Engaging your Core

This is a very common phrase that is used in gyms and in yoga and pilates studies. It is even said that you should engage your core while sitting or running. But what does it mean and why would you need to do it? The simple answer is… you don’t.
The reality is that Physiotherapists see many patients who hurt themselves in gyms, or sitting in chairs, or running. But when it comes to lower back pain you are much more likely to hurt yourself over-bracing your abdominal muscles and in doing so creating more rigidity and compressive forces on the spine.
The muscles around your “core” are commonly talked about as being your abdominals, specifically Rectus Abdominis, Transversus Abdominis and your Internal and External Obliques. These muscles don’t all activate the same amount at the same time, they have more complicated activation patterns based on your natural movement patterns. So next time you are in the gym don’t focus on tensing your core, or glutes, instead focus on keeping good technique and the muscles that need to work will do so naturally.
For more information on this or to learn to move more naturally book in for a Functional Movement (FuMo) assessment or in to one of our BodyFit or ReformerFit classes.


Is Poor Sleep Making Me Worse at Sport?

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Last week I talked about the relationship between sleep and pain. This week I wanted to touch on the surprising effect sleep might have on your sports performance.
In 2011 a study was published looking at the effect of improved sleep on the men’s basketball team at Stanford University. They found that athletes had faster sprint times, improved shooting accuracy (3 point shooting increasing by 9.2% and field shooting by 9%), improved mood, increased vigor, decreased fatigue and improved overall ratings of physical and mental well-being.
Got that big game coming up? Make sure you getting good sleep!

Is Poor Sleep Making My Pain Worse?


Chronic pain and pain sensitivity is a thoroughly researched area of medical science. One of the strongest factors that correlate with increased pain may surprise you – poor sleep patterns. And the relationship is quite interesting.
It might seem obvious that if you have pain you are more likely to have poor sleep, but the relationship also goes the other way. Poor sleep patterns have been found to increase pain sensitivity and even decrease the effectiveness of pain relieving medications.
This is just one more reason that it’s so important to get your 8 hours.
For more information about what might affect your pain book in to see one of our friendly and experienced physiotherapists.

Laugh Without Leaking!

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Incontinence is one of the most embarrassing yet extremely common concerns amongst Australians.

·         1 in 3 adult Australians are affected by incontinence (up from 1 in 4 previously stated)

·         38% of Australians will experience loss of bladder or bowel control at some point…a scary figure, especially if you are a woman

·         74% of those living with incontinence are women!

·         Only 38% of people with incontinence seek help – meaning 62% do not seek help!

If we just look at Stress Urinary Incontinence (SUI) - the leakage you get from coughing, sneezing, laughing or exercise – there is very good evidence that conservative treatment can help.

·         Pelvic floor exercises can cure just over 50% of all women with SUI

·         Pelvic floor exercises can cure or improve 72% of women with SUI

Doing pelvic floor exercises correctly is often difficult and many studies show that the more supervision you have, the better your chances of cure or improvement from pelvic floor training.

I would encourage you to seek help if you or someone you know experiences incontinence. Don’t be one of the statistics – you CAN do something about it.

Our physiotherapist Genevieve has a special interest in Women’s and Men’s Health as well as assisting women to continue or return to sport during the pregnant and postnatal period. We also have experienced physiotherapists who are able to guide you in a pelvic floor assessment with real time ultrasound. If you need assistance with your pelvic floor, please do not hesitate to contact us on 9245 7007 or book online

Movement and Pain

People are often surprised to learn that one of the best treatments for chronic pain is movement. This includes conditions such as osteoarthritis and degenerative joint disease as well as back and neck pain.
You may not feel like exercising when you have long term pain but this can often be a big step towards your recovery. An exercise as simple as walking can help to relax muscles and mobilise joints as well as help reduce some of the other negative consequences of long term pain such as poor sleep patterns, increased stress and low mood.

It’s also important to realise that some pain is normal during your recovery and this does not mean that you are doing more damage. If you are fearful of moving you will often tense up more and slow your recovery further.

For more information about movement for pain, or to learn what type of exercise might be helpful for your pain book in to see one of our friendly and experienced physiotherapists.


Good Movement vs Bad Movement


Are certain movements unsafe to do? What makes a movement a good movement or a bad movement? To answer these questions let’s take the example of a person who injured their lower back bending to lift a heavy box at work. Let’s call this person Jim. Jim thinks back on the injury; it wasn’t a particularly heavy box but he thinks because he wasn’t concentrating and his back was flexed at the time he may have not lifted correctly. “You’re supposed to lift with your legs not your back” he says in hindsight. Therefore, he determines that his chosen movement to lift the box was a “bad movement”.

Jim allows his back to recover and returns to work, determined to ONLY lift correctly and ALWAYS have good posture. Which works, until one day it doesn’t. A momentary lapse in concentration and Jim lifts poorly again this time injuring himself even worse than before.

So why has this happened? And how can Jim stop it from continuing to happen when his job involves a lot of lifting? Let’s go back to the beginning and look at Jim’s problem with a different perspective.

Jim injured himself doing a specific movement, therefore that is a movement pattern that Jim is quite poor at performing. So instead of totally stopping that movement pattern (and continuing to get worse at performing it), perhaps Jim should strengthen himself to be able to perform it without injury. Lifting with a neutral spine and using your legs might be the preferred method of lifting a heavy object but it won’t always be possible, and when it isn’t your body should be resilient enough to manage without injury.

It’s never a good idea to be fearful of certain movements because ALL movements are good movements.

If you would like to know more about how movement can make you become more resilient book in to one of our Fu.Mo. Exercise Therapy sessions.

Stress and the body


Part 2: Psychological stress on the body

Psychological stressors influence our bodies in many ways, including alterations to our immune system, cardio-vascular system, metabolic system and musculoskeletal system. But the main thing I want to discuss in this article is the effect of psychological stressors on our bodies pain response.
We have long known that pain is created by the brain which takes input from the nervous system about potential injuries or dangers. This information is thoroughly assessed by the brain which decides what response to create.

There are many factors that will change a potential pain response by your brain. This might include memory of a similar stimulus (the danger level may be perceived as higher if you have had a similar pain in the past) or the environment you are in (a potentially dangerous or hazardous environment might amplify a pain response).

Cognitive and psychological factors can also have a huge impact on the pain response that you feel and because of this are primary predictors of having issues like lower back pain. Your belief system around pain and your condition has a big effect on your pain. Negative beliefs about your pain, fear of movement and decreased self-efficacy are great predictors of pain and disability.

Feelings of anxiety, worry, depression and stress can also amplify your pain response.
All of these extra factors can have a huge impact on whether your body turns the pain response volume knob up or down. If you want more information on what impact various stresses are having on your pain book in to see one of our friendly and experienced physiotherapists.

Stress and the body

Part 1: Physical stress on the body – without stress there can’t be change

Most people think of stress as being a bad thing for your body but in a lot of ways it can be very beneficial and in fact is crucial to our survival.

The human body responds to stress by improving its capacity to withstand that stress and thereby becoming more resilient. This can be witnessed when the body acclimatises to extreme temperatures or changes in altitude, or when building muscle strength in the gym. In fact, you can apply the same rules to all of the body’s systems.

Humans have harnessed this throughout history to improve our health whether it be football players exposing themselves to a variety of stresses in the pre-season to become stronger and more robust or using a small dose of a disease in a vaccine to immunize the body to that disease. A recent dieting trend is to intermittently fast from food which is just taking advantage of stress applied to the body’s digestive system.


In physiotherapy we use stress to our advantage daily. Let’s say hypothetically that a patient present to us after a recurrent episode of lower back pain and has decided to completely rest and stop all exercise to allow the pain to subside. The problem is that the pain didn’t resolve and now when the patient returns to exercise the symptoms return worse than ever! Often these injuries can arise from a lack of resilience in the area of injury and so by resting the tissues you might find that the loading capacity of the tissue actually can decrease. So by keeping moving and safely loading all of the muscles, bones, joints and discs the capacity will continue to increase, allowing the patient to return to normal function (MAGIC!)

Pain Management Resources

The following resources are ones we, as physiotherapists, commonly recommend to clients to help them manage their pain. These relate primarily to chronic pain, which is ongoing or longstanding or recurrent. They are useful whether or not you have been diagnosed with a “condition” (eg. disc bulge, osteoarthritis, spinal stenosis). They are particularly useful when other forms of management, especially hands-on or “passive” treatment, have not been successful in resolving your pain.

The “best evidence” in the research into chronic pain tells us that “active” forms of treatment work best. This means a suitable form of exercise, which could include Clinical Pilates, gym programmes, therapeutic yoga and/or aerobic exercise such as walking, swimming and cycling. It also means being proactive with self-management strategies, which involves identifying and addressing factors, unique to you, that may contribute to your pain.

These groups are two of the most up-to-date and internationally renowned in pain and pain management research.  Both groups are Australian, the first being West Australian.

painHEALTH: www.painhealth.csse.uwa.edu.au
(sections “Management” and “Stories” are particularly helpful)

NOI Group: www.noigroup.com/en/resources

The NOI group also has several associated books (and even an app!) for the self-management of pain. 

The websites themselves are very informative, using multimedia including videos and imagery to “explain pain”. 

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I've torn my ACL....what now?


Whether you get surgery or not, an important thing to understand is that there is no quick fix after an ACL injury. If you plan to return to your previous level of activity the rehabilitation process can be long and difficult but is imperative to minimise chance of re-injury. 
Step 1: Get a plan. Navigating the lengthy rehabilitation process can be quite a daunting prospect so getting a solid plan written up is the first thing you need to do. Your physio will happily explain this process to you in detail.
Step 2: Optimise pain and swelling early. This might involve talking to your GP about appropriate painkillers or anti-inflammatory’s to take, or using non-pharmacological pain and swelling management such as ice, compression, elevation or combine all 3 using a device such as the GameReady. Horizon has use of 2 GameReady devices for this purpose. 
Step 3: STICK TO YOUR PROGRAM. This might sound obvious but ACL rehabilitation involves a lot of hard work and consistency is key. At Horizon we will treat you like an elite athlete and use everything at our disposal to optimise your recovery but ultimately it comes down to you being able to follow your program effectively. 
If you want more details about this process drop into Horizon and grab an ACL booklet that highlights what to expect throughout the rehabilitation or book in to see one of our friendly and talented physiotherapists.