Category Archives: Blog Page

My Disc Has Slipped

My disc has slipped!


That is a phrase I hear way too often as at. And it can lead to a poor attitude and approach to how people understand and manage their back injury.


I want to explain the usual timeline that occurs with back pain. Most people will often visit the GP to get some pain medication to help make functional movements bearable. Of course, this is only a band-aid solution for the injury and your pain often persists or worsens. It can become so debilitating that you’re sent off for an X-ray, CT scan or MRI to provide some clarification of what is actually going on beneath the surface. And wallah! It is a ‘slipped disc’. Now you’re probably walking around like the tin man of the Wizard of Oz because you fear any movement that involves the back.

Luckily for you, I’m here to tell you that discs don’t “Slip”. This is a complete misnomer and should never be used to describe a back injury. This term is actually referring to a bulging or a herniation of the disc. These injuries are far more common than you think and, furthermore, these bulges and herniations can exist even in the absence of pain or dysfunction!!


What is a disc?

I want you to picture a jam donut. Like the donut, discs are composed of two parts; a tough outer portion and a soft inner core. The outer layer is designed to withstand large compressive forces and has cartilaginous end plates that firmly attach the disc to the vertebrae above and below.

Together with the inner structure, the discs are designed to act as shock absorbers for the spine. Each vertebral joint in the spine has a disc that sits between each bone and these are surrounded by many spinal ligaments.


What is a disc bulge/herniation?

Discs are incredibly strong. But they do get damaged by excessive compressive or torsional forces. So it’s not a good idea to lift heavy items off the floor with an extremely flexed spine or with a jerking twisting motion. They can also be damaged and deteriorate over time from bad posture, poor movement patterns and simple wear and tear. As the cartilage deteriorates (Think of the outer shell of the donut), the gelatinous nucleus (The inside of the jam donut) starts to push out against and distend the disc. Hence the name, bulging disc. If the nucleus breaks through the outside of the disc, that is then a disc herniation.


Herniations come in two varieties, extrusions or sequestrations. Put simply, extrusions are when the disc material has come out of the disc but is still intact with the remainder of the nucleus. Whereas sequestrations are when a portion of the disc material has come away from the rest and now resides in the layers of the annulus or possibly into the spinal canal. Pressure on the spinal cord or spinal nerve roots can cause serious problems so a correct diagnosis is vital.


What signs are seen with a disc herniation?

For a lumbar (lower back) herniation, you might be experiencing any of the following:

  • Back pain and spasms
  • Muscle weakness in either or both legs
  • Numbness in either or both legs
  • ‘Pins and needles’ or Tingling
  • Pain down the back of either or both legs
  • Loss of lower-body motor function.


Is treatment necessary?

Herniated discs DO often heal on their own. However, they don’t necessarily heal well. As mentioned above, the discs play an important role in the mobility of your spine in addition to shock absorption. If incorrectly healed or rehabilitated, the affected segment will have reduced mobility and therefore place additional strain on the segments above and below. Over time, they can become unstable and develop their own bulge and this can become a never-ending problem.

Pain and damage to the spinal structures, including the discs, will lead to reflex wasting of the spinal muscles and persistent weakness. Symptoms may often resolve on their own but this does not mean that the underlying cause of the injury have been addressed, or that the supporting muscles have been completely rehabilitated. Our advice is always to be proactive with your injuries, not reactive.


Can you fix a bulging disc?

The majority of symptoms can be relieved by working with your physiotherapist and getting the right exercise program for you! Yes, you read that correctly. Rest isn’t best. Movement is key! So, your first step with treatment should involve having a thorough assessment by a physiotherapist to determine all the contributing factors to your pain. Scans are rarely recommended for the typical back pain as they are often misleading and not useful for all care. There will be some rare cases that require injections or even surgery, but the majority of symptoms can be relieved by working closely with your physiotherapist.

Your treatment options after your initial assessment will include:

  • Postural advice and retraining movement patterns
  • Education and advice surrounding safe lifting techniques
  • Following a home exercise program working on your posture & core control
  • Conditioning and rehabilitation exercises
  • Manual therapy

Experiencing back pain that hasn’t gone away for some time now? Ceased exercise or sports because you have been told it could make your ‘slipped disc’ worse? Then call us on 02 8068 5158 so we can help take care of your spine.

Meal Prep Your Way Through Winter

Meal Prep Your Way Through Winter


When it comes to healthy eating, there is one strategy that works time and time again –meal prepping. Why? Because making healthy food choices is the hardest when we are busy, tired and stressed. By planning ahead and having plenty of prepped ingredients in your fridge, all it takes is a little last-minute assembling to create healthy and varied meals during the week.


Putting aside just 1-2 hours for meal prep every weekend is usually enough and can save you countless hours in the kitchen during the week. Not only will meal prepping mean one less thing to worry about during the week, it will save you money by limiting ingredient wastage and the temptation to order-in when you come home to an empty fridge.

Winter is an ideal time to meal prep entire meals. Soups, curries and slow cooker meals are all perfect to cook in big batches and store in the fridge or freezer in individual serve containers for reheating during the week.


Meal prepping ingredients over full meals is another great way to meal prep and avoid eating the same reheated meal over-and-over again during the week. This will take a little longer than just popping a meal in the microwave but if you have all the components of the meal ready to go it should only take you 5 or so minutes.


How to ingredient prep


There are so many ways you can meal prep but changing up the ingredients you use weekly is important to ensure nutrient variety. Choosing 1-2 ingredients from each of the categories below is a great start. Remember, the goal is to have enough prepped ingredients to make assembling meals quick and easy.


  • Baked salmon fillet
  • Poached and shredded chicken breast
  • Marinated tofu
  • Boiled eggs
  • Black bean burgers
  • Turkey or lean beef mince meatballs
  • Cooked legumes (e.g. chickpeas, cannellini, borlotti beans)



  • Overnight oats or homemade muesli
  • Roasted sweet potato
  • Cooked brown rice, quinoa or barley
  • Baked polenta
  • Cooked legumes (e.g. chickpeas, cannellini, borlotti beans)



  • Washed and pre-chopped vegetables to use in stir-fries
  • Roasted and pre-cooked vegetables for re-heating
  • Spiralled vegetables for pasta sauces
  • Washed and pre-sliced salad vegetables for sandwiches



  • Washed and sliced fruit
  • Mixed nuts and dried fruit
  • Pre-chopped vegetable sticks
  • Hummus or Tzatziki dip
  • Roasted chickpeas
  • Homemade raw nut and date balls


In addition to the ingredients you prep, make sure you have a few staples ready to help flavour your meals – extra-virgin olive oil, avocados, lemons, fresh or dried herbs, nuts and seeds, hummus dip, olives and feta cheese are flavours that work well with virtually any meal.

If you’d like some more meal-prep ideas or help with any of your nutrition needs our dietitians are available for both in-clinic and telehealth appointments. To make an appointment……

Running Related Injuries Series – Part 1

Running Related Injuries Series – Part 1


With the difficulties we have faced over the past 3 months due to COVID-19 restrictions, we have seen a huge percentage of people rediscovering the importance of their health and fitness. Many of us have utilised this extra time we have to eat healthier and get fit. And with many also returning to team sports very soon we are seeing a huge spike in running related overuse injuries.

This is the first part of a series dealing with running related injuries and how to manage them:

ITB friction Syndrome

Iliotibial Band (ITB) friction syndrome is a very common overuse injury resulting in pain and tenderness in the outside of the knee. It is commonly seen in runners, accounting for up to 22% of all lower limb injuries, however it can also be seen in any active population.

The ITB is a thick band of connective tissue which runs down the outside of your thigh. At the top of your thigh it attaches to your Tensor Fascia Latae muscle and your Gluteus Maximus muscle, and at the knee it attaches to the top of your tibia (shin bone) as well as the end of your femur (thigh bone).

When the knee is bent, the ITB slides across the outside of the knee with the maximal compression occurring between 20-30° of knee bend.  ITB friction syndrome occurs when excessive tightness or biomechanical issues cause increased compression at the knee leading to an increase in friction.  This increased friction combined with high repetition involved with running causes the tissue to break down and become inflamed.

ITB friction syndrome presents with pain localised to the outside of the knee however can occasionally refer pain up the leg. You will find that the pain gets worse with activity with the majority of cases being pain free at rest or walking unless the syndrome progresses to an extreme level.  You will likely experience that downhill running is more aggravating than flat ground as it places more stress on the muscles around the knee. Quite often, the onset of pain can be attributed to recent and sudden change in training load, type of activity (eg. more hill running) or equipment (eg. change of footwear).

Conservative treatment is very successful in most people suffering from this condition and it is recommended that you see your physio immediately for a detailed assessment and management plan. Management of this condition usually involves relative rest (never complete rest) to allow for tissue healing, massage to release tight muscles, stretching and strengthening of the muscles around the hip and knee, and correction of any contributing biomechanical issues. Relative rest refers to modifications to running load or the type of training which allows you to maintain strength and fitness without aggravating the inflamed tissue.

‘Hands-on’ treatment is ideal in the acute phase, when pain and inflammation at the insertion is felt. The use of a foam roller on tight muscles is also highly beneficial and our therapists can demonstrate the most effective technique for this, allowing you to treat yourself at home. Exercises to strengthen muscles that stabilise the hip such as band resisted side walking, glute clamshells, hip hikes and thrusters should form the main part of any rehab program. All sound a bit confusing? Our experienced team of physiotherapists will talk you through all of these exercises and send you home with a detailed and specific program tailored to your individual needs.

physio foam roller

Finally, load management is an integral part of managing and rehabilitation with a recommended reduction initially of 30% intensity and volume of training. If this doesn’t result in pain free activity a further 10% reduction should be applied until training doesn’t result in pain. Load should then be progressed gradually (approximately 10% per week) until pre-injury levels are reached. While these are very rough guidelines, and need to be varied for every individual, it highlights the importance of managing training loads in an overuse injury.

Redfern Physio – Working From Home Guide.

With the craziness thatis COVID-19, most of the world has had to rapidly transition to work from home until further notice in order to practice social distancing.

For some, the chance to be able to work from the couch will be a difficult offer to resist. After a couple of days of working from home, your neck, back, shoulders, hips, elbows and wrists, are likely already letting you know that this isn’t going to be a sustainable working arrangement. Physiotherapists all around the globe have already seen a reduction in sports related injuries, but an increase in postural related pain as a result of poor work setups in the home.


COVID-19 is certainly still in it’s early days in Australia and continues to spread, so ensuring that you have an optimal ergonomic working set up at home is going to be well worth your while. While you may not have the space or cash flow to purchase new fancy furniture, physiotherapists possess many tools and tricks that are free or cheap and have the ability improve your setup and comfort.

A few generic tips include: 

  • Ensure that your feet are well supported on the floor and knees are at or close to 90˚
  • Aim to have your screen height so that the top half of the screen is at eye line
  • If you are using a laptop, obtain a separate keyboard so that the above is possible
  • Try to change your posture and move regularly. Sustained postures in the one position pose the biggest risk to muscular aches and pains


For some more detailed information on ideal workstation setup, refer you the blog in our series titled ‘Workstation Setup’.

If you think that you need individualised advice, and you are feeling well and have not recently travelled from overseas, our Physiotherapists are always available to conduct ergonomic assessments. If you are feeling unwell or would prefer to practice social distancing, we are now offering appointments via video consult. Simply contact our friendly team at Redfern Physiotherapy and Sports Medicine via phone or email to arrange a telehealth time to suit you.

Workstation Ergonomics – The Ultimate Guide

Workstation Setup – The Ultimate Guide


Posture related pain and musculoskeletal problems are becoming more prevalent in the digital age as we spend increasing amounts of time at work, as well as glued to our mobile phones. With developments in technology and an understanding of how the human body interacts with these environments, comes better knowledge on how to combat these problems. Gone are the days of being expected to sit perfectly upright, sit on a balance ball, or any number of one size fits all generic approaches. While there is no one correct way to sit at a workstation, seating should support postures that can be changed frequently within a comfortable range throughout the day. It should accommodate the work being done, the visual demands and the workers’ individual differences. This will reduce fatigue and strain on the neck, shoulders, back and legs.


The two most important items in any office setup for appropriate ergonomics are the chair and work desk. An appropriate workstation should be designed to allow adequate height, depth and work surface for your body dimensions, the type of work you do and the equipment that is required for use. The workstation should have the following features:


  • a flat smooth surface for the keyboard and mouse
  • space to position all the equipment so that posture or vision is not compromised
  • a suitable height between 68 and 72cm from the top of the desk to the floor
  • adequate clearance for legs under the desktop
  • sufficient space under the desk to comfortably stretch legs


Most ergonomic chairs these days have all the adjustments required to ensure that it is the right fit for you. Typically, office chairs are classified as ergonomic when they have an adjustable seat height, seat depth and lumbar support. In addition, they should ideally have:


  • An adjustable headrest
  • Adjustable arm width and height
  • Adjustable tilt tension and subsequent lock


An ideal posture when seated at your workstation should, therefore, look similar to this:

Height adjustable workstations

Height adjustability is another highly desirable workstation feature and all height adjustable

workstations need to be to easily adjustable. Sit to stand workstations allow the desktop to be used in either the seated or standing position and should have similar dimension to a standard workstation as well as being able to be raised to at least 110cm without disruption to equipment or items. Height adjustable workstations are important for highly sedentary work or where work requires sitting or standing positions for long periods. They are also extremely useful for very tall or short people as they can adjust the workstation to suit their needs.




The introduction of standing desks can improve physical (chronic disease prevention or management) and psychological (worker productivity, well-being) outcomes with workers. Because sitting for prolonged periods is harmful to physical health and incorporates large health costs, employers should consider standing desks as an alternative to sitting desks that could improve workplace health and the general well being of their staff. Recent research has shown that prolonged standing can also come with its own physical costs which brings us back to our main goal that aims for work stations which support postures that can be changed frequently within a comfortable range throughout the day.


Adopting some of the above changes to your work set up can significantly help with postural related workplace injuries. However, the most important factors that can prevent issues are how you interact with your environment, your posture and general muscle strength and flexibility. For a detailed assessment of your workstation set up, or for some advice on strategies to counteract workplace injury, contact our expert team at Redfern Physiotherapy and Sports Medicine.

To stretch or not to stretch? That is the question!

To stretch or not to stretch? That is the question!


There are multiple scientific studies to both prove and dispute the benefits of stretching. From personal experience, with years spent working with both elite athletes and the general public, we will all benefit from stretching on a daily basis. So why is stretching good for you?

Stretching keeps the muscles flexible, strong, and healthy, and we need that flexibility to maintain a range of motion in our joints. Without range of motion, our muscles are prone to becoming tight and therefore shorten. Then, as we start to train and work the muscles, they will be weaker as they are not working in their optimal range. If you continue to train, then you are putting yourself at risk of muscle damage, strains and joint pain.

If the majority of your day is spent in a slumped position, relaxing or commuting to work then you may start to notice a muscle imbalance within the body. For example, sitting in a chair all day results in tight hamstrings in the back of the thigh. This can make it harder for you to extend your leg or straighten your knee all the way, which inhibits optimal walking mechanics.


Likewise, when tight muscles are suddenly called on for a strenuous activity that loads them as they stretch, such as playing touch footy or tennis, they may become damaged from suddenly being overloaded. In addition, tight or injured muscles may not be strong enough to support the joints, which can lead to joint injury.


What type of stretching should you do?


Dynamic stretching involves active movements where you will move the arms or legs through a full range of motion. Usually performed before starting a workout to help you warm up the muscles. This stretching routine should go for 6-12 minutes. We avoid static stretching prior to any workout as this has been shown to impair your performance.


Static stretching involves you holding in place for a set period of time without movement, between 20-60 seconds usually. This is usually done at the end of a workout once the muscles are warmed up but also beginning to relax. We recommend taking a minimum of 10 minutes for a post-workout cool down stretch.


Most people skip static stretching and it is difficult to understand to why? Stretching will help improve your flexibility and help you to stay injury free. Stretching takes 10 minutes out of your day, but an injury can significantly affect your health and lifestyle for 6 months or more! It’s a no brainer.


Try these quick stretches to help with everyday tightness from sitting or decreased activity during your day.


  1. Seated Piriformis (Buttock) stretch
  • Start in a seated position.
  • Keeping your right foot flat on the floor, lift your left leg and place your left ankle on your right knee.
  • Apply gentle downwards pressure to the knee as you lean forward, increasing the depth of the stretch.
  • Hold this position, you should feel a comfortable tension with no pain in the bottom region of the leg that is not making contact with the ground.
  • Repeat every hour with each leg for 20-60seconds.

  1. Chest Openers
  • Sit up straight on a chair.
  • Place your hands behind your head and extend your upper back over the top of the chair.
  • Hold this position for 2 seconds.
  • Repeat 1 set of 10 repetitions each hour you are seated at work.


  1. Cat – Cow stretch
  • Start on your hands and knees, with your knees directly underneath your hips and your hands underneath your shoulders and your back in a neutral position.
  • Place your hands flat on the floor and contract your abdominal muscles, making sure that your spine is well aligned with your back straight as a tabletop.
  • Inhale, and arch your spine away from the floor, pulling your belly up like a cat.
  • When it comes time to exhale, round your spine in the opposite direction, lowering your belly towards the floor and lifting your head.
  • Hold the end of each position for 2 seconds, repeat 3 times with 10 repetitions in each direction. Alternate sets with the following exercise.



  1. Lumbar Rolls
  • Lie on your back with your knees bent and your feet flat on the floor.
  • Keeping your shoulders flat on the ground, roll both knees out to one side.
  • Hold this position.
  • You may feel the stretch in your hips, as well as your lower back.
  • Bring your knees back to the middle before repeating the same movement on the other side.
  • Complete 3 sets of 10 repetitions each side, morning and evening


If you are unsure about how to stretch safely, or even what you should be stretching, you can ask our experienced team of physiotherapists to show you how. We will assess your muscle flexibility and tailor a stretching program to fit your needs. Book a session now and you will never feel the same again!


COVID-19 Nutrition – Stocking a Healthy Pantry

Covid 19 Nutrition

COVID-19 Nutrition – Stocking a Healthy Pantry


With the evolving impact of the COVID-19 pandemic, many are planning to stay at home for extended periods and access to nutritious food has become top of mind. While being prepared is important, unnecessary stockpiling of food puts strain on the most vulnerable members of our community. Below are some tips for sensibly stocking a healthy pantry while considering others.


Check out what you already have in the pantry, fridge and freezer – there is no point doubling up unnecessarily. Throw out any food that is out of date food to free up storage space.

Write a list before heading to the supermarket but be prepared to do the best you can with what you can get. Some foods may be difficult to find, or too expensive, so being flexible is important. Include a variety of fresh, canned, dried and frozen produce from the major food groups below and focus on foods that you will enjoy, therefore avoiding future food waste.

Foods to consider:


  • Canned fish such as tuna, salmon or sardines
  • Canned or dried legumes – drain and rinse canned legumes before use
  • Fresh meat and poultry – freeze in individual portions for future use
  • Nuts, seeds and nut butters – store them in the fridge to last longer
  • Long life dairy milk – UHT or powdered or non-dairy alternatives such as soymilk, almond milk or oat milk

Fruit and vegetables

  • Fresh fruit and vegetables – choose those that last longer such as celery, broccoli, cauliflower, Brussel sprouts, carrots, pumpkin, cabbage, onions, sweet potatoes, oranges and apples
  • Frozen and canned fruit and vegetables – drain and rinse canned vegetables and choose canned fruit in natural juice where possible


  • Stock up on a variety of dried wholegrains – barley, rice (brown, red, wild), pasta, quinoa, rolled oats and cereals
  • Consider freezing a loaf of wholegrain bread or rolls to extend their shelf-life

Covid 19 Nutrition

Flavouring staples

  • Extra-virgin olive oil
  • Balsamic vinegar, lemon juice (frozen in ice-cubes)
  • Dried herbs and spices
  • Garlic and onion

Comfort foods

  • Whatever these are for you – coffee, chocolate, wine – don’t forget these!
  • Seeking foods that provide a source of comfort is not only understandable during a time of such uncertainty but also encouraged as they can be beneficial to your mental health.

While some of us are enjoying the extra time at home to experiment with new recipes – it is low on the priority list for others. Juggling child-care, full-time work and other competing responsibilities is the reality for many, and for some, unemployment and reduced income are making mealtimes particularly challenging. Focus on easy recipes with simple ingredients and adapt as necessary. Meals that can be made in batches and frozen for future use can help provide meal variety and while reducing cost and wastage.

For recipe ideas and individualised nutrition advice during this challenging time our dietitians are available for telehealth appointments. To make an appointment call us on 8068 5158 or book online by clicking here

Probiotics and Prebiotic’s: What You Need to Know

Probiotic Guide

Lately, it seems like everyone is talking about gut health – and with good reason.

A healthy gut is important for effective digestion, a strong immune system, cognitive function and mood – it is even thought to be effective at preventing and managing chronic diseases.

The best way to promote a healthy gut is to eat a diet rich in fibre with plenty of prebiotic and probiotic foods. Getting enough probiotics and prebiotics in your diet ensures a healthy balance of the good and bad bacteria in your gut – impacting much more than just your digestion.

Probiotic Guide
Super Healthy Probiotic Fermented Food Sources, drinks, ingredients, on white marble background copy space top view

Probiotics are live bacterial cultures, which when consumed with a healthy diet can help restore and support a healthy gut. They are particularly beneficial if gut health has been compromised. Although people often choose to consume probiotics in the form of a supplement, they occur naturally in foods too.

Some of the best probiotic foods include:

Yoghurt: Not all yoghurt on the supermarket shelves contain probiotics so if you’re looking to improve your gut health, make sure you check the label. Avoid sweetened varieties as we know refined sugar can destroy the good gut bacteria

Sauerkraut: AKA fermented cabbage, is arguably the healthiest food there is for your gut. Choose those in the refrigerated section to ensure more live probiotics

Tempeh: A plant-based protein food made from fermented soybeans is jam packed with good bacteria. This probiotic food doubles as a great source of protein, iron, magnesium and calcium

probiotic diet

Miso: A popular flavouring made from fermented soybean paste used in Japanese and Chinese cuisine. As well as being packed with millions of beneficial bacteria for your gut miso is a rich source of protein, essential minerals and vitamins. Avoid boiling to maximise its gut health benefits

Kombucha: A mildly fizzy, flavoured drink taking over shelves at cafes and health food stores is made by fermenting brewed tea. A great alternative to soft-drinks and sweetened fruit juices however more research is needed to show whether the number of probiotics produced translates to a gut health benefit

As there is no way to know the exact quantities of these probiotic rich foods to include in your diet – adding a variety daily is recommended.

You may choose to take probiotics in supplement form when therapeutic doses are required and particular strains may have a beneficial effect on conditions such as irritable bowel syndrome, diarrhoea, allergies, colds and more.

What about prebiotics?

Probiotics and prebiotics work together and while they sound similar, they play very different roles in gut health.

Prebiotics are fermentable fibres found in plant foods that end up the food source for the growth of good bacteria in our gut – they feed probiotics. The health-promoting benefits of probiotics are transient unless you keep feeding them.

Some of the best prebiotic foods to include in your diet are:

Oats: A versatile wholegrain with prebiotic benefits. Oats contain large amounts of beta-glucan fibre, as well as some resistant starch and are particularly suited to breakfast – porridge, muesli or added to smoothies

Onion: Nutrient-dense and rich in prebiotics and antioxidants, onions aid digestion and strengthen gut health. To boost their prebiotic benefits, eat onions raw and avoid over peeling them as most of the flavonoids are contained in the outermost layers

Garlic: Loaded with nutrients including manganese, Vitamin B6, Vitamin C and selenium as well as containing almost 20% fibre by weight, garlic is a versatile prebiotic food. There are several healthy ways to add garlic to your diet – stir-fries, pasta sauces, curries and dips

Bananas: High in fibre, vitamins, and minerals – slightly unripe bananas have particularly powerful prebiotic effects

Chicory Root: Available in supplement form and commonly used as a coffee replacement, chicory root is one of the best prebiotics around. You may have even eaten it without knowing as it is commonly used as a food additive

Legumes: Beans, peas, lentils and soybeans – legumes contain the prebiotic galacto-oligosaccharides (GOS) and resistant starch. Cooking legumes with spices such as fennel, ginger and cumin can help minimise flatulence and bloating

Jerusalem artichoke: Rich in potassium, thiamine and fibre, Jerusalem artichoke they can be prepared similarly to a potato – boiled, sautéed or roasted. Despite its name, the Jerusalem artichoke is unrelated to the globe artichoke

Every meal you eat can make a difference – research has shown that within days of eating a diet rich in probiotics and prebiotic foods our gut bacteria transforms, becoming more balanced and diverse.

Redfern Physio for an introductory dietitian consultation to get your gut health on track.

Plantar Fasciopathy – This one simple exercise can help heel it!

Plantar Fasciopathy – This one simple exercise can help heel it!


Do you wake up every morning and dread taking that first step when getting out of bed? It may feel like you are walking on a continuous line of thumbtacks and this quickly starts your day on the wrong foot (pun intended).


You notice that the first few steps are always the worst but then it slowly improves with activity as it warms up. The pain will start under the heel in your foot or in the arch after you have rested the feet all night. The lifetime prevalence of obtaining this injury is as high as 10% – That is a quite a large number of people who will be affected by this at some point.


Where does the pain come from?

A thick fibrous band of connective tissue called your plantar fascia (PF). It originates on the medial (the middle) aspect of your calcaneus (heel bone) and extends along the sole of the foot before inserting at the base of the toes. It supports the arch of your foot to prevent flattening. When your PF develops micro tears or becomes inflamed, this is known as plantar fasciitis.


What are the causes?

Unfortunately, no one really knows the answer to this question. There have been numerous studies performed over the years, but the findings remain fairly inconclusive. All we do know is that Plantar Fasciitis is thought to be a traction and overuse injury where the PF has been repeatedly overstretched.


This can be due to weak foot stabiliser muscles (the intrinsic foot muscles) and poor foot biomechanics, which causes overpronation. If the muscles in your feet are weakened, then an excessive force is transmitted to other tissues such as your PF. The pain will then arise if the tolerance of your PF is exceeded.


Could my running technique be causing me the pain?

It is a common assumption that the repetitive impact caused by landing on your heel when running is what causes Plantar Fasciitis. However, one study has shown that the high impact forces that occur when you overstride (poor running technique) can be a contributing factor in developing the condition.

From our experience with athletes, we have found that landing on your forefoot with your foot in front of your body is a likely technique-related cause for Plantar Fasciitis. Often runners make the mistake of intentionally trying to land on their forefoot or midfoot when they are running. This causes dropping of the forefoot but a stiffening of the foot, which quickly overloads the plantar fascia, calf muscle and Achilles tendon.


Research suggest that ideal landing is when your foot lands close under your body/hips and for your foot to be relaxed when it lands. However, if you run in cushioned, well supported shoes then you are more likely to contact the ground heel first (heel-striking). As long as your foot is under your body, then the impact and stress on the PF is significantly reduced compared to landing with the foot in front of the body. Now we know the cause, let’s look into the question you really want to know….


How do you fix it!

You might have tried a combination of orthotics, massage, new shoes, plantar specific stretching, complete rest from exercising or a number of other popular recommendations found on Doctor Google. These interventions will provide some relief but there are a high percentage of you that will still have symptoms for up to 2 years after your initial diagnosis. If those approaches haven’t worked, then it’s time to try something different: Progressive loading.


Recent evidence suggests that high load strength training has been placed superior to that of PF stretching in improving heel pain. Progressive loading strengthens the PF, connective tissue and foot muscles. Book an appointment with your physiotherapist to begin loading at an optimal range for you (every case is different and you might delay recovery if you load too heavy too soon). A usual starting point will begin with heel raises.


Toe Elevated Heel Raises

Place a rolled-up towel under the toes to stretch the PF, especially at the top of the heel raise. Start the exercise with both feet and then progress to one if that’s too easy. To decrease the risk of symptoms flaring, start loading with 12 repetitions for 3 sets and gradually work down to 8 repetitions for 5 sets.

Each heel raise should consist of a three-second concentric phase (going up) and a three second eccentric phase (coming down) with a 2 second isometric phase (pause at the top of the exercise). They need to be performed slowly and completed every day. To progress the load you can wear a backpack with books which will then involve decreasing the amount of reps but increasing the sets.


It is common to experience mild pain when completing this exercise. However, pain should be no higher than 3 on a 10 scale (10 being the worst pain imaginable). If you have a flare up in pain don’t stress, you may have over worked it. Next time adjust your reps, sets or weight.


Some individuals are lucky enough to continue running whilst rehabbing their PF, but others may need to cease training for a short while. Check in with your physiotherapist today to see what will work best for you in giving you the quickest reduction in pain.

Carbohydrates – friend or foe?

Carbohydrates – friend or foe?

In case you haven’t noticed, low-carb diets are all the rage these days. Popular diets such as Paleo and Keto have heightened the misconception that all carbohydrates are bad and should be avoided at all costs. But are carbohydrates really the enemy, or could excluding them from your diet be detrimental to your long-term health?

Carbohydrates = Fuel !!

Carbohydrates are the most important energy source for your body and the reality is your body needs them to function optimally.

Carbohydrates in the food that we eat are broken down into smaller sugars (glucose) and used as fuel – even the simple task of breathing relies on this fuel source. Any unused glucose is then stored in the muscle in the form of glycogen for future use. Our body recruits this stored carbohydrate during exercise or whenever glucose levels in the blood are low.

It is therefore no surprise that a low carbohydrate diet can result in low energy levels as well as fatigue and delayed recovery from exercise. In addition, the brain depends solely on carbohydrates – it is unable to used stored energy. As a result, low-carbohydrate diets may also adversely impact cognitive function and mood.


Carbohydrates are a major source of dietary fibre and as a population we are far from meeting the recommended intake of 30g per day. Fibre is essential for our digestive health. It helps you feel fuller for longer, can improve cholesterol and blood sugar levels, and can assist in preventing a number of diseases. Considering its importance, avoiding carbohydrate foods rich in dietary fibre is not a good idea.

All carbs are not created equal

Not all carbohydrates are equal when it comes to nutrition. Eating the right type of carbohydrates, in appropriate amounts for your individual requirements, is definitely worth incorporating in your diet.

Complex carbohydrates such as those found in whole-grains, legumes, fruit and vegetables are digested slowly and released into the blood stream gradually. They are also packed with dietary fibre and have important vitamins and minerals adding to their value. Including a serve of these carbohydrates in main meals is advisable. Some examples include:



Whole-grain bread



Brown rice

Starchy vegetables such as sweet potato


Simple carbohydrates on the other hand are often refined and stripped of fibre. They are digested quickly and can cause a rapid spike and then drop in your blood sugar levels. While all foods can have a place in a healthy diet, limiting simple carbohydrates is recommended. Simple carbohydrates can be found in:

Refined breakfast cereals

White bread

Brown or white sugar

Fruit juices – particularly concentrate

White rice

Flavoured yoghurt


Soft drinks

Getting portions right

Carbohydrate requirements vary considerably and some individuals do indeed eat too much. A good starting point is to include a fist sized portion or ½ cup cooked complex carbohydrate with your main meals. Remember, this portion will need to be increased significantly for some – particularly those exercising regularly.

While there is no best diet for everyone, a restrictive way of eating is usually not the right path for most. Low- carb diets such as Paleo and Keto – that promise fast weight loss – can seem attractive but their effectiveness and safety long term is unknown.

Our dietitians can help you find a carbohydrate balance and plan that will work best for your individual needs. To make an appointment call us on 8068 5158 or book online