Physiotherapy

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We are experts in movement and function and can help you to overcome movement disorders acquired from birth or those that are the result of accident, injury, ageing or life-changing events. We can help you

  • recover from injury
  • resolve pain and stiffness
  • restore and increase your mobility


Neck and Back Conditions

Herniated / Bulging Disc / Annular Tear

A herniated or bulging disc would by far be the most common answer I receive when I ask patients the question- “what do you understand to be the cause of your pain?” When we are discussing disc related neck or back pain, it is really important that we place the herniated or bulging disc within the broader physiological context from which symptoms emerge. Put simply, the presence of a disc bulge or disc herniation is only part of the story of neck or back pain. It may be a big part of the story, or a small part of story… as time goes by, the bulging or herniated disc should become a smaller part of the story.

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Compressed / Pinched Nerveroot

This diagnosis often goes hand in hand with a diagnosis of a bulging or herniated disc. Very often patients will explain to me that their pain is a product of a disc bulge squashing a nerve root in their spine, with their pain spreading down the leg or arm. It is quite common for an MRI study to reveal contact between a bulging / herniated disc and a spinal nerveroot. But again, these findings also turn up in MRI results of people with no pain. So I think it is worth reiterating the concept of nerve sensitivity.

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Sciatica

Sciatica is a diagnostic term that was coined in the 1980s to describe the classical presentation of pain running down the back of the leg along the path of the sciatic nerve. It is not a particularly useful diagnostic label. Typically, someone with this diagnostic label will have an MRI showing compression of the S1 spinal nerveroot.

As we have already discussed above however, the compression of a spinal nerveroot is only part of the “i have a pinched nerve in my back” story. Sciatica is essentially a label used to describe the most common location at which a spinal nerve becomes symptomatic- that being the L5/S1 segment. Like any clinical scenario in which there is spinal pain, and pain referred along the path of a particular nerve, we need to ensure that the treatment plan includes appropriate education about how pain works, combined with appropriate medication, manual therapy and a graded return to pre-injury or pre-pain activities.

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Scoliosis

Scoliosis was originally a Greek word meaning curved or bent. Today it is a word used to describe the most common type of spinal curvature. Scoliosis is simply a descriptive term, like headache- it is not a precise diagnosis. In other words, if you have had some imaging like an x-ray, or some other form of assessment that indicates that you have a spine that curves laterally, the next step is to work out why your spine is curved in such a manner.

There is some useful information about the various “types” of scoliosis on www.scoliosis-australia.org.

Small lateral curves in the spine a common and are of no particular consequence to an individual. For most people, a mild scoliosis is not something that warrants any specific treatment. We (people in general) are not perfectly symmetrical beings. We are capable of adapting to a mild scoliosis and performing our preferred occupational and recreational activities over a lifetime.

There is however, a smaller group of the population who develop more pronounced or prominent curves in their spines. And since every pronounced or severe case of scoliosis starts off at some point as a mild case, it does make sense to take measures to identify those who might be at a higher risk, as this will provide the best opportunity to commence effective treatment.

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Weak Core

The concept of “core” strength and it’s role in back pain and rehabilitative exercise programs emerged from research carried out in the early 1990s. The popularity of core stability training soared as this research made its way into the practice patterns of clinicians and trainers throughout the 1990s and into the 2000s. The message that has long since been propagated is two fold:

  1. that a weak core predisposes one to lower back injury and pain
  2. that the resolution of back pain is contingent upon strengthening of the core

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Whiplash Injuries

A whiplash injury is the term used to broadly classify injuries resulting from a sudden acceleration / deceleration of the head and neck. The common example is the whiplash motion of the head in motor vehicle accident. Other common scenarios that involve a whiplash motion of the head and neck include a heavy fall onto one’s buttocks or back, resulting in sudden jerking back motion of the head. Similarly, sports involving high force body collisions can create whiplash scenarios.

If you have suffered a whiplash injury, particularly a high force injury such as a car crash, it is important to have the injury assessed by a doctor or physio. We can assess your condition to determine whether or not it is necessary for you to have diagnostic imaging such as an x-ray carried out. The purpose of the x-ray would be to rule out the presence of a suspected fracture to one of your neck bones. In the event that a fractures is present, you will likely be admitted to hospital for monitoring and treatment. Depending on the severity of the fracture, you could require surgery.

When the assessment reveals that there is no fracture, or no clinical signs of a fracture or other serious structural pathology, conservative (meaning non medical, non surgical) management is indicated. This is where our role as physios is really important. If you’ve had a whiplash, and we know that there is no scary damage that has occurred to your neck, it is really important to commence a guided and graded return to your normal occupational and recreational activities.

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Shoulder Conditions 

SLAP lesions and Glenoid Labrum Injuries

Rotator Cuff Injury

The rotator cuff is a term used to describe a group of 4 muscles that help your arm bone to stay attached to your shoulder blade bone. Those muscles known as;

  • supraspinatus
  • infraspinatus
  • subscapularis
  • teres minor

Any of the four muscles may be acutely injured or subjected to wear and tear changes over a number of years. When we examine a shoulder with an MRI or ultrasound scan, one of these 4 muscles in particular, the supraspinatus most commonly reveals signs of injury or wear and tear. When you hear about someone having “rotator cuff surgery”, very often they are having the supraspinatus tendon repaired. The other common surgical repair is to the subscapularis tendon. Although not technically part of the “rotator cuff”, the long head of the biceps tendon is another commonly injured structure within the shoulder.

Injuries to the rotator cuff or biceps tendon fall into two broad categories- those associated with trauma or obvious inciting event, or those which have an insidious onset of symptoms and can’t easily be traced back to a specific precipitating event.

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Sub-Acromial Bursitis

Inflammatory Conditions

Osteoarthritis

If you’ve been told that you have “osteoarthritis”, it means that your doctor, or your physio, or someone, suspects (or has confirmed via x-rays) that the cartilage that lines the ends of the joint surfaces of, say your knee joint, has to some degree, worn away. We begin life with a nice thick layering of shock absorbing, slippery and padded cartilage. It is true that this cartilage layer, especially in our weightbearing joints is subjected to a great deal of compression and shear forces on a daily basis. It is normal for cartilage to wear out with age. For some people, this wearing process is faster than for other people. Researchers do not really understand why some people’s cartilage wears out faster than others.

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Bursitis

Tendon Problems

Tendinopathy & Tendinitis

Pain Conditions

Chronic Regional Pain Syndrome

Fibromyalgia

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Treatments

Some common treatment options are listed below. The decision to use one or more of these options is derived from a careful and thorough assessment of your current symptoms and medical history.

Joint Mobilisation
Joint (thrust) Manipulation
Graded Strength & Conditioning
Activity Modification
Trigger Point Therapy
Eccentric & Isometric Loading
Remedial Massage
Sports Massage
Core Strengthening

Physiotherapists are first contact practitioners, which means a doctor’s referral is not necessary to book an appointment. Having said that, we always liaise with your GP or other referring specialist to ensure congruence between your broader health management and your physiotherapy treatment plan.

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