Exercise Extra – Figure 4 Stretch

This specifically stretches the piriformis and iliotibial band (ITB). This can be useful for knee, hip and back pain when used appropriately.

  • Lie on your back with your feet flat on the floor.
  • Cross your left foot over your right thigh.
  • Lift your right leg off the floor. Grab onto the back of your right leg (behind the knee so you don’t compress your knee) and gently pull it toward your chest. If you have difficulty reaching your thigh then use a towel so your head and shoulders can rest comfortably on the floor.
  • Maintain a hollow in the small of your back.
  • When you feel a comfortable stretch, hold there.
  • Hold for 30 seconds to 2 minutes.
  • Switch sides and repeat.

Feel free to try this stretch. Please be aware this exercise is not for everyone and is best considered for individual prescription following the advice of your physiotherapist. STOP IMMEDIATELY and do not continue if you experience ANY pain.

Exercise Extra – Pectoralis Stretch

The pectoral muscles (major and minor) are located in the chest attaching to the collarbone (clavicle), sternum, ribs and the arm bone (humerus).

Pectoral tightness results in the movement of the shoulder forward and occurs with poor postural habits (‘slouching’) where the chest concaves and the shoulders become rounded.

This positioning increases the risk of shoulder injury with tasks such as reaching and is particularly relevant to those doing upper body weight training.

How? Place your forearm on a doorframe so that the elbow is at shoulder height. Lunge forward with the same foot as arm keeping your chest facing forward and you should feel a stretch across the front of your chest. Hold for 60secs each side. Alternatively, stretch both arms at the same time.

Feel free to try this stretch. STOP IMMEDIATELY and do not continue if you experience ANY pain (especially pins and needles or discomfort into the neck, upper back, arms or hands)!

Exercise Extra – Posterior Cuff Stretch

If the back of your shoulder is tight, you may be more likely to develop rotator cuff problems — especially if you golf or participate in overhead racket or throwing sports, such as tennis, cricket or baseball.

How? Bring your left arm across your body and hold it with your right arm, preferably above the elbow. You should feel a stretch in the back of the shoulder and/or the outside of the arm. Hold for 60 seconds, switch arms, and repeat to the right.

Feel free to try this stretch. STOP IMMEDIATELY and do not continue if you experience ANY pain!

If you have problems in this area, see your physiotherapist for a thorough assessment to determine the cause of your tightness or pain and to receive a treatment plan to correct this.

Exercise Extra – Quadriceps Stretch

Quadriceps refers to a group of muscles in the front of your thigh: vastus medialis, vastus intermedius, vastus lateralis and rectus femoris.

All muscles are the primary produces of knee extension (ie. straightening the knee) while the rectus femoris muscle also crosses the hip joint and is therefore responsible for flexing the hip (ie. lifting the knee) as well.

Poor length will affect your stride length and knee flexion. Poor strength will affect your ability to squat, bend, lift, ascend or descend stairs. Both poor length and strength can produce knee, hip or lower back pain.

How to stretch? Whilst standing, lift your foot behind you (bending your knee) and grab a hold of your foot. If you cannot reach, use a towel or place your foot on a chair or bench. Keep your knee pointing down and next to your other knee.

Feel free to try this stretch. You should feel the stretch in the front of the thigh. STOP IMMEDIATELY and do not continue if you experience ANY pain!

National Pilates Day

National Pilates Day was on the 5th May and to celebrate Nelson Bay Physiotherapy & Sports Injury Centre hosted a special Pilates event on the Tomaree Headland foreshore with donations going to MND (Motor Neuron Disease) Australia.

One of our participants remarked “For a National Event, where else in Australia would you rather be”. We had a lovely morning with the fresh air, beautiful sunshine and rolling waves passing by. It certainly reminded everyone of the great surrounds in which we reside. All this while raising nearly $300 for charity.

A great thanks to Nicole and Lisa who volunteered their time to provide the Pilates to all participants and of course our wonderful participants for ‘giving it a go’ and donating selflessly.

If you’re interested in learning more about the benefits of our Pilates programs please click here or simply contact us. We’d love to hear from you and help you achieve your goals!

Read here for more on Motor Neuron Disease and the invaluable work MND Australia are doing. MND is an irreversible neurological condition that attacks the nerves responsible for muscle control.

Of interest to the Pilates world, Mari Winsor, who made Pilates popular in the 1990’s with her video’s, suffers from Amyotrophic Lateral Sclerosis (ALS) which is one of subtypes of MND. Mari was diagnosed in 2013 and currently with the progression of the disease is wheel chair bound and non-verbal, requiring 24-hour care.

Neil Daniher, former AFL football player & Coach was diagnosed with MND in 2013 and is now a prominent campaigner for medical research and associated with the Big Freeze.

Typically, people with this incurable condition die within 3-4 year from diagnosis, although is some rare cases people with MND, such as recently passed Professor Stephen Hawking, may live much longer.

There is no known cure.

Nelson Bay Physiotherapy & Sports Injury Centre



02 4981 3461

Exercise Extra – Hamstring Stretch

Hamstring stretching can benefit bending, walking and sitting.

Poor hamstring length can compromise one’s lower back. This is particularly the case when sitting in a sedan seat, when straightening your knees, and when sitting and bending.

Hamstring tightness can also reduce stride length.

Did you know that you have 4 hamstring muscles? The muscles run from the sitting bones (ischial tuberosity) to the top of the shin just below the knee. They are what we call 2 joint muscles as they cross the knee and hip, influencing the movement of both of these joints.

How? Lie on your back, place a towel around your heel, straighten the knee and lift the leg towards your shoulder OR stand up, place your heel on a fence/chair/stool and straighten the knee. Do not reach for your toes but rather stick your bottom out (ie keeping your back from collapsing forward)

Feel free to try this stretch. You should feel the stretch in the rear of the thigh, NOT the calf. Do not hold if you feel it in your calf (as it is your sciatic nerve NOT the calf muscle). STOP IMMEDIATELY and do not continue if you experience ANY pain!

Exercise Extra- Calf Stretch

Calf stretching can benefit walking and bending and assist in preventing calf tears, Achilles problems and plantar fasciitis (commonly known as heel pain or heel spurs).

Did you know that poor calf length can also effect you balance?

Did you know that there are two main calf muscles? The calf muscles attach below (Soleus) and above (Gastrocnemius) the knee and together form a common tendon onto the heel, known as the Achilles tendon.

Are your calves tight or do you commonly injure these muscles? Why? Apart from a traumatic incident, there is usually a biomechanical cause for the overactivity or tightness of your calves. See your physiotherapist for a thorough assessment to determine the cause of your tightness or pain and to receive a treatment plan to correct this.

Feel free to try this stretch. You should feel the stretch in the rear calf. STOP IMMEDIATELY and do not continue if you experience ANY pain!

Active Kids Rebate

Wow, some good news for parents. Congratulations to the Government on a great initiative to help address the low physical activity levels of our children and adolescents and the obesity problem.

The NSW Government will allocate $207 million over four years to establish Active Kids. Active Kids is a program to help NSW families meet the cost of getting their kids into sport and active fitness and recreation activities.

The NSW Government will provide a rebate through a voucher system to parents/guardians of school enrolled children. The $100 voucher can be used for registration and participation costs for sport and fitness activities.

The initiative will reduce the barriers to participation and help change the physical activity behaviours of children and young people in NSW.

To read more about the eligibility, commencement, guidelines, administration and application procedures please click here.

A word of warning though, whilst the rebate will help families of active children financially, research suggests that this alone is not enough. Please read the following previous posts of ours to see why this is an important point to remember for your children’s health





Stability – Part 2 – The Pelvis

Stability Part 2 – Pelvic stability

PelvicStab1In the first blog on stability (click here) we spoke about the core and all the components that make up the core. We spoke about how the core acts as the stabiliser of the spine and trunk, and its importance as a point of transition of forces from the lower limbs to the upper limbs, and vice versa. This is an integral to ensure correct kinetic chain mechanics, and prevention of increased loading and injury to the spine….


Over the last 20 years the profession of sports rehabilitation has undergone a trend away from traditional, isolated assessment and strengthening. We have moved toward an integrated, functional, movement‐based approach. Being functional is of utmost importance to excellent and comprehensive rehabilitation.

Therefore focusing on the core alone is not the answer, instead we need to look at the pelvis and lumbar spine as a whole in functional movement patterns to ensure optimal positioning and loading.

What is Pelvic stability?

Pelvic Stabilisation is geared toward improving the function and strength of the pelvis and hip regions. Inefficient pelvic and hip stabilisation can lead to faulty movement patterns as listed below (seen in the pictures alongside):

  • Trendelenburg (drop hip)
  • Rotation and side flexion of the spine
  • Internal rotation of the lower limb
  • Knocked knees
  • Foot pronation
  • Excessive forward or backward pelvic tilt

These changes in body alignment can lead to problems in the lower back, hip, knee and ankle.


How does the Pelvis become inefficient in the first place?

There are many reasons as to why we see weakness in the pelvis:

  • Sedentary lifestyle resulting in increased sitting, and less activity
  • Sitting and standing in poor postures places the glutes in less optimal positions for activation
  • Pain in the lower back, hip and knee region can lead to muscle inhibition in the pelvis area
  • Pregnancy/ post-child birth

PelvicStab3When your body forgets how to properly activate the gluteal muscles, you lose the ability to move your hips through their full range of motion and compensatory recruitment of other muscles. Ultimately this means that other back and hip muscles tend to tighten up to try and stabilise your wobbly hip. This leads to overactivity of the wrong muscles which alters movement patterns and results in pain and injury.


The body works as whole and when certain body regions are inefficient, the body will find a way to make the movement happen using another muscle or joint in a way that was not intended. If your not feeling 100% it is likely that your body is already ‘cheating’ and not moving the way it should. A full assessment by your Physiotherapist will identify and optimise your movement and performance, as well as prevent injury and pain.

Written By: Nicole Pereira (Physiotherapist & Pilates Instructor, Nelson Bay Physiotherapy & Sports Injury Centre)


Phrompaet, S., Paungmali, A., Pirunsan, U., & Sitilertpisan, P. (2011). Effects of Pilates Training on Lumbo-Pelvic Stability and Flexibility. Asian Journal of Sports Medicine, 2(1). doi:10.5812/asjsm.34822In‑text: (Shamsi, Sarrafzadeh, & Jamshidi, 2014, p. xx)

Shamsi, M. B., Sarrafzadeh, J., & Jamshidi, A. (2014). Comparing core stability and traditional trunk exercise on chronic low back pain patients using three functional lumbopelvic stability tests. Physiotherapy Theory and Practice, 31(2), 89-98. doi:10.3109/09593985.2014.959144

Physiotherapy and Prostatectomy

Physiotherapy for Urinary Incontinence following surgical prostate gland removal.

Evidence shows that physiotherapy-guided pelvic floor retraining and exercise helps men regain continence significantly faster and more effectively than men not receiving treatment.

Urinary incontinence, or bladder weakness or leakage, is an unfortunate but very common result for men who undergo surgical removal of their prostate gland as treatment for prostate cancer. Rates of incontinence for men post-surgery vary greatly across the literature but can be as much a 70% in the short term. This number decreases with time post-surgery, however up to 5% of men may require surgery to help them recover their continence. It is estimated that 1 in 7 men will be affected by prostate cancer in their lifetime.



The cause of urinary incontinence following surgical prostate removal is the disruption of two muscles acting like valves, called urinary sphincters. One is around the bladder neck, the other is around the urethra and is part of the pelvic floor. These muscles act together to control the flow of urine by opening and closing the bladder ‘door’ on automatic command from your brain. The prostate is a walnut-sized male reproductive organ located at the base of the bladder and alongside the urethra. If the sphincters or pelvic floor are damaged or weakened during removal of the prostate gland then urinary incontinence can result. As well as these surgical side-effects, radiotherapy treatment can cause irritation, inflammation and swelling to the bladder, prostate, urethra and rectum and this may cause urinary issues, although this is much less common.

There are two main forms of urinary incontinence. Stress urinary incontinence (SUI) occurs on an action or movement that causes stress to the pelvic floor such as coughing, sneezing, laughing, lifting or jumping. This is due to an increase in abdominal pressure on these activities. Urge urinary incontinence (UUI) can occur when the person feels unable to hold their urine once they decide they need to seek out the toilet/on a full bladder ie a sudden strong urge with the inability to delay it. Individuals may experience one or many of the following:

  • Urgency (as per UUI)
  • Frequency (needing to urinate every two hours or less)
  • Pain (any discomfort such as burning, stinging or pain while urinating)
  • Nocturia (need to urinate overnight)
  • Intermittency (a stop/start urinary stream)
  • Dribbling (slight urinary leakage after urinating is completed)
  • Straining (having to push or strain to begin your urinary stream)
  • weak urinary stream (slow flow with minimal force).

The other unfortunate side effect of pelvic floor damage or weakness following prostate surgery is erectile dysfunction as this control involves the same muscles and nerves. Men may experience problems in this area following surgery.

Many men find that their symptoms can resolve or minimise within 12 months after surgery but research has proven that early pelvic floor retraining involving education and strengthening exercises can significantly shorten the time period for full recovery. This is where physiotherapy comes in and is recommended by the Prostate Cancer Foundation of Australia.

The pelvic floor is a sling of muscles and connective tissue that spans the area at the base of your pelvis. It provides support to our organs including bladder and intestines (and uterus in females). It helps control our bladder, as discussed above, as well as our rectum. It also works in conjunction with our abdominal muscles to form our ‘core.’

Our pelvic floor muscles can be trained and strengthened like any other muscle in our body. If we want strong biceps what are we going to do? Bicep curls! Want strong quads? We’re going to squat. So if we want stronger pelvic floor muscles, we need to exercise them. The trick is learning how to activate them correctly, as for many men it’s not something they’ve ever had to do or think about before. If we are doing the contractions incorrectly or imperfectly then the desired results will not be forthcoming. One of our professionally trained physiotherapists will be able to work with you to teach you the appropriate cues and techniques for your individual case to ensure correct activation of the pelvic floor muscles and monitor your progress with the goal of normalising function to allow you to return to regular daily activities and your favourite exercise or leisure activities.

In our clinic the assessment of your pelvic floor activation and the subsequent education and practice is done in a completely non-invasive manner, where the physiotherapist may simply palpate your tummy muscles, which also contract when we correctly activate our pelvic floor. Once the physiotherapist ascertains that you are able to engage the right muscles with the correct technique, they will then provide you with a personalised strengthening exercise program for you to continue at home. We will then follow you up regularly to check that progress is being made and to ensure correct technique is maintained. At these times we will also progress the difficulty of your exercises as you improve, and guide you through returning to any more demanding sports, exercise and leisure activities you may be eager to get back to.

Physiotherapy and pelvic floor strengthening exercises can be very beneficial prior to prostate removal surgery for those men who have some warning and preparation time between diagnosis and potential surgery. In this instance we would perform the same assessments and provide strengthening exercises to do to help strengthen your pelvic floor in the lead up to surgery with the idea of minimising weakness post-surgery. This is very similar to what we do with a lot of clients in the lead up to their total hip or knee replacements, strengthening the quadricep and gluteal muscles to provide a good base strength for their post-surgical recovery.

If you or someone you know are dealing with a prostate cancer diagnosis and are facing prostate gland removal, please consider seeking physiotherapy treatment in the lead up. If you have undergone prostate removal and are experiencing any adverse side effects please don’t suffer in silence, we are here to help.

Written by: Laura Black



  1. Cornel, E. B., de Wit, R., & Witjes, J. A. (2005). Evaluation of early pelvic floor physiotherapy on the duration and degree of urinary incontinence after radical retropubic prostatectomy in a non-teaching hospital . World Journal of Urology , 23(5), 353-355.
  2. https://www.pelvicpainrehab.com/male-pelvic-pain/4630/what-does-physical-therapy-do-for-men-following-prostatectomy/
  3. https://www.continence.org.au/pages/continence-management-following-prostate-surgery.html
  4. http://prostate.org.au/media/743467/physiotherapy-before-and-after-prostate-cancer-surgery.pdf
  5. Santos NA et al. Assessment of physical therapy strategies for recovery of urinary continence after prostatectomy. Asain Pac J Cancer Prev 2017;18(1):81-86. doi:10.22034/APJCP.2017.18.1.81
  6. https://www.continence.org.au/pages/continence-management-following-prostate-surgery.html
  7. Wolin, K., Luly, J., Sutcliffe, S., Andriole, G. & Kibel, A. (2010) Risk of Urinary Incontinence Following Prostatectomy: The Role of Physical Activity and Obesity. J Urol, 183(2): 629–633.
  8. http://www.prostate.org.au/ (Prostate Cancer Foundation of Australia)
  9. http://www.prostate.org.au/media/468680/understanding-urinary-problems.pdf

Are you Stable or ?

What is Stability?

Clinical stability can be defined as the spines ability under load to limit patterns of displacement in order not to damage or irritate the spinal cord and nerve roots, and to prevent deformity or pain caused by structural changes. Spinal stability is the basic requirement for the transfer of movement between the upper and lower extremities used for tasks of daily living, exercise and sports. Studies show that without any forms of ‘stability’ the human spine collapses easily.

How Does it Work?

Stability is provided in a coordinated manner by the active (e.g. muscles), passive (e.g. lumbar spine/ ligaments) and control (e.g. neurological) systems. The deep core muscular system is a 3 dimensional space comprised of:

Transversus Abdominus

  • Acts to compresses the abdominal cavity, by doing so it acts as a lumbar stabiliser in that it doesn’t actually move the trunk, but rather supports and stabilises each individual vertebrae.
  • Assists in breathing.


  • This muscle lies in between either side of the spinous processes of the spinal vertebrae, and runs along the entire length of the spine.
  • The multifidus provides stiffness, stability, and support to the spinal column.

Pelvic Floor

  • Forms the floor of the deep core, aids in supporting pelvic organs ( e.g. bladder,  intestines).
  • Assists with continence control.
  • Helps to maintain optimal intra-abdominal pressure.


  • Forms the roof if the deep core.
  • Helps control intra-abdominal pressure for optimal stabilisation support of the lumbar spine.


Why is it so important?

The inherent nature of these muscular boundaries is to produce a corset like stabilisation effect on the trunk and spine. This is important in the prevention of early biomechanical deterioration of the spine components (e.g. arthritis) and reduction of energy expenditure during muscle activity.

More over substantial evidence exists demonstrating that people with lower back pain have insufficient activation and weakening of transversus abdominus and multifidus than those without lower back pain.

Here at Nelson Bay Physiotherapy and Sports Injury Centre we believe that stability is an integral part in injury rehabilitation and prevention. As part of our services we run tailored Pilates programs to target your individual needs. For more information please ask our friendly reception staff, click here ‘Clinical Pilates’ or read our previous post ‘Personalised Pilates Men too’.

Written by: Nicole Pereira


Eunyoung, K., & Hanyong, L. (2013). The effects of deep abdominal muscle strengthening exercises on respiratory function and lumbar stability. Journal of Physical Therapy Science, 25(6), 663-665.

Chang, W.D., Lin, H.Y., & Lai, P.T. (2015). Core strength training for patients with chronic low back pain. Journal of Physical Therapy Science, 27(3), 619-622.

Izzo, R., Guarnieri, G., Guglielmi, G., &Muto, M. (2012). Biomechanics of the spine. Part 1: spinal stability. European Journal of Radiology, 82(1), 118-126.

Ramos, L.A., Franca, F,J., Callegari, B., Burke, T.N., Magalhaes, M.O. & Marques, A.P. (2015). Are lumbar multifidus fatigue and transversus abdominus activation similar in patients with lumbar disc herniation and healthy controls? A case control study. European Spine Journal, 25 (5), 1435-1442.

Southwell, D.J.; Hills, N.F.; Mclean, L. & Graham, R.B. (2016). The acute effects of targeted abdominal muscle activation training on spine stability and neuromuscular control. Journal of NeuroEngineering and Rehabilitation, 13(1), 19.

Golf Warm-Up

Improve your golf swing and recovery time with a dynamic, golf specific warm up.
Current research and thinking around pre-performance warm up has found significant benefit in a dynamic warm up – that is moving and activating your muscles, instead of your traditional stretch and hold (static stretching).
Ultimately the idea is to prime your muscles to contact quicker, more effectively and with greater control. The key here is that we are targeting the muscle unit at a neurological level.
A traditional prolonged stretch has been found to relax a muscle prior to an event, exactly when we want it to be ‘firing’. With reduced muscle activity your body relies on ligaments and joints to provide stability against the forces exerted upon it.
In a recent international study of 2000 soccer players, there was a significant reduction (30-50%) in knee reconstructions after a dynamic sport specific warm-up called the 11+.
A great introductory Golf specific dynamic warm up has been put together by Jason Glass. Please click here to watch the video and add it to your game tomorrow!

Written by: Lachlan Pappas

Running Injuries and Gait Analysis

Running is a popular fitness choice for many Port Stephens residents. It is inexpensive and requires minimal equipment and allows us to take advantage of some of our beautiful natural surrounds.

However, research suggests that between 30% and 80% of recreational runners sustain a running-related injury at some point in their training. These injuries can cause disruption to training and prevent participation in events.

Risk factors for running injuries:

Having a previous running-related injury

This is a risk factor for further injury for two reasons. Firstly, the ‘new’ injury may be an exacerbation of an old injury that was not completely recovered, or secondly, a new injury may be caused by runners changing their running pattern (gait) to protect an older injury and therefore cause a new problem.

High amount of training per week

Higher volumes of running per week are associated with an increased risk of injury due to the heavier load on joints and tissues.

‘Too much too soon’

If we gradually increase the distances that we run, our muscle, tendon, and bone cells can respond to this increased workload and increase their ‘strength’ and endurance. However, if we increase this workload too quickly, these structures can start to break down. The chart below shows the increased injury risk associated with higher rates of increased training load per week. Note that if a runner tries to double their training load each week they put themselves at a 50% chance of creating an injury!



Speed training and hills

Incorporating speed training and hill runs into training too soon or too quickly also increases the stress on our joints and soft tissue making them more prone to injury. Speed work and sprinting tends to place the runner into more of a tip-toed running gait, increasing the strain on their calf and other muscles. Hill running does a similar thing by forcing us to propel ourselves upwards, using greater amounts of force.

Gait Analysis

Gait analysis can be used to assess gait abnormalities that lead to injury.

One of our highly trained physiotherapists will be able to identify abnormalities in your gait simply by watching you run on our treadmill. Video can be used to slow down your running action for both assessment and correction purposes.

Running gait analysis can show us the following variables:

  • Cadence (step rate): This is how many steps a runner takes per minute. A lower step rate per minute has been shown to increase the load or impact through your joints when running.
  • Crossover gait: runners who tend to have a narrow step width and cross their feet over their midline have an increased risk of ITB problems and shin splints (see injuries below).
  • Alignment: this may be an excess of rotation of the runner’s hips or shoulders, or a lot of side-to-side (lateral) motion of the hips. This can be suggestive of poorer core control in running.
  • Arm swing and knee lift: variations of these can make us more or less effective in our running.
  • Stride length/foot landing: the drawing below shows the three variations in how runners land on their foot during running. A rear-foot strike has us landing on our heel, a forefoot strike has us more on our toes, and mid-foot strike is landing more on the middle of our foot. The different striking positions are associated with different injuries, and the perfect landing position is individual to each runner.


  • Posture/hip position: it is important to align our posture in running before trying to change other elements of our gait.

Common Injuries We See:

Approximately 50% of injuries we see in runners are knee injuries. Some examples are:

  • Patellofemoral pain: pain in the front of the knee and associated with the quadriceps and ITB.
  • ITB friction syndrome: friction of the iliotibial band on the outer side of the knee.

Other common running injuries include:

  • Achilles tendinopathy: damage to the Achilles tendon at the rear of the ankle.
  • plantar fasciopathy: pain in the arch of the foot, often associated with calf problems.
  • Shin splints (medial tibial stress syndrome): pain in the front of the shins, also associated with calf issues.
  • Stress fractures: can be in any loaded bone but often in the foot. Usually associated with the ‘too much too soon’ concept.
  • Ankle sprains
  • Muscle strains or tears

Early signs of an injury

  • Joint pain
  • tender to touch
  • swelling
  • Reduced ROM
  • weakness


  • Identification of modifiable risk factors .eg with a running gait analysis, can allow us to help you change elements of your gait or running style to decrease the load on certain muscles or joints and make you more efficient.


  • gait analysis to assess and correct running gait anomalies
  • Manual (hands-on) therapy.
  • Strengthening exercises tailored to the findings of your gait analysis. Your physiotherapist may diagnose a weakness in particular muscles which is causing you to fall into the poor gait patterns described above. Specific and targeted strengthening exercises will help you combat this problem.
  • modifying your footwear to suit you. Your physiotherapist can recommend the best running footwear for your foot shape, running mechanics and training load. Footwear ranges from minimalist, meaning there is minimal material beneath your foot and no change in elevation between your heel and toes, to full support which has up to an 8mm variation in the sole from heel to toe and offers a lot more cushioning.
  • Orthotics prescription. Some people who are found to over-pronate in their gait (ie. their foot rolls in and arch flattens) may benefit from the fitting of orthotics to suit their feet. The orthotics can help support these runner’s feet and assist in properly aligning their lower limbs in their running gait.

Written by: Laura Black

More of the Same or Balance?

Have you ever considered what you do each day from a movement and positioning point of view? Are you static or dynamic in your movement? Do you sit or are you on your feet during the day at work or home? For those on your feet, are you walking around, standing still, doing lots of bending and lifting?


As our day-to-day life becomes more technologically involved, the Western world is becoming more sedentary with more and more time spent sitting. Research has identified the benefits of standing versus sitting, and similarly the benefits of movement versus static positioning, to our overall health. So do you need to do more moving in your day, should you consider a change in your exercise habits to balance your spinal position better through the day or week?


• Activity 1: list the physical positions you spend your day/week in, in the order of events. Take into account the time from when you rise to the time you return to bed each day but exclude any exercise.

• Activity 2: list all your exercise during the course of a typical day/week, again listing the activities in order of most to least.

• Activity 3: analyse your exercise activities and write down the position of your body during these activities. For example, are you standing/upright, sitting, lying, bending, etc.

• Activity 4: analyse the results. Are you balancing and countering the positions of your body during your normal daily activities with the positions of your body during your exercise?

There is a lot to be said for the old saying of ‘everything in moderation’ when it comes to movement. The Australian Physiotherapy Association slogan ‘Move Well Stay Well’ is an excellent memory verse for this area of your life. Many of the injuries that we incur happen through an accumulation of moving poorly until finally we hit breaking point and seek help. Can you avoid this by paying more attention to your movement habits?

Thoughts by Scott Ward

Exercise alone is not enough

Reading the cover of Time Magazine several years ago I noticed a title: ‘The Myth of Exercise and Weight Loss’. Naturally it captured my attention and I read the article. It went on to explain that many people perform great exercise but quickly undo their good work with a coffee and cake or similar afterwards, effectively consuming near enough or more calories in 5 minutes than they burnt off in their entire bout of exercise. Remember that maintaining a healthy weight and level of fitness is not possible without the combination of consistently having a good exercise regime, a healthy diet and a strong mind.

Thoughts by Scott Ward

Finding the balance in movement

You may have considered what your life looks like in the overall balance of what you do, and how you balance your time and energy with family and friends, work, rest and recreation, personal development, etc. But have you ever considered the balance of what you do within the realm of those subgroups, and more specifically in relation to your health and fitness?

Old habits die hard – mental v. physical

There are many benefits to exercise, both physically and mentally and we need to ensure we are getting the most out of it. Old habits die hard and often when it comes to it we stick to doing what we know and what we enjoy, repeating it over and over again several days a week, every week to achieve our exercise goals. But to a certain degree this doesn’t really work for most. You may find that your fitness time is compromised, not because you don’t recognise the need to do it, but more because you become tired of doing the same thing over and over again and lose your motivation. Perhaps this is when you need to change your fitness activities by engaging a friend, or even by joining a club/gym/group and making a financial commitment to the cause. For many, however, failure happens because of a lack of mental stimulation. For example, if you’re a walker or a runner and you go away for a short getaway, how much easier is it to pound the pavement in a new, unfamiliar and stimulating environment? The same can happen when you listen to some good music, or an audiobook whilst exercising. The time ticks by really quickly and before you know it your time has elapsed and you have moved further and with greater ease than when you’re back at home plodding along the same old beaten track. The mental stimulation helps the physical performance. The same is true of the reverse and Health & Fitness by many of you will attest to the improvement in mental state and productivity that follows a period of sustained physical exertion.


Review your exercise regime. Is it merely routine or fresh? Do you need to change the environment you exercise in, the type of exercise you perform or make healthy choices about when you do that exercise to gain the best of the benefits in the rest of your life? Or perhaps you also need to review what you do after that exercise?

Thoughts from Scott Ward


Is 10,000 steps enough?

Now that’s a question. With all the wearable technology at present that has become more affordable, this mark has become somewhat of a target for people measuring their daily activity. But is it relevant? Click here to read more about how this mark was derived, whether the distance or intensity of your exercise is more important and what to do if your are consistently achieving your target.

Foam Roller Exercise

They are inexpensive, can be used for a massage, to make you stronger and more flexible. Read this article where Holly Brasher, Australian Physiotherapy Association Sports Physiotherapist, speaks of the benefits of foam rollers to your health. Do you own a foam roller? Come in and get one from us and help yourself to better health. Available in long and short lengths.

Pilates Pereira

Completion of Pilates

Nicole recently completed her training in Pilates enabling her to pass on her skills and knowledge to the clients of Nelson Bay Physiotherapy & Sports Injury Centre. Here’s some of Nicole’s thoughts on the Pilates method…..

“Mid this year, I was honoured to have completed my Pilates training under the guidance of Lisa Ward. It was so fascinating to learn both the theoretical and practical side to the Pilates method. Below are a few interesting facts I learnt through my training that you may not know:

  • The method took 40 years to develop, by a man named Joseph Pilates.
  • An important concept of Pilates is mind control over muscles (our current Pilates clients would understand this!). As said by Joseph Pilates himself; “ideally our muscles should obey our will. Reasonably our will should not be dominated by the reflex actions of our muscles. “
  • Pilates exercises reawakens thousands of dormant muscle cells (by activating particular muscle groups). Correspondingly we stimulate further function of the mind J
  • “Good posture is acquired when the body mechanisms are under perfect control – just as a smooth running automobile engine is a result of the proper parts correctly assembled together so that it operates with a minimum consumption of gasoline and oil and comparatively little wear” – An analogy of the results gained through Pilates.

I’m having such a great time teaching and seeing the benefits of Pilates. An exercise beneficial for all ages and fitness levels. Any further questions, please don’t hesitate to ask”.

Are sit-ups bad for you? The US Navy seems to think so

Sit-ups are an abdominal exercise often mistaken to be reflective of having good core strength. The US Navy is reviewing their  presence in fitness testing protocol because of the loading on the the lower back.

The presence of a six-pack and the performance of sit-ups and other more generalised ‘global’ abdominal exercises such as the ‘plank’ can create a false reading of someone’s true core stability.

What is ‘core stability’? Core stability refers to your deep abdominal muscles (transverses abdominus, and internal oblique), pelvic floor and deep lower back muscle (multifidus) ability to stabilise the spine in it’s neutral lordotic backwards curved position during task performance.

The body has muscles that stabilise and muscles that move the body. The further the muscles lie away from joint over which they cross the greater the movement force they produce at the joint. Whereas, the closer they are to the joint the greater they compress the joint and stabilise it. This is the difference between the deep muscles of your body and the more superficial muscles (in most cases) and therefore the reason why the muscles that are the prime movers of the body are the muscles we can often see. Sometimes what’s out of sight is out of mind!

Therefore, like an apple that you pick up in the supermarket with a firm skin and take home to find later when you bite in that it’s rotten inside, the perception of core stability can be very similar. For your health and true core stability you need to start on what’s inside and deep to stabilise your spine and then work out towards the more superficial and movement muscles of your body. So it’s deep first working on specifics in a safe and neutral position, then once mastered adding global strength via these movement muscles. This is true core strengthening.

Part of muscle training and strength is neuromuscular training. Training to reinforce the same incorrect muscle recruitment patterns will create more harm than good. So not only do you need to train the deep muscles first, you need to often work on disengaging the other muscles as well before moving forward.

Plank may be safer and easier to monitor but it trips the brain into turning everything on and can reinforce those same poor muscle recruitment patterns. True training requires specific instruction, expert supervision AND small classes (no greater than 3-5). There is no one in our community that has the level of knowledge and expertise in body biomechanics and core stability as our physiotherapy pilates teachers. We speak with the best knowledge available and often treat many clients who have been elsewhere with adverse effects.

What do you think of the linked article? Click here to read. Correct about neutral with the plank but we need to train core strength to stabilise your spine as your limbs move, not just in a set static position. This sort of training only improves strength at the joint position you train.

Be more specific and enrol in our Pin Point Pilates classes today. Give us a call or e-mail reception today with your interest. Classes run most days of the week including Saturdays.

Back to school: Start the new year active and healthy

Almost all young Australians , including pre-schoolers, are not as physically active as they should be with 9 out of 10 young Australians sitting too much and not moving enough, according to the recommended Australian guidelines. A change towards sedentary lifestyles has happened for many people in many developed countries, including Australia [Australian Institute of Health and Welfare (2004) as cited in 2]. With improved access to mobile phones and the internet, children do not need to leave home to keep in contact with their friends outside of school. Children today are far less likely than children of earlier generations to walk or cycle to get from A to B, or to play outdoors [2].

Instead, children are spending more than the recommended two hours each day using electronic media. The SPANS study in New South Wales found that 61 per cent of boys and 45 per cent of girls in year six (aged approximately 11–12 years) were using more than two hours per day of electronic media. This percentage was higher in older age groups: in year 10, 78 per cent of boys and 67 per cent of girls fell into this group [2].

This increased screen time, combined with a lack of physical activity, can lead to young children being overweight, which often continues into adulthood [3]. In Australia, more than 1 in 4 children and adolescents are overweight or obese and it is predicted that 65 per cent of young Australians will be overweight or obese by 2020 [4]. Increases in the number of overweight and obese children leads to an increasing number of children who suffer with illnesses – including diabetes, asthma and mental health problems -as well as physical pain in muscles and joints, such as back pain [2]. Even type 2 diabetes – a chronic disease traditionally diagnosed only among adults – is now increasingly being detected in Australian children. Research also shows that overweight and obese children are more likely to be overweight or obese adults. Around 80 per cent of Australia’s obese adolescents will become obese adults [4]. This in turn can lead to a number of serious chronic conditions and even premature death [2].

Keeping children physically active

National guidelines for physical activity recommend infants and preschool children be physically active for at least three hours daily [5] and older children at least one hour [1, 6, 7]. The benefits of physical activity are enhanced further when children are more physically active than these recommended times [7]. The guidelines also provide recommendations for the types of physical activity that are appropriate for children.

National guidelines for sedentary behaviour recommend infants and preschool children should not be sedentary, restrained, or kept inactive for more than one hour at a time [5], and for older children these sedentary activities should be broken up as much as possible [1, 6]. These guidelines also recommend that the amount of time children spend sitting and watching television and using other electronic media (DVDs, computer and other electronic games) should be limited to one hour daily for infants [5] and preschool children and two hours daily for older children [1, 6].

Participation in physical activity

It is widely accepted that being physically active provides numerous health benefits. These have been described in a review by Buhlert-Smith, Hagiliassis [8] whose summary is based on works of the Australian Government Department of Health [6], the Centre for Community Child Health [3] and the World Health Organization [7], including:

Social benefits:

  • creates opportunities for social interaction, making friends and having fun
  • reduces anti-social behaviours
  • develops cooperation and teamwork skills

Emotional and intellectual benefits:

  • improves self-expression
  • improves self-esteem, confidence and independence
  • improves management of anxiety, stress and depression
  • improves concentration
  • promotes relaxation

Health benefits:

  • improves physical fitness by improving heart and lung functions
  • improves balance, coordination and movement skills
  • improves posture
  • improves flexibility
  • builds stronger muscles and bones
  • promotes healthy joint tissues
  • promotes healthy growth and development
  • reduces the risk of unhealthy weight gain by controlling the expenditure of energy
  • reduces the risk of developing type 2 diabetes and cardiovascular diseas

An active commute – walking or riding to school

Increased use of cars and the associated reduction in physical activity participation is a crucial factor in the rise in childhood obesity [4]. An easy way for school children to increase their physical activity participation is to walk or ride to school, but this type of commute is also in significant decline, with the 2015 Active Healthy Kids Australia [11] study finding:

  • 42 per cent decline in children walking or riding a bike or scooter to or from school, in the past 40 years, with no signs of this decline slowing down [11, p.18]
  • only 50 per cent of children and young people in Australia use active transport (bike, scooter) at least once a week to travel to or from school [11, p.11]
  • just 11 per cent of children ride a bike to or from school, however 90 per cent of Australian households have at least one child’s bike in working order [11, p.6]

The Australian Physiotherapy Association (APA) strongly advises parents to encourage their children to walk, ride a bike or scooter to school daily as an easy way for them to increase their physical activity participation. The study also found that active transport (through walking or riding a bike or scooter) provides a key contribution to the overall physical activity levels of children and young people in Australia and is feasible, given it can be easily incorporated into daily routines with minimal planning prior and involves little to no financial cost [11].


Reference list

  1. Australian Government Department of Health, Australia’s physical activity and sedentary behaviour guidelines 13-17 years, Department of Health, Editor. 2014, Department of Health: Canberra, Australia.
  2. Australian Government Australian Institute of Health and Welfare, Australia’s health 2006, Australian Institute of Health and Welfare, Editor. 2006, Australian Institute of Health and Welfare: Canberra, Australia.
  3. Centre for Community Child Health. Movement and exercise for kids. 2015; Available from:http://www.rch.org.au/ccch/growthrive/movement_exercise/movement_exercise_for_kids.
  4. Better Health Channel. Obesity in children – causes. 2013; Available from: https://www.betterhealth.vic.gov.au/health/healthyliving/obesity-in-children-causes.
  5. Australian Government Department of Health, National physical activity recommendation for children 0-5 years, Department of Health, Editor. 2014, Department of Health: Canberra, Australia.
  6. Australian Government Department of Health, Australia’s physical activity and sedentary behaviour guidelines 5-12 years, Department of Health, Editor. 2014, Department of Health: Canberra, Australia.
  7. World Health Organization, Global recommendations on physical activity for health 5-17 years. 2010, World Health Organization: Geneva, Switzerland.
  8. Buhlert-Smith, K., N. Hagiliassis, and J. Pegler, Move, Play & Thrive. Literature review in preparation. 2016, Scope: Melbourne, Australia
  9. Rimmer, J.H., et al., Physical activity participation among persons with disabilities: barriers and facilitators. American Journal of Preventive Medicine, 2004. 26(5): p. 419-425.
  10. World Health Organization, Global recommendations on physical activity for health. 2010, World Health Organization: Geneva, Switzerland.
  11. Active Healthy Kids Australia, The road less travelled. The 2015 progress report card on active transport for children and young people. 2015, Active Healthy Kids Australia: Adelaide, South Australia.
  12. Better Health Channel. Back pain – school bags. Available from: http://www3.betterhealth.vic.gov.au/bhcv2/bhcpdf.nsf.
  13. American Academy of Orthopaedic Surgeons. Ortho info. Backpack safety. 2015; Available from: http://www.orthoinfo.aaos.org/topic.cfm?topic=a00043.
  14. Education Queensland. Health and Safety Fact Sheet. Heavy school bags. 2012; Available from: http://www.education.qld.gov.au/health/pdfs/healthsafety/factsheet_hevbags.pdf.
  15. Osteopathy Australia. Back(pack) to school – tips on how to pick a backpack for your child. 2014; Available from: http://www.osteopathy.org.au/data/Media/PressReleases/Packpack_to_School__Tips_How_To_Pick_a_Backpack_For_Your_Child.pdf.
  16. American Occupational Therapy Association. Backpack safety: stats on injuries. 2015; Available from: http://www.aota.org.au/conference-events/backpack-safety-awareness-day/handouts/infographic-injury-stats.aspx.
  17. Wiersema, B., E. Wall, and S. Foad, Acute backpack injuries in children. Pediatrics, 2003. 111(1): p. 163-166.

Spring Free Trampolines

Imagine bringing home the benefits of therapy while having fun! From sensory stimulation, balance and motor development to encouraging socialisation and family bonding; the benefits of bouncing are well documented.

At Springfree® Trampoline we believe that every child should have the opportunity to harness the benefits of bouncing – in the safest possible way! We are proud to be partnering with Nelson Bay Physiotherapy and Sports Injury Centre and thank them for supporting our goal of reducing the number of trampoline related injuries one backyard at a time.

Fun for kids and peace of mind for mums and dads

Redesigned from the ground up, Springfree is the only trampoline that has successfully removed all the impact areas and hazards seen in traditional trampoline and replaced them safe alternatives, reducing the risk of product related injury by 90%. And that’s why Springfree is the world’s safest trampoline.

Why Support the Partnership?

The benefits of Springfree Trampoline’s Health Professionals Program are threefold. For Nelson Bay Physiotherapy and Sports Injury Centre it means funds to assist them in providing support to their community.

For your child, the trampoline is a therapeutic tool that is also fun! With the coolest, most enjoyable activity around they won’t even realise that it’s therapy in disguise.

And for you, a Springfree Trampoline means peace of mind. You know your child is safe while they jump, and that the premium quality of a Springfree will support their development and wellbeing long into the future … and you just can’t beat those big smiles on their little faces!

If you’re thinking of a Springfree Trampoline for your family, be sure to quote ORGP107 when you make your purchase.

Personalised Pilates, Men too

Wow! What progress. Great to see so many people making excellent gains in strength, stability and functional capacity through real commitment to their exercise and having such fun doing it. You have two awesome instructors.

Recently, it has become evident that people are really improving their quality of life through regular participation in our Pilates classes. The men too! For those men out there who think that Pilates is just for ‘latte sipping, well to do women’ only you really need to change your thinking. I’d suggest you talk to those men currently participating in our general classes, check out pictures of Joseph Pilates and also read this article in Mens Fitness.

To everyone, stay tuned for the personalised sessions that are coming soon. For those of you who may not know, express your interest by calling reception today.