Category: Physio Insights

One on One Clinical Pilates at Fixio

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.

Why you should choose a Titled Physiotherapist

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

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.

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

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

4 common treatment techniques used by musculoskeletal physiotherapists

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.

1. 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.

2. 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.

3. 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.

4. 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

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!