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Osteoporosis and the Benefit of Pilates
Osteoporosis and the Benefit of Pilates

Benefits of Clinical Pilates for Neurological Patients

In recent years, Pilates has gained traction not just as a popular fitness trend but also as a valuable tool for rehabilitation, particularly among neurological patients. This mind-body practice, known for its emphasis on core strength, flexibility, and mindful movement, is increasingly being recognized for its therapeutic benefits.

As more healthcare professionals advocate for holistic approaches to recovery, Clinical Pilates has emerged as an effective method for enhancing mobility, improving balance, and promoting overall well-being in individuals with neurological conditions.

Let’s take a closer look at the advantages of incorporating Clinical Pilates into the rehabilitation journey for neurological patients.

1. Improved Mobility and Flexibility

One of the primary goals of rehabilitation is to enhance mobility. Clinical Pilates focuses on controlled movements and stretching, which can help improve flexibility. For neurological patients who suffer from changes in muscle tone, muscle tightness and joint stiffness, pilates exercise can result in a better range of motion in joints, making daily activities easier and more manageable.

2. Strengthening Core Muscles

A strong core is crucial for maintaining balance and stability. Clinical Pilates emphasizes core strength through various exercises that target the abdominal muscles, lower back, and pelvic floor. Strengthening these areas can help neurological patients regain control over their movements and improve postural stability.

3. Enhanced Balance, Coordination and Proprioception

Many neurological conditions can affect balance, coordination and body awareness, also known as Proprioception. Pilates exercises promote this sense of body awareness and spatial orientation, helping patients develop better motor control and coordination of their movements. As balance improves, patients may experience reduced falls and an increased sense of confidence in their mobility.

4. Customized and Adaptive Approach

Clinical Pilates is highly adaptable, making it suitable for individuals with varying levels of ability. Physiotherapists are trained in working with neurological patients and can tailor exercises to meet specific needs and limitations, ensuring a safe and effective rehabilitation experience. This personalized approach encourages patient engagement and promotes steady progress.

5. Pain Management

Chronic pain can often accompany neurological conditions. Pilates emphasizes gentle movements and proper alignment, which can help alleviate discomfort. The focus on controlled breathing during exercises also promotes relaxation, reducing stress and tension that may contribute to pain.

6. Social Interaction and Support

Participating in group Pilates classes can offer social benefits as well. Engaging with others facing similar challenges fosters a sense of community and support. This social aspect can be particularly beneficial for mental well-being, reducing feelings of isolation that can accompany neurological conditions.

7. Mental Health Benefits

Physical activity, including Clinical Pilates, has been shown to improve mental health. The focus on movement, breathing, and relaxation can reduce anxiety and depression, common among individuals with neurological issues. As patients gain strength and mobility and work towards achieving their goals, their confidence often increases, positively impacting their mental outlook.

8. Promotes Functional Movement

Ultimately, the goal of rehabilitation is to restore functional movement. Clinical Pilates emphasizes movement patterns that translate to everyday activities, making it easier for patients to perform tasks like walking, sitting, and standing. This functional approach can lead to greater independence and improved quality of life.


Clinical Pilates offers a holistic approach to rehabilitation for neurological patients, addressing physical, emotional, and social aspects of recovery. By improving strength, balance, and body awareness, it empowers individuals to regain control over their movements and enhance their overall well-being. If you or a loved one is navigating a neurological condition, consider incorporating Clinical Pilates into your rehabilitation plan for a supportive and effective path to recovery.

MSK vs. Orthopedic Physiotherapy: Key Differences

Many of our patients often ask about the differences between musculoskeletal (MSK) physiotherapy and orthopedic physiotherapy, as both are essential in patient care but serve distinct purposes.

Orthopedic Physiotherapy focuses on pre and post-surgical rehabilitation.

  • Prehab: Prepares patients for surgery through strengthening exercises to optimise outcomes and manage pain.

  • Rehab: Helps patients recover post-surgery by improving joint and muscle function.

MSK Physiotherapy addresses a wide range of injuries, including:

  • Strains and sprains

  • Back and neck pain

  • Repetitive stress injuries

Treatment methods include massage, mobilisation, dry needling, and tailored exercises to correct weaknesses and movement patterns.

In summary, orthopedic physiotherapy specializes in surgical recovery, while MSK physiotherapy provides a comprehensive approach to various musculoskeletal conditions. If you have any questions about which type of physiotherapy is right for you, feel free to ask!

The Key Step Athletes Skip After a Knee or Ankle Sprain

After suffering a knee or ankle sprain, many athletes follow the standard advice—strengthening exercises, rest, and a break from running for 4-6 weeks. Once the pain has settled, they’re eager to return to the field, often relying on a brace or tape for support. Frequently, minor injuries can develop and significantly impact your performance. But what if this approach isn’t enough to prevent further injuries?

Research shows that many athletes face recurring issues after returning to their sport too soon. Up to 65% of those with ankle injuries report ongoing instability, and a significant percentage experience re-sprains. Similarly, knee injuries can lead to re-ruptures or tears, particularly in younger athletes.

The key to a full recovery isn’t just about regaining strength and balance; it’s about taking that extra step—incorporating explosive exercises or plyometrics into your rehab. But how do you know which exercises are right for you?

To best prepare for a return to sports, it's essential to incorporate explosive exercises or plyometrics. Many athletes tend to overlook this crucial step, but identifying the right plyometric exercises through functional testing, such as single-leg squats and hopping tests, is key. Your physiotherapist can play a crucial role in conducting tests that assess key components such as:

Quantity: This involves comparing the number or distance of hops/jumps between your affected and non-affected leg. Rehab protocols generally suggest that the injured leg should perform at least 90% as well as the non-affected leg to be cleared for running, and 95% for a full return to sports.

For example, doing a side hop test. If your non-affected side can complete 50 repetitions, your injured leg should aim for 45 reps to resume running and 48 reps to return to sports.

Here are two videos demonstrating functional tests: Drop Jump Test - Side Hop Test

These videos show how to measure your hopping performance. While there's no "perfect" way to jump, both legs should move similarly in terms of quantity and quality.

Also, take a look at these videos on different aspects of hopping: Hip/Knee Dominant - Jumping and Landing Technique

So, if you're in the mid to later stages of rehabbing an ankle or knee injury, chat with your physio about adding some plyometric exercises to your routine. Functional tests like single-leg squats and hopping can help figure out what level of plyometrics is right for you. This way, you’ll speed up your recovery and get back to your sport faster. Just talk to your physio and get back in the game stronger!

References

Kotsifaki et al (2019) - https://pubmed.ncbi.nlm.nih.gov/31142471/

Melick et al (2021) - https://pubmed.ncbi.nlm.nih.gov/33650704/

Melick et al (2016) - https://pubmed.ncbi.nlm.nih.gov/27539507/

Melick et al (2024) - https://www.jospt.org/doi/10.2519/jospt.2024.12374

Middlelkoop et al (2012)- https://www.sciencedirect.com/science/article/pii/S1836955312701091

Image: <a href="https://www.freepik.com/free-photo/shot-young-sporty-athlete-jump-against-concrete-wall-background_11036122.htm#fromView=search&page=1&position=22&uuid=008eb1bb-1a48-4370-b0fb-addeceb36faa">Image by aleksandarlittlewolf on Freepik</a>

Pelvic Health

Discussing uncomfortable and awkward topics is essential because many Australians suffer in silence without receiving the help they need. Did you know that 1 in 4 Australians experience incontinence, yet 70% do not seek help?

Incontinence refers to any involuntary leakage of urine or feces from the bladder or bowel. It affects both men and women, and common risk factors include pregnancy, aging, obesity, constipation, and certain medications.

Incontinence can significantly impact your emotional health, restrict activities, and affect self-esteem, motivation, and independence. However, there's good news!

The great news is there is lots of positive research that shows that pelvic floor strengthening can prevent and treat incontinence issues, including improving sexual function and satisfaction.

Pelvic floor muscles in men and women

The pelvic floor muscles are internal muscles that span from the pubic bone to the sacrum (tailbone). They support pelvic organs like the bladder, bowel, and in women, the uterus. The pelvic floor has small openings for urine, feces, and in females, the vagina.

Think of the pelvic floor as a hammock at the bottom of your pelvis. You can contract and relax these muscles to control the flow of urine and feces. For instance, when you need to use the toilet but can't, you tighten your pelvic floor to hold it in. Once you're at the toilet, you relax the muscles to let it out.

A strong, well-coordinated pelvic floor enables you to control bladder and bowel function effectively. Conversely, pelvic floor dysfunction can lead to incontinence.

The beauty of this is our pelvic floor, just like any muscle, which can be trained and strengthened with an exercise program with regular targeted exercises.

How to Strengthen Your Pelvic Floor Muscles

Strengthening your pelvic floor is possible with regular targeted exercises. Here’s how to get started:

  1. Find a comfortable seat or lie down on your back.

  2. Focus on closing your front and back passages.

  3. You should feel an internal tightening and lifting sensation.

  4. When relaxing, feel a release and dropping sensation.

Start by contracting your pelvic floor muscles, hold for 3-5 seconds, then release. Begin with 10 reps daily.

If you struggle with these exercises or experience incontinence, remember this is not a normal part of aging. Seek help from a medical professional—you have the power to treat your problem.

References

https://www.continence.org.au/

Image: <a href="https://www.freepik.com/free-photo/top-view-woman-strengthening-pelvic-floor_30555186.htm#fromView=search&page=1&position=35&uuid=18771675-e9ab-4440-94aa-d2bc56e4ec07">Image by freepik</a>

Finding Your Perfect Physio Match: A Guide to Our Team's Expertise

At our clinics, our physiotherapists are extensively trained to address various issues. However, they also bring their unique strengths and areas of expertise.

We understand that every injury is unique, so we have a diverse team of skilled physiotherapists. This guide will help you find the ideal physio that aligns perfectly with your needs.

Here's a breakdown of our team's specialties:

  • Sports Injuries: Are you looking to recover from a sports injury and return to the game? Book with Jordan or Jason, who has extensive experience treating athletes of all levels and utilises advanced techniques to promote and optimise performance.

  • Chronic Pain Management: Struggling with persistent pain? Jordan specialises in personalised pain management programs. He integrates manual therapy, movement strategies, and education to empower you to manage your pain effectively.

  • General Pain and Stiffness: Whether you wake up with a stiff neck, have hand discomfort after work, experience backaches from driving, or just general aches and stiffness, Phoebe can help. She will help you regain feeling your best with strategies to reduce your pain quickly and identify the root cause of your discomfort to prevent future flare-ups.

  • Post-Surgical Rehabilitation: Physiotherapy is crucial for a complete and successful recovery following surgery. Jason is skilled in post-surgical rehabilitation, helping you regain strength, mobility, and confidence after surgery.

  • Work-Related Injuries: If you're experiencing pain from a work-related injury, Jordan can help. He understands the demands of various workplaces and can design a treatment plan to get you back to work safely and efficiently.

  • Strength and Flexibility: Phoebe is our head of Physfit, which offers a tailored system of physiotherapy exercises and Pilates that is available in both group classes and personalized one-on-one sessions. Whether you're looking to build strength, increase flexibility, or rehabilitate an injury, Phoebe will guide you towards your goals.

Not sure who to choose? Don't worry! During your initial consultation, we'll discuss your needs and goals to match you with the physiotherapist who best suits your case.

Feel free to call our reception team at 1300 884 171 for any questions about our services or to schedule an appointment.

Remember, UPG Studios is committed to helping you move better and feel your best!

Hip Pain Journey

In a series of videos, our experienced physiotherapist, Jason, shares his personal story about struggling with hip pain and his journey towards a full recovery. Even though he's well-versed in the mechanics of the human body, a sharp discomfort running down his leg while driving home reminded him that pain can strike unexpectedly.

Throughout these videos, Jason talks about his efforts to identify the source of his pain, develop targeted exercises for rehabilitation, and manage it effectively. His journey highlights the importance of seeking professional help since everyone's body reacts differently to pain. This emphasizes that consulting a physiotherapist for a tailored assessment and treatment is crucial.

Furthermore, Jason's story reminds us that injuries and setbacks can happen to anyone, regardless of their expertise in the field. However, he demonstrates that with the right approach and unwavering determination, it's possible to overcome even the most challenging obstacles.

If you're going through a similar experience, Jason's journey can inspire you to take control of your recovery journey and seek support from a qualified physiotherapist who can provide personalized guidance and assistance.

If you have any questions or would like a complete assessment of how to begin your treatment, book here for a consultation with one of our physiotherapists who will help you manage your pain, restore function and achieve your goals.

The Perfect Warm-Up Routine for Melbourne Marathon

Are you ready for the Melbourne Marathon this weekend? If you're planning to participate, Please make sure you warm up your glutes, hamstrings, calves, core and quads. Completing a proper warm-up will reduce your likelihood of injury on the day.

As a physiotherapist and a seasoned runner, Phoebe shared the warm-up routine she followed before her half marathon last year.

1. Glute Bridge Warm-Up:

  • Lie on your back with knees bent, and feet flat on the floor.

  • Lift your hips towards the ceiling, squeezing your glutes.

  • Lower your hips back down.

  • Repeat 12 times.

2. Single Leg Bridge:

  • Stay in the same position, but this time raise one leg off the ground.

  • Perform 12 bridges on each side, alternating legs.

3. Dead Bug:

  • Lie on your back with your arms extended towards the ceiling.

  • Bend your knees at a 90-degree angle.

  • Lower one arm and the opposite leg towards the ground, keeping your core engaged.

  • Return to the starting position and repeat 20 times (10 on each side).

4. Side Plank:

  • Get into a side plank position with your elbow directly under your shoulder.

  • Hold for 30 seconds on each side.

5. Full-Range Calf Raise:

  • Stand with your feet hip-width apart.

  • Rise onto your tiptoes, then lower your heels below the level of the step.

  • Perform 10 full-range calf raises.

6. Single Leg Straight Knee Calf Raise:

  • Similar to the full-range calf raise, this time perform 20 repetitions on each leg individually.

7. Single Leg Bent Knee Calf Raise:

  • Again, similar to the full-range calf raise, but this time with a bent knee.

  • Perform 20 repetitions on each leg.

You can also incorporate lunges into your warm-up routine to activate your quads. Lunges will help prepare your legs for the marathon's intense demands.

By following this warm-up routine, you'll be setting yourself up for a successful and injury-free Melbourne Marathon. Good luck to all the participants, and may the wind be at your back as you tackle this incredible event. 🏃🏼‍♀️💨

Photo by Melbourne Marathon Gallery - https://melbournemarathon.com.au/gallery/nggallery/page/2

Muscle Health Implications for Tradies: Insights from Our Physios

August is National Workers' Health Month, and with tradies making up 30 per cent of the workforce, it’s in all our interest to help them stay healthy by highlighting the importance of preventing and treating musculoskeletal problems. 

Therefore, guided by our physiotherapists, we present the potential impacts on muscle health that tradies may experience due to the physical demands of their work plus how physios can help them to boost longevity and work until they are ready to retire. 

Muscle Imbalances:

Some tasks can cause muscle imbalances, where some muscles are overdeveloped while others are underused. This imbalance can cause discomfort, reduce the range of motion and increase the risk of injury.

How physiotherapy can help you out?

Physios can review where imbalances are and provide manual therapy techniques to release any tightened areas and guide through strength exercises to improve any weak areas. 

Strains and Sprains:

Using muscles to lift objects or hold positions for prolonged periods can lead to strains and sprains, in which muscles and tendons are stretched or torn due to overexertion.

How physiotherapy can help you out?

Physio’s are able to help you deload the area to allow for effective tissue healing. Your physio will then be able to guide you through your strength and rehabilitation to get you back to the level of activity that you were previously at. And potentially have you even stronger/better. 

Reduced Flexibility:

Repetitive movements and sustained postures can cause reduced flexibility in muscles and joints, potentially leading to stiffness and limited range of motion.

How physiotherapy can help you out?

Physiotherapists can use manual therapy techniques to help improve your range of motion and muscle length. We can also teach you how to lengthen increase the range of your joints and muscles. 

Postural Issues:

Tradies often bend, lift, and twist, resulting in poor posture over time. Muscles that maintain proper posture may weaken, leading to slouching or other postural problems.

How physiotherapy can help you out?

Physiotherapists are able to help you improve your posture through massage, manipulation and exercise prescription 

Risk of Overuse Injuries:

Performing the same tasks repeatedly can strain particular muscle groups, increasing the risk of overuse injuries such as tendinitis or bursitis.

How physiotherapy can help you out?

Physiotherapists can provide guidance to help you reduce your risk of overloading injuries. They can offer strength programs, load management advice, and correct your techniques.

Muscle Tightness:

Certain trades can lead to chronically tight muscles due to the demands placed on them. Tight muscles can contribute to discomfort and reduced functionality. Weak core muscles may lead to lower back pain and reduced stability.

How physiotherapy can help you out?

Physios will continue to help strengthen muscles to help you improve your function and reduce your pain. 

If you want to know more about keeping your body healthy as a tradie, check out choose.physio/tradieshealth

If you're struggling with pain management and need help with your symptoms, it's important to schedule an appointment with one of our expert physiotherapists. Our team is dedicated to providing you with the best care possible, so don't hesitate to reach out to us for assistance.

Image by <a href="https://www.freepik.com/free-photo/man-working-roof-front-view_11105955.htm#query=tradie&position=7&from_view=search&track=sph">Freepik</a>

Source: Freepik" target="_blank">https://www.freepik.com/free-photo/man-working-roof-front-view_11105955.htm#query=tradie&position=7&from_view=search&track=sph">Freepik

Sam Kerr's Injury in the FIFA Women's World Cup 2023 - Why did it take so long?

Why did it take so long for Sam Kerr’s calf to get ready for the FIFA Women's World Cup?

Sam Kerr had been ruled out for the majority of the FIFA Women’s World Cup Tournament due to her calf injury. She only managed to start the bench at the 80th minute against Denmark, played 35 minutes against France and only managed to start the semi-final game against England, 4 weeks after the initial day of injury (20th July). UPG Physiotherapist Jason take a deep dive into the calf muscle and break down what really went down with Sam.

Let's begin by understanding what the calf is…

The calf is mostly made up of 2 separate muscles, gastrocnemius (gastroc) and soleus. The gastrconemius muscle is the “powerhouse” of the calf; it generates explosive force to propel us running. Where the soleus muscle is a flat muscle which helps generate sustained forces during longer runs. When the gastroc is injured, pain is felt more suddenly and most people will describe it as like “being shot in the leg”. But a soleus strain, pain builds gradually and generally more diffused and somewhat like a cramp.

The gastrocnemius and soleus muscles

Understanding the calf injury risk and its nature

Among elite soccer athletes, the prevalence of a calf injury is about 6%. Older age and a history of previous calf injury are related to higher risk of this injury. The chance of a re-injury is also quite high, 15%. Especially higher with age again, recent history of ankle injury and involvement of soleus muscle. The extent of the injury can be diagnosed with clinical testing, with a range below:

  • 10 days to 3 weeks recovery - Myofascial injury - pain in stretching the muscle and loss of range of motion

  • 4- 8 weeks - Muscle/ tendon injury - pain in using and stretching the muscle

  • 2 months and more -Tendon injury - pain in walking and limping

The recovery tends to be long if an MRI shows a deeper muscle injury and if the mechanism of injury is related to running. 

So, looking at everything mentioned, the fact that Sam needed four weeks to resume full-capacity 90-minute play strongly indicates the likelihood of her having encountered a low-grade muscle injury.

What are the steps involved in recovering from this type of injury?

Based on a study conducted in 2022 with insights and results from a panel of skilled clinicians, specialising in elite sports and relevant research has identified six distinct rehabilitation phases in the recovery process.

  1. Early loading - early movement as tolerated, isometrics, lower reps/load or restricted range

  2. Loaded strengthening - strength work through the range, and soleus work is important regardless of the type of injury

  3. Power and plyometric development - demands in direction, intensity, duration, and external loading. Small-length excursions like pogos; large-length excursions like forward hopping

  4. Locomotion and preparation for sport - walking/ marches, skips. Then a graded return to running

  5. Return to play - guided by exposure and response to sports-specific activities. Testing sprinting, change of direction

  6. Athlete monitoring -  high rate of recurrence, recommend follow up at least 2 months post return to sport.

    The results showed a high emphasis on prevention and recognition of weaknesses.

It's important to note that while specific details about Sam's recovery process remain undisclosed, it's clear that her journey towards her calf muscle recovery followed a carefully paced approach. The recovery of her muscle required intermittent periods of rest and healing, which evidently contributed to her gradual and well-considered return to the matches,

So, if you're wondering how likely you are to end up with calf injuries? Here are a few tests you can try to that can give you an idea. These tests allow you to know your risk zone and get an idea of your situation.

  1. Max calf raises - do as many calves raises as you can do having a metronome at 60 bpm, compare it to the other side. The normal value for a female in her 20s is 30 reps. 

  2. Side hop test - see how strong your ankle stability and calf strength are by hopping side to side 40cm apart for 30secs. Aim to have both sides quite similar. The benchmark for a 21-year-old male is 55-60 reps

If you're aiming to strengthen your calves as a preventive measure against injuries, here is a set of exercises with a video for you:

  1. Wall Squat Calf Raises: This one's all about giving your soleus a workout. Get against a wall, squat down a bit, and then rise up onto your toes. Feel the burn!

  2. Wall Calf Plyometrics: Looking for some explosiveness? This exercise has your back. Push off the wall with your calves, using that power to lift yourself off the ground slightly. It's like calf fireworks!

https://photos.app.goo.gl/k9ts3qyHBYpy39jG7

References

Featured Image: Adam Head - Source: News Corp Australia Injured Matildas skipper Sam Kerr (left) chats to a team medico at training.

Green B, McClelland JA, Semciw AL, et al. (2022). The Assessment, Management and Prevention of Calf muscle Strain Injuries: A Qualitative Study of Practices and Perspectives of 20 Expert Sports Clinicians. Sports Med Open. 8(10), 10.

Green B, LinM, McClelland JA wt al. (2020). Return to Play and Recurrence After Calf Muscle Strain Injuries in Elite Australian Football Players. AJSM.

Knee Pain in Teens

Written by Suramya Yadav - UPG Senior Physiotherapist

Teenagers often experience knee pain, and it can happen for various reasons. Sometimes, it's simply from doing too much or getting injured, like having strains or sprains playing their favourite sport. Other times, medical conditions can also lead to knee pain. But it's important to remember that knee pain might not always be related to an injury but rather changes in activity levels or growth spurts.

Considering the many factors that can cause knee pain, it's crucial to have a physiotherapist check it out if your teen complains about it. Please don't dismiss it as growing pains, as there could be a more significant issue. In this article, we'll explore the reasons behind teenage knee pain and how to prevent it; and we will emphasise the importance of seeking help from a physiotherapist for proper diagnosis and treatment.

What are the causes of knee pain in teenagers?

When a teenager's knees hurt, aka anterior knee pain can be due to three causes:

  • Patellofemoral dysfunction is the abnormal alignment of the kneecap in its groove, patellar tendinitis or bursitis.

  • Injuries to ligaments and tendons of the knee or to the kneecap itself. This includes meniscal tears, sprains to knee ligaments - Anterior or Posterior Cruciate ligaments, medial and lateral collateral ligaments, and patella dislocation.

  • Medical conditions that affect the knee such as Osgood-Schlatter disease, Sinding-Larsen Johansson Syndrome, Osteochondritis Dissecans and Juvenile Arthritis.

It is important to remember that knee pain can be aggravated by repetitive impact activity such as jumping, running, twisting or participating in competitive sports and inadequate muscle strength and conditioning.

Who typically experiences anterior knee pain?

While anterior knee pain and patellofemoral pain syndrome can affect anyone, it is more common in:

  • Active people, particularly those who run, jump, ski or bike regularly.

  • Healthy teen girls and young women (more than males)

  • People who have previously injured their knee cap through dislocation or fracture

  • People who are overweight

Suppose your active teen needs to compensate for movement limitations. In that case, they can alter their standard mechanics, which places more significant stress on the knee. For example, suppose a dancer has insufficient turnout (external rotation at the hips). In that case, they might compensate by turning their shins out (external tibial rotation) and rolling over the arch (pronation), which can increase knee stress.

Other factors that increase stress on the knee include tightness in the Illio-Tibiall band, excessive knee extension and weak quadriceps muscles.

Signs and Symptoms of Knee Pain

Whilst there is no clear definition of anterior knee pain, patients can present with various symptoms depending on the underlying pathology, for example:

  • If your teen experience more pain when going downstairs, squatting, jumping, or sitting with their knees bent for extended periods, it's called the 'movie sign.'

  • Swelling in a specific area.

  • Feeling pain or tenderness when pressing on the patellar tendon (tendinitis).

  • Pain during muscle contraction, squatting and kneeling.

  • Weakness in the muscles, particularly the Quadriceps

How to Manage and Prevent Knee Pain

The best way to prevent and treat knee pain for your teenager is to see a physiotherapist who will analyse their specific case and give personalised advice. However, here are some simple strategies you can include in the daily routine to prevent knee pain and some things to do if the pain happens:

  • REST: Taking a break is essential for tissues to recover and heal. It might be necessary for your teen to avoid the activity that triggered the pain temporarily.

  • ACTIVE REST: Active recovery involves reducing activities that aggravate the pain until it is better managed. For instance, go for low-impact exercises like biking or swimming instead of high-impact activities like running and jumping.

  • COLD COMPRESSION THERAPY: Ease inflammation and swelling by applying ice to the knee. Apply for up to 20 minutes at a time.

  • MUSCLE STRENGTHENING: 

    • Start by incorporating closed-chain exercises, as they are more functional and reduce stress on the joint. For example, squats, deadlifts, lunges, power cleans, and leg presses.

    • Progress to include isometric exercises such as presses, pulls, and holds. Then move to isotonic or aerobic exercises, for example, running, hiking, swimming, skiing, and dancing. Finally, include energy storage exercises to meet sports demands with specific drills.

  • STRETCHING: Do repetitions of specific stretches for the quadriceps, hamstrings and calves to increase the length of these muscles. These will give support to the knee joint and minimise pain.

  • TAPING AND BRACING:  Whichever of these you choose will help ensure the correct kneecap alignment. A recommended knee taping recommendation for knee pain relief is the Mcconnell technique.

  • KEEPING APPROPRIATE WEIGHT: By maintaining a healthy weight through a balanced diet and regular exercise, they can reduce the stress on their knees and help prevent knee pain.

  • LOAD MANAGEMENT: Depending on the severity of the injury, its prognosis, and functional requirements of the sport, it is recommended to make a plan that includes a gradual and optimal loading of the healing tissue after an initial period of rest.

  • Consulting a physiotherapist can be very helpful in designing individual-specific exercise plans, progressive tissue/joint loading, faster recovery and return to play.

  • STRUCTURED WARM-UP AND COOL-DOWN: By incorporating a proper warm-up, cool-down, and stretching routine into your exercise routine, you can significantly reduce the risk of injuries and minimise the occurrence of knee pain.

  • A highly recommended warm-up protocol for soccer players is the 11+ FIFA protocol. It has been extensively researched and designed to reduce the risk of injuries. A version specifically tailored for children aged 11 years and older can be found and demonstrated at the following link: https://fit4football.co.nz/physical-conditioning/the-11/the-11-kids/. This protocol is an effective way to prepare young soccer players for training or matches while promoting their safety and well-being.

The AUSTRALASIAN COLLEGE OF SPORT AND EXERCISE PHYSICIANS (ACSEP) developed guidelines based on research that provide recommendations for how much training is appropriate for young athletes to prevent injuries. These guidelines consider factors like age, physical development, and the demands of the sport. By following these guidelines, coaches and parents can help young athletes train safely and avoid getting hurt. Finding the right balance of training, rest, and recovery is important to keep young athletes healthy and injury-free.

Here are some highlights from the guidelines that are easy to keep in mind when analysing the sports routine of young people.

  1. Each week, a player should only participate in organised, structured sport for a maximum of their age in years - For example, an eight-year-old should participate in at most eight hours of organised, structured sport per week.

  2. It is advised that players should only engage in a single sport for up to eight months per year. This recommendation aims to prevent overuse injuries, mental burnout, and a potential drop in interest or participation in the sport. It is generally recommended to avoid specialising in a single sport until players reach the age of fifteen to sixteen years old, considered late adolescence. This allows young athletes to explore and participate in various sports and activities, promoting their overall physical development and reducing the risk of overuse injuries associated with early specialisation.

  3. Children should have regular opportunities for unstructured play each week. Unstructured play allows them to be creative, develop social skills, and engage in physical activity without rigid rules or guidelines.

As the enthusiasm for youth participation in sports continues to grow, prioritising their enjoyment, safety, and injury prevention becomes increasingly important. Seeking guidance from a physiotherapist ensures that teenagers have the necessary tools to address and treat knee pain when it arises. By implementing preventive strategies and utilising professional support, they can maintain their passion for sports while minimising the risk of injuries and pain, allowing them to enjoy their athletic pursuits fully.

Don't let knee pain get in the way of your teen's active lifestyle - book now a session with one of our expert physiotherapists

References:

https://www.physio-pedia.com/Anterior_Knee_Pain

https://www.physio-pedia.com/Patellofemoral_Pain_Syndrome

https://www.physio-pedia.com/Patellar_Tendinopathy

https://fit4football.co.nz/physical-conditioning/the-11/the-11-kids/

https://my.clevelandclinic.org/health/diseases/16716-knee-pain-in-teens

https://kidshealth.org/en/parents/runners-knee.html

https://kidshealth.org/en/parents/osgood.html

https://www.chop.edu/conditions-diseases/anterior-knee-pain-children-and-teens

https://www.childrensmercy.org/departments-and-clinics/orthopedics/sports-medicine/injury-management/patellofemoral-pain-syndrome/

https://www.physio-pedia.com/Load_Management

Image by <a href= "https://www.freepik.com/free-photo/sideways-kid-sitting-after-game_5053015.htm#query=kid%20running%20pain&position=45&from_view=search&track=ais">Freepik</a>

 

Check-Up Time: 4 Reasons For Physio Visits

  1. Your body loses mobility in muscles and joints every day

    Muscles lose size and strength as we age, contributing to fatigue, weakness and exercise tolerance. Bone structure changes, resulting in a loss of bone tissue. Low bone mass means weaker bones and puts people at risk of fractures from a sudden blow or fall.

  2. No more masking muscle pain with medication without solving the problem

    The use of anti-inflammatory and analgesic drugs used to treat muscle and joint pain does not really solve the ailment, but simply palliates the pain momentarily, reproducing it later and sometimes creating a rebound effect that is difficult to reverse when the medication is discontinued.

  3. Don’t let that slight discomfort become chronic pain

    Related to the previous point, if we endure an occasional pain that we treat as something inevitable and do not give it the importance it deserves, over time, it can become something chronic due to the wear and tear and the mistreatment to which we have been subjecting that particular part of our body.

  4. Nothing hurts, as usual; the usual is that nothing hurts!

    Pain is a warning from our body that something is wrong. Whether it is due to illness, a response to stress or injury, we need to be aware of the problem and try to solve it as soon as possible.

Visit your physiotherapist at least once a year and start believing in preventive medicine as a solution to serious health problems triggered in the medium and long term.

BOOK HERE with one of our physiotherapists.

References

Image by <a href="https://www.freepik.com/free-photo/full-shot-woman-physical-rehabilitation_20489704.htm#query=visit%20physio&position=49&from_view=search&track=robertav1_2_sidr">Freepik</a>

Pilates and Football: A Winning Combination

As the 2023 AFL Season begins in Melbourne, players at every level of the sport, from professional to recreational, need to consider their readiness for the season ahead regarding individual and team goals. Even more essential is that they remain healthy enough to stay on the starting lineup instead of becoming injured and sitting on the sidelines. Combining Clinical Pilates with football practice is an effective way to reduce the risk of injury.. This winning combination strengthens muscles, increases flexibility, and provides stability and balance.

The nature of Australian Football, a contact sport, leaves players prone to many injuries from tackling, kicking, running, marking and constant competition for the ball. Overuse injuries are common in AFL, as the game is full of repetitive movements. These can include injuries such as patellofemoral pain, shin splints, rotator cuff-related pain, tendinopathies, muscle strains and much much more! On the other end of the spectrum, there are also those unpredictable contact-related injuries that are unavoidable when on the field. 

In 2021, hamstring strains, concussions, and calf strains were the three most frequent causes of match absence. Such injuries typically arise from unexpected physical contact between players and can involve joint dislocation, a concussion, a sudden muscle tear such as in the hamstrings, groin, or calves, or a tear/rupture of ligaments and tendons. With the proper training, our bodies can be better equipped to withstand impacts, whether unexpected or unintentional. Doing so helps protect our structures and, ultimately, elevates our performance on the field.

Why should AFL players do Clinical Pilates? 

Clinical Pilates has proven to be a powerful preventative tool against both acute and chronic injuries, in addition to prehabilitation, ultimately leading to better performance during high-stress and intense sporting scenarios. Football players at all levels have increasingly become aware of the advantages Clinical Pilates can bring in terms of injury prevention and performance enhancement. Its success lies in its approach to more than just muscle strength.

If you are still deciding if Clinical Pilates can improve your football performance, Hannah, one of our physiotherapists, gives you six reasons to add Clinical Pilates to your football routine. 

1. Corrects muscle imbalances

Clinical Pilates is designed to correct muscular imbalances caused by an athlete's repetitive movements. Repetitive movements often cause overuse injuries so by stretching out the tight muscles and strengthening the weak ones, you can recreate your body's equilibrium. This takes stress off the overused tissues and can activate the underused, thus preventing those overuse/repetitive strain injuries! 

2. Improves strength/endurance/stability

Clinical Pilates is a full-body workout, focusing on all your muscle groups to create that body equilibrium. By adding resistance to the reformer machine or using body weight (or many other pieces of pilates equipment), you can constantly work to build on your strength. It also works on our endurance system by completing movements in a slow and controlled manner. Building up your strength and endurance has a direct impact on your balance, posture and stability!

3. Improves performance on the field

Clinical Pilates teaches your body to adapt to intense and stressful conditions, forcing the body to push through fatigue whilst maintaining the correct technique. This translates to the game as when a player gets tired their performance generally deteriorates. If you can play well for longer, well isn't that the secret to success?

4. Trains all planes of motion/unpredictability of sport 

  • AFL and Clinical Pilates work in all three planes of motion and involve multidirectional movements whereas the gym often only involves one single plane of motion!

  • Being on the field involves many unpredictable situations. With regular strength and conditioning workouts in our UPG studio with a 1:1 session, we can ensure your body is ready to take on anything.

  • That buzzword of 'core stability' with the help of those big gluteal muscles is essential in absorbing force as well as creating those powerful propelling movements required in single leg movements such as sprinting, lunging, jumping and quick change of directions. 

5. Improves movement patterns and joint stability 

  • Clinical Pilates rebalances your body, stretching and strengthening different muscle groups. Engaging in a specialised pilates program for your body can help to improve movement patterns, making your body move more efficiently as well as provide the correct amount of stability to your joints. 

  • Clinical Pilates also focuses hugely on this concept of 'core stability'. This means that the muscles of your torso are strong enough to maintain your posture during movement. Having a 'strong core', can help absorb impact, thus preventing back and lower limb injuries during those harsh landings and tackles.

6. Flexibility /Recovery

  • Clinical Pilates provides a form of rehabilitation, combining stretches to ease tight muscles and promote joint mobility after a strenuous game or practice session, helping to prevent the unpleasant aftermath of DOMS (delayed onset muscle soreness).

  • Clinical Pilates as part of an 'active' recovery process can help decrease your risk of suffering an overuse injury and enhance your athletic performance and training ability. It can lessen the impact that the game has on your body in the aftermath of a game.

No experience with Pilates? No problem! Come join us in one of our group classes on Thursdays or schedule an appointment with one of our physiotherapists here.

Be ready to perform at your peak for the next AFL season!

Resources:

https://sma.org.au/resources-advice/sport-fact-sheets/afl-fact-sheet/

https://www.afl.com.au/news/768285/afl-releases-2021-injury-report 

https://www.pilatesinguelph.com/blog/2017/3/15/why-soccer-stars-from-the-uk-are-turning-to-the-mat 

https://thecore.balancedbody.com/pilates-on-the-pitch-how-professional-soccer-players-are-using-it-to-train/ 

https://www.ten.co.uk/pilates-for-football

Max King Shoulder Injury - Physio Analysis

If you are a footy fan, you might have heard about Max King’s shoulder injury just before Christmas last year. As a result of the injury, Max had to undergo reconstruction surgery and will miss the start of the AFL season in 2023.

You might have seen quite a few footy players getting a shoulder injury every now and then, but did you know that this kind of injury has a rate of 1-2 per club per year? And the chance for a recurrence of the injury can range from 9%- 15% and even as high as 54%. (Saw et al., 2018)

UPG Physiotherapist Jason analyses Max King's shoulder injury and takes a deeper view of what causes the injury, what are the treatment options and how long it takes to recover.

What is this shoulder injury?

What Max suffered from was an anterior dislocation of his shoulder joint, which means his shoulder “popped” forwards out of the joint. Doctors at the emergency room can “pop” it back in place, but the player may suffer from ongoing joint instability which may damage more structures in the shoulder. Often these other structures then require surgical intervention.

How does this shoulder injury happen?

The most common way to dislocate a shoulder in AFL is from a contested overhead mark. This movement requires the athlete to have their arm fully elevated and rotated which is the most vulnerable position for dislocation.

Photo from Getty Images

What is damaged in the shoulder and why is surgery needed?

The shoulder is a ball and socket joint; it gives us extreme mobility and movement but lacks structural stability from the bony structures. The main form of stability and support is from the labrum (cartilage) and the active structures (ligaments and muscle tendons). 

The labrum provides support by deepening the contact surface of the ball in the socket. Whereas the ligaments and muscle tendons provide dynamic support by covering around the joint. 

When the shoulder is dislocated forwards, it stretches the active structures and in up to 40% of cases, causes tears and fractures of the labrum and/or glenoid fossa which requires surgical intervention to repair.

What does the surgery involve and what options do I have?

There 2 different approaches to repair the torn cartilage:

  1. Bankart Repair where the labral fragment is sutured back (Collin et al., 2017)   

  2. Latarjet Procedure where this approach repairs the labral tear and adds stability by transferring a piece of bone (coracoid) to the front of your glenoid - socket (Sydney Shoulder Unit).

Max has undergone the Latarjet procedure and he was expected to return to AFL about 8 months after surgery.

So which one should you be considering? Let’s review the risks and benefits of both!

Bankart Repair 

Pros: 

  • Small incision site (key-hole/ arthroscopic surgery)

  • Minimal risk of complications, less than 4%

  • Reduce soft tissue damage

  • Faster recovery of strength

  • Faster return to sport time, average of 6.8 months

Cons:

  • Higher shoulder instability recurrence rate, 20.2% 

  • Higher re-dislocation rate, 15%

Latarjet Procedure

Pros:

  • It provides more passive stability from the extra bone (coracoid bone) and biceps tendons

  • Lower risk of instability recurrence rate, 14.8%

  • Lower risk of redislocation rate, 2.7%

Cons:

  • Higher risk of complications like nerve injuries and non-union (failed bone healing) at the coracoid bone graft, 10.6%

  • Return to sports time usually 1-2 months longer than Bankart repair

(Rollick et al, 2017)(Perret et al, 2021)

Bankart repair is the more preferred option in the general population because it results in no change to the normal structure of the shoulder and with proactive Physio led rehabilitation, the recurrence rate of dislocation rate can be reduced to as low as 5% (Drummond Jr et al, 2021)

The recovery and rehabilitation period for this injury could be a long one, however there is a recent study looking into a criteria-based approach to clear patients back into sports. This study proposes some targets or milestones the patient needs to reach before returning to contact sports such as:

  • rotator cuff strength (isokinetic and isometric)

  • rotator cuff endurance (external rotation endurance test)

  • closed kinetic chain upper extremity stability test (CKC-UEST)

  • unilateral seated shotput (USS) test

To be cleared by the physio to return to sport, the person must reach a score of >90% strength compared to the unaffected extremity. If this isn’t reached, the patient must continue rehab exercises for 4 to 6 more weeks. Using these criteria has been shown to reduce shoulder instability rate to 5%.

References

Main Photo - (Scott Barbour/AAP PHOTOS)

Abrams R, Akbarnia H. Shoulder Dislocations Overview. [Updated 2020 Jan 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.

Castagna A, Markopoulos N, Conti M, Delle Rose G, Papadakou E, Garofalo R (2010). Arthroscopic Bankart suture-anchor repair: radiological and clinical outcome at minimum 10 years of follow-up. Am J Sports Med.

Collin, Philippe & Lädermann, Alexandre. (2017). Dynamic Anterior Stabilization Using the Long Head of the Biceps for Anteroinferior Glenohumeral Instability. Arthroscopy Techniques

Driscoll MD, Burns JP, and Snyder SJ (2015). Arthroscopic transosseous bony bankart repair. Arthroscopy Techniques. 

Drummond Jr M, Popchak A, Kevin W & Gillian K (2021). Criteria-based return-to-spor testing is associated with lower recurrence rates following arthroscopic Bankart repairs.

Journal of Shoulder and Elbow Surgery. Latarjet procedure: Shoulder surgery. Sydney Shoulder Unit. (2021, December 30). Retrieved March 16, 2023, from https://sydneyshoulderunit.com.au/procedures/latarjet-procedure/ 

Saw, R., Finch, C. F., Samra, D., Baquie, P., Cardoso, T., Hope, D., & Orchard, J. W. (2018). Injuries in Australian Rules Football: An Overview of Injury Rates, Patterns, and Mechanisms Across All Levels of Play. Sports health.

Guide to understand Achilles Pain

What is the Achilles?

Your Achilles is a tendon that connects the muscles of your calf to the back of your heel. The Achilles tendon is the biggest and strongest in the whole body.

What is the role of Achilles?

The Achilles tendon is involved in plantarflexing (planting your foot, i.e. pushing on the accelerator in your car) the foot. This is a crucial body movement for functions such as walking, running and jumping. The Achilles tendon plays a big role in producing explosive power and can produce force 10x your body weight.

How common is Achilles' pain?

The Achilles tendon is susceptible to damage with repetitive use or overload. These types of injuries typically occur in athletes and are usually sports or exercise-related.

The most common diagnosis of Achilles pain is Achilles Tendinopathy (which accounts for about 55-65% of cases - Järvinen 2001). You can also rupture your Achilles However, it is quite rare, being such a strong tendon.


Common symptoms

  • Pain in your heel or Achilles tendon

  • Morning pain - This is an extremely common symptom

  • Pain following activities (immediately after or the next day)

  • Difficulty walking/planting your foot

  • Swelling, tenderness and even warmth of the Achilles tendon

Common Symptoms Achilles Pain

Difficulty walking/planting your foot. Swelling, tenderness and even warmth of the Achilles tendon

What can be the causes?

The most frequent reason patients seek us out in our studio is that they have done too much excersice, too soon. This is usually something you see in longer-distance activities like running or bush walking when patients haven’t previously done these activities in a while or ever!  

Overpronation or ‘flat-feet’ can be another cause of Achilles pain as greater demands are placed on the Achilles tendon. Over-pronation can also lead to Achilles pain due to a lack of blood flow in that position, leading to injury (Karzis, et al, 2017). Overpronation can initiate an inflammatory response to the Achilles tendon and potentially begin an Achilles tendinopathy 

 

Treatment Techniques

  1. Manual Therapy

    For those patients with acute or chronic Achilles pain, a range of manual therapy techniques may be used to help decrease their level of pain, improve their range of motion and improves function. This can include massage, trigger pointing, dry-needling and many more techniques.

    This is a significant variable of how we treat as physiotherapists but it has an even greater effect when paired with strength and conditioning for the Achilles.

  2. Load Management

    If a key contributor to Achilles tendon pain is overloading the tendon, managing those loads is an obvious direction for treatment. Recognising current loads for our clients is crucial in the advice we give to help manage those loads.

    Your Physiotherapist has a great understanding of how much force is needed to complete a task related to the Achilles tendon. Therefore, your physiotherapist can help guide you with what exercises you can still complete without overloading the tendon. Once symptoms settle, this is when we can look to increase our loading with a range of different exercise approaches.

  3. Strength

    Strengthening our Achilles is crucial in building a greater load tolerance. The more load the Achilles can tolerate, the less chance of that tendon being overloaded. These are very much based on calf-based exercises which can progress to more impact-based movements like jumping and hopping.

If you want to know more about Achilles pain, treatment or rehab,

BOOK HERE with one of our physiotherapists.

References:

  • Järvinen TA, Kannus P, Paavola M, Järvinen TL, Józsa L, Järvinen M. Achilles tendon injuries. Current opinion in rheumatology. 2001 Mar 1;13(2):150-5.

  • Karzis K, Kalogeris M, Mandalidis D, Geladas N, Karteroliotis K, Athanasopoulos S. The effect of foot overpronation on Achilles tendon blood supply in healthy male subjects. Scand J Med Sci Sports. 2017 Oct;27(10):1114-1121. doi: 10.1111/sms.12722. Epub 2016 Sep 27. PMID: 27671520.

  • <a href="https://www.freepik.com/free-photo/closeup-young-man-with-ankle-injury_10421017.htm#page=7&query=heel%20injury&position=40&from_view=search&track=robertav1">Image by wayhomestudio</a> on Freepik

Nick Kyrgios Knee Injury - Physio Analysis

The world No.21 Australian tennis player Nick Kyrgios announced his withdrawal from the Australian Open 2023 due to a left knee injury.

UPG Physiotherapist Dane Monaghan discusses and answers some of the most common questions to better understand Nick's situation and analyse his injury and its implications.

What are the causes of what happened to Nick Kyrgios that led him to retire from the AO?

He has had previous meniscus injuries in the past - in the healing process; it seems as though he has grown a small cyst within his knee. 

This can make the knee uncomfortable and feel like there is added pressure within the joint.

What might be the symptoms that he presented? 

According to what Nick and his physio told the press was some swelling and pain in his knee. Other common symptoms associated with meniscus-based injuries in athletes may include some locking or catching of the knee.

Will there be long-term implications for Kyrgios?

Multiple surgeries on his knee could lead to an early onset of arthritis. The main long-term indication is that Nick will have to maintain a good exercise routine for his knee to ensure it stays strong and avoids being exposed to forces higher than his knee capacity (The higher the capacity, the more the knee can deal with the demand).

A lot of evidence shows the positive effects of regular exercise on the knee following a meniscus injury. In fact, it can be comparable, if not better, than surgery! We must, however, understand that surgery is a viable option for Nick as his job is to play tennis, and surgery is likely the faster route to do that. 

How could this injury have been prevented?

Very hard to say. What we do know is that for Tennis players, we can reduce the risk of injury through a number of factors such as:

  • Having a consistently progressive off-season with appropriate load management (avoiding doing too much too soon).

  • Practising landing, jumping, sprinting and all the movements that are exposed during a tennis match.

  • Having an appropriate warm-up

  • Appropriate footwear 

The Australian Open is tough for tennis players as though they go from their 'off-season' into basically a grand final. Of course, there are a few lead-in tournaments, but they are very limited compared to what is asked of the champion over two weeks.

What is the recovery process for Kyrgios, and how long does it take? 

Without knowing exactly what procedure he is undergoing, it is likely, we are looking at a 2-3 month process where the initial stages are about managing symptoms and restoring his everyday function. Once his symptoms settle and his range and function restore, we look to load up the knee with exercises to become stronger and be ready for the next competition.

How can physiotherapy help Kyrgios?

  1. Exercise prescription and injury prevention:
    Having an adequate base of strength in key areas of the body helps reduce the risk of injury.

  2. Treating any ‘niggles’ before playing

  3. Muscle strength and functional movement assessments:
    Identifying weaknesses and creating a plan for them (such as exercise prescription) can reduce the risk of injury and enhance performance!

Photo: Australia's Nick Kyrgios has his knee attended to. - AP Photo/Aaron Favila Source: AP https://www.foxsports.com.au/tennis/australian-open/australian-open-2019-live-scores-results-from-night-2-nick-kyrgios-v-milos-raonic-novak-djokovic-v-mitchell-kreuger/news-story/52eeca621bea8ea13486816785f6260c

January 19, 2023

Don’t be a wrist taker. Manage your wrist sprain.

Written by Jenny Wu - UPG Physiotherapist & Pilates Instructor

One of the most underrated but delicate parts of our bodies is the wrist. Your wrist is made up of 8 small carpal bones and 2 long bones in your forearm. Beyond the bony structure, the wrist is a complex network of ligaments, tendons, nerves, bones and cartilage. Although spraining a wrist is a common occurrence, it can wreak havoc in our day-day life, therefore in this blog, you find the importance and how to manage a wrist sprain correctly.  

 

What is a wrist sprain?

A wrist sprain is an injury to the ligaments of your wrist. This means the ligaments connecting the carpal bones and/or the ligaments connecting your carpal bones to the bones of your forearm are stretched beyond their limits, twisted or torn.

“A wrist sprain can vary in severity depending on how badly the structures are injured.”
— Jenny Wu - UPG Physiotherapist

What causes wrist sprains?

A wrist sprain is often a result of an acute injury, the most common being a fall on an outstretched hand. Whether from our normal day-to-day activities such as working, cooking, writing, or playing sports, the wrist is forced too far back, and the supporting structures are stretched or torn. Another cause is when the wrist is over-twisted, especially when the hand is gripped, such as playing racquet sports.

Although less common, wrist sprains can also occur due to repetitive stress; excessive weight-bearing or twisting motions can gradually irritate structures in your wrist.  

How do you know if you have a sprained wrist?

Many signs indicate a wrist sprain, but some of the common symptoms to look out for include:

  • Feeling a popping or tearing in your wrist

  • Pain weight bearing on your wrist

  • Pain with twisting and rotation motions

  • Pain with moving your wrist from side to side

  • Tenderness on touch

  • Warmth around your wrist

  • Swollen wrist

  • Difficulty moving the wrist

  • Difficulty and painful gripping

  • Weakness in your wrist

How do I manage my sprain?

Initially, it is essential to do no harm and manage the swelling and pain in your wrist. This can be done through the PEACE method (Protection, Elevation, Avoiding anti-inflammatory drugs, Compression, and Education).

After a few days, our tissues need LOVE (Load, Optimisation, Vascularisation and Exercise) which is important as it considers the ongoing management and continuum of tissue healing. 

Depending on the severity of the injury, wrist sprains may need bracing, splinting or taping to help promote protection and healing. Once the swelling and pain have settled to a manageable level, it is essential to mobilise and strengthen your wrist to avoid long-term complications. It is worthwhile to also add proprioceptive exercises, especially if you play sports. As you do your exercises to improve the range, strength and stability of your wrist, it is imperative that you start with a manageable load and slowly increase the difficulty. Going too hard too fast will hinder the healing process.

The recovery time varies depending on the type of sprain and the management of the injury. It is important to have your wrist sprain examined if symptoms persist. A physiotherapist can help assess which structures are injured and the extent of the injury. This is important to guide treatment and can help set you up with an optimal treatment plan to meet your specific needs and ensure the best possible outcome.

In addition, a physiotherapist can help progressively load your wrist, modify activities to suit your current capabilities, and review improper form, equipment or training habits that may have contributed to or prolonged injury.

 If this sounds familiar and you need help managing your wrist sprain, book here with one of our physiotherapists.

References

May Jr DD, Varacallo M. Wrist Sprain. [Updated 2022 Sep 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK551514/

Avery, D.M., Rodner, C.M. & Edgar, C.M. Sports-related wrist and hand injuries: a review. J Orthop Surg Res 11, 99 (2016). https://doi.org/10.1186/s13018-016-0432-8

<a href="https://www.freepik.com/free-photo/sad-frustrated-young-woman-striped-top-frowning-holding-hand-her-aching-wrist-massaging-pain-area-having-painful-facial-expression-suffering-from-joint-pain-arthritis-gout_11033367.htm#query=wrist%20pain&position=43&from_view=search&track=sph">Image by karlyukav</a> on Freepik



What is Clinical Pilates or Physfit?

Written by Phoebe Cunningham - UPG Physiotherapist & Pilates Instructor

Clinical Pilates is a modification of pilates-based exercises that are used therapeutically by physiotherapists. At UPG we use practice Clinical Pilates within our Physfit service which is one of the treatment options where the physio focuses on rehabilitation and injury prevention through exercises. Our Physfit consultations and group classes are run by physiotherapists who have been trained in clinical pilates and will plan your goals together based on your physical needs and expectations.

Everyone’s life is unique and so is their Physfit program, therefore your first session will be an initial assessment one-on-one where your physio will gain an understanding of what you may need to work on, to reach your goals. This session will guide the physiotherapist in the creation of your individualised program and you will also be provided with a home exercise plan to complement the program practised in the studio.

Once your Physfit program has been created you will have a 1:1 sessions with a physiotherapist to guide you through your series of exercises. We will be able to modify and check your progress with each exercise where appropriate, to ensure you are gaining the most out of your exercises. Once you are feeling more comfortable with your program, you will have the option of joining the group class that has up to 5 people or continuing with your 1:1 sessions. 

Physfit Initial Consult

One-on-one session run by a physiotherapist who has been trained in Clinical Pilates.

How is Clinical Pilates different from fitness-based Pilates?

Clinical Pilates or Physfit is quite different from a fitness-based exercise class. Clinical Pilates is used by physiotherapists as a treatment tool, this means that in each class you will be working on specific exercises that have been selected to help with your rehabilitation or injury prevention goals.

Another difference is that during our Physfit session, you will be closely monitored by a physio to ensure that each exercise is completed with the correct technique. This gives you the opportunity to do the movements properly, to reduce the likelihood of injuring yourself whilst completing any exercises, and can help with reducing your levels of pain.

In our Physfit group class, unlike a fitness-based pilates class, the physio is able to modify any exercise to ensure that it is at the correct level for you. Additionally, because it is a Clinical Pilates session, the class group is small with no more than 5 people which allows each participant to receive adequate feedback and supervision whilst completing the exercises.  

Lastly, at our studio, we have a range of different equipment that we can utilise within our Physfit sessions. We are able to offer a large repertoire of exercises with the ability to progress/regress where necessary. Some pieces of equipment that are available for use at UPG studio are 6 x reformers, along with many accessories for the reformers, a cable machine, a variety of dumbbells, bars and heavier weights. If you’d like to have a physiotherapist guide you through the use of these different bits of equipment we are able to help you. 

Closely monitored by your UPG Physio

To ensure that each exercise is completed with the correct technique.

Why you should do Physfit?

If you are questioning whether clinical pilates is the right type of exercise for you? my direct answer would be that clinical pilates can be suitable and beneficial for any type of person, especially if you have any of the following conditions:

  • Musculoskeletal injuries

  • Prevention of injuries

  • Back and neck pain

  • Headaches

  • Hip and knee injuries  

  • Chronic pain

  • Pre and post-natal

  • Pre and post-surgery

  • Posture retraining

  • Core strengthening

What are the benefits of Clinical Pilates/Physit?

Clinical pilates has been validated by numerous research papers and has been demonstrated to provide incredible benefits. Some included are: 

  • Improve strength, balance, coordination, flexibility/mobility, posture, movement patterns and stability. 

  • Facilitate rehabilitation by allowing muscles to stretch and relax to promote healing. 

  • Injury prevention - able to strengthen and stabilise muscles to prevent displacement. 

  • Improves core strength and pelvic floor function 

  • Strength training to improve bone density and muscle tone. 

  • Improve mental health 

  • Increase body awareness - requires focus and control 

If you would like to try one of our Physfit sessions book your initial assessment at reception or by calling 1300 884 171.

 

5 principles to kick start your Pilates journey

Written by Hannah Moran - UPG Physiotherapist & Pilates Instructor


Want to start Pilates but don’t know where to start? Try these basic Pilates Principles to help you release some muscles and begin your Pilates journey.

1) Head & Cervical Placement

  • In most instances, the neck should continue the line created by the thoracic spine.

  • Begin with a slight head nod, eye gaze drops, and head stays resting on the mat (avoid jamming your chin to your chest).

  • Try adding in a crunch by lifting your shoulder blades up off the floor, keeping your neck in line with your spine.

2) Pelvic Placement

  • Rock your pelvis through anterior and posterior tilts, neutral will be found somewhere between the two. 

  • Engage TA (transverse abdominis) by drawing your belly towards your spine, think about “tightening the corset”.

  • The strongest position for stability is the neutral pelvis with your TA activated.

  • If unable to maintain control in this position, you may need to try the imprint position by moving into a slightly more posterior pelvic tilt position with TA and obliques engagement (think about “sliding ribs to hips”)

3) Rib Cage Placement

  • The abdominal wall attaches to the ribcage and can appear lifted or flared when abdominal muscles are not engaged. 

  • Think about maintaining a sense of the weight of the ribs resting on the mat, without pushing heavily down on the mat. 

  • When adding in arm movements, think about keeping the abdominal connection and rib cage resting on the mat.


4) Scapular Movement & Stabilisation

  • The ’shoulder blades’ are very mobile body parts so require stabilization throughout all exercises whether arms are moving or not. 

  • Try these different movements of the scapulae to gain awareness of their positioning.

5) Breathing

  • 3D breathing is encouraged to promote muscle activation and helps to avoid the build-up of tension.

  • Breathe in through the nose, expanding the rib cage.

  • Breathe out through the mouth, and focus on the gentle engagement of the pelvic floor and abdomen as the air escapes. 


Come and meet me at the UPG Studio where I can work with you to identify your goals and create your individualised Physift program that incorporates aspects of clinical exercise and physiotherapy on mat & reformer.

Once you’re comfortable with your program, you can join our small group classes with a maximum of 5 clients to continue to progress through your Physfit program! Find more information about our Physfit Classes here.


Does Pilates really help with Low Back Pain?

Written by Hannah Moran - UPG Physiotherapist & Pilates Instructor

Low back pain is a major health problem worldwide and is something that most people will experience at some stage in their life. According to the European Guidelines low back pain (LBP) is defined as a discomfort localised below the costal margin and above the inferior gluteal folds and is a pain not attributed to recognisable, known specific pathology.

More than 80% of all health care costs can be attributed to chronic LBP and it is the most common reason for people to attend a doctor or to miss work and is the leading cause of disability worldwide. Based on the National Health Survey (NHS) 2017–18 of the Australian Bureau of Statistics (ABS); about 4.0 million Australians (16% of the total population) have back problems including a range of conditions related to the bones, joints, muscles, nerves and connective tissue. 

There are many causes of back pain and these can be related to work, sports, lifestyle issues, injuries or diseases such as arthritis, disc disease and osteoporosis. Factors that may increase the risk of developing back problems include age, physical fitness, smoking, being overweight, and the type of work a person does. Back pain can range from a muscle aching to a shooting, burning or stabbing sensation. In addition, the pain may radiate down your leg or worsen with bending, twisting, lifting, standing or walking. 

What is Pilates & How does it help low back pain?

Pilates is a form of exercise and body conditioning developed by Joseph Pilates in the early 20th century, mostly as a method of injury recovery for dancers. Over time, it became clear that the average person could benefit from this form of exercise. Due to our habits, postures and increasingly sedentary lifestyles, our muscles can get imbalanced from overuse and the main goal of Pilates is to counteract those imbalances.

The principles of Pilates focus on the use of the abdomen and low back muscles in flowing movement patterns that are precise, steady and with controlled breathing. It aims to build muscle tone, specifically focusing on the core. While some people might consider just your abdomen to be the core, the Pilates method extends well beyond that, working on the theory of ‘Everything’s attached’ and how all muscles are interconnected. If we work on our core, it will affect the rest of our body too. 

Pilates can help with low back pain by:

  • Improving a person's awareness of their core, body positioning and alignment.

  • It can help to improve body control, strength and flexibility.

  • Building muscle tone in your core and associated muscles helps to provide stability to your area of pain, whether it be your back, shoulders or any body part!

  • Gaining core control and awareness then translates to your everyday movements where you’ll have more core stability and strength in daily tasks, reducing your risk of injury or strain. 

What can I do for my lower back pain?

To manage your low back pain, you should see a physiotherapist to have an in-depth assessment of your pain and begin your personalised treatment program to get you on the road to recovery. You should contact your doctor if you sustained back pain from a trauma, have unexplained weight loss, fever, night pain, saddle anesthesia, incontinence or progressive neurological symptoms such as loss of sensation or severe weakness in the legs. Any low back pain that has been present for longer than three months is considered chronic.

A lot of research has been published that recommends Pilates as an effective form of treatment for injury rehabilitation and long-term pain management. Pilates has been found to be effective in reducing pain and improving function and quality of life in patients with chronic non-specific low back pain. Interventions based on exercises have been the most commonly used treatment for patients with chronic low back pain. Over the past few years, the Pilates method has been one of the most popular exercise programs used in clinical practice.

Check out here 5 basic principles to kick start your Pilates Journey that you can practice at home and will help you not only release some muscle but also to know about how Pilates can help with your low back pain. Come and meet me at the UPG Studio where I can work with you to identify your goals and create your individualised Physift program that incorporates aspects of clinical exercise and physiotherapy on mat & reformer.

Once you’re comfortable with your program, you can join our small group classes to continue to progress through your Physfit program! Book here your Physfit Class.

References:

Australian Institute of Health and Welfare. (2020). Back problems. Retrieved from https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/back-problems

Burton AK.(2004) European guidelines for prevention in low back pain. COST B13 Working Group. 1-53. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454541/pdf/586_2006_Article_1070.pdf

Chou R, Qaseem A, et all. (2007). Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Ann Intern Med;147:478-491.https://doi.org/10.7326/0003-4819-147-7-200710020-00006

Lin HT, Hung WC, et all. (2016). Effects of pilates on patients with chronic non-specific low back pain: a systematic review. J Phys Ther Sci. 2016 Oct;28(10):2961-2969. doi: 10.1589/jpts.28.2961. Epub 2016 Oct 28. PMID: 27821970; PMCID: PMC5088161. https://pubmed.ncbi.nlm.nih.gov/27821970/

<a href="https://www.freepik.com/free-photo/close-up-man-rubbing-his-painful-back-isolated-white-background_1602560.htm">Image by jcomp</a> on Freepik

Adolescent Scoliosis

Written by Jason Lui - UPG Physiotherapist

Adolescent idiopathic scoliosis (AIS) is a condition where the spine is rotated and curved, it becomes most obvious when children hit puberty around 11 or 13 years old. The causes remain unknown based on the current state of knowledge of the condition, thus the word “idiopathic” (Negrini et al. 2012). However, there are some signs in children's posture like uneven shoulders and waist, one hip higher than the other or back pain; that may be an indicator to consult a physiotherapist, to prevent any further progression, improve function or/and reduce pain.

Although a scoliotic curve does not necessarily cause pain or dysfunction. Ramirez and colleagues (1997) found that 31.5% of patients with scoliosis presented back pain. The patients usually only complain of back pain and/or radicular symptoms such as numbness, tingling, or weakness in the arms or legs, when they have reached adulthood. Some of the reasons for back pain may be spinal imbalance; facet arthropathy; muscle imbalance; fatigue or foraminal stenosis (Agabegi et al. 2015)

As shown in the picture below, muscles along the spine either get adapted to be shorter or longer according to curvature. The change of muscle tension will resist lengthening and thus limit the range of motion of the joints that are crossed. The increase in tension will also cause increased pressure on the joints which may lead to pain, dysfunction and even greater degenerative changes over time. (Muscolino, 2018)

Musculature on the concave side of a scoliotic curve - Source: Muscolino, 2018.

Diagnosis

The diagnosis of AIS is made by a physical examination, an x-ray, spinal radiograph, CT scan or MRI, measuring the intersecting angle of each part of the rotated spine (AKA Cobb angle), if the angle is equal to or greater than 10 degrees, the person is diagnosed with AIS (Cheng et al. 2015).

The magnitude of this angle is used to classify the severity of the condition: 

  • Mild scoliosis - curve up to 25°

  • Moderate scoliosis - curve between 25° and 45°

  • Severe scoliosis - curve above 45°

(Romano et al. 2012)

If the spinal curve is more than 30° at the end of growth, the potential risks in adulthood increase significantly: 

  • Pain

  • Deformity of the thorax and shoulder girdle

  • Decreased quality of life (QOL)

  • Disability 

  • Possible respiratory problems 

(Altaf et al. 2013; Romano et al. 2012)

Treatment:

A recently published study (Lotan &Kalichman, 2019) compared 14 different articles, and clinical trials and concluded that a combination of manual therapy techniques like myofascial releases and spinal manipulative along with other conservative treatments are effective in treating AIS. 

Manual therapy aims to improve range of motion and decrease muscle tone (especially on the shortened side) and pain, while other conservative treatments are based on exercise aiming to strengthen the lengthened side of the spine. 

Exercises are often recommended for patients with curvature angles between 10° and 30°. Dunn and colleagues (2018) have suggested that Pilates exercise training improves flexibility and overall physical health by emphasizing strength, posture, and coordination of movements associated with respiration. Pilates exercises like side planks, single bridges and “Superman” to be completed daily for 6 months have shown an improvement in Cobbs angle by 32% (Fishman et al, 2014).

If you are having pain or have a history of scoliosis, book here with one of our physiotherapists where we can provide you with a tailored Pilates program to get stronger, as well as manual therapy to help loosen those tight muscles and assist you further in your recovery process.

Together, we can help you get back to doing the activities and hobbies that you love to do!

References:

Altaf, F., Gibson, A., Dannawi, Z. & Noordeen, H., 2013, ‘Adolescent idiopathic scoliosis’, British Medical Journal 346(1), f2508. https://doi.org/10.1136/bmj.f2508

Cheng, J., Castelein, R., Chu, W., Danielsson, A., Dobbs, M., Grivas, T. et al., 2015, ‘Adolescent idiopathic scoliosis’, Nature Reviews Disease Primers, from http://europepmc.org/abstract/med/27188385.

Dunn J, Henrikson NB, Morrison CC, Blasi PR, Nguyen M, Lin JS.2018 Screening for adolescent idiopathic scoliosis: evidence report and systematic review for the US Preventive Services Task Force. JAMA ;319:173–87.

Fishman LM, Groessl EJ, Sherman KJ. Serial case reporting yoga for idiopathic and degenerative scoliosis. Glob Adv Health Med. 2014;3(5):16-21

Muscolino J.E. 2018. Scoliosis: Clinical Orthopedic Manual Therapy Treatment. Journal of the Australian Traditional Medicine Society 24 (4), 220-226.

Lotan S and Kalichamn L. 2019. Manual therapy treatment for adolescent idiopathic scoliosis. Journal of Bodywork and Movement Therapies 23 (1), 189-193. 

Negrini S, Aulisa AG, Aulisa L, et al. 2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth. Scoliosis 2012; 7: 3.

Ramirez, N., Johnston, C.E.I. & Browne, R.H., 1997, ‘The prevalence of back pain in children who have idiopathic scoliosis’, Journal of Bone and Joint Surgery 79(3), 364–368. https://doi.org/10.2106/00004623-199703000-00007

Romano, M., Minozzi, S., Zaina, F., Chockalingam, N., Kotwicki, T., Hennes, A. et al., 2012, ‘Exercises for adolescent idiopathic scoliosis-review’, Cochrane Database of Systematic Reviews 8, 10–12.

Schreiber, S., Parent, E.C., Moez, E.K., Hedden, D.M., Hill, D., Moreau, M.J. et al., 2015, ‘The effect of Schroth exercises added to the standard of care on the quality of life and muscle endurance in adolescents with idiopathic scoliosis – An assessor and statistician blinded randomized controlled trial: SOSORT 2015 award winner’, Scoliosis 10(1), 24. https://doi.org/10.1186/s13013-015-0048-5

<a href="https://www.freepik.com/free-photo/young-woman-standing-touching-lower-back-feeling-painful-sensations-high-quality-photo_14265190.htm#page=3&query=scoliosis&position=37&from_view=search">Image by azerbaijan_stockers</a> on Freepik