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Can Physio Help Tennis Elbow?

So you’ve got a pain in your elbow and you’re wondering if physio can help tennis elbow? You’ve all probably heard of Lateral Epicondylitis also known more commonly as Tennis Elbow. There is a high prevalence of this injury especially in individuals older than 40 years old, as well as those who play racquet sports i.e tennis and squash. It is also common in those who undertake repetitive movements of wrist extension and/or gripping such as painters or carpenters.

Tennis elbow is the most common type of elbow pain people present with, characterised by pain on the outside aspect of the elbow. It can vary from low grade occasional discomfort to high grade continuous pain. Tennis elbow is an overuse injury where the common extensor tendon and the extensor carpi radialis brevis tendons are subjected to repetitive loads causing microtears and pain. It can be very painful and debilitating, affecting your day to day activities which is why it is very important to seek treatment earlier rather than later. If not treated appropriately it can develop into a chronic condition.

Treatment for Tennis Elbow favours conservative management with majority of tennis elbow injuries resolving within 12 months. There is a high recurrence rate if not managed appropriately. The aim of treatment is to initially manage load (relative rest), control inflammation, manage pain and patient education. The next stage is to re-introduce appropriate loads through specific wrist and elbow exercises with the goal to return to pre-
injury strength and function. It is necessary to strengthen above and below the elbow as well as allowing adequate recovery of the area.

Come and visit one of our team members to help you on your road to recovery.

Physio for Lower Back Pain

Why am I experiencing back pain?

Lower back pain is a pain and understanding why we get it and how to treat it will have you back on your feet in no time. Our spine is an interconnected system of bones, nerves, muscles, tendons and ligaments – it is central in how our body operates. Starting at your head and moving down towards the pelvis, we have 31 segments which are pivotal in normal human functioning. We use it in everything we do! This blog will outline how we can help optimise the movement of your spine and in turn, help improve your overall health.

The spine is a major cause of grief for many individuals. The Australian Institute of Health and Welfare reports:

  • Over 4 million people reported significant back problems in 2017-2018
  • Back problems are the 2nd leading cause of disease burden in Australia
  • 86% of the population will experience pain at least once per week.

During the current COVID times, we have seen the impact of self-isolation, social distancing and working from home on the spine.

These include:

  • Postural related injuries
  • Osteoarthritis flare-ups
  • Disc degeneration
  • Neural compromise
  • And many more

What can cause back pain?

There are many factors that contribute or increase risk of back pain. Age, physical fitness, weight, type of work are all factors that can influence your own individual experience of pain. Clinically, we see people present with a significant reduction in function and movement. Whether it is having difficulty sleeping, focusing on work or study, exercising or simply doing daily activities, back related problems can have a significant effect on our day to day lives.

Our bodies are strong, and robust and this includes our spine! It is built to withstand all the stress we put it through daily. The key to physiotherapy and back pain, is figuring out how we can help make it stronger and even more robust. There are many ways we can work on helping you with this, including:

  • Pain management so your day to day activities are less impacted
  • Improve your movement, so you can do the things you want to do
  • Increase your strength and stability in key muscles and joints to optimise your movement and reduce too much strain on your spine.

At Physio On Miller, this could include one-on-one physiotherapy, private or group rehab sessions that incorporate clinical pilates and strength and conditioning principals. Our team are here to support your overall spinal health and help you continue to function to the best of your ability.

If you are experiencing back pain, please book into to see one of our fantastic physiotherapists. We would love to get you back to feeling and moving better!

Pre season injuries prevention - Physio On Miller, Cammeray

Pre season injuries – how to avoid them

It’s been an endless summer (at least in theory) since we all played our team sports. Change in schedules, unplanned holidays with last minute openings of boarders and of course the big wet have all contributed to our time away from sport being a bit longer than usual. Enter the risk of pre season injuries.

With training kicking off we have had an influx of pre season injuries related to this sudden, yet welcomed, change in our activity levels. Common areas of injuries have been ankle sprains, quad strains and of course the dreaded hamstring. Our anecdotal findings seem to be happening amongst the pros too.

 A recent study in the British Journal of sports medicine conducted on professional football (soccer) players it was found that…

“The thigh (23%), knee (17%), and ankle (17%) were the most common locations for injuries during the preseason, there was a relatively greater number of lower leg injuries (15%) during the preseason.  Achilles tendonitis was most prevalent in the preseason, with 33% of all Achilles related injuries sustained during this period. Muscle strains were the most common injury during preseason (37%). Rectus femoris muscle strains were observed twice as frequently during the preseason relative to the in season. Ligament sprains were the second most common injury during preseason (19%). Non-contact mechanisms were the cause of significantly more injuries during the preseason with relatively more preseason injuries sustained while running or shooting”.

But don’t let this put you off. While you may be at an increased of injury during this period – it is well documented that those who engage in regular physical activity can add in excess of 4 years to their lives  (Reimers et al, 2012).

So if you’re interested in living longer and spending less of it with pre season injuries I have put together a few strategies to get the best of both worlds.

1. Warm – up:

The reasons for warming up before any physical activity are well known. But are our warm-ups adequately preparing us for an improved performance on the pitch while reducing our inherent risk of injury? Developed and studied by the FIFA Medical Assessment and Research Centre (F-MARC), the FIFA 11+ injury prevention program has been proven in multiple research studies worldwide to significantly reduce injuries and enhance performance.

Injury Prevention

The FIFA 11+ warm-up has been shown to substantially reduce major injuries, particularly in females between the ages of 13-18 who have a high risk of knee and ACL injury, by 50% and a reduction of 39% of overall injury incidence in recreational/sub-elite football.

The program is only effective when the warm-up exercises are performed regularly, at least twice a week. Compliance is of utmost importance—injury risk is lowest in those players with higher adherence to the program.

The program consists of 3 parts with a total of 15 exercises that are to be completed in a specific order.

Part 1: Slow-speed running exercises paired with active stretching and partner work.
Part 2: Core and leg strength exercises, along with balance, plyometrics, and agility exercises.
Part 3: Moderate/high speed running exercises integrated with cutting and pivoting movements.

Pre season injuries prevention - FIFA 11+
FIFA 11+ program

2. Strength and conditioning program

  1. Strength and conditioning exercises

Developing a specific and highly individualized fitness plan that includes a varied range of exercises such as cardiovascular exercise, strength training, flexibility and mobility is effective in increasing sporting performance and sports injury prevention.  There is no one size fits all and the demands on your individual sport would dictate the program you should follow. However, I have formulated a list of a few fundamental exercises that would feature in the majority of strength and conditioning programs.

  • Calf raises
  • Single leg squats
  • Side lying leg raises
  • Glute bridges
  • Hamstring curls
  • Explosive bodyweight movements
  • Agility exercises such as sprints
  • Single leg balancing with catching and throwing.

Ensure that you are gradually increasing your load and progression as you progress through these exercises.

 If you have any further questions about how you can minimise your risk, or your loved ones risks of injury, or what to do if this e-mail got to you a little to late then give us a call at Physio on Miller so you can start of your season with a bang!

Reimers, C. D., Knapp, G., & Reimers, A. K. (2012). Does physical activity increase life expectancy? A review of the literature. Journal of aging research2012.

Woods, C., Hawkins, R., Hulse, M., & Hodson, A. (2002). The Football Association Medical Research Programme: an audit of injuries in professional football—analysis of preseason injuries. British journal of sports medicine36(6), 436-441.

ACL Injury Prevention Physiotherapy Cammeray, Physio On Miller

ACL injury prevention and physio

A big focus in our clinic is injury prevention, in particular ACL injury prevention. With the run of ACL injuries we’re treating we’re highlighting the importance of ACL injury prevention.

Many of our clients are active sports people and we’re keen to see our clients succeed in their sport and most importantly injury free. There’s been an abundance of research into the success of injury prevention programs and fortunately many physios, coaches and athletes are adopting these programs. In particular there’s been a lot of research around ACL injury prevention and the significant reduction of injury in athletes who regularly complete a prevention program.

When it comes to ACL injury prevention it is important to include strength, agility, proprioception (balance) and plyometrics. In addition these programs need to be completed regularly, for at least 10 minutes prior to playing sport and continue for 6 weeks or the duration of the sports calendar (whichever is longer).

There are many sport specific programs that have been developed with the knee and ACL in particular in mind.

Netball: https://knee.netball.com.au/

Soccer FIFA 11+ and Santa Monica PEP

AFL – FootyFirst

With this in mind if you’re joining a team this season, have a previous ACL tear that needs rehab or a weekend warrior come see one of our fantastic physios to get your program started. To book an appointment click here.

Hip flexor stretch - Physio On Miller, Cammeray

How to improve your hip mobility – Hips don’t lie

As humans we are the most adapted and have potential to be the best movers on the planet. Yes, we cannot jump up a fence like a cat or sprint like a cheetah but we can throw a Frisbee, tie a shoelace and loco mote on 1,2,3 or 4 limbs.
As a species we evolved for long distance migration (walking and running) yet, foot, knee and Achilles ‘over use’ injuries have never been so prevalent. So why is this? Sadly, the majority of us have lost the ability to do everything that our body has evolved to do and, as a society, we take our movement for granted.

The body is a highly adaptable machine. It allows us to move, even with joint restrictions in place, but it is only a matter of time until it begins to break down and you go to see your physiotherapist.
When walking (and running) form follows function. If we lack movement in the lower limb – especially in the hips we begin to compensate. This leads to
increased transmission of force in the joints and ligaments and our doctor or other health care provider diagnoses us with ‘jumpers knee”, Achilles tendonitis or some kind of plantar fasciopathy we are unable to pronouce.

Lower limb and lower back injuries almost always have a hip component. Because we do not regularly use our body for the purpose it has evolved for and the 90° lifestyle that has become the norm, think sitting, prevents us from accessing the full function of our hips.
The many hours we spend sitting causes us to loose hip mobility and in turn hip stability. Our hip flexors and lower back begin to tighten and our pelvis starts to tip forward. This in turn leads to an inability to extend our hip and thus propel us forward in and efficient manner when walking or running. If our hip cannot extend we cannot access the full power of our gluts and then other, less suited muscles take over leading us down the path of over use injuries and metal joints.
It’s not all bad news! To adapt means to “make (something) suitable for a new use or purpose” or “become adjusted to new conditions”. With this in mind it tells us that we merely have to change the conditions to change our destination.
Listed below are a few ideas of how to reclaim your hip movement and prevent yourself from injury. While this list is not exhaustive it is a great start and seeking the advice of a health or movement professional should not be avoided altogether.

  1. Reduced the amount of time spent sitting at 90°. Sitting can be divided into optional and non-optional.

Optional:

  • E-mails
  • Netflix
  • Park

Non-optional:

  • Car
  • Meeting (where everyone sits)
  • Work

For those times where sitting is optional think about a different position you could adopt: standing, sitting on the floor, walking etc

2. Offset the amount of time spent sitting with hip extension stretches.
Spend 1 minute in the modified hip flexor stretch for every 1-hour you spend sitting on any given day.

  • Kneel on the Left knee.
  • Right knee at 90.
  • Drive the hips forward and keep
  • The core engaged.
  • Squeeze the left glut and feel the
  • Stretch in the left hip flexor.
  • Hold 1 minute – change leg

3. Obtain hip dominance and glut activation in standing – Complete 2 x 5s hold on each leg.

  • Stand on the left leg.
  • Pull the right knee to the chest using the hands.
  • Squeeze the left glut and keep the left knee straight.
  • Release the Right knee and hold for 5 seconds.

These are a few ideas for you to reclaim you hip mobility and once you have done the hard work of obtaining it, all you have to do to keep it is to use it.

So you are at a fork in the road – do you want to run yourself to injury or do you want to move yourself to health.  Like with all things health, prevention is better than cure and remember…. Embrace progress, no perfection.