Can You Do These Two Simple Shoulder Movements?

Hand Behind Your Back (HBB) and Hand Behind Your Head (HBH) are two of the first movements your physio will often ask you to perform.

They might seem simple, but these quick tests can tell us a lot about how your shoulder is moving, what structures may be involved, and how your symptoms affect everyday life.

Hand Behind Back (HBB)

This movement includes reaching one hand up behind your back, as though you’re trying to your shoulder blade.

In everyday life, we use this movement more often than we realise. Think about:

– Tucking in your shirt

– Fastening or unfastening a bra

– Reaching into your back pocket

– Scratching the middle of your back

– Pulling up your pants or shorts

– Washing or drying your lower back

To achieve this position, your shoulder need a combination of:

– Internal rotation

– Extension

– Adduction

– Good movement of the shoulder blade

If this movement is painful or limited, it can point towards conditions such as:

– Rotator cuff related shoulder pain

– Shoulder impingement

– Frozen shoulder

– Arthritis

– General shoulder stiffness following injury or surgery

Sometimes it’s not just about pain. You might notice one side simply doesn’t reach as high as the other, which can help identify mobility restrictions before they become a bigger problem.

Hand Behind Head (HBH)

Next, we ask you to place your hand behind your head, like you’re relaxing on the couch or washing your hair.

This movement is essential for many daily tasks, including:

– Washing or styling your hair

– Reaching overhead

– Putting on a jumper or jacket

– Taking off a shirt

– Resting with your hands behind your head

– Reaching into high cupboards

This position requires:

– External rotation

– Abduction

– Elbow flexion

– Good upward rotation and control of shoulder blade

Pain or restriction here may suggest:

– Rotator cuff pathology

– Shoulder instability

– Post-operative stiffness

– Neck restriction

It can also reveal weakness or altered movement patterns that aren’t always obvious during normal shoulder movement.

Why Do Physios Test These?

These aren’t just random stretches. As physio’s, we’re interested in how far you can reach, but we’re more interested in how you get there.

We’re looking at:

– Where your pain occurs

– How much movement you have

– Whether your shoulder blade moves normally

– If you compensate by twisting your trunk or lifting your shoulder

– Differences between your left and right side

Because these movements combine several shoulder motions into one, they provide a quick snapshot of your shoulder function and often reproduce the activities that are difficult in everyday life.

They also give us an easy way to measure progress. If you couldn’t reach your bra strap, wash your hair comfortably,, or scratch your back at your first appointment, we can compare these same movements throughout your rehabilitation to see how you’re improving.

The Takeaway

Being able to reach behind your back and behind your head isn’t about flexibility for the sake of it, it’s about maintaining independence in everyday life.

If either movement is painful, stiff or noticeably different from the other side, it may be your shoulder’s way of telling you something isn’t quite right.

The good news? Identifying these limitations early allows us to determine what’s causing the problem and develop the right treatment plan to get you back to doing the things you need and want to do, without pain!

Are You Snow Ready? Why Ankle, Knee & Hip Mobility Matter Before You Hit the Slopes!

Whether you’re heading to Perisher, Thredbo or planning an overseas snow trip, preparing your body before you leave can make all the difference.

Skiing and snowboarding are physically demanding sports. They require you to absorb uneven terrain, maintain balance, react quickly and spend hours in a semi-squat position. If your joints aren’t moving well or your muscles aren’t prepared, your body will often compensate – and that’s when discomfort, fatigue and injury can creep in.

Here’s why your ankles, knees and hips deserve some attention before you hit the slopes!

Start from the ground up: Ankle Mobility

Your ankles are your foundations on the slopes!

Good ankle mobility allows your knees to move comfortably over your toes, helping you maintain a strong, athletic position inside your ski boots or snowboard bindings. It also helps you absorb bumps, control your turns and adapt to changing terrain.

When ankle mobility is limited, it’s common to compensate through the knees, hips or lower back. This can reduce control, increase muscle fatigue and make it harder to stay balanced throughout the day.

QUICK CHECK: Try the Knee-to-Wall Test

> Keep your heel flat on the floor

> Touch your knee to the wall

> Aim for appox. 10cm between your big toe and the wall.

> Compare both sides!

Knee Mobility: More than just bending

While your knees don’t require huge amounts of mobility, they do need to move comfortably through a squat position.

Whether you’re carving turns, riding moguls or getting on and off the chairlift, your knees are constantly bending and absorbing load.

If knee movement is restricted due to stiffness, previous injury or pain, you may find yourself relying more on your hips or back. This reduces efficiency and increases fatigue.

Equally important is having the strength to repeatedly control these movements over a full day on the mountain.

QUICK CHECK: CAN YOU HOLD A WALL SIT?

> Slide your back down a wall until your knees are around 90degrees

> Keep your feet flat and knees tracking over your toes.

> Hold the position for as long as you can with good control

> Aim for 45-60seconds. Bonus if you can do this 3-4x

Hip Mobility: Your Steering Wheel

Your hips play a huge role in balance, control and generating movement.

Good hip mobility allows you to stay centred over your skis or board, while making smooth, controlled turns. It also helps distribute forces through the lower body rather than overloading one particular joint.

Stiff hips can make it harder to maintain good posture, particularly as fatigue sets in later in the day.

Strong glute muscles also help improve stability, reducing unnecessary stress on the knees!

QUICK CHECK: Try this 90/90 hip rotation test

> Sit on the floor with both knees bent at 90degrees, feet wider than your knees.

> Rotate your knees side to side, while keeping your chest tall.

> Compare both sides.

> Aim for: Smooth, controlled movement, with no pinching or sharp pain.

Mobility is only half the story

While good joint mobility is important, it’s only one piece of the puzzle. Preparing for the snow should also include:

> Strength training

> Single leg balance

> Core control

> Plyometric exercises

> Cardiovascular fitness

The stronger and more conditioned your body is before your trip, the more you’ll enjoy long days on the mountain.

SNOW READY checklist:

Before your next ski or snowboard trip, see if you can tick these off:

> Knee-to-Wall test: ~10cm both sides

> Comfortable body weight squat

> Hold single leg balance for 30seconds each side. BONUS – do this on uneven surface eg. grass, sand etc

> Complete 25 single leg calf raises each leg

> Hold a wall sit for 60seconds. BONUS – complete this 3 times!

> Walk, hike or cycle comfortably for 30-45minutes.

Ready to hip the slopes?

A little preparation before your trip can go a long way towards improving your confidence, reducing fatigue and helping you get the most out of every run.

If you’re dealing with stiffness, recovering from an injury or simply want to make sure you’re snow ready, our physiotherapists can assess your mobility, strength and movement to help you enjoy a safer and stronger ski season.

Why Are Quad Strains So Common in Soccer?

With the 2026 FiFA World Cup captivating football fans around the globe, we’re seeing the game’s biggest stars sprint, change direction and unleash powerful strikes on goal. While the goals and spectacular saves make the headlines, these explosive movement pace enormous demands through the quadriceps – particularly the rectus femurs.

In fact, quad strains account for almost one in every five muscle injuries in soccer. While hamstring injuries often steal the spotlight, injuries to the front of the thigh remain a significant cause of missed training and match time, particularly in players who spring, accelerate, decelerate and kick at high velocity.

The Rectus Femoris

The quadriceps consist of four muscles, but the rectus femurs is injured far more often than the others.

Unlike the facts muscles, the rectus femoris crosses both the hip and knee. This means it works hard to:

> Flex the hip

> Extend the k nee

> Produce explosive force during sprinting

> Generate power during kicking

Recent elite athlete data found that over 90% of quadriceps strains involved the rectus femoris, with almost half occurring during kicking actions.

Why Does Kicking Increase Injury Risk?

Kicking is one of the most important skills in soccer, and the quads play a major role in generating power. Most players can tolerate these loads well, but when kicking is combined with fatigue, sudden increases in training or match load, or inadequate strength, the risk of a quadriceps strain can increase.

The highest forces actually occur just before your foot strikes the ball. During this phase:

> the hip rapidly extends

> the knee moves into extension

> the rectus femoris lengthens while producing large amounts of force.

The good news is that kicking itself isn’t the problem. With good strength, appropriate training and gradual exposure to kicking and sprinting, most players can continue to perform confidently while reducing their injury risk.

It’s Not Just About Kicking

Many quad injuries actually occur during:

> Maximal sprinting

> Sudden acceleration

> Sharp deceleration

> Rapid changes of direction

Fatigue towards the end of training or matches can also reduce force control, increasing injury risk.

Who’s Most at Risk?

Risk factors include:

> Previous quadriceps strain

> Rapid increases in training load

> Returning too quickly after injury

> Poor strength or side-to-side asymmetry

> Limited exposure to high-speed running during training

> Heavy kicking volumes, particularly in pre-season

Can Quad Strains Be Prevented?

While no injury is completely preventable, you can reduce your risk by:

> Building quadriceps, hamstring and glute strength

> including regular sprinting in training to prepare for match demands

> increasing training and match loads gradually

> Completing a dynamic warm-up, such as the FIFA 11+, before training and games.

If you do develop pain or tightness in the front of your thigh, early assessment and treatment can help you recover faster and reduce the risk of a more significant injury

How Physiotherapy Helps

Effective rehabilitation goes beyond stretching. A progressive rehab program should include:

> Restoring strength throughout the full range

> Eccentric quadriceps loading

> Hip flexor strengthening

> Sprint progression

> Graded kicking exposure

> Agility and change-of-direction drills

> Return to play testing

The goal isn’t simply to get back on the field, it’s to return with the capacity to tolerate the demands of soccer.

The Bottom Line

Quadriceps strains remain one of the most common muscle injuries in soccer, accounting for around one in five muscle injuries at the professional level. Because the quadriceps are responsible for explosive kicking, sprinting and acceleration, they are exposed to some of the highest forces in the game. A structured rehab program that progressively restores strength, speed and kicking capacity offers the best change of returning safely while reducing the risk of recurrence.

Why Arthritic Joints Tend to Flare in Winter

As the colder months roll around, many people living with Osteoarthritis notice their joints becoming stiffer, achier, and more irritable. While winter itself does not directly damage your joints, colder weather can absolutely influence how your body feels and moves.

If you’ve ever felt like your knees, hips, hands or back are “worse in winter”, you are definitely not alone!

Why Do Joints Feel Worse in Winter?

There is no single reason, but several factors can contribute to increased symptoms during colder weather.

1. Muscles and Soft Tissues Become Stiffer

Cold temperatures can make muscles, tendons and surrounding soft tissues feel tighter and less flexible. When this happens, joints may feel less mobile and more uncomfortable during movement.

Think about trying to stretch cold Blu Tack – it is much stiffer and less adaptable until it warms up. Our bodies can feel similar.

This is why many people notice:

> More morning stiffness

> Difficulty getting moving

> Increased aches after sitting still

> Reduced flexibility

2. We Tend to Move Less in Winter

Rainy mornings, darker evenings and colder temperatures often mean we become less active overall. Fortunately, joints with arthritis generally do better with regular movement.

When activity levels drop:

> Joints can stiffen further

> Muscles around the joint may weaken

> Circulation decreases

> Pain sensitivity may increase

Movement acts like a natural lubricant for joints, helping maintain mobility and function.

3. Changes in Air Pressure May Play a Role

Some people are particularly sensitive to weather changes, especially drops in barometric pressure before cold or rainy weather.

While research is still ongoing, it is thought these pressure changes may slightly affect joint tissues and surrounding nerves, contributing to increased pain or stiffness in some individuals.

4. Winter Often Changes Our Daily Habits

During winter we also tend to:

> Sit more

> Warm up less before activity

> Spend less time outdoors

> Exercise less consistently

All of these factors can contribute to joints feeling more irritable!

The Good News: Movement Helps

One of the best things you can do for arthritic joints during winter is keep moving.

That does not mean pushing through severe pain or doing high intensity exercise every day. Instead, consistent and appropriate movement can help:

> Reduce stiffness

> Improve circulation

> Maintain strength

> Support joint mobility

> Reduce pain over time

Some helpful strategies include:

> Gentle morning mobility exercises

> Walking

> Strength training

> Hydrotherapy

> Warming up before exercise and sport

> Staying generally active throughout the day

Why Strength Matters

Strong muscles help support and offload joints affected by arthritis.

For example:

> Strong quads can help support arthritic knees

> Strong glutes can reduce the load through hips and lower backs

> Better core strength can improve overall movement efficiency

This is why exercise based management is now considered one of the gold standard treatments for osteoarthritis!

Don’t Fear Winter Movement

It is completely normal for arthritic joints to feel stiffer during winter, but avoiding movement entirely can often make symptoms worse!

The key is finding the right balance:

> Keep moving consistently

> Warm up properly

> Modify activity when needed

> Build strength gradually

> Listen to your body

If your joints are becoming increasingly painful, swollen or limiting your daily activities, seeing a physiotherapist can help guide the right exercise and management plan for you!

Why Your Thoracic Spine Matters More Than You Think!

When people think about spinal pain or stiffness, attention often goes straight to the neck or lower back. But sitting right in the middle is an area that plays a huge role in how we move, breathe, and perform every day – the thoracic spine!

The thoracic spine refers to the mid-back region, made up of 12 vertebrae connected to the ribs. This area is designed for both stability and movement. It helps support posture, allows rotation and extension through the trunk, and protects vital organs including the heart and lungs.

Why Does the Thoracic Spine Become Stiff?

Modern lifestyles don’t do the thoracic spine many favours. Long hours sitting at desks, driving, studying, doomscrolling and repetitive sport positions can all encourage us into rounded postures over time.

When the thoracic spine spends prolonged periods in flexed or slouched positions, the surrounding joints, muscles, and connective tissues can gradually lose mobility. Many people begin to notice:

> Mid-back stiffness or tightness

> Neck tension or headaches

> Shoulder discomfort

> Difficulty rotating during sport

> Feeling “stuck” when trying tog to stand upright

Athletes can also develop thoracic stiffness from repetitive loading patterns. Cyclists, swimmers, runners, desk workers, and gym-goers commonly develop reduced mobility through the region due to the positions they spend the most time in.

Why Thoracic Mobility Is So Important

The thoracic spine is designed to rotate, extend, and move with breathing. When mobility is reduced, other areas of the body often compensate.

For example:

> Limited thoracic extension can increase load on the neck and shoulders

> Poor rotation can place extra stress through the lower back

> Restricted rib movement can affect breathing efficiency

> Shoulder movement can become limited if the upper back cannot move properly

Good thoracic mobility helps the body distribute load more efficiently. This becomes especially important running, throwing sport, swimming, lifting, golf, tennis, and even everyday tasks like reaching overhead or turning when driving.

The Link Between the Thoracic Spine and Breathing

One of the most overlooked roles of the thoracic spine is its relationship with breathing.

The ribs attach directly to the thoracic spine, meaning every breath requires movement through this area. During the efficient breath, the rib cage should expand in multiple directions while the diaphragm works alongside the the abdominal muscles and pelvic floor to manage pressure within the trunk.

When the thoracic spine and rib cage become stiff, breathing mechanics can change. People may begin to rely more heavily on shallow chest breathing, overuse the neck and upper shoulder muscles, or struggle to take full deep breaths during exercise.

Poor breathing can contribute to:

> Increased neck and shoulder tension

> Reduced exercise efficiency

> Feelings of stiffness through the chest and upper back

> Difficulty relaxing the nervous system

> Poor trunk pressure management during lifting or management

More Than Just Movement: Protection and Support

The thoracic spine also has an important protective role. Together with the rib cage, it forms a strong structure around vital organs including the heart and lungs.

Because of this protective role, the thoracic spine is naturally a little stiffer than the neck or lower back. It’s designed to provide stability while still allowing enough movement for breathing and rotation.

The goal isn’t excessive flexibility – it’s balance mobility, strength, and control

How Can You Keep Your Thoracic Spine Healthy?

Some simple ways to support thoracic mobility and function include:

> Regular movement breaks from sitting

> Rotational and extension-based mobility exercises

> Strengthening the upper back and trunk muscles

> Improving breathing mechanics

> Gradually progressing training loads

> Maintaining variety in movement throughout the day

If you’re experiencing persistent mid-back stiffness, neck tension, restricted movement, or discomfort during sport or exercise, assessment from a physiotherapist can help identify what may be contributing and guide an appropriate management plan.

Your thoracic spine does far more than just “sit in the middle” of the body – it plays a key role in movement, breathing, posture, performance, and overall function every single day.

Risk Factors for Bone Stress Injuries

Bone stress injuries sit on a spectrum, from early stress reactions through to stress fractures – and they occur when bone breakdown temporarily outpaces bone repair. The key idea is that bone is dynamic tissue, constantly adapting to load. When the balance tips too far in one direction, especially over time, injury risk increases.

These risk factors rarely act in isolation. Most cases involve a combination of training load, recovery capacity, and individual physiology.

1. TRAINING LOAD FACTORS

Sudden increases in training load

One of the strongest risk factors is a rapid spike in load, for example, increasing running volume, intensity, or impact work too quickly. Bone adapts to load, but it needs time. When load is progressed faster than bone can remodel, micro-damage accumulates.

Change in training surface or terrain

Switching from softer to harder surfaces (eg. grass to pavement), or introducing hills, intervals or plyometric without gradual progress can significantly increase bone stress.

Repetitive impact sports

Sports involving high repetition loading such as running, gymnastics, basketball etc place continuous stress on bone, especially when combined with limited recovery.

2. RECOVERY AND ENERGY AVAILABILITY

Low Energy Availability

Low energy availability occurs when there is insufficient energy intake to support both exercise demands and the body’s basic physiological functions (eg. Bone turnover, hormone regulation, and immune fuction). This can occur both intentionally (dieting, weight goals) or unintentionally (high training loads without matching fuelling).

Common indicators may suggest low energy availability include:

– Persistent fatigue or poor recovery from training

– Unintentional weight loss or difficulty maintain weight

– Increased frequency of niggles or overuse injuries

– Reduced performance or training tolerance

– In some cases (particularly females), menstrual disturbances or loss of regular cycles.

Importantly, LEA does not only affect elite athletes, it can occur in recreational runners, adolescents, and individuals increasing training load without adjusting nutrition appropriately.

A sports dietitian plays a key role in assessment and management, helping to identify energy gaps, optimise fuelling around training and support adequate intake for bone health, recovery, and performance.

Inadequate recovery time

Bone requires recovery days to complete its remodelling process. Back-to-back high-load session without sufficient rest can tip the balance toward breakdown.

Sleep deficits

Sleep is a key time for tissue repair and hormonal regulation. Poor or insufficient sleep can negatively impact bone recovery and adaption.

3. BIOMECHANICAL AND STRUCTURAL FACTORS

Previous bone stress injury

A history of bone stress significantly increase recurrence risk, particularly if underlying contributing factors were not addressed.

Muscle strength and capacity deficits

Reduced strength or fatigue in key muscle groups can shift load directly onto bone, increasing stress.

4. HORMONAL AND PHYSIOLOGICAL FACTORS

Low oestrogen or menstrual dysfunction

Hormonal disruption can reduce bone density and impair bone remodelling capacity, increasing susceptibility to stress injury.

Low bone mineral density

Reduced bone density means less structural strength to tolerate repetitive load. This can increase susceptibility to bone stress injury, even with training loads that would otherwise be well tolerated.

Relative energy deficit in sport (RED-S)

A broader condition affecting metabolic, hormonal, and bone health due to chronic energy imbalance.

5. ATHLETE AND LIFESTYLE FACTORS

High training motivation / pain ignoring behaviour

Continuing to train through early symptoms is a common factor that allows stress reaction to progress.

Adolescence and growth phases

During growth spurts, bone remodelling is already increased, and coordination between bone lengthening and strengthening may be temporarily mismatched.

KEY TAKEAWAY

Bone stress injuries are rarely caused by a single factor. They occur when load exceeds recovery capacity over time, influenced by training habits, nutrition, biomechanics, and physiology.

Early recognition of risk factors and modifying load before pain escalates, is one of the most effective ways to prevent progression from a stress reaction to a stress fracture.

Why Do My Hips Click?

Hip clicking is something most people notice at some point – during squats, walking up stairs, getting out of a car, or even just rolling over in bed. It can sound dramatic, but in many cases it’s completely benign.

The distinction isn’t the sound itself, it’s whether the click is painful, progressive or limiting movement.

What actually causes hip clicking?

The hip is a deep ball-and-socket joint surrounded by muscles, tendons, and a joint capsule. A click usually comes from one of these structures moving or changing position during motion.

Common causes include:

1. Tendons sliding over bone

One of the most common reasons. Tendons from the hip flexors or glutes can flick over bony landmarks during movement, creating a snapping or clicking sensation

2. Normal pressure changes in the joint

Small shifts in joint fluid pressure can create a soft pop or click, similar to cracking knuckles.

3. Muscle control and coordination changes

If certain muscles are doing more work than others, movement can become less smooth, which may make clicking more noticeable during specific tasks or ranges

Where do you usually feel it?

– Front of the hip/ groin: often related to hip flexor tendon movement or deep hip motion

– Side of the hip: commonly linked to the gluteal tendons moving over the outer hip

– Deep inside the joint: may be related to joint mechanics or load through deeper ranges

The location can provide clues, but it doesn’t confirm diagnosis on its own.

When hip clicking is usually harmless

Clicking on its own is generally not concerning when:

– It is not painful

– It doesn’t worsen over time

– It doesn’t affect your ability to move, train, or function

– It is intermittent rather than constant

Many people have clicking hips long-term with no issues

When a click becomes more important: Painful hip clicking

A painful click is different. Pain suggests that the movement is now irritating a structure rather than just passing smoothly.

Painful clicking may be:

– Felt in the groin or front of the hip

– Occurring in deeper positions (squats, lunges, getting up from low chairs)

– Followed by a lingering ache after activity

– Associated with stiffness or a feeling of “pinching”

In these cases, it’s less about the sound and more about how the hip is tolerating load and range of motion.

What you should do if your hip click is painful

If clicking is accompanied by pain, the goal is not to “push through it” or aggressively stretch it out.

Instead, start with:

1. Modify aggravating positions

– Reduce depth in squats or lunges temporarily

– Avoid repeatedly pushing into the exact range that provokes the pinch

– Adjust training volume if symptoms flare after activity

2. Monitor load response

– Pay attention to how the hip feels 24-48 hours after activity

– If symptoms settle quickly, the load is usually acceptable

– If symptoms linger or worsen, it may need adjustment

3. Focus on control and strength

– Glute and hip stability work (bridges, side-lying work, single-leg control)

– Improving how the hip moves under load rather than just how far it moves

– Rebuilding tolerance gradually rather than avoiding movement completely

4. Don’t rely on stretching alone

– Stretching a painful hip that is already irritated can sometimes make symptoms worse

– The issue is often control and load, not just tightness

When to get it checked

It’s worth seeing a physiotherapist if:

– Painful clicking is persistent or recurring

– It limits your training, walking, or daily activities

– You feel catching, locking, or instability

– Symptoms are not improving with load modification

A physiotherapy can help determine whether the issue is tendon-related, joint-related, or movement-control related, and guide a clear plan forward.

The Takeaway

Hip clicking is often just a normal part of movement, especially when it is not painful.

If symptoms are present, seek advice from a health professional to help diagnose the issue, manage load, and guide appropriate treatment pathways.

Returning to Exercise Postpartum: What Every Woman Should Know

The return to exercise after having a baby is often filled with motivation, uncertainty, and plenty of conflicting advice. Whether you’ve had a straightforward pregnancy or a more complex journey, one thing is true for all women: your body has gone through significant change, and it deserves a thoughtful, guided return to movement.

This isn’t just about “getting back” to where you were. It’s about building a strong, resilient foundation for the long term.

Your Body Has Been Preparing for Months

Pregnancy itself is not a passive experience for the body. Over nine months, your body adapts to support your growing baby! This includes changes to:

– The pelvic floor (increased load and length)

– Abdominal wall (including abdominal separation)

– Ribcage and breathing mechanics

– Ligaments and joint stability

Even before delivery, these changes influence how your body manages pressures, load, and movement. This means your starting point postpartum is already different and should be respected.

The Pelvic Floor: More Than Just “Kegels”

The pelvic floor plays a key role in continence, organ support, and managing pressure during movement. Postpartum, it may be:

– Weakened and/or stretched

– Overactive or tight

– Poorly coordinated with breathing

– Over-recruiting through abdominals

Simply doing generic pelvic floor exercises isn’t always enough, and in some cases, may not be appropriate. What matters most is how well your pelvic floor functions as part of your whole system.

Strength Before Intensity

One of the most common mistakes in postpartum recovery is progressing too quickly to high-impact or high-intensity exercise.

Before returning to running, heavy weights or HIIT training, it’s important to rebuild:

– Deep core control (including breath and pressure management)

– Pelvic floor strength and coordination

– Hip and lower limb strength

– Whole-body load tolerance

Think of this phase as laying the groundwork. Without it, your body may compensate, leading to pain, pelvic floor dysfunction or injury risk

Loading Matters More Than Time

While timelines are often used as a general guide, they don’t reflect your individual readiness to return to higher levels of exercise. What matters most is how well your body Is prepared to handle increased load.

Following pregnancy and birth, your capacity to tolerate load may have changed. This is due to:

– Physical demands of pregnancy

– Period of reduced activity postpartum

– Factors including sleep, energy levels, pelvic floor function and body positioning

Progressing exercise should involve a gradual and structured increase in load, with appropriate clearance before advancing intensity or impact. This ensures your body can adapt safely and reduces risk of overload or compensation.

Why Every Woman Should See a Physio Postpartum

A postpartum physiotherapy assessment is one of the most valuable steps you can take.

A Women’s Health Physiotherapist can:

– Assess your pelvic floor (strength, coordination, and function)

– Check for abdominal separation and core control

– Guide safe and progressive return to exercise

– Identify risk factors early

– Tailor a plan specific to your goals – whether thats walking, strength training, CrossFit, running, returning to sport, or simply activities of daily living.

Many postpartum issues – like leaking, heaviness or back pain, are common, however, they are not something you should “put up with”.

The Bigger Picture

Returning to exercise postpartum isn’t just about your physical recovery, it’s about confidence, longevity and feeling strong in your body again.

There is no one-size-fits-all approach to postpartum recovery. Every woman’s experience is different, and every return to exercise should be guided accordingly.

If there’s one takeaway – don’t leave it to guesswork. A tailored approach, guided by a physiotherapist, can make all the difference in your postpartum journey!

Growing Pains in Young Athletes: Understanding Apophysitis as Winter Sports Return

As winter sports return, we often see a rise in young athletes presenting with heel or knee pain. Sports like soccer, netball, AFL, basketball and rugby all ramp up again .. . and so do conditions linked to growing bodies under increasing load.

Two of most common causes of pain in active kids during this time are Sever’s disease and Osgood-Schlatter’s disease. Both fall under a broader category called apophysitis.

What is Apophysitis?

Apophysitis refers to irritation or inflammation at a growth plate where a tendon attaches to bone. In growing children, these areas are naturally weaker because the bone is still developing. When strong muscles repeatedly pulll on these developing areas durign sport, the attachment site can become irritated and painful.

A key factor is that bones and muscles don’t always grow at the same rate. During growth spurts, bone may lengthen quickly while muscles and tendons temporarily become tighter. This increase tension places more stress on the attachment points .

When sport volumes increases, like at the start of a season, these areas can become overloaded.

Sever’s Disease (heel pain)

Sever’s disease affects the back of the heel, where the calf muscles attach via the Achilles tendon. It commonly occurs in children aged 8-12 years, particularly those involved in running and jumping sports.

Common signs include:

– Heel pain during or after sport

– Tenderness at the back or sides

– Limping or discomfort walking after activity

– Pain with running, jumping or calf raises

Osgood-Schlatter’s Disease

Osgood-Schlatter disease affects just below the kneecap, where the patella tendon attaches to the shin bone. It typically occurs in children aged 10-16 years, especially during periods of rapid growth.

Common signs include:

– Pain or swelling just below the kneecap

– Tenderness at the tibial tuberosity (the bony bump below the knee)

– Pain when running, jumping, kneeling or squatting

– Pain worsens with sport

Why We See More Cases at the Start of Sports Seasons

At the beginning of winter sports seasons, young athletes often experience:

– A sudden increase in training load

– Multiple sports or training sessions per week

– Growth spurts

– Reduced recovery between activities

These factors together can increase stress on developing growth plates.

The Good News – Kids Can Usually Keep Moving

These conditions are very common and often managed well. In most cases, young athletes don’t need to stop sport complete. Instead, management usually focuses on:

– Adjusting training load

– Managing symptoms

– Improving strength and flexibility

– Supporting a gradual return to full activity

With the right approach, kids can stay active while allowing the irritated area to settle.

A Quick but Important Note

While Sever’s disease and Osgood-Schlatter disease are common causes of heel and knee pain in growing athletes, similar symptoms can sometimes be caused by other conditions or injuries. Because of this, it’s always best to have ongoing pain assessed by a physiotherapist who can help differentiate the cause and guide the most appropriate treatment and return-to-sport plan.

When to Seek Advice

If your child is experiencing ongoing heel or knee pain with sport, it’s worth having it assessed early. Appropriate guidance can help manage symptoms, prevent flare-ups, and keep kids participating in the activities they enjoy.

At our clinic, we work with young athletes and their families to identify the cause of pain, guide treatment, and support a safe return to sport for growing bodies

Understanding Menopause: How to Support Your Body Through Change

Menopause is a natural biological transition, but it influences far more than reproductive hormones. Research shows that hormonal shifts can affect muscle, bone, sleep and nervous system regulation. Understanding these changes helps guide strategies to support physical and emotional wellbeing!

MUSCULOSKELETAL CHANGES

Reduction in Muscle Mass

Oestrogen plays a key role in muscle and connective tissue health. After menopause, muscle mass declines at an estimated 1-2% per year, which can accelerate strength loss and increase the risk of sarcopenia (age-related muscle loss). This can influence balance, functional capacity and long-term resilience.

Strength is highly adaptable. Resistance training can improve muscular strength by 25-100% depending on baseline capacity and program design. This makes it one of the most effective strategies to preserve function and independence.

Increase Risk of Osteoporosis

Bone health is also affected. Bone density peaks around the age of 30 years old for both men and women. However the reduction in oestrogen during menopause accelerates this reduction, increasing risk of osteoporosis and fractures for women. Studies have shown progressive resistance training and impact loading stimulate bone adaption and help slow the rate of bone density reduction. It is important that these programs are individualised and specific to each person.

Tendon Loading

Tendons may respond differently to load during menopause. Some women may notice changes tendon health and increased susceptibility to tendinopathies such as tennis elbow or proximal hamstring issues. Progressing loading and individualised rehabilitation help tendons adapt and improve resilience.

SLEEP AND RECOVERY

Sleep disturbance is common during menopause, affecting 40-60% of women. Poor sleep influences recovery, mood and pain sensitivity, and can heighten nervous system reactivity.

When sleep is disrupted, the nervous system may become more sensitive, amplifying feelings of pain, discomfort and fatigue. This does not always indicate structural damage, it reflects how the body processed information. Addressing sleep hygiene and establishing consistent routines can support better rest and recovery.

Regular physical activity also improves sleep quality and mood in many individuals. Movement helps regulate circadian rhythms and promotes physiological recovery, contributing to overall wellbeing.

NERVOUS SYTEM AND SENSITIVTY

The nervous system regulates how we perceive and respond to stress and sensory input. Hormonal changes during menopause can influence nervous system sensitivity, sometimes heightening pain perception.

This increased sensitivity does not always mean tissue damage, it reflects changes to how the body is processing. Graded exercise, movement and stress management strategies can help regulate nervous system responses and improve tolerance to activity.

WHAT THIS MEANS FOR MOVEMENT AND FUNCTION

Movement is protective. It supports physical and emotional wellbeing, reducing the risk of long-term functional decline and helps maintain independence.

Strength training, progressive exercise and individualised programs help:

– Maintain muscle and bone health

– Support tendon resilience

– Improve sleep and recovery

– Enhance functional capacity

– Regulate nervous system responses

HOW PHYSIO CAN HELP

Every person experiences menopause differently. As physio’s we work with you to assess and treat areas of concerns, whilst considering physiological changes at this time. We want to keep you moving!

Physiotherapy can help:

– Assess and treat joint stiffness, muscle tightness and structural changes

– Guide safe and progressive loading

– Educate on how to support musculoskeletal health

– Manage pain and movement concerns

Working with a multidisciplinary team – including your GP, specialists, exercise physiologist, dietitian, psychologist etc – helps provide comprehensive care tailored to your individual needs.

If you have any questions, or would like support – our team is here to help!