quit my job due to severe low back pain. I wasn't feeling very optimistic about when I would be feeling 100% again, but within 2 sessions I was literally back to full function and pain free.I can say without doubt Damien is the best physio I've been to.

Sian B

05:48 08 Jul 20

THE BEST PHYSIO in Sydney, period.I had chronic nerve pain in my hamstring which is now gone thanks to the staff at Fixio. I haven’t felt this happy in a long time and finally feel like my body can get better and won’t be broken for the rest of my life. I’ve seen other Physios before and they never helped, my pain never went away.The staff at Fixio are always understanding of your issues and when I come in they’re always so vibrant! I cannot recommend them enough!Thank you!!

Gordon Salier

04:23 22 Jun 20

When you have some physical issues, these are the people to call on!Courtney (and Damo) know their stuff. I have seen a few physios in my time but never had the results that I am getting from here. I will never go anywhere else. Always happy to see their customers. Very encouraging and willing to work at whatever pace you can handle. Having had persistent shoulder issues for many years, I am now getting more sleep than ever. Old calf injury? Better than ever. New Quad injury? Too easy. Valuable exercise plans as well to help you manage your recovery when you are not there.

Category: Physio Insights