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Keep moving with kneecap pain


Keep moving with kneecap pain

Pain in the front of the knee, around the kneecap can be a common issue in people presenting to Physiotherapy. This issue can be caused by an irritation of the patellofemoral joint, the joint between your kneecap and the base of your thigh bone. Often pain can occur in this joint when running, walking up or down stairs or during other exercise such as squatting. Pain in this area often relates to pressure on the kneecap as it articulates with the bottom of your thigh bone – your femur. The force on this joint is mainly influenced by two things: the amount of force being produced by the quadriceps muscles on the top of your thigh, and the amount of knee bend or flexion that occurs when the joint is under load.

Here are a few strategies you could implement to reduce your patellofemoral pain whilst continuing to exercise:

  1. Choose exercise activities that gradually expose the knee to greater stresses.
  There is a systematic review by Hart et al. (2022) that has looked at the average reaction force that different activities place on the patellofemoral joint in healthy individuals. Walking: 0.9x body weight Descending stairs: 2.8x body weight Ascending stairs: 3.8x body weight Running: 5.2x body weight Squatting: 1 – 18x body Looking at these averages, a good way to try and reduce the load on the patellofemoral joint could be to target start with a low loading exercise such as walking and gradually progress to stairs and then running. As you can see, there is a very large variability in the loads that are placed on the knee during squatting movements. Therefore, if you can minimise the amount of knee bend during your squats, you may be able to reduce your knee pain.
  1. Modify your current exercise program to reduce the stress on the knee joint.
  We know that the joint reaction force will increase with greater knee bend. Choosing squat variations that limit your knee from bending more than 90 degrees could allow you to maintain lower body strength whilst reducing your pain. Choosing exercises that are double-legged rather than single-legged may reduce the tendency of your knee to track inwards, which may help to settle your patellofemoral pain. If you are a runner, increasing your step rate may help you to settle your knee pain and keep you running. If you keep the same running pace, an increased step rate will reduce your stride length, which reduces the amount of knee bend through the weight-bearing portion of the running cycle. This can then reduce the reaction force in the patellofemoral joint, and it will be easier to maintain better alignment through your hips to avoid a scissoring pattern. Then once symptoms have settled you can begin gradually re-expose the knee to more loads over time so that it can get used to it. As with many areas of the body, this advice is generalised and may not be affective for individuals with varied anatomy and movement patterns. Try a few of these strategies, and if you’re still having issues with your knee pain, we’d be happy to help you here at the clinic. Reference: Hart, H. F., Patterson, B. E., Crossley, K. M., Culvenor, A. G., Khan, M. C. M., King, M. G., & Sritharan, P. (2022). May the force be with you: understanding how patellofemoral joint reaction force compares across different activities and physical interventions—a systematic review and meta-analysis. British Journal of Sports Medicine, 56(9), 521–530. https://doi.org/10.1136/bjsports-2021-104686

Tennis Elbow – Why is my elbow hurting?


Tennis Elbow - Why is my elbow hurting? Lateral epicondylitis (also known as Tennis elbow), is considered an overload injury of the extensor tendons of the forearm where they attach at the lateral epicondyle. It affects up to 3% of the population, and symptoms may persist for up to 1 year in 20% of people. Up to 17% of workers within the highly repetitive hand task industries such as factory workers, admin workers and tradesman, experience lateral epicondylitis.   What does it feel like? Lateral elbow pain presents as pain and tenderness over the outside of the elbow when doing activities such as:

  • Writing or typing on the computer
  • Lifting an object (even as light as a sheet of paper)
  • Opening the car door or those horrible pasta sauce jars
The pain may build up over a few weeks to become a burning sensation, and cause swelling of the area, stiffness, or weakness in the forearm.   Is it from playing too much tennis? It can be, but it is categorised as an overload injury. Overload injuries tend to occur after a minor or sometimes unrecognised trauma to the extensor muscles of the forearm. Despite the commonly known title of tennis elbow, tennis is a direct cause in only 5% of people. How should I manage this injury? Modify and lower the load going through the extensor tendons. However, make sure not to completely rest the tendon for prolonged time (e.g., resting completely for 10 weeks, and returning to the activity with pain remaining). Throughout the course of the tendon injury, it is essential to continually modify the load because as the tendon heals, it will gradually be able to handle more load and you will be able to do more things with less pain. Some “handy” tips on how to reduce the load through your elbow include:
  • Doing your best to avoid repetitive tasks
  • Use the unaffected hand
  • Adjusting your work environment (e.g. height of work chair)
  • Wearing a brace to disperse load from tendon]
Exercises that specifically load the tendon gradually have been shown to have improved long-term outcomes. The aim is to progressively increase the load as the tendon heals within pain free limits. These exercises are to be best prescribed to you by your Physiotherapist. Will cortisone injections give me a quick fix? Cortisone injections have been proven to reduce pain and improve function in the short term, the quick fix of 6 weeks. However, it does have the highest rate of re-occurrence and repeated cortisone injections will increase the risk of surgery. With Physiotherapy intervention where patients are educated about their pathology, given advice on medication, braces and how to deload the tendon, people will get out of pain faster and experience less pain over the duration of their recovery. Other treatment options you can try including Acupuncture, Extra-corporeal Shock Wave Therapy, orthoses/braces, manipulation and exercise and mobilisation. Take home message!
  • Tennis elbow is an OVERLOAD injury.
  • Don’t do nothing. Learn how to modify your daily tasks to avoid overloading the wrist extensor muscles
  • Cortisone injections may be good for a quick fix, but think long term
If you are suffering from tennis elbow and would like to learn how to manage this injury appropriately, visit your local Physiotherapist. You can also visit our YouTube channel to view a video I have created to provide a few exercises to get you started.

Lateral Hip Pain


Lateral Hip Pain

Have you recently started to get pain in the side of your hip? Has it been there before and then come back again? Have you had corticosteroid injections that have relieved pain temporarily or not at all? If so, read the blog below to help you get on-top of your stubborn hip pain and start the pathway back to performance.   Lateral hip pain can be referred to as Greater Trochanteric Pain Syndrome, Trochanteric Bursitis, Glute Medius Tendinopathy or Hip Bursitis. All these terms are used to describe pain inside the hip and buttock region, on the bony part on the side of your hip (greater trochanter) and sometimes down the outside of the thigh. The hip pain can be aggravated by sitting cross-legged, prolonged walking, prolonged sitting, climbing stairs/hills and lying on the painful hip.   Ultrasound imaging of lateral hip pain often illustrates inflammation or thickening of the trochanteric bursa or ‘bursitis’. A bursa is a small fluid-filled sac that provides a cushion between bones and tendons throughout the body to minimise friction. You may have been given a corticosteroid injection into your bursa to ease this inflammation.   These injections can be effective in reducing your pain, but this may only be short-lasting! Often trochanteric bursitis is a secondary reaction to a Gluteus Medius/Minimus tendinopathy or weakness in this hip muscle group. Dysfunction in these muscles can increase the compression force on the bursa and tendons. Prolonged and repeated compression of these structures without suitable exercise and lifestyle modifications can cause thickening and inflammation of the bursa, and potentially tendon degeneration.    




We all know we should exercise, and the science is clear, exercise is medicine. The following explains what an Exercise Physiologist is and why your doctor might refer you to one.   What IS AN EXERCISE PHYSIOLOGIST? Accredited Exercise Physiologists (AEPs) are university-qualified allied health professionals. They specialise in designing and delivering safe and effective exercise interventions for people with chronic medical conditions, injuries or disabilities. Services delivered by an AEP are also claimable under compensable schemes such as Medicare and covered by most private health insurers. When it comes to the prescription of exercise, they are the most qualified professionals in Australia.  


  EXERCISE TO IMPROVE YOUR MENTAL HEALTH Mental illness can have an impact on a person’s cognitive, behavioural and social functioning. Those with a mental illness often struggle to engage in their regular work, social and physical activities which can further impact the illness. Mental illness includes anxiety, depression, schizophrenia, bipolar affective disorder and personality disorders. There is mounting evidence that suggests exercise is an effective treatment method for people suffering from acute and chronic mental illness, with some studies suggesting that exercise is just as effective, if not more effective than pharmacological intervention in alleviating depressive symptoms.   EXERCISE TO MANAGE CHRONIC PAIN AND ILLNESS  Chronic pain is pain that persists beyond the expected healing time of an injury. Unlike acute pain which is caused by tissue damage, chronic pain is less about the structural or tissue damage and more about the sensitivity of the nervous system and ‘non tissue related factors’. Significant research has shown that exercise is an essential component in the treatment of chronic pain. Studies have shown that it can be an effective way to reverse this downward cycle of deconditioning and worsening pain, and gradually over time help those with chronic pain engage more in activities of enjoyment and essential activities of daily living with greater ease.   EXERCISE TO REDUCE YOUR RISK OF FALL AND IMPROVE YOUR BALANCE Falls can result in permanent disability, restriction of activity, loss of confidence and fear of falling, all of which reduce quality of life and independence. There is now good evidence that exercise can prevent falls in older people by decreasing a number of key risk factors. For example, exercise can improve muscular strength, balance, balance confidence and walking speed, as well as psychological factors such as mental ability and mood.   EXERCISE TO INCREASE YOUR MUSCLE MASS AND BONE STRENGTH Osteoporosis occurs when bones lose minerals, such as calcium, more quickly than the body can replace them, leading to a loss of bone thickness (bone density). Any bone can be affected by osteoporosis, but the most common sites are the hip, spine, wrist, upper arm, forearm or ribs. Exercise can help bones modify their shape and size so they become stronger and this can prevent injuries. Exercise also increases muscle strength and improves balance which can help reduce the risk of falls.   EXERCISE TO CONTROL YOUR DIABETES OR PREDIABETES Diabetes mellitus is a metabolic disease indicated by an elevated fasting blood glucose level due to deficiencies in insulin secretion or inability to use insulin. Everybody benefits from regular exercise but for people with diabetes mellitus (Type 1 or 2) exercise can play a vital role in the management of their condition. Exercise cannot reverse the damage to the cells in the pancreas that leads to the decreased production of insulin. Exercise can improve the way the muscles respond to insulin, which, in turn, helps regulate the blood glucose level for some hours after the exercise. Exercise also increases glucose uptake by the muscles and can lower the dose of insulin required by improving the body’s response to insulin.   EXERCISE TO IMPROVE OUTCOMES DURING CANCER TREATMENT AND BEYOND Cancer is developed when abnormal cell function occurs.  can develop within all parts of the body and can invade surrounding and distant sites by spreading through the blood vessels and lymphatic systems. If diagnosis and treatment are not administered in the early stages of the disease, cancer can be life-threatening. The potential benefits of exercise during and after treatment are significant and research has proved its effectiveness. Exercising during chemotherapy can help ease side effects, such as fatigue and nausea, and can help to boost the immune system of those undergoing cancer treatments.   Our Accredited Exercise Physiologist at Pottsville and Cabarita Physiotherapy will take you through a full screening to assist in prescribing you the appropriate program to achieve your goals in a safe manner. You can book an appointment with our Exercise Physiologist Sammy here  or call 6676 4000




For Australians aged 65 and over, physical activity becomes important in maintaining energy levels, increasing joint movement, preventing, and managing mental health problems (by reducing stress and anxiety), and improving mood and memory function. Older adults are a diverse group, with different ages and socioeconomic backgrounds and different life experiences and lifestyles. These factors all influence the ageing process. In our younger years, we grow well and experience positive change in wellbeing. Through mid-life we plateau in health, even in the presence of stress and poor lifestyle choices. But in later life, it is these unhealthy choices that will come back to bite us with a decline into poor health, a possible loss of functional independence and increased likelihood and severity of chronic disease. The cheapest and most effective countermeasure to this decline is choosing to be physically active at every age. Even if you start for the first time tomorrow, measurable, noticeable improvements will occur and not just physically but also psychologically. There is no doubt about it, exercising regularly, combining resistance, aerobic and balance exercises will guarantee better health outcomes. The following includes important benefits that exercise can provide to us as we age.  


Reduced risk of developing chronic diseases or managing the ones you may already have Physical activity lowers the risk of many chronic conditions such as dementia, diabetes, obesity, heart disease, osteoporosis, and cancers, to name a few. As well as this, physical activity also assists in managing the symptoms of any chronic diseases you may have e.g., blood sugar control for diabetics or pain management for those with osteoarthritis. Memory and brain function improve Keeping a healthy body is essential to keeping a healthy mind. Regular exercise boosts oxygen to the brain and in turn can improve cognitive processing, memory recall and reaction times. These notable benefits effectively reduce the risk of dementia and cognitive decline in later life. Studies have consistently shown that exercise stimulates the human brain’s ability to maintain old and create new network connections that are vital to cognitive health. Other studies have shown that exercise increases the size of a brain structure important to memory and learning, improving spatial memory. Reduced risk of falls Every year, 1 in 3 people aged 65 years and over will have a fall, and falls are the most common cause of injury among older people. Physical activity improves balance and coordination and in turn can minimise the risk of falls. Increased bone strength As we age, the focus is addressing risk factors for frailty and falls. Bone strength effectively can be addressed through different types of exercise. Ultimately, bones become stronger when a certain amount of load is placed on them. We improve our physical function and independence With exercise improving muscle strength and muscle function, and reducing the risk of falls, this in turn then improves our physical function and independence as we age. Maintaining functional independence is important as we age as it provides older adults with the choice to stay at home and enjoy all aspects of their daily lives at their own pace which then has positive effects on their mental health. We recover from illness more quickly Just like a healthy diet, exercise can contribute to general good health and therefore to a healthy immune system. It may contribute even more directly by promoting good circulation, which allows the cells and substances of the immune system to move through the body freely and do their job efficiently. We stay socially connected Our ability to maintain social connections is often compromised as we age. This is mainly due to our decline in functional abilities and independence, which in turn makes it difficult to get out and maintain our social connections, often leading to feelings of loneliness and poor mental health. Group based exercise programs are a great solution to social isolation and prolonging independence, as they effectively provide a safe, supportive, and motivational environment to build self-confidence and maintain relationships with others.   If you have not exercised regularly for a long time or at all, you should consult with an accredited exercise professional or your GP. To get you started on your exercise journey you can book a consult with our Accredited Exercise Physiologist Sammy here Sources: ESSA Australia

Cricket Season!


Summer is on its way, which means so is the emergence of the iconic Aussie summer sport cricket. You will even see our Senior Physio / resident athlete Kai Allison playing for the Pottsville cricket club this summer! The demands of the sport of cricket can be variable depending on whether the player involved is a speed or spin bowler, and whether they field infield or outfield. For those who are bowling fast or consistently throwing from the boundary, the forces needed from their shoulders to generate speed on the ball are very high and with repetition this can lead to injury if the players shoulder musculature isn’t ready for the task. That is common sense, right?! To do difficult tasks with your shoulders they need to be strong. What is not common sense is the impact that the players ability to create forces through their lower body and trunk will have on their ability to bowl or throw with speed. With specific training of stepping patterns and trunk rotation patterning and strength, we can significantly reduce the risks of shoulder injuries in the overhead throwing athlete as well as improve performance. Studies published by Oyama et. al (2009) and Richardson et. al (2015) showed that with poor control of stepping patterns and trunk rotation sequences there is an increase in electromyographic activity in the muscles of the rotator cuff and all of the stabilisers of the shoulder blade, as well as an increased external rotation range of motion in the cocking phase of the throw. That is technical talk to say that the amount of force going through your shoulder muscles is increased and the positions that your have to get into to achieve force in the throw are more precarious if you don’t have good control of your trunk and stepping patterns. The other way to look at the information from the studies above is that we are able to reduce the forces through our rotator cuff (deep shoulder muscles) by adding rotation and stepping patterns which is great for injury prevention and performance, but it also suggests that if we are trying to specifically drive rotator cuff and scapular adaptation from our training, then we need to train them in isolation. So the take away from the above info is that for building strong and resilient shoulders in the overhead athlete we need to be training both isolated rotator cuff / scapular muscle strengthening AND full body stepping + trunk rotation + shoulder rotation strength and patterning. The other major aspect of maintaining shoulder health is throwing athletes is the ability to control acceleration and deceleration of our upper limb at the start/end of the throw. This wont just happen by itself with regular strength exercises, we need to be specific with our training. That’s a lot of information about WHAT to do, so lets go through some examples of HOW to go about it. The following exercises are a non-exhaustive example program of some ways to target the goals above (I will put a video of these on our Instagram and Facebook in case the photos and explanation don’t make sense).

  1. Band / Cable shoulder internal & external rotations
With these exercises we need to be working on strength through range of our shoulder joint, and to be more specific to the throwing motion they need to be completed in a range of different shoulder positions. The classic position for these is elbow by your side with the rotation, but that alone wont drive change in a throw. Other suitable positions to work on these rotations include 90degress of glenohumeral abduction, and also in 90degress of glenohumeral flexion + neutral horizontal adduction (see the pictures and these positions will make a lot more sense). These will be good at building general rotator cuff strength and can be great as a warm-up exercise.  
  1. Weighted Ball accelerations/ decelerations
This exercise is a little trickier to complete solo and is best done in pairs (unless you’re really tricky and bounce the ball from a wall). One person in the pair is doing the acceleration/deceleration exercises and the other is being an assistant and throwing the ball into the right place to catch. I like to do these in a kneeling lunge position, however you can do them in sitting or standing too. The assistant will throw the weighted ball to the athlete at just above shoulder height, and the athlete’s goal is to catch, control and recoil the ball back to their partner.
  1. Single and double hand Palloff press
Despite looking very similar, the outcome and goals of these exercises is quite variable. I have put them together in this program as I like to complete them in a superset with both exercises. The amount of external load being used will be significantly less for the single hand compared to the double. The goal of the single hand version is to be active through the muscles in the back of your shoulder/ shoulder blade while your arm is in a position out in front, whereas the double hand version becomes an anti-rotation exercise for the muscles of your trunk. While being less specific to the throwing motion, these are both great for learning to activate and control the muscles needed in the throwing pattern. When done well, it will look like you aren’t doing much, as the goal is to only move from the shoulders and limit movement from the rest of your body.  
  1. Swiss Ball DeadBug
The target of this exercise is to learn/practice simultaneous activation of the muscles that we will use in the trunk rotation to create momentum before we get to the shoulder rotation. We need to be pressing downwards into the swiss ball with our arms and upwards with our thighs, then maintain this contraction as we take away the opposite hand and leg. The remaining contact points will ensure that we are active through the hip flexors on one side, through the trunk/abs to the opposite shoulder. This is exactly the force transfer we need when patterning our throwing.
  1. Cable weighted step & rotate
In the deadbug we have worked on activation, now this is putting activity into motion. Start slow and work on the step into the activation pattern created in the deadbug, then following through with the hands. This exercise can be completed slowly with moderate resistance for motor patterning, or with lighter weights and more speed to be more specific to the true throw. As mentioned earlier, this is a sample program of some of the many appropriate ways to achieve the goals mentioned in the first part of the blog. As every person/athlete is individual, their program should reflect this so if you need assistance or help with any of the above exercises, or others you are doing in your strength work don’t hesitate to contact us for assistance.

Exercise and Mental Health


Exercise and Mental Health

  Staying active is not only critical for maintaining physical fitness during the COVID-19 restrictions, but also for providing important mental health benefits during the current period of social isolation. Physical activity is a key factor for the prevention and management of mental health issues such as anxiety, depression, Post-traumatic stress disorder (PTSD), Bipolar affective disorder (BPAD) and eating disorders. Physical activity, even in low doses, could lower the risk of mental illness in the community. The current Australian guidelines for exercise are 150 minutes of moderate-intensity aerobic activity and two sessions of resistance-based exercises per week, but for mental health a little bit of activity is better than doing nothing at all. Even one session per week has been shown to have great improvements. Mental disorders are already among the leading causes of disease and disability globally. There is mounting evidence that suggests that exercise is an effective component of treatment for people living with acute and chronic mental illness. With exercise making a big difference in mood and promoting a positive mental health, whilst also helping to reduce the symptoms of mental illness, there is a significant need for exercise to be a fundamental part of mental health treatment, particularly whilst we are in isolation. While gyms and fitness classes are now shut down, exercise is still considered an essential activity. Here are some tips for maintaining or building movement into your day:
  • Keep motivated by scheduling exercise into your diary as you would for a gym class
  • Put on your favourite music and do some simple body weight exercises such as squats, lunges, and push ups
  • Make use of online exercise classes to guide your home exercise. You can find some great online Pilates classes here
  • Get outside into the fresh air if you can, take a walk along the beach or kick the football in the backyard
  • Book in for an online consultation or alternatively a one-on-one session with our Accredited Exercise Physiologist for clinical exercise advice and treatment here
It is important to remember that it’s not about what type of exercise is the best kind, but rather to find something you enjoy doing as you are more likely to stick with it and achieve the mental health benefits. The most important thing is to find time every day to move your body – even if it is a couple of laps around the block. Regular exercise will help boost your state of mind and protect your mental well-being. If you or someone you love needs help, there is always someone to talk to at Lifeline on 13 11 14

The low down on Hip Replacement


The low down on Hip Replacement

The current state of affairs

Hip replacements are becoming increasingly common. Currently 1.3 people in every 1,000 will undergo a hip replacement operation, and more than 1.2 million are carried out each year worldwide. The biggest risk factors for needing a hip replacement are age and arthritis, with 85% of people having a hip replacement, also having osteoarthritis. In terms of gender, women have a higher risk of needing a hip replacement (58%) compared with men (42%). Hip replacement surgery in patients aged 45-54 has also doubled in the past 10 years.

What can we do, to reduce the risk of needing a hip replacement?

Physical activity helps. Running decreases your risk of developing osteoarthritis by 18% and as osteoarthritis is present in 85% of people who undergo a hip replacement, this has a knock-on effect in reducing your risk of needing a hip replacement by 35-50%. And if you’re not up for running that’s OK, walking can also reduce the risk of needing hip surgery, although by a smaller percentage (23%). Almost half of the protective effective of being physically active comes from weight control. The higher your BMI, the greater your risk of needing a hip replacement.  

And what can you do if you’re already experiencing hip pain?

If you need a hip replacement then the sooner you have it, the better the outcome is likely to be and the quicker you will recover from your operation. This is because the more pain you suffer prior to having surgery, the more compensations and adaptations the muscles and soft tissues will have made around the joint, in an effort to try and protect it and you from that pain, and the harder that will be to re-train once you’ve had the operation. That’s not to say it can’t be done, it will just take a bit longer and need a bit more of an investment in your time and energy. The good news is that outcomes from hip replacements are very good. Developments in materials and surgical techniques, mean that the artificial hips are lasting longer, and success rates are very good, with more than 80% of people experiencing pain relief and functional improvement, meaning their daily lives become easier and they’re able to do more.  

We hope you find this information helpful and if you have any questions or queries, please feel free to get in contact with us 6676 4000 or 6676 4577.

We are running the GLA:D program as a preventative for surgery for hips and knees with osteoarthritis.

Follow this link to read more - GLA:D program Pottsville and Cabarita Physiotherapy.


What is an exercise physiologist?


What is an exercise physiologist?

An Accredited Exercise Physiologist (AEP) is a university qualified allied health professional who specialises in the delivery of exercise and lifestyle programs for healthy individuals and those with chronic medical conditions, injuries or disabilities.   AEPs possess extensive knowledge, skills and experience in clinical exercise delivery. They provide health modification counselling for people with chronic disease and injury with a strong focus on behavioural change.   Working across a variety of areas in health, exercise and sport, services delivered by an AEP are also claimable under compensable schemes such as Medicare and covered by most private health insurers. When it comes to the prescription of exercise, they are the most qualified professionals in Australia.   What makes AEPs different to other exercise professionals?
  • They are university qualified
  • They undertake strict accreditation requirements with Exercise and Sports Science Australia (ESSA)
  • They are eligible to register with Medicare Australia, the Department of Veteran’s Affairs and WorkCover, and are recognised by most private health insurers
  • They can treat and work with all people. From those who want to improve their health and well-being, to those with, or at risk of developing a chronic illness
Why should you see an AEP? AEPs are the experts in prescribing the right exercise to help you prevent/manage your chronic disease, help you recover faster from surgery or an injury, or help you to maintain a healthy lifestyle.   AEPs can help treat and/or manage:
  • Diabetes and pre-diabetes
  • Cardiovascular disease
  • Arthritis and osteoporosis
  • Chronic respiratory disease and asthma
  • Depression and mental health conditions
  • Different forms of cancer
  • Musculoskeletal injuries
  • Neuromuscular disease
  • Obesity
  • And much more!
    What makes AEPs even more special is they know how to set goals and maintain motivation, these are two aspects that will most commonly see people fail at exercise. What to expect when seeing an AEP?   During an initial consultation with your AEP, you will undertake a comprehensive assessment in order to develop an exercise plan based on your unique requirements. This session will likely be a fair few questions about your health and history. A lot of people are concerned about what to wear to this appointment. We always say wear comfortable clothing as you may be asked to do a range of movements and bring some comfortable walking shoes as you may need to complete an aerobic assessment. After this session, you will be provided with a plan of action. Working with an AEP can be a truly rewarding process and they can make a hugely positive impact to your life. Our AEP, Sammy, has special interests in the areas of Cancer and Exercise, Osteoporosis and Clinical Pilates. To make a booking with Sammy our AEP  please call 6676 4000 or 6676 4577.  

Don’t Get into Deep Water with Swimming Injuries


Don’t Get into Deep Water with Swimming Injuries

Swimming is one of the most popular sports in the world. We swim in the sea, pools, lakes, streams, rivers and even ponds. And given 70% of the Earth’s surface is water, we’re not short of opportunities. And while swimming is considered a ‘low-impact’ sport due to the fact that the water supports a large percentage of, more than 84% of regular swimmers suffer from some type of overuse type injury caused by swimming. Why? The main reason is the high repetition number and forceful nature of the shoulder revolutions which takes our shoulder joint through its full range of motion (which is one of the greatest of all our joints), against resistance, over and over again. And as 50-90% of the power generated to propel you forward comes from the shoulders, you can see why they are the most frequently injured joint. However, swimming also puts stress on your back, to hold you level in the water; on the neck when raising your head out of the water to breathe and if you favour breaststroke as a stroke, there’s added pressure from the unnatural twisting motion on the knees. So, despite it seeming to be a low-impact sport, swimming actually carries a surprisingly high risk of injury. Let’s take a look at those injuries, why they happen and what you can do about them. Swimming injuries generally stem from two sources, and often these sources will combine:
  1. Muscle imbalances
  2. Stroke technique issues
Muscle Imbalances Our everyday posture, particularly if you spend a lot of time sitting at desk or in a car, or generally not moving around, creates all sorts of muscle imbalances from short hamstrings, tight muscles around the neck, back and shoulders. We unconsciously adopt a curved forward upper back, round shoulders and chin poke, which not only add to shoulder problems in swimmers but neck pain too. Poor posture is the biggest culprit of short tight trapezius and pectoral muscles and weak anterior (front) neck and upper back muscles. These muscles can be painful and develop trigger points which are hyperactive spots in the muscle, commonly referring pain and causing headaches. Tight muscles may also limit your neck movements. Good posture ensures good alignment of the joints and ligaments which allows for optimal contraction of your muscles and off-loads underlying structures. Stroke Technique This a big topic to cover because it depends what stroke you’re swimming mostly with and what kind of injury you may have but issues include: a wide, swinging arm recovery which requires excessive internal rotation, causing impingement on the joint; thumb in first with hand entry, which again causes excessive internal rotation in the shoulder and a dropped elbow or straight arm pull through which creates a long lever and overloads the shoulder. What does all of this mean to you? You shouldn’t swim? You should reduce your training or change your sport? The bottom line is that the benefits of swimming - whether it’s for general fitness and physical activity, the desire to win competitions, or just to find your quiet place for stress relief - far outweigh the risk of injury.