Redfern Physiotherapy & Sports Medicine

Nutrition to Support Injury Recovery

Tue, 07 Apr 2026 04:11:03 GMT

Nutrition to Support Injury Recovery

When you’re dealing with an injury, it’s easy to focus only on rest and rehab. But what you eat during this time can have a huge impact on how well and how quickly your body recovers.

One of the most important things to understand is that recovery is an active process. Your body is working hard to repair tissue, manage inflammation, and maintain muscle mass. This means your nutrition needs to support that process, not work against it.

Start with an anti-inflammatory approach

During injury, following an anti-inflammatory style of eating can help support recovery. This often looks like a Mediterranean-style diet, with a strong focus on whole, plant-based foods and plenty of colour on your plate.

Aim to include at least 5–6 serves of vegetables and 2 serves of fruit each day. Think variety. Different colours provide different nutrients, so a good rule of thumb is to aim for at least 3 colours at each meal. If your plate is mostly beige, it’s likely missing key nutrients.

Base your meals around:

Extra virgin olive oil as your main fat source (aim for around 3 tablespoons per day)
Oily fish like salmon or sardines 2–3 times per week
Nuts and seeds daily
Legumes 3–4 times per week
Lots of veggies

At the same time, try to limit ultra-processed foods, red and processed meats, and alcohol, as these can contribute to inflammation and may slow recovery.

Don’t underfuel

One of the most common mistakes during injury is unintentionally eating too little. Even if your activity levels have reduced, your body still requires adequate energy to heal. This is not the time to be in a calorie deficit or focus on weight loss. Undereating can delay recovery, increase fatigue, and contribute to muscle loss. It can also be a vulnerable time for disordered eating patterns, particularly for those used to training regularly.

Carbohydrates are still important

Carbohydrates are your body’s preferred source of energy and play a role in both physical and mental performance. Rather than cutting them back, focus on quality.

Include whole grain options such as oats, whole grain bread, and brown rice. These provide fibre and support gut health, which can be particularly important if you’re taking pain medications.

Prioritise protein

Protein plays a key role in tissue repair and maintaining muscle mass during periods of reduced activity.

Aim for protein intake, spread evenly across the day. Including around 20–40g of protein every 3–4 hours can help support muscle preservation. Focus on high-quality sources such as meat, chicken, fish, eggs, and dairy, or suitable alternatives.

Include healthy fats

Healthy fats are important for managing inflammation and supporting overall health. Including a source of fat at each meal, such as olive oil, avocado, nuts, or seeds, can also help with satiety and meeting energy needs.

Lifestyle factors matter too

Recovery isn’t just about food. Sleep and lifestyle habits play a key role as well.

Aim for 7–9 hours of quality sleep each night, as this is when much of the body’s repair work takes place. Limiting caffeine after midday, reducing screen time before bed, and avoiding alcohol can all support better sleep and recovery.

Alcohol in particular can negatively impact healing by increasing inflammation, disrupting sleep, and interfering with muscle repair.

The bottom line

Injury recovery is not the time to restrict or overhaul your diet. It’s about going back to basics and doing them well.

Focus on eating enough, including a variety of whole foods, and building balanced meals consistently. These small, simple habits can make a significant difference in how your body heals and how you feel during the process.

What Causes Bone Stress Injuries? Risk Factors Explained by Sports Physios

Mon, 29 Sep 2025 07:00:32 GMT

What Causes Bone Stress Injuries?

Bone stress injuries (BSIs), often referred to as stress fractures, occur when repetitive loading on a bone exceeds its ability to remodel and recover. These injuries are common among runners, athletes, military recruits, and active individuals who rapidly increase training loads.

At Redfern Physiotherapy and Sports Medicine, we regularly treat athletes and everyday runners with BSIs. Understanding the risk factors behind bone stress injuries is essential for prevention, early diagnosis, and effective rehabilitation.

What is a Bone Stress Injury?

A bone stress injury develops when tiny amounts of microdamage accumulate in the bone faster than the body can repair them. If not managed, this can progress to a stress fracture, a visible crack in the bone that requires longer recovery.

These injuries most often affect weight-bearing bones, including the tibia, fibula, metatarsals, femur, and pelvis.

Intrinsic Risk Factors (Within the Body)

Intrinsic factors are linked to an individual’s biology and biomechanics.

1. Bone Health and Density

Low bone mineral density (BMD) and osteoporosis increase susceptibility.
Conditions such as Relative Energy Deficiency in Sport (RED-S) or the female athlete triad (low energy intake, menstrual dysfunction, low BMD) are major contributors.
A 2023 review found athletes with RED-S had up to 3x greater risk of developing BSIs.

2. Sex and Hormonal Status

Females have a higher incidence, particularly in endurance sports.
Menstrual irregularities and low oestrogen levels reduce bone repair capacity.
Oestrogen plays a crucial role in bone metabolism and remodelling.

3. Anatomical and Biomechanical Factors

Foot arch morphology: both flat feet (pes planus) and high arches (pes cavus) alter force distribution.
Leg length discrepancies or alignment issues (e.g., knock knees, hypermobility).
Muscle weakness, especially in hip stabilisers and calves, can create compensatory loading.

4. Previous Injury

Athletes with a history of BSIs or lower-limb injuries are more likely to experience recurrence due to lingering biomechanical deficits.

Extrinsic Risk Factors (Training & Environment)

Extrinsic factors relate to the external stresses placed on the body.

1. Training Load and Intensity

Rapid increases in training volume, frequency, or intensity are the leading cause of BSIs.
A 2022 meta-analysis found runners who increased weekly mileage by >10% were 2.5x more likely to develop BSIs.
Physiotherapist-guided load management plans can reduce this risk.

2. Training Surfaces and Footwear

Hard or uneven surfaces increase impact.
Worn-out or unsupportive shoes raise loading stress.
Sports physios can provide running gait assessments and footwear recommendations.

3. Nutrition and Recovery

Inadequate calcium, vitamin D, and protein intake negatively impacts bone health.
Vitamin D deficiency has been linked with higher BSI risk in military populations.
At Redfern Physio, clients are also able to book in with our in-house dietitian, who can provide tailored nutrition strategies to support bone strength, energy availability, and recovery.
Poor sleep and insufficient recovery time further impair repair processes.

4. Environmental and Psychological Stressors

Psychological stress and elevated cortisol interfere with bone turnover.
High-altitude or cold-weather training may also increase susceptibility.

How Risk Factors Interact

Bone stress injuries rarely result from a single cause. Instead, it’s usually a combination of intrinsic and extrinsic factors. For example:

A female runner with irregular periods (intrinsic) who rapidly ramps up her mileage (extrinsic) has compounded risk.
Poor biomechanics plus inappropriate footwear amplifies strain, often leading to shin pain, stress fractures, or long-term rehab needs.

How Physiotherapy and Nutrition Help Manage and Prevent BSIs

At Redfern Physio, our multidisciplinary team offers:

Early diagnosis of BSIs using clinical assessment and imaging referrals.
Load management plans to gradually build training volume.
Strength programs targeting hips, calves, and core for better load distribution.
Nutritional support with our in-house dietitian, focusing on calcium, vitamin D, protein, and fuelling strategies to prevent RED-S.
Footwear and running assessments to correct biomechanical issues.

Key Takeaway

Bone stress injuries result from the interplay of biological vulnerabilities and training errors. Recognising modifiable risk factors like training load, footwear, nutrition, and recovery can dramatically reduce risk.

If you’re experiencing persistent bone pain or preparing for events like the Hoka Half Marathon, early intervention is essential.

Book a consultation with our sports physio team and dietitian in Redfern today to prevent injury, improve performance, and recover stronger.

The Best Ways to Reduce the Risk of Developing Bone Stress Injuries

Mon, 29 Sep 2025 07:00:29 GMT

Best Ways to Reduce the Risk of Developing Bone Stress Injuries

Bone stress injuries (BSIs), or stress fractures, are common overuse injuries that pose a significant challenge to athletes and active individuals. Preventing these injuries is paramount to maintaining performance and long-term musculoskeletal health. This blog post synthesises the latest high-quality evidence and systematic reviews to provide practical, evidence-based strategies to reduce the risk of BSIs.

Our sports physios , massage therapists and dietitians see first-hand how bone stress injuries impact athletes at all levels. By combining careful load management, nutritional guidance, and strength training, an experienced physio can help reduce risk and keep athletes performing at their best.

Understanding Bone Stress Injury Risk

Before prevention, it’s important to remember that BSIs develop when repetitive mechanical loading outpaces the bone’s ability to repair and remodel.

Effective prevention targets both intrinsic and extrinsic risk factors. Many patients benefit from working with a sports physiotherapist who can identify these risks and tailor an injury prevention program.

1. Gradual and Structured Training Load Progression

One of the strongest modifiable risk factors is a rapid increase in training volume, intensity, or frequency.

Evidence: Multiple cohort studies and meta-analyses confirm that increasing weekly mileage or training load by more than 10% substantially raises BSI risk.
Practical approach: Employ the “10% rule” - do not increase running or training load by more than 10% per week.
Periodisation: Incorporate rest weeks and taper phases to allow bone remodelling.
Monitoring: Use wearable devices or training logs to track load and detect risky spikes.

Physiotherapists often guide training load progression to help athletes avoid overload while still improving fitness.

2. Optimise Nutrition and Energy Availability

Adequate nutrition is fundamental to bone health and injury prevention.

Calcium and Vitamin D: Both are critical for bone mineralisation. Systematic reviews link vitamin D insufficiency to increased stress fracture rates.
Energy availability: Maintaining sufficient caloric intake relative to expenditure prevents RED-S and supports hormonal balance.
Protein: Adequate protein intake supports tissue repair and bone remodelling.
Practical tips: Encourage balanced diets rich in dairy or fortified alternatives, leafy greens, and consider supplementation if deficiencies are identified.

At Redfern Physio, our dietitian works alongside physiotherapists to ensure athletes fuel correctly for performance, recovery, and long-term bone health.

3. Correct Biomechanical and Anatomical Issues

Addressing biomechanical risk factors reduces localised bone stress.

Gait analysis: Identifies abnormal loading patterns such as overpronation or excessive impact forces.
Footwear: Select appropriate shoes based on foot type and activity demands. Replace worn-out footwear regularly.
Orthotics: Custom or prefabricated orthoses can improve load distribution, especially in those with structural abnormalities.
Strength training: Target hip abductors, calf muscles, and foot intrinsic muscles to improve shock absorption and movement mechanics.

An experienced physiotherapist can assess movement patterns, provide tailored strengthening, and recommend orthotics where needed to reduce BSI risk

4. Incorporate Strength and Conditioning Programs

Beyond endurance and sport-specific training, strength conditioning plays a protective role.

Muscle strength: Stronger muscles absorb impact forces, reducing bone loading.
Balance and proprioception: Enhances neuromuscular control and reduces injury risk.
Evidence: Recent RCTs show strength programs reduce stress injury incidence by improving movement quality.
Program design: Include weight-bearing resistance exercises, plyometrics, and neuromuscular training progressively.

Athlete physiotherapy programs often combine strength training with mobility work to build resilience against bone stress injuries.

5. Ensure Adequate Recovery and Sleep

Bone remodelling occurs during rest periods; inadequate recovery delays repair.

Sleep: Poor sleep quality or duration is associated with increased injury risk.
Rest days: Schedule regular rest or low-impact activity days.
Cross-training: Utilise low-impact activities like swimming or cycling to maintain fitness while reducing bone stress.

Recovery strategies are often guided by physiotherapy programs tailored to an athlete’s workload , ensuring balance between training and rest.

6. Manage Hormonal Health and Screening

Hormonal health is particularly important for female athletes, but relevant for all.

Menstrual health: Monitor for irregularities; early intervention for amenorrhea is critical.
Bone density testing: Consider in athletes with risk factors or recurrent BSIs.
Referral: Collaborate with dietitians or medical professionals for RED-S or osteoporosis.

Our clinic offers both sports physio and dietetic support , helping athletes address underlying risk factors that influence bone health.

7. Environmental and Equipment Considerations

External factors also contribute to injury risk.

Train on softer surfaces when possible, especially during high-intensity phases.
Use shock-absorbing insoles or surface modifications for hard or uneven terrain.
Be mindful of environmental factors such as temperature and altitude.

Preventing bone stress injuries requires a multifaceted approach targeting training practices, nutrition, biomechanics, and recovery.

At Redfern Physio, our team of sports physiotherapists and dietitians work together to provide evidence-based prevention and rehabilitation strategies. Through careful load management, nutritional optimisation, strength conditioning, and proactive screening, athletes can reduce their risk of injury and improve long-term performance.

Whether preparing for a marathon, returning from an overuse injury, or looking to prevent conditions such as Achilles heel pain or groin injuries, working with an expert physio ensures you can keep training, competing, and moving well.

Five Methods to Manage Plantar Fasciitis

Wed, 17 Sep 2025 08:52:07 GMT

Five Methods to Manage Plantar Fasciitis

BASED ON LATEST EVIDENCE

Plantar fasciitis (PF) is one of the most common causes of heel pain, particularly in runners, people who are overweight, and those whose jobs require prolonged standing. It is characterised by degeneration and microtears in the plantar fascia, a thick band of connective tissue that supports the arch of the foot. Patients typically report sharp, stabbing pain near the heel, often worse in the morning or after prolonged periods of inactivity.

This blog explores five gold-star management strategies based on recent systematic reviews and randomised controlled trials (RCTs), providing an evidence-based approach for exercise physiologists, physiotherapists and patients alike.

1. Calf and Plantar Fascia Stretching

Stretching remains one of the first-line treatments for PF, and recent literature continues to support its efficacy. A Cochrane review (2021) and several individual RCTs confirm that both calf muscle and plantar fascia-specific stretching improve pain and functional outcomes.

Stretching helps relieve tension on the fascia and improve dorsiflexion range of motion, which may reduce tissue stress during gait.

Best Practice: Stretch the plantar fascia by pulling the toes back while seated (3 times/day, 3 reps of 30 seconds). Calf stretches against a wall should also be incorporated.
Evidence: DiGiovanni et al. demonstrated superior outcomes with specific plantar fascia stretches over Achilles tendon stretching in patients with chronic PF.

A long-term stretching program (min 8 weeks) is more likely to yield sustained relief. Combining static and dynamic stretches into a morning routine can also improve first-step pain.

2. Foot Orthoses

Foot orthoses, whether prefabricated or custom, are effective in redistributing plantar pressures and reducing strain on the fascia. They are particularly useful for patients with flat feet or overpronation.

Short-Term Benefits : Prefabricated orthoses have shown significant short-term relief in pain over 6–12 weeks, according to a 2022 meta-analysis in the Journal of Foot and Ankle Research .
Long-Term Use : Orthotics should be used as part of a broader management strategy and not as a standalone solution.

A 2023 review indicated that although custom orthoses may offer slightly better long-term outcomes, they are not significantly superior to high-quality prefabricated options, making the latter a cost-effective choice. Many patients also benefit from combining orthotics with remedial massage or sports physiotherapy.

3. Shockwave Therapy (ESWT)

Extracorporeal Shockwave Therapy (ESWT) is increasingly used for chronic cases (symptoms >6 months) that have not responded to conservative treatment. It works by delivering mechanical energy to the affected area, promoting neovascularisation and stimulating tissue repair.

Effectiveness: A 2020 systematic review found ESWT significantly improved both pain and function compared to placebo, especially when used alongside exercise therapy.
Types: Radial and focused ESWT both have evidence, though focused shockwaves may penetrate deeper.
Caveat: Multiple sessions are usually needed, and results may take several weeks to become noticeable.

Clinicians need to ensure appropriate patient selection - those with recalcitrant PF and failed conservative care are the best candidates.

4. Low-Dye Taping and Kinesiology Taping

Taping techniques, particularly Low-Dye taping, are effective short-term interventions to reduce load on the plantar fascia and alleviate pain. Kinesiology taping is less rigid but still provides some support and proprioceptive feedback.

Application: Taping is most beneficial during high-load periods (e.g., work shifts, sports participation).
Research: A 2021 systematic review confirmed temporary improvements in pain scores with taping lasting up to 7 days.

Taping can also act as a diagnostic tool - if patients improve significantly, it indicates load reduction strategies will be effective.

Many patients combine taping with massage or physiotherapy services such as those available in Marrickville, Surry Hills, or Redfern to support plantar fasciitis recovery.

5. Foot Intrinsic Muscle Strengthening

The role of the foot's intrinsic muscles in maintaining arch integrity is increasingly recognised. Strengthening these muscles reduces overload on the fascia and improves dynamic foot control.

Exercises: Include towel scrunches, marble pickups, toe spreads, and short-foot exercises.
Evidence: A 2023 RCT found that intrinsic foot strengthening improved arch height and pain scores when added to traditional treatment.

Progression from isometric holds to dynamic balance challenges (e.g., single-leg stance with perturbation) can further enhance outcomes. Many sports physios combine this with Pilates-based physiotherapy or tailored exercise programs.

Integrative Treatment Planning

The most effective treatment plans combine several of the above strategies and adapt based on symptom chronicity, patient activity levels, and comorbidities (e.g., diabetes, obesity).

Here's a suggested 8–12 week plan:

Weeks 1–4: Emphasise stretching, taping, & education on load management.
Weeks 4–8: Introduce strengthening and orthoses. Consider ESWT if pain persists.
Weeks 8–12: Progress strengthening, reduce reliance on passive supports.

Rehabilitation should also address proximal control. Weakness in the glutes or poor single- leg mechanics can perpetuate excessive pronation. Physiotherapists and exercise physiologists can assist in assessing these movement patterns.

Additional Considerations

Load Management: Gradually return to high-impact activities. Use pain as a guide.
Footwear: Supportive shoes with arch support and cushioning are essential.
Manual Therapy: Soft tissue release of the plantar fascia and calf muscles can complement active therapy. Massage services in areas such as Marrickville, Redfern, or Alexandria are often used in conjunction with physiotherapy.
Education: Address beliefs about pain—fear avoidance and catastrophizing are associated with worse outcomes.

While no single treatment works universally, a tailored plan incorporating stretching, orthoses, strengthening, and possibly shockwave therapy can significantly reduce symptoms and restore function. Early intervention, patient education, and combined care from physiotherapists and exercise physiologists are key to preventing chronicity and recurrence.

The Latest in ACL Rehabilitation

Tue, 16 Sep 2025 08:52:09 GMT

The Cross Bracing Protocol Explained: The Latest in ACL Rehabilitation

Anterior cruciate ligament (ACL) injuries are among the most common and impactful injuries in sports medicine. Traditionally, ACL ruptures—especially complete ones—were considered irreparable and almost always managed surgically in active individuals. However, recent developments in bracing protocols have reopened the door to non-operative management, particularly for proximal ACL tears. The Cross Bracing Protocol (CBP) is one such innovation drawing attention in physiotherapy and orthopaedics.

This post explores the rationale behind the CBP, the evidence supporting it, how it works in practice, and key considerations for physiotherapists involved in early to mid-stage rehabilitation.

What is the Cross Bracing Protocol?

The Cross Bracing Protocol is a non-surgical approach developed primarily to treat proximal ACL tears—those close to the femoral attachment of the ligament. The protocol uses immobilisation in knee flexion (usually between 60–90 degrees) for a defined period, aiming to bring the torn ends of the ACL into close proximity to facilitate natural healing.

It challenges the long-held assumption that a ruptured ACL cannot heal and must be reconstructed. Instead, CBP posits that under the right mechanical conditions (reduced tension and improved ligament contact), biological healing is possible—similar to how MCL injuries often heal without surgery.

The Science Behind Ligament Healing

The idea that ACLs cannot heal stems from early studies that didn’t control for limb positioning or stability post-injury. However, we now understand that:

Proximal ACL tears have better vascularity and cellular potential to heal.
Immobilisation in flexion reduces tension across the ACL, preventing retraction of the torn stump.
Mechanical stability (e.g., from bracing) is critical to allow bridging tissue to form.

A 2022 study by Murray et al. in The American Journal of Sports Medicine found that spontaneous healing of the ACL is possible in selected cases, particularly with bracing and early rehab supervision. From an exercise physiologist or sports physio.

Evidence Supporting the Cross Bracing Protocol

Several key studies and case series have explored the efficacy of CBP:

Blachut et al. (2021, AJSM): In a case series of 80 patients with proximal ACL ruptures, over 70% showed MRI-confirmed healing at 12 weeks with CBP, and many returned to pre-injury levels of sport within 6–9 months.
Burgi et al. (2023): Found that the healing ligament, although slightly different structurally from the native ACL, had sufficient continuity and functional stability for high-level sport participation.
Systematic review (2024, Sports Med): Concluded that CBP is promising for selected patients and may reduce unnecessary surgeries in well-screened populations.

While the sample sizes remain modest and follow-up periods limited in some cases, the preliminary outcomes are compelling for those working with athlete physiotherapy services and sports rehabilitation centres such as Sports Lab Alexandria..

Who is Suitable for Cross Bracing?

Ideal candidates meet the following criteria:

Acute, proximal ACL rupture, confirmed on MRI
Minimal or no concomitant meniscal damage requiring repair
No significant instability on initial manual testing when knee is braced
Strong patient adherence and motivation

CBP is not suited to mid-substance or distal ACL tears, or to individuals with significant rotational instability. It also requires access to imaging and specialist review for ongoing monitoring – typically guided by an exercise physiologist or experienced physiotherapists in clinics like Marrickville Physio or Erko Physio.

Phases of the Cross Bracing Protocol

The protocol typically unfolds over 12–14 weeks and consists of the following phases:

Phase 1: Immobilisation in Flexion (Weeks 0–4)

Position: Knee is braced at 90° flexion
Goals: Promote ACL stump approximation and biological healing
Intervention: Isometric quadriceps, hamstring co-contractions, hip strength maintenance, ankle pumps

Phase 2: Controlled Extension (Weeks 4–8)

Gradual extension (10–15° per week) introduced via adjustable brace
Continued quadriceps and hamstring activation
Partial weight-bearing may begin by week 6
MRI at week 6 often used to assess healing

Phase 3: Full Range and Load Reintroduction (Weeks 8–12)

Brace removed around week 10–12 if healing is confirmed
Focus on normalising gait, increasing strength, and proprioceptive training
Begin cycling, bodyweight exercises, and balance drills

Phase 4: Return to Sport Prep (Weeks 12–24+)

Progressive return to cutting, jumping, and sport-specific tasks
Formal hop testing, Y-balance, and isokinetic testing to confirm readiness

Physiotherapist’s Role in CBP

The role of the physiotherapist is central throughout the CBP:

Monitoring adherence: Bracing must be consistent. Poor compliance can disrupt healing.
Progressive loading: The transition from isometric to dynamic exercise must be based on both clinical progress and imaging.
Neuromuscular retraining: Emphasise hamstring and hip strength to reduce anterior tibial translation forces.
Gait correction: Monitor for compensations during reintroduction of walking and jogging.

This is where collaboration between elite physiotherapists, remedial massage practitioners, and exercise physiologists becomes invaluable. Many patients also complement their program with remedial massage services, such as those located in Marrickville, Redfern Sydney, or Alexandria to assist with pain relief, flexibility, and circulation during rehab.

Limitations and Controversies

Despite its promise, CBP is not without criticism:

Limited long-term data: Most studies report outcomes up to 12–24 months; re-tear rates long-term remain unknown.
Lack of randomised trials: Most evidence is observational or from case series.
Risk of stiffness: Especially if knee is immobilised in flexion too long without adequate rehab.

Some sports physicians argue that delaying surgery in non-responders may increase meniscal or chondral damage, especially in high-risk sports. This is why close collaboration with sports physiotherapists or massage and physiotherapy services is critical to ongoing management.

Conclusion

The Cross Bracing Protocol represents a shift in how we view ACL management. For select patients, particularly those with proximal tears—it offers a chance to heal without surgery, potentially reducing downtime, costs, and surgical risk. However, it demands careful patient selection, close monitoring, and a highly engaged rehab process.

As the evidence base grows, physiotherapists, exercise physiologists, and sports physios are in a pivotal position to guide patients through this novel approach with a combination of structured rehabilitation, progressive loading, and functional testing.

The Latest Physiotherapy Evidence for Knee Osteoarthritis

Tue, 16 Sep 2025 08:52:02 GMT

The Latest Physiotherapy Evidence

for Knee Osteoarthritis

Knee osteoarthritis (OA) is a highly prevalent musculoskeletal condition and a leading cause of pain and disability among adults over 50. It involves progressive degeneration of the articular cartilage, changes in subchondral bone, and inflammation of the synovial membrane. Symptoms typically include joint pain, stiffness, swelling, and reduced mobility.

Traditionally managed with pharmacological and surgical approaches, there has been a growing emphasis on physiotherapy-led interventions grounded in high-quality evidence. Let’s explore the most effective physiotherapy strategies based on the latest systematic reviews and clinical guidelines used by elite physiotherapists and exercise physiologists.

1. Exercise Therapy

Exercise remains the cornerstone of OA management, supported by nearly every major guideline globally (NICE, EULAR, ACR, RACGP). Its benefits extend beyond symptom relief—exercise improves joint function, promotes cartilage health through mechanotransduction, reduces inflammation, and supports weight management.

Types of beneficial exercises:

Aerobic exercise (e.g., walking, cycling, swimming): improves general conditioning and joint lubrication.
Strength training: especially targeting the quadriceps and gluteal muscles to support knee alignment and reduce joint load.
Neuromuscular training: enhances joint proprioception and dynamic stability.
Flexibility and range of motion (ROM) exercises: counteract stiffness and maintain functional mobility.

Evidence: A 2022 Cochrane review concluded that land-based therapeutic exercise provides moderate improvements in pain and function. Meta-analyses have shown strength training to be particularly effective, especially when supervised.

Practical advice:

Start with low-impact aerobic work and isolated strength training.
Progress to functional, closed kinetic chain exercises (e.g., sit-to-stands, step-ups).
Aim for 3+ sessions per week, sustained over at least 12 weeks.

2. Weight Loss and Load Management

Obesity is a well-established modifiable risk factor for both the onset and progression of knee OA. Weight loss reduces the mechanical load on the joint—every 1 kg of weight loss equates to ~4kg of load reduction per step on the knee joint.

Combined intervention: The IDEA trial (2013) demonstrated that combining weight loss with exercise improved pain and function more than either alone. Patients who lost ≥10% of body weight showed the greatest symptom relief.

Key load management strategies:

Limit deep squats and high-impact activity initially.
Encourage cycling or hydrotherapy for cardiovascular fitness without joint strain.
Assess footwear and consider cushioned or rocker-bottom soles.

Many patients seek advice from Move Physiotherapy or exercise physiology programs to support safe weight loss alongside rehab.

3. Manual Therapy: Adjunct, Not a Standalone

Manual therapy techniques, such as joint mobilisation and soft tissue remedial massage, may provide short-term pain relief and reduce stiffness. They can enhance patient comfort and facilitate movement, especially early in rehabilitation.

Evidence: A systematic review in JOSPT (2021) found manual therapy to be more effective when combined with exercise. However, the benefits are modest and short-lived if used in isolation.

Best practice involves using manual therapy, such as remedial massage services offered in the Marrickville, Alexandria, and Redfern clinics, to enable participation in more active treatments.

4. Bracing, Taping, and Assistive Devices

Unloader knee braces and kinesiology taping can help redistribute joint forces and improve alignment. Walking aids, like canes or trekking poles, can offload the affected limb and increase confidence.

Taping: McConnell taping can help align the patella and reduce pain, though evidence is mixed.
Bracing: More effective in unicompartmental OA, especially medial knee OA.
Assistive devices: Should be individually prescribed and introduced with proper instruction.

5. Patient Education and Self-Management

Empowering patients with knowledge is essential. Misbeliefs—such as the idea that walking worsens joint wear or that OA inevitably leads to surgery—can drive fear-avoidance and inactivity.

Educational topics should include:

The benefits and safety of exercise.
Pain neuroscience and flare-up management.
Weight control and nutrition.
Joint protection strategies.

Digital tools: Mobile apps, online exercise videos from physio Pilates or exercise physiologists, and self-monitoring platforms can increase adherence and autonomy.

6. Electrotherapy and Other Modalities

While not first-line, certain modalities may be useful adjuncts in specific cases:

TENS (Transcutaneous Electrical Nerve Stimulation): May provide temporary pain relief.
Ultrasound: Lacks strong evidence and is not routinely recommended.
Cryotherapy or heat: Can assist in symptom management before or after activity.

Their use should not replace exercise but can support engagement in active rehab.

7. Group Programs and Multidisciplinary Models

Programs such as GLA:D (Good Life with osteoArthritis: Denmark) have shown significant benefits by combining education and neuromuscular exercise in a group setting.

Results: Large reductions in pain, improved function, and delayed surgical consideration.
Structure: Typically includes 12 exercise sessions and 2 education classes over 6–8 weeks.

Participation in group-based rehab run by exercise physiologists, physios, and remedial massage providers, fosters social support, accountability, and motivation—key components of long-term success.

8. When to Refer for Surgery?

Surgery (e.g., total knee replacement) may be considered when:

Pain significantly limits daily activities despite conservative management.
Functional decline persists beyond 6 months.
Radiological findings align with symptoms (though X-ray alone should not drive decision-making).

Even when surgery is likely, prehabilitation with sports physiotherapy services improves postoperative outcomes.

Conclusion

Physiotherapy plays a central, evidence-backed role in the management of knee OA. The combination of therapeutic exercise, education, load management, and behavioural support can significantly improve patient outcomes. Tailoring the program to each individual—considering their goals, comorbidities, and preferences—is essential. With the right approach, many patients can delay or avoid surgery and lead a more active, pain-free life.

Special Considerations for Hamstring Injuries

Thu, 03 Aug 2023 06:47:03 GMT

Hamstring Injuries

Hamstring injuries are a common injury among athletes, particularly those involved in sports that require sudden changes of direction, explosive acceleration, and high-speed running. Rehabilitation after a hamstring injury can be a challenging process, and it is essential to understand the special considerations involved in the rehabilitation process to ensure optimal outcomes.

The latest evidence has shown hamstring injuries require assessment and treatment of multiple areas of the body such as lumbopelvic control, posterior chain strength and stability and hamstring strength in a fatigued state. Due to the complex nature of hamstring injuries and their relationship with the aforementioned areas, they have a high recurrence rate.

In this blog, we will discuss the special considerations for hamstring rehabilitation.

The Importance of Early Intervention

One of the most critical special considerations for hamstring rehabilitation is the importance of early intervention. Delaying rehabilitation can prolong the recovery time and increase the risk of re-injury. Therefore, it is essential to initiate rehabilitation as soon as possible after the injury.

Gradual Progression

Another important consideration for hamstring rehabilitation is the need for gradual progression. It is crucial to progress rehabilitation exercises slowly and steadily, focusing on regaining strength, flexibility, and mobility while avoiding overloading the hamstring muscles.

Eccentric Exercises

Eccentric exercises are particularly effective for hamstring rehabilitation. These exercises involve lengthening the muscle while it is under tension, which helps to promote muscle fibre remodelling and healing. Eccentric exercises can also help to improve muscle strength and reduce the likelihood of recurrence.

Sports-Specific Rehabilitation

Rehabilitation exercises should be tailored to the specific requirements of the athlete's sport. For example, athletes involved in sports that require high-speed running may benefit from incorporating high-speed running drills into their rehabilitation program. This approach can help to improve neuromuscular control, endurance, and power.

How Can High-Speed Running Help with Hamstring Rehabilitation?

The use of high-speed running as a rehabilitation strategy for hamstring injuries is based on the principle of progressive loading. High-speed running involves significant eccentric loading of the hamstring muscles, which can help to stimulate muscle fibre remodeling and improve muscle strength and endurance.

Evidence for High-Speed Running for Hamstring Rehabilitation

Several studies have explored the use of high-speed running as a rehabilitation strategy for hamstring injuries, with promising results. A systematic review published in the British Journal of Sports Medicine evaluated the effectiveness of high-speed running in the rehabilitation of hamstring injuries. The review analysed seven studies with a total of 301 participants.

The review found that high-speed running was effective in improving hamstring strength, running performance, and reducing the risk of re-injury. The review also found that high-speed running did not increase pain or re-injury risk compared to traditional rehabilitation programs.

Another study published in the Journal of Orthopaedic and Sports Physical Therapy evaluated the effectiveness of high-speed running in the rehabilitation of elite soccer players with hamstring injuries. The study found that high-speed running was effective in reducing the time to return to play, improving hamstring strength, and reducing the risk of re-injury.

The Role of Manual Therapy

Manual therapy can also be beneficial for hamstring rehabilitation. Soft tissue mobilisation techniques, such as soft tissue release, can help to improve blood flow, reduce muscle tension, and promote tissue healing. Joint mobilisation techniques around the lumbar spine and pelvis can also help to improve joint mobility, reducing the risk of further injury. This is integral as we work on ensuring the lumbopelvic region is working efficiently to allow the hamstrings to rehabilitate to their full potential.

Psychological Considerations

Recovering from a hamstring injury can be a frustrating and challenging process, and psychological considerations should also be taken into account during rehabilitation. It is common for people to experience the highs and lows of rehab & may benefit from working with a sports psychologist to help them cope with the emotional and psychological challenges of rehabilitation and stay motivated throughout the process. This is also integral for return to sport considerations as it can be a daunting experience after injury. Concerns of re-injury or not being able to perform at their pre-injury level is often felt and thus it is important for people to feel confident and mentally prepared to return to sport following a hamstring injury.

Conclusion

Hamstring rehabilitation requires special considerations to ensure optimal outcomes. Early intervention, gradual progression, eccentric exercises, sports-specific rehabilitation, manual therapy, and psychological considerations are all essential elements of an effective rehabilitation program. It is essential to work with a physiotherapist to develop a personalised rehabilitation program tailored to the athletes specific needs and goals.

Blood Flow Restriction (BFR) Training

Tue, 11 Jul 2023 04:01:25 GMT

Application and benefits during rehab.

Blood flow restriction (BFR) training involves restricting the blood flow to working muscles during exercise, resulting in hypoxia in the muscle tissue. It can be applied to both resistance and aerobic exercise; however, the purpose of this blog is to have a look at the potential benefits of using BFR during resistance-based exercise in rehab.

BFR resistance training has been shown to help increase muscle size and strength in young, old and load compromised populations (including post ACL replacement surgery and people suffering from OA). The greatest benefits of BFR training have been shown to occur during low-load resistance exercise, with some studies showing that muscle hypertrophy and strength adaptions using BFR are significantly greater than those achieved with low load resistance exercise alone.

Benefits of BFR during rehab

After sustaining an injury or having surgery, people will often struggle tolerating heavy loads through the affected area, which can cause an increase in pain during activity, reduce function and impact rehab and recovery timeframes. During rehab for any type of injury, it is important to load and strengthen the muscles around the injured or painful structure, however pain (and injury) can often prevent a person from being able to perform the required exercises (or tolerate the required load during exercise) to actually achieve this increase in strength, which can often lead to slow progression during rehab.

This is where BFR training can be beneficial. BFR training can be used to get the most out of low-load resistance training for load compromised people who can’t tolerate heavy-load training during the early stages of rehab.

Applying BFR training to rehab

As mentioned above, BFR training can be a useful tool when trying to maximise the impact of low-load exercise during rehab. This can often be beneficial when pain/injury is impacting the ability to appropriately load the injured area in order to elicit a change in symptoms. A good example of this presentation in the clinic is during rehab following a patella dislocation or subluxation. The sensitivity and reduced capacity to load the patellofemoral joint after this type of injury can make it hard to perform quadriceps strengthening exercises with adequate load to elicit a meaningful change in strength, which can lead to the development of compensatory strategies and slow progression during rehab. BFR can be used to help overcome this hurdle. Have a look at our Instagram here to see an example of a rehab session using BFR for a client who suffered a patella dislocation.

There are many other types of pain/injury that could benefit from the use of BFR at certain stages of rehab, such as managing OA pain and when recovering from ACL replacement s urgery.

Overall, BFR can be a useful tool to use during certain stages of rehab; but just like all aspects of rehab there is no ‘one size fits all’ approach, so get in contact in you would like to discuss if BFR could be useful for you.

Reference for information

Hughes L, Paton B, Rosenblatt B, Gissane C, Patterson SD. Blood flow restriction training in clinical musculoskeletal rehabilitation: a systematic review and meta-analysis. Br J Sports Med. 2017 Jul;51(13):1003-1011. doi: 10.1136/bjsports-2016-097071. Epub 2017 Mar 4. PMID: 28259850.

Anterior Cruciate Ligament Prehab

Tue, 21 Feb 2023 01:46:56 GMT

ACL Prehab

Injuring your ACL can be overwhelming, often you will be deliberating whether or not to get surgery while coming to terms with the long rehab process ahead. This blog will shed a bit of light on something that everyone should be doing after sustaining an ACL injury; Prehab.

What is ACL Prehab?

ACL Prehab is what is done between tearing your ACL and having surgery/performing rehab. It is the term used for the exercises and training that needs to be performed after sustaining an ACL injury and should be performed even if you are considering not having surgery.

What does ACL Prehab involve?

Prehab involves a block of supervised exercise sessions with a focus on lower body strengthening (particularly the quadriceps and hamstrings), knee mobility and stability/motor control. The timeframes and specific types of exercise will vary between different people, but the goal of prehab remains the same; maximise the chance of returning to your pre-injury level of activity and staying there.

Why is Prehab so important?

Performing a 5-week block of prehab training has been shown to increase the chance of returning to your pre-injury level of sport following an ACL replacement, it has also been shown to significantly improve knee function after ACL injury, regardless of whether you decide to have surgery or not (Eitzen et al, 2010).

Prehab also provides a great opportunity to perform some strength and hop testing, which will be used later in rehab. This testing will provide a good comparison for leg strength and function prior to returning to sport, doing this has been shown to help reduce the risk of reinjury by up to 75% (Capin et al, 2019).

The take home message.

A short block of Prehab has been shown to have a great impact on knee function after ACL injury and will increase the chances of having a good recovery and returning to your chosen sport or activity, regardless of whether or not you require surgery. Everyone who suffers an ACL injury should perform some amount of Prehab; if you have recently injured your ACL and would like to have a chat about Prehab, then get in touch….

Understanding the Low FODMAP Diet

Fri, 12 Aug 2022 01:04:39 GMT

The Low FODMAP Diet

If you suffer from IBS (Irritable Bowel Syndrome), there’s a high chance that you have heard of the low FODMAP diet – you may have even started one and feel better! The low FODMAP diet is broken down into three phases: elimination, reintroduction and personalisation. Understanding these three stages and working through them with a dietitian is key to getting the most out of the diet and controlling your symptoms long-term.

What is IBS?

IBS is a collection of unpleasant symptoms such as abdominal cramping, pain, bloating, diarrhoea and/or constipation. Unfortunately, it affects around one in five Australians at some point. Its cause is often unknown but, in some cases, it can be triggered by gastro or food poisoning. Psychological stress and genetics have also been implicated in the development of IBS.

FODMAPs explained

The low FODMAP diet was a breakthrough for IBS suffers. FODMAPs, stand for Fermentable, Oligosaccharides, Disaccharides, Monosaccharides and Polyols. FODMAPs are a type of carbohydrate found in certain foods that are poorly absorbed in those with IBS. They then act as a food source to bacteria and ferment in the gut causing all those troubling IBS symptoms mentioned.

The 3 Phase of a Low FODMAP Diet

The low FODMAP diet should not be a lifelong diet. Rather it is an investigative tool to work out your IBS triggers so you can make better informed food choices to help you live more comfortably.

Phase 1: Elimination

To be commenced under the supervision of a dietitian, this phase involves eliminating all high FODMAP foods from the diet for a period of 2-6 weeks. Many begin to feel better as early as a few days into the elimination phase, but for some, it can take a few weeks. So, don’t be discouraged! The better you stick to this phase the more accurate the results. Your dietitian will help determine how long you spend in this phase, but it should never be long-term, no matter have great you feel.

Phase 2: Reintroductions (or challenge steps)

This phase involves reintroducing high FODMAP foods back into the diet in a methodical way to determine which trigger symptoms and which do not. It is the most informative phase of the diet and can often produce surprising results! As each FODMAP is reintroduced it is important that your background diet remains low in FODMAPs to ensure an accurate result. A dietitian is crucial during this phase to help interpret your responses. This phase can take 6-8 weeks to complete.

Phase 3: Personalisation

The last phase of the low FODMAP diet involves establishing your longer-term, personalised FODMAP diet. Initially this will involve reintroducing FODMAPs that were well tolerated and avoiding those that triggered your symptoms. Determining your thresholds of those FODMAPs that did trigger symptoms is the final step and important to expand the variety of your diet and allow as much food freedom as possible. Thresholds can change over time too, so if there are FODMAPs you didn’t tolerate well during the challenge steps, try again in a few months and see if anything has changed.

As you can see, the low FODMAP diet is an involved multiphase diet. The end goal is to eat as freely as possible without triggering IBS symptoms.

Help! I’ve got a grumpy shoulder

Mon, 04 Jul 2022 03:10:19 GMT

Shoulder Pain

Last year, I injured my shoulder in COVID-19 lockdown whilst completing a bench press at the gym. Having an injured shoulder caused me to be frustrated and anxious as I was unable to continue with my training program. Being on the ‘other side of the fence’ dealing with an injury highlighted some aspects of recovery which I feel are worth reminding you about!

Shoulder injuries are very common and often are incorrectly prescribed with “rest” and other passive management tools such as cortisone injection to treat the pain and inflammation. However, the root cause of the shoulder pain is often not assessed and treated appropriately, and this predisposes you to getting persistent shoulder pain or a GRUMPY shoulder!

Do any of these common shoulder complaints relate to you?

I get pain in my shoulder:

when I reach out into awkward rotated positions behind me. ‘I have difficulty putting on shirts/clothes overhead or grabbing the seat belt in the car.’
after completing a task (cleaning/gardening/painting) for over an hour (or even less). ‘I avoid doing these tasks because of the pain.’
during certain exercises in the gym. ‘I am frustrated as this stops me working out/ going to the gym and building strength.’
when sleeping on my side through the night. ‘I’ve tried sleeping on my back, but I can’t fall asleep and wake when I roll onto that side.’

My best advice is that you need to listen to your shoulder. Ignoring the pain can lead to persistent symptoms, further weakness and breakdown of tissue, and therefore chronic pain. Many of our clients we see at Redfern Physio have a Grumpy Shoulder for several weeks or months before they present to our practice.

This chronic overload of the shoulder usually causes pain which we labelled as “rotator cuff related shoulder pain”. This incorporates the following:

Rotator cuff tendinopathy or tendinitis
Partial / Full thickness tears of the rotator cuff muscles
Subacromial bursitis
Subacromial or rotator cuff impingement syndrome

Often it is not “just the shoulder” causing pain, but an overload in the muscles around the shoulder blade, mid-back and neck. A thorough physiotherapy assessment will aim to assess the compensatory movement patterns that have caused pain into the shoulder.

What’s our message here? If you experience pain in your shoulder whilst gardening, don’t expect it to improve if you continue to ‘push through’. If you hurt your shoulder at the gym, you will need a minimum of period of reduced intensity of that activity as well as a period of physiotherapy and rehab to get you back to lifting at your best. You must pace yourself back to your normal activities over a period of time, usually several weeks.

I had the most benefit after a physio assessment, which gave me a clear diagnosis with a physiotherapy management plan to work with me on my weakness and reduce my fear of reinjury. I am now able to train without any pain. Next time you come into the clinic, make sure you ask about my story with my shoulder injury!

Muscle Tightness – To Stretch or To Strengthen.

Mon, 04 Jul 2022 03:05:00 GMT

Feeling Tightness: To Stretch or Strengthen?

Feeling “tight” is something we have all gone through in life at some stage. Whether that is after sitting at our work-desks for hours on end and getting a gripping discomfort in our neck or after a hard day training session and feeling like we can’t move our legs properly. You’ve clicked on this blog to find out how to deal with it. But before we do that, we need to take a bit of a dive into what tightness is.

What is Tightness?

Contrary to common belief, tightness is not mechanical but a feeling. It is not the same thing as physical stiffness in a joint or shortness in a muscle causing a decrease in range of movement.

Often, we may see someone come through the door complaining of tightness in their hamstrings after increasing their running; but on physical assessment they are able to touch the floor. And on the flip side of that, there are people who can barely reach past their knees and don’t complain of any feeling of restriction, discomfort or tightness in their hamstrings.

A study by Stanton et al. 2017 hypotheses that back “stiffness” is a “perceptual protective construct” rather than biomechanics. Those who feel stiff, are self-protective; over-estimating forces applied to their spine but also more acute at detecting small changes in force. This perception can be altered with audio input without changing actual stiffness.

This study is much in line with recent Pain Science pioneered by Professor Lorimer Moseley; providing evidence for the fact that pain can exist in the complete absence of physical tissue damage.

Using this study, we can reason similarly that tightness is a protective construct and that when we feel tight, it is our body trying to protect us against the stresses we are placing on it; whether that is sitting for excessively long periods or pushing a Couch to 5 km running program a bit too enthusiastically.

Why Am I Feeling Tight?

The precipitating factors that would have led to your specific individual tightness can only be accurately assessed by a thorough history and objective examination.

However, in a nutshell, feelings of muscle tightness are usually a sign that the loads we are placing on our tissue are exceeding their capacity.

For example, dramatically increasing your running load over a few weeks to prepare for a Marathon or heading back into your first few training sessions after the Off-Season, may cause tightness in certain muscles of the legs. This is a sign that we are doing a little too much and placing ourselves at a much greater risk of injury if you were to continue or increase that work-rate.

On the other hand, you may feel tight after long days sitting at the desk. This is likely due to a lack of endurance in the muscle, inadequate blood flow to them and a build-up of metabolic stress. The feeling of tightness is literally urging you to get moving.

How do I fix tightness?

Given that tightness is a subjective sensation and not reflective of joint stiffness or muscle shortening; all the stretching in the world will not be of much use unless there was in fact a biomechanical restriction.

Resistance Training on the other hand, has been shown to create local adaptations in muscle to improve their endurance and reduce the likelihood of metabolic distress and feelings of tightness.

Furthermore, Resistance Training will increase the load capacity of tissue and minimise the risk of actual injury.

Research has also shown that exercise has an analgesic effect and can reduce Central Nervous System sensitivity.

Next time you are feeling tightness in your upper traps after sitting for too long, try some Shrugs rather than Stretching it out and see how you feel?

“You Can’t Go Wrong, Getting Strong”

For a more comprehensive assessment of all the Contributing Sport, Work and Lifestyle Factors that may be contributing to your tightness; book in with one of our Physiotherapists for a Consultation to identify and address the underlying issues before it turns into Pain.

How To Help Your Shin Splints

Mon, 04 Jul 2022 02:59:57 GMT

What Can I Do to Help My Shin Splints?

What Are Shin Splints?

Shin splints are a common overuse injury characterised by pain along the front of your lower leg near your shin bone. This pain is due to irritation from the overloaded tendons and muscles along the tibia or ‘shin bone’ constantly creating friction and inflammation at their attachment onto the bone.

Shin splints are common among:

Runners
Dancers
Athletes in sports that require a lot of running on hard surfaces (like tennis), or with unsupportive shoes like rugby/football boots

What Causes Shin Splints?

Causes of shin splints include:

extended periods of running on hard surfaces
overexertion of your lower leg muscles
not stretching adequately
stiff and/or weak calf muscles
poorly fitted or worn out footwear
increasing your training loads suddenly
flat feet or high arch feet
weak gluteal muscles, weak foot/ankle stabilising muscles

If you experience pain in your shin area during exercise, we advise that you do not continue as the pain will only be exacerbated, causing it to prolong symptoms and recovery.

How to Prevent Shin Splints

A few tips to help you prevent shin splints include:

Wearing shoes that fit adequately and comfortably
Invest in shoe inserts (orthotics) if you have flat feet or high arches
Consulting your physiotherapist to perfect your running stride
Replace your shoes often
Gradual build up in your training level to prevent injury
Embrace cross-training to avoid overusing the muscles in your lower legs
Be sure to always maintain a good stretching program
Have an adequate dynamic warm-up before any exercise
Strengthen your hips, ankles, and core muscles

How Can My Physio Help Shin Splints?

Getting assessed by a physio will help you understand the condition so that you can better learn how to manage it. During your physio sessions for shin splints, you will likely be treated with:

Lower leg soft tissue releases
Strapping or taping
Strengthening exercises for weak ankles, hips, or core muscles tailored to your individual needs
Self-release techniques and stretches for tight muscles
You will also be given specific advice, tips, and suggestions to help manage the pain and get you on the path to recovery.

While you’re being treated for shin splints by a physio, it is advised you are taking relative rest by reducing or completely stopping the aggravating activity – pushing through the pain will only make things worse!

Shin splints can be very frustrating if you ignore it and fail to get the appropriate treatment. For detailed advice and an individual management program contact our team at Redfern Physio on 8068 5158, or book now by clicking Book an appointment.

5 Healthy Lunch Ideas for Work

Mon, 04 Jul 2022 02:53:12 GMT

5 Healthy Lunch Ideas for Work

Have you found yourself returning to work and slipping straight back into the same boring lunch routine as last year? Or maybe you’ve started relying on takeaway often because you’re lacking inspiration in the kitchen. It can take a while to get back on track with meal prep after a break, so here are 5 delicious and easy lunch ideas for work to help get you started:

The Classic Sandwich

Sandwiches are often overlooked when it comes to healthy lunches, but the fact is, they can be one of the quickest and easiest, balanced meals around. There are plenty of healthy breads to choose from when making a sandwich – wholegrain, sourdough, rye and spelt are all wholegrain options high in fibre and packed with nutrients. As for what goes between the bread, the options are endless! Aim to include the following for a satisfying and nutritious sandwich:

Protein: chicken, canned fish, lean meat, tofu
Vegetables: grated carrot, beetroot, cucumber, tomato, roasted capsicum, baby spinach, shredded cabbage
Healthy spread: nut butter, hummus, cottage cheese, avocado

Healthy Burrito Bowl

Burrito bowls are versatile, tasty and require minimal prep time, making them an ideal work lunch. Using precooked brown rice and canned legumes helps this nutritious meal come together in no more than 5 minutes. Simply add brown rice to a bowl (or multiple containers if meal prepping for the week ahead). Add drained and rinsed legumes, and a variety chopped salad vegetables. Top with some chopped avocado and some grated cheese. Simple as that!

The Ultimate Salad

It is a common misconception that salads are boring, but they don’t have to be! Preparing a salad that is healthy and tasty is possible, and a great option for work lunches during the warmer months. Here are 4 elements to include:

Protein – to keep you feeling nice and full. Choose from chicken, fish, eggs, legumes, tofu or lean red meats and aim to fill ½ of your salad bowl.
Carbohydrates – to boost your intake of fibre and micronutrients and to give you energy too! Opt for wholegrains such as brown rice, quinoa, barley, wholegrain bread.
Vegetables (and fruit) – get creative and colourful to keep it interesting. Spinach, mixed leaves, rocket, grated beetroot, snow peas, mushrooms, shredded cabbage, roasted capsicums, mushrooms, grated apple or even blueberries work wonderfully in salads.
Flavour – think nuts, seeds, hummus, guacamole, olives, sun-dried tomatoes, crumbled feta, fresh herbs and pesto. These are the ingredients to jazz up your salads. Drizzle salads with homemade dressing made with extra-virgin olive oil to avoid added salt and sugar in store-bought varieties.

Rice Paper Rolls

Rice paper rolls are quick and easy to make, and are a great change for the lunchbox, especially when the weather is warm! You can fill them with a huge variety of ingredients. By adding some protein such as shredded chicken breast, prawns, tofu or tempeh they will make a substantial and satisfying lunch. Aim to add plenty of colourful vegetables, and fresh herbs as well as cooked vermicelli rice noodles. A dipping sauce of equal parts fish sauce, sesame oil and soy sauce plus some lime juice and chopped cashew nuts is a delicious addition!

Simple Veggie Frittata

Frittatas are a great way to use up all the leftover vegetables in your fridge at the end of the week and are ideal for work lunches. They can be eaten warm or cold, and are loaded with veg, protein and healthy fats, so are super healthy for you! Simply transfer any cooked and cooled vegetables of your choice into a mixture of whisked eggs and milk. If you have time, roast the vegetables for extra flavour! Pour into a greased pan and bake in the oven until set through. Serve with a slice of wholegrain bread and side salad. Easy and so nutritious.

Food & Mood

Fri, 26 Nov 2021 01:17:00 GMT

Food and Mood

Depression and anxiety are the most prevalent mental health conditions worldwide affecting a large portion of the population. Many aspects of lifestyle are important factors in keeping healthy, both physically and mentally. The relationship between food and mood has gained particular interest recently.

A number of studies have already demonstrated that a good quality diet is important in reducing the risk of mental health disorders. However, the idea of food having the ability to improve mood and clinical outcomes for those with existing depression and anxiety is a relatively new and exciting area of research.

A randomised control trial called the SMILES trial asked this exact question, ‘if I improve my diet , will my mood improve?’ The trial recruited participates experiencing depression symptoms and split them into two groups, a control group and a dietary intervention group. The dietary intervention group were encouraged to follow a Modified Mediterranean Diet, a dietary pattern focused on fruit, vegetables, wholegrains, legumes, nuts, extra virgin olive oil, and fish but including slightly higher intake of red meat than traditional Mediterranean diets. The results showed that those in the dietary intervention group had much greater reduction in depression symptoms than the control group over a 3-month period. A higher percentage also met remission for depression. Put simply, those who improved the quality of their diet experienced the greatest reduction to their depression.

While acknowledging the complex nature of mental health conditions, the SMILES trial shows how certain foods and dietary patterns could indeed affect mental health in a positive way.

So how might you move towards a more Mediterranean-style diet to look after your mental health? Below are some ideas:

Cook with extra virgin olive oil Drizzle it on cooked dishes and use in mashed potato instead of butter.
Eat more fish . Twice a week to start and choose salmon or sardines, all rich in omega-3 fatty acids.
Switch to wholegrains. Brown rice, wholegrain bread, quinoa, barley and oats are all great choices.
Snack on nuts and seeds or add to salads.
Use avocado as a spread instead of butter or margarine or try in a smoothie.
Limit red meat and poultry . Add small amounts or replace with plant proteins such as legumes and tofu.
Enjoy fruit for dessert or snack.
Limit heavily processed food and sugar-sweetened drinks.

All About Ankles: Syndesmosis

Wed, 22 Sep 2021 00:26:00 GMT

All About Ankles: Syndesmosis

Have you ever been watching sport, particularly Rugby League, AFL or Football, and seen a player go down injured with what looks like some kind of ankle injury, only to hear the announcer use the term ‘syndesmosis’?

‘Oh, that looks like a syndesmosis injury’

‘That must be their syndesmosis’

‘I’m not too sure what it is but I’m going to say syndesmosis ’

Now, I’m not having a dig at the announcers in anyway. Maybe they are a former player (which is common) that has experienced something similar. But, for most people, the term syndesmosis sounds like a buzz word some announcers use to sound clever, whilst your sitting there having no idea what they’re talking about.

You may even think, ‘it just looks like a normal ankle sprain’. And here is where things change. Syndesmosis injuries, or ‘high ankle sprains’ are more complex in comparison to injuries affecting the lateral ligaments and can (if managed poorly) lead to greater disability and poorer outcomes in regards to long term pain. Everyone I seem to talk to or see in the clinic has had some kind of old ankle injury that ‘was just a sprain’ and didn’t think much more of it. This is until they develop progressively worsening symptoms in their ankle or feel as if their ankle rolls ‘all the time’. In that manner, sometimes a sprain isn’t just a sprain.

So, to make things easier to understand, and for the next time an announcer drops the term ‘syndesmosis’, I’m going to go through what the term syndesmosis means, and how we go about management of this condition.

Syndesmosis Injuries – High Ankle Sprains

Put simply, the syndesmosis is an area between your Tibia and Fibula (lower leg bones) where ligaments in the ankle act to secure the distal aspect of the lower leg, above the ankle joint. Hence, they are commonly referred to as high ankle sprains (refer to photo below).

When the syndesmosis gets injured, it will involve at least one, if not all of the structures that secure the joint. In the majority of cases, for this injury to occur requires significant force to the ankle (such as a tackle or an opposition player falling onto the ankle). This mechanism is where the foot is forced into external rotation (turning out) and the ankle into dorsi flexion (pointing upwards). When a player is injured, they usually describe the sensation of the ankle and foot being twisted outwards under force followed by sharp pain at high in the ankle. This force places increased stress on the syndesmosis joint, forcing the tibia and fibula apart, causing ligaments to either strain, or in worst cases, rupture.

Like most injuries, syndesmosis issues are graded in severity with Grade 1 being minor strains through to Grade 4 injuries which are substantial and may require surgery to stabilise the joint. Thankfully, most Grade 1 and Grade 2 injuries can be managed non-surgically with great results. Grade 3 injuries can also be managed conservatively but may require a surgical opinion with an orthopaedic specialist. This can depend on a number of reasons such as which ligaments of the syndesmosis have been injured, the sport you play, type of work you participate in and lifestyle habits.

As for management, let’s look at an example case. And by example case, I mean my own personal experience. I suffered a Grade 2 injury to my syndesmosis after I was tackled from the side during a game of Rugby League. The below outlines the week by week processes I went through to manage and eventually return to sport.

Week 1 – 2

Placed into CAM boot but allowed to walk as tolerated. I would remain in boot for the first 2 weeks. For the first 72 hours, the injury was allowed to settle using the PRICE (protection, rest, ice, compression, and elevation) regularly. The boot was also able to be removed to complete basic ankle range of motion exercises, only to neutral or plantar grade. In the second week, I began balance exercises in the boot and commenced non-weight bearing exercises for the other lower limb muscle groups.

Week 3 – 4

Boot was removed and I was able to commence double leg strength exercises in weight bearing positions. I could also commence exercise bike for conditioning. I also attend a local pool to begin hydrotherapy exercises such as water running, single leg strengthening and water jumps. The water allows you to complete these exercises at a reduced level of body weight without the chance of aggravation. All exercises were progressed with the physiotherapist and regular testing was undertaken to determine progression.

Week 5

Passed all Return to Running criteria and began to run with ankle strapped in straight lines. This was progressed during the week to increase intensity and slight directional changes. Exercises and strengthening continued to progress with plyometric and single leg strengthening.

Week 6

Running drills for change of direction were introduced. This progressed from simple drills with focus on technique to game simulated drills in chaos with an emphasis on maintaining technique. Re-introduced to light game-based skill drills such as passing and non-contact ball work.

Week 7-8

Progressed through all return to sport criteria during weeks 7-8 which was guided by a physiotherapist based on specific testing criteria. This criterion involved knee to wall differences between injured and non-injured side, symmetrical lower limb strength, various hopping tests, balance tests and questionnaires.

Overall, if managed well under the guidance of a physiotherapist , athletes and individuals can make a full recovery and return to their sport or activities without problems. It is important to note, as mentioned earlier, if your failure to complete guided rehab exercises and implement appropriate loading strategies, long term problems can occur.

If you have an ankle injury or have previously sustained a syndesmosis injury which continues to limit your function and activity levels, we can perform a detailed initial assessment and prescribe you a tailored exercise program to manage your symptoms and get you back on the field or track.

Dietitians, The Missing Part of The Injury Recovery Puzzle.

Mon, 16 Aug 2021 23:58:00 GMT

Dietitians, the missing part of the injury recovery puzzle.

Has your physiotherapist ever referred you to a dietitian before? Because they probably should have!

Imagine if you could win the race by having a 50m head start. This kind of edge is the power of combining both physiotherapy and dietitian guidance in your injury journey.

Here are a few examples of how adding a consult with a dietitian can help your injury process and give you that head start.

Injury Prevention:

Physiotherapists don’t just work towards returning you to sport or helping decrease your injury pain. They continue the process assisting to decrease your chance of secondary injuries. This can include long term strengthening programs and ongoing load monitoring adjustments, to ensure you have the best chance of decreasing any secondary injury. So what role does seeing a dietitian have in injury prevention? Fuelling your activity adequately can assist with energy levels and fatigue prevention, in turn reducing the risk of overtraining and injury. Seeking individual advice from a dietitian can assist you to make food choices that ensure you are getting energy delivered at the right times for your chosen sport or activity to prevent fatigue and injury.

Did you know that Johnston ., et el 2013 found that athletes who don’t have adequate time to recover between training, fatigue will accumulate compromise performance and result in an increase risk of injury and illness.

Joint Pain:

Joint pain and osteoarthritis are one of the most commonly seen injuries in the clinic. Physiotherapists can assist to manage daily pain levels, by restoring your joint range of movement and increase your overall strength levels. Increasing your strength can decrease the loads going through your joints. A long term strength program can also decrease your joint pain and allow you to participate in more sport and activity.

How can a consult with a dietitian assist your joint pain?

It is well researched that diet and lifestyle changes can decrease your joint pain.

Messier ., etel 2005 found that each kg of weight reduction, decreased the compressive force within the knee joint. So every kg of weight lost was shown to have a 4 fold reduction of load going through the knee. Some studies have reported up to 50% decrease in knee pain with a 10% body weight loss.

The Mediterranean Diet has also been shown to reduce inflammation and pain in those with joint pain and osteoarthritis . The Mediterranean Diet is a way of eating that is high in anti-inflammatory and antioxidant nutrients including plenty of fruit, vegetables, legumes, wholegrains, nuts, seeds, herbs, spices and olive oil.

Improving Performance:

How can physiotherapy and dietetics help to improve your sports performance? As mentioned before, physiotherapist’s don’t just return you to sport. They can help take you to a higher level, faster and stronger post injury. Throughout your rehabilitation stages there will be a time where you transition into some form of training. This means added training sessions and rehab sessions. To maximize your return, working closely with a dietitian can assist you achieve your return to sport goals.

Sports performance can largely be influenced by the correct fuelling of macronutrients prior to sport and more importantly the right dosage after activity to help your recovery. Training under fuelled can result in poor performance and feeling like you are lacking energy and unable to perform at your best, it also increases your risk of injury and illness. Dietitians can also discuss the use of supplements to help you achieve the best performance you can. If supplements are right for you and your sport, a dietitian can help prescribe how best to incorporate these into your diet.

These are just a few examples of how combining the power of physiotherapy and dietitian guidance can give you that 50m head start in winning your injury race. Every injury is different and every case if different from the next, therefore it is important to get tailored guidance that is individualised for you. At Redfern Physiotherapy & Sports Medicine we believe incorporating the whole team can give you the best outcome in your journey. If you are looking for that cutting edge in your injury journey, speak to your physiotherapist about booking a dietitian consult now.

References:

Written by Antonietta Del Pinto & Fiona Kupresanin

Johnston RD, Gabbett TJ, Jenkins DG (2013) Influence of an intensified competition on fatigue and match performance in junior rugby league players. J Sci Med Sport. 16(5):460-5.

Messier S, Gutekunst D, Davis c, DeVita P (2005) Weight loss reduces knee joint loads in overweight and obese older adults with knee Osteoarthritis. Arthritis & Rheumatoidism Journal. 52:2026-2032.

Hoffa’s Fat pad impingement- is it causing your knee pain?

Sun, 25 Jul 2021 10:40:00 GMT

Hoffa’s Fat pad impingement

If you’re suffering from a pain at the front of your knee then it may be coming from your fat pad! We aren’t saying you have a weight problem – we all have a pad made of fatty soft tissue just behind the bottom of our knee cap.

There are three fat pads at the front of the knee however, the Infrapatellar Fat Pad , sometimes called Hoffa’s Fat Pad, is one of the more common causes of pain.

How does Fat Pad Impingement present?

Pain in the front of your knee exacerbated by extension or prolonged flexion – prolonged standing will be provocative, sometimes even a straight leg raise will hurt. Prolonged sitting may also irritate the pain.
The fat pad is tender to touch – this will be just below the knee cap.
A puffy anterior knee - the fat pad is a bit like a sponge and when inflamed will become engorged
Pain may be worse when barefoot or wearing flat shoes compared with a heeled shoe.

Treatment: Acute vs Chronic

The main difference between treating acute or chronic infrapatellar fat pad pain is screening for and correcting causative factors. When acute trauma is identified as the reason for inflammation, then focus is concerned primarily on offloading the fat pad and allowing it to settle. When the pain is a persistent issue that has developed over time, it’s likely there is an underlying reason that needs to be resolved.

This process can be described in two stages:

Stage 1: Reduction of Inflammation

Activity Modification – reduce aggravating activities which may mean reducing walking or running time/distance, reducing prolonged standing and anything else provocative
Wearing heeled shoes (no we don’t mean high heels but anything with a good heel lift and support) – avoiding barefoot or flat shoes especially if it is painful
Ice Massage over the tender area
Offload Taping – lifting the inferior patella away from the fat pad with a ‘V-Tape’ technique. This may be applied 24/7 until symptom free. Our experienced team of physios will be able to teach you the appropriate taping technique.

Stage 2: Recondition the limb / Fix the cause

Progressive loading exercise : with a strong focus on the quadriceps and also considering glutes and hip external rotation exercises for control of the knee.
Isometric Knee Exercise : may be useful in the early stages, working within a safe zone of 20-40° of knee flexion can be manageable if the pain is irritable.
Stretching: of the quadriceps and hip flexors may be beneficial.

Things your physiotherapist will assess:

Knee Hyperextension – if the patient has poor control over inner range quadriceps or stands often in a hyperextended position then this may irritate the fat pad. Quads control exercises may be prescribed to correct this.
Patellar Hypermobility – the patella may have a large amount of movement which can impinge the fat pad. Dynamic quad exercises can be prescribed to treat this.
Patella position – tight structures on the lateral aspect of the knee may cause a lateral pull or maltracking. Treatment and focussed stretches can help to manage this.

These two stages are not mutually exclusive and quite often will overlap.

Planning to eat a plant-based diet in 2021?

Wed, 07 Apr 2021 23:14:00 GMT

Planning to eat plant?

The popularity of plant-based diets has been on the rise for some time and there is evidence to suggest that this trend is here to stay. The shift to plant – based diets has been predominately driven by concern surrounding health, animal welfare and the environment.

So, what is a plant-based diet? Exactly as it suggests, a diet that is based on plants.

Plant foods include fruit and vegetables, wholegrains, nuts and seeds, lentils and legumes and healthy fats such as olive oil.

A vegetarian diet is an example of a plant-based diet with some flexibility. While it doesn’t include any meat, poultry or seafood, it does allow animal-derived products such as dairy, eggs and honey.

A vegan diet on the other hand, strictly excludes all animal and animal derived products (dairy eggs and honey included).

Other variations of plant based have also immerged in recent years, such as a pescatarian diet (vegetarian diet plus seafood) and a flexitarian diet (vegetarian diet with occasional consumption of meat, poultry or seafood).

Health benefits of going plant-based

The health benefits of plant-based diets are numerous. Plant foods are nutrient dense, packed with vitamins, minerals, antioxidants and fibre. It is therefore not all that surprising that plant-based diets have been associated with lower levels of chronic diseases such as type 2 diabetes, cardiovascular disease and certain cancers. Diets high in fibre and resistant starch, found in plant foods, have also been associated with improved gut health now linked to mental health and other positive health outcomes.

You don’t necessarily need to go vegetarian or vegan to get the health benefits associated with plants foods. A moderate change to your diet such as replacing one serve of animal food with plant food a day can have a great impact on your health.

Despite all these potential health benefits it is worth noting that not all plant-based diets are created equal. A plant-based diet focused primarily on processed or packaged foods will not necessarily be any healthier than its animal-containing alternative. A wholefood diet approach is always best to minimise saturated fat, salt and added sugar.

Plant-based diet downfalls

Following a strict plant-based diet (i.e., vegan), or even vegetarian diet, requires some planning to ensure nutritional adequacy. While most nutrients we require are abundant in plant foods, there are a key few vitamins and minerals that are only found in animal foods or are better absorbed when they come from animal sources. Strict plant-based diets can also make it harder for those with particularly demanding energy requirements to meet their energy needs (e.g., adolescents or athletes).

Key nutrients for consideration in plant-based diets:

Iron

Iron is found in both animal and plant foods, however, the type found in plants (non-haem iron) is less readily absorbed making requirements harder to meet.

Vitamin B12

Only found in animal foods, and essential for healthy blood cells and neurological function, Vitamin B12 must be added by consuming fortified foods (e.g., breakfast cereals, dairy milk alternatives) or supplementation.

Protein

A key macronutrient in meat, poultry, seafood and animal derived foods. While there are plenty of plant-based proteins too, think tofu, lentils, legumes and quinoa, they can often be overlooked when transitioning to a plant-based way of eating.

Calcium

Essential for muscle function and bone health, the highest amounts of calcium are found in dairy products. Adequate calcium intake may not be a big issue for less strict plant-based diets; however, vegan diets require considered planning to ensure calcium intake is adequate.

Omega-3 fatty acids

Found in the highest quantities in fish, and extremely beneficial for health, omega-3 supplementation may be required.

As you can see while the health benefits of going plant-based are plentiful, so are the nutritional considerations. The consequences of nutrition deficiencies can be greatly detrimental, so it is highly recommended that you seek individualised nutrition advice from your doctor and a dietitian when following a strict plant-based diets. Please don’t just rely on social media, websites on the internet and advice from family and friends.

Nutrition in Managing Osteoarthritis

Mon, 08 Mar 2021 23:14:00 GMT

Managing Osteoarthritis

Osteoarthritis (OA) is the most prevalent form of arthritis, affecting a rising number of people worldwide.

The pain associated with OA is one of the key barriers to maintaining physical activity in those with the condition, which in turn can greatly impact quality of life. Those affected would benefit from ways to self-manage their condition and this is where nutrition can play an important role.

Is there a diet to cure OA?

Is there a diet to cure OA? Short answer, no. However, while there is no miracle diet that can cure OA, we do know that maintaining a healthy body weight and ensuring nutrient needs are met can help symptom management and improve quality of life.

Maintaining a healthy body weight is one of the important ways diet can assist with OA management. OA occurs when the protective cartilage that cushions joints wears down over time, so reducing unnecessary impact on these joints is an effective management strategy. Excess body weight can cause increased wear and tear as well as joint inflammation and pain for those with OA. Research suggests that a reduction of as low as 5% in body weight can improve pain felt in affected joints. Everyone has different energy requirements and understanding what this is for you can be difficult. Seeking individualised nutrition advice from a dietitian can help make sure you are mastering nutritious, balanced meals and getting your portion sizes right.

What should I eat?

What should I eat? Research suggests that the Mediterranean Diet could help reduce inflammation and pain in those with OA. The Mediterranean Diet has been thought to assist with OA management due to the anti-inflammatory and antioxidant nutrients abundant in this way of eating. It includes plenty of fruit, vegetables, legumes, wholegrains, nuts, seeds, herbs, spices and olive oil, a moderate amount of fish, seafood, poultry, eggs and dairy, and small amounts of red meat and sweets. It also emphasises enjoying food socially, in moderation, and has been seen to be beneficial in maintaining a healthy weight.

Nutrition research in the area of OA is constantly evolving, and while there is currently limited evidence to suggest any one particular nutrient can prevent or delay OA, certain nutrients have been deemed to be important for symptom control. For example, adequate protein intake is important for those with OA to ensure adequate muscle mass and strength is maintained as low muscle strength has been linked with increased pain. Research has also shown that vitamin E may have an anti-inflammatory role that may reduce the progression of OA, and higher intakes of vitamin D has been implicated in less progression of cartilage damage. Future research is sure to shed more light on the importance of specific nutrients.

Eccentric Training – why do we use it?

Wed, 23 Dec 2020 04:03:00 GMT

Eccentric Training.

If you have ever been to the Physio , chances are that you been asked to perform some eccentric exercises – but what exactly does this mean?

‘Eccentric movement’ refers to a muscle contracting whilst it is lengthening. On the contrary, ‘concentric movement’ is when a muscle is contracting whilst shortening.

The simplest example to explain this is performing a bicep curl.

The upwards part of the movement (hand to shoulder) is when the bicep is shortening under load, thus contracting “concentrically”.
The downwards part of the movement (hand lowering down) is when the bicep is lengthening under load, thus contracting “eccentrically”.

Without knowing it, you work several muscles eccentrically every day!

Every time you take a step – The tibialis anterior muscle in the front of your shin bone helps to flex the foot upwards when you run or walk, but then works “eccentrically” to help lower the toes to the floor. Without this control, your feet would slap the ground every time.
Every time you go down the stairs – The quadriceps muscles contract “eccentrically” to prevent the knee from collapsing too fast or too far forward.

Notice that these two examples often correspond to body parts that tend to be sore after exercising. This is because eccentric contractions are deemed a more efficient way to exercise the muscles compared to concentric contractions given they are able to work the muscle harder with less energy expenditure.

It is for this reason that the phenomenon of delayed-onset muscle soreness (DOMS) is greatest when a muscle has been placed under a greater eccentric load. This i explains why your shins are sore after running on a firm surface and why your quadriceps is sorer after running down hill.

But why are eccentric contractions so important for rehab?

Eccentric training is commonly used to treat tendinopathies, hamstring strains and for preventative purposes in a wide array of sports.

Research has suggested that the implementation of eccentric exercises for the treatment of common injuries such as Achilles and Patella tendinopathies can help to significantly decrease pain levels, improve function and increase tendon strength. It is suggested that this is achieved by increasing the muscle strength at longer lengths by exposing the tendon to a greater load, and therefore progressively being able to withstand loads that could have caused the initial damage.

This is further evident in a study by Mafi et al, 2001, which found that when comparing eccentric and concentric exercises in the treatment of mid-portion Achilles tendinopathy, patients performing eccentric contractions had greater improvements compared to those performing concentric contractions. The results found that 82% of the eccentric exercise group were able to return to their baseline function and activity compared to only 36% of the patients who performed the concentric exercise regime.

Hamstring strains are another common injury seen in various sports and also has a high recurrence rate. As a result, eccentric training has been well researched and has formed part of the gold standard rehabilitation process for these types of injuries. The Nordic Curl is a popular and highly effective eccentric hamstring exercise for the prevention of hamstring strains.

A study by Mjølsnes et al, 2004 found that eccentric hamstring training resulted in an 11% increase in eccentric hamstring strength and a 65% reduction in hamstring strains in football teams that implemented the Nordic Curl exercise compared with those that do not.

All our rehab programs at Redfern Physio are tailored to your specific needs and these may include eccentric exercises. Now, the next time you’re asked to perform these as part of your rehabilitation plan we hope you have a little more understanding into the reasons why. To book an appointment with one of our experienced therapists please click on the link below or call us on 8068 5158

Running Into Trouble

Fri, 16 Oct 2020 06:01:00 GMT

Running Into Trouble

With the weather warming up, and many of us finding ourselves with more time to exercise as we work from home, people are taking to running in order to maintain health and fitness. Whilst this means everyone is getting up off the couch, eating better and getting fit, it is also leading to a wide range of overuse and training related injuries.

With all chronic overload injuries, load management should be the cornerstone of any rehabilitation program. An initial reduction of 30% intensity and volume of training is recommended. If this does not result in pain free activity, a further 10% reduction should be applied every week until training does not result in pain. Load should then be progressed gradually (approximately 10% per week) until pre-injury levels are reached.

Other treatment options that will aid in the reduction of intensity and occurrence of lower limb injuries from running include:

Gait and footwear analysis: to identify abnormalities such as excessive pronation, coordination issues and excessive shock or strain. This may involve retraining the walking/running pattern, increasing the cushioning of shoes or inserting orthotics.
Range of motion exercises for the hip, knee, ankle and foot to improve blood circulation, reduce inflammation and relieve pain.
Strengthening of the muscles through eccentric exercises as well as developing core stability via training of the abdominal, gluteal and hip muscles to improve running mechanics.
Proprioceptive balance training which is crucial in neuromuscular education and will increase the efficiency of joint and postural stabilisation muscles which in turn help the body to react to changes in surface whilst running.

Here are 3 very common conditions related to running and how to manage them:

Achilles Tendinopathy

The Achilles tendon is the largest tendon in the body, attaching the calf muscles onto the heel bone. This band of connective tissue, mostly made up of collagen fibres, can become painful when subject to repetitive and sudden changes in load. Achilles tendinopathy is the term used to describe an overuse injury to this tissue. Tendons that are inflexible and stiff are at a greater risk of injury.

Often those suffering from an Achilles tendinopathy will feel stiffness and pain into the heel/calf in the morning. Symptoms can ease with movement however, the tendon often reaches a threshold point with activity and can become symptomatic again. Swelling or thickening of the tendon may or may not be seen at the site of pain.

Typically, tendons do not have a good blood supply in comparison to other tissues in the body; subsequently any healing takes place on a much slower timeframe. Research has shown the most effective way to rehabilitate a tendon and enable it to tolerate load again is through eccentric strengthening exercises. This program will be put together by your physiotherapist following a detailed assessment and will be tailored to your specific needs.

Self-massage and stretching will also be beneficial in the rehabilitation of the Achilles tendon and these will also be demonstrated by your treating physiotherapist to form part of your program. By releasing the calf muscles, the load on the Achilles tendon can be reduced leading to a reduction in pain.

Medial Tibial Stress Syndrome (MTSS or Shin Splints)

Medial Tibial Stress Syndrome (MTSS), commonly referred to as Shin Splints, is an exercise induced condition that is characterised by pain and discomfort of the lower leg along the inside border of the tibia. Shin Splints are the result of a training error (poor technique) or overload (intensity, duration and repetition) occurring primarily in running and jumping athletes. Tightness and weakness of the calf muscles along with other supporting muscles in the lower leg are the most common cause of MTSS.

Muscle tightness and weakness leads to fatigue and ultimately altered running or jumping patterns. This can place excessive strain on the Tibia causing chronic inflammation of the attachments and bony changes, all leading to pain. Typically, this pain will be experienced at the start of the workout and dissipate once warm, before returning after cooling down. However as the condition worsens it may be experienced throughout the activity leading to being unable to continue.

MTSS is the most prevalent lower leg condition and accounts for 13% to 17% of all running-related injuries. Dancers have been shown to have injury rates of 22% whilst younger population runners and athletics are 13%. Risk factors for developing shin splints include cold weather exercise, poorly trained people, overweight runners, excessive pronation at the foot and excessively tight calf muscles. Symptoms can include:

dull pain and mild oedema along the second third of the posteromedial tibia
pain that develops either side of shin during exercise
swelling, heat and redness of the shin region
numbness or weakness in the feet
associated muscle pain of the legs

Ceasing the provocative activity is the most effective treatment for MTSS along with ice to relive pain and inflammation. Symptoms will return upon resumption of exercise unless preventative treatment and rehabilitation program is applied in consultation with you physiotherapist.

Acute phase: involves mainly rest for a period of 2-6 weeks depending on severity. Pain relief is generally through the use of anti-inflammatory medications (in consultation with your doctor) and ice immediately after exercise for 20 minutes. Manual therapy can include dry needling and soft tissue mobilisation such as massage, trigger point therapy and stretching.

Subacute phase: should be focussed on behaviour and training modification such as decreased distance, intensity and frequency by as much as 50%. Uneven surfaces should be avoided and cross training with minimal impact (x-trainer, stationary bike) should be utilised during rehabilitation to compensate for the drop in training load. A stretching/ strengthening (eccentric loading) regime for the calf muscles will prevent muscle fatigue and further exacerbation of symptoms upon return to normal running loads.

Gluteus Medius/Minimus Tendinopathy

A Gluteal Tendinopathy (GT) is a non-inflammatory tendinopathy of the Gluteus Medius and/or Minimus muscles. It is due to excessive hip adduction (hip drop) in combination with other muscle or bone factors and results in moderate to severe disabling pain in the lateral hip region (Greater Trochanter). The gluteus medius and minimus muscles are two muscles found in the posterior aspect of the pelvis. Their places of origin and insertion are very close to one another, which means they act synergistically.

Traditionally a GT was diagnosed as Trochanteric Bursitis due to the similar presentations and focal point of pain. Recent research has shown however that GT is the most common source of hip pain with the condition affecting primarily runners and less active people. Women are 2-4 times more likely than men to develop a GT and as many as 1 in 4 females over 50 are likely to be affected by a Gluteal Tendinopathy. Research has shown that as much as 35% of those with low back pain (LBP) develop a GT with increased duration of LBP resulting in an increased risk of developing a tendinopathy.

A GT is a result of repeated and excessive loading of the tendon due to factors mentioned above. Some symptoms may include:

Pain is often described as a constant ache or bruising on the side of the hip
Increased pain and stiffness during the night or first thing upon waking
The area is tender, warm, red or swollen
A crunch sensation during weight bearing
Pain when you run, walk up and down stairs, or balance on one leg
Discomfort at night or trouble finding a comfortable sleeping or sitting position

Physiotherapy has been shown to be the best treatment option for managing GT. Initial management involves rest, avoiding the aggravating activity and ice for pain relief (20min every hour for first 72hrs). Gentle range of motion exercises and stretching are important to prevent stiffness, as well as specific treatment modalities applied by your therapist. Other management options that will aid in the recovery from a gluteal tendinopathy include:

Gait analysis: to identify abnormalities such as excessive foot pronation, coordination issues and hip control issues. This may involve retraining the gait pattern or inserting orthotics.
Strengthening of the hip, abdominal and core muscles including eccentric exercises for the glute muscles to provide stability and improve tissue tolerance to load.
Retrain hip and core control.

My Disc Has Slipped

Wed, 09 Sep 2020 23:05:00 GMT

My disc has slipped!

That is a phrase I hear way too often as a physiotherapist, 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 legs
‘Pins and needles’ or Tingling
Pain down the back of either 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

Mon, 27 Jul 2020 22:41:00 GMT

Meal Prep

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.

Protein

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)

Carbohydrates

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

Vegetables

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

Snacks

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.

Running Related Injuries - Part 1

Mon, 15 Jun 2020 01:59:00 GMT

Running Related Injuries

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.

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.

Elastoplast Taping and Movement Series – Episode 11: Gluteal Muscle Strengthening and Control

Tue, 26 May 2020 02:22:00 GMT

Episode 11: Gluteal Muscle Strengthening and Control

Redfern Physio – Working From Home Guide.

Tue, 05 May 2020 03:02:00 GMT

Working From Home Guide.

With the craziness that is 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.

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

Tue, 05 May 2020 02:58:00 GMT

Workstation Setup – 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 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 .

Elastoplast Taping and Movement Series – Episode 4: Ankle Taping and Rehabilitation

Mon, 04 May 2020 01:04:00 GMT

Episode 4: Ankle Taping and Rehabilitation

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

Thu, 16 Apr 2020 06:14:00 GMT

To stretch or not to stretch?

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.

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 20-60 seconds.

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.

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.

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

Thu, 16 Apr 2020 06:04:00 GMT

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:

Protein

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

Grains

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

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.

Probiotics and Prebiotic’s: What You Need to Know

Fri, 31 Jan 2020 01:19:00 GMT

Probiotics and Prebiotics'

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.

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
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!

Mon, 18 Nov 2019 20:48:00 GMT

Plantar Fasciopathy

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?

Fri, 01 Nov 2019 03:55:00 GMT

Carbohydrates.

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.

Fibre

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 bloodstream 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:

Oats
Legumes
Whole-grain bread
Quinoa
Barley
Brown rice
Starchy vegetables such as sweet potato
Fruit

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
Confectionary
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.

Strapping Basics – Notes from our Level 1 Course

Tue, 22 Oct 2019 09:28:00 GMT

Strapping Basics

Level 1 Strapping Course

Strapping tape and Supportive taping is commonly used by physiotherapists and trainers to:

relieve your pain
improve joint stability
enhance athlete confidence
reduce injury recurrence
prevent injury

Types of Strapping Tap:

Rigid strapping tape commonly used in taping or strapping is often referred to as “sports tape” or “athletic tape” and is most often a rigid style of strapping tape.
Elastic strapping tape can also be used when less rigidity or support is required, or as an overwrap to provide added support.
Kinesiology tape (or K-Tape) is an improved version of elastic sports tape that acts to dynamically assist your muscle function.
Underwrap tape is used to protect any sensitive areas.

One of the main functions of tape is restriction of movement:

Elastic tape DELAYS the movement
Rigid tape LIMITS the range of movement by up to 25-50%
Use of underwrap – loss of 30-50% of effectiveness

Other main function of tape is stimulation of our proprioceptive system!

Serves as a ‘Reminder’.

Preparation and Protection of the skin:

Check that the person to be taped is not allergic to adhesive tape. They may not know this if they have not been taped before but it is best to ask. Also, make sure there is no broken skin or existing rashes.
You may ask the patient to shave to remove hair from the area to be taped (generally only for patient comfort upon removal only). For best results this should be done 12 hours before application of tape to reduce skin irritation.
Clean and prepare the skin. Before taping the area and skin should be clean and free of any oils or creams, as they will reduce the effectiveness of the tape’s adhesive. If the athlete has particularly oily skin or you want increased adhesion you may opt for a pre-tape adhesive spray
Pad any sensitive areas or cuts with underwrap. We utilise Leukofoam Lite or Elastowrap (or other hypo-allergenic underlays) on areas where ‘tape cuts’ are more common (e.g ‘heels’ or ‘laces’ for ankle taping).

Rules of tape application:

Place limb or joint in position that offers most stability and comfort to athlete. Joints are normally strapped in the ‘neutral’ or functional resting position. Positioning is one of the most important things to consider when strapping!! Need to ask yourself – “What are we trying to achieve?”
As sports physiotherapists and trainers we need to identify the positions in which the joint/ligaments is most at risk, and therefore should tape the joint in a position of protection. For example, an anterior shoulder dislocation taping is performed with the athletes shoulder in internal rotation, to protect the shoulder from the ‘at-risk’ position of external rotation and abduction.
Choose an appropriate thickness of tape for the part to be strapped. Take into consideration the size and musculature of the person you are tapping.
Follow natural anatomical boundaries for tape application. Due to the conical shape of the limbs (e.g. the calf muscle) applying the tape perpendicularly leads to uneven pressures at the top and bottom portions of the tape.
With musculature, allow for contraction/expansion.
Hold the roll in one hand and pull off the roll with the other, then apply to the body part. Alternatively cut or tear lengths of tape to fit the part, then apply.
Each layer of tape should overlap the previous layer by approximately a third to half the width of the tape.
Smooth and mould tape as it is laid on skin. The strapper should be acutely aware of the ‘line of pull’ of the tape which they apply. Novice strappers often just lay down the tape in pre-learned directions without thought about what they are trying to achieve.
The tape should mould to the anatomy of the region and follow the line of the ligaments to be supported. Allow tape to fit natural contours of skin/body part.
Always start taping with anchor pieces and finish with closing pieces (lock-off).
Where maximum support is required tape directly on skin (use minimal underwrap).
Tape should be applied firmly to the skin but not so firmly as to cut off the blood supply.
Use an amount of tape sufficient to support the joint. Too much will restrict the joint and too little will offer poor support.
With practice you will get better at applying and judging the amount required. Like any other skill – it takes years of practice to master!
When finished tape application, check tape job for support, tidiness and flaws

Caution:

Always check once you have completed the taping to see if it is too tight and loosen or reapply if necessary.
Check circulation distal to tape. This is more of an issue with wrists, thumbs and fingers.

Removal of tape:

Tape should be removed immediately if the circulation appears to be affected or the person taped complains of itching or develops a rash.
Under normal circumstances, it should be removed once the activity it was put on for has finished.
Use either bandage scissors (which have a rounded end so as not to cut the person) or take the tape off in individual pieces.
With the scissors slip them between the tape and the skin in a muscular part of the body, not against the bone. Slide and cut at the same time.

Common flaws of tape application:

skin not prepared properly (too oily)
wrinkles/rolling of tape
tape applied to tight
tape applied too loose
‘windows’ in tape job
natural anatomical boundaries ignored
failure to apply proper anchors
failure to use sound biomechanical principles

New concepts in ACL injury management

Sun, 20 Oct 2019 22:29:00 GMT

Anterior Cruciate Ligament Injury

Most people wanting to return to sports after an anterior cruciate ligament (ACL) injury are commonly recommended anterior cruciate ligament reconstruction (ACLR). Consequently, the annual incidence of ACLR continues to rise, particularly for younger patients and those seeking revision surgery. Unfortunately, only 65% of patients return to their pre-injury level of sports participation following ACLR, and of those who do, nearly one in four experience a subsequent ACL injury.

It is important to understand that neither surgical nor conservative management will guarantee an uncomplicated return to sport, but there is now strong evidence that conservative management of ACL injuries does not result in inferior outcomes compared to surgery.

The rehabilitation process following an ACL injury is very similar whether you have opted for the surgical or non-surgical path. however timeframes for non-surgical management are usually faster, given there is no need to recover from surgery, or graft to monitor.

The initial consultation

Development of a comprehensive, long-term structured rehabilitation program for any patient with an ACL injury begins at the initial consultation. It is common thought that surgery is a ‘quick-fix.’ A key part of a physiotherapist’s role is to help the patient understand that irrespective of their end goal, they need to commit to a purposeful rehabilitation program, as this is a key factor in the determinant of successful outcome (Ericsson et al 2013, Eitzen et al 2010)

As a priority, our physiotherapists at Redfern Physiotherapy and Sports Medicine like to use the subjective exam/interview to get a feel for the patient’s beliefs, expectations and goals around the injury, with the best research showing it is these elements that determine whether a patient chooses surgery, or not (Thorstensson et al. 2009). Here are some simple questions we commonly use to help us understand your goals, understanding of injury and potential barriers to recovery:

‘What do you understand the best research-evidence says about the management of ACL tears?’
‘Would you be pleased to know that for many patients, physiotherapy and exercise actually becomes their treatment?’
‘How long do you think it will take to get back to your desired level of activity?’
‘Are you worried about using your knee again?’
‘Do you believe that if you feel pain you are causing damage?’
‘If you feel an increase in your knee pain during an activity, do you stop or carry-on? Why/why not?’
‘How fearful are you of re-injuring your knee?’

Having identified a series of functional limitations in the patient interview during the initial consultation, Our physiotherapist’s then like to attempt to show a patient that often their pain can quickly be modified. This can be as simple as supporting the painful site.

Many patients who have injured their ACL, can be pleasantly surprised at how quickly their resting pain and pain with functional tasks can be considerably abolished with simple strategies like this, which diminishes a reductionist focus on the ligament as being the sole cause of their pain.

At the first session, we like to conclude by recorrecting any aberrant functional movement patterns and then use these as the initial building blocks of an exercise program. They might include repetition and practice at home of a relaxed sit-to-stand, two-legged squats or ‘baby lunge’ tasks within pain tolerable limits.

Controlled, high-quality, supervised rehabilitation over time

Generally, by the end of the first or second consultation, We like to talk about prognosis in terms of time frames with patients. Clinical guidelines and the best trials of non-surgical management for this injury recommend three to six months for returning to pre-injury activity for non surgical management and nine to twelve months for surgical management. Time frames can be quicker or longer than this (Rooney 2018, Frobell et al 2010). For non surgical management, we generally outline to patients verbally three key, fluid phases, with approximate timeframes and key focuses of management, which may include:

Weeks 0-4, symptom relief: Manual therapy techniques , active range of motion exercises, balance/proprioception exercises, restoring normal functional movement patterns, 2- and 1-legged exercises as able, cycling and normal gait with graded walking programs
Weeks 5-13, a progression of functional exercises and strengthening: Advancing 2- and 1-legged functional exercises, then stationary plyometrics, jogging/running/sprinting
Weeks 14-28 and beyond, return to sports progressions and assessments: Dynamic plyometrics, cutting/agility drills, sports-specific drills, psychological readiness, prevention/performance-enhancing exercises.

What to Expect When Seeing a Dietitian

Mon, 22 Jul 2019 06:09:00 GMT

What to expect.

Prior to your first appointment

Before we even see you, our reception staff will send you a form to fill in. This is to help us get to know you better before the first consultation. The form includes questions about your medical history, food history and lifestyle habits, along with what you are hoping to achieve from working with us.

At your first appointment

At your initial consultation we spend time going over the initial questionnaire to ensure we have clarified any information, gain more insight and information into any medical symptoms, training program or lifestyle habits that may be impacting you, and then put together initial strategies to help you work towards achieving your goal. This may be some specific changes to your current food intake, or education around a certain aspect of nutrition that will be the most effective first step towards best health.

How long is an appointment?

Your first appointment is scheduled for 45 minutes. Follow ups are scheduled for 30 minutes. If you require a longer appointment, this can be discussed with our reception team at time of booking.

How many times, and how often will we see you?

This really depends on your personal needs, and the reason you have to come to see us. Regular reviews with your dietitian have been shown to improve compliance and achieve better health outcomes compared with going it alone. Follow up appointments are essential to provide you with all the relevant information and practical advice you need to achieve your health goals. In your follow up sessions, we build on the information you are already familiar with and adjust the content to target your priorities. We will always discuss your treatment pathway with you as well, to ensure you understand why and when we want to see you.

A Heated Topic About Cold Therapy

Mon, 22 Jul 2019 00:51:00 GMT

Hot and Cold Therapy

I want you to think back to the last injury you had. Did you have an initial impulse to put an ice pack on it? Or did you prepare a heat pack in the microwave? Well, different types of injuries require different types of management.

We all know that both cold and hot therapy can help treat many injuries. They are both quick, drug-free, inexpensive and easy self-treatment options. But do you know when it’s appropriate to use a cold or hot pack to treat a problem? Here I will explain when you should use hot or cold treatments.

Firstly, how does it work?

In the initial stages following an injury the immune system responds with an inflammatory response which sees an increase of blood flow to the area. This causes a rush of white blood cells, antibodies, proteins and other fluids to the injury site. This increase in swelling and inflammation causes the pain. Too much swelling will slow down the healing, be uncomfortable and also limit joint range of motion.
Ice reduces tissue temperature by slowing down metabolic activity around the injured area and as a result, decreases tissue damage. This will also lessen the pain by numbing the nerve endings involved.
Heat increases the surfaces temperature of the skin, which stimulates your sensory receptors and as a result, blocks the pain signals being sent to the brain. Heat also makes your muscle tissue more elastic, which releases tension and increases blood flow. Therefore providing oxygen and more nutrients to the painful area to aid in the healing process and restore range of movement.

How do you know which one to choose?

Cold Therapy:

Think ‘acute’ sports injuries. These include sprained ankles, torn muscles/ligaments and bruises. When an acute injury occurs they become red, swollen and hot due to damaged muscle tissues.
Get it on fast! Ice is most effective immediately following an injury and loses its affect significantly after approximately 48hours. The sooner you get it on; there is a greater chance of reducing swelling and minimising inflammation.
What form of ice? Ice therapy includes raw ice, gel packs (used with a towel to reduce intensity), ice baths or the trusty bag of peas. The most effective method is the use of crushed ice in a bag applied to the injury site.
You can purchase gel packs that turn into ice in your freezer or, to make things quick and easy on the sideline of a game, use instant ice packs, which are designed to turn cold instantly with a simple squeeze.
A commercial device such as a Game Ready is commonly used in an outpatient setting. It provides intermittent compression whilst delivering cryotherapy (cold therapy) to the injury site. This is the best way to deliver cold and compression therapy to an injured site and is used commonly by the world’s best athletes. Redfern Physiotherapy is equipped with its very own Game Ready machine to help manage your acute injuries!
Did you know? Ice has been shown to be more effective than gels (a common item in a sports parents freezer) at reducing skin surface temperature. It has the ability to absorb more heat as it goes through a state of physical change – melting from ice to water.

Hot Therapy:

Think ‘chronic’ sports injuries. Is best used for consistent pain (pain lasting from weeks to months), stiffness, muscle spasms, whiplash, arthritis and to loosen and relax tired muscles. However, it should not be used directly after exercise.
No Exceptions! Refrain from using heat for at least 48-72 hours after a new injury has occurred. If swelling or redness to the skin occurs following an injury then do not apply heat.
Signs of a chronic injury include a dull ache when at rest or pain when performing an activity.
Ways to heat it up? Heat therapy includes wheat packs, hot water bottles, a sauna or hot bath. Deep Heat and Tiger Balm are often used to provide a neurological distraction due to their warming sensation on the skin only.
Did you know? The continuous application of low-level heat eased low back pain better than two common over the counter painkillers.

Friendly reminders:

How long? Whether hot or cold, be sure to keep exposure to 20 minutes per session. You should wait at least 1 hour between treatments (starting when you take off the ice until you reapply the ice).
Protect your skin from burns by wrapping packs in a towel or cloth before applying.
What a mess! A Ziploc bag is a great solution for keeping ice therapy mess-free! No bag or cloth to use? Perform an ice massage by constantly moving the ice around the area of discomfort.
The Price is right! A common acronym to remember what steps to take in the initial stages of an acute injury is:

Protect = Protection from further damage
Rest = rest to avoid prolonged irritation
Ice = To control pain, bleeding and edema (swelling)
Compression = For support and to control edema
Elevation = Place the injury site above the heart to drain fluid away from the area.

As a general rule of thumb, you should use heat on stiff, aching and chronic injuries and ice on acute or new injuries that occur suddenly. Remember! Ice and heat provide symptom relief but are not going to treat the underlying issue. To find out how to recover from your acute or chronic injury, book an appointment with our team of physiotherapists to help you follow a customized rehabilitation management plan.

Food Packaging Label Reading Made Simple

Mon, 10 Jun 2019 07:22:00 GMT

Food Packaging Labels Made Simple

Label Reading

Food labels are meant to be helpful – a quick scan and you should be able to compare products and make a healthy choice. But all too often, they cause more confusion than clarity, and add to the hassle of supermarket shopping. Does this breakfast cereal have too much sugar? How important is sodium? Should I even worry about total fat? It can be difficult to know what to look for!

Below are some simple tips to help you take the stress out of label reading and choose products with the right balance of ingredients.

Start with the ingredient list

All ingredients must be listed on a product in order of the most to least by weight. Therefore, if a source of fat, salt or sugar is listed as one of the first few ingredients, this product may not be a healthy choice. My advice; choose products with a short ingredient list. If you pick up a product with numerous ingredients you’ve never heard of before, or lots of numbers, it is generally a good idea to put it back on the shelf. Familiarising yourself with the alternate names for sugar, salt and fat can also be helpful. Did you know that corn syrup, dextrose, glucose and rice malt are all just other names for sugar?

Check serving sizes

Always use the per 100g column on food labels to assess and compare products. Use the per serve column when looking at energy (kJ) content or sugar per serve. Remember there are often multiple servings in one package. Therefore, if a bag of potato chips contains three servings and you eat the whole bag, you’re going to need to multiple the kJs per serve by three.

Take energy into account

Everybody’s energy needs are different, so providing a kJ recommendation for food products is tricky. Some manufactures choose to include information about percentage (%) daily intake, which can be used as a guide, but remember this has been calculated on the needs of an ‘average adult’. Aim for 600 kJ or less per serve for a snack.

Watch out for added sugar

You’ll find sugar where you least expect it so always check this one. Stick to products that contain less than 10g per 100g and no more than 5g per serve. The exception to this rule is if the product contains fruit (as one of the first three ingredients), 20g per 100g is acceptable in this case.

Keep an eye on fat

While it’s a good idea to keep an eye on total fat, the others are more important!

Saturated fat and trans fat should be as low as possible, as these are the fats associated with disease risk. Look for products with less than 2g of saturated fat and no more than 1g trans fat per 100g. Monosaturated and polyunsaturated fats are an essential part of our diet and important for good health. Consume fish, avocado, nuts, seeds, extra virgin olive oil in small amounts. Less than 10g per 100g is ideal.

Check the sodium content

Sodium is used to enhance flavour, and even ‘non-salty foods’, can contain high amounts. Less than 120mg per 100g is considered low and anything greater than 400mg per 100g high. Compare products like bread, crackers and canned produce and choose ‘no added salt’ where possible.

Fill up on fibre

Particularly important when looking at products like bread, breakfast cereals and crackers. Products made with wholegrains will generally be high in fibre and do a better job of filling you up. Aim for 7.5g of fibre per 100g.

Be mindful of nutrition claims

Nutrition claims are statements made by food businesses and can often be misleading. Example, ‘baked not fried’ does not mean the product is lower in fat or energy, it may still be baked in oil. This is where knowing a few simple label reading tips can be helpful.

Our dietitians Chloe and Fiona, are available for individualised advice on reading food labels and help meeting any nutritional needs y ou may have.

5 Office Exercises for Relieving Neck Pain

Wed, 29 May 2019 02:07:00 GMT

5 Office Exercises for Neck Pain

You wouldn’t go running, bench press or sit in a car for 8 hours continuously without a break or two to move around, would you? So why do we find it perfectly normal to sit, hunched over, with muscles in constant contraction, straining our eyes as we stare into a fluorescent screen all day? It’s absolute madness…

Never fear however as help is at hand for relieving those aches and pain as well as tight neck muscles that leave you feeling sore, tired, heavy and at quite possibly with a splitting headache. Fortunately, we have some easy to do, take anywhere, anytime exercises that will get you loose as a goose and ready to face the afternoon slog.

Active Neck Rotation

This is a great one for general mobility of the neck when it feels tight. Starting incorrect posture (which is sitting tall, shoulders slightly back and down, chin tucked in and head facing forward) slowly rotate the head to the left keeping the line of sight parallel to the ground (not looking up or down). When you reach a position where the neck is slightly uncomfortable with the stretch pause for 1 second and then turn the head back through centre and to the right. Repeat this in a slow controlled motion for one minute, take a short 30-second break and repeat.

Levator Scapulae Stretch

If this muscle could be renamed it would surely be the gremlin muscle. When your neck and shoulders get tired you can trust good old Levator Scapulae to take over and try to hold things up but it comes at the cost of a tight neck, sore shoulders and even headaches. To stretch it out place one arm by your side (or even tucked behind your back) and rotate your head to look the opposite way, gently look down and with your free arm reach over the head and apply moderate pressure for 30 seconds then repeat on the opposite side. Stretch both sides a total of three times applying slightly more pressure each repetition.

Chin Retractions

Ever wondered why your neck gets tired and sore? Does it feel like you head weighs 100kilos by the end of the day? Chances are you’re spending your day with your head tilted forward and your chin poking out, which places huge amounts of strain on your neck. To counteract this, the chin retraction exercise is our favourite.

Start by standing up tall and looking straight ahead. Raise one arm and shape your thumb, pointer and middle finger into a tripod. Place the thumb and middle finger on each collar bone and the pointer finger on your chin. This should cause you to retract your chin and engage to muscles as the upper back of your neck (where it connects to the skull). Hold this posture for 10-20 seconds and rest 5 seconds. Repeat 10 times

Neck Stretches

Now it’s time to stretch out all those tight muscles, particularly the Upper Traps that spend all day working overtime and also your neck extensors which are under strain from crooning your neck forward to peer at the screen or look at the keyboard. Flex your head to one side, reach over with same side hand and apply a moderate amount of pressure to increase the flex to the desired side. Hold for 20 seconds and then repeat on the opposite side. Stretch both sides twice before moving on to the back of the neck. Looking down, place both hands on the back of your head and lightly apply pressure in a forward motion and hold for 20 seconds (repeat this twice more). Your neck should feel nice and loose now so let’s move on to posture.

Isometric Neck Strength

Finally, it’s time to make our neck resilient and robust. The idea is to apply only a moderate amount of force and match it in the opposite direction with your hand so that the head remains in the same place. Looking straight ahead, place either your right or left hand onto the side of your head and push into the hand meeting the resistance. Hold this for 5 seconds and relax (Repeat 10 times). Now swap to the opposite side and repeat. Finally, placing your hands behind your head similar to the neck stretch, push back into your hands and hold for 5 seconds (repeat 10 times).

Neck pain is common but most cases are not caused by serious problems. These exercises, if done correctly and regularly, should help keep you pain-free and moving well.

Physio vs Remedial Massage

Wed, 29 May 2019 01:34:00 GMT

Physio vs Remedial Massage

What is the difference between Physiotherapy and Remedial Massage?

Often when seeking injury attention, it is difficult to know where to go or who to see. Today we help you answer this question.

Below are a couple of key differences which should help you better understand when to visit your local Redfern Physiotherapy therapist, and who to book your consultation with.

Physiotherapist

Diagnosis – Ability to identify specific illness or injury based on an examination of symptoms.

Assessment – Provide a detailed assessment of condition with greater emphasis initially on consultation and education.

Sudden severe pain – Acute injuries requiring more frequent treatment should seek advice from a physio.

Variety of techniques – Offer a range of techniques including: dry needling, exercise prescription & manual therapy.

Investigative Scans – Ability to refer for further diagnostic testing (e.g. x-rays) or to medical specialists.

Massage Therapist

Prognosis – Ability to provide an experienced professional opinion on the likelihood of an outcome.

Less talky, more touchy – More hands- on time to really get stuck into those tight muscles.

Ongoing maintenance – After initial treatments, there will likely be longer periods between massages, and sessions are focussed on maintaining your level of mobility

No more stress! – Promotes stress relief and relaxation for the busy modern day workers lifestyle

Race day! – Sports mass age before and after an event has proven beneficial for performance and limiting the dreaded DOMS! (Delayed Onset Muscle Soreness)

Both Physiotherapists and Remedial Massage Therapists can prescribe their patients with rehabilitation programs which may include mobility, strength, and postural alignment exercises. These two disciplines work hand in hand and complement each other so for best results it is recommended to take a holistic approach and our therapists at RPSM work closely with each other to ensure you are given the best possible tailored treatments for a speedy recovery.

Hopefully this helps distinguish between the 2 disciplines and we look forward to seeing you all in the Redfern Physiotherapy and Sports Medicine clinic to assist with any of your health-related needs.

May is Crohn's and Colitis Awareness Month

Fri, 17 May 2019 04:37:00 GMT

Crohn's and colitis awareness month

The month of May is Crohn’s and Colitis awareness month. So what better time to share part of my personal story, to help us explore the impact that inflammatory bowel disease (IBD) can have on physical and emotional wellbeing.

10 days after my 20th birthday I was diagnosed with Crohn’s disease. I’d never heard of this disease before and to be honest, I thought that Crohn’s was an “old person’s” disease. But I was wrong – Crohn’s Disease & ulcerative colitis are lifelong, and affect many lives, starting from young children, right through to adulthood. Australia has one of the highest incidence in the world with more than 80,000 Australians living with these conditions, and numbers expected to increase to more than 100,000 by 2022.

For those that don’t know

IBD is an autoimmune disorder – this occurs when a person’s immune system mistakenly attacks their own body tissues. In many ways IBD has more in common with other autoimmune disorders – such as rheumatoid arthritis (which affects the joints), psoriasis (which affects the skin) and lupus (which affects the connective tissue) – than irritable bowel syndrome (IBS).

Unlike IBD, IBS does not cause inflammation, ulcers or other damage to the bowel. The digestive system looks normal but doesn’t work as it should. Irritations include stress, infection and some foods can aggravate the condition.

A small percentage of people with IBD may also experience problems outside the gastrointestinal tract including joint pain, skin conditions, eye inflammation, liver disorders, and thinning of the bones (osteoporosis).

Crohn’s disease may not have a cure, and there is no replacement for regular consultations with your Doctor, dietician, or other medical professionals (physiotherapy). But with the right advice and management, you can ensure a happy & healthy life is possible!

Being diagnosed with a lifelong disease has not stopped me or slowed me down. This has been largely in thanks to the support of my Dad. He has showed me that a good life is possible despite suffering from ankylosing spondylitis (a bad form of Rheumatoid Arthritis) by combining a few different therapies over the years. To this day we are both living our lives to the fullest!

Massage has saved me many times through the tough days of fatigue, muscle pain, body aches, depression and stress. Though it may seem to be a somewhat unconventional remedy, massage actually has many benefits. Massage therapy can help relieve stress. And by lowering stress levels, you can help reduce inflammation and other symptoms.

General strengthening of muscles surrounding peripheral joints provides additional joint stability, reducing stress placed on the joint itself.

Postural and stretching exercises are beneficial for improving symptoms of axial arthritis.

This is where a physiotherapist can complete a thorough assessment and provide individual exercises tailored to suit your symptoms and requirements.

Whilst making dietary changes will not cure Crohn’s or ulcerative colitis, it can significantly help with symptom management and ensure overall good nutrition is achieved and maintained.

Each and every person with IBD, has an individual experience with nutrition. Foods that cause problems for one person, may not impact another at all.

For example, some people find that a bland, low-fibre diet is easier to tolerate than one that contains high-fibre or spicy foods when experiencing a flare-up. Others have found that adopting a low FODMAP diet helps manage their symptoms.

As well as managing symptoms, attaining adequate nutrition can also be challenging for individuals with IBD due to symptoms, disease complications and medications. Adjusting the diet with guidance to avoid nutritional deficiencies is often necessary.

One of the best ways to understand how diet affects your condition is to start recording a food and symptom diary and to see an Accredited Practising Dietitian for tailored management and a diet plan. Consultation with an experienced dietitian is strongly recommended and the therapists at RPSM are ready to help guide you through this journey.

I hope this has helped you find a few answers, especially if you have been newly diagnosed or never had someone in the family go through the emotions and hidden pain you deal with on a daily basis. As lucky as I have been over the last 17 years managing Crohn's disease, there are definitely some days that are better than others. So be smart in your management and seek the right advice. Try understand your body and listen to what it needs or doesn’t want. But also know with a positive attitude & good support, the good days will outweigh the bad.

Now get out there and enjoy every possible adventure!

by Hayley Rawson – Massage Therapist at Redfern Physiotherapy and Sports Medicine

Effective Treatment Of Osteoarthritis

Wed, 27 Mar 2019 22:53:00 GMT

Treatment Of Osteoarthritis

A recently published report from the Australian Commission on Safety and Quality in Healthcare (ACSQHC) reported that knee osteoarthritis (OA) treatment in Australia is falling well short of what is considered ‘best practice’. The report found in particular that knee arthroscopy surgery can cause more harm than good, providing no long-term benefits. This finding is supported by research which demonstrates that knee arthroscopies are no more beneficial than placebo procedures for knee OA (McAlindon et al 2014) . Conservative treatment (i.e physiotherapy) combined with a focus on promoting weight loss and becoming more active is best practice for managing hip and knee osteoarthritis. Joint replacements should only be considered as a last resort when other treatment options no longer provide adequate relief or progress.

Suffering from OA?

People suffering from OA often believe that their joint has worn out, (like the sole of a shoe), and avoid physical activity as it will only lead to further deterioration of the joint. The research evidence is conclusive in demonstrating that loading of a joint through exercise stimulates and promotes tissue regeneration, and is essential for joint health. Exercise based management has been proven to provide the following benefits for individuals suffering from symptoms of OA;

reduce overall pain levels
aid joint lubrication and nourishment
ease your joint pain and stiffness
improve flexibility
build muscular strength
improve your balance
help you sleep better
improve posture
improve or maintain the density of your bones
improve overall health and fitness
lower stress levels
improve your mood
help you maintain a healthy body weight

Despite the clear evidence in favour of exercise as the best treatment of OA, the majority of Australians with knee OA do not participate in any form of exercise (Hinman et al. 2015). Exercise also has additional benefits for those suffering from OA, beyond reducing pain and increasing function in an arthritic joint. Two in three people with OA have other comorbidities, such as diabetes and cardiovascular disease. Exercise has been demonstrated to be the optimal treatment for a number of such chronic diseases due to its anti-inflammatory effects. Although exercise may not be considered the “easy” option, it has the strongest evidence for treating OA and is associated with many other health benefits (Skou et al. 2018).

Our highly skilled physiotherapists at Redfern Physiotherapy and Sports Medicine are committed to helping all of our clients in pain. So, If you think you may have knee or hip OA, our Physiotherapists are able to provide you with an individualised exercise program targeted to your needs and preferences., as we understand that not all knee injuries are the same. We are able to supervise you doing your exercises to promote self-efficacy and confidence in managing your OA in the future.

Physiotherapy in Redfern

Wed, 03 Oct 2018 03:34:00 GMT

Physiotherapist in Redfern

Are you looking for a physiotherapist in Redfern? Redfern Physiotherapy & Sports Medicine has been the leading community physio and health centre for 10 years.

Our clinic was founded by two therapists who’ve been leading the South Sydney Rabbitohs and have helped the club find major success. Whether it’s with the local NRL club or just helping locals in Redfern eat right and be the best version of themselves, we are dedicated to improving the health and well-being of our communities any way we can.

Physiotherapy located in the Heart of Redfern, Sydney

Our neighbourhood has experienced rapid growth in the last decade. What was once a quiet suburb is now a bustling commercial centre complete with restaurants, pubs, and shopping for all budgets.

Our physiotherapy and injury clinic is located right in the thick of it all, just 200 metres from Redfern Station.

Take the train, ride the bus, walk, or drive—parking is ample and cheap. We are only a few minutes from anywhere in the area and a short train ride from the CBD.

Book an appointment online or stop by and see us today. Our elite health professionals include:

Physiotherapists
Dietitians
Massage Therapists

We are also one of the few clinics in the Sydney Are specialising in Bike Fit, a one-of-a-kind program used by high-level athletes to get maximum stamina and distance during their bike rides. We’ll keep you aerodynamic will giving you maximum flexibility, perfecting your technique and propelling you to your fitness goals faster.

If you’re in Redfern or Alexandria , come to the physio that helped propel our South Sydney Rabbitohs to success with their physio and injury healing services. If you need help regaining your mobility, want a great massage, or are ready for a personalized Bike Fit plan to achieve maximum fitness results on your wheels, contact us today to book your appointment!

Physiotherapy in Darlington

Thu, 03 Oct 2013 04:28:00 GMT

Darlington Physiotherapist

Redfern Physiotherapy & Sports Medicine is located mere minutes from Darlington (200 metres from Redfern Station). Just cross the tracks and you’re practically at our door. Our physiotherapy, injury, and health centre has been helping people in Darlington and all of Sydney improve their well-being and live happier, healthier lives.

Our founders helped propel the local NRL team, the South Sydney Rabbitohs, to the most success they’d had in decades! Their cutting-edge sports medicine techniques and dietary plans are designed specifically for the client, regardless of whether you’re a rugby pro or a rugby fan.

Our clinic is staffed by elite health experts who specialise in personalised exercise regimens, diet plans, and educating our patients on how to self-manage chronic conditions.

We’re so Close to Darlington That we Might as Well be in Darlington!

Darlington might be one of Sydney’s smallest neighbourhoods, but there’s still plenty to see and do. And it’s just a hop, skip, and a jump from all the action around Redfern Station. Right in the centre of all that action is our health clinic! If you want to get to us, just head down Cleveland or Abercrombie Street and cross the tracks. It only takes about 5 minutes.

Book an appointment online or stop by and see us today.

Our elite health professionals include:

Physiotherapists
Dieticians
Massage Therapists

We treat all musculoskeletal and orthopedic conditions including back and neck pain!

We also help patients optimize their cycling technique to achieve maximum power while remaining safe and aerodynamic. Our one-of-a-kind Bike Fit program helps you achieve powerful fitness results regardless of your condition. One consultation with our cycling experts will help you achieve your fitness goals and manage your long-term health as efficiently and quickly as possible. Come see why elite athletes have used these techniques to improve their strength and conditioning and how it can help you too!

If you’re in Darlington, come to the clinic that helped propel our South Sydney Rabbitohs to success with cutting-edge physiotherapy and sports medicine. Just take the 5-minute ride to Redfern Station and our clinic is right there. Book your appointment online today!

Physiotherapy in Kensington

Thu, 03 Oct 2013 04:11:00 GMT

Physiotherapy in Kensington

Are you looking for an elite physiotherapist near Kensington? Redfern Physiotherapy & Sports Medicine has been the leading community physiotherapist, sports medicine , and injury clinic for 10 years.

Redfern Physiotherapy & Sports Medicine was founded by two therapists who’ve been leading the South Sydney Rabbitohs. Their cutting-edge techniques and programs have helped the club turn things around and have major success.

Whether it’s helping our local NRL club or helping the students at the University of New South Wales, we’re dedicated to improving the well-being of this community and helping its residents live happier, healthier lives.

We’re Located Just a Short Ride from Anywhere in Kensington!

Kensington has long been known for its wide open spaces and spacious university greens (and one of Sydney’s best golf courses!.

This growing suburb, affectionately known as “Kenso” to the locals, has outdoor activities for any age! If you’re looking to get back to health and start enjoying everything life has to offer, our physiotherapy and injury clinic is located just a few minutes away by car, no matter if you’re close to ANZAC Parade or UNSW’s campus.

Book an appointment online or stop by and see us today. Our elite health professionals include:

Physiotherapists
Dieticians
Massage Therapists

We are also one of the few clinics in the Sydney Are specialising in Bike Fit. This unique exercise consultation was once practised only by elite athletes to help them achieve optimal stamina and distance during their biking. One consultation with us will maximize your fitness results by making you more aerodynamic and helping you attain more power. It will also help you prevent injury and bike further than you ever have before.

If you’re in Kensington, come to the clinic that helped steer our South Sydney Rabbitohs to success with cutting-edge physiotherapy and sports medicine. If you need help regaining your mobility or healing any range of conditions (or just need some expert diet advice), book an appointment online and take the short ride to Redfern and see us!

Physiotherapy in Zetland

Thu, 03 Oct 2013 03:58:00 GMT

Physiotherapist Zetland

Redfern Physiotherapy & Sports Medicine is one of Zetland’s leading therapy and injury clinics, and our team of health professionals is dedicated to improving the health and well-being of all Sydney communities.

We are located just a stone’s throw from the quiet streets of the Zetland neighbourhood of Sydney, and we are just a few minutes away from you by car or bus. Just head North on Botany Road and you’ll be at our clinic in no time! We’re only 200 metres from Redfern Station.

Parking is easy and convenient, and we are only a few minutes drive anywhere around Bourke or Botany Road.

Our team of elite health professionals offers the South Sydney Area’s leading physio health services, including:

Physiotherapy – We assess, treat, and manage all musculoskeletal conditions including injuries to the muscles, bones, and ligaments. Our team is trained in the latest exercise and recovery techniques , ensuring a fast recovery. We don’t stop there though. Our team empowers you to self-manage your chronic conditions and live a better, happier life.

Massage Therapy – Our skilled massage therapists use the latest techniques to manipulate and massage the soft tissues of your body. Our elite team can help relieve your spasms and muscle pains while also helping you put an end to headaches or those nagging mobility issues.

Bike Fit services – Redfern maximizes your fitness results from biking with our unique Bike Fit program. Our expert bike science team will show you how to optimise your riding power while keeping you aerodynamic and improving your stamina and recovery. Get incredible results fast with a Bike Fit session from our cycling experts.

Dietitians – Your long-term health is heavily dependent on your diet. Our dieticians are familiar with a range of conditions, meaning they know exactly how to transform you into the best version of yourself no matter your health objectives or conditions.

If you live in Zetland , Surry Hills or the local area Redfern Physiotherapy in just minutes away. Our expert staff is ready to help you become the healthiest, happiest version of yourself. Book your appointment online now!

Physiotherapy in Surry Hills

Thu, 03 Oct 2013 03:51:00 GMT

Surry Hills Physiotherapist

Do you need an affordable physiotherapy, sports medicine, or injury clinic near the Surry Hills neighbourhood of Sydney? Then get the clinic that propelled the South Sydney Rabbitohs to success!

Redfern Physiotherapy & Sports Medicine is a “hands-on” therapy clinic dedicated to improving community well-being. We specialise in sports rehabilitation and the healing of all musculoskeletal or orthopedic issues, focusing on personalized patient recovery plans and the cutting edge of sports medicine. All of our efforts will help you live your best life regardless of your injuries or issues.

Our individualised and highly targeted exercise and diet programs will help you fully recover your long-term mobility and achieve your health goals.

Our clinic is staffed by an elite team of physiotherapists, dieticians, and massage therapists. We even have a one-of-a-kind “Bike Fit” program where we optimize your biking technique to get maximum fitness results fast.

Surry Hills Physiotherapy

Known for its stylish, cultural, and hip cafe scene, Surry Hills is an evolving neighbourhood of Sydney that has a little something for everyone. Fashion boutiques, world-class cuisine, hip coffee shops, and trendy pubs line the streets of one of Sydney’s most vibrant corners. There’s also a fair share of green space for biking, walking, running, and enjoying the Sydney sunshine! Redfern’s team of elite health professionals and multidisciplinary practice is located just a few minutes away. You’re barely a 5-minute ride from us anywhere in the Surry Hills Area.

And, since we’re only 200 metres from Redfern Station, there’s plenty of parking!

If you’re in need of anything from help sticking to your diet to the latest sports medicine and physiotherapy, book your appointment online today and begin your journey to healing at Australia’s leading physiotherapy clinic. We’ve been helping the people of Sydney achieve their health goals for 10 years, and we can help you too!

Physiotherapy in Waterloo

Thu, 03 Oct 2013 03:19:00 GMT

Waterloo Physiotherapist

Redfern Physiotherapy & Sports Medicine is dedicated to improving the health and well-being of all Sydney communities.

We are located just a stone’s throw from the hip, up-and-coming industrial Waterloo neighbourhood of Sydney. Our clinic is just 200m from Redfern Station and is well connected to your area via public transport. Parking is ample and convenient, and we are only a few minutes drive anywhere around McEvoy, Bourke Street, or Elizabeth Street.

Our team of elite health professionals offers the Waterloo Area’s leading physio health services, including:

Physiotherapy – We assess, treat, and manage all musculoskeletal conditions including injuries to the muscles, bones, and ligaments. Our hands-on treatment and personalized exercise programs are designed to quickly improve your health and ensure your injuries do not reoccur.

Massage Therapy – Our skilled massage therapists use a mix of ancient and modern techniques to manipulate the soft tissues of your body to relieve spasms, muscle pains, headaches, and mobility issues.

Bike Fit Services – Want to take your biking ability to the next level? With Bike Fit, Redfern will maximize your riding power while keeping you aerodynamic and improving your stamina and recovery. Get incredible results fast with a Bike Fit session from our cycling experts.

Dietitians – The best training regimen is nothing without the right diet. Our dietitians are familiar with a range of conditions, so they’ll know exactly how to make you the best version of yourself no matter your objectives or health condition.

If you live in Waterloo, Redfern Physiotherapy in just minutes away. Our expert staff is ready to help you become the healthiest, happiest version of yourself.