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Wednesday, 24 August 2016 10:42

Why Is Good Posture So Important?

in Back

Health care professionals seem to constantly be talking about posture. While many people take away the message that they should “stand up straighter” the truth about what good posture is and why you should aim to have it is a little more complicated.

One of the reasons why posture is so important is that the body has an ideal alignment for almost every joint that provides the most stability and efficiency for movement in that position. This is particularly true for the spine, which has a large number of joints that work together to provide movement, stability and support for the body. The spine must also provide a stable base for the shoulder and head. When the spine is in its optimum position, this also allows for free movement of the nerves that supply the trunk, arms and legs. While the human body is highly adaptable and will continue to function when a posture is not “ideal”, a lot of energy is wasted and undue stress is placed on the muscles, tendons and ligaments of the body. Over time this can cause pain, tightness and loss of flexibility.

While being able to find these optimum postures is important, it is also important to simply keep moving and not be stuck in the same position for long periods. No matter how ‘ideal’ a posture is, when joints are held in the same position for too long, this can be troublesome. Working with a great base posture combined with regular movement and stretches can have a surprising impact on your overall wellbeing. Having good posture has been linked to higher self-esteem, improved concentration, and even better lung function.

Friday, 26 February 2016 01:50

The Relationship Between Pain and Your Brain

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For someone suffering from pain, to be told “It’s all in your head” can be a frustrating experience. What many people don’t understand is that pain is a complex process and the mind plays a role in the perception of pain for everyone.

All pain, no matter the cause, must be recognized by the brain and processed for you to be aware of it. Pain is actually an important part of human survival, letting you know which activities are dangerous and encouraging you to rest and in many cases to protect damaged tissue. When the body loses the ability to perceive pain, this can lead to further injury and even death.

There is a famous condition where people don’t feel any pain at all, known as “congenital analgesia”. This is actually a very dangerous condition and these people are at risk of dying young. They have no warning system letting them know that they need to seek treatment. It can be hard to get your head around the idea that pain helps you survive, but it really is an important strategy of our bodies to keep us protected.

Pain isn’t always associated with tissue damage.

Even though pain is an important part of human survival, sometimes things go wrong. A famous example of this is phantom limb pain, where amputees continue to have severe pain, sometimes for decades after the limb has been removed.

Sometimes pain can even be felt on the injured side when looking at a mirror image of their uninjured limb moving.

The amount of attention you give to pain and how you feel about it will also change how severely you experience that pain.

Have you ever noticed a bruise and couldn’t remember how you got it? That is an experience of tissue damage without much pain. On the flip side, if you have suffered recent emotional trauma or are grieving you might find a small injury very difficult to deal with. Some people believe the best way to deal with pain is to ignore it and push through with all activities. Other people believe that the best treatment for all pain is to rest and stop all activities.

What you believe about pain and how you react to it can have a big effect on how your brain interprets pain signals. Feeling in control of your pain is also very important. For people who are experiencing pain for long periods of time without any way to reduce symptoms this can be very distressing, particularly if this pain is impacting their ability to participate in activities.

Your physiotherapist is trained to help you deal with pain in the best way possible. This may involve counselling and education about how to deal with your pain and not just physical treatment of your injury. Don’t hesitate to ask us more next time you come in.

Friday, 26 February 2016 01:49

Tips for Travelling

in Back

Travel has almost become a necessity of modern life. Many people travel for work, and most of us travel for pleasure at least once per year. Unfortunately, the hours of sitting involved in travel often also result in a stiff lower back, neck pain, and headaches. Below is a list of tips and tricks to avoid travel-related aches and pains:

Lower Back:

Lower back pain is the chief complaint of most car and plane travellers. To avoid low back pain, try the following tips:

1) Adjust the seat angle. If you are able, tilt the seat slightly down towards your feet, not towards your hips. Ideally, your knees should be level with your hips, or even slightly lower. A footrest to lift your knees can also help.

2) Adjust the seat back. To avoid compression through your lower back and pelvis, your seat should be upright, not tilted backwards. This will be more comfortable with implementation of tip #1, and aligns your whole spine.

3) Lift the height of the whole seat. This will assist with tip #1 by lifting the whole body away from the floor. When your hips are less bent, it is easier for your back to sit comfortably in an upright position.

4) Use a lower back support. Many cars nowadays come equipped with in-built lumbar supports. Often this support is a generic design and not fitted for your specific shape or height. A proper lumbar pillow, or even a rolled towel in the small of the back, can be more effective in maintaining the natural arch of your spine. This relieves pressure through your intervertebral discs, spinal ligaments, and spinal muscles.


Neck discomfort is easier to improve when tips for lower back are implemented first. Some very easy tips to reduce neck pain are as follows:

1) Use a travel pillow. If travelling on an airplane, try wearing the pillow backwards or sideways. This assists in supporting the head in a slightly better position when you rest or sleep, which helps to reduce the stress placed on the muscles, ligaments and joints within the neck.

2) Every hour, perform 10 chin retractions (also called chin tucks). This is easiest to perform correctly if you sit tall and press your chin straight backwards, lengthening the back of your neck. Do not tuck the chin to the chest. This exercise stretches the small postural muscles at the base of the skull, relaxing them.

3) Keeping your eyes on the road, rotate your head side to side gently. Then tilt side to side gently. Performing any neck movements helps reduce the tension within the muscles from holding still for long periods of time.

The tips above are only suggestions. If you find they are helpful, continue performing them throughout your travels. However, if any of the above tips cause you pain or discomfort, it is advisable to seek your physiotherapist’s opinion. It is also advisable to stop for 15 minutes to stretch your legs and walk around every two hours when driving. When on a plane, refer to the guidelines written by the airline for prevention of deep vein thrombosis.

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Friday, 26 February 2016 01:48

Degenerative Disc Disease

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Between adjacent vertebrae sit flexible discs that provide movement and shock absorption in the spine. In the thoracic region these are completely fibrous while the discs in the lower back and neck are filled with a jelly like substance and surrounded by protective, fibrous rings. The discs of the lower back are the largest as they need to transmit higher loads through the spine.

As we age, these discs lose hydration, height and elasticity. Unfortunately, this also means that the discs are unable to provide the flexibility and support they previously did. Like any form of soft tissue, discs can also become sprained and are able to heal. It is also possible for these discs to bulge and even have the jelly contents spill out into the surrounding region.

You may have heard people talk about having a slipped disc, however this is a misleading expression as discs almost never slip out of place and are very securely attached to the bones above and below them


When these discs first begin to degenerate, abnormal stress is placed on the surrounding joints and muscles of the spine. Facet joints and the vertebrae themselves can also degenerate and produce small bony outgrowths called osteophytes, although these can occur independently of disc degeneration. During this period people may notice feeling stiff and sore at regular intervals. Symptoms are usually located in the neck and lower back.

As the degeneration progresses and the discs become less functional, episodes of pain will often be more frequent and more severe. Many people describe pain with prolonged sitting or standing, along with pain radiating into the hip or buttock region. Pain will often be relieved by changing positions, lying down or walking. Pins and needles or numbness may occur when the spinal nerves around the affected disc become irritated.

As disc degeneration continues, the spine actually becomes more stable with painful epidodes subsiding in severity and frequency.

Disc degeneration is considered to be a normal part of aging, however research on twins has shown that a genetic predisposition to degeneration is the most accurate predictive factor. Smoking, poor nutrition, posture and biomechanics may also increase your chances of suffering from disc degeneration.


Your physiotherapist can diagnose this condition clinically with a thorough examination, including careful questioning and in depth assessment. In most cases imaging is not required, however if you have had previous medical imaging please bring this to your initial appointment.

An important thing to note in spinal pain is that many people can have severe back pain without an obvious finding on their imaging and other people have no pain with very significant structural changes in their back. Some people have even had their discs rupture and heal without realising it!


Treatment of any spinal disorder is often complex and your physio will tailor your management plan to suit you. Many people respond well to specific strengthening exercises, particularly Pilates style exercise. Trigger point therapy or dry needling can help to relax muscles that are often abnormally tight, reducing pain. Your physio is also trained to safely mobilise the spine, which allows the back to move with improved range and can reduce pain.

Your physiotherapist will have a great deal of advice and education for you to assist in managing your symptoms. Diagnosis of a condition such as degenerative disc disease can be daunting, however it doesn’t have to be a life sentence of pain. For more information, speak to your physiotherapist about treatment options.

Friday, 26 February 2016 01:48

Cauda Equina Syndrome

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Cauda equina syndrome is a rare condition that you may not have heard of, however it can have catastrophic consequences if it is not recognized and treated quickly. This condition occurs in about two percent of cases of herniated lumbar discs, causing loss of lower leg function, incontinence and lower back pain. It is one of the few medical emergencies related to back pain and can be devastating if symptoms persist.


At the end of the spinal cord there is an area of spinal nerves arranged together in a bundle that looks a little like a horses tail. (In Latin horses tail is cauda equina). These nerves are encased in the spine at the lumbar region.

If for some reason these nerves are compressed, nerve signals to the bowel, bladder and lower extremities can become disrupted. Left untreated, this compression can cause permanent paraplegia and incontinence.

Common causes of compression are disc herniation associated with disc degeneration, tumours, inflammatory disorders, spinal stenosis or complications from surgery. Trauma-related cauda equina syndrome from knife wounds or motor vehicle accidents can affect people of all ages.


This disease is difficult to diagnose because its symptoms mimic many other conditions. However, there are a few symptoms that health professionals know to take very seriously. These include:

  • Sudden loss of reflexes in the legs
  • Unusual and rapid onset of Bladder/bowel incontinence or sexual dysfunction
  • Pain in one or both legs
  • Motor and sensory loss
  • Tingling or numbness in the saddle region (Groin and inner thighs)
  • Bilateral sciatica

These symptoms may be associated with severe low back pain and if you suddenly experience more than one, particularly incontinence, contact a health professional immediately.


Treatment will depend on the severity and cause of the syndrome. However, most of the time cauda equina syndrome requires decompression surgery as soon as possible to relieve pressure on the nerves. The longer the period between symptom onset and surgery, the less likely it is for a full recovery. Most patients will need physiotherapy, pain management and counseling even if their condition is treated quickly. Recovery time is based on the amount of damage to the nerves.

While this a very rare condition, public education is important, as rapid treatment is vital to prevent permanent damage.

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Thursday, 07 August 2008 12:01

Golfers Back

in Back

Many golfers experience back pain at some time in their playing career; below are a few tips to assist in reducing risk of back pain helping you stay on top of your game.

  • Ensure your clubs are professionally fitted; ill fitting clubs put extra stress on your back.
  • Get lessons from a golf professional good technique decreases strain on the back.
  • Warm up prior to playing. A recommended warm up includes brisk walking for 10 minutes, and performing the following stretches at least 10 times each: