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Jaw Problems Or TMJ Issues 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 Jaw Problems Or TMJ Issues The jaw, or temporomandibular joint (TMJ) are the joints that are located on either side of the head. They open and close the mouth. These joints are functionally related to the head and neck. Symptoms of temporomandibular disorders (TMD): Jaw pain or tightness in the jaw Clicking or grinding with opening or closing of the mouth Limited opening of the mouth / stiffness Tooth pain or ear ache Headaches Dizziness "As in many problems of the human body, a jaw problem is most of the time something that has been building up over time." It could be caused suddenly due to an acute trauma (direct impact to the face or chin), but mostly it’s a combination of either stress, bruxism, postural tension or neck issues. The jaw, or temporomandibular joint (TMJ) is a joint in the skull which makes opening and closing of the mouth possible. It's a 'ball-in-a-socket' joint with a small joint in between. Sometimes, the disc can move a bit, causing the jaw to click with movements such as eating, jawning or simply opening or closing the mouth. In some cases, the jaw can get stuck in the opening or closed position of the mouth. As with all other joint issues, there will be muscles affected with this problem as well. The Masseter muscle is a common overworked and tight muscle, which can cause pain and referring pain as well. RELATIONSHIP TMJ AND THE NECK Due to its close proximity with the top of the neck and the ligament connection, there is big overlap between the TMJ and head and neck issues. With most TMJ issues, there can be some upper neck problems expected as well. Headaches and dizziness are also symptoms that can be related to the same issue, and should be assessed by your physio. TREATMENT OF JAW PAIN In most cases, jaw problems can be treated effectively with physiotherapy. Gentle manual techniques or dry needling can both be efficient ways to get rid of the problems. Mobilising the joint from inside the mouth is an effective technique often used at Physio K. We put gloves on and manually get more mobility in that TMJ. Soft tissue techniques to reduce the tightness of the tight muscles, including the masseter muscle, can often also be really helpful. Dry needling of the affected muscles is often really effective and in most cases, has a really good effect on the joint and the muscle at the same time. Some specific exercises at home can be given to maintain and further improve the good health of that joint as well.

Ankle Sprains 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.

RADI ZINGER | REMEDIAL MASSAGE THERAPIST | DIPLOMA OF REMEDIAL MASSAGE, TAFE NSW | AQUA EXERCISE INSTRUCTOR, AT Radi Zinger Remedial Massage Therapist | Qualifications:Diploma of Remedial Massage, TAFE NSW | Aqua Exercise Instructor, AT Radi is a qualified and experienced remedial massage therapist with a passion for helping people feel their best through tailored to specific condition and person, evidence-based body work. With holistic and client-based approach, Radi takes time to listen and understand your needs before designing a treatment plan to suit your body, lifestyle and goals. Radi specialises in treating musculoskeletal pain, improving mobility and supporting recovery from injuries and chronic soft tissue tension. Using a range of massage techniques – including deep tissue massage, myofascial release, trigger point therapy and assisted stretching – Radi will help you to deal with sport related injuries, postural imbalances, stress induced tension and general aches and pain. Working with clients of all ages and activity levels, from athletes and fitness enthusiasts to older active adults, Radi’s intention is not just to treat symptoms, but to identify and address underlying causes and help you maintain lasting results through effective massage work, education and practical self-care advice, with ultimate goal of enabling you to enjoy doing what you love. Radi believes in greatly unrealised potential of remedial massage to contribute to effective treatment of injuries and musculoskeletal condition, maintaining health and sport performance and enhance lifestyle. In his spare time Radi enjoys reading and self-educating himself on health issues, playing tennis, kayaking, swimming, cycling and traveling.

KENNY MERLEVEDE | SENIOR PHYSIOTHERAPIST | FOUNDER AND DIRECTOR OF PHYSIO K | PASSIONATE AND DRIVEN PHYSIOTHERAPIST WITH OVER 13 YEARS OF EXPERIENCE AS AN INDEPENDENT PRACTITIONER ACROSS PHYSIOTHERAPY, MANUAL THERAPY AND SPORTS REHABILITATION. 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).

Bursitis 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 .

Shoulder Pain 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.

MARK HOWLIN | PHYSIOTHERAPIST | DRY NEEDLING | SPORTS INJURY | POST-OPERATIVE | CHRONIC PAIN Mark Howlin Physiotherapist | Dry Needling | Sports injury | Post-operative | Chronic pain Qualifications: undergraduate degree in Athletic Therapy and Training at Dublin City University, Level 9 Masters in Physiotherapy at University College Dublin. Mark is an Associate Physiotherapist at Physio K, originally from Ireland. He has six years of musculoskeletal experience, including three years specialising in musculoskeletal physiotherapy in a busy clinic setting. He completed his undergraduate degree in Athletic Therapy and Training at Dublin City University and went on to earn a Level 9 Masters in Physiotherapy at University College Dublin. Mark is passionate about helping patients feel at ease while identifying the root cause of their issues. He has a particular interest in sporting injuries, but also treats post-operative patients, chronic pain, and those with reduced mobility. Using a combination of hands-on therapy, dry needling, mobilisation, exercise rehabilitation, and education, Mark empowers patients to understand and manage their symptoms—helping them get back to what they love, and stronger than before. Outside the clinic, Mark enjoys training, beach time, socialising over food and drinks, and following Arsenal football. Since moving to Australia, he’s excited to continue growing as a physiotherapist and supporting the Physio K community to stay active and pain free.

Hamstring Injuries 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 Hamstring Injuries Hamstring injuries can be the source of a lot of pain or discomfort for many of us. Issues may range from stiffness to tears and everything in between. In this blog, we will explore not only the cause and treatment of hamstring injuries but also the ways in which we can work to prevent them. The hamstrings are composed of 3 muscles; the semimembranosus, semitendinosus and the biceps femoris. These muscles work together to perform the movements of knee flexion (bringing your heels to your bum) and hip extension (going from sitting to standing). Cause The causes of hamstring injuries are numerous. They can range from your own biomechanics to the sport you play but to name a few. Let's explore the most common causes of Hamstring injury below. Pelvic tilt A pelvic tilt is the angle at which your pelvis sits. This may be anterior or posterior. If you have an anterior tilt this leads to over stretching of the hamstrings over a long period of time and subsequently, muscle weakness. This weakness leaves the hamstrings open to an increased chance of injury. Muscle imbalance If one muscle group is stronger than its opposing muscle group, a muscle imbalance can occur. In the case of the hamstrings, the opposing muscle group is the quadriceps at the front of the thigh. During activities requiring high speed the hamstrings may fatigue a lot faster than the quads if an imbalance is present. This too can lead to a strain. Previous injury Ankle sprains can lead to a change in body biomechanics and make you more susceptible to hamstring strains. Our bodies work on a balance of mobility and stability. Our hips and ankles take care of mobility, whereas the knee and foot work on stability. If any of these areas become injured it may compromise the muscle function and thus lead to strain. Previous hamstring injury is the highest risk factor of all for the chance of the strain recurring. Many people return to sport or normal activity far too quickly and can prolong an injury by months. If not treated properly hamstring problems can last for entire sporting careers! Type of physical activity Anyone can experience hamstring strain, but those especially at risk are: ● Sports that require kicking and sprinting: football, soccer, basketball ● Runners ● Dancers ● Older athletes whose exercise is primarily walking ● Teenagers athletes who are still growing Treatment The primary objective of physical therapy and the rehabilitation program is to restore the patient’s functions to the highest possible degree and/or to return the athlete to sport at the former level of performance and this with minimal risk of re-injury.(Physiopedia, 2022) Similar to all types of muscle strains and sprains, the course of treatment and time spent in rehabilitation will vary depending on the individual and the grade of the injury. All muscle injuries should follow the “ PEACE & LOVE” protocol. This is the updated version of the traditional RIC E. Check out our blog detailing “PEACE & LOVE” here . Your physiotherapist will guide you through a personalized rehab programme that you will be required to follow in clinic and at home. In general, it is recommended to stop running and stretching for three weeks or so, you will need to let the scar tissue lay down over the tear without disrupting it. If you stretch the muscle immediately it leads to difficulty for the hamstring muscle fibers to knit back together effectively. It is very rare we ask a patient to stop activity, however in the case of a strain, best available evidence suggests that this is the most effective and time efficient way to return to sport and reduce re injury risk. Once your physio feels you have gone through the healing phase then the fun rehab can begin and eventually get you back out running, kicking, jumping or dancing. How long this lasts varies and is based on individual factors and you will have to reach certain checkpoints before the physio lets you back 100% but on average it’s a few weeks. The main areas of strengthening and soft tissue work in the case of a hamstring strain is not only the hamstrings themselves but also the core and glutes due to their proximity to each other. Physiotherapists can carry out a number of different techniques at various stages during your recovery. These include but are not limited to: ● Manual therapy ● Soft tissue work ● Joint mobilisations ● Trigger point dry needling ● Taping ● Active release techniques ● Biomechanical assessment and gait analysis Prevention There is no fool proof method for preventing the occurrence and recurrence of hamstring injuries. Simple steps you can take to decreasing your chances of sustaining a hamstring injury are: ● Continued stretching. Even once your injury is better, it is important to maintain flexibility. ● Staying strong. Ensuring strong hamstrings helps with muscle imbalances occurring. ● Take your rest days. Fatigue can be a huge risk factor. ● If your hamstrings start to feel achy, don't push them. Our bodies do a great job of letting you know when you’re pushing things too far, so you just need to hear the call. References Hamstring strain (no date) Physiopedia. Available at: https://www.physio-pedia.com/Hamstring_Strain (Accessed: November 1, 2022).

Headaches 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 Headaches CAUSE OF HEADACHES Headaches can result due to a variety of reasons including stress, poor posture, accidents, medications, etc. Neck pain is another common cause of headaches and specific physiotherapy treatment can be very effective in the treatment of this condition. A cervicogenic headache, also referred to as cervical headache or migraine, is a headache caused by a disorder of the neck and related structures. "These headaches are often associated with neck pain" These headaches can present themselves on one side, can fluctuate in frequency and intensity (sometimes the pain is constant) and the pain often begins in the neck and then spreads to other areas of the head. At Physio K, you will get a thorough physical examination. Once we know the cause of the symptoms, we can help you with a specific treatment plan to get rid of your headaches asap! CAN DRY NEEDLING HELP WITH HEADACHES? Headaches can have different causes, but overactive muscles in the neck are a big contributor to these symptoms. Stress, cold or a wrong sleeping or sitting pattern can all have an effect on this and can result in either neck pain, stiffness, dizziness or headaches. Releasing this tightness can have a significant reduction or elimination of these headaches and dry needling is definitely a way to achieve this goal! To learn more about dry needling, click here .

Neck Pain 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 Neck Pain Physio K offers treatment for many different types of neck pain. Problems in this part of the body can present in many different ways. Some common presentations of neck pain include: Reduced range of motion Pain when turning the head Muscle tightness, either constant or with movements of the head Pain radiating in the shoulders or arms from the neck Pain at the top of the neck, often combined with headaches CAUSE OF NECK PAIN: BAD POSTURE: Poor posture during the day can cause the weight of the head to shift forward and away from the center of the body (forward head posture), forcing the neck muscles to work harder to support the head. Prolonged computer work or looking down at a phone not only moves the head forward but also forces the neck to bend with it. This bending can overextend the muscles in the back of the neck, resulting in pain and inflammation. SLEEPING POSITION: Sleeping with the head turned or twisted can result in neck pain (e.g. with sleeping on the tummy or on a pillow that is too thick or too thin). Short term symptoms could be stiffness and muscle pain. Sleeping with the head rotated to 1 side can result in disc problems in the long run. The intervertebral discs are supposed to recover during the night and that’s not possible when the neck and head are rotated during the entire night. . Cold also has a big impact on the neck muscles. Air Conditioning or sleeping next to a window with a breeze can make the muscle tense up and result in a stiff neck in the morning. TEETH GRINDING: Bruxism is a condition in which people grind or clench their teeth while they sleep. Grinding or clenching the teeth puts pressure on the muscles in the jaw and neck, which can cause neck tension, pain or headaches. WHIPLASH: Whiplash is caused by an injury to the neck when the head moves forward and backwards in a rapid motion that ends up placing strain on the surrounding muscles and ligaments and usually occurs in a motor vehicle accident. Symptoms of whiplash include: Neck pain and stiffness Reduced mobility of the neck Headaches Disc issues (bulges or herniated discs) Nerve issues with referring pain in the shoulders or arms Neck pain caused by whiplash can become chronic if left untreated. STRESS: Stress has a huge impact on the entire human body. It affects some parts more often than others; the neck being one of the most frequent areas. Stress is the body’s natural reaction to a dangerous situation. When we feel threatened, a chemical reaction occurs in our body that allows us to act in a way to prevent injury (‘fight-or-flight reaction’). When a person experiences stress regularly, their muscles remain tense and contracted for longer periods, which can result in neck and shoulder tension. "Most neck pain is a result of bad posture combined with stress and asymmetric movements." It normally builds up over time, but people usually don’t realise it. It’s like slowly filling up a bucket with water; and most people only remember the last drop that makes the bucket overflow: the last wrong movement or the bad position we slept in, which results in a stiff neck. NECK PAIN TREATMENT: Neck pain is treated in our clinic after determining the cause of your pain. We perform a thorough examination after taking a health history. Once we know the cause of your problems, we can treat you with a broad range of techniques. Manual therapy, exercise treatment, education and dry needling can all be used to help get you back moving well and feeling great. Watch the following exercises videos for neck pain: 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. Neck pain treatment In the above video, Anthony from Physio K runs you through a neck mobility program, targeted at increasing your movement during the early stages of neck pain. 1. Gentle range of motion exercises. Standing up or sitting down, bringing your chin down towards your chest, then coming back up looking up towards the roof and then coming back down to eye level. Then, try to rotate across to the right and to the left. The last one is side bending or lateral flexion of the neck: taking your ear down towards the shoulder on the right hand side and then coming back again towards the other side. When you're performing these exercises we generally get you to do it for about 10 times per day and you really can't get enough of these; especially during those early stages of neck pain. 2. Upper trap stretch For this one here, we have you sitting right on top of your right hand, reaching over your head with your left hand and gently pulling your left ear down towards that shoulder. Now as you're doing this exercise, you'll get a nice stretch through your upper trap muscle, that's exactly what we're looking for. You're going to hold this stretch for 30 seconds and repeat that three times. Best neck exercises In the above video, Kenny from Physio K is showing a combination of 2 of the best exercises to do when you’re having neck pain. The first one is great when you are doing computer work or are sitting for prolonged periods. The second one is the best strengthening exercise for the neck. 1. Shoulder rolls You can do this one sitting or standing up. Just relax your arms in your lap and rotate the shoulder girdle backwards, making big circles backwards. Try not to use your arms, relax them in your lap and make big circles backwards. Do this for a full minute, if possible 10 times per day. Your muscles are under constant stretch when you’re sitting all day so we would like to get some blood flow in your upper trapezius muscles. 2. Deep neck flexor strengthening Almost everyone could benefit from this exercise. It’s good to improve your strength and also to improve your posture! Start with laying on your back on a mat on the floor and try to make a double chin and hold this for 12 seconds. Keeping your head on the floor. If this is easy, you can go to the next step which is basically the same but after making a double chin, then try to lift up your head just slightly, for 1 centimeter off the floor and hold this position for 12 seconds. This is a tough exercise, try not to compensate and keep the double chin position at all times!

Disc Bulges, Herniated Discs And Sciatica 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.

Achilles Tendonitis 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 .