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INJURIES AND CONDITIONS WE CAN TREAT At Physio K , all problems of the movement system can be treated. Here are some of the most common injuries or conditions we are qualified to treat: Achilles Tendonitis Ankle Sprains Back Pain Bursitis Disc Bulges, Herniated Discs And Sciatica Dizziness Or Vertigo Elbow Pain Hamstring Injuries Headaches Jaw Problems Or TMJ Issues Lower Back Pain Meniscus Injury Neck Pain Osteoarthritis Plantar Fasciitis Post Operative Rehabilitation Posture And Alignment Problems Shoulder Pain Sports Injuries Sprains, Strains And Tears Achilles Tendonitis WHAT’S IN A NAME ​ Tendonitis - tendinitis - tendonosis ​ The suffix ‘itis’ means inflammation; therefore, tendonitis literally means inflammation of the tendon. At some point, people started to use tendinitis as well, which is exactly the same, only with a different spelling. With tendonitis or tendinitis, the tendon is overloaded due to an acute injury causing pain and swelling from tears in the injured tissue. ​ TENDONOSIS Sometimes also referred to as tendinosis - occurs from failed healing or repetitive trauma to a tendon. This microtrauma leads to a loss of collagen continuity with micro tears in the tendon. As a result, there is a loss of strength and further injury will happen when continuing to (over)use the tissue. However, inflammation is generally NOT present with tendonosis (or tendinosis), whatever writing you prefer. ​ In rare cases, chronic degeneration with or without pain may result in a rupture of the tendon. ​ CAUSES ​​ "Active people and athletes are at a higher risk for developing disorders of the achilles tendon." A sudden increase in training (too much too soon) is a classic example where individuals will put too much stress on their ankles and feet. Foot position also has an impact on this tendon, such as people with a flat foot or overpronation. Due to the greater demands placed on the tendon when walking and running, there is a higher chance of getting tendonitis or tendonosis. ​ SYMPTOMS ​ The most common symptoms are an achy pain, stiffness or soreness along the tendon or just below the calf muscle. Often the pain is worse in the morning or after periods of rest and then improves with movement but later worsens with increased activity. ​ TREATMENT​ ​ "Tendonitis or tendinitis, where inflammation is present is best treated with the simple RICE principle (rest, ice, compression and elevation) to reduce the inflammation and to allow healing." Physiotherapy is very helpful at this stage as well; with specific hands-on treatment and guided exercises. The tendonitis should heal in about 6 weeks and can also benefit from anti-inflammatory medicine and sometimes with a cortisone injection. With Tendonosis, (no inflammation present at this stage) anti-inflammatory medication and cortisone injections are not appropriate, because they inhibit collagen repair. Tendonosis healing time is normally between 3 and 6 months once it becomes chronic. Studies show that it takes up to 100 days to rebuild collagen. The primary treatment plan for tendonosis is to break the injury cycle and to reduce the stress on the tendon with relative rest (or altered physical activity), proper ergonomics/biomechanics and physiotherapy. Our physiotherapist will first determine what has caused the condition to arise, as mentioned ‘too much too soon’ is typical of tendinosis, so the first step is adjusting your training load if you're an athlete or your employment load. We can set manageable loads of work through your week with modifications to your tasks that will provide the tendon with relative rest. Upon settling the episode of pain in the tendon we will gradually build the tolerance within the tendon using specific exercises to strengthen the tendon whilst not triggering a relapse in the condition. ​ DOES DRY NEEDLING HELP WITH ACHILLES TENDONITIS? It sure can. As mentioned before, there is too much stress on the tendon due to various reasons. The muscle can be too tight and cause the tendon to get thicker or inflame. Releasing the muscle will reduce the pulling on the Achilles tendon and therefore reduce the pain or inflammation. Dry needling is a great way to release muscle tightness fast and effectively. To learn more about dry needling, click here .

Eimear O'Conner University College Dublin | Masters in Sports and Exercise Medicine | Qualified Pilates Instructor | Keen Interest in the Area of Musculoskeletal Physiotherapy with a Specific Interest in Female Athletes Eimear is from Ireland and recently moved to Sydney. She graduated from University College Dublin with an undergraduate degree in Physiotherapy in 2020. Following this she completed her masters in Sports and Exercise Medicine in Trinity College Dublin in 2021. She is also a qualified Pilates instructor and previously led classes for runners and for the older population. Eimear has a keen interest in the area of musculoskeletal physiotherapy with a specific interest in female athletes. Her master’s thesis focused on relative energy deficiency in athletes, a condition that is prevalent in many young female athletes. Eimear is an accomplished runner having previously captained and competed for her university athletes club in 2019-2020. She has run many international marathons and recently her first sub 3 hour marathon in Wales. She also enjoys swimming and playing golf. Her interest in sports has given Eimear a strong strength and conditioning background which facilitates injury prevention and rehabilitation. It is her belief that exercise is a fundamental part of physiotherapy treatment and uses exercise to allow you to not only fix your problem but to help you improve your performance in every day activities or sports.

INJURIES AND CONDITIONS WE CAN TREAT At Physio K , all problems of the movement system can be treated. Here are some of the most common injuries or conditions we are qualified to treat: Achilles Tendonitis Ankle Sprains Back Pain Bursitis Disc Bulges, Herniated Discs And Sciatica Dizziness Or Vertigo Elbow Pain Hamstring Injuries Headaches Jaw Problems Or TMJ Issues Lower Back Pain Meniscus Injury Neck Pain Osteoarthritis Plantar Fasciitis Post Operative Rehabilitation Posture And Alignment Problems Shoulder Pain Sports Injuries Sprains, Strains And Tears Elbow Pain TENNIS ELBOW / GOLFERS ELBOW These terms refer to tightness and pain of the tendons on either side of the elbow. The extensor muscles and tendons of the forearm, who are responsible for extension of the wrist can get inflamed (tennis elbow or lateral epicondylitis). The same can happen with the flexors, the muscles on the inside of the elbow. Overuse can result in stiffness in that area and/or weakness in the hand or fingers (medial epicondylitis). ​ ​ SYMPTOMS: ​ Pain and/or tenderness around the elbow and lower arm Weakness in the hand and fingers Radiating pain in the upper arm Swelling around the elbow ​​​ The symptoms are either a result of an overuse injury (labour intensive work such as gardening, painting or gyprocking) or a result from a problem in another area of the body. When there’s a problem in the mid back or the neck, sometimes the body compensates, and the arm pain is a result of that. ​Lateral epicondylalgia VS Lateral epicondylitis Lateral elbow pain can also be a result of cervical radiculopathy. The outside of the elbow has nerves that originate from the C6, C7 nerve roots meaning the pain may be referred from the compression or irritation of these nerve roots in the neck. Our physiotherapists always screen the joints above and below an area experiencing pain as the pain may be getting referred from another area in the body. This is becoming more commonly observed in practice and is supported by the most current scientific evidence. ELBOW PAIN TREATMENT ​ ​ We first need to search for the cause of the problems, before an accurate treatment plan can be made. Is the origin of the problem where the pain is felt? Fascia treatment in different areas of the body will mostly be combined with stretching, education, strengthening exercises and dry needling. In the bellow video, Kenny from Physio K runs you through a few exercises for your elbow and your lower arm. These are good if you have elbow issues, such as golfer's elbow or tennis elbow or if you have tightness in your lower arm. These exercises should be an addition to your physiotherapy treatment to do at home. Please always check with your physio to know which exercises will be helpful for you. These videos are here as a guide and will contribute to your rehab, in addition to some specific manual treatment. Sometimes you'll need a different approach, so always contact your health practitioner to get the best recommendation for you. ​ Watch a video with elbow exercises 1. Extensor stretch Sitting or standing, extend your elbow with your palm facing down. Then, make a fist with your thumb inside your fist. Bend your fist down and help push that one down with your other hand. Hold this position for about 20 seconds. Make sure your elbow is straight and your thumb is inside. Do this two to three times in a row. 2. Stretch of the flexors of the forearm Standing up in front of a table, turn your hand around so the ball of your hand is facing away from you. Try to push your palm down; you should feel a stretch in your forearm. This can be done with the fingers over the edge of the table (beginner) or with the whole hand on the table (advanced). Hold for about 20-25 seconds and then just shake it out and repeat 3 times. 3. Eccentric strengthening (for tennis elbow) You'll need a weight for this exercise, a weight of about a kilo. If you don't have a weight you can use a pack of sugar or salt, something that's compact enough to hold in your hand. With your elbow totally straight and your palm facing down, holding the weight. Start with the weight up and slowly release in an eccentric movement. Divide this whole range in six seconds. Then, with your other hand, you'll assist to come up again and then repeat the exercise. This is an eccentric exercise to strengthen the tendons. Do 3 sets of 10 repetitions and build up to 3 sets of 20.

INJURIES AND CONDITIONS WE CAN TREAT At Physio K , all problems of the movement system can be treated. Here are some of the most common injuries or conditions we are qualified to treat: Achilles Tendonitis Ankle Sprains Back Pain Bursitis Disc Bulges, Herniated Discs And Sciatica Dizziness Or Vertigo Elbow Pain Hamstring Injuries Headaches Jaw Problems Or TMJ Issues Lower Back Pain Meniscus Injury Neck Pain Osteoarthritis Plantar Fasciitis Post Operative Rehabilitation Posture And Alignment Problems Shoulder Pain Sports Injuries Sprains, Strains And Tears Bursitis Bursitis is inflammation of the bursa. A bursa is a sac, filled with fluid that acts as a cushion between your bone and the soft tissues (muscles, tendons, ligaments, skin, fascia,...). The reason why we have these bursae (plural of bursa) is to minimise friction and assist with joint movements. We can compare bursa fluid with the oil in your car or in a machine: everything moves smoother with a bit of extra lube or oil. WHERE COULD YOU HAVE BURSITIS? ​ ​ ​ There are over 150 bursae in the body, so there are many different areas where your bursa could get inflamed! The most common joints are the places you put a lot of pressure on. The top 5 we see and treat at Physio K are: Shoulder bursitis (subacromial bursitis) Elbow bursitis (olecranon bursitis) Hip bursitis (trochanteric bursitis) Knee bursitis (prepatellar bursitis) Feet: big toe, heel or ball of the foot CAUSES OF BURSITIS: THE MILLION-DOLLAR QUESTION ​ "The most common cause is overuse or repeated pressure on a part of the body." Many patients arrive at our clinic with an ultrasound scan showing bursitis. At Physio K, we tend not to see this as a diagnosis, but as a result of a problem. Let’s explain this with a few examples: Posture induced overpressure causing bursitis is quite common. Treatment for the bursitis will only solve your current symptoms, but does nothing to the cause of your issue, which is your posture! Repetitive gym workouts could cause overpressure in a joint (for example the shoulder joint) and because of that give inflammation of the bursa. Shoulder instability or imbalance of the shoulder muscles can be the real cause to address, rather than just do treatment for the bursitis! Bursitis can also be caused by acute trauma, such as motor vehicle accidents, falls and sporting collisions. SYMPTOMS OF BURSITIS: The most common symptoms are: Localised pain Swelling Stiffness Warmth or heath in that area Redness of the skin in that affected area ​ TREATMENT OF BURSITIS: ​ ​ As mentioned above (in causes of bursitis), it is important to treat the cause of the real problem, rather than just treating the symptoms. Anti-inflammatory medication, relative rest, cold packs and sometimes corticosteroid injections may resolve the symptoms. But if we maintain the same lifestyle, these symptoms will come back at some point. A thorough assessment will be necessary to find the root cause, which is what we do at Physio K. ​ ​ DOES DRY NEEDLING HELP BURSITIS? ​ With bursitis, together with treatment for the symptoms, we need to address the root cause of your problem. Sometimes, that can be a wrong movement pattern or muscle tension that has been building up over time. Releasing a taut band and trigger points in the affected muscle can ease the pressure in the joint and therefore ease the bursitis. To learn more about dry needling, click here .

INJURIES AND CONDITIONS WE CAN TREAT At Physio K , all problems of the movement system can be treated. Here are some of the most common injuries or conditions we are qualified to treat: Achilles Tendonitis Ankle Sprains Back Pain Bursitis Disc Bulges, Herniated Discs And Sciatica Dizziness Or Vertigo Elbow Pain Hamstring Injuries Headaches Jaw Problems Or TMJ Issues Lower Back Pain Meniscus Injury Neck Pain Osteoarthritis Plantar Fasciitis Post Operative Rehabilitation Posture And Alignment Problems Shoulder Pain Sports Injuries Sprains, Strains And Tears Shoulder Pain The shoulder joint is a very complex, highly mobile structure that actually comprises 3 different joints: The glenohumeral joint: where your upper arm (humerus) connects with your shoulder blade (scapula) The acromioclavicular joint: where your shoulder blade (scapula) connects with your collarbone (clavicle) The sternoclavicular joint: where the collarbone (clavicle) meets the chest bone (sternum) The 4th joint scapulothoracic joint: is not really a joint between 2 bones, but the shoulder blade glides over the thoracic spine. It is seperated with muscles and ligaments; no ligaments connect the bones at this ‘joint’. ​ There are many different muscles attaching to the shoulder joint and as it’s the most mobile joint of the body, many things can go wrong with this part of the body. The ‘outer sleeve’ muscles are the pectoralis muscles, the latissimus dorsi, the deltoid muscle and the trapezius. Underneath, we can find the ‘core muscles’ of the shoulder: levator scap, rhomboids, serratus anterior, pec minor and the subclavius muscle. ​ Important muscles to stabilise the upper arm into the shoulder blade are called rotator cuff. CAUSES OF SHOULDER PAIN Arthritis Inflammation (tendons, the shoulder capsule, bursa) Injuries Instability (structural and mechanical) Referred pain into the shoulder (from the neck) Reduced mobility in the mid back (please see the page about back pain to learn more about this) Scapular dyskinesis: Shoulder pain may arise from a dysfunction in movement that may not be necessarily related to weakness or tightness of the muscles of the shoulder but rather coordination (motor control). The scapula must move in a manner that allows the shoulder joint to change position as the arm is brought over head and to the side, if the scapula fails to move appropriately this can also cause pain in and around the shoulder joint due to compression or impingement of the shoulder joint. Our physios can assess scapula position at rest and during movement through functional testing to determine whether your shoulder pain is related to diminished control of the scapula during movements of the upper limb. "Physiotherapy should be one of the first treatment approaches for shoulder problems." SHOULDER PAIN TREATMENT PHYSIO K A good understanding of the shoulder joint is needed. Everything in the body is connected through fascia and sometimes a tightness in one area can cause problems in another area. This happens a lot with the shoulder. The rib cage or the low back could be the culprit and shoulder pain can be the result. At Physio K, we have a deep understanding of how the body functions and how other areas can be the cause of your problems. Soft tissue work, dry needling , joint mobilisations and manipulation, traction, education and exercise therapy are all treatment methods which can be used to effectively alleviate the shoulder pain. ​ In the video bellow, Kenny from Physio K runs you through an exercise program to increase the mobility of your shoulders. Please always check with your physio to know which exercises will be helpful for you. These videos are here as a guide and will contribute to your rehab, in addition to some specific manual treatment. Sometimes you'll need a different approach, so always contact your health practitioner to get the best recommendation for you. Shoulder mobility exercises ​ 1. Arm swings This one is great in the initial stages of shoulder rehab or after shoulder surgery. Standing up and bending forward with the other (non-affected) hand and arm on a table below you. Make sure you put your body weight on that other arm, so you don't have any pressure in your lower back. From here we'll start swinging, try to swing your arm up and down. Imagine having a small weight in your hand, you could even have a little weight in your hand and let it swing like a pendulum up and down. Small movements are fine, try not to control the movement, just let your arm swing. Do that for about a minute. The next one is swinging left and right for a minute and then making circles and swinging clockwise and anti-clockwise. Try to do those one minute each so that's about four minutes in total. 2. Crawling up the wall Start with facing a wall and touch the wall with your toes and your nose. Now put one hand up against the wall about shoulder height and start crawling up with your fingers. Try to crawl as high as you can, hold for a few seconds before sliding down until the beginning position. Repeat this for about 15 times. 3. Stick exercises With a broomstick in your hands, shoulder width apart, moving up and down behind your head. Try to extend your elbows all the way and come back down behind the head. Then, try to make circles in the air, forward and backwards. Do this for about 10 to 15 times each. Lastly, the most challenging one is called shoulder dislocations (don’t try this if you have dislocated your shoulder in the past). Hold the stick as wide as you can over your head and try to go backwards behind your head, keeping your elbows extended. Try to go until you touch your lower back, and then come back up. Repeat 10 to 15 times. ​ ​ Shoulder stability exercises In the above video, Anthony from Physio K runs you through a shoulder strengthening program, targeted specifically if you have any shoulder pain or weakness within your shoulder . These are the 3 exercises we would recommend: 1 . Rotator cuff strengthening exercise: external rotation To perform this one, you're going to start by holding a theraband in your hand, making a nice fist, pointing up at the roof and keeping your elbow nice and close to your side. You're going to gently rotate your arm outwards, stopping at about 30 to 45 degrees. For this exercise we're looking to engage that rotator cuff, so we want to make sure that there's tension on the theraband the entire time and we're looking at repeating this for 10 reps and repeating that three times. 2. Rotator cuff strengthening exercise: internal rotation This exercise is very similar; the only difference is we're doing it the opposite way. So we're going to have you holding it in that same hand with the same grip and you're just going to start by pulling from outside to inside, towards the belly button. For both of these exercises, you can have the theraband anchored on a doorknob or something roughly about this height, belly button height. 3. Straight arm pull back For this exercise, you're going to hold a theraband in a closed fist pointing down, making sure your elbow is nice and straight as you do that. Then you're going to extend your fist so it comes straight past the hip. All of these exercises should be performed 10 times and repeated three times.

INJURIES AND CONDITIONS WE CAN TREAT At Physio K , all problems of the movement system can be treated. Here are some of the most common injuries or conditions we are qualified to treat: Achilles Tendonitis Ankle Sprains Back Pain Bursitis Disc Bulges, Herniated Discs And Sciatica Dizziness Or Vertigo Elbow Pain Hamstring Injuries Headaches Jaw Problems Or TMJ Issues Lower Back Pain Meniscus Injury Neck Pain Osteoarthritis Plantar Fasciitis Post Operative Rehabilitation Posture And Alignment Problems Shoulder Pain Sports Injuries Sprains, Strains And Tears Back Pain The spine is usually described by dividing it into 3 major sections: the cervical spine (the neck), the thoracic spine (the mid or upper back), and the lumbar spine (the lower back). Below the lumbar spine, we can find the pelvis. This complex structure is an interconnected complex of bones, nerves, muscles, tendons, ligaments and fascia, and all of these can become damaged and cause pain, neurological symptoms or cause a loss of mobility. Check the links below to find more information about: lower back and lower back pain You can also find more detailed information regarding disc bulges and sciatica Or more information about neck pain ​ In this section, we’ll talk about the middle of the back, or the thoracic spine. ​ UPPER BACK PAIN TREATMENT "Most problems in the middle part of the back are caused by repetitive movements." Many times it’s a classic example of small things that build up and generate problems over time. Heavy labour or lifting together with a rotation can cause pain or stiffness locally. Sometimes the pain can refer to the side of the chest or to the front, around the sternum or chest bone. Many people confuse rib stiffness with a heart issue. When the joint between the rib and the vertebrae gets stiff, it can cause local and referred pain until the chest, hence the thought of heart problems. ​ At Physio K, we deal with these problems on a weekly basis and most of the time, we can get you up and running within a few sessions. We first make an accurate diagnosis and based on that, we’ll combine hands on manual treatment with specific home exercises to get your back functioning again asap. Dry needling can be helpful if the deep thoracic muscles are tight or stiff. ​ We made a few interesting videos, 3 of these 4 videos will focus on increasing the mobility of the mid back, as this is often a rigid and stiffer area with many people. The more mobility you have in the mid back, the better for the neck and shoulders. Many shoulder problems occur because of rigidity in this area, so these exercises can help as prevention for shoulder problems as well. Please always check with your physio to know which exercises will be helpful for you. These videos are here as a guide and will contribute to your rehab, in addition to some specific manual treatment. Sometimes you'll need a different approach, so always contact your health practitioner to get the best recommendation for you. Watch them: ​​ ​ Middle back mobility exercises In the above video, Kenny from Physio K runs you through some exercises to improve your thoracic spine mobility, which is the mobility of your mid back. They are good to increase the movement in that area but also to prevent issues in your neck and your shoulders down the track. 1. Cat-cow exercise Starting on all fours position. You can do this on the floor on a mat. Make sure your hips are above your knees and your hands are under your shoulders. Start with tilting the pelvis. The pelvis is the part that's just below your lower back, so you can tilt this forward and backwards. Focus on the middle back, so when you tilt your pelvis forward, you'll push the middle of your back down and you look up towards the ceiling.Then you’ll change the direction, tilting your pelvis backwards and push the midpoint of your mid back up towards the ceiling and you'll look down. Do this for about a minute: 20 to 30 times and if possible multiple times a day. 2. Threading the needle or thoracic rotations In the same position as exercise 1, try to rotate your arm as far as you can and look at your hand while you do this, then come back to the beginning position and switch sides. Do this for about a minute: 20 to 30 times and if possible multiple times a day. Try not to force this exercise. These two exercises are the best ones to increase your thoracic mobility. Try to do them as much as you can, frequently during the day. ​ ​ Thoracic kyphosis exercises: strengthening and mobility for the mid back In the above video, Kenny from Physio K shows you some exercises to improve thoracic mobility, which is the mobility in the middle of your back. These are especially good if you have a big thoracic kyphosis, which is a big forward bend in the middle of your back, and also if you have stiffness in that area. These exercises will improve your mobility and will also be good for strengthening. 1. Cat cow exercise On your hands and knees, in all four position, making sure that your hips are above your knees and your hands are underneath your shoulders. Try to tilt your pelvis forward and backwards. We're going to focus on the middle back, so when you tilt your pelvis forward, you'll push the middle of your back down and you look up towards the ceiling.Then you’ll change the direction, tilting your pelvis backwards and push the midpoint of your mid back up towards the ceiling and you'll look down. Do this for about a minute: 20 to 30 times and if possible multiple times a day. 2. Prone lateral raise Lay on your tummy and have your arms at 90˚ abduction. Try to lift your arms up and squeeze your shoulder blades together. Hold for about 10 seconds and then go down again and you can rest your arms on the floor. Try to do this for about 20 times and if possible 3 sets. If this is too easy without any weights, you can use small weights in each hand, you can go from 1 kilo, I wouldn't go too high, we're focusing on endurance. Make sure you focus on squeezing your shoulder blades. 3. Front raise thumbs up Laying on your tummy on a mat, keep your forehead on a small towel and raise your arms forward. Make sure that your thumbs are up towards the ceiling. Lift up your arms without bending your elbows. Hold that for five seconds and then go down again. This is a tough one. Do this one about 10 to 15 times and if possible 3 sets. If it would be too easy, you can use some weights as well, about one to three kilograms in each hand. Mid Back mobility: progression ​ In the above video, Anthony from Physio K runs you through a couple of exercises that are great for improving your mid-back mobility. 1. Bow and arrow Laying on your back, you're going to have both of your arms in front of you and both of your knees bent. Your hands are going to be together out in front of you. Now, just as if you were drawing a bow and arrow, you're going to pull one arm back, bending your elbow all the way across your body. Now the goal of this exercise is to touch the ground. But if you can't get there at the start, don't worry about it, bit by bit as you start to improve you'll notice that you can make it further and further closer towards the ground. For these exercises, we generally recommend that you do 10 each side and you repeat them three times a day. 2. Book opener In the exact same position as the previous exercise with knees bent and hands together, you're going to open up, keeping your elbow straight this time, opening up all the way, reaching for the roof and coming straight back down again. Like the previous one, the goal is to touch the floor on both sides at the same time. But if you don't get there at the start, don't worry about it. We're going to go for 3 sets of 10 for those exercises. 3. Windmill In the same starting position, try to reach up above your head, trying to drag your hand all the way across. Try to keep your hand in contact with the ground as you do this. It's important to remember for all of these exercises that your head follows your hand everywhere it goes. 4. Variation of the world's greatest stretch. For this one, you're going to be up on your hands and knees. The goal for this to start off, is having your hips and your shoulders square with your body then reaching with your right hand, you're going to come underneath your body, going as far as you can, and then opening straight up towards the roof and coming down again. For this one here, we're looking at doing three sets of ten on both sides. ​ Foam rolling for the mid back In the above video, Kenny from Physio K shows you a few things to increase the mobility of your mid-back , which is your thoracic spine. They will both include a foam roller. 1. Foam rolling your upper back (mid back) For the first one, try to just lay on your back, with your upper back on a foam roller. Try to cross your arms over your chest, lift up your hips and gently roll up and down on the foam roller. Don't go too fast, you won't have any benefits if you go too fast. Try to do that for about two to three minutes. 2. Breathing on the foam roller We are laying on the foam roller in a very similar position as exercise 1. Just try and relax your hips down on the floor and then put your arms over your head, and just try to relax in this position and just try to breathe. Take a few deep breaths in and out, and after that, you can try and move a little bit up or down on the foam roller. These two are really good to increase your mobility in your upper back.

INJURIES AND CONDITIONS WE CAN TREAT At Physio K , all problems of the movement system can be treated. Here are some of the most common injuries or conditions we are qualified to treat: Achilles Tendonitis Ankle Sprains Back Pain Bursitis Disc Bulges, Herniated Discs And Sciatica Dizziness Or Vertigo Elbow Pain Hamstring Injuries Headaches Jaw Problems Or TMJ Issues Lower Back Pain Meniscus Injury Neck Pain Osteoarthritis Plantar Fasciitis Post Operative Rehabilitation Posture And Alignment Problems Shoulder Pain Sports Injuries Sprains, Strains And Tears Disc Bulges, Herniated Discs And Sciatica A spinal disc is the natural shock absorber and also allows movement of the spine. A bulging disc is actually a very common condition in our spine. It is natural wear and tear, the older we become, the more discs can bulge. ​ DIFFERENCE BULGING DISC AND HERNIATED DISC ​ The spinal disc consists of 2 parts: ​ the inner nucleus: is a jelly-like structure, a bit comparable with the liquid part inside a chocolate cake. The outer annulus fibrosus: the more dense part of the cartilage. When a disc is moving out as a whole, it’s called a disc bulge. When the outer ring (annulus) is damaged and the inner nucleus is escaping from within the disc, it’s called a herniated disc. ​ CAUSES ​ Spinal degeneration (wear and tear) Repetitive trauma such as shocks from work or sports, or poor posture can lead to degeneration of the discs. An acute injury with heavy lifting or in an accident (although most disc problems due to an acute injury already had some kind of degeneration) ​ Initial bulging or herniation might be symptom free. A bit more chronic condition will usually give a broad ache in the area, often accompanied with muscle tightness. When the disc is heading towards the nerve root (beginning of the nerve), it can cause inflammation of that nerve. Sciatica is a condition where the nerve gets irritated and refers into the leg. The further down the leg you feel the sensations, the more the nerve will be irritated. Early stage nerve irritation will only give different sensations (numbness, pins and needles), more inflammation or nerve compression can result in loss of strength of the limb. DISC BULGE TREATMENT SCIATICA TREATMENT "At Physio K, we will determine the best course of treatment for you. It is important to know exactly what you have, before moving on to a solution." We will provide a thorough assessment to determine what specifically is causing your problems. Treatment is predominantly determined by the stage of your healing as more chronic pains will require longer and different treatment than more acute ones. We are very experienced in the treatment of all kinds of low back pain and neck pain and will provide you with the best outcome in order to get you moving well again. HOW CAN DRY NEEDLING HELP WITH NERVE PAIN /SCIATICA? ​ ​ When certain muscles are tight or overactive, they can cause pressure on the spine and therefore directly or indirectly cause irritation of the nerve root (which is the beginning of the nerve when it's exiting the spine). Sometimes these muscles can be overactive or underactive, and via dry needling, we can normalize the tone. Underactive muscles can be stimulated and overactive muscles will get released. As a result, the irritation around your nerve should disappear and therefore, your symptoms as well! To learn more about dry needling, click here . In the bellow video, Kenny from Physio K is showing an exercise program for people with lower back pain, tailored for people who have disc issues or sciatic nerve problems. Numbness in the bum or further down the leg or the feeling of pins and needles could be an indication of this problem. Please always check with your physio to know which exercises will be helpful for you. These videos are here as a guide and will contribute to your rehab, in addition to some specific manual treatment. Sometimes you'll need a different approach, so always contact your health practitioner to get the best recommendation for you. ​ Watch the video with lower back pain exercises for people with disc problems or sciatic nerve issues. 1. Cat cow exercise. On your hands and knees, in all four position, making sure that your hips are above your knees and your hands are underneath your shoulders. Try to tilt your pelvis forward and backwards. We're going to focus on the lower back, imagining tucking a tail in between your legs and then putting your tail up in the air. The curved up position is a bit like how a cat is rounding its back and the opposite, curved down position, is similar to the position of a cow. Make sure you stay mid range, don’t push all the way up or down if you have disc issues or sciatic nerve irritation. Do this for about a minute: 20 to 30 times and if possible multiple times a day. 2. McKenzie extension exercise Laying on your tummy on a mat on the floor and putting your elbows underneath your shoulders (sphinx pose). Try to extend your lower back and look up with your head. You'll have a little bit of compression in the lower back which is great for your disc and you can also feel a little bit of stretch in the front so that's why you have to look up to have the maximum amount of stretch in the front. Stay in that position for 20 - 25 seconds and go down again. Do that four to five times in a row. If this is too easy for you then you can go to the next step, which is trying to extend your elbows. Put your hands underneath your shoulders, extend your elbows totally and try to relax in your back and look up. 3. Stretch of the Piriformis Laying on your back on a mat, pull up one leg and grab your knee with one hand and grab your heel with your other hand. The purpose is to try and pull your knee towards your opposite shoulder and make sure you leave your head relaxed on the table. You should feel a deep stretch under your glutes. The piriformis is a muscle that's laying in the pelvis, underneath your glutes. That's a very important muscle for your nerve health. If you have any kind of nerve issues make sure you do that stretch. Hold this position for 20 to 25 seconds, relax, do that four or five times in a row. Make sure you have a straight angle in your knee which is 90 degrees and pull across 4. Nerve glider Laying on your back on a mat with your knees bent and feet flat on the floor. If the problem is on the right side, then you'll do the exercise with your right leg. Put your right knee on top of your left knee and then, in this position, relax your foot and try to extend your right knee up and down. Don't hold, don't try to stretch, we're trying to get a glide in the nerve. This is a good stand alone exercise, or could be used as a warm up. The next step is the same thing but at the same time, pull your toes towards your nose while you extend the knee and then go down again, leaving your knee on top of the other one. Try to do 20 to 30 repetitions each, a few times per day. ​ ​

Jack Frith Physiotherapist | Sports Physiotherapy Enthusiast | Exercise and Manual Therapy Based. Uses an evidence-based approach to ensure that all treatment is not only functional and individualised, but based on a wealth of research. Jack is an extremely passionate sports Physiotherapist. He has experience in numerous sports clubs such as South Sydney Rabbitohs, West Tigers, UNSW Rugby League, and Central Coast Hearts Netball Academy. In addition to sports clubs, Jack has worked as a Physiotherapist in the Royal Prince Alfred Hospital, Westmead Hospital, and Sydneys' leading Occupational Medicine clinic. Jack is well-trained to diagnose and treat various musculoskeletal conditions. Jack enjoys an active lifestyle outside of work with his main focus being: weightlifting, running, crossfitting, swimming, road cycling, and tennis. Jack is training to complete an IronMan at the end of 2024. In Jack's downtime, he enjoys partaking in spearfishing, freediving, surfing, and road-tripping. Qualifications: - Masters in Physiotherapy | University of Sydney - Bachelor in Exercise and Sports Science | University of Newcastle - Strength and Conditioning Coach | ASCA - Sports Physiotherapist | APA - Dry Needling Practitioner | CPD Health Courses - Sports Trainer | SMA - Emergency Care for Suspected Spinal Cord | SMA - Concussion Management | NRL - Advanced Sports Taping | USYD - State Insurance Regulatory Authority WorkerCover NSW Allied Health

Kenny Merlevede Senior Physiotherapist | Founder & Director | Marathon and Sport Enthusiast | Recovery CoachExpertise: (sports) physiotherapy / Musculoskeletal and Manual therapy / Dry Needling Qualifications: Masters in Physiotherapy from University of Ghent, Belgium. Masters in Musculoskeletal physiotherapy and postgraduate degree in Manual Therapy. Kenny is a passionate, driven Physiotherapist with over 13 years’ experience as an independent Practitioner across Physiotherapy, Manual therapy and Sports Rehabilitation. He has worked in a number of private practices and has since concentrated on musculoskeletal problems and sport injuries. Kenny believes in holistic physiotherapy and is passionate about identifying and addressing the underlying cause of your pain rather than just treating the symptoms. He has particular interests and expertise within low back pain, neck pain and headaches, core stability and sports injuries. In his spare time Kenny enjoys running, swimming, soccer and basketball. He is a marathon runner and has played competition basketball for over 20 years. In December 2019, he completed the Ironman in Busselton (WA).

INJURIES AND CONDITIONS WE CAN TREAT At Physio K , all problems of the movement system can be treated. Here are some of the most common injuries or conditions we are qualified to treat: Achilles Tendonitis Ankle Sprains Back Pain Bursitis Disc Bulges, Herniated Discs And Sciatica Dizziness Or Vertigo Elbow Pain Hamstring Injuries Headaches Jaw Problems Or TMJ Issues Lower Back Pain Meniscus Injury Neck Pain Osteoarthritis Plantar Fasciitis Post Operative Rehabilitation Posture And Alignment Problems Shoulder Pain Sports Injuries Sprains, Strains And Tears Ankle Sprains A sprained ankle is one of the most common sporting injuries, often recurring regularly if not treated and rehabilitated correctly. In most cases the foot is rolled inwards, resulting in stretching or tearing of the ligaments on the outside of the ankle. Occasionally, there is associated muscle, bone or cartilage damage involved too. Stepping or running onto an unstable surface or landing unbalanced can cause your ankle to ‘roll’ and sprain your ankle. Pain, swelling and bruising may follow. Depending on the severity of your sprain, you may have trouble standing on your foot or walking. In these cases, a walking boot, crutches or strapping might be advisable. ​ ​ ​ ​ HOW LONG DOES IT TAKE FOR AN ANKLE SPRAIN TO HEAL? ​ This can vary greatly depending on the grade of your ankle sprain. Grade 1 will most likely heal within 2 to 3 weeks, although it can take up to 6 weeks for full scar tissue maturation. Untreated mild ankle sprains quite often result in joint stiffness, ligament laxity, muscle weakness or reduced proprioception (balance and joint awareness). This can lead to compensations in other parts of the body, which can lead to other injuries at a later time. Grade 2 sprains have more severe ligament stretch and need 4 to 6 weeks recovery time. Grade 3 ligament injuries are when the ligament is completely ruptured. The rehabilitation of a Grade 3 ankle sprain normally takes 6 to 12 weeks but is quite variable depending on your specific injury. ​ TREATMENT OF ANKLE SPRAINS ​ Depending on the grade or severity of your injury, treatment will be tailored to your individual needs. "A sprained ankle can increase your risk of re-injury as much as 40-70%, but the correct post-injury rehabilitation exercises significantly decrease the risk." Pain relief, regaining full range of motion, strengthening of calf and ankle muscles, restoring proprioception, normalising gait patterns and returning to sports are goals that will be addressed to get you the best rehabilitation and get you back to doing what you love. DRY NEEDLING ANKLE SPRAIN ​ Dry needling is often a technique that is not commonly used with an ankle sprain, but it can have significant benefits. The peroneal group is a muscle group on the outside of your lower leg, which plays an important role in the stability of your foot and ankle. We’ve seen chronic ankle instability and pain due to the overactivity and trigger points in this muscle group. It is important that this is addressed and dry needling can be an effective way to treat this. To learn more about dry needling, click here . In the video bellow, Kenny from Physio K runs you through a stability exercise program for your ankle and your foot. These are particularly handy after you sprained (or rolled) your ankle or if you have ankle instability. You really should master these ones after an ankle sprain, otherwise you could have an instability for a long time. This exercise program will start off easy and will progress to more difficult exercises. Please always check with your physio to know which exercises will be helpful for you. These videos are here as a guide and will contribute to your rehab, in addition to some specific manual treatment. Sometimes you'll need a different approach, so always contact your health practitioner to get the best recommendation for you. ​ Watch the video about ankle and foot stability exercises 1. Standing on one foot That's a very easy exercise. You can do that anytime: when you wait for traffic lights or when you're cooking, just stand on one foot. You can make it a little bit harder if you close your eyes. Doing that will eliminate a part of your balance system, so that will be a little bit harder. Try to do that for a minute or longer, if possible. 2. Standing single leg with movement Bending through your knee, up and down while standing on 1 leg is a very good progression from the first exercise. Next, moving the free leg in different directions can be used to challenge your balance system. Try to do this for a minute each time. 3. Lunges steps (forward and sideways) Take big steps forward and then sideways: lunges. Keep your bodyweight on top of the front foot and try to keep your balance for 3 seconds before switching to the other leg. Try to do 10 repetitions each side, 3 sets. 4. Jumping lunges Big jumps forward and sideways. This is very similar to the previous exercise, only now it requires jumps instead of steps. Start with jumping from 1 leg to the other, then switch to continuously jumping with the same leg. Try to make your foot and leg tired to improve your balance and your stability in your ankle. These exercises are paramount to increase the stability of your foot and ankle. Really try to do them as much as you can, you should do them at least for a few weeks to a few months. ​

Physiotherapy Treatments Bondi Junction WE BLEND TRADITIONAL WITH INNOVATIVE TECHNIQUES OF PHYSIOTHERAPY At Physio K, our physiotherapists take the time to understand the pain you are experiencing and get to the underlying heart of the problem. Our approach is based on hands-on treatment, using our systematic and scientific process, we make sure the right technique is applied. We are experts in manual therapy, sports and remedial massage techniques. We are also advanced in the innovative technique of dry needling, having taught this technique to other physiotherapists, we have advanced skills in this area and know the appropriate times and situations when this technique should be used. ​ We believe a combination of old and new techniques to speed up recovery and get you back into action. Physiotherapy treatments is dealing with conditions that cause joint and muscle pain, movement or mobility disorders, sports injuries, work related injuries and musculoskeletal dysfunctions. We are in the business of treating and prevention. Sports and Remedial Massage Post-operative Rehabilitation Treatment Manual manipulation techniques Dry Needling

Going beyond your symptoms with physiotherapy that is driven by results. BOOK AN APPOINTMENT Physiotherapist Bondi Junction OUR PHYSIO TREATMENTS PROCESS When you visit Physio K at our clinic in Bondi Junction, you are in safe hands. Our depth of expertise is matched by our ability to understand your pain. We take the time to assess your unique situation so that we can first get to the root cause of the pain and then tailor the treatment to suit your needs FIND THE PROBLEM ​ We deep dive into the diagnosis of the problem and apply our anatomical knowledge, and clinical reasoning and experience to get to the root cause of the pain. TREAT THE CAUSE ​ We treat the cause, not the symptom. Our thorough approach aims to set you on the path to recovery. We provide ongoing support plans to ensure you stay on track with your recovery. INNOVATIVE TECHNIQUES ​ We are highly skilled and experienced practitioners and use innovative techniques such as dry needling alongside traditional hands-on manual therapy. OUR SERVICES QUALITY TREATMENT At Physio K, we have a simple but fundamental philosophy; to provide you with the very best of care. The aim is to give you elite level treatment in a professional and welcoming environment. We tailor all treatments to your individual needs and pride ourselves on a high level of care, a wealth of knowledge and quality results without overtreatment. Read More SPORTS AND REMEDIAL MASSAGE Sports and remedial massage: Massage and fascia techniques are often used to release tight muscles and free up areas of the musculoskeletal system. When these are used in combination with other techniques in the movement system, they will almost always give better results than only massage. MANUAL THERAPY The therapists at Physio K will use their extensive knowledge and expertise in the musculoskeletal system to get you pain free again. A combination of hands-on treatment with specific exercises will be used to get you back to the things you love. Read More HOLISTIC TREATMENT At Physio K, symptoms are never seen as isolated issues, but as a part of a dysfunction in a physiological chain. We believe in holistic physiotherapy and will identify and address the underlying cause of your pain rather than just treating the symptoms. Other aspects in health, such as diet , exercise, stress and habits will play a role and should be addressed in the treatment process. DRY NEEDLING The management team at Physio K is teaching at GEMt (global education of manual therapists), where the skill of dry needling is taught to manual therapists across the globe. Read More POST-OPERATIVE REHABILITATION TREATMENT Post operative rehabilitation treatment: To regain your strength, flexibility and functional fitness after an orthopaedic surgery, it will be essential to get specific physiotherapy treatment. To ensure optimal recovery and to avoid compensation patterns in the future, a tailored treatment plan will be offered to you. At Physio K, we are experienced in post operative rehabilitation to get you back to what you love. Did you know... Using our HICAPS system, we can swipe your health fund card at the time of your appointment. This means you only have to pay the gap and won't have to make any further claims to your health fund. Contact We’re here for you when you need us! Book in online, call us to schedule an appointment, or send us an email and we’ll get back to you as soon as possible. Address: Suite 801 / 3 Waverley St, Bondi Junction NSW 2022 NEW LOCATION Email: info@physiok.co m.au Phone: 02 7902 1408