Why visit us?
Throughout life the body is meant to move, stretch and exercise constantly. Sedentary life style and occupational faulty sustained posture (esp long hours at a computer), will lead to adaptive shortening of those muscles and ligaments held in a relaxed (shortened) and contracted position, whereas those muscles opposite become weakened, leading to muscular imbalance, causing chronic stress and strain with subsequent pain and disability.
We have an extensive range of experience in both Australia and overseas and are committed to continuing mandatory education, keeping us up to date with the latest treatment techniques and technology. We have in depth knowledge of how muscles, joints, bones, ligaments and nerves are related to pain and injury and can address a wide range of issues, including sports injury, occupational health, chronic pain and spinal problems incl. headaches and symptoms referred from the spinal column down into the limbs.
The beneficial effect of just-one I hourly (intensive) physiotherapy session as described, should be evident straightaway and should not cause discomfort, except for possibly delayed onset muscle fatigue following some exercises (which can be relieved by remedial massage).
We have an extensive range of experience in both Australia and overseas and are committed to continuing mandatory education, keeping us up to date with the latest treatment techniques and technology. We have in depth knowledge of how muscles, joints, bones, ligaments and nerves are related to pain and injury and can address a wide range of issues, including sports injury, occupational health, chronic pain and spinal problems incl. headaches and symptoms referred from the spinal column down into the limbs.
The beneficial effect of just-one I hourly (intensive) physiotherapy session as described, should be evident straightaway and should not cause discomfort, except for possibly delayed onset muscle fatigue following some exercises (which can be relieved by remedial massage).
What we treat
Low back (lumbar) pain
Because of shortened hip flexors (iliopsoas), which have their origin in the lumbar spine and pelvis insert into hip joints, cause low back strain and disability.
Tight hamstrings the iliotibial band (ITB) and eg piriformis (hip abductor), weak abdominals and overactive back extensors produce the same effect of muscular imbalance and subsequent low back pain.
Neck (cervical) pain
May follow sustained forward head posture, (A.K.A poking chin) with forward rolled (anterior) shoulders and slumped upper thoracic spine cause pain in these areas and if the upper three cervical vertebrae
(C1 to C3) become dysfunctional "cervico-genic headaches" may ensue (often called tension headaches) these headaches may affect any part of the head including "retro-orbital" pain (ie pain behind one or both eyes), and auditory disturbance (ringing, singing or buzzing in the ears,) disorientation, dizziness and diminished concern for others.
Thoracic spinal pain
A sustained slumped posture will (eventually) cause thoracic spinal rigidity with a tendency to compress the (anterior), thoracic cage (chest). In addition to pain in the thoracic spine and the ribs, pain can sometimes radiate to the "sternum" and on occasion even into the throat (with mild nausea). This anterior chest pain may mimic cardiac disease and is known as "Pseudo-angina-pectoris". Of course actual cardiac pathology (incl stress related true angina pectoris) must be ruled out.
It is possible for both Pseudo and True Angina Pectoris to be present simultaneously. Appropriate manual therapy for (non cardiac related) anterior chest pain, can usually produce immediate and dramatic relief (physical as well as psychological).
Herniated Discs
The vertebrae of your spine are separated by discs which have a fairly tough outer layer (the annulus fibrosis) with a soft interior (the nucleus pulposis) to cushion against the shocks and strains experienced as you move. These are subject to injury, disease, and degeneration with use over time. Certain activities, types of work and prolonged sitting posture increase the risk of being damaged and cause deterioration.
When the "Nucleus Pulposis" due to degeneration, pushes against the "Annulus Fibrosis" it may cause it to bulge or even rupture through a tear, a small fragment of the nucleus may become extruded and cause the emerging nerve root to be compressed with subsequent referred symptoms away from the site of compression. Herniated discs are also called protruding, bulging, ruptured, prolapsed or degenerated. There are fine distinctions between these terms, but all really refer to a disc that is no longer in its normal condition and / or position.
A "slipped" disc is simply a popular name for one of the above terms. Most disc herniation takes place in the lower back (lumbar spine L4-S1). The second most common site of herniation is the neck (cervical spine).
A herniated lumbar disc may send pain shooting through to your buttock and thigh into the back of your leg (sciatica), cervical disc herniation may cause symptoms in the shoulder, arm and hand - a herniated disc may also produce tingling and numbness and loss of muscular strength.
Hemiated discs in the lumbar spine make it hard to get up when you've been sitting or lying down for sometime and cause pain when you move, even when you cough or sneeze. They sometimes produce pain elsewhere (referred pain).
A spinal body prominence of say a large spinous process, may simply be a natural congenital variant in its shape and size known as tropism, whereas it may also be slightly out of alignment with the vertebrae above and below. A radiologist would normally describe these minor variations as being within normal limits, whereas many practitioners (other than physiotherapists) maintain, that the joint is "out" and should be manipulated back "in", the rewarding click (which is a natural cavitation occurrence) indicating that the joint has gone back "in" so then it is presumed that if the pain recurs, the joint has slipped "out" again and needs to be manipulated back "in".
The problem is that then the wrong overly mobile (hypermobile) joints, when repeatedly manipulated may become "unstable" leading to chronic recurring problems. The simple answer is to mobilise and / or manipulate the stiff (hypomobile) joints, which are the last ones (and hardest) to move (this is also a basic osteopathic and correct concept) and stabelise the weakened (hyper mobile) joints by appropriate strengthening exercises.
Any technique just on its own (eg 10-15 mins of manipulation only) cannot usually achieve a long term positive outcome and also carries the potential risk of flareup, (some call this the normal attempt and response of the body to correct itself as the spine is realigning itself which defies common sense). Incidentally it is within normal limits for the spinal vertebrae (spinous and transverse processes and vertebrae) to be somewhat out of alignment in anyone including all those without symptoms (particularly in the cervical spine, a spinal misalignment is only of any significance if it is not within normal anatomical limits as a radiologist would describe it).
In any case in the cervical spine alone, there are some six anatomical barriers (impediments) that, prevent it to be realigned by manipulation, alone without the potential of causing damage. Multiple X-rays are generally unnecessary, so as to avoid excessive ionising radiation and subsequent health hazard, whereas MRI carries no such risk and it details the X ray does not. (they are also more expensive).
Just one full set of X-rays a the lumbar spine (back) exceeds the annual allowable dosage by a factor of five. Generally a professional clinical evaluation will show more than any x-ray can and maybe all that is required to make a diagnosis and provide effective treatment. Therefore the object of the various treatments (as described) is not to realign the spinal vertebrae, but to restore flexibility, mobility, strength muscular balance and provide symptomatic relief.
Because of shortened hip flexors (iliopsoas), which have their origin in the lumbar spine and pelvis insert into hip joints, cause low back strain and disability.
Tight hamstrings the iliotibial band (ITB) and eg piriformis (hip abductor), weak abdominals and overactive back extensors produce the same effect of muscular imbalance and subsequent low back pain.
Neck (cervical) pain
May follow sustained forward head posture, (A.K.A poking chin) with forward rolled (anterior) shoulders and slumped upper thoracic spine cause pain in these areas and if the upper three cervical vertebrae
(C1 to C3) become dysfunctional "cervico-genic headaches" may ensue (often called tension headaches) these headaches may affect any part of the head including "retro-orbital" pain (ie pain behind one or both eyes), and auditory disturbance (ringing, singing or buzzing in the ears,) disorientation, dizziness and diminished concern for others.
Thoracic spinal pain
A sustained slumped posture will (eventually) cause thoracic spinal rigidity with a tendency to compress the (anterior), thoracic cage (chest). In addition to pain in the thoracic spine and the ribs, pain can sometimes radiate to the "sternum" and on occasion even into the throat (with mild nausea). This anterior chest pain may mimic cardiac disease and is known as "Pseudo-angina-pectoris". Of course actual cardiac pathology (incl stress related true angina pectoris) must be ruled out.
It is possible for both Pseudo and True Angina Pectoris to be present simultaneously. Appropriate manual therapy for (non cardiac related) anterior chest pain, can usually produce immediate and dramatic relief (physical as well as psychological).
Herniated Discs
The vertebrae of your spine are separated by discs which have a fairly tough outer layer (the annulus fibrosis) with a soft interior (the nucleus pulposis) to cushion against the shocks and strains experienced as you move. These are subject to injury, disease, and degeneration with use over time. Certain activities, types of work and prolonged sitting posture increase the risk of being damaged and cause deterioration.
When the "Nucleus Pulposis" due to degeneration, pushes against the "Annulus Fibrosis" it may cause it to bulge or even rupture through a tear, a small fragment of the nucleus may become extruded and cause the emerging nerve root to be compressed with subsequent referred symptoms away from the site of compression. Herniated discs are also called protruding, bulging, ruptured, prolapsed or degenerated. There are fine distinctions between these terms, but all really refer to a disc that is no longer in its normal condition and / or position.
A "slipped" disc is simply a popular name for one of the above terms. Most disc herniation takes place in the lower back (lumbar spine L4-S1). The second most common site of herniation is the neck (cervical spine).
A herniated lumbar disc may send pain shooting through to your buttock and thigh into the back of your leg (sciatica), cervical disc herniation may cause symptoms in the shoulder, arm and hand - a herniated disc may also produce tingling and numbness and loss of muscular strength.
Hemiated discs in the lumbar spine make it hard to get up when you've been sitting or lying down for sometime and cause pain when you move, even when you cough or sneeze. They sometimes produce pain elsewhere (referred pain).
A spinal body prominence of say a large spinous process, may simply be a natural congenital variant in its shape and size known as tropism, whereas it may also be slightly out of alignment with the vertebrae above and below. A radiologist would normally describe these minor variations as being within normal limits, whereas many practitioners (other than physiotherapists) maintain, that the joint is "out" and should be manipulated back "in", the rewarding click (which is a natural cavitation occurrence) indicating that the joint has gone back "in" so then it is presumed that if the pain recurs, the joint has slipped "out" again and needs to be manipulated back "in".
The problem is that then the wrong overly mobile (hypermobile) joints, when repeatedly manipulated may become "unstable" leading to chronic recurring problems. The simple answer is to mobilise and / or manipulate the stiff (hypomobile) joints, which are the last ones (and hardest) to move (this is also a basic osteopathic and correct concept) and stabelise the weakened (hyper mobile) joints by appropriate strengthening exercises.
Any technique just on its own (eg 10-15 mins of manipulation only) cannot usually achieve a long term positive outcome and also carries the potential risk of flareup, (some call this the normal attempt and response of the body to correct itself as the spine is realigning itself which defies common sense). Incidentally it is within normal limits for the spinal vertebrae (spinous and transverse processes and vertebrae) to be somewhat out of alignment in anyone including all those without symptoms (particularly in the cervical spine, a spinal misalignment is only of any significance if it is not within normal anatomical limits as a radiologist would describe it).
In any case in the cervical spine alone, there are some six anatomical barriers (impediments) that, prevent it to be realigned by manipulation, alone without the potential of causing damage. Multiple X-rays are generally unnecessary, so as to avoid excessive ionising radiation and subsequent health hazard, whereas MRI carries no such risk and it details the X ray does not. (they are also more expensive).
Just one full set of X-rays a the lumbar spine (back) exceeds the annual allowable dosage by a factor of five. Generally a professional clinical evaluation will show more than any x-ray can and maybe all that is required to make a diagnosis and provide effective treatment. Therefore the object of the various treatments (as described) is not to realign the spinal vertebrae, but to restore flexibility, mobility, strength muscular balance and provide symptomatic relief.
How we treat it
A physiotherapist will examine and question you carefully, take a complete history, and conduct appropriate diagnostic tests. He will focus what symptoms you've been suffering from and determine which parts of your spine and other structures are the likely cause of your pain and loss of function.
A physiotherapist has special training and experience needed to safely and effectively treat your spine, so that the stress on the discs and related areas is minimised, the pain relieved, the damaged or displaced structure given a chance to heal and your ability to return to normal functioning restored. Our other aim is:
Further, diagnostic procedures include assessment of joint function including - joint range of movements measurement by the use of an "inclinometer and protractor" and its finding detailed on a (highlighted) body diagram (copy to patient).
Treatment Techniques employed:
Manual Therapy
a) Massage and mobilisation, positional release.
b) Spinal Manipulation - must he safe and gentle and "only" performed after muscular balance has been normalised and should be performed with minimal force, maximal technique, avoiding full range movement and without forceful overpressure (esp on the upper neck).
Pre-manipulative testing known as V.B.I. test of the upper cervical spine is absolutely essential to avoid (eg) cerebro-vascular accident (C.V.A) Research has shown, that "mobilisation" mostly being superior to manipulation, in its result and will avoid any concern of untoward effects.
Manipulation - a technique of treatment applied to joints for the relief of pain and improvement of motion. It is a single high velocity, low amplitude movement applied passively to the joint towards the limit of its available range. (But never as a the only treatment technique).
Multimodal treatment - Management that includes simultaneous application of several different treatment modalities, which has the best long term outcome.
Passive joint mobilization - A technique of treatment applied to joints for the relief of pain and improvement of motion. Mobilisation is the passive application of repetitive, rhythmical, low velocity small amplitude movements to the joint within or at the limit of its available range.
Electro-therapeudic modalities - such as ultrasound often simultaneous to interferential (not T.E.N.S), electro-magnetic resonance (mild heating), can be most effective in ameliorating pain inflammation, swelling and tenderness, beneficially affecting soft tissue metabolism, pain relief (electro-analgesia) and muscular stimulation (electro-motor stimulation) and intermittent positive pressure for lower limb oedema.
A physiotherapist has special training and experience needed to safely and effectively treat your spine, so that the stress on the discs and related areas is minimised, the pain relieved, the damaged or displaced structure given a chance to heal and your ability to return to normal functioning restored. Our other aim is:
- Restore flexibility muscular strength, muscular imbalance and control (i.e. proprioception)
- To improve wellbeing through gentle mobilisation, manual therapy (eg: hold/relax stretches), muscle energy techniques and manipulation as indicated
- To quickly reduce swelling (oedema), and inflammation of affected areas by the use of electro-medical modalities.
Further, diagnostic procedures include assessment of joint function including - joint range of movements measurement by the use of an "inclinometer and protractor" and its finding detailed on a (highlighted) body diagram (copy to patient).
Treatment Techniques employed:
- Osteopathic and Nordic (Swedish)
- Manual therapy
- Manipulation and Mobilisation
- Sports and Spinal Physiotherapy
- Exercise Rehabilitation
- Mulligan Techniques (NZ)(ie mobilisation with movement)
- Postural Correction
- Electrotherapy and Ultrasound (computerised)
- Cervical and Lumbar Spinal Traction (computerised)
- Soft Tissue Techniques incl. Deep tissue Massage
- Sports Taping
Manual Therapy
a) Massage and mobilisation, positional release.
b) Spinal Manipulation - must he safe and gentle and "only" performed after muscular balance has been normalised and should be performed with minimal force, maximal technique, avoiding full range movement and without forceful overpressure (esp on the upper neck).
Pre-manipulative testing known as V.B.I. test of the upper cervical spine is absolutely essential to avoid (eg) cerebro-vascular accident (C.V.A) Research has shown, that "mobilisation" mostly being superior to manipulation, in its result and will avoid any concern of untoward effects.
Manipulation - a technique of treatment applied to joints for the relief of pain and improvement of motion. It is a single high velocity, low amplitude movement applied passively to the joint towards the limit of its available range. (But never as a the only treatment technique).
Multimodal treatment - Management that includes simultaneous application of several different treatment modalities, which has the best long term outcome.
Passive joint mobilization - A technique of treatment applied to joints for the relief of pain and improvement of motion. Mobilisation is the passive application of repetitive, rhythmical, low velocity small amplitude movements to the joint within or at the limit of its available range.
Electro-therapeudic modalities - such as ultrasound often simultaneous to interferential (not T.E.N.S), electro-magnetic resonance (mild heating), can be most effective in ameliorating pain inflammation, swelling and tenderness, beneficially affecting soft tissue metabolism, pain relief (electro-analgesia) and muscular stimulation (electro-motor stimulation) and intermittent positive pressure for lower limb oedema.