Prehab: More essential than insurance before surgery!!

Prehabilitation, prehab for short, is conditioning the body and mind for surgery–before the surgery. Studies have shown that patients who participate in moderate exercise before surgery experience an accelerated recovery. This occurs because prehab creates an optimal environment for recovery by helping prepare the individual for surgery mentally, emotionally and physically. One of the main reasons for prehab is to help prevent unnecessary atrophy and is cental parts of helping the individual meet their post-surgical challenge. After surgery, patients display higher levels of functioning and less pain compared to those who did not participate in prehab. Continue reading


Get into the swing of things with this golf warm up

Golf is a sport that requires good range of movement, coordination, flexibility, timing and muscle control.  It also puts a large amount of strain on your joints and muscles, especially if you are not warming up correctly or have enough range of motion.

Without a warm-up, muscles and soft tissues are cold, inflexible and less forgiving.  When muscles are warm, they have increased elasticity, pliability and can withstand forces much better, thus reducing the risk of injury.

The best warm-up for any sport should mimic the activity, to ensure that your brain can begin communicating with our muscles about the activity and you can begin to increase your range of motion of the specific joints used in activity.  A good warm up should also be followed by appropriate stretches to increase flexibility and range of motion.

Here are our best 6 essential stretches to do for any golfer before they play a round.

Standing Pelvic TiltsPelvic-Tilt-in-Standing-300x297
Tuck the pelvis under, creating a posterior tilt of the pelvis; arch the back, creating an anterior tilt of the pelvis and return to a neutral spine. Repeat five times in each direction.


Speed Trunk RotationImage result for Speed Trunk Rotation

Cross your arms across you’re chest. Inhale as you rotate from the core as you got he the left. Exhale as you rotate back to the center. Repeat 10 times in each direction. Continuing in your address position, extend the arms to shoulder height and rotate from the core. Repeat 10 more times.


Standing Hip Stretch

  1. To stretch the left hip flexors kneel on your left knee and put your right kneelinghipflexorfoot in front of you such that your right hip and knee are about 90 degrees.
  2. Put a cushion on the floor for your knee if you find this uncomfortable.
  3. Put your left hand on your left hip and push your left hip forward so that it is in front of your left knee.
  4. Keep your chest up and don’t bend forward at the hips.
  5. Then repate on the other side.

Shoulder Stretch with Club Behind Back
Place the club or towel in your right hand, palm facing the ceiling. Bring the right arm over your head and the right palm behind your back. Bring your left arm behind your back and clasp the club or towel. Inhale as you gently pull on the towel, exhale and release. Repeat five times and switch sides.

Neck StretchImage result for neck stretches
Bring the right ear toward the right shoulder. Inhale as you press your left arm toward the floor, exhale and relax the left arm. Repeat very slowly five times, and gently return your head and neck to neutral. Switch sides.


Standing Rhomboid / Upper Back / Neck StretchImage result for standing rhomboid stretch
Bring the club to shoulder height, bend your knees and tuck your pelvis under. Inhale as you press your arms away from you, tucking your chin into your chest. Exhale, lift the head
and squeeze the shoulder blades together. Repeat five times.


For any questions, or if you would like us to go through this in more detail, please come in and see us today. You can call and book an appointment by calling 99712185.


Shock Wave Therapy- An effective treatment for Tendon attachment injuries

Northern beaches physiotherapy is very excited to be able to offer Shockwave therapy to our patients.

What is Shockwave Therapy?

Shockwave is an innovative, non-invasive treatment involving high frequency, short duration, bursts of high-energy pulses that are transmitted into injured tissues. These high intensity pulses of mechanical energy aggravate the injured tissues (muscles, tendons, ligaments, bone, etc.) at a cellular level, which stimulates a healing response. Ultimately, this treatment strategy accelerates tissue healing with minimal scar tissue production. The literature has shown this technique to be very successful in the treatment of chronic soft tissue injuries, tendinopathies and repetitive strain disorders.


Conditions that we successfully treat with Shockwave Therapy

Extracorpeal shockwave therapy can be used to treat a variety of musculoskeletal conditions especially in regions where soft tissues such as tendons and ligaments connect to bone. Some of these include:

  • Tennis elbow                                                         SWT
  • Golfers elbow
  • Rotator cuff tendonopathies
  • Calcific tendonitis
  • Jumpers knee
  • ITB friction syndrome
  • Hamstring tendonopathy
  • Gluteal tendonopathy



One of the most common regions treated with shockwave therapy is the foot due to the strong support for its use in research studies. Some conditions in the foot that respond very well to shockwave include:

  • Plantar Fascitis
  • Heels spurs
  • Achilles Tendonosis
  • Peroneal tendonosis
  • Tibialis posterior tendonosis

What should I expect when I am receiving Shockwave Therapy?

If you are a good candidate for shockwave therapy, your physiotherapist will let you know. Your physiotherapist will locate the area of pain through palpation.  This area will then be marked and some ultrasound gel applied.  The shock wave impulses are delivered using a hand-piece.  It takes about five minutes to deliver a single treatment. Typically you will require 3-5 treatments of shockwave and your sessions are generally scheduled one week apart, Most people will notice the benefits of shockwave therapy right away (even right after the first session).

Is Shockwave Therapy Painful?

Shockwave therapy can be mildly painful for some however most patients are able to tolerate the discomfort well. Your physio can adjust the intensity of the energy so that it is comfortable for you and can ramp up intensity if you are able to tolerate more. The most intense pain is during the application of shockwave, which only lasts 3-5 minutes. The best part is that the majority of patients will notice a great deal of relief right after the treatment. In rare cases you may feel some soreness for approximately 24 hours after your session and you may have an inflammatory reaction which can include redness and local tissue swelling.

If you have any questions regarding shockwave therapy or wondering if it could be a beneficial treatment for you’re condition, please call us in 99712185 and have a chat with one of our physiotherapists.






An ankle sprain refers to tearing of the ligaments of the ankle. The most common ankle sprain occurs on the lateral or outside part of the ankle (ATFL). This is an extremely common injury which affects many people during a wide variety of activities and sports.

ankle 1


Any movement that suddenly twists the foot beyond the natural range of motion can cause an ankle sprain such as:

  • Landing wrong when jumping or running on to an uneven surface.
  • Stepping off a curb wrong
  • Slipping on ice
  • Tripping on a hole in the ground


Grade 1 – a first degree ankle sprain is when the ligaments have been stretched but not torn. Symptoms include:

  • Mild pain
  • Some swelling
  • Some joint instability
  • Mild joint stiffness
  • Difficulty jogging or jumping

Grade 2 – a second degree ankle sprain is the most common of ankle injuries and is a partial tearing of the ligament. Symptoms include:

  • Significant swelling
  • Bruising
  • Moderate pain
  • Some loss of motion or use of the ankle
  • Trouble walking

Grade 3 -– a third degree ankle sprain is the most severe of ankle injuries. With this sprain, the ligament has been torn completely. Symptoms include:

  • Severe swelling
  • Severe pain
  • Instability of the joint
  • Extreme loss of motion
  • Walking can be quite painful


The initial treatment option is to provide the principal of Ricers to the ankle.

Rest – especially in the first 24 to 48 hours
Ice – for the first 48 hours for 20 minutes at a time
Compression – wear a brace or a wrap that is snug, but not cutting off circulation
Elevate – above the heart as often as possible

Rehabilitation and return to play

Most ankle sprains heal within 2 to 6 weeks, however severe sprains many take as long as 12 weeks.

A comprehensive rehabilitation program minimizes the chance of the injury recurring and includes flexibility, balance, stretching, strengthening and sport specific exercises.  During this time taping or bracing the ankle may be prescribed to provide support until full function is regained.  If, while performing a rehabilitation exercise, ankle joint pain or discomfort is experienced, stop immediately and consult you’re physiotherapist.

Players with significant ligament injuries (Grade 2 or 3) are advised to use bracing or protective taping when playing sport for a minimum of 6 to 12 months post injury.

If you have any questions regarding ankle sprains or the require treatment for one, feel free to call us on 02 9971 2185!


Dry Needling: An effective technique to relieve pain and treat injuries

What is dry needling?


Dry needling is a treatment technique that involves the insertion of fine acupuncture type needles into muscle trigger points to release the contraction knot in a muscular band.

Uses of this technique

This technique is a useful and very safe treatment option for patients suffering from soft tissue pain and sports injuries including:

  • Various knee conditions
  • Tennis/golfers elbow
  • Lower back and neck pain
  • Achilles tendonopathy
  • Shin splits
  • Muscular strains and strains
  • And many more!!

Benefits of dry needling  


Dry needling can be used to relieve pain, restore normal muscle and joint function and increase flexibility by relaxing tight muscle bands, stimulating the release of endorphins and increasing blood supply to the region to stimulate healing.

 Dry needling vs Acupuncture

Dry needling is different to traditional Acupuncture.

Dry needling in based on western anatomical and physiological principles using acupuncture type needles. The needles are inserted and moved slightly aiming to achieve a small muscle twitch which usually results in a reflex relaxation of the muscle.

Acupuncture, based on traditional Chinese medicine, involves the insertion of thin needles into the body acupuncture points and are usually left for a certain time period.

Sensation of dry needling

The needle, once inserted, is directed down into the trigger point which may stimulate the feeling of a deep cramping of the muscle along with some involuntary muscle jumps/twitches. This is called the local twitch response (LTR) and means that we are positively affecting the desired tissue.

Expectations after needling

After dry needling it is common to experience an ache or mild fatigue sensation in the treated area for the rest of the day. In this period heavy/intense exercise isn’t recommended. Some patients will get instant relief of their injury/condition following dry needling while others feel better after 1-2 days.

Dry needling is an effective technique used in conjunction with other physiotherapy techniques and exercise prescription to ensure return to normal function.

Contact Northern Beaches Physiotherapy to make an appointment to see one of ours physios.

Ph [02] 9971 2185



Breastfeeding and Posture & Pelvis the ups and downs!

New mums have expectations of the joy of breast feeding, aiming to bond with their new baby and provide the best nourishment on the planet however…

Breastfeeding in the early days can be a stressful time and doesn’t always come easily. It is also something you will spend a large amount of your day doing, so it is important to maintain a good posture for both you and the baby. What’s more, hormonal changes in pregnancy can loosen the joints and the ligaments that attach your pelvic bones to your spine, which can make you less stable and cause pain during pregnancy.

These changes don’t go away overnight. So you need to be careful in this post partum period to protect your back until your muscles regain their strength and your joints become less lax.

An ideal sitting position for feeding involves:

  • bottom back in the chair
  • distribute body weight evenly between the hips
  • knees bent at 90 degrees and feet flat on the floor or a foot stool
  • arms supported by pillows so that shoulders are relaxed

By maintaining good posture you also allow for the breast to be positioned straight, making it easier for the baby to attach and feed. A good attachment helps with prevention of mastitis.


Mastitis is a condition where the breast tissue becomes inflamed; this may or may not be in association with an infection. Mastitis is usually the result of a blocked milk duct that hasn’t cleared. Some of the milk banked up behind the blocked duct can be forced into nearby breast tissue, causing the tissue to become inflamed.

Early symptoms of mastitis can make you feel as if you are getting the flu. You may begin to get shivers and aches. The breast will be sore like it is with a blocked duct, only worse. It is usually red and swollen, hot and painful. The skin may be shiny and there may be red streaks.

The best treatment for mastitis is to drain the breast often, but gently. Let the babies chin direct the drainage of the breast, position the baby so their chin “points” to the area of hardness. Vary the baby’s position on the breast so that all ducts are emptied. Mastitis is most common in the upper outer quadrant of the breast as we don’t tend to position to drain that area. Examples of some safe breastfeeding positions are shown below.


In some cases it may also be helpful to express by hand or pump depending on pain. Using hot and cold packs can also be helpful. A hot pack is best used just before feeding to help aid with the let-down reflex and cold backs after feeding to reduce pain and swelling.

Physiotherapists can help with massage through the blockage and use of therapeutic ultrasound to provide faster relief.

It is important to note that if you are also suffering from a fever contact your GP or maternity unit as you may require antibiotics.

Tips to help prevent Mastitis:

1) Choose a comfortable chair with armrests. Bring the baby up to the nipple and use pillows for extra support for your back and arms. This should ensure that your baby is attached and feeding well.

2) Avoid missing feeds and if the breast becomes uncomfortably full, wake your baby for a feed. If your baby is not interested in feeding, you may want to express a small amount.

3) Alternate from which breast you begin each feed. This should ensure over the course of a day that both breasts get evenly drained

4) Change feeding positions regularly. Try to choose positions that allow the milk to flow downhill to your baby. Let your baby’s chin direct the drainage from the breast.

If you have any questions or if you would like to book an appointment to see one of our Physios, please call 9971 2185.



The Pilates reformer, an exciting fun way to improve core strength and flexibility!

New Pilates Reformer at Northern beaches physiotherapy

reformer 1

Joseph Pilates, the creator of the ‘Pilates’ designed the ‘Reformer’ to focus on strengthening muscles to ensure the maintenance of symmetrical movement, optimal posture and reduce the risk of injury while improving the performance of the human body.

The reformer offers an exciting way to improve the coordination of muscle function to protect against injury, as well as enhancing fluidity of movement, and improving muscular tone and posture. A large range of exercises can be done in a variety of positions including sitting, kneeling, standing and laying down. Every exercise can be progressed to ensure continual improvements are made.


The Reformer has a sliding platform attached with springs at one end and is moved via pushing from the foot bar or pulling from the straps at the other end. The springs offer resistance to the exercise and vary from light to heavy, depending on the users capabilities. The resistance offered by the springs reduces stress on tendons and ligaments in the body as the springs offer more resistance at the strongest point of muscle contraction, instead of at the finishing and starting point of the exercise.

We offer 1:1 physiotherapy supervised sessions on the reformer which is essential to ensure your understanding of the subtleties required to maximize the benefits of the reformer. Furthermore specific supervision and instruction is essential for correct use of this machine. The reformer is beneficial to people of all different ages, Pilates and/or reformer experience, fitness levels, conditions and goals/outcomes.

The reformer is an effective rehab tool and is very useful in the rehab and recovery from:
• Lower back conditions
• Neck/upper back conditions
• ACL reconstruction and other knee injuries
• Hip conditions

The ‘Reformer’ is not just for rehabilitation, being best used on a regular basis to maintain general strength, flexibility and core stability,

If you are interested please call us to enquire further and book an appointment on (02)9971 2185

back, Gluteal, Nerve Pain, Physiotherapy, Sciatica

The Secret to Sciatic Pain

Sciatica is a complex problem that many of us have either experienced, or know someone that has.  “Sciatic pain” however, is not just one problem but an umbrella term used to describe many sciatic-nervedifferent problems that cause the sensation of nerve pain in the area of the body controlled by the sciatic nerve.

Nerve pain can be caused by any irritation of a nerve either through compression, excessive or prolonged stretching, damage due to trauma, local chemical changes or even interference from scar tissue.

Nerve pain can feel different to different people and can be in different areas for different people, with either hot or cold feelings, pins and needles or numbness, sharp or shooting pains or even loss of power to muscles.  These differences are dependent sciatic painon which nerve has been affected and how significantly it has been affected.

The reason why sciatic pain can be caused by so many different problems is because the path of the sciatic nerve can be affected by multiple structures.
The four structures that are mostly responsible for sciatic pain are:

The Spine
When our nerves travel from the spinal cord and leave the spine, they must pass through small holes between vertebrae.  These holes (foramen) can be narrowed by different variables such as repetitive poor movement patterns, degeneration of joints, dehydration of spinal discs or disc protrusion.

The Pelvis
The lowest segment of the spine, the sacrum, also has small holes through which nerves emerge to service our legs.  If the sacrum is not gliding correctly through movement or there is poor alignment of the pelvis, these nerves can be affected.

The Buttockspiriformis syndrome
Within the buttock muscles, there is a singular muscle called the piriformis.  In most of the population, the sciatic nerve passes underneath this muscle, but 17% of people have this nerve pass through the piriformis.  Incorrect length or function of the piriformis muscle can aggravate the sciatic nerve in both populations but is more likely among the 17%.

The Muscles of the Leg
Scar tissue and a history of damage to muscles close to the sciatic nerve can cause adherence to the nerve itself and lead to pain.

Due to these multiple causes, there are multiple solutions to what seems as though it is the same problem.  What may be beneficial for your relative or friend with sciatica, may not be as effective, or may even be detrimental to your own situation.  This is why it is important to consult your physiotherapist, who will perform a thorough examination, to determine which problem is attributing to your nerve pain and create a program tailored specifically for you.


Limber Up: Dynamic Quadriceps Stretch

Following on from our post “The truth about stretching”, we present “Limber Up” designed to provide you with demonstrations and explanations of ways to stretch your whole body using various stretching methods.

The quadriceps are a powerful muscle complex at the front of our thighs that are vital in almost every lower body activity.  They are responsible for straightening and stabilising our knees and bringing our thigh forward in front of our body.

Due to the amount of work it has to do during exercise, it is important to stretch it dynamically during your warm up.  Below is a video showing you an example of a dynamic stretch of your quadriceps.


Post by Mitchell Sandvoss (B. Physiotherapy)

Flexibility, Improving Movement, Physiotherapy, Stretching

Four types of stretching, which is the best?

Regardless of which physiotherapist you see or which sport you have played in your lifetime, you are bound to have heard or been told that stretching is good for you.

The truth? It is, BUT… there are different types of stretching and it is important you use the right type of stretching at the right time!

Being aware of the possible risks of each type of stretching could make a difference to your likelihood of injury or even your performance!

The main types of stretching are; Static, Dynamic, Proprioceptive Neuromuscular Facilitation and Ballistic.

8stretching-istock159682821Static Stretching is the type of stretching that we all know well.  You tension a muscle until you feel a stretch, then hold for  a period of time (usually 20-30 seconds).


  • Increases the extensibility of the muscle(s) stretched
  • With prolonged repetition can increase muscle length


  • It can increase the risk of injury if done before exercise because of an increased risk of instability.
  • Has been shown to reduce muscle power by 7-8% and muscular endurance by up to 30% for up to 24 hours.

When is it appropriate? After exercise to release tightened muscles and if you are looking to increase overall flexibility and muscle length.

Dynamic stretching is a stretching technique that we may not all be familiar with.  It uses momentum to stretch a muscle for a short period within its range of motion.  Below is a video that runs through an example of a dynamic stretch.



  • Has shown to improve muscular strength, power, endurance and agility
  • Appropriate during a pre-exercise warm up without compromising stability


  • Does not provide an overall lengthening of muscles
  • Can be hard to perform without demonstration or clear instruction

When is it appropriate? Before exercise and daily during rehabilitation programs if appropriate.

Proprioceptive Neuromuscular Facilitation is simply shortened to PNF.  It is a form of stretching with the aim of providing large increases in range of motion in a short time by contracting opposing muscles against a passive stretch, or in other words, pushing against a static stretch.


  • Can produce large increases in range of motion and muscle extensibility in a short time
  • Facilitates muscle inhibition to allow spasmodic or tight muscles relax


  • Has the same effects on muscle power and endurance as static stretching
  • Can lead to injury if not performed correctly and safely

When is it appropriate? After exercise to release tightened muscles, to release muscle spasm and as part of exercise programs to increase flexibility and performance. It is, however, not always necessary and you should consult your physiotherapist on how to do these stretches correctly and to determine which stretches are most appropriate for you.

Ballistic Stretching is similar to static stretching, but involves a bouncing at end of range.  It is not Screen-Shot-2012-08-07-at-9_41_03-PM1recommended as it is not shown to have any lasting benefits and there is an increased risk of injury when performing the stretches.

For more examples of stretches, feel free to view some of our other posts by clicking the links below.

Post by Mitchell Sandvoss (B. Physiotherapy)

Diet, Food, Low-GI, Physiotherapy

Why Low GI?

As physiotherapists, we understand the importance of having balance in our life so that our bodies remain in sync and functioning smoothly and efficiently.  This philosophy is not just limited to bones and muscles, but also to our diet because of the fuels we require to make it through each day.examples of low vs high GI foods

Low-GI is a term that is thrown around a lot, but most of us don’t know how it is relevant to us.  GI (glycemic index) refers to the speed at which carbohydrates are absorbed and raise the blood glucose levels in our body.

If something is high-GI,
carbohydrates are absorbed very quickly and causes our blood glucose levels to spike.

If something is low-GI, carbohydrates are absorbed much slower and cause a steady increase or even a maintenance of our blood sugar levels, depending on what we are doing at the time.

This means that when we eat high-GI foods, the glucose (energy for our muscles) is absorbed quickly into our muscles and provides a short sharp burst of energy, where as low-GI foods provide a longer lasting and more consistent supply.hp_lgi_dailyintake_day1

When our blood sugar levels rise, this sugar needs to be absorbed by our muscles as energy. When our levels spike, if our body cannot transfer the energy to our muscles as fast as it is being absorbed, it is instead stored as fat.

If you consistently eat high-GI foods, there is always an overflow of energy that our body cannot use, causing an increase in your body-fat percentage.  There is evidence to show that a heightened body-fat percentage can increase your risk of stroke, heart disease/attacks, diabetes, cancer and the list goes on.

So before a big day, or before exercise it is recommended that you try to consume something low-GI so that your energy lasts and you don’t crash.  However, these shouldn’t be the only times you eat low-GI foods, as they are the best foods for weight control and getting the most out of each and every day.

When it comes to knowing what is considered low- and high-GI, the ranges are as follows: glycemic-index

Low-GI = 55 and under

Medium GI = 55-69

High-GI = 70 and over

For a list of low-GI foods, click the
following link:

Post by Mitchell Sandvoss (B. Physiotherapy)


The 5 Tips to getting the most out of your Retirement Years!

When you retire, you will find you have much more time on your hands.  Good health begins with a good lifestyle, and below are 5 tips to improve your longevity and allow you to think, move and live well long after you stop working.

WALKING is a great activity that almost everyone can do.RetireesWalking2
It has many benefits including reducing the risk of heart disease and improving lung function. It also increases or maintains muscle strength and balance while also maintaining bone density.

It is accessible to everyone and it is important that you add walking to your daily routine for 20-30mins.  A new local walk worth trying is the loop around Narrabeen Lake which stretches for 8.5kms and has beautiful scenery!

STRETCHING is an excellent way to take the pressure off your body.  It reduces that feeling of stiffness by providing a greater amount of Thoracic Open Book stretchextensibility in your muscles.

Incorporating a simple stretching routine into your morning routine can be a great way to start the day.  The muscles to focus on include your hip flexors (front of your thigh), hamstrings (back of your thigh), gluteals (bottom muscles), neural stretches and rotating and distracting the spine.  For instruction on stretches and technique, links will be provided at the end of the blog.

LIGHT RESISTANCE TRAINING is a great tool for regulating blood pressure and increasing bone density while reducing your risk of falls.  It also increases muscular strength and endurance which allows you to complete daily tasks with greater ease.

Resistance female1training can be conducted through the use of resistance bands, body weight, free weights, machine weights, etc. and is recommended 2-3 times a week.

Choose a weight that you can lift 12-15 times without great difficulty and complete 2-3 sets of 4-5 different exercises concentrating on closed-chain (hand/foot stay still, body moves) exercises that work all major muscle groups (legs, chest, back, shoulders).

As we age, we also become more susceptible to injury so it is important to consult a trained professional to create a program that is appropriate for your age and fitness level.

A BALANCED DIET is vital to looking after our bodies regardless of age, but becomes more important as our body becomes less efficient.  Be sure to include a large variety of foods with emphasis on natural meats, fruit and vegetables to allow us to receive the necessary vitamins, minerals and fuelsfood for each day.

The newest research states that we should be increasing our daily intake of natural fats (found in grain-fed meat products and things like avocado and unsalted nuts) and reducing our overall intake of
processed carbohydrates (such as white rice, white bread and fruit juices).

Also be aware that you aren’t over-indulging in foods containing processed saturated fats, processed sugar, or a high salt content or by over-eating, because these can a gradual rise in cholesterol which can increase the likelihood of heart attack or stroke.

FIND A PASSION/HOBBY to give yourself the motivation to keep healthy and fit.  They provide you with the opportunity to be physically and mentally active on a consistent basis and as we all bikeoldknow if we don’t use it, we lose it!

Ensure that you choose something that is easily accessible and appropriate for your physical and mental capabilities, but still challenges and engages you.

Always make sure that safety is your first thought when exercising or trying something new.  Try to avoid extreme conditions (hot or cold) and choose an intensity that is within your limits.  If you are unsure about how to approach something, we recommended that you seek professional advice.

Post by Mitchell Sandvoss (B. Physiotherapy)

Ankles, Feet, Physiotherapy, Sports

Ankle Sprains – Putting your Best Foot Forward


Musts following any ankle sprain.

Ankle sprains are very common among young and old  alike.  There are many different types and vary depending on the type and severity of the mechanism of injury. Most commonly ankleswollen-ankle sprains occur when we roll our foot inwards, stressing the ligaments that attach from the bone in our leg to the bone in our foot.  They are usually characterised by immediate swelling, pain and reduced range of movement.

After an ankle sprain, it is important to begin on the road to recovery as soon as possible and you can get started by using these simple tips.

RICER Tryptich

Rest – give the structures in your ankle time to heal and minimise the amount that you aggravate the injury.

Ice – place ice, a cold pack or frozen peas over the injured area for 20minutes every 2 hours for the first 72 hours to minimise swelling and reduce pain.

Compression – make use of an elastic bandage or compression sock to apply light compression to the area to reduce swelling.

Elevation – try to keep your ankle elevated with a foot stool when sitting and propping on pillows when lying down or sleeping.

Range of Motion – move your foot and ankle through light and pain-free movements to keep the blood flowing and prevent stiffening of the joint.

Support – if a crutch or stick is required because you cannot weight bear, use it correctly as shown in the video clip below and try to continue your walking pattern as similar to pre-injury as possible.

Always hold the support on the opposite side to the injury, put injured leg forward first accompanied by the support – this will provide you with a wider and more stable base of support.


Referral – book in to see your physiotherapist ASAP for treatment, further advice and redirection of care as an X-ray, MRI or specialist appointment may be necessary.

These tips are just some of the steps required immediately after a sprain to allow a return to full functional capacity.  Physiotherapists have a much broader range of tools and strategies at their disposal and their consultation could prevent long-term issues and promote faster recovery.

Post by Mitchell Sandvoss (B. Physiotherapy)

Lifestyle, Physio's Personal Tips, Physiotherapy, Stability, Work

Avoiding a Pain in the Neck

The link between neck pain and technology use.

laptop-postureNeck pain is becoming more prevalent in recent times and much of it is linked to the poor postures we adopt when using technology.

On average, we spend 15 hours a week in front of a screen (almost 1 month of the year), and up to 50 hours a week if it is required for work. When using technology, our eyes need to be in an optimal position to focus on the screen. For most of us, it is easiest to poke our chin out to get closer to the screen.

For each inch that your head sits forward of its normal position, the head adds 4.5kg of force onto the small and fragile structures within your neck.  All of this added pressure can cause neck pain, shoulder pain, arm pain and headaches from the muscles in your neck having to work harder and the added pressure placed on the discs, nerves and vertebrae.


If you are someone who spends a lot of your hours in front of the screen, behind the wheel or on the couch, there are some strategies that you can adopt to ease the pressure on your poor neck!

Activation of your Deep Neck Flexors

Your deep neck flexors are muscles in front of the spine responsible for neck stability (similar to the role of the deep abdominals in your lumbar spine) and supporting the head directly over the spine.  When your neck is over your spine, the pressure on other parts of your neck and body will be reduced.

Activating them can be difficult if you are doing so for the first time, so follow these simple steps:

Step 1 – Lie down on your back with a pillow underneath your head and neck, legs bent up and muscles relaxed.

Feeling Neck FlexorsStep 2 – Tuck your chin in so it feels as though it is lightly blocking your windpipe and push the back of your skull into the pillow.  Do NOT activate the muscles at the front of your neck.  Place your fingers on these muscles if necessary to stop them from activating.

Step 3 – Hold this position for 5 seconds before relaxing.  Repeat 10 times before having a rest, then complete 1-4 more sets of 10 until fatigued.

Chin Retraction

Chin Retraction – make a double chin, hold for 5 secs, then relax

Constant awareness of your neck position

When in the car, use the head rest and tuck your chin in.  When at your desk or when using technology, make sure you are not protruding your chin to see the screen.  And, when you are sitting on the couch make sure your head is in a good position and is supported appropriately.

Set up your environment correctly

Move the items in your environment (screen, mouse, keyboard, chair) so that you can maintain a good posture and still work efficiently.   Laptops and tablets force poor posture as looking down at the screen and typing so close prevents good posture. Purchasing a wireless keyboard to use with your tablet to separate hands and screen, increase the font size on your smartphone, correct the angle of your screen on your laptop and position pillows properly when sitting on the couch to provide low back support..


Take regular breaks

Increasing the amount of time that the structures in your neck are under pressure will increase the likelihood of developing pain.  Scheduling regular breaks will allow your neck to have a rest and to relieve the strain.


If you do suffer from neck pain due to poor posture, these strategies will help you.  Poor posture, however, is not the only cause of neck pain and if pain persists we do recommend consulting your physiotherapist for a full assessment.

Post by Mitchell Sandvoss (B. Physiotherapy)

Balance, Daily Exercises, Lifestyle, Physiotherapy, Stability

Heart – the Most Important Muscle of All

People tend to think of physiotherapy as only being concerned with the obvious muscles like “glutes”, “pecs”, “biceps”, “quads” etc.  And although having strength and power in these muscles is important, there is one muscle that overrides all in it’s importance to maintaining good health.

SkippingI’m referring of course to the heart muscle! Without a healthy heart then all the good work done in keeping your other muscles strong is wasted!

Here at Northern Beaches Physiotherapy we are dedicated to helping our patients maintain good overall health. One major aspect of this is achieving good cardiac fitness and endurance!

There are myriad ways to exercise the heart but one of the easiest and most convenient (and therefore most likely to be done on a regular basis) is skipping.  The equipment costs are probably less than $5 and you need a space only as big as a small room or courtyard to do it in!

Skipping for five-ten minutes every day is about as good an exercise as you’ll get. Its not just aerobic – it will also keep many other muscles in tone, including your calves, thighs and buttocks.

Skipping also provides a challenge to the stabilising muscles of your ankles and core, as well as challenging the coordination of your shoulders, wrists and legs!

So go buy yourself a skipping rope and challenge yourself!! Skip for five-ten minutes everyday and in next to no time you will see the benefits to your overall fitness and health!


Post by Angus Tadman (B.App.Sc Phty Hons I)