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• Begin by laying on your back.
• Bring your arms overhead.
• Slide your legs to the unaffected side.
• Slide your arms to the same side creating a “banana shape”
• For a deeper stretch, cross one outside leg over the inside leg.
• Repeat this or on the other side as advised by your Physiotherapist.

Instructions

• Stand on a firm surface with your feet together
• Take a moment to find your balance with your eyes open
• When you’re ready, gently close your eyes for 30sec
• Stand near a stable surface (like a kitchen bench or wall) for safety

What is concussion?

A concussion is a type of brain injury that happens when a person experiences a direct hit to the head or a heavy impact to the body that causes the brain to move inside the skull.

How to know if you are concussed?

It’s important to know that loss of consciousness happens in fewer than 10% of concussion cases. So, a player doesn’t need to be knocked out to have a concussion.

Concussion usually doesn’t show up on scans like CT or MRI, as it affects how the brain functions rather than causing visible damage. Symptoms can include confusion, headache, dizziness, blurred vision, nausea, fatigue, memory problems, and feeling mentally foggy or “not quite right.” Observable signs might include unusual behaviour, lying motionless, a vacant stare, or poor balance.

Why is concussion management so important?

Effective concussion management is vital to reduce the risk of serious complications. Returning to play too soon can increase the chance of another concussion, prolong symptoms, and, in rare cases, lead to dangerous brain swelling—especially in younger athletes. Poorly managed concussions are also linked to long-term mental health issues and may contribute to brain degeneration later in life. While research is ongoing into conditions like Chronic Traumatic Encephalopathy (CTE), it’s clear that proper diagnosis, rest, and medical clearance before returning to sport are essential to protect both short- and long-term brain health.

How can Peak Physio help?

Standardised assessment tools

• SCAT6 in the first 72 hours/3 days post injury
• SCOAT6 beyond 72 hours/3 days post injury

Additional assessment:

• Neck/Cervical Spine
• Headaches
• Vestibular/Visual System
• Balance
• Exercise Tolerance
• Psychosocial Factors including thinking, mood and mental health

Treatment:

• Graded exposure/pacing
• Exercise
• Education and guidance
• Manual therapy (including massage and mobilisation)
• Vestibular management
• Correspondence and liaison with other medical professionals and your sporting organisation
• Referral to other specialists as required

Graded return to activity and sport

Your physiotherapist will guide you through a graded progression of both cognitive and physical exertion with criteria to progress through each stage

• Relative rest
• Daily activities
• Light aerobic exercise
• Moderate aerobic exercise
• High intensity aerobic exercise
• Non contact –> Limited contact –> Full contact training
• Return to play

Returning to play

Requirements as per the AFL

• Completed all stages of the return to play process
• Minimum 21 days after injury with the injury date being day “0”
• Obtained a medical clearance before returning to play (from a medical doctor)

Requirements as per Rugby Australia

• Blue Card triggers Concussion Management Procedure (CMP)
• CMP requires all players with potential head injury, concussion or suspected concussion to be assessed by an appropriately trained healthcare practitioner (e.g., medical doctor or physiotherapist) within 72 hours of the injury for an initial assessment.
• For adults aged 19 and over: the minimum period before return to play is 12 days
• For children and adolescents aged 18 and under: the minimum period before return to play is 21 days.
• Medical clearance required before returning to play (from a medical doctor)

We are here to help

If you or someone you know has experienced a concussion and need assistance please get in touch with us to discuss how we can help

Hip labral disorders are conditions affecting the acetabular labrum, a fibrous cartilage that lines the acetabulum (the socket of the hip joint). The labrum plays a crucial role in hip joint stability, shock absorption, and the distribution of pressure across the joint. Damage to the labrum, often caused by trauma, overuse, or structural abnormalities, can lead to pain, reduced mobility, and eventual joint degeneration.

Signs & Symptoms

Patients with hip labral disorders typically present with the following signs and symptoms:

• Pain:
  • More than 90% of individuals experience pain in the anterior hip or groin.
  • Less commonly, pain is felt laterally or deep in the posterior buttocks.
  • Women may report concurrent pelvic floor pain.
  • The pain is often described as a constant dull ache with intermittent sharp episodes.
  • Night pain occurs in 71% of patients.
• Mechanical Symptoms:
  • Clicking, locking, or catching sensations in the hip.
  • Feeling of instability or “giving way” in the joint.
• Functional Limitations:
  • Limping in 89% of cases.
  • Difficulty climbing stairs (67% require support).
  • Walking distance and prolonged sitting are often limited.
  • Aggravation of symptoms with activities such as running, pivoting, or prolonged sitting.
• Range of Motion (ROM) Restrictions:
  • Limited rotation is commonly noted during assessment.

Causes and Contributing Factors

Several factors can contribute to the development of hip labral disorders:

1. Structural Abnormalities:
   • Femoroacetabular Impingement (FAI): Abnormal bone shapes in the hip joint can increase stress on the labrum.
   • Acetabular Dysplasia: A shallow hip socket reduces joint stability.
2. Trauma:
   • High-impact injuries, such as those from contact sports or falls, can tear the labrum.
   • Dislocations or subluxations often damage the labrum.
3. Capsular Laxity or Hypermobility:
   • Looseness in the joint capsule can lead to excessive movement and strain on the labrum.
4. Degeneration:
   • Wear-and-tear from repetitive movements or ageing can weaken the labrum over time.
5. Biomechanical Factors:
   • Gait abnormalities, poor foot alignment, or pelvic instability can increase hip joint stress.

Diagnosis

Accurate diagnosis of hip labral disorders is essential for effective treatment. The most reliable diagnostic methods include:

• Clinical Assessment:
  • Thorough history and physical examination to identify signs and symptoms consistent with labral tears.
• Imaging:
  • Magnetic Resonance Imaging (MRI): A 3-Tesla (3-T) MRI provides the highest sensitivity for detecting labral tears.
  • Magnetic Resonance Arthrography (MRA): Combines MRI with the injection of contrast dye into the joint, offering superior accuracy in identifying labral abnormalities.
  • X-ray and CT Scan: Useful for assessing structural abnormalities like FAI or acetabular dysplasia but less effective in visualising soft tissue.
• Hip Arthroscopy:
  • Considered the gold standard for diagnosis and treatment, arthroscopy allows direct visualisation of the labrum but is reserved for cases where other diagnostic methods are inconclusive.

Grading of Labral Tears

Labral tears can be classified by their location, morphology, or cause:

• By Location:
  • Anterior tears: Most common due to poor vascular supply and high mechanical stress.
  • Posterior tears: Often associated with trauma or dislocation.
  • Superior/Lateral tears: Less common but occur under specific loading patterns.
• By Morphology:
  • Classified as radial, longitudinal, or degenerative based on the tear’s shape and extent.
• By Cause:
  • Traumatic, degenerative, or related to structural abnormalities.

Physiotherapy

Physiotherapy plays a central role in the conservative management of hip labral disorders. Goals of treatment include reducing pain, improving joint stability, and enhancing functional capacity. A comprehensive physiotherapy program typically includes:

1. Activity Modification:

• Avoid pivoting, twisting, and other movements that increase stress on the labrum.
• Educate patients on ergonomic movements and proper biomechanics during daily activities.

2. Strengthening Exercises:

• Focus on the hip, core, and lower limb muscles to stabilise the joint.
• Gradually progress from non-weight-bearing exercises (e.g., bridges) to weight-bearing exercises (e.g., squats or lunges).
• Functional training specific to the patient’s goals, such as running or stair climbing.

3. Mobility and Flexibility:

• Stretch tight hip flexors, hamstrings, and pelvic muscles.
• Joint mobilisation to improve hip, pelvis, and lumbar spine movement.

4. Gait Training:

• Correct abnormal walking patterns.
• Incorporate orthotics, taping, or shoe modifications to improve foot mechanics.

5. Proprioception and Balance:

• Use balance boards, foam surfaces, or dynamic exercises to enhance joint awareness and stability.

6. Pain Management:

• Techniques such as heat, ice, or manual therapy may be used to manage pain during treatment.

Physiotherapy is typically recommended for 12-24 weeks before considering surgical options.

Surgical Management

Surgery is considered when conservative treatments fail to alleviate symptoms or if functional limitations persist. Common procedures include:

• Labral Repair:
  • The torn portion of the labrum is sutured back into place to restore joint stability.
• Labral Debridement:
  • Damaged or frayed parts of the labrum are trimmed away.
• Hip Arthroscopy:
  • A minimally invasive procedure used for both diagnostic and therapeutic purposes.
• Addressing Underlying Causes:
  • Procedures to correct FAI or acetabular dysplasia may be performed alongside labral repair.

Prognosis

The prognosis for hip labral disorders varies based on the severity of the tear and the treatment approach. Key findings include:

• Mild to Moderate Tears:
  • Respond well to physiotherapy, with significant improvements in pain and function.
• Severe Tears:
  • May not show substantial improvement with conservative management alone.
  • Surgical intervention may be necessary for symptom relief and functional recovery.

Long-term untreated labral tears are associated with an increased risk of early-onset osteoarthritis (OA) due to joint instability and increased cartilage stress.

Information is provided for education purposes only. Always consult your physiotherapist or other health professional.

References: 

Byrd, J. W., & Jones, K. S. (2009). Hip arthroscopy for labral pathology: Prospective analysis with 10-year follow-up. Clinical Orthopaedics and Related Research, 467(3), 747–753. https://doi.org/10.1007/s11999-008-0470-5

Martin, R. L., Enseki, K. R., Draovitch, P., Kelly, B. T., Philippon, M. J., & Boykin, R. E. (2022). Acetabular labral tears: Physical therapy management. International Journal of Sports Physical Therapy, 17(2), 193–202. https://doi.org/10.26603/001c.33672

Griffin, D. R., Dickenson, E. J., O’Donnell, J., Agricola, R., Awan, T., Beck, M., … & McCarthy, C. (2021). The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): An international consensus statement. British Journal of Sports Medicine, 55(1), 1–18. https://doi.org/10.1136/bjsports-2019-101690

Discitis is a rare condition, characterised by an infection of intervertebral discs in our spine. These discs seperate our vertebrae; the bones in our spine, and act like a pillow to allow movement, absorb shock and transmit loads through our spinal column. Therefore, infection and subsequent inflammation can result in high levels of discomfort and pain. As these discs receive minimal blood supply, our immune cells and medications have difficulty travelling to the site of the infection, so recovery can be a long process. However, through receiving treatment through a team of qualified health practitioners, full rehabilitation is possible.

Signs and Symptoms

The symptoms of discitis can vary greatly, with pain levels varying from mild discomfort to high levels of pain. The severity is largely dependant on a few factors, including how progressed the condition is (depending on the time to detection), age and immune status. Most common signs and symptoms include:

• Localised neck and/or back pain (depending on the disc infected): Generally, this is a gradual onset that can progress to unbearable, severe levels of pain
• Fever and/or chills
• Loss of appetite and/or weight loss
• Night pain
• Fatigue
• Stiffness / limited range of motion in the neck and/or back
• Neurological deficits: This can include muscle weakness, reduced sensation and impaired reflexes depending on the areas of the body supplied by the specific spinal level affected. However, this is less common

Diagnosis

Diagnosis comprises of a comprehensive medical exam from a registered practitioner, including:

• Blood Tests: Which look specifically at your levels of CRP and ESR. High levels indicate inflammation in the body.
• Magnetic Resonance Imaging (MRI): Which show disc inflammation.

Causes and Contributing Factors

In most cases, the infections are either caused by:

• Contiguous spread: meaning infection spread from an infected area close by e.g an infection of vertebrae (osteomyelitis)
• Hematogenous spread: meaning the infection was spread through the bloodstream from another site of infection e.g pneumonia, urinary tract infections
• Direct inoculation: meaning from direct contact and subsequent infection to the area e.g through spinal injections, diagnostic lumbar punctures or spinal surgeries

Contributing factors include:

• Increased alcohol intake
• Immunocompromised individuals
• Intravenous drug users
• Renal (kidney) dysfunction
• Hepatic (liver) cirrhosis
• Cancer
• Type 2 Diabetes Mellitus
• Autoimmune diseases
• > 50 years old

Prognosis

Prognosis is varying. It largely depends on the severity of the condition, how early it was detected and whether you have other Risk Factors (mentioned above) that can impact your bodies ability to fight infection.

(Samy et al., 2021) strongly recommend that your medical team closely monitor you for a year-post to monitor improvement and deterioration.

Treatment

Medical Treatment

• IV Antibiotics: This is the standard treatment, which will help you fight the infection. This is generally provided at an infusion centre, Hospital In The Home (HITH) or other in-home nursing services. This generally lasts 6 – 8 weeks.
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): These medications, such as ibuprofen, may also be prescribed. This can reduce both pain and inflammation, providing relief from pain, stiffness and discomfort.
• Surgery: This is the considered in cases where all other treatment fails or complications arise, such as neurological deficits, spinal instability, or abscess formation (formation of an infection pocket). Procedures may involve debridement (removal) of infected tissue and stabilisation of the spinal column.

Physiotherapy Management

Physiotherapy plays a pivotal role in the rehabilitation of patients with discitis, aiming to restore mobility, strengthen muscules, and enhance functional independence. A comprehensive physiotherapy treatment may include:

• Pain Management: Utilisation of modalities such as manual therapy, bracing and therapeutic exercises to alleviate pain and reduce inflammation.
• Mobilisation Exercises: Gentle, progressive exercises designed to improve spinal flexibility and range of motion, tailored to your tolerance and stage of recovery.
• Strengthening Programs: Targeted exercises aimed at improving strength and stability, to support spinal structures and prevent deconditioning.
• Functional Training: Activities aimed at improving the your ability to perform daily tasks safely and effectively, thereby helping you achieve individualised goals and enhancing quality of life.

References

Aagaard, T., Roed, C., Dahl, B., & Obel, N. (2016). Long-term prognosis and causes of death after spondylodiscitis: A Danish nationwide cohort study. Infectious diseases (London, England), 48(3), 201–208. https://doi.org/10.3109/23744235.2015.1103897

Berbari, E. F., Kanj, S. S., Kowalski, T. J., Darouiche, R. O., Widmer, A. F., Schmitt, S. K., Hendershot, E. F., Holtom, P. D., Huddleston, P. M., Petermann, G. W., Osmon, D. R., & Infectious Diseases Society of America. (2015). 2015 Infectious Diseases Society of America (IDSA) clinical practice guidelines for the diagnosis and treatment of native vertebral osteomyelitis in adults. Clinical Infectious Diseases, 61(6), e26–e46. https://doi.org/10.1093/cid/civ482

Cornett, C. A., Vincent, S. A., Crow, J., & Hewlett, A. (2016). Bacterial spine infections in adults: Evaluation and management. Journal of the American Academy of Orthopaedic Surgeons, 24(1), 11–18. https://doi.org/10.5435/JAAOS-D-13-00102

Samy, D. A., Gandham, S., & DeMatas, M. (2021). The diagnosis and management of discitis and spinal infection. Surgery (Oxford), 39(8), 540-546. https://doi.org/10.1016/j.surge.2021.05.008

Zimmerli, W. (2010). Clinical practice. Vertebral osteomyelitis. The New England Journal of Medicine, 362(11), 1022–1029. https://doi.org/10.1056/NEJMcp0910753

The plantar plate is a strong, fibrous ligament located in the ball of the foot, beneath the metatarsophalangeal (MTP) joints. It plays a crucial role in stabilising the toes and preventing excessive dorsiflexion (upward bending). A plantar plate injury occurs when this ligament is overstretched, partially torn, or completely ruptured. This condition most commonly affects the second toe but can also involve the third and fourth toes. Left untreated, plantar plate injuries can lead to deformities such as hammertoe, claw toe, or crossover toe.

Signs & Symptoms

A plantar plate injury presents with a variety of symptoms, which can vary depending on severity.

• Pain in the ball of the foot – Often described as an aching or bruised sensation, typically localised around the affected MTP joint.
• Swelling (oedema) – Mild to moderate swelling may occur, particularly on the top (dorsal) and bottom (plantar) aspects of the foot.
• Pain with weight-bearing activities – Walking, running (especially forefoot running), dancing, or jumping can increase discomfort.
• Pain relief with rest – Symptoms improve when non-weight bearing.
• Increased pain with certain footwear – High heels, open-toe shoes, and flexible shoes (such as minimalist running shoes) can aggravate symptoms.
• Reduced toe strength – The affected toe may not be able to grip the ground effectively. This can be assessed with the ‘Digital Purchase Test’, where a piece of paper is placed under the toe, and the patient is asked to resist its removal. A weak plantar plate allows the paper to slide out easily.
• Toe deformity – In more advanced cases, the toe may start to lift off the ground (floating toe), drift sideways (Churchill sign), or develop a hammertoe or claw toe appearance.
• Positive Lachman’s or Vertical Stress Test – These tests, performed by a clinician, assess joint stability and are useful in diagnosing plantar plate injuries.

Causes & Contributing Factors

Plantar plate injuries often develop due to repetitive stress rather than a single traumatic event.

Biomechanical Factors

• Forefoot loading – Excessive force through the front of the foot, often seen in forefoot runners, dancers, and athletes engaging in high-impact activities.
• Toe deformities – Conditions like hallux valgus (bunions) can shift weight away from the big toe, increasing stress on the second and third MTP joints.
• Metatarsal length variations – A longer second or third metatarsal (such as Morton’s toe) increases the likelihood of plantar plate overload.
• Tight calf muscles – Limited ankle dorsiflexion can cause compensatory changes in gait, leading to excessive pressure on the forefoot.

Footwear & External Factors

• High heels – Elevating the heel places excessive stress on the forefoot, increasing plantar plate strain.
• Minimalist or flexible shoes – These provide less support and can contribute to excessive dorsiflexion of the MTP joints.
• Barefoot walking on hard surfaces – Lacking shock absorption can increase stress on the plantar plate.

Other Risk Factors

• Ageing – Ligament elasticity decreases with age, making injuries more likely.
• Gender – Women are more commonly affected, possibly due to footwear choices (e.g., high heels).
• Inflammatory conditions – Rheumatoid arthritis and other inflammatory joint diseases can weaken ligaments and contribute to plantar plate injuries.

Imaging & Diagnosis

Accurate diagnosis of plantar plate injuries often requires imaging, as clinical tests alone may not detect the severity of the injury.

X-ray

• Weight-bearing X-rays (lateral or oblique views) may show dorsal subluxation of the proximal phalanx on the metatarsal head.
• An anterior-posterior X-ray can reveal a transverse toe deformity.
• X-rays help rule out other causes of forefoot pain, such as fractures or arthritis.

Ultrasound

• A dynamic and cost-effective imaging option for diagnosing plantar plate injuries.
• Allows real-time assessment of ligament integrity and MTP joint stability.
• Operator-dependent, meaning accuracy can vary between practitioners.
• Sensitivity: ~93%, Specificity: ~33%.

MRI (Magnetic Resonance Imaging)

• The most reliable imaging method for diagnosing plantar plate injuries, providing a comprehensive view of soft tissue structures.
• Highly sensitive for detecting partial or full-thickness tears.
• Sensitivity: ~95%, Specificity: ~54%.
• A short tau inversion recovery (STIR) sequence can increase sensitivity and specificity for detecting plantar plate injuries.
• MRI is more expensive than ultrasound but provides a clearer picture of surrounding structures.

Clinical Considerations in Imaging

• One study found that 35% of asymptomatic individuals had plantar plate injuries, raising questions about whether all diagnosed cases require treatment.
• Imaging should be used in conjunction with clinical symptoms to guide management decisions.

Grading of Plantar Plate Injuries

Several classification systems exist to assess the severity of plantar plate injuries. The two most widely used are:

Thompson & Hamilton Classification

• Stage 0 – No visible displacement of the toe.
• Stage 1 – Subluxation (partial dislocation) of the joint is possible, but the toe remains in place.
• Stage 2 – The toe can be fully dislocated but remains reducible (can be put back into place).
• Stage 3 – The toe is in a fixed dislocated position and cannot be realigned manually.

Yu & Judge Classification

• Stage 1 – Mild swelling and tenderness with no visible deformity.
• Stage 2 – Moderate swelling with noticeable deviation of the toe.
• Stage 3 – Severe swelling with significant toe displacement or dislocation, often leading to permanent deformity.

Prognosis

The prognosis for plantar plate injuries depends on the severity of the tear and the effectiveness of treatment.

• Mild to moderate injuries (Stages 0–1) – Generally respond well to conservative treatment, with symptoms improving over several months.
• Moderate to severe injuries (Stages 2–3) – May require more intensive management, including prolonged offloading, orthotics, or surgical intervention.
• Chronic cases with deformity – If left untreated, persistent instability can lead to hammertoe, claw toe, or crossover toe, which may require surgical correction.

Return to normal activities varies:

• Mild cases – 6–12 weeks with appropriate rehabilitation.
• Moderate cases – 3–6 months.
• Severe cases or post-surgical recovery – 6–12 months before full return to high-impact activities.

Treatment

The primary goal of treatment is to offload the plantar plate and promote healing while maintaining toe function.

Conservative Management

• Activity modification – Avoid barefoot walking and high-impact activities for at least six weeks.
• Footwear advice – Use stiff-soled shoes or rocker-bottom shoes to reduce toe dorsiflexion. High heels and flexible shoes should be avoided.
• Strapping & taping – Using rigid tape (such as zinc oxide tape) to hold the toe in a plantarflexed position can reduce strain. Tape should be changed every 72 hours.
• Orthotics – Metatarsal pads or domes help redistribute pressure away from the affected MTP joint. Carbon fibre insoles can provide additional support.

Physiotherapy in Conservative Management

Physiotherapy plays a key role in rehabilitation by restoring foot function, reducing pain, and preventing recurrence. A physiotherapy program should include:

1. Strengthening Exercises

• Intrinsic foot muscles – Exercises such as toe curls, marble pickups, and short foot exercises strengthen the small stabilising muscles of the foot.
• Toe control exercises – Toe resistance band exercises improve strength in the affected toe.
• Calf strengthening – Seated or standing heel raises to enhance calf and foot strength.

2. Stretching & Mobility

• Calf stretching – Reducing tightness in the gastrocnemius and soleus muscles prevents compensatory forefoot overload.
• Toe mobilisation – Gentle manual mobilisation of the MTP joint to maintain flexibility.

3. Gait Retraining

• Modifying foot strike patterns – Encouraging midfoot or rearfoot striking can reduce forefoot stress.
• Stride adjustments – Reducing stride length can lower ground reaction forces.

4. Balance & Proprioception

• Single-leg stance exercises – Improves foot stability and control.
• Wobble board or BOSU ball training – Enhances dynamic foot and ankle stability.

Regular physiotherapy reviews help monitor progress and adjust the rehabilitation program as needed.

Surgical Management

Surgery is recommended for:

• Full-thickness plantar plate tears.
• Persistent pain despite conservative treatment.
• Progressive toe deformity.

Post-surgical rehabilitation follows a structured program with gradual return to activity over 6–12 months.

By incorporating physiotherapy into conservative management, patients can strengthen the foot, improve biomechanics, and reduce the risk of future injuries.

Information is provided for educational purposes only. Always consult your physiotherapist or other health professional.

References

Kussl, S., Schöffmann, S., Pezzei, C., Bock, F., Bale, R., Hohenberger, G., & Dammerer, D. (2023). Plantar plate tears of the lesser toes: A review of diagnosis and treatment options. Journal of Orthopaedics and Traumatology, 24(1), 6. https://doi.org/10.1186/s10195-024-00814-x

Majeed, H., Alsousou, J., & Hassaan, S. (2024). Plantar plate pathology: An update on diagnosis and management. Foot & Ankle Surgery: Techniques, Reports & Cases, 4(1), 100101. https://doi.org/10.1016/j.fastrc.2024.100101

Waizy, H., & Keller, K. (2022). Diagnosis and treatment of plantar plate tears. Journal of Clinical Medicine, 11(1), 234. https://doi.org/10.3390/jcm11010234

Systemic Lupus Erythematosus (SLE) is the most common type of Lupus. SLE is an autoimmune disorder in which the immune system mistakenly attacks healthy tissues. This can result in pain, inflammation and damage to various tissues/organs within the body. It is most commonly seen in women of childbearing age and the severity can vary widely on a case-by-case basis.

Signs and Symptoms

SLE is known to have a range of symptoms that can either present sporadically in “flare-ups”, or be more persistent in nature. These symptoms include the following:

• Fatigue
• Joint pain and swelling
• Rash/Skin sensitivity: This is often exacerbated by exposure to direct sunlight and is commonly manifested in what is described as a “butterfly rash across the face”
• Loss of appetite and weight loss
• Fever
• Muscle weakness
• Chest pain or shortness of breath: Due to inflammation in the lungs or heart lining.
• Kidney issues: Swelling in the legs or around the eyes, and changes in urine colour or frequency.
• Neurological symptoms: Headaches, confusion, memory problems, or seizures.

Diagnosis

As seen above SLE can present with a wide range of symptoms, hence mimicking other conditions and making diagnosis challenging at times. That being said early diagnosis is important and consultation with your medical team can help start this process.

Diagnosis is based on the presentation of clinical signs and confirmed with further testing, including blood tests. A blood test will involve Anti-Nuclear Antibody (ANA) testing in which the presence of antibodies that may attack healthy tissues in the body is assessed.

Causes

Unfortunately, we are yet to determine the exact cause of SLE but we believe it to be a result of a combination of genetic, hormonal and environmental factors including;

• Genetics: Family history is an indicator of increased risk
• Hormones: Oestrogen is thought to play a role, as SLE is more common in women.
• Environmental triggers: Exposure to sunlight, infections, stress, or certain medications.

Prognosis

It is important to note that the nature of this condition is chronic and at times can be unpredictable, with periods of flare-ups and remission (periods of time where symptoms improve).

That being said the prognosis for people living with SLE has improved significantly due to advances in medical treatment and early diagnosis. Most people with SLE can manage their symptoms and maintain a good quality of life.

Prognosis also depends on the severity of organ involvement, particularly in the kidneys and heart. Early detection and appropriate management are crucial for reducing complications and improving long-term outcomes. With ongoing treatment and lifestyle adjustments, many people with SLE lead active and fulfilling lives.

Treatment

Unfortunately, at this time there is no cure for SLE although there are a range of treatments that can help to manage symptoms and improve quality of life. Treatments may include medications such as;

• Nonsteroidal anti-inflammatory drugs (NSAIDs): To relieve pain and reduce inflammation.
• Corticosteroids: To control inflammation during flares.
• Immunosuppressants: To reduce overactivity of the immune system.
• Antimalarials: To manage skin and joint symptoms and reduce flare frequency.
• Biologic agents: For severe cases not responding to standard treatments.

Physiotherapy and Rehabilitation

Physiotherapy plays a crucial role in the management of SLE, particularly in maintaining mobility, reducing pain, and improving overall function. Physiotherapists can help by:

• Exercise programs: Tailored exercises to enhance muscle strength, joint flexibility, and cardiovascular fitness. Low-impact exercises, such as swimming, walking, and stretching, are particularly beneficial.
• Pain management techniques: Including heat and cold therapy, gentle manual therapy, and relaxation exercises to reduce muscle tension.
• Fatigue management: Developing pacing strategies and energy conservation techniques to help clients manage fatigue more effectively.
• Posture correction and ergonomic advice: To minimise joint strain during daily activities.
• Education and support: Helping clients understand their condition, recognise early signs of flares, and implement self-management strategies.

Additional Management Strategies

• Sun protection: Wearing sunscreen and protective clothing to avoid UV-triggered flares.
• Healthy diet and hydration: To support overall health and reduce inflammation.
• Stress management: Using relaxation techniques to minimise flare triggers.

Sources

Blaess, J., Goepfert, T., Geneton, S., Irenee, E., Gerard, H., Taesch, F., Sordet, C., & Arnaud, L. (2022). Benefits & risks of physical activity in patients with Systemic Lupus Erythematosus: a systematic review of the literature. Seminars in Arthritis and Rheumatism, 58, 152128. https://doi.org/10.1016/j.semarthrit.2022.152128

Branch, N. S. C. a. O. (2025, January 8). Systemic lupus erythematosus (Lupus). National Institute of Arthritis and Musculoskeletal and Skin Diseases. 

The Royal Australian College of general Practitioners. (n.d.). Systemic lupus erythmatosus. Australian Family Physician. https://www.racgp.org.au/afp/2013/october/systemic-lupus-erythmatosus

Systemic Lupus Erythematosus. (2023, August 4). National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK535405/

This exercise strengthens the glutes, hamstrings, and core while incorporating a calf activation element. The heel raise adds an extra challenge to stability and lower limb control. It’s useful for improving posterior chain strength, coordination, and endurance, particularly in rehabilitation settings or athletic conditioning.

Progression 1: Double-Leg

• Lie on your back with your knees bent and feet flat on the floor, hip-width apart.
• Engage your core and press through your heels to lift your hips, creating a straight line from your shoulders to your knees.
• Once at the top, lift both heels off the ground, rising onto the balls of your feet.
• Lower your heels back down, then slowly return your hips to the floor.
• Complete repetitions as prescribed by your physiotherapist.

Progression 2: Double Leg with Maintained Heel Raise

• Lie on your back with your knees bent and feet flat on the floor, hip-width apart.
• Lift your heels off the ground so you are on the ball of your foot before initiating the bridge.
• Engage your core and press through your heels to lift your hips, creating a straight line from your shoulders to your knees.
• Keep a strong, controlled movement as you lower back down, ensuring your heel stays off the floor.
• Complete repetitions as prescribed by your physiotherapist.

Progression 3: Single-Leg with Heel Raise

• Start lying on your back with one foot planted and the other leg extended.
• Engage your core and press through your heels to lift your hips, creating a straight line from your shoulders to your knees.
• Once at the top, lift the heels off the ground, rising onto the ball of your foot.
• Lower your heel back down, then slowly return your hips to the floor.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Letting the lower back arch excessively instead of engaging the glutes.
• Lifting the hips unevenly or letting them drop to one side (especially in the single-leg variations).
• Pushing through the toes instead of using the whole ball of the foot when raising the heel.
• Moving too quickly, leading to loss of control.

Progressions

To make the exercise more challenging, you can:

• Slow down the movement, increasing time under tension.
• Add a resistance band around the thighs for extra glute engagement.
• Hold a weight on your hips for additional resistance.
• Perform the exercise on an unstable surface, such as a foam pad or BOSU ball.

Regressions

To make the exercise easier, you can:

• Keep both feet flat on the floor throughout the movement.
• Reduce the height of the bridge to limit strain.
• Perform the movement without the heel raise to focus on basic glute activation.
• Support the movement by placing your hands on the floor for added stability.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Nerve sliders or neural ‘flossing’ provide an effective strategy to alleviate neural tension within the muscle interface that is passes through, without exacerbating symptoms. Discuss with your Physiotherapist which variation is appropriate for you dependent on the degree of neural tension.

Instructions

• Lying on your back, use a towel to help keep your leg in a comfortable 90 degree position with your ankle in neutral position.
• Straighten your knee, and let your ankle turn outwards
• Bend your knee back to 90 degrees and bring your ankle back to neutral
• Complete as per Physiotherapist guidelines

Precautions

• Perform this exercise strictly as guided by your physiotherapist – do not be tempted to perform more repetitions as this may irritate the tissue
• If your symptoms become aggravated, stop immediately and notify your physiotherapist

Side stepping without resistance is a fundamental exercise designed to improve balance, lower limb strength, and lateral stability. It targets the hip abductors, quadriceps, and core stabilisers, helping to enhance control during sideways movements. This exercise is often prescribed to improve mobility and falls prevention.

Instructions

• Stand tall with your feet hip-width apart. Maintain an upright posture with your shoulders relaxed.
• Place your hands on a stable surface for support e.g. kitchen bench or back of a couch.
• Step sideways with your leading foot, ensuring the movement comes from the hip rather than dragging the foot. Keep your toes pointing forward. 
• Follow with the trailing foot, returning to a stable stance.
• Continue stepping in one direction for the prescribed number of steps, then repeat in the opposite direction.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Taking steps that are too large, which may reduce control and balance.
• Twisting at the hips/torso instead of keeping a neutral posture.
• Dragging the trailing foot rather than actively lifting it.

Progressions

To make the exercise more challenging, you can:

• Take larger steps while maintaining control.
• Perform the exercise with a slight bend in the knee to engage more lower limb muscle. 
• Reduce hand support if balance allows by hovering your hands above a stable surface whilst performing the exercise or holding your hands on your hips.

Regressions

To make the exercise easier, you can:

• Take smaller steps to reduce balance demands.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

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Peak Physio now offers mobile and home visit physiotherapy services, bringing expert care directly to your home in Newcastle, Rutherford, Budgewoi, and surrounding areas. Whether you have mobility challenges, require post-surgery rehab, or simply prefer treatment in the comfort of your home, our experienced physiotherapists are here to help.

Why Choose Mobile Physiotherapy?

• Convenient & Accessible – No need to travel; we come to you.
• Personalised Treatment – One-on-one care tailored to your needs.
• Disability & Seniors Support – Ideal for those with disabilities or aged care needs.
• Post-Surgery Rehabilitation – Recover safely in a familiar environment, reducing stress and improving outcomes.
• Reduce Hospital Readmission – Physiotherapy can help prevent complications and re-injury.

Our Mobile Physiotherapy Services

Our team provides a wide range of treatments, including:

• General Physiotherapy – Pain management, injury recovery & movement improvement.
• NDIS Physiotherapy at Home – We offer in-home physiotherapy for NDIS participants, providing tailored treatment to support mobility, rehabilitation, and overall well-being.
• Pre & Post-Surgery Home Physio – Safe and effective physiotherapy at home after hip, knee, or back surgery.
• Seniors Exercise & Rehabilitation – Strength, balance & fall prevention.
• Vestibular Physiotherapy – Dizziness & vertigo treatment at home.

Mobile Physio Locations – Newcastle, Maitland, Central Coast & Lake Macquarie

We provide home visit physiotherapy in the following regions:

• Newcastle
  • Newcastle, Merewether, Hamilton, Adamstown, and nearby areas.
• Maitland
  • Rutherford, Maitland, Thornton, East Maitland, Aberglasslyn, and nearby areas.
• Central Coast
  • Budgewoi, Toukley, The Entrance, Wyong, Woy Woy, and nearby areas.
• Lake Macquarie
  • Charlestown, Belmont, Toronto, Warners Bay, and nearby areas.

Frequently Asked Questions

Who can benefit from mobile physiotherapy?

Mobile physiotherapy is perfect for individuals with mobility issues, post-surgery patients, NDIS participants, seniors, and busy professionals who prefer home-based care.

Do you bring all necessary equipment?

Yes, our physiotherapists can bring weights, exercise bands, creams, tapes, and any other required tools to ensure a full-service experience at home.

Book Your Mobile Physiotherapy Session

Get expert physiotherapy care without leaving your home. Whether you need rehab, injury treatment, or mobility support, our mobile physios are ready to help.

Don’t let pain or mobility issues hold you back. Call your nearest clinic today and get expert treatment at home!

Thoracic rotation against a wall in a half-kneeling (lunge) position is an excellent exercise to improve mid-back mobility while promoting core stability and hip control. The half-kneeling position helps limit compensation from the lower back and encourages proper spinal rotation. This exercise is beneficial for those with postural stiffness, athletes requiring rotational movement (such as golfers or tennis players), or individuals looking to counteract the effects of prolonged sitting.

Instructions (Left Side)

• Begin in a half-kneeling position with your left knee on the floor and your right foot forward, creating a 90-degree angle at both knees.
• Position yourself so that your right side is facing the wall, about 30 cm away.
• Engage your core and keep your hips squared forward.
• Extend both arms straight in front of you at shoulder height, with palms together.
• Keeping your lower body stable, slowly rotate your left arm open towards the wall, following your hand with your eyes.
• Try to touch the wall with your left hand while keeping your right arm extended forward.
• Hold briefly at the end of the movement, then return to the starting position with control.
• Complete repetitions as prescribed by your physiotherapist.

Instructions (Right Side)

• Begin in a half-kneeling position with your right knee on the floor and your left foot forward, creating a 90-degree angle at both knees.
• Position yourself so that your left side is facing the wall, about 30 cm away.
• Engage your core and keep your hips squared forward.
• Extend both arms straight in front of you at shoulder height, with palms together.
• Keeping your lower body stable, slowly rotate your right arm open towards the wall, following your hand with your eyes.
• Try to touch the wall with your right hand while keeping your left arm extended forward.
• Hold briefly at the end of the movement, then return to the starting position with control.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Allowing the hips or lower back to rotate instead of isolating movement through the thoracic spine.
• Rushing the movement instead of controlling the rotation.
• Losing stability in the half-kneeling position by shifting weight or letting the front knee collapse inwards.
• Shrugging the shoulders or holding excessive tension in the upper body.

Progressions

To make the exercise more challenging, you can:

• Hold a light weight in the moving hand for added control and resistance.
• Increase the range of motion by gently pressing your hand against the wall for an extra stretch.
• Perform the movement without using the wall as a reference, requiring greater body awareness and control.

Regressions

To make the exercise easier, you can:

• Sit on a stable surface (such as a chair) to reduce lower-body demands.
• Stand closer to the wall to reduce the required range of motion.
• Use a foam roller or block between your knees for extra stability and to prevent hip movement.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Marching in place is a gentle but effective exercise designed to improve balance, lower limb strength, and coordination. It primarily targets the hip flexors, quadriceps, and core stabilisers, helping to enhance walking ability and reduce fall risk. 

Instructions

• Stand tall with your feet hip-width apart and shoulders relaxed. Position yourself near a stable surface, such as a countertop or sturdy chair, for support if needed.
• Engage your core muscles to maintain an upright posture and keep your gaze forward.
• Slowly lift one knee towards hip height, or as high as comfortably possible, keeping your foot flexed and avoiding leaning backward.
• Lower your foot back to the floor with control.
• Repeat on the other side, alternating legs in a steady marching motion.
• Continue as prescribed by your physiotherapist.

Common Errors

• Leaning too far backward instead of keeping a tall posture.
• Lifting the knee too quickly, reducing control and stability.
• Placing weight unevenly on one side, leading to loss of balance.
• Dragging the foot down instead of lowering it with control.

Progressions

To make the exercise more challenging, you can:

• March without holding onto support, if balance allows, starting by hovering hand above a stable surface and progressing to hands by sides.
• Increase the height of knee lifts while maintaining good posture.
• Slow down the movement to improve control and strength.

Regressions

To make the exercise easier, you can:

• Keep your hands on a stable surface for added support.
• Lift your knees only a small amount to maintain control.
• Perform the exercise in a seated position, lifting one foot at a time.
• Focus on weight shifting side to side before progressing to full knee lifts.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

The upright row is an effective exercise for strengthening the shoulders (deltoids), upper back (trapezius), and arms (biceps). It helps improve shoulder stability, posture, and upper body strength, making it beneficial for daily activities that involve lifting or pulling. This exercise is often prescribed for individuals recovering from shoulder weakness, improving postural control, or enhancing general upper body function.

Variation 1 – Kettlebell

Instructions

• Stand up straight with your feet hip-width apart, knees slightly bent, and core engaged for stability.
• Hold a kettlebell in both hands with an overhand grip (palms facing your body). 
• Start with your arms fully extended in front of your body, keeping the weight close to your thighs.
• Slowly lift your hands towards your chest, leading with your elbows and keeping the weight close to your body. Your elbows should rise higher than your hands, but avoid lifting them above shoulder height.
• Pause briefly at the top of the movement, ensuring your shoulders remain relaxed and not shrugged.
• Lower the weight back to the starting position in a slow and controlled manner.
• Complete repetitions as prescribed by your physiotherapist.

Variation 2 – Dumbbell

Instructions

• Stand with your feet hip-width apart, knees slightly bent, and core engaged for stability.
• Hold a dumbbell in each hand with an overhand grip (palms facing your body). 
• Start with your arms fully extended in front of your body, keeping the weights close to your thighs.
• Slowly lift your hands towards your chest, leading with your elbows and keeping the weights close to your body. Your elbows should rise higher than your hands, but avoid lifting them above shoulder height.
• Pause briefly at the top of the movement, ensuring your shoulders remain relaxed and not shrugged.
• Lower the weights back to the starting position in a slow and controlled manner.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Shrugging the shoulders instead of keeping them relaxed.
• Lifting the elbows too high, which can cause shoulder discomfort.
• Using momentum rather than controlled movement.
• Gripping too tightly, causing unnecessary tension in the wrists.
• Leaning backward, instead of maintaining an upright posture.

Progressions

To make the exercise more challenging, you can:

• Use a heavier weight.
• Slow down the movement, particularly during the lowering phase, to enhance muscle control.

Regressions

To make the exercise easier, you can:

• Use a lighter weight.
• Perform the movement seated for added stability.
• Reduce the range of motion, lifting only to mid-chest level rather than all the way up.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Clock work

• Lie on a raised surface such as your bed or table
• Relax your head down
• Slowly lift your head to a horizontal level from the floor
• Rotate your nose around the lines of the drawing

Following numbers

• Slowly lift your head horizontal from the floor in a neutral position
• Start from the centre of the drawing, follow the line to the edge of the circle
• Go around clockwise and anti clockwise as per your physiotherapist guidance

Precautions

• Stop the exercise if feeling neck strain
• Stop the exercise if feeling dizzy

Mobilisation with movement (MWM) for the elbow using a doorframe is a self-treatment technique based on Mulligan’s principles. It is commonly used to manage lateral epicondylalgia (tennis elbow) by improving joint mechanics and reducing pain. This technique involves applying a sustained lateral glide to the elbow joint while performing a functional movement, such as gripping. By altering joint positioning, the movement can be completed with reduced pain, helping to restore normal function.

Instructions

• Stand side-on to a sturdy doorframe with your affected arm straight. Place the outside of your arm against the doorframe, the frame should be pressing against the upper arm, just before the elbow joint.
• You may want to place a soft towel between your arm and the doorframe for comfort.
• With your opposite hand, place the webspace of your thumb and index finger on the inside of your elbow, just after the joint.
• Apply a lateral glide by gently pushing your forearm towards the doorframe using your opposite hand. Maintain this pressure throughout the exercise.
• While holding the glide, grip a small towel in your affected hand and squeeze firmly.
• Release the grip slowly and repeat the movement while maintaining the glide.
• Complete repetitions as prescribed by your physiotherapist.

This exercise should be completely pain-free. If you experiencing pain, attempt to slightly change the angle of the pressure.

Common Errors

• Applying excessive force, causing discomfort or increased pain.
• Letting the glide release before completing the grip movement.
• Incorrect hand positioning, leading to ineffective mobilisation.
• Moving too quickly without maintaining control.

Progressions

To make the exercise more challenging, you can:

• Increase the intensity of the grip by using a thicker towel or resistance object.
• Apply a firmer lateral glide while still ensuring it remains pain-free.
• Hold the grip contraction for a longer duration before releasing.

Regressions

To make the exercise easier, you can:

• Reduce the pressure of the lateral glide.
• Use a softer towel or sponge to make gripping easier.
• Decrease the duration of the grip contraction or reduce the repetitions.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Known Issues

Instructions:

• Come into a kneeling posture with the wrists directly underneath the shoulders and the knees directly underneath the hips.
• Inhale and allow the abdomen to expand, ribs moving wide. Visualise a balloon in the abdomen and it expanding 360 degrees.
• Exhale and draw the lower abdomen towards the spine. Visualise a candle underneath the belly-button and draw away from the floor.
• Repeat for a cycle of 3-5 or as prescribed by Physiotherapist.

Demonstration:

This exercise is aimed at improving your lumbar flexion (forward bending) by resetting your pelvic position and encouraging sequential movement through each joint in your spine. It helps to increase spinal mobility, particularly in the lumbar and thoracic regions, and can reduce stiffness or discomfort by promoting proper movement patterns.

Instructions

• Stand tall with your feet hip-width apart, ensuring your weight is evenly distributed.
• Place the palms of your hands on your lower abdomen or the bony area at the front of your hips (pelvis).
• Gently press your hands into your pelvis to encourage a slight backward tilt (posterior pelvic tilt).
• Begin rolling your spine downwards:
  • Tuck your chin towards your chest to start the movement from your neck.
  • Gradually let the movement flow down your spine, one vertebra at a time, progressing through your neck, to upper and mid back.
• Slowly roll back up to a standing position by reversing the movement.
• Repeat the movement, and on each repetition, try to roll slightly further than before, without forcing the motion or causing discomfort, until eventually you are rolling down through the whole spine.
• Complete repetitions as prescribed by your physiotherapist.

Tip: Imagine your back is attached to a strip of Velcro on a wall, and you are peeling yourself off slowly, starting at the neck and working downward.

Common Errors

• Moving too quickly—this should be a slow, controlled movement.
• Skipping parts of the spine, instead of moving segment by segment.
• Forgetting to tilt the pelvis gently backward before rolling down.
• Allowing the knees to lock or overly bend during the movement.

Regressions

To make the exercise easier, you can:

• Perform the exercise with your back supported against a wall for guidance.
• Roll down only partway to your comfort level instead of going as far as possible.
• Bend your knees slightly to reduce tension on the hamstrings and lower back.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Instructions:

• Begin by lying on your back (supine) with your knees bent and feet flat on the ground, about hip-width apart.
• Place a looped theraband just above your knees to add resistance.
• Keep your pelvis neutral and your core gently engaged to prevent any excessive arching of the lower back.
• Keeping one leg still, slowly move the other knee outward, creating tension in the theraband. Your foot should remain flat on the ground as the knee moves.
• Stop once you feel the contraction in your outer hip or glute and avoid letting your pelvis roll or tilt.
• Slowly return your moving leg to the starting position in a controlled manner.
• Repeat the movement on the same leg or alternate sides, depending on your physiotherapist’s recommendation.
• Complete repetitions as prescribed by your physiotherapist.

Bilateral Variation

• Begin by lying on your back (supine) with your knees bent and feet flat on the ground, about hip-width apart.
• Place a looped theraband just above your knees to add resistance.
• Keep your pelvis neutral and your core gently engaged to prevent any excessive arching of the lower back.
• Pull both knees outwards to create tension on the band and then return to the starting position.
• Repeat as per your physiotherapist guidelines

Hamstring bridges are an excellent exercise to strengthen the posterior chain, targeting the hamstrings, glutes, and lower back. These progressions are often prescribed to improve hamstring strength, stability, and control, particularly in injury rehabilitation or for enhancing athletic performance. The exercise focuses on activating the hamstrings by maintaining a flexed knee angle of 30° throughout, reducing reliance on the glutes.

Instructions:

Level 1: Double-Leg Hamstring Bridge (Flat Ground)

• Lie on your back with your knees bent at approximately 30° and your feet flat on the ground, hip-width apart.
• Rest your arms at your sides with palms facing down for stability.
• Engage your core and gently press your lower back into the ground.
• Push through your heels, lifting your hips off the ground until your body forms a straight line from your shoulders to your knees.
• Hold the top position briefly, ensuring your hamstrings are activated.
• Slowly lower your hips back to the ground with control.
• Repeat for the prescribed number of repetitions.

Level 2: Single-Leg Hamstring Bridge (Flat Ground)

• Begin in the same position as Level 1.
• Lift the resting leg off the ground. Try to hold this leg still throughout, do not use it for momentum.
• Push through the heel of the grounded foot, lifting your hips off the ground until your body forms a straight line from your shoulders to your knee.
• Maintain control and avoid letting your hips dip or rotate.
• Slowly lower your hips back to the ground.
• Alternate legs or complete all repetitions on one side as prescribed by your physiotherapist.

Level 3: Single-Leg Hamstring Bridge (Elevated Surface)

• Position yourself near a stable elevated surface (e.g., a bench or step) and place one heel on it while keeping the other leg extended.
• Lie back and ensure your elevated knee remains at a 30° angle.
• Press through the heel on the elevated surface, lifting your hips until your body forms a straight line from your shoulders to the elevated knee.
• Hold the top position briefly while engaging your hamstrings and core.
• Slowly lower your hips back down to the starting position with control.
• Repeat for the prescribed number of repetitions.

Common Errors

• Allowing the hips to drop or rotate during single-leg variations.
• Pushing through the toes instead of the heels, reducing hamstring activation.
• Overarching the lower back instead of keeping the core engaged.
• Using momentum to lift the hips instead of controlled muscle activation.

Progressions

To make the exercise more challenging, you can:

• Add resistance by holding a weight or placing a resistance band around your thighs.
• Perform the elevated bridge with a stability ball instead of a fixed surface for additional balance demands.
• Increase the duration of the hold at the top position to improve endurance.

Regressions

To make the exercise easier, you can:

• Perform the double-leg version with reduced range of motion.
• Use a supportive surface (e.g., pushing against a wall) to assist with stability.
• Place a cushion or towel under your hips to partially reduce the load.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Toe taps with a foam roller are a fantastic core activation and stability exercise, primarily targeting the transverse abdominis and other deep core muscles. This exercise also engages the hip flexors and promotes pelvic control, making it an excellent choice for individuals working on core strength, lumbar stabilisation, or postural improvements. By incorporating a foam roller, this variation enhances the challenge to your balance and coordination, encouraging better proprioception and body awareness.

Instructions

• Lie on your back with your knees bent and feet flat on the floor. Place a foam roller vertically along your spine, supporting your head and tailbone.
• Engage your core by gently drawing your belly button towards your spine, ensuring your lower back is not arching off the roller.
• Lift both legs into a tabletop position (knees bent at 90 degrees, shins parallel to the floor).
• While maintaining a stable pelvis, slowly lower one foot towards the floor, lightly tapping your toes.
• Return the lifted leg to the starting position and repeat with the other leg.
• Keep your breathing steady, exhaling as you lower the leg and inhaling as you return.
• Continue alternating legs. Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Letting the lower back arch or lifting off the foam roller.
• Moving too quickly, which can reduce control and engagement.
• Losing balance on the foam roller by not evenly distributing weight.
• Allowing the shoulders or neck to tense up during the movement.

Progressions

To make the exercise more challenging, you can:

• Perform the movement with both legs simultaneously.
• Add a resistance band around your thighs for increased activation.
• Extend the leg fully as you lower it instead of tapping with a bent knee.
• Incorporate small arm movements, such as overhead reaches, to increase the balance demand.

Regressions

To make the exercise easier, you can:

• Lower one foot to the floor and keep it planted while the other leg taps.
• Perform the exercise without the foam roller, lying flat on a mat.
• Reduce the range of motion, only lowering the leg partway down.
• Place hands on the floor beside you for additional stability.

Variations

Knee Extensions

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Seated heel raises are a fantastic exercise for targeting the soleus muscle, a key player in maintaining ankle stability and improving lower-leg endurance. Strengthening the soleus is particularly beneficial for running, walking, and managing lower limb injuries like Achilles tendinopathy or shin splints. These raises are a low-impact exercise ideal for gradual strengthening.

Unweighted

Instructions

• Sit on a sturdy chair or bench with your knees bent at approximately 90 degrees and feet flat on the floor, hip-width apart.
• Place your hands on your thighs for balance.
• Press through the balls of your feet and lift your heels off the ground as high as possible, feeling the contraction in your calves.
• Slowly lower your heels back down to the floor, controlling the movement throughout.
• Repeat until you’ve completed the repetitions as prescribed by your physiotherapist.

Common Errors

• Using momentum instead of controlled movement.
• Letting heels drop too quickly without control.
• Incomplete range of motion—failing to fully raise or lower the heels.
• Slouching or poor posture in the seated position.

Progression: Add Weight

Instructions

• Sit on a sturdy chair or bench with your knees bent at approximately 90 degrees and feet flat on the floor, hip-width apart.
• Place a weight on each thigh, just above the knees. Use your hands to stabilise the weights.
• Press through the balls of your feet and lift your heels off the ground as high as possible, keeping the weights balanced on your thighs.
• Slowly lower your heels back to the floor in a controlled manner, ensuring the weights don’t shift.
• Repeat until you’ve completed the repetitions as prescribed by your physiotherapist.

Common Errors

• Letting the weights move around or become unstable.
• Using jerky motions to lift the weights instead of smooth, controlled movements.
• Incomplete range of motion—failing to lift heels fully or control the descent.
• Allowing knees to splay outward instead of keeping them aligned with the feet.

To make the exercise more challenging, you can

• Increase the weight placed on your thighs.
• Perform the exercise on one leg at a time (unilateral seated calf raises).
• Slow down the movement to increase time under tension.

To make the exercise easier, you can

• Perform the unweighted version to reduce resistance.
• Use a lower weight if the weighted progression feels too challenging.
• Reduce the range of motion initially and build up over time.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Community physiotherapy focuses on improving the quality of life for individuals of all ages by providing physiotherapy services in their homes, local facilities, or community settings. It is designed to support people who may find it challenging to access traditional clinic-based services due to mobility, health, or transportation issues.

Our team of highly qualified physiotherapists collaborates with individuals, families, and carers to provide tailored care plans that meet specific needs and goals. With an emphasis on holistic, person-centred care, community physiotherapy can help people regain independence, manage chronic conditions, recover from injury, and maintain their overall wellbeing.

What We Offer

1. Home-Based Physiotherapy Services
We bring expert physiotherapy care directly to your home, ensuring comfort and convenience. Home-based services are ideal for individuals recovering from surgery, managing long-term conditions, or facing mobility challenges.

2. Group Exercise and Wellness Programs
We facilitate group sessions in community centres, aged care facilities, and other local settings to promote social engagement and physical activity. These programs cater to diverse needs, including fall prevention, strength training, and chronic disease management.

3. Post-Hospital Rehabilitation
After a hospital stay, it’s essential to rebuild strength and mobility. Our physiotherapists provide comprehensive post-hospital care to help you recover safely and effectively.

4. Chronic Disease Management
Community physiotherapy plays a critical role in managing chronic conditions such as arthritis, diabetes, or heart disease. We focus on tailored exercise programs, education, and strategies to enhance mobility and reduce pain.

5. Support for Carers
We provide guidance and training for carers to ensure they are confident in supporting the physical needs of their loved ones. This includes safe manual handling techniques and home environment adjustments.

Who Can Benefit from Community Physiotherapy?

• Older adults seeking to maintain mobility and independence.
• Individuals recovering from surgeries such as hip or knee replacements.
• People managing chronic health conditions like Parkinson’s disease or multiple sclerosis.
• Those requiring rehabilitation after injury or stroke.
• Families and carers needing professional advice and support.

Why Choose Us?

• Tailored Care Plans: Every individual is unique. Our physiotherapists assess your specific needs and create personalised treatment plans.
• Experienced Professionals: Our team has extensive experience in community-based care, ensuring you receive high-quality, evidence-based treatment.
• Convenient Access: We come to you, removing barriers to accessing care.
• Holistic Approach: Beyond treatment, we focus on education and prevention strategies to empower you to live your best life.
• Community Connection: Our programs foster a sense of community and belonging, promoting mental and physical wellbeing.

Our Approach

We begin with a thorough assessment to understand your physical condition, lifestyle, and goals. From there, we develop a structured plan, which may include:

• Exercise Therapy: Strengthening and flexibility exercises tailored to your ability.
• Manual Therapy: Hands-on techniques to alleviate pain and improve movement.
• Education: Guidance on posture, safe movement, and injury prevention.
• Equipment Advice: Recommendations for mobility aids or modifications to your living environment.

Our physiotherapists regularly monitor progress, adjusting your plan as needed to ensure optimal outcomes.

Get Started Today

Our radius for home visits and services is within 5km of our 2 x Newcastle Clinics, Budgewoi and Rutherford locations. Pending Physiotherapist availability and capacity for the week, appointments can commonly be coordinated within 2 weeks.

Contact us today to book an appointment or learn more about our services.

Information provided is for general purposes only. Always seek the advice of a qualified physiotherapist or healthcare provider.

Thoracic extension with a foam roller is an effective mobility exercise targeting the thoracic spine, which includes the mid-back region. It helps counteract stiffness often caused by prolonged sitting or poor posture. This exercise is commonly prescribed to improve thoracic extension, a key movement for overhead activities, spinal alignment, and overall posture. It also gently engages the muscles of the upper back and shoulders, promoting relaxation and flexibility.

Instructions

• Starting position: Sit on the floor with your knees bent and feet flat. Position a foam roller horizontally behind you, just beneath your shoulder blades.
• Lean back so your upper back rests on the foam roller and place your hands behind your head to support your neck, keeping your elbows wide.
• Engage your core slightly to avoid overarching your lower back.
• Slowly arch your upper back over the foam roller, allowing your spine to gently extend. Focus on opening up through the chest without straining the neck.
• Pause briefly at the end of the movement, then return to the starting position by engaging your core.
• Gradually adjust the position of the foam roller up or down your thoracic spine and repeat to target different segments.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Allowing the lower back to overextend instead of focusing on the thoracic spine.
• Straining the neck by pulling it forward or letting it drop back too far.
• Moving too quickly through the exercise, reducing its effectiveness.
• Skipping core engagement, which may lead to unwanted compensation in the lumbar spine.

Progressions

• To make the exercise more challenging, you can:
• Add small weights or resistance in your hands to increase the stretch.
• Extend your arms overhead while performing the movement for greater range.
• Perform the exercise with a longer hold at the end range of extension.

Regressions

• To make the exercise easier, you can:
• Use a softer or smaller foam roller for less intensity.
• Limit the range of motion to what feels comfortable and pain-free.
• Perform the exercise lying on a flat surface with a rolled-up towel under the upper back for support.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Foam rolling the gluteus maximus is a self-myofascial release technique designed to alleviate muscle tightness, reduce soreness, and improve mobility. The gluteus maximus, the largest muscle in the buttocks, plays a crucial role in hip extension, external rotation, and overall lower body strength. Foam rolling this area is often recommended to release tension, promote circulation, and prepare the muscle for exercise or aid in recovery post-workout. It can also be helpful in addressing tightness caused by prolonged sitting.

Instructions:

• Set up: Sit on the foam roller placed perpendicular to your body, ensuring it is positioned under your gluteal muscles. Keep your feet flat on the floor, knees bent.
• Target one side: Shift your weight slightly to one side to focus on a single glute. You can cross the opposite leg over your working leg to target the Gluteus Medius muscle belly.
• Roll slowly: Use your arms and feet to control the movement. Roll back and forth slowly, focusing on the glute area. Move about 10–15 cm at a time, pausing on any tight or tender spots for 20–30 seconds.
• Switch sides: Once completed on one side, shift your weight to the other glute and repeat the process.
• Complete as prescribed: Perform as directed by your physiotherapist.

Common Errors:

• Rolling too quickly, which can reduce the effectiveness of the release.
• Applying too much pressure, causing discomfort or bruising.
• Allowing the lower back to hyperextend or losing a neutral spine.
• Avoiding tender areas instead of pausing on them to release tension.

Progressions:

• To make the exercise more challenging, you can:
• Use a firmer foam roller or a massage ball to increase the intensity.
• Cross one leg over the opposite thigh in a figure-4 position to place more pressure on the glute.

Variations:

• Glute Medius- Crossing the leg of the targeted side of the opposite and complete the same motion as previous.
• Glute Minimus-

Regressions:

• To make the exercise easier, you can:
• Use a softer foam roller to reduce intensity.
• Keep both feet on the ground to distribute weight more evenly and decrease pressure.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Foam rolling for the latissimus dorsi (lats) targets one of the largest muscles in the back, which plays a key role in shoulder stability and arm movement. This exercise is often used to release tightness and improve the flexibility of the lats, making it beneficial for people with shoulder or upper back tightness, or those who engage in activities like lifting, swimming, and overhead sports. By easing tension in the lats, foam rolling can increase range of motion in the shoulders, which supports better posture and helps reduce the risk of shoulder and back pain.

Instructions

• Begin by lying on your side, placing a foam roller just beneath your armpit.
• Extend the bottom arm above your head and place your top leg over your bottom leg for stability.
• Slowly roll from just below your armpit down towards the middle of your rib cage, applying gentle pressure to the lat muscle.
• Stop and pause on any tender or tight spots, holding the pressure for 15–30 seconds before moving again.
• Roll back and forth slowly, focusing on keeping your upper body relaxed.
• Continue rolling for the time recommended by your physiotherapist or until you feel a release in tension.

Common Errors

• Rolling too quickly, which prevents adequate muscle release.
• Applying excessive pressure, which can cause discomfort or pain.
• Arching the back or shrugging the shoulder, which can decrease effectiveness.
• Not pausing on tight areas, missing the benefits of a deep release.

Progressions

To make the exercise more challenging, you can:

• Angle your body slightly forward or backward to target different fibres of the lat muscle.
• Use a denser or textured foam roller to increase pressure.

Regressions

To make the exercise easier, you can:

• Use a softer foam roller to reduce pressure.
• Decrease the time spent on each tender spot to make it more comfortable.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Tibialis anterior foam rolling is a self-myofascial release technique targeting the tibialis anterior, a muscle located at the front of the shin. This exercise is often prescribed to reduce muscle tension, improve flexibility, and alleviate discomfort from overuse or tightness in the shin area. It is particularly beneficial for individuals experiencing shin splints, runners, or those recovering from lower leg injuries.

Instructions

• Position yourself correctly: Sit on the ground with one leg extended. Place a foam roller under the front of your shin, just below the knee.
• Support your body: Use your hands and the opposite leg to lift your body slightly, ensuring control and balance.
• Begin rolling: Slowly move your shin over the foam roller, rolling from just below the knee to above the ankle.
• Pause on tight spots: If you feel a tender area, hold pressure there for 15–30 seconds or until the discomfort lessens.
• Control pressure: Use your hands and other leg to adjust how much weight is placed on the foam roller.
• Complete both sides: Once finished, switch legs and repeat on the other shin.

Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Rolling too quickly, which reduces effectiveness and increases discomfort.
• Applying too much pressure, causing pain rather than relief.
• Failing to cover the full length of the tibialis anterior.
• Allowing the ankle to twist excessively, reducing targeted pressure on the shin.

Progressions

To make the exercise more challenging, you can:

• Place more of your body weight onto the foam roller for deeper pressure.
• Perform the exercise on a harder roller, such as a textured or dense foam roller.

Regressions

To make the exercise easier, you can:

• Use a softer foam roller for reduced intensity.
• Reduce the amount of body weight applied by keeping more weight on your hands and opposite leg.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Using a foam roller to target the peroneal muscles, which run along the outer side of your lower leg, can help reduce tension, improve flexibility, and alleviate discomfort caused by overuse or tightness. This exercise is often prescribed for individuals with ankle instability, shin splints, or tightness following running or repetitive activities. It promotes circulation and assists in recovery by reducing muscle stiffness.

Instructions:

• Set-up: Sit on the floor with your legs extended in front of you. Place a foam roller under the outer side of one lower leg, just below the knee. Support yourself by placing your hands flat on the floor behind you.
• Position the non-target leg: Cross the opposite leg over the working leg for added weight or rest it on the floor if more comfortable.
• Begin rolling: Lift your hips slightly off the floor using your arms and slowly roll your leg back and forth over the foam roller. Move from just below the knee to above the ankle.
• Control the motion: Apply gentle, consistent pressure, adjusting your body weight to suit your comfort level. Avoid rolling directly on bony areas.
• Pause on tender spots: If you find a particularly tight or sore area, pause for 15–30 seconds while maintaining a tolerable level of pressure.
• Switch sides: Repeat the process on the opposite leg.
• Hold/maintain as prescribed by your physiotherapist.

Common Errors:

• Rolling too quickly without giving the muscles time to release.
• Applying excessive pressure that causes pain or discomfort.
• Rolling directly over the bony areas, such as the fibular head or ankle bones.
• Neglecting to maintain proper arm support, which can strain your shoulders.

Progressions:

• To make the exercise more challenging, you can:
• Add more pressure by crossing your other leg over the working leg.
• Increase the rolling time to further target the muscle.

Regressions:

• To make the exercise easier, you can:
• Keep your non-working leg on the floor for reduced pressure.
• Use a softer foam roller for less intensity.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

The foam roller for rhomboids exercise focuses on relieving tension and improving flexibility in the rhomboid muscles, located between your shoulder blades. This exercise can help release tightness in the upper back and improve mobility through the thoracic spine, making it ideal for those who experience stiffness or discomfort in the upper back due to prolonged sitting or poor posture. It’s also beneficial for those aiming to improve shoulder movement and reduce tension build-up in the upper back.

Instructions

• Begin by sitting on the floor with a foam roller positioned horizontally behind you at the base of your shoulder blades.
• Lean back against the foam roller, crossing your arms over your chest or reaching them forward to separate the shoulder blades.
• Lift your hips slightly off the ground, distributing your weight onto the foam roller.
• Slowly roll up and down from the base of the shoulder blades to the top, focusing on the area between your shoulder blades.
• Pause briefly on any tender spots, breathing deeply to allow the muscles to relax.
• Continue rolling gently until you feel tension released.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Rolling too fast, which can prevent deep muscle release.
• Arching the lower back instead of keeping the core lightly engaged.
• Rolling onto the neck, which can strain the cervical spine. Limit movement to the upper back area only.

Progressions

To make the exercise more challenging, you can:

• Add more weight by placing a light weight on your chest to increase pressure on the roller.
• Perform the exercise with arms extended overhead to increase the stretch in the upper back.

Regressions

To make the exercise easier, you can:

• Keep your hips on the floor for a lighter, more controlled roll.
• Place a pillow or rolled-up towel under your head to reduce neck strain if it feels uncomfortable.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

The adductor trigger point release with external rotation is a self-release technique that targets tight or tender points in the groin muscles near the pelvis. It helps alleviate muscle tension, improve mobility, and may reduce discomfort in the inner thigh or groin region. This exercise is particularly useful for those experiencing localised tightness or discomfort in the area.

Instructions:

• Sit comfortably on a chair with both feet flat on the ground and your back upright.
• Use your thumbs to palpate the inner thigh near the groin, close to the pelvis, and locate a tender or tight spot in the adductor muscles.
• Once you’ve found the trigger point, apply firm but tolerable pressure with your thumbs.
• While maintaining pressure, lift the same-side hip slightly off the chair.
• Turn your foot inward and your knee outward, mimicking the movement as if you were trying to cross your legs.
• Hold this position and pressure as prescribed by your physiotherapist.
• Test: Try to cross your legs before completing this exercise, then try again after. If you’ve done it correctly, it should become easier.

Common Errors:

• Applying too much pressure, causing unnecessary pain or discomfort.
• Slouching or leaning excessively, which can compromise posture.
• Losing consistent pressure on the trigger point during the movement.
• Moving the leg too quickly or erratically rather than in a controlled manner.

Progressions:

To make the release more effective, you can:

• Increase the duration of the hold if it feels comfortable.
• Combine this technique with slow, deep breathing to enhance relaxation.
• Gradually increase pressure as tolerance improves over time.

Regressions:

To make the release easier, you can:

• Reduce the pressure applied with your thumbs.
• Skip the hip-lifting movement and focus only on gentle external rotation of the leg.
• Use a soft ball (e.g., a massage ball) placed on the trigger point instead of your thumbs for less strain on your hands.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

The seated hamstring stretch with neural glide is a dynamic exercise targeting the hamstring muscles and neural structures, such as the sciatic nerve. It is often prescribed to improve hamstring flexibility and mobility while gently mobilising the nerve, which can help reduce tension and improve overall comfort in the posterior chain. This exercise is ideal for individuals experiencing tightness or neural discomfort in the lower limbs.

Instructions:

• Sit upright on a sturdy chair or surface with your back straight and shoulders relaxed.
• Make sure you are sitting upright, lift your shoulders high and look straight ahead.
• Straighten one knee until you feel resistance in the back of the leg.
• While maintaining this position, point your toes downward (plantarflexion), then flex your foot upward (dorsiflexion) toward your shin.
• Repeat this controlled movement slowly and smoothly.
• Keep your upper body steady and avoid slumping or rounding your back.
• Continue this hold for as long as your Physiotherapist has prescribed.

Common Errors:

• Slouching or rounding the back, which reduces the effectiveness of the stretch.
• Leaning backwards too much, which reduces the effectiveness of the stretch.
• Bouncing the leg or performing the movement too quickly.
• Extending the knee excessively, causing discomfort or strain.
• Holding your breath – remember to breathe deeply and steadily.

Progressions:

To make the exercise more challenging, you can:

• Increase the duration of the stretch.

Regressions:

To make the exercise easier, you can:

• Reduce the range of motion by slightly bending the knee.
• Lower the leg if elevating it feels too intense.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Instructions

• Anchor a theraband at chest height to a secure point. Hold the free end in both hands with your arms extended in front of you.
• Stand perpendicular to the anchor point and shift your weight onto the leg furthest from the anchor. Lift the opposite foot slightly off the ground.
• Engage your core and maintain an upright posture.
• While balancing on one leg, rotate your upper body away from the anchor point, pulling the theraband across your chest. Keep your arms extended and your gaze following your hands to enhance thoracic engagement.
• Slowly return to the starting position, resisting the band’s pull as you rotate back.
• Repeat the rotation for the prescribed repetitions while maintaining balance, then switch to the opposite leg and direction.

Common Errors

• Losing balance or relying on the raised leg for support.
• Rotating through the hips instead of isolating the thoracic spine.
• Using momentum rather than controlled movement to pull the band.
• Allowing the shoulders to shrug or rounding the upper back.

Progressions

To make the exercise more challenging, you can:

• Use a heavier resistance band.
• Perform the exercise on an unstable surface, such as a foam pad or balance cushion.
• Hold the single-leg balance position for a longer duration before initiating the rotation.
• Add a pause at the end range of the thoracic rotation.

Regressions

To make the exercise easier, you can:

• Use a lighter resistance band.
• Keep the non-stance foot closer to the ground for additional balance support.
• Practice the thoracic rotation in a standing position with both feet on the ground.
• Perform the single-leg balance without the theraband to focus on stabilisation.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Instructions

• Anchor a resistance band at chest height to a secure point. Hold the free end with both hands, stepping away from the anchor point until you feel tension in the band.
• Stand perpendicular to the anchor point with the band positioned at your chest.
• Step forward with the leg furthest from the anchor into a lunge, lowering your back knee towards the ground. Ensure your front knee stays aligned over your toes.
• While holding the lunge position, press the band straight out from your chest, keeping your torso upright and resisting the band’s pull.
• Hold the extended position momentarily, then slowly bring your hands back to your chest.
• Maintain stability throughout the movement, focusing on engaging your core and preventing your body from rotating toward the anchor point.
• Step back to the starting position and repeat on the same side for the prescribed repetitions, then switch to the opposite side.

Common Errors

• Allowing the front knee to collapse inward or extend too far past the toes.
• Rotating the torso toward the anchor point instead of maintaining a straight, stable position.
• Leaning forward or losing balance during the lunge.
• Using momentum to press the band instead of controlled movement.

Progressions

To make the exercise more challenging, you can:

• Use a heavier resistance band.
• Perform a deeper lunge to increase lower body demand.
• Pause longer at the end range of the press for increased core activation.
• Add a single-arm Pallof press variation for greater anti-rotational challenge.

Regressions

To make the exercise easier, you can:

• Use a lighter resistance band.
• Perform a shallow lunge instead of a full-depth lunge.
• Practice the Pallof press while standing upright, removing the lunge element.
• Hold onto a stable surface for added balance support.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Instructions

• Anchor a theraband at chest height to a secure point. Hold the free end in both hands with your arms extended in front of you.
• Begin in a split stance with the target leg in front and the back leg positioned behind you. Lower into an isometric lunge, keeping the front knee bent at approximately 90 degrees and aligned over your toes.
• Face perpendicular to the anchor point of the theraband. Ensure your torso remains upright and your core engaged.
• Holding the lunge position, rotate your torso away from the anchor point, pulling the theraband across your chest. Keep your arms extended throughout the movement, and let your gaze follow your hands for optimal thoracic engagement.
• Slowly return your torso to the starting position, maintaining tension on the band and keeping your lunge stable.
• Repeat the rotation while holding the lunge for the duration prescribed by your physiotherapist.

Common Errors

• Allowing the front knee to collapse inward (valgus position).
• Rising out of the lunge or losing balance during the rotation.
• Rotating through the hips instead of isolating the thoracic spine.
• Using momentum to pull the band rather than moving with control.

Progressions

To make the exercise more challenging, you can:

• Use a heavier resistance band.
• Lower into a deeper lunge for increased muscle activation.
• Perform the thoracic rotation at a faster pace while maintaining control.
• Hold a pause at the end range of the rotation before returning to the starting position.

Regressions

To make the exercise easier, you can:

• Use a lighter resistance band.
• Maintain a higher lunge position for reduced intensity.
• Practice the thoracic rotation without the band to focus on the movement pattern.
• Hold onto a stable surface for added balance support if needed.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Level 1: Foot on the floor

Instructions:

• Stand at a 45° angle to a wall, so that your working leg is the outside leg.
• Bend your other knee and rest it against the wall, keeping your toes rested on the ground. Do not push into the wall, this is purely for balance.
• Stand up straight, pull your shoulders high and look straight ahead.
• Try to turn your upper thigh outwards. This is a small movement, and you should only feel the muscles in your buttock / side of hip turn on.
• Hold for the amount of time prescribed by your physiotherapist.
• Tip: Avoid activating the quadriceps (front of thigh muscles). If you can keep these relaxed, it will increase the activation of your gluteals.

Level 2: Foot off the floor

Instructions:

• Stand at a 45° angle to a wall, so that your working leg is the outside leg.
• Bend your other knee and rest it against the wall, lifting your toes off the ground. Do not push into the wall, this is purely for balance.
• Stand up straight, pull your shoulders high and look straight ahead.
• Try to turn your upper thigh outwards. This is a small movement, and you should only feel the muscles in your buttock / side of hip turn on.
• Hold for the amount of time prescribed by your physiotherapist.
• Tip: Avoid activating the quadriceps (front of thigh muscles). If you can keep these relaxed, it will increase the activation of your gluteals.

Precautions

• Please make sure you are able to stand on one leg
• Use the wall to help you with balance
• Your physiotherapist will give you the details of repetitions
• Please discontinue if painful

This version of the exercise focuses on strengthening the external rotators of the shoulder, primarily the infraspinatus and teres minor, while in a functional arm position. Facing the theraband allows for controlled, outward rotation of the shoulder joint, promoting joint stability and dynamic strength in a more symmetrical setup

Instructions

• Setup: Anchor the theraband securely at waist height. Stand facing the anchor point with feet hip-width apart. Hold the band with the working arm, ensuring light tension in the band.
• Starting Position: Raise the working arm to 45° abduction (partway between your side and shoulder height), keeping your elbow bent at 90°. Ensure your shoulder blades are drawn slightly back and down.
• Engage: Keep your torso upright and shoulders level, avoiding any shrugging.
• Movement: Slowly rotate your forearm outward, pulling the band away from the anchor point, while keeping your upper arm steady. Move until you reach your comfortable range or feel resistance.
• Return: Gradually control the band as you bring your arm back to the starting position.
• Breathing: Exhale as you rotate outward and inhale as you return.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Allowing the shoulder to lift or roll forward during the movement.
• Turning your body instead of isolating movement at the shoulder joint.
• Moving the entire arm instead of focusing on external rotation.
• Using momentum or performing the exercise too quickly.

Progressions

• To make the exercise more challenging, you can:
• Use a heavier resistance theraband.
• Perform the exercise on one leg to engage core stability.
• Add a hold at the end range of external rotation.

Regressions

• To make the exercise easier, you can:
• Use a lighter resistance band.
• Perform the exercise seated for better control and support.
• Decrease the range of motion to stay within a pain-free arc.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

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This variation of the traditional heel raise, using a soft ball between the ankles, is designed to enhance ankle stability and activate the muscles around the ankle joint. By squeezing the ball, you engage your inner calf muscles and foot stabilisers, promoting better alignment and control throughout the movement. This exercise is ideal for strengthening the calf muscles, improving ankle proprioception, and reducing the risk of ankle injuries.

Instructions

• Stand tall with feet hip-width apart, placing a soft ball between your inner ankles.
• Lightly press your ankles inward to hold the ball, engaging your inner thighs and calf muscles.
• Slowly lift your heels off the ground, rising onto the balls of your feet. Focus on maintaining the squeeze on the ball.
• Hold briefly at the top, feeling the contraction in your calves and ankle stabilisers.
• Slowly lower your heels back to the floor with control, keeping pressure on the ball throughout.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Allowing the ball to slip by not maintaining a consistent squeeze.
• Rising too quickly or not controlling the descent, which can reduce muscle engagement.
• Letting the ankles roll outwards or inwards, which can strain the ankle joint.

Progressions

To make the exercise more challenging, you can:

• Perform the movement on a single leg, maintaining the ball squeeze with the raised foot hovering off the ground.
• Stand on a soft or unstable surface (such as a foam pad or folded towel) to increase the stability challenge.
• Add a pause at the top for 2-3 seconds to further activate the calf muscles.

Regressions

To make the exercise easier, you can:

• Hold onto a stable surface (e.g., wall or back of a chair) for balance support.
• Use a smaller or softer ball to make it easier to maintain the squeeze.
• Perform smaller heel lifts if full range of motion is difficult.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

The following exercises introduce running and change of direction to your rehabilitation plan. These are some general exercises that will assist with safe return to sport, however each persons rehab plan should be specific to the sport they wish to return to. Your Physiotherapist will tailor your plan to your needs.

Plyometric Heel Raise

Running

• Beginning a running program at this stage is important to restore cardiovascular fitness lost during past rehabilitation.
• Begin with slow, straight line running on flat ground. You can gradually progress this to add in interval training with direction changes.
• Following a gradual running program is also a good idea. Your program should be individually tailored depending on your needs. This is an example of a beginners running program.

Hopping to a Step

Hopping with Direction Changes

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Notes:

To Increase the challenge of the class consider:

• completing more repetitions of each exercise eg. 15 or 20 repetions
• repeat each exercise multiple times eg. 2-3 sets
• repeat whole program multiple times eg. 2-3 times

Feedback

We are always looking to improve our content and would value any feedback regarding this class

Please send any feedback to [email protected]

Notes:

To Increase the challenge of the class consider:

• completing more repetitions of each exercise eg. 15 or 20 repetions
• repeat each exercise multiple times eg. 2-3 sets
• repeat whole program multiple times eg. 2-3 times

Feedback

We are always looking to improve our content and would value any feedback regarding this class

Please send any feedback to [email protected]

This exercise is a fantastic way to strengthen the shoulder’s rotator cuff, especially the subscapularis, while also improving shoulder mobility. This exercise is often prescribed to enhance internal rotation and scapular control, which is essential for shoulder health, particularly for individuals recovering from shoulder impingements or rotator cuff injuries. By lifting the arm off the lower back while lying prone, you also work on your scapular stability and posture muscles.

Instructions:

• Begin by lying face down (prone) on a comfortable surface with your arms at your sides.
• Place one hand behind your back, around the lower spine area. Your palm should be facing upwards.
• Keep your neck in a neutral position, chin tucked slightly, and your head resting gently on the surface.
• Engage your shoulder blades by gently drawing them down and together.
• Without twisting your torso or neck, lift your hand off your lower back, raising your arm as high as you comfortably can.
• Hold the lift for a moment, ensuring that your shoulder remains down, not hiked up towards your ear.
• Slowly lower your hand back to the starting position.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors:

• Allowing the shoulder to shrug up towards the ear.
• Rotating the torso or neck to assist the lift.
• Not fully engaging the scapula before lifting.
• Rushing the movement instead of lifting slowly and with control.

Progressions:

To make the exercise more challenging, you can:

• Hold a light weight in your hand (e.g., a small dumbbell or wrist weight).
• Increase the hold time at the top of the lift.
• Perform the exercise with both arms at the same time for added difficulty.

Regressions:

To make the exercise easier, you can:

• Perform the lift without attempting to raise your hand as high, focusing on smaller lifts.
• Support the arm on a small towel or cushion to decrease the range of motion.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Massage balls, both spiky and smooth, are versatile tools that can help release muscle tension, improve circulation, and enhance mobility. Spiky balls provide a deeper, more intense massage due to their pointed texture, which stimulates blood flow and targets knots or trigger points. Smooth massage balls offer a gentler pressure and can be used for larger muscle areas, providing a broader release. These tools are commonly prescribed to alleviate muscle tightness, improve flexibility, and aid in recovery from injury. They can be used for various parts of the body, including the back, glutes, feet, shoulders, and calves.

Instructions:

• Lower back release:
  • Lie on your back with knees bent and feet flat on the floor.
  • Place the ball between your back and the floor, positioning it on one side of your spine (avoid placing it directly on the spine).
  • Slowly roll your body over the ball to find areas of tension.
  • Hold on any tight spots for 20-30 seconds or until the muscle relaxes.
  • Repeat on the other side.
• Glute and hip release:
  • Sit on the floor with legs bent, leaning on your hands for support.
  • Place the ball under one glute and slowly move your body around to target tight spots.
  • Adjust the intensity by lifting or lowering your body.
  • Hold pressure on any sore spots until the tension releases.
  • Switch sides and repeat.
• Foot massage:
  • Stand or sit with one foot on the ball.
  • Roll the ball under your foot, from heel to toes, applying as much pressure as comfortable.
  • Focus on any tight or tender areas, holding the pressure for a few seconds before continuing to roll.
  • Repeat on the other foot.
• Shoulder and upper back release:
  • Stand against a wall with the ball between your shoulder blade and the wall.
  • Gently roll the ball up, down, and side to side, focusing on areas of tension.
  • Maintain steady pressure on tight spots for 20-30 seconds, then continue rolling.
• Calf massage:
  • Sit on the floor with legs extended.
  • Place the ball under your calf muscle and roll your leg over it, moving slowly to find areas of tightness.
  • Hold pressure on any sore areas, or roll the ball back and forth for a deeper massage.
  • Repeat on the other leg.

Hold/maintain pressure or complete repetitions as prescribed by your physiotherapist.

Spiky Ball:

Smooth Ball:

Common Errors

• Placing the ball directly on bony areas or joints.
• Using too much pressure too soon, leading to discomfort or bruising.
• Holding your breath during the massage instead of breathing deeply to aid in muscle relaxation.

Progressions

• To make the exercise more challenging, you can:
  • Use a spiky ball for deeper pressure on areas like the glutes or back.
  • Increase the amount of body weight on the ball for more intense pressure.
  • Perform the release for a longer duration or on multiple areas.

Regressions

• To make the exercise easier, you can:
  • Use a smooth ball instead of a spiky one for gentler pressure.
  • Support more of your body weight with your hands or feet to decrease the intensity.
  • Perform the release against a wall rather than the floor for lighter pressure.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Instructions

• Step both feet onto the step.
• Keeping your affected leg on the step, slowly step down with your unaffected side until your heel gently taps the floor.
• On your affected side, ensure your knee is in line with your second toe and hips remain level.
• Modify as prescribed by your physiotherapist.

Precautions

• Make sure this exercise is done with a proper step surface at an appropriate height prescribed by your physiotherapist.
• It should be performed carefully at home using a rail or wall for support if needed.  

Instructions:

• Lie on your stomach
• Bend the knee of your affected side and gently bring your heel up towards your bottom
• Slowly lower the heel back down

Instructions: Progression

• Tie your prescribed Theraband in a loop and place over ankles
• Lie on your stomach
• Bend the knee of your affected side and gently bring your heel up towards your bottom
• Slowly lower the heel back down being careful to control the recoil of the Theraband

Precautions

• Complete and modify as per physiotherapist instructions.
• Maintain control of the hips throughout the movement.
• If any of these exercises cause pain, please cease and speak to your physiotherapist.

Seated hip abduction with a theraband is a great exercise to strengthen the gluteus medius, the muscles on the side of your hips, and stabilise the pelvis. It’s commonly prescribed for improving hip stability, addressing knee pain, and enhancing lower limb control. This exercise is often used in rehabilitation settings for individuals with hip, knee, or lower back issues.

Instructions

• Sit upright on a chair or bench with your feet flat on the floor, hip-width apart.
• Wrap a theraband around both thighs, just above your knees. Make sure the band is secure but not too tight.
• Engage your core and keep your back straight throughout the movement.
• Press your knees outward against the resistance of the theraband, keeping your feet flat and your torso stable.
• Hold the end position briefly, feeling the muscles on the outside of your hips engage.
• Slowly bring your knees back to the starting position with control.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Allowing your torso to lean or shift sideways during the movement.
• Moving your feet off the floor or lifting your heels.
• Letting the theraband slide up or down the legs, affecting the resistance.

Progressions

• To make the exercise more challenging, you can:
  • Use a stronger theraband with higher resistance.
  • Perform the exercise while lifting one foot slightly off the ground to increase balance demands.
  • Add a small pause (2-3 seconds) at the end of the outward movement.

Regressions

• To make the exercise easier, you can:
  • Use a lighter resistance band or no band at all to start with.
  • Perform the movement with smaller ranges of motion.
  • Place a pillow or towel under your thighs to provide more support and stability.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

The banded squat is an excellent way to engage the hip muscles, particularly the gluteus medius, while also strengthening the quadriceps, hamstrings, and gluteus maximus. By using a theraband around the knees, you promote proper knee alignment and hip stability, which can help prevent inward knee collapse (valgus) and improve overall squat form. This exercise is commonly used in injury prevention programs and lower body strengthening routines.

Instructions

• Stand with your feet shoulder-width apart, toes pointing slightly outward.
• Place a theraband around your thighs, just above your knees. Make sure it is secure but not overly tight.
• Engage your core and keep your chest lifted and back straight.
• Begin the movement by pushing your hips back as if sitting into a chair, while bending your knees.
• Focus on pressing your knees outward against the band to keep them aligned directly over your toes, resisting the inward pull.
• Lower yourself down until the height recommended by your Physiotherapist, or as far as is comfortable, ensuring your weight remains through your heels.
• Push through your heels and squeeze your glutes as you rise back up to a standing position, maintaining the outward pressure on the band.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors

• Allowing your knees to collapse inward (valgus) during the squat.
• Dropping your chest forward or rounding your back.
• Failing to keep the theraband engaged by not pressing your knees outward.
• Lifting your heels off the ground instead of keeping your weight distributed through your heels.

Progressions

• To make the exercise more challenging, you can:
• Use a stronger theraband with higher resistance.
• Squat deeper while maintaining form and knee alignment.
• Add weight, such as a dumbbell or kettlebell (goblet squat), to increase intensity.

Regressions

• To make the exercise easier, you can:
• Use a lighter resistance band or no band initially.
• Perform a partial squat, stopping before your thighs reach parallel.
• Hold onto a stable surface like a wall or chair for balance support.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

The Hip “Open the Gate” exercise is a dynamic mobility drill used to warm up and activate the muscles around the hips, including the hip flexors, glutes, and inner thighs. This exercise is commonly prescribed to improve hip joint range of motion, stability, and flexibility, making it useful for athletes and anyone preparing for lower body exercises such as squats, lunges, or running. It’s also a great way to enhance coordination and hip control.

Instructions:

• Stand tall with your feet hip-width apart, hands resting on your hips or extended out for balance.
• Lift your right knee up towards your chest, creating a 90-degree bend at the knee and hip.
• Keeping your torso upright and your core engaged, slowly rotate your right knee outward, as if you’re “opening a gate,” while keeping your standing leg stable.
• Once your hip is fully rotated outward, lower your foot back down to the ground.
• Repeat on the left side.
• Continue alternating legs for the duration prescribed by your physiotherapist.

Common Errors:

• Rotating your torso or shifting your upper body to compensate for limited hip mobility.
• Moving too quickly, which can reduce the effectiveness of the exercise.
• Letting the standing leg lose stability by shifting the weight unevenly or allowing the knee to collapse inward.
• Not lifting the knee high enough to get a full range of motion in the hip joint.

Progressions:

• To make the exercise more challenging, you can:
  • Perform the movement while balancing on a soft surface like a foam pad to increase the difficulty of stabilisation.
  • Add ankle weights to further engage the muscles.
  • Increase the speed of the movement once you have mastered control, turning it into a more dynamic warm-up.

Regressions:

• To make the exercise easier, you can:
  • Perform the movement while holding onto a stable surface (such as a wall or chair) for balance.
  • Reduce the height to which you lift your knee if you find the range of motion too difficult.
  • Slow down the movement and focus on controlled, smaller rotations to gradually increase hip mobility.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

The Lunge with Weighted Soleus Stretch is a mobility exercise designed to target the soleus muscle, a deep calf muscle located underneath the gastrocnemius. This stretch improves ankle dorsiflexion, which is essential for squatting, running, and other lower body movements. By adding a weight, the stretch becomes more effective, encouraging greater range of motion. It is often prescribed to improve ankle flexibility and reduce tension in the lower legs, especially for those recovering from lower limb injuries or dealing with tight calves.

Instructions:

• Begin in a forward lunge position with one foot flat on the ground and the other leg extended behind you, with the back knee resting gently on the floor.
• Hold a weight (e.g., a dumbbell or kettlebell) and place it on your front thigh, just above the knee.
• Keeping your front heel flat on the ground, bend your front knee and shift your body weight forward to deepen the stretch.
• Make sure your back is straight, and your hips are square as you lean into the stretch.
• Hold this position, feeling the stretch deep in your lower calf (soleus) while keeping the weight stable on your thigh.
• Hold/maintain as prescribed by your physiotherapist.
• Switch legs and repeat on the other side.

Common Errors:

• Allowing the front heel to lift off the ground, which reduces the effectiveness of the stretch.
• Using too much weight, causing strain or discomfort in the knee or ankle.
• Leaning forward excessively at the waist, which reduces the focus on the soleus muscle.
• Not maintaining proper alignment by letting the knee collapse inward or outward during the stretch.

Progressions:

• To make the exercise more challenging, you can:
  • Increase the weight on your front thigh.
  • Hold the stretch for a longer duration to improve flexibility.
  • Perform the stretch on a slightly elevated surface, such as a small step, to increase the range of motion.

Regressions:

• To make the exercise easier, you can:
  • Reduce or eliminate the weight and perform the stretch using only your body weight.
  • Place a towel or mat under the back knee for extra cushioning and comfort.
  • Reduce the depth of the lunge to decrease the intensity of the stretch.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Instructions

• In a standing position, step the feet out wide with both feet facing forward
• Ensure both feet remain flat as you gently shift your weight toward your target side by bending the knee
• Ensure your knee is in line with your second toe and that your trunk remains upright throughout
• Gently shift your weight back to the opposite side by driving through the foot of your bent leg to come back into standing
• Only use a depth that is comfortable for you
• Complete and modify as per physiotherapist instructions

Precautions

• If you are aware that you are unsteady or feeling weak in your legs, please use your hands on a stable surface throughout
• Ensure to complete the exercise slowly and controlled  
• If you feel pain or are unsure of the technique, please stop and speak to your physiotherapist

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Here are three progressive concentric hip adduction exercises, commonly referred to as “Copenhagen adductions.” These exercises target the inner thigh (adductor) muscles and are typically used for strengthening, injury prevention, and rehabilitation, especially for groin strains. Each progression increases the demand on the adductor muscles and core, starting from a more supported position and gradually increasing the load on the working leg.

Progression 1: Side-Lying Concentric Hip Adduction (Unaffected Side Resting on Ground)

This exercise serves as the starting point for building adductor strength with minimal load on the working leg.

Instructions:

• Lie on your side, with the affected leg (working leg) on top and your unaffected side resting on the ground.
• Place your top leg (working leg) on the bench so that your foot or calf is resting on it, with the leg extended.
• Support your upper body by propping yourself up on your elbow, ensuring your body is in a straight line from shoulders to hips.
• Bend your bottom (unaffected) leg at a 90-degree angle and rest it on the ground for stability.
• Extend your top (working) leg straight and slightly in front of your body, keeping it in line with your hips.
• Using the adductor muscles of your working leg, lift your hips off the ground, bringing your body into a side plank position.
• Slowly lower your hips back down toward the floor but do not let them touch the ground.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors:

• Letting the hips rotate backward or forward.
• Bending the top leg, reducing adductor engagement.
• Allowing the torso to sag or slouch.

Progression 2: Copenhagen Hip Adduction (Unaffected Side Resting on Working Leg)

This version increases the load by having the unaffected leg supported by the working leg, requiring more strength from the adductors.

Instructions:

• Position yourself lying sideways on the floor next to a bench or sturdy surface.
• Place your top leg (working leg) on the bench so that your foot or calf is resting on it, with the leg extended.
• Your bottom leg (unaffected leg) should be resting on top of the working leg.
• Support your upper body by propping yourself up on your forearm, maintaining a straight line from your shoulders to your hips.
• Using the adductor muscles of your working leg, lift your hips off the ground, bringing your body into a side plank position.
• Keep the unaffected leg passive while allowing it to rest on the working leg.
• Slowly lower your hips back down toward the floor but do not let them touch the ground.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors:

• Allowing the hips to sag or rotate during the lift.
• Poor alignment, such as bending at the hips or knees.

Progression 3: Advanced Copenhagen Hip Adduction (Unaffected Side Lifted in the Air)

This is the most challenging progression, requiring both legs to be off the ground, demanding maximum strength and control from the adductors and core.

Instructions:

• Lie on your side beside a bench or sturdy surface.
• Place your top leg (working leg) on the bench so that your foot or calf is supported, ensuring your leg is extended straight.
• Your bottom leg (unaffected leg) should hover underneath the bench, not touching it.
• Support your upper body by propping yourself up on your forearm and maintain a straight body line.
• Engage your core and adductors to lift your hips off the floor into a side plank position.
• Hold briefly at the top, then slowly lower your hips and bottom leg without letting them touch the floor between repetitions.
• Complete repetitions as prescribed by your physiotherapist.

Common Errors:

• Allowing the hips to drop or rotate.
• Over-relying on the upper body for stability instead of engaging the core and adductors.

Progressions Across All Exercises:

• Increase the number of repetitions or the time spent holding the plank position at the top.
• Add ankle weights to increase resistance.
• Elevate the bench height to increase the intensity and range of motion.

Regressions Across All Exercises:

• Reduce the range of motion by lifting the leg only partway or lower the height of the support.
• Shorten the hold time at the top.
• Perform the exercise on a softer surface for added comfort and stability.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

The long lever isometric hip adduction is not only beneficial for strengthening the inner thigh muscles (adductors) but is also commonly used for pain relief, particularly in individuals recovering from groin strains or hip-related injuries. The isometric nature of the exercise allows for muscle engagement without movement, which can help reduce muscle tension and discomfort while promoting circulation to the area. This makes it a gentle yet effective method for pain management during rehabilitation phases.

Option 1: With a Ball

Instructions:

• Lie flat on your back with your legs extended and your arms resting comfortably by your sides for stability.
• Place a soft ball or small Pilates ball between your feet, ensuring it is securely held.
• Lift your legs slightly off the floor, keeping them straight and hovering a few centimetres above the ground. Make sure your lower back remains flat against the floor by engaging your core muscles.
• Gently squeeze the ball with your feet, engaging your inner thigh muscles (adductors) to create a controlled isometric contraction.
• Focus on holding the squeeze, making sure not to over-exert but just enough to feel the muscles activate and provide relief.
• Breathe steadily, ensuring the core remains engaged and your lower back does not arch.
• Hold the squeeze for as long as prescribed by your physiotherapist.
• Gently release the squeeze and lower your legs back to the ground to rest before repeating.
• Hold/maintain as prescribed by your physiotherapist.

Common Errors:

• Arching the lower back or allowing the pelvis to tilt, which can increase strain on the lower back.
• Allowing the ball to slip or shift during the squeeze.
• Over-squeezing, which may cause unnecessary discomfort in the groin or hips.
• Holding your breath during the exercise; keep your breathing smooth and steady.

Progressions:

• To make the exercise more challenging, you can:
  • Use a firmer or smaller ball to increase the intensity of the adductor contraction.
  • Increase the duration of the hold to challenge muscle endurance.
  • Lift your legs higher off the ground, engaging the core more intensely.

Regressions:

• To make the exercise easier, you can:
  • Use a larger, softer ball for a gentler squeeze.
  • Bend your knees slightly, reducing the strain on your core and lower back.
  • Perform the exercise with your feet resting on the ground, which lessens the load on your lower body.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Option 2: Against a Stationary Object

Instructions:

• Stand next to a sturdy stationary object, such as a table leg or door frame.
• Position yourself with the inside of your ankle resting against the object, so that your legs are straight and feet together.
• Shift your weight slightly onto the opposite leg for balance, keeping your standing leg straight but not locked.
• Press the inside of your ankle against the stationary object, engaging your inner thigh muscles (adductors). Maintain an upright posture, ensuring your hips stay level and your core is engaged.
• Hold the contraction steadily, focusing on a controlled isometric squeeze against the object.
• Keep your breathing regular and your body still, preventing any movement from the hips or torso.
• Hold for the duration prescribed by your physiotherapist.
• Gently release the pressure and relax before repeating.
• Hold/maintain as prescribed by your physiotherapist.

Common Errors:

• Leaning too much to the opposite side, causing improper posture.
• Allowing your hips to rotate or tilt during the contraction.
• Pressing with your foot instead of engaging the inner thigh (adductor) muscles.
• Holding your breath; remember to breathe calmly throughout the hold.

Progressions:

• To make the exercise more challenging, you can:
  • Increase the duration of the isometric hold.
  • Stand further away from the object to increase the lever length, making the contraction harder.
  • Use a more challenging object to press against, such as a wall, which provides more resistance.

Regressions:

• To make the exercise easier, you can:
  • Stand closer to the object, reducing the length of the lever and the intensity of the contraction.
  • Place a cushion or padding between your ankle and the object to reduce pressure on your joint.
  • Hold the contraction for a shorter period initially.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist

The pelvic floor muscles are responsible for maintaining continence and supporting the organs within the pelvic cavity. There are times when the coordination of these muscles is reduced affecting your bladder, bowel or sexual function. The goal of downtraining is to create awareness of the pelvic floor and promote relaxation by focusing on controlled breathing and muscle release.

Instructions:

• Find a comfortable position, either lying down with your knees bent, sitting, or supported on your side.
• Take a deep breath in through your nose, allowing your belly and rib cage to expand.
• As you exhale, gently focus on releasing and relaxing the pelvic floor muscles. Imagine letting go of any tension, like you’re softening the muscles at the base of your pelvis.
• Visualise your pelvic floor as a hammock, lowering and widening as you breathe out.
• Avoid tensing any other muscles (such as your buttocks, thighs, or abdominals) during the relaxation phase.
• Continue to take slow, deep breaths, ensuring each exhale is paired with a conscious release of the pelvic floor muscles.
• Hold/maintain as prescribed by your physiotherapist.

Common Errors:

• Holding tension in the pelvic floor throughout the exercise.
• Contracting the abdominals or gluteal muscles instead of focusing on pelvic floor relaxation.
• Shallow breathing or rushing through the breaths.

Progressions:

• To make the exercise more challenging, you can:
  • Practise the relaxation in more upright postures, such as sitting or standing.
  • Increase awareness of your pelvic floor in different activities like walking or gentle stretching.

Regressions:

• To make the exercise easier, you can:
  • Practise in a more supported position, such as lying down with a pillow under your knees.
  • Use visual or audio cues, like guided relaxation, to help focus on letting go of tension.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

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You’ll be sent online forms via SMS once our team has reviewed the booking. These forms can be easily completed on your mobile device. Doing so will save you time at the clinic and ensure that your physio has all relevant information available for your consultation.

If you have any questions, don’t hesitate to contact us.

Cancellation Policy

We have a firm 24-hour cancellation policy. Our team works hard to help as many people as possible, so please be respectful of their time. Please call as soon as possible if you need to change your appointment!

Our pelvic floor plays a crucial role in core stability and movement. Pelvic floor fascial release helps ease restrictions in the fascia, supporting better urination, defecation, sexual function. Regular care of this area can assist in reducing pelvic girdle pain, and even lower back pain. Your body will thank you for taking care of this essential area!

Instructions

• Find a comfortable sitting position on a towel, cushion or bolster
• You can use a sock for a softer feel, a tennis ball, or hard ball based on your level of comfort
• Place the ball on your perineum, the space between your vagina and anus for women, or scrotum and anus for men
• Sitting in a comfortable sitting position, rest your hands on your knees, shoulders relaxed
• Bring awareness to you pelvic floor, taking slow deep breaths
• Bring awareness to the front of your pubic bone and relax this area as you exhale
• Breathe to the back of the pelvic triangle (anus) and relax
• Breathe and focus on your sit bones, allowing them to gently part
• Use your inhalation to expand
• Use your exhalation to release the pelvic floor allowing a feeling of softness around the ball
• Lean forward to remove the ball
• Sit back in a comfortable position and stay for a few more minute to breath and relax the pelvic floor, brining your awareness to the different sensations you might feel without the ball.

Notes:

To increase the challenge of this class consider:

• completing more repetitions of each exercise eg. 15 or 20 repetions
• repeat each exercise multiple times eg. 2-3 sets
• repeat whole program multiple times eg. 2-3 times

Precautions

• If any of these exercises increases pain, please cease.

Feedback

We are always looking to improve our content and would value any feedback regarding this class

Please send any feedback to [email protected]

Notes:

To increase the challenge of this class consider:

• completing more repetitions of each exercise eg. 15 or 20 repetitions
• repeat each exercise multiple times eg. 2-3 sets
• repeat whole program multiple times eg. 2-3 times

Precautions

• If any of these exercises increases pain, please cease.

Feedback

We are always looking to improve our content and would value any feedback regarding this class

Please send any feedback to [email protected]

Instructions:

• Come into standing with a ball between the palm and the wall.
• Position the wrist just below shoulder height.
• Gently draw the shoulder blade towards the spine.
• Keeping the shoulders and chest level and the hips stable, begin tracing the alphabet with the target limb.
• Complete the alphabet from A-Z unless otherwise directed from your Physiotherapist.

Precautions:

• If you experience any discomfort please alert your Physiotherapist and cease.

Instructions

• Sitting upright in a chair.
• Use the long edge of a towel and sit it across the affected level as indicated by your therapist, with one edge of the towel/pillow case in either hand.
• Apply a comfortable but firm pressure over the low back by pulling the ends of the towel/pillow case whilst keeping your thumbs pointed upward. You may add a gentle elbow bend to increase the level of pressure.
• Ensure you are ulling in an upward diagonal.
• Whilst maintaining this pressure, gently lean forward in your chair.
• Once at the ned of your comfortable range, slowly rise back up.
• Complete and modify as prescribed by your physiotherapist.

Precautions

• Ensure your feet are firmly planted on the floor throughout
• If you experience an increase in pain, cease the exercise and contact your physiotherapist

Instructions

• Position yourself in side-lying with a soft bend in the knees.
• Ensure the target side is on top.
• Ensure your ankles are in line with the buttocks and that your hips and shoulders are stacked.
• Maintaining this position, keep your knees together and slowly lift and lower the top heel.
• Modify as prescribed by your physiotherapist.

Precautions

• Ensure your hips remained stacked throughout
• Cease if this exercise brings on any pain and advise your physiotherapist

Instructions:

• Come to a side-lying position with the affected side on top
• Using the prescribed weight/dumbbell, let your hand rest across the stomach with the elbow in a 90 degree position
• Keep your arm tucked into the side of the body
• Bring the back of your hand up towards the roof as we work into external rotation of the shoulder
• Return to the starting position and repeat as per physiotherapist instruction

Precautions:

• Stop this exercise if this exacerbates your pain.
• Speak to your physiotherapist prior to performing this exercise if you have had a history of shoulder dislocations prior to attempting this exercise.

Progressions and Regressions:

There are plenty of ways to make this class harder or easier, some ideas are:

• Progressions:
  • Try some more balance exercises with your eyes closed.
  • Increase the number of repetitions and sets with the strength exercises.
• Regressions:
  • Only do what feels safe. Repeat some of the lower level balance exercises if you don’t feel confident with the more difficult ones.

Precautions:

• Make sure you do your balance exercises near the kitchen bench or something safe.
• Before you start, make sure there are plenty of objects nearby that you could use to help yourself off the ground incase you fall. Also ensure you have a phone nearby to call for help if needed.

Feedback:

We are always looking to improve our content and would value any feedback regarding this class

Please send any feedback to [email protected]

Instructions

1. Lie down on your back.
2. Whilst keeping your knee straight, lift the foot up until you feel restriction.
3. Turn your foot inwards to bias the Peroneal Nerve.
4. Whilst slowly lowering the leg and returning the foot to neutral, lift your head up.
5. Slowly lower the head back down whilst lifting the leg back up and turning the foot inwards.
6. Repeat steps 4 and 5 to slide the peroneal nerve back and forth.

Precautions

• Only do this as many times as your Physiotherapist has prescribed, as you can overdo this and further irritate the nerve.
• This should cause some symptoms, however overall should make your pain better, not worse.
• Contact your Physiotherapist for any questions.

Instructions

1. Tie a theraband into a circle or fasten a belt around the ankles.
2. The band should be tight enough to feel some tension when your feet are shoulder width apart.
3. Pull the target limb outwards, keeping the knee straight. until you feel sufficient resistance on the band.
4. Sustain for 5s or as specified by your Physiotherapist.
5. Relax the tension for the rest period.
6. Repeat as many times as your Physiotherapist recommends.

Precautions

• This exercise should feel hard, but not painful. If you’re feeling pain, contact your Physiotherapist.

Insrutctions:

• Start standing in a staggered stance.
• Raise your arms out in front of you with a resistance band in both hands.
• Imagine you are holding a bow and arrow and pull back your arm as if you are drawing back on the bow.
• As your pull your arm back your body should twist in the same direction.
• Return to the start position.
• Repeat as per your Physiotherapist guidelines.

Open Chain Knee Extension can be used safely from 12 weeks post op – and likely earlier.

Earlier use of Open Chain Knee Extension can be considered if clinically indicated, with the following restrictions:

• Restricted ROM (45 – 90 degrees)
• Isometrics at 60 degrees and 90 degrees

Evidence has shown

• no increased ACL laxity with the introduction of Open Chain Knee Extension at 6 weeks.
• no increased ACL laxity with using full range Open Chain Knee Extension at 12 weeks

Open Chain Knee Extension exercises are recommended in multiple ACL Reconstruction rehabilitation guidelines

• Janssen, van Melick, van Mourik, Reijman, & van Rhijn, 2018
• van Melick et al., 2016
• Wright et al., 2015

Summary

• Consider starting supervised Open Chain Knee Extensions between 45-90 degrees from 6 weeks
• Consider starting full range Open Chain Knee Extensions from 12 weeks

Progressions and Regressions:

There are plenty of ways to make this class harder or easier, some ideas are:

• Progressions:
  • Try some more balance exercises with your eyes closed.
  • Increase the number of repetitions and sets with the strength exercises.
• Regressions:
  • Only do what feels safe. Repeat some of the lower level balance exercises if you don’t feel confident with the more difficult ones.

Precautions:

• Make sure you do your balance exercises near the kitchen bench or something safe.
• Before you start, make sure there are plenty of objects nearby that you could use to help yourself off the ground incase you fall. Also ensure you have a phone nearby to call for help if needed.

Feedback:

We are always looking to improve our content and would value any feedback regarding this class

Please send any feedback to [email protected]

Progressions and Regressions:

There are plenty of ways to make this class harder or easier, some ideas are:

• Progressions:
  • Increase number of reps, or sets.
  • Add a resistance band around the ankles or knees for hip abduction and clamshell exercises.
  • Incorporate the side-plank into more exercises.
• Regressions:
  • Decrease number of reps or sets.
  • Decrease heigh of hip abduction and clamshell exercises.
  • Remove side-plank, or try a modified side-plank.

Feedback:

We are always looking to improve our content and would value any feedback regarding this class

Please send any feedback to [email protected]

Falls are a major public health problem to the elderly population in Australia. They are one of the leading causes of injury for people over the age of 65 years. At Peak Physio, we are committed to the ongoing education and awareness around falls and falls risks. Exercise and education is highly recommended for falls prevention to improve cognition, balance, strength, bone density and cardiovascular health. In a supervised environment, we are able to support and empower our clients to improve their current health status and minimise falls risks.

Common Falls Risk Factors:

The following are some important examples discussed during the course that can increase risk of falling:

• Current health
• Medications
• Eye health
• Continence
• Walking aids
• Environment
• Fear of falling

Peak Physio Falls Prevention Program

Program Structure

Peak Physio Falls Prevention program is a five week structured course delivering evidence based recommendations and strategies in a small group environment. Led by a Physiotherapist, our aim is to provide a solid foundation to regain your confidence with everyday function and improve your current baseline. The program will include education on health, balance, strength, upper limb control and recovery from falls.

The course is run twice a week for five consecutive weeks. At the initial session, objective outcome measures will be taken to assess your baseline. These measures are directly associated with falls prevention and risk assessments. At the cessation of the course, we will reassess these measures to monitor for improvement and change.

Each class will consist of a new module where you will receive new exercises specifically targeted to your goals and areas for improvement. The small group settings allows for catering to each participants learning style and create a collaborative learning environment that is positive and engaging. You will learn specific exercises to gain strength, balance and improve your confidence. Participants will learn to view falls and fear of falling as controllable.

What to Bring?

Please bring comfortable clothes and proper shoes for exercise. You might want to bring a note book for note taking.

Our Falls Prevention Program has been designed by our Physiotherapists who are passionate about making sure you stay connected to your community and make some new friends along the way.

‘It takes a child one year to acquire independent movement and ten years to acquire independent mobility. An older person can lose both in a day from a single fall’ – Professor Bernard Isaacs (1924–1995)

How to start?

Please enquire within about our next group intake by calling our friendly team.

Our Physiotherapists would also be more than happy to discuss the program or any questions that you might have.

Notes:

Consider picking 4-5 of these movements to complete regularly

Feel free to repeat each exercise 2-3 times or repeat the entire class 2-3 times.

Feedback

We are always looking to improve our content and would value any feedback regarding this class

Please send any feedback to [email protected]

Level 1 Instructions

• Begin by laying on your back with your knees bent and engage abdominal muscles by drawing the belly button towards the spine
• Lift both legs up into the tabletop position
• Maintain a neutral spine and keep your bent knee position throughout
• Slowly lower both your legs down to the ground and back up into tabletop position
• Repeat as per your Physiotherapist advice

Level 2 Instructions:

• Begin by laying on your back with your knees bent and engage abdominal muscles by drawing the belly button towards the spine
• Lift both legs up into the tabletop position
• Maintain a neutral spine
• Slowly straighten your legs as you lower the towards the ground
• Bend your legs as your float them back up into tabletop position
• Repeat as per your Physiotherapist advice

Level 3 Instructions:

• Begin by laying on your back and engage abdominal muscles by drawing the belly button towards the spine
• Start with your straight legs pointing towards the ceiling
• Maintain a neutral spine
• Slowly lower your legs towards the ground
• Float your legs back up towards the ceiling
• Repeat as per your Physiotherapist advice

Precautions:

• Ensure that your lower back is flat to the floor
• Complete the exercise slow and controlled
• If you experience any pain, please stop the exercise and speak to your physiotherapist

Strapping for Ankle Ligament Tears (Lateral OR Medial)

Key Points:

Taping differs slightly depending if lateral (outside) ligaments are damaged, or medial (inside) ligaments are damaged.

• This video showcases taping for LATERAL (outside) tears. Medial (inside) tears are very similar.
• LATERAL (outside) ligament tears:
  • As per video.
  • Hold the ankle with the toes pointed towards you, and to the outside.
  • Most layers of tape are pulled from inside to outside.
• MEDIAL (inside) ligament tears:
  • Opposite of video.
  • Hold the ankle with the toes pointed towards you, and to the inside.
  • Pull in opposite direction, ie if video starts on the inside and pulls to the outside, then start on the inside and pull to the outside.

Allergies / Irritation:

• You can use a tape underlay such as hyperfix, to improve the tape’s adhesiveness, but also prevent reactions or skin irritation.

Taping will only last for 2-3 days.

Level 1 – Figure 6

1. Pull ankle towards you, and roll toes outwards. This places the ligament in a shortened position.
   • Roll toes inwards if your injury is on the inside of the ankle.
2. Wrap a layer of tape around the leg, just above the ankle.
3. 2-3 x stirrups: Start inside, pull down and back around up to the opposite side. Repeat 2-3 times, until the bony part of the ankle is covered.
4. 2 x lateral figure 6’s: Start inside and pull down, underneath the foot. Once on the other side, pull the tape across the top of the foot, back to where you started.
5. 1 x medial figure 6: Start outside and pull down, underneath the foot. Once on the other side, pull the tape across the top of the foot, back to where to started.
6. Repeat step 2, to hold tape in place.
7. If requiring more support, continue to video 2

Level 2 – Heel Lock / Figure 8

• If you require more support than Level 1, complete Level 1 video and then progress to a heel lock to add more support.

1. Start on the outside. Pull behind the ankle diagonally, across the Achilles. Continue pulling down diagonally, wrapping underneath the foot. Pull straight back up and place the tape down where you started.
2. Start on the inside. Pull behind the ankle diagonally, across the Achilles. Continue pulling down diagonally, wrapping underneath the foot. Pull straight back up and place the tape down where you started.

Precautions

• If you have any itchiness, redness or pain take the tape off as it could cause a reaction.
• If you have access, place a layer of hyperfix underlay tape down first to protect the skin.

Level 1 instructions:

• Lay on your stomach with your forehead on a pillow to allow for some breathing room
• Squeeze the shoulder blades together and lift the palms up, in line with the hip
• At the same time lift from your breastbone so you shoulders, head and neck lift off the ground while maintaining a neutral neck position.
• Slowly lower back to the ground with shoulders rested
• Repeat as per your Physiotherapist instructions

Level 2 instructions:

• Lay on your stomach with your forehead on a pillow to allow for some breathing room
• Repeat the same movement from above: squeeze the shoulder blades together, lift your arms up, lift from your breastbone so your shoulders, head and neck lift off the ground
• Simultaneously lift both legs off the ground
• Slowly lower back to the ground with shoulders and legs rested
• Repeat as per your Physiotherapist instructions

Precuations:

• If you experience any pain, please stop the exercise and speak to your Physiotherapist

Notes:

To increase the challenge of this class consider:

• completing more repetitions of each exercise eg. 15 or 20 repetitions
• complete 1 more set of 5 exercises to make it 3 sets total

Feedback

We are always looking to improve our content and would value any feedback regarding this class

Please send any feedback to [email protected]

Instructions Level 1:

• Lie on your back with knees bent up
• Bring one leg up into tabletop position while also raising the opposite arm to point to the ceiling
• Lower both your arm and leg
• Repeat on the opposite side
• Make sure your core is engaged throughout the movement

Instructions Level 2:

• Lie on your back with knees bent up
• Bring one leg up into tabletop position while also raising the opposite arm to point to the ceiling
• Lower both your arm and leg while simultaneously bringing your opposite arm and leg up
• Repeat 10 times or as prescribed by your physiotherapist
• Make sure your core is engaged throughout the movement

Instructions Level 3/ Extended:

• Lie on your back with knees bent up
• Slowly one leg at a time bring your legs into tabletop position
• Extend both arms to the ceiling directly in front of your chest
• Extend opposite arm and opposite leg away from your trunk breathing out as you do
• Bring the arm and leg back to the start point while breathing in
• Repeat on the opposite side
• Complete 10 reps on each side

Precautions:

• Ensure that your lower back is flat to the floor
• Ensure to use your breathe to complete the exercise
• Ensure to take the exercise slow and controlled
• If you experience any pain, please stop the exercise and speak to your physiotherapist

Instructions

• Anchor the band at elbow height and hold it next to your body with a straight arm
• Take a small step away from anchor point while keeping your arm next to your body
• Do not let your arm drift away from your body
• Hold and repeat as per your physiotherapist instructions

Instructions:

• Start with your head tilted away from the affected arm and and your elbow bent so your hand is touching your shoulder
• Slowly start to straighten your arm until it is down beside your body with your wrist pulled back
• Simultaneously move your head back to the centre and then turn it towards your moving arm until you are looking down at your hand.
• Return to the start position by bending your arm and bringing your head back up until you head is tilted away from your arm again
• Repeat this 10 times or as prescribed by your physiotherapist

Precautions

• Do not be tempted to perform more repetitions as this may irritate the tissue.
• Complete all movements slowly
• Do not push past a light stretch/ tension when performing these movements
• If your symptoms become aggravated, stop immediately and notify your Physiotherapist.

Instructions

• Place the prescribed Theraband over both feet
• Starting in the tabletop position, ensure your hips and knees have a 90 degree bend
• Maintain a neutral pelvic position
• Keep the arms and shoulders relaxed by your side
• Slowly extend the knee of one leg out so the toes are at the same level
• Draw the knee back to the starting position and repeat on the opposite side

Precautions

• Ensure that your lower back is flat to the floor
• Ensure to use your breathe to complete the exercise
• Ensure to take the exercise slow and controlled
• If you experience any pain, please stop the exercise and speak to your physiotherapist

Instructions: Prone

• Lay on your stomach with your head resting on your forearms
• Slowly bend your knee until you feel a stretch in your leg
• As you lower your leg, raise your head up at the same time
• As your bend you knee again, lower your head back onto your forearms
• Repeat this 10 times or as directed by your physiotherapist

Instructions: Sidelying

• Lay on your side and hug your bottom knee into your chest
• Have your top knee bent at a 90 degree angle
• Slowly extend your top leg backwards while keeping your knee bent
• At the same time tilt your head backwards
• Then tilt your head forwards as you bring your top leg forwards into hip flexion
• Maintain a 90 degree knee bend in your top leg throughout the exercise.
• Repeat x10 or as prescribed by your physiotherapist

Precautions

• Perform this exercise strictly as guided by your physiotherapist – do not be tempted to perform more repetitions as this may irritate the tissue.
• Complete all movements slowly
• Do not push past a light stretch/ tension when performing these movements
• If your symptoms become aggravated, stop immediately and notify your Physiotherapist.

Instructions:

• Stand hip width apart in front of a chair
• Hold on to the chair for balance and keep your body upright throughout the movement
• Bend your knee to bring your heel towards your bottom
• Slowly lower your foot back to the ground
• Repeat as per your physiotherapist instructions

Precautions:

• Do not arch your back
• Make sure your thighs stay in line with each other as your bend your knee

Retraction – “A” Stance Instructions

• In a standing position, secure the prescribed Theraband around a sturdy pole just above waist height.
• With a proud chest and thumbs pointing towards the roof, pull the hands back keeping the elbows straight
• As you pull back, focus on squeezing the shoulder blades together.
• Control the return.

Retraction – “T” Stance Instructions

• In a standing position, secure the prescribed Theraband around a sturdy pole just below shoulder height.
• With a proud chest and thumbs pointing towards the roof, pull the hands back keeping the elbows straight.
• As you pull back, focus on squeezing the shoulder blades together.
• Maintain tension between the shoulder blades as you control the return.

Retraction – “W” Stance Instructions

• In a standing position, secure the prescribed Theraband around a sturdy pole just below shoulder height.
• With a proud chest and thumbs pointing towards the roof, pull the hands back and gentle bend the elbows to 90 degrees and rotate your hands upward 90 degrees.
• As you pull back, focus on squeezing the shoulder blades together.
• Maintain tension between the shoulder blades as you control the return.

Precautions

• Maintain proud chest as the band returns to the starting position.
• Ensure that the shoulders do not roll forward or hitch upward.
• This exercise should not be painful. If you are finding the exercise is increasing your symptoms, cease the exercise and speak to your Physiotherapist.

Instructions:

• Start in sitting with a resistance band around the middle of your feet.
• Gently pull your feet away for each other and hold for a period of time determined by your Physiotherapist.
• Let your feet slowly come back together and relax.
• Do not let your ankles turn inwards during the exercise.
• Hold and repeat as per your Physiotherapist guidelines.

Variation 1 instructions:

• Start sitting with your affected ankle next to the wall.
• Have a ball or towel between your ankle and the wall.
• Gently turn your foot outwards to press the outer edge of your foot into the ball or towel and hold for a period of time determined by your Physiotherapist.
• Do not let your knee turn inwards during this movement.
• Repeat as per your physiotherapist guidelines.

Instructions:

• Sit on the ground or on your bed with your legs out straight in front of you.
• Loop a towel or belt over the top end of your foot.
• Keep your leg straight.
• Gently pull on the ends on the towel/ belt to pull your ankle back.
• Hold for 30-60 seconds or as advised by your Physiotherapist.

Precautions

• The sensation should be a strong stretch, not pain.
• If you experience pain, stop the exercise or reduce the movement.

Instructions:

• Place the laser on your head and stand arms length away from the wall
• Move your head to trace the laser around a picture frame or other object such as a doorframe or along blinds
• Complete this as slowly and accurately as possible
• Complete 10 repetitions in each direction

What is Gait Analysis?

Running assessments and gait analysis can be helpful for all types of runners, whether you are just starting out, or an experienced runner looking to improve your performance. During the analysis your Physiotherapist will assess multiple parameters that affect your running economy. How efficient you are during your stride will determine how much load is taken on by the muscles, joints and tendons.

Areas assessed:

• Foot strike – Do you land with your heel, midfoot or forefoot?
• Knee valgus – Does the knee fall inwards during stance phase?
• Pelvic drop – Do the hips fall side to side?
• Knee flexion angle – How much does the knee bend during stance and swing phases?
• Hip extension angle – How much does the hip extend during stance phases?
• Over striding – Does the foot land under or in front of the body?

For more information on the running gait, read one of our articles here.

What Will The Appointment Look Like?

A running assessment is a 30 minute consultation that will begin with one of our Physiotherapists taking a subjective history, to gain some information surrounding your running history, your goals, any past injuries and your medical history.

From there, you will be asked to run on a treadmill for 2-3 minutes. Your Physiotherapist will film you from a back and side view to get the data required. This video will then be broken down frame by frame to look for any areas to improve your efficiency and identify modifiable movement patterns or abnormalities.

Your Physiotherapist will then extract relevant information and assess the angles at relevant lower limb joints, trunk position and running parameters such as step and stride length.

Your Physiotherapist will discuss the findings with you, provide you with advice and education, and finally develop an individualised exercise program with you to address any deficits that are found.

How Can A Running Gait Analysis Help?

Improving Performance and Injury Prevention

Addressing the deficits found during running gait will improve your performance, or “running economy”, as well as reduce your chance of getting injured in the future.

Certain patterns that are commonly seen in runners can lead to a misbalance in force creation and absorption, meaning certain areas experience more load than what they need to, and other areas might not be working hard enough.

An example of this might be running with increased knee valgus which can be a result of weakness in the hip, and lead to unnecessary loading at the knee. An individualised, functional exercise program that addresses weakness of the lateral hip muscles will assist in evening out the share of load when running.

Rehabilitation and Preventing Recurrence

Gait analysis can also be particularly useful in rehabilitation to prevent re-injury.

For example, someone who continually develops a patella tendinopathy might be running with too much of a forefoot strike, leading to increased load at the anterior knee.

Gait analysis will help confirm this, and with advice surrounding foot-strike patterns, as well as an exercise program aimed at improving strength and ankle dorsiflexion range, you can fix this recurring issue for good.

Booking an Appointment

You do not need a referral to see a Physiotherapist or to have a running assessment completed. Please call your nearest location or book an extended initial consultation online.

Double Arm Instructions:

• Locate a sturdy table or bench top at hip height.
• Place both palms of your hands onto the bench and ensure weight distribution is equal on each side.
• Ensure the amount of weight you put through your hands is appropriate to your wrist strength and does not provoke your symptoms.
• From this position pull your finger down into the bed, whilst maintaining a straight hand position in order to elevate your palms off of the bed.
• Slowly lower the palms of your hands back down to the bed.
• Complete this exercise for the repetitions prescribed by your Physiotherapist.
• When completing this exercise ensure the appropriate weight is still being pressed through the hands throughout the entire movement.

Single Arm Instructions:

• Locate a sturdy table or bench top at hip height.
• Place one palm onto the bench and ensure weight distribution into the palm is at a level as to not provoke your symptoms.
• From this position pull your finger down into the bed, whilst maintaining a straight hand position in order to elevate your palm off of the bed.
• Slowly lower the palm of your hands back down to the bed.
• Complete this exercise for the repetitions prescribed by your Physiotherapist.
• When completing this exercise ensure the appropriate weight is still being pressed through the hands throughout the entire movement.

Precautions:

• If this exercise exacerbates your symptoms, cease immediately.
• Ensure the table or bench you perform this on is sturdy and can support your bodyweight.

Instructions:

• Find an appropriate weight to use that has been prescribed by your Physiotherapist given your symptoms.
• Pinch the plate between your four fingers and thumb.
• Hold for a time prescribed by your Physiotherapist.
• Rest and repeat for the number of times prescribed by your Physiotherapist.

Precautions:

• When completing this exercise ensure your symptoms are not provoked. If this occurs cease the exercise immediately.
• Ensure when completing this exercise not to let the weight drop onto any unsafe surfaces or onto your own body.

Wrist Flexion Instructions:

• Find a towel that you can comfortably hold within both hands.
• Stabilise the towel with one hand whilst griping the towel with the other.
• Rotate the towel forwards with the gripping hand so that your knuckles will point towards the ground.
• Release the towel with your gripping hand, ensuring the tension is maintained within the towel.
• Grasp the towel again with your knuckles pointing towards the roof and complete the previous motion again twisting the towel forward and increasing tension within the towel.
• Repeat this process as many time as your Physiotherapist has prescribed.

Wrist Extension Instructions:

• Find a towel that you can comfortably hold within both hands.
• Stabilise the towel with one hand whilst griping the towel with the other.
• Rotate the towel backwards with the gripping hand so that your knuckles will point towards the roof.
• Release the towel with your gripping hand, ensuring the tension is maintained within the towel.
• Grasp the towel again with your knuckles pointing towards the floor and complete the previous motion again twisting the towel towards yourself and increasing tension within the towel.
• Repeat this process as many time as your Physiotherapist has prescribed.

Precautions:

• Ensure symptoms are not provoked when completing this exercise. If this occurs cease exercises immediately.

Instructions

1. Lie down on your back.
2. Place a rolled up towel, small ball or foam roller in the crease of your knee.
3. Bend your knee to keep the towel in place.
4. Use your hands to pull your knee slightly further into flexion, and then release.
   • Tip: If you can’t reach your leg, use a towel or belt to bend the knee further.
5. Repeat this as many times as your Physiotherapist has prescribed.

Precautions

• This exercise should reduce your pain, if it is increasing it then stop the exercise and contact your Physiotherapist.
• Don’t push the knee too far, try to stay in a pain-free range.

Instructions

1. Rest your elbow on a table.
2. Place a rolled up towel, small ball or foam roller in your elbow crease.
3. Bend the elbow to keep the towel in place.
4. Use your other hand to bend the elbow slightly further, and then release.
5. Repeat this as many times as your Physiotherapist has prescribed.

Precautions

• This exercise should reduce your pain, if it is increasing it then stop the exercise and contact your Physiotherapist.
• Don’t force the elbow further than it feels it can go, start in pain-free range.

Notes:

To increase the challenge of this class consider:

• completing more repetitions of each exercise eg. 15 or 20 repetions
• repeat each exercise multiple times eg. 2-3 sets
• repeat whole program multiple times eg. 2-3 times

Feedback

We are always looking to improve our content and would value any feedback regarding this class

Please send any feedback to [email protected]

Instructions:

• Start in a split stance by stepping one foot forwards with your feet hip width apart
• Tuck your tailbone while keeping your chest up
• Keep your back leg straight
• Slowly lunge forwards through the front leg
• You should feel a stretch in the back leg at front of the hip
• You can do this next to a chair and hold on for balance if required
• Hold for 30-60 seconds or as prescribed by your Physiotherapist

Instructions

• Start in a 4 point kneeling position with your hands under your shoulders and knees under your hips
• Have your chin slightly tucked and look straight down at the bed
• Slowly turn your head to look at your little finger on one side and then the other side
• Repeat 10 times or as instructed by your therapist

Precautions:

• Do not let your head drop down throughout the movement
• Keep your jaw relaxed
• If this is painful on your wrists try making a fist with your hands instead

Instructions

1. Place the leg you are wanting to train on a step.
2. Hinge at your hips, leaning forward so that your knee is above your ankle.
3. On a count of roughly 3 seconds, step up with other leg.
4. As you step up, focus on activating the muscles in your thigh, and try to keep your knee over the middle of your toes, don’t let it wobble side to side or fall inwards. This targets your quadriceps.
5. As you step up, also focus on driving forward with the hips, and standing all the way up. Doing this will target your gluteal muscles.
6. Reverse this movement, and slowly step back down again on a 3 second count. Remember to hinge at the hips, and keep your knee stable.
7. Repeat this as many times as your Physiotherapist has prescribed.

Precautions

• Ensure your step is at a safe height. Do this near a rail or wall that you can hold onto for balance if you need.
• This exercise might feel hard but should not feel painful, if it is aggravating your pain contact your Physiotherapist.

• Lie comfortably on the floor with. your ankles over the roller
• lift your hips off the floor and hold
• The length and number of holds will be determined by your physiotherapist

Useful for:

• Treatment of right posterior canal BPPV

Instructions:

• Start in long sitting with a pillow behind your back
• Turn your head 45 degrees to the right side
• Slowly lay backwards over the pillow until your head touches the bed while maintaining your head turn. This will put you into 30 degrees of neck extension.
• Hold this position for at least 1 minute
• Keep your head in contact with the bed and slowly turn your head to the left side until you head is facing 45 degrees to the left.
• Hold this position for at least 1 minute
• Tuen onto your left side and turn your head another 90 degrees until your nose is pointing into the bed and gently tuck your chin.
• Hold this position for 1 minute
• Slowly sit up on the left side of the be and keep your head turned until you are upright
• Hold this position for another 1 minute
• Repeat this again and do this twice a day

Useful for:

• Treatment of left posterior canal BPPV

Instructions:

• Start in long sitting with a pillow behind your back
• Turn your head 45 degrees to the left side
• Slowly lay backwards over the pillow until your head touches the bed while maintaining your head turn. This will put you into 30 degrees of neck extension.
• Hold this position for at least 1 minute
• Keep your head in contact with the bed and slowly turn your head to the right side until you head is facing 45 degrees to the right.
• Hold this position for at least 1 minute
• Tuen onto your right side and turn your head another 90 degrees until your nose is pointing into the bed and gently tuck your chin.
• Hold this position for 1 minute
• Slowly sit up on the right side of the be and keep your head turned until you are upright
• Hold this position for another 1 minute
• Repeat this again and do this twice a day

• Lie down on your back
• Bring the towel behind your neck just under your skull
• Relax your shoulders as you gently pull away
• Sustain as per physiotherapy guidelines

Instructions

• Sit next to a table with your hand raised towards the ceiling and elbow resting on the table surface inline but below your shoulder height
• Holding a theraband tied behind you, press your hand down towards the table surface
• Return your hand slowly back to the start position
• Repeat as prescribed by your physiotherapist

Precautions

• Stop this exercise if this exacerbates your pain
• Speak to your physiotherapist prior to performing this exercise if you have had a history of shoulder dislocations prior to attempting this exercise

Instructions Supported: Theraband

• Sit next to a table with your elbow and hand resting on the table surface inline but below your shoulder height.
• Holding a theraband tied in front of you, lift your hand up towards the ceiling while keeping your elbow in contact with the table.
• Return your hand slowly to the table surface.
• Repeat as prescribed by your physiotherapist.

Instructions Supported: Dumbbell

• Come into sitting with the chest open and head stacked above the pelvis
• Position the target limb on a bench at 90 degrees with the wrist on a forward diagonal
• Utilise a hand weight prescribed or a theraband anchored in front of you
• Pull the weight back to position the wrist above the elbow
• Return to the start position with control
• Repeat as per Physiotherapists guidelines

Instructions Supported: Dumbbell Seated

• Come to a semi – seated position as shown in the video, with the arm you are wanting to train on the same sided knee
• Hold onto the weight/dumbbell prescribed by your physiotherapist
• The elbow should not move off from leaning on the knee
• From this position, keep your elbow in a 90 degree angle
• Bring the back of your hand and weight up towards the roof, this will perform the external rotation movement
• Return to the starting position and repeat as per physiotherapist guidelines

Instructions Unsupported: Theraband

• Anchor the resistance band in front of you at the level of the shoulders
• Take the band with the target limb and step to the side- towards the band
• Hold the shoulder in a 90 degree angle, with the elbow bent so the wrist is in front of the elbow
• Pull the resistance band back so the wrist moves from chest height to directly above the elbow
• Return to the start position with control
• Repeat as per Physiotherapists instructions

Instructions Unsupported: Dumbbell

• Using a hand weight at a load that has been prescribed, come into the above position
• The weight will stack directly above the elbow with the elbow in line with the shoulder
• To move into external rotation: move from the above position back using the muscles through the shoulder blade
• Repeat as per Physiotherapists guidelines

Precautions

• Stop this exercise if this exacerbates your pain.
• Speak to your physiotherapist prior to performing this exercise if you have had a history of shoulder dislocations prior to attempting this exercise.

The single-arm row with rotation using a theraband is an excellent exercise for strengthening the back while also improving thoracic mobility and core stability. It is commonly prescribed to improve posture, enhance functional pulling strength, and promote coordinated movement between the upper and lower body.

Variation 1 – Upright

Instructions:

• Anchor the theraband securely at approximately chest height, ensuring it won’t slip. Hold the band in one hand with a firm grip.
• Step into a split stance with the opposite foot forward (e.g., if rowing with your right arm, place your left foot forward). Keep a slight bend in both knees and distribute your weight evenly between your front and back foot. Engage your core to maintain stability.
• Extend your working arm in front of you, keeping slight tension in the band. Your torso should remain upright with a neutral spine.
• Begin the movement by pulling your elbow back, keeping it close to your body, as if performing a rowing motion.
• As you pull, rotate your upper back and chest towards the working arm, ensuring the movement comes from the thoracic spine rather than the lower back. Your hips should remain relatively stable.
• At the end of the movement, squeeze your shoulder blade back and pause briefly before slowly returning to the starting position with control.
• Complete repetitions as prescribed by your physiotherapist.

Variation 2 – Lawn Mower / Bent Over

Instructions:

• Start in a split stance with your back foot turned out and hips facing forwards
• Place the resistance band under your foot and hold the band in the opposite hand
• Start with your hand close to your opposite foot 
• Slowly start to straighten up and twisting towards your back foot as you pull your elbow back
• You will end up facing 90 degrees to how you started
• Slowly return to your starting position and repeat

Common Errors

• Shrugging the shoulders instead of keeping them relaxed.
• Allowing the hips to twist excessively, reducing core engagement.
• Standing too narrow in the split stance, compromising balance.
• Letting the band snap back instead of maintaining control throughout the movement.

Progressions

To make the exercise more challenging, you can:

• Use a heavier resistance band.
• Perform the movement more slowly to enhance control and muscle activation.

Regressions

To make the exercise easier, you can:

• Use a lighter resistance band.
• Shorten the range of thoracic rotation to focus on control.
• Perform the exercise in a seated position if balance is a challenge.

All exercises are provided as an educational resource and should only be completed under the guidance of your physiotherapist.

Instructions:

• Have your arm supported on table and start with your fingers straight
• Bend at the large knuckles while keeping the rest of your joints straight to make a table top
• Bend at your middle set of knuckles to touch your palm while keeping the end joints straight
• Curl your fingers and make a full fist
• Uncurl your fingers into the hook position
• Straighten your fingers back into the start position

Variation: Hook Fist

• Have your arm supported on table and start with your fingers straight
• Bend your fingers into a hook position
• Curl your fingers and make a full fist
• Uncurl your fingers into the hook position again
• Straighten your fingers back into the start position

Variation: Straight Fist

• Start with your fingers straight
• Bend at the large knuckles while keeping the rest of your joints straight to make a table top
• Bend at your middle set of knuckles to touch your palm while keeping the end joints straight
• Come back up into table top position
• Straighten your fingers back into the start position

Instructions

• Hold 2 targets arms length away
• Look at one target first and then turn your head towards that same target. Then look at the other target before turning your head to face this same target 
• Repeat by first looking and then turning your head towards each target
• Continue for 1 minute and then rest for a minute, complete this twice in a row. Repeat 3 times a day

Horizontal Instructions

• Hold the target card with an “x” arms length away
• Slowly move your arm in one direction while you shake your head in the opposite direction and then come back to the centre and repeat in the opposite direction
• Continue to keep with “x” in focus throughout 
• Continue for 1 minute and then rest for a minute, complete twice in a row. Repeat 3 times a day

Vertical Instructions:

• Hold the target card with an “x” arms length away
• Slowly move your arm up while tilting your head down and then move your arm down while tilting your head up.
• Continue to keep with “x” in focus throughout the exercise
• Continue for 1 minute and then rest for a minute, complete twice in a row. Repeat 3 times a day

Instructions

• Hold a pen arms length away and focus on the top of the pen
• Slowly bring the pen towards your nose until you start to see double
• Hold it at this point and focus on trying to bring 1 pen back into focus before slowly moving the pen away again
• Repeat 10 times

Instructions:

• Hold the pen arms length away and slowly move it side to side
• Follow the pen with your eyes and don’t move your head
• Keep the pen in focus throughout the exercise

Instructions: Horizontal/ Head Shaking

• Begin by sitting or standing in front of a plain wall.
• Hold a target card with the letter “x” arms length away at eye level. Alternatively, you can stick this to the wall in front of you.
• Keep your eyes focused on the letter and shake your head side to side.
• The letter MUST stay in focus.
• Continue for 1 minute and then rest for a minute, complete twice in a row. Repeat 3 times a day

Instructions: Vertical/ Head Shaking

• Begin by sitting or standing in front of a plain wall.
• Hold a target card with the letter “x” arms length away at eye level. Alternatively, you can stick this to the wall in front of you.
• Keep your eyes focused on the letter and nod your head up and down.
• The letter MUST stay in focus.
• Continue for 1 minute and then rest for a minute, complete twice in a row. Repeat 3 times a day

Progressions:

• Stand in front of a busier background. For example: A picture frame, a patterned wall and then television screen
• Challenge your balance by progressing to standing, then standing with feet together and then tandem stance

Precautions:

It is normal to have some symptoms associated with this exercise however this should settle within a few minutes of completing the exercises. If your symptoms worsen please consult with your treating physiotherapist.

Double Leg

Instructions

1. Stand on an incline board, facing downwards.
2. Make your feet shoulder width apart, and your toes pointing straight ahead.
3. Bend your knees and move your hips behind you, going down to the depth you feel comfortable with.
4. Try to keep your knees over your middle toe. Try to keep your back straight.
5. Slowly return to standing straight up.
6. Repeat as many times as your Physiotherapist has prescribed.

Single Leg Down, Double Leg Up

1. Stand on an incline board, facing downwards.
2. Have one leg in the middle of the board, and take the other one off the ground.
3. Bend your knees and move your hips behind you, going down to the depth you feel comfortable with.
4. Try to keep your knees over your middle toe. Try to keep your back straight.
5. Bring the other foot back to the board, and use both legs to slowly return to standing straight up.
6. Repeat as many times as your Physiotherapist has prescribed.

Single Leg

Instructions

1. Stand on an incline board, facing downwards.
2. Have one leg in the middle of the board, and take the other one off the ground.
3. Bend your knees and move your hips behind you, going down to the depth you feel comfortable with.
4. Try to keep your knees over your middle toe. Try to keep your back straight.
5. Slowly return to standing straight up.
6. Repeat as many times as your Physiotherapist has prescribed.

Precautions

• This is an advanced exercise, make sure your Physiotherapist is happy for you to start this.
• If you experience any increases in pain during this exercise, contact your Physiotherapist.

Instructions:

• Start in a sitting position with affected limb out long
• Place the theraband around the top of your foot and toes
• Slowly point your ankle and toes towards the ground while maintaining tension on the theraband
• Return to a comfortable resting position and repeat
• Repeat as per Physiotherapist guidelines

Sitting:

• Sit on the chair with the affected limb out long.
• Place the theraband around the top of your foot and toes
• Slowly point your ankle and toes towards the ground while maintaining tension on the theraband.
• Keep your leg slightly bent throughout
• Return to a comfortable resting position and repeat
• Repeat as per Physiotherapist guidelines

Instructions

1. Anchor a theraband by stepping on top of it.
2. Hold the other end of the theraband in your affected sides hand.
3. Whilst keeping the elbow straight, raise the arm.
4. Hold at the end of the range for as long as prescribed by your Physiotherapist.
5. Return the arm down by your side.
6. Repeat as many times as your Physiotherapist has prescribed.

Precautions

• Ensure the band is properly anchored to the ground and you have a firm step on it.
• This should not increase your pain, if it does, speak with your therapist.

Variation 1: Standing

Double Leg Instructions:

1. Stand with your hand on a wall or a sturdy object for balance.
2. Bend both knees to 45°.
3. Lift both heels off the ground, trying to keep your knees at the 45° angle.
4. Slowly lower back down.
5. Repeat as many times as your Physiotherapist has prescribed.

Single Leg Instructions:

1. Stand with your hand on a wall or sturdy object for balance.
2. Lift the resting foot off the ground.
3. Bend the working legs knee to 45°.
4. Lift the heel off the ground, trying to keep your knee at the 45° angle. Keep the resting leg still, try not to use it’s momentum to help.
5. Slowly lower back down.
6. Repeat as many times as your Physiotherapist has prescribed.

Variation 2: Wall Sit

Instructions

1. Position the back flat against the wall
2. With straight knees, extend the legs away from the wall so you are leaning back
3. Bend the knees to a 90-degree position
4. Slowly lift and lower the heels

Variation 1: Double Leg

Instructions

1. Stand on a step with your heels off the edge.
2. Slowly lift your heels up.
3. Slowly lower your heels down, going lower than the step.
4. Repeat this as many times as your Physiotherapist has prescribed.

Variation 2: Single Leg

Instructions

1. Stand on a step with one foot, hanging your heel over the edge.
2. Slowly lift your heel up.
3. Slowly lower your heel down, going lower than the step.
4. Repeat this as many times as your Physiotherapist has prescribed.

Variation 3: Double Leg – Fast Concentric, Slow Eccentric

Instructions

1. Stand on a step with your heels off the edge.
2. Slowly lower your heels down, going lower than the step.
3. Quickly lift your heels up.
4. Going up should take less than 1 second, and going down should take 2-3 seconds.
5. Repeat this as many times as your Physiotherapist has prescribed.

Precautions

• These are all strength exercises. Be careful not to go overboard, only do the amount and frequency prescribed by your Physiotherapist.

Instructions

1. Lie on your side with the affected leg up.
2. Tie a band around your knees.
3. Bend the knees and hips to about 30 degrees.
4. Keep your feet together, and lift the top knee up, applying tension to the band.
5. Return the knee down.
6. Try not to rotate through the back, this movement should be with your hips.
7. Repeat this as many times as your Physiotherapist has prescribed.

Precautions

• Don’t move your upper body much. This exercise should be done with the hips. If you cannot do this, the exercise may be too difficult and you should speak to your Physiotherapist.
• This is a strength exercise, meaning your muscles need time to recover. Don’t do more than your Physiotherapist has prescribed, as you might risk overdoing it.

Variation 1: Side-Lying

Instructions

1. Lie down on your side with the affected leg up.
2. Tie a theraband around your ankles / lower leg.
3. Ensure your aligned, by making your shoulders, hips, knees and feet all in one straight line.
4. Lift the top leg up, putting tension on the band.
5. Return to the start.
6. Repeat this as many times as your Physiotherapist has prescribed.

Variation 2: Standing

Instructions:

1. Stand near a chair or wall to give yourself support.
2. Tie a theraband around your ankles.
3. Extend one leg out towards the side, putting tension on the theraband.
4. Return the leg to the starting position.
5. Repeat this as many times as your Physiotherapist has prescribed.

Precautions

• Try not to move too much with your upper body. If you cannot, this means you might be compensating for weakness and this exercise could be too difficult for you.
• This is a strength exercise, and your muscles need time to recover. Don’t try to do more of this than your Physiotherapist has prescribed, as you could over do it.

Instructions

1. Sit on a chair with your feet hanging freely.
2. Slouch through your back and drop your shoulders towards the ground.
3. Look down towards your feet, bend your knee back, and point toes to the ground.
4. This is the starting position.
5. Slowly straighten your knee, look up to the ceiling and point your toes back towards you.
6. Then slowly bend your knee, look down to the ground and point toes downwards to return to the starting position.
7. Repeat this movement as many times as your Physiotherapist has prescribed.

Instructions: Chair

• Sit upright in a chair
• Extend your affected leg in front of you and rest it on a comfortable surface, keeping your knee straight
• Maintaining an upright posture, slowly bend your ankle back towards you
• From this position, simultaneously point your toes away while bending forward from your hips
• Once your reach the end of your range, slowly return to the start position by now sitting back upright while simultaneously bending your ankle back towards you
• Repeat this sequence as guided by your physiotherapist
• It may help imagining there is a rope tied to your toes to the top of your head
• Once your point your toes away, your head and body will follow and vise versa

Precautions

• Do not try to overdo this exercise as it could irritate your symptoms. Stick to the repetitions prescribed by your Physiotherapist.
• It is okay to feel some symptoms, however they should reduce as you complete each repetition. If you find symptoms are getting worse, then stop doing this exercise and contact your Physiotherapist.

Instructions

1. Tie a theraband in a circle and place both hands inside.
2. Place your hands against a wall.
3. Pull outwards with both hands to apply appropriate tension to the theraband.
4. Squeeze your shoulder blades backwards and maintain this position.
5. Thinking of numbers on a clock, begin by moving the affected arm upward towards 12 O’clock.
6. Return to the starting position.
7. Repeat this in a clockwise direction, by moving the hand to 1:30, then 3 O’clock, then 4:30 and finally 6 O’clock.
8. Maintain the shoulder blades retracted throughout all of these movements.
9. Repeat this as many times as your Physiotherapist has prescribed.

Level 1: Double Leg Jump

Instructions

1. Begin standing with a step in front of you.
2. Jump onto the step using both legs.
3. Land with both legs.
4. Jump back down to the start.
5. Repeat as many times as your Physiotherapist has prescribed.

Level 2: Double Leg Jump with Single Leg Landing

Instructions

1. Begin standing with a step in front of you.
2. Jump onto the step using both legs.
3. Land with only one leg
4. Jump back down to the start, landing with both legs.
5. Repeat as many times as your Physiotherapist has prescribed.

Level 3: Single Leg Jump

Instructions

1. Begin standing with a step in front of you.
2. Jump onto the step using just one leg
3. Land with the same leg.
4. Jump back down to the start, using just one leg.
5. Repeat as many times as your Physiotherapist has prescribed.

Level 4: Single Leg Jump Progression

Instructions

1. Begin standing with a step in front of you.
2. Jump onto the step using just one leg
3. Land with the same leg.
4. Jump forwards off the step using the same leg. Try make this one continuous movement, without much of a pause on top of the step.
5. Step back over the step, or walk around the step to repeat.
6. Repeat as many times as your Physiotherapist has prescribed.

Level 5: Single Leg Jump with Direction Change

Instructions

1. Start standing facing the step in front of you.
2. Use one leg to hop onto the step, turning as you hop so that you land facing 90 degrees from your starting position.
3. Land on the same leg you hopped with.
4. Hop back down, landing back in the position that you began in.
5. Repeat this as many times as your Physiotherapist has prescribed.

Level 6: Single Leg Lateral Hop

Instructions

1. Start standing facing side on to the step.
2. Using one leg, hop sideways onto the step, landing with the same leg you hopped with.
3. Hop back down from the step with the same leg, landing back in the starting position.
4. Repeat this as many times as your Physiotherapist has prescribed.

Precautions

• Plyometric exercises are high load on joints and tendons, make sure to do a proper warmup before starting, and get clearance from your Physiotherapist before beginning plyometric training.
• These are high level plyometrics, make sure you are comfortable hopping on the spot before beginning these.
• Allow sufficient time for the body to recover after plyometric training (48-72 hours).

Option 1: Lateral Hopping

Instructions

1. Set up two points on the ground roughly 30cm apart.
2. Begin in the middle of the two marks.
3. Hop on one leg over one of the points, then back over the other point.
4. Try not to land on the points, make sure you jump all the way over.
5. Repeat as many times as your Physiotherapist has prescribed.

Option 2: Direction Changes

Instructions

1. Set up two points on the ground, roughly 30cm apart.
2. Begin standing 30cm behind one the points.
3. Hop forwards to the point in front of you, then hop sideways over the other point.
4. Repeat this going in the opposite direction.
5. Repeat as many times as your Physiotherapist has prescribed.

Option 3: Quadrant

Instructions

1. Set up 4 points as seen in the below video. Each point should be 30-50cm from the centre.
2. Begin in the centre of the 4 points.
3. Start by hopping forwards over the point in front of you, and then back to the middle.
4. Continue in a clockwise direction, jumping over each point until you are back to the start.
5. Repeat as many times as your Physiotherapist has prescribed.

Precautions

• Plyometric exercises are high load on joints and tendons, make sure to do a proper warmup before starting, and get clearance from your Physiotherapist before beginning plyometric training.
• These are high level plyometrics, make sure you are comfortable hopping on one leg before beginning these.
• Allow sufficient time for the body to recover after plyometric training (48-72 hours).

Instructions

1. Put a weight in your affected hand.
2. Use your other arm to help lift the weight up towards your shoulder.
3. Slowly lower the weight downwards, controlling the movement.
4. Use your other arm to lift the weight back up.
5. Repeat as many times as your Physiotherapist has prescribed.

Patella Tendinopathy, also known as Jumper’s Knee, is a common overuse injury affecting the patella tendon which connects the base of the patella (knee cap) to the tibia (shin bone). This condition is predominantly activity related and as per its name sake, commonly affects athletes that perform repetitive jumping.

What is the Patella Tendon?

The patella tendon acts as a pulley for the quadriceps muscle which acts to extend or straighten the knee. When you run, jump and bend the knee, the patella tendon works to absorb and redistribute the force in a spring like action. This elastic nature of the tendon helps to protect the knee joint and facilitate movement.

What happens during Patella Tendinopathy?

Tendons have a high capacity for load. However, if the demand on the tendon becomes greater than the current tendon tolerance, then the tendon may become painful and symptomatic.

As repeated stress is placed on the tendon, micro tears may develop over time. As the volume of stress increases, the tears in the tendon accumulate and can lead to tendon degeneration.

The Tendinopathy Continuum

Tendon pathologies occur as part of a 3 stage continuum.

• 1. Reactive:
  • Short-term response where the tendon thickens to reduce stress and increases in stiffness.
  • Usually occurs acutely from a sudden increase in load on the tendon

• 2. Tendon Disrepair:
  • Can occur when the tendon is not offloaded and cannot return to its normal state
  • The tendon has begun to change in structure (becoming increasingly stiff), but these changes are still reversible.
  • These changes may now be visible on Magnetic Resonance Imaging (MRI) and Ultrasound scans

• 3. Degenerative Tendinopathy:
  • Can occur when a tendon is chronically overloaded
  • Structural changes are now irreversible

As tendinopathies may progress over each of these stages, it is important to de-load and manage pain and inflammation as soon as possible. This is to prevent the onset of long-term structural changes to the tendon. These changes can result in complications such as:

• Decreased knee range of motion
• Decreased functional capacity
• Everyday movements may become painful
• Deformities may develop in the muscle

Common Causes

Patella Tendinopathy is a condition where pain develops gradually overtime, and is typically unrelated to a specific traumatic injury. Patella Tendinopathy arises as a result of an increase in load and/or inadequate rest between sessions.

Some examples of load increases include:

• Starting a new activity/ rapidly increasing load
• A one off high-intensity training session or activity that places high demand on the knee
• Inadequate rest between training sessions

Contributing factors may include:

• Muscle tightness over the quadriceps and hamstrings
• Decreased ankle mobility
• Decreased knee bend when landing

Signs and Symptoms

Common signs and symptoms include:

• Pain at the front of the knee
• Morning stiffness
• Pain with squatting
• Pain with prolonged sitting
• Pain with jumping, hopping
• Pain with going up and down stairs

Symptom Characteristics

• Pain and stiffness usually improve with warming-up prior to exercise
• Pain is related to load

Diagnosis

Diagnosis is usually based on a thorough subjective and objective examination, with little emphasis placed on imaging. Many individuals will present with knee pain but have minimal changes present on imaging, whilst others will present without pain but show degenerative changes.

Therefore, diagnosis is based on clinical presentation as there is little correlation between tendon pain, and functional capacity with imaging findings.

Physiotherapy Management

Effective management of this condition occurs in stages. It is important to regularly check-in with your physiotherapist to ensure that the tendon is not being loaded too quickly, and is responding well to each graded increase in capacity. Where each individual starts will be based on their current level of pain and functional capacity.

Load Management

A period of de-loading consisting of rest and/or activity modification may be needed to settle inflammation and reduce pain.

Progressive Strengthening Program

A progressive strengthening program will help introduce load to the tendon in a progressive manner that minimises the risk of further inflammation and pain provocation. The stage and level of rehabilitation needed will be determined by your personal functional goals.

• Isometrics: To improve pain and motor control
• Eccentrics: To improve muscle strength
• Slow-Heavy Concentrics: To improve tendon stiffness and muscle strength
• Plyometrics: To introduce energy release to the tendon
• Faster Loads: To improve capacity for return to sport

Stretching Program

Increasing muscle length through stretching can help to increase knee range of motion and reduce the amount of tension placed on the patella tendon during movement.

Adjuncts to Exercise

Depending on your level of pain and irritability, your physiotherapist may recommend the use of other strategies to help aid with recovery. These include:

• Shockwave: A safe and non-invasive treatment which involves the delivery of high frequency shock waves (sound impulses) which can be effective in reducing pain and promoting soft tissue healing.
• Dry Needling: The use of fine acupuncture-like needles which can be applied directly over the tendon to optimise healing by decreasing local inflammation and increasing blood flow to the area.
• Deep Friction Massage: The use of deep tissue massage over the patella tendon can result to immediate pain relief.
• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Can be useful in short-term pain relief. Optimum dosage should be at the discretion of your general practitioner or pharmacist.

References

Charles, R., Fang, L., Zhu, R., & Wang, J. (2023). The effectiveness of shockwave therapy on patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis: a systematic review and meta-analysis. Frontiers in immunology, 14, 1193835. https://doi.org/10.3389/fimmu.2023.1193835

Charnoff J, Ponnarasu S, Naqvi U. Tendinosis. [Updated 2022 Oct 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448174/

Chaves, P., Simões, D., Paço, M., Silva, S., Pinho, F., Duarte, J. A., & Ribeiro, F. (2019). Deep Friction Massage in the Management of Patellar Tendinopathy in Athletes: Short-Term Clinical Outcomes. Journal of sport rehabilitation, 29(7), 860–865. https://doi.org/10.1123/jsr.2019-0046

Reinking M. F. (2016). CURRENT CONCEPTS IN THE TREATMENT OF PATELLAR TENDINOPATHY. International journal of sports physical therapy, 11(6), 854–866.

Santana JA, Mabrouk A, Sherman Al. Jumpers Knee. [Updated 2023 Apr 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532969/

Stania, M., Król, T., Marszałek, W., Michalska, J., & Król, P. (2022). Treatment of Jumper’s Knee with Extracorporeal Shockwave Therapy: A Systematic Review and Meta-Analysis. Journal of human kinetics, 84, 124–134. https://doi.org/10.2478/hukin-2022-0089

Instructions:

• Come into lying on your back, you will need a stick (broom, golf) nearby
• Tuck the stick behind the back of one knee and in front of the other
• Lift the knees above the hips so they are directly above
• At this point the stick should be held at both ends by the arms and wrapped over/under the knees
• Simultaneously push/pull the legs into the stick
• Hold for 5 seconds or as prescribed by your Physiotherapist. Repeat as guided.

Instructions:

• Come into a 4 point kneeling position with the wrists underneath the shoulders and the knees underneath the hips
• Maintain a bent knee as you use the target hip to press the foot up towards the ceiling and circle the knee around to return to the start position
• Repeat in the opposite direction
• Complete repetitions as prescribed by your Physiotherapist

Instructions

• In a seated or standing position.
• Start with your shoulders in a neutral, comfortable position.
• Lift your shoulders up. Hold for 3 seconds. Return to neutral.
• Bring your shoulders forwards. Hold for 3 seconds. Return to neutral.
• Drop your shoulders downwards. Hold for 3 seconds. Return to neutral.
• Pull your shoulders backwards. Hold for 3 seconds. Return to neutral.
• Repeated these 4 movements as many times as your Physiotherapist has prescribed.
• This is a small movement, and should be felt at the shoulder blades.

Precautions

• This exercise should not be painful. If it is painful, try to decrease how far you are moving in each movement.
• If it is still painful, stop the exercise and contact your Physiotherapist.

Looking for Vestibular Physiotherapy in the Hunter or the Central Coast? You’ve come to the right place.

Our expert physios can treat a wide range of vertigo, dizziness, and balance issues. We have Vestibular Physiotherapists ready to help in Newcastle, Budgewoi, and Rutherford NSW.

What is Vestibular Physiotherapy?

Vestibular physiotherapy focuses on the assessment and treatment of vertigo, dizziness, and balance disorders. Research shows that 34% of people over the age of 50 experience dizziness and 85% of people over the age of 80 have some level of vestibular dysfunction.

Common Vestibular & Balance Disorders

• Benign Positional Paroxysmal Vertigo (BPPV)
• Neuritis / Labyrinthitis
• Meniere’s Disease
• Peripheral Hypofunction
• Vestibular Migraines

What is BPPV?

Benign Positional Paroxysmal Vertigo (BPPV) is the most common cause of dizziness and is recognisable as short bouts of vertigo or spinning caused by changes to your head position. The name can be understood as follows:

Benign: Not dangerous.
Paroxysmal: Rapid onset that eases and then returns.
Positional: Triggered by head movement.
Vertigo: Spinning sensation.

The most common time to experience these symptoms is rolling over in bed and/or sitting up on the edge of the bed.

What Causes BPPV / Vertigo?

The inner ear is comprised of the semi circular canals that have endolymph fluid and hair cells inside them as otoconia or calcium carbonate crystals that are usually found in the utricle. The crystals are responsible for sending signals to your brain regarding head motion and position. When the crystals become dislodged and fall into one of the semicircular canals they send mismatched information about head movements to your brain resulting in a spinning sensation and involuntary eye movements.

These episodes can be very distressing; however, the spinning usually eases quickly, within 1 minute. Your balance may continue to be affected, increasing your risk of falls, which is why it is important to get treated as soon as possible. Treatment involves manoeuvring your head and body around to move the crystals out of the affected canal.

Get Relief from Dizziness & Vertigo with the Help of an Expert Vestibular Physiotherapist

We will take you through an extensive assessment to determine the cause of your symptoms and then the appropriate management. Assessment may include: oculomotor, co-ordination, central testing, Vesticam, cervical and BPPV positioning tests.

Treatment will depend on your diagnosis but common strategies are:

• Repositioning manoeuvres.
• Balance exercises.
• Adaptation exercises.
• Cervical/neck treatments.
• Vestibular-ocular rehabilitation exercises.

Please see below how Vesticam technology may be used in the clinic:

Preparing for Your Appointment

Please bring your referral if you have one, your medication list and any relevant documentation including CT or MRI brain results and hospital discharge summaries.

We strongly recommend having someone drive you on the day of the appointment.

If you are booking for vestibular rehabilitation, please let our team know, as not all physiotherapists have the same level of training in this form of treatment.

What is it?

A ligament is a strong, fibrous connective tissue that connects bone to bone. They help to increase the stability of the joint through limiting the movement between bones. In the knee joint, this is through restricting side to side movement of the femur (thigh bone)and tibia (shin bone) to allow the knee to move in a hinge like motion.  

The Medial Collateral Ligament (MCL) is found on the inside of the knee and runs from the bottom of the femur to top of the tibia. Its role is to provide support to the inside of the knee.

Causes

The MCL is the most frequently injured ligament in the knee. MCL sprains are often caused by abruptly turning, twisting or sustaining force to the outside of the knee. A “tearing” sensation or audible “pop” may be noticed immediately during or after injury. 

Common Signs and Symptoms

• Pain and/or tenderness over the inside of the knee
• Swelling 
• Locking or catching with movement 
• Instability and/or feeling the knee give way
• Difficulty weight bearing
• Decreased knee movement

Diagnosis

Diagnosis can be determined by a Physiotherapist who will complete a thorough subjective and objective assessment. This will involve a hand-on assessment comprising of palpation to locate areas of tenderness, range of motion, ligament testing and functional strength testing. Evidence suggests that the most accurate time to complete an assessment is immediately post-injury.

Investigations such as Ultrasound and X-Ray are not necessary for diagnosis, however, may be indicated to rule out fractures and assist in grading the degree of injury severity. The injury may be categorised as Grade I (mild sprain), Grade II (moderate sprain) or Grade III (severe sprain).

Management

Most isolated MCL injuries are able to be managed conservatively through Physiotherapy and exercise. 

During the acute stage, treatment will aim to manage pain and inflammation, and restore knee movement. This may consist of: 

• Equipping you with strategies or equipment such as a hinged knee brace or crutches to protect the area 
• Elevating the knee above the level of the heart 
• Avoiding anti-inflammatories unless at the discretion of your health provider 
• Providing compression garments
• Supporting you with education around aggravating activities and self-management strategies to help you become actively involved in your rehabilitation. 

Once pain-free movement and function are restored, your Physiotherapist will work with you to help strengthen the muscles around the knee and build joint stability. This will progress to a graduated resistance and functional retraining program which will aim to ensure that you return to your pre-injury level of function.

A full recovery may take anywhere between 1-4 weeks for low grade sprains, and up to 12 weeks for higher grade sprains, depending on your functional goals.

Risk of Re-Injury and Prevention

The best way to prevent re-injury is to engage in a progressive strengthening program alongside other strategies such as:

• Performing a warm-up and cool-down prior to engaging in physical activity
• Using a supportive knee brace
• Wearing supportive footwear

Overall, Physiotherapy is associated with high rates of success and return to sport post MCL sprain. Engaging in a comprehensive physiotherapy rehabilitation program has been associated with low reports of long-term instability in Grade I and Grade II MCL sprains and a re-injury rate of as little as 3% in elite athletes.

References

Duffy, P. S., & Miyamoto, R. G. (2010). Management of medial collateral ligament injuries in the knee: an update and review. The Physician and sportsmedicine, 38(2), 48–54. https://doi.org/10.3810/psm.2010.06.1782

Phisitkul, P., James, S. L., Wolf, B. R., & Amendola, A. (2006). MCL injuries of the knee: current concepts review. The Iowa orthopaedic journal, 26, 77–90.

Lundblad, M., Hägglund, M., Thomeé, C., Hamrin Senorski, E., Ekstrand, J., Karlsson, J., & Waldén, M. (2019). Medial collateral ligament injuries of the knee in male professional football players: a prospective three-season study of 130 cases from the UEFA Elite Club Injury Study. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 27(11), 3692–3698. https://doi.org/10.1007/s00167-019-05491-6

Lavoie-Gagne, O. Z., Retzky, J., Diaz, C. C., Mehta, N., Korrapati, A., Forlenza, E. M., Knapik, D. M., & Forsythe, B. (2021). Return-to-Play Times and Player Performance After Medial Collateral Ligament Injury in Elite-Level European Soccer Players. Orthopaedic Journal of Sports Medicine, 9(9), 232596712110339. https://doi.org/10.1177/23259671211033904

Knee Ligament Sprains and Tears: Clinical Practice Guidelines Ensuring Best CareJournal of Orthopaedic & Sports Physical Therapy 2017 47:11, 824-824

Naqvi U, Sherman Al. Medial Collateral Ligament Knee Injury. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK431095/

Variation 1: Chin Tuck Activation

Instructions:

• Lie down on your back.
• Using the small, deeper muscles in your neck, draw your chin downwards.
• Hold this position for 5 seconds.
• Repeat 10 times, or as prescribed by your Physiotherapist.
• Try not to use the large superficial neck muscles. Watch the video at the bottom of this page to know what this feels like.

Precautions:

• Make sure your head can touch the ground and is supported.
• This should not be painful, if it is worsening your pain then stop and contact your Physiotherapist.

Variation 2: Chin Tuck with Head Lift

Instructions:

• Lie down on your back.
• Using the small, deeper muscles in your neck, draw your chin downwards.
• Whilst maintaining the position of your chin, lift your head slightly off the ground.
• Hold this position for 5 seconds.
• Repeat 10 times, or as prescribed by your Physiotherapist.

Precautions:

• Between repetitions, make sure your head can touch the ground and is supported.
• This should not be painful, if it is worsening your pain then stop and contact your Physiotherapist.

Variation 3: Chin Tuck with Head Lift and Turn

Instructions:

• Lie down on your back.
• Using the small, deeper muscles in your neck, draw your chin downwards.
• Whilst maintaining the position of your chin, lift your head slightly off the ground and add a turn to look to each side.
• Repeat 10 times, or as prescribed by your Physiotherapist.

Precautions:

• Between repetitions, make sure your head can touch the ground and is supported.
• This should not be painful, if it is worsening your pain then stop and contact your Physiotherapist.

Checking for Superficial Muscle Activation

• Put your fingers below the side of your chin.
• Lift your head off the ground.
• You should feel the large superficial muscles contract under your fingers.
• These are not the muscles that we want to train when completing deep neck flexor training.
• You should not feel the activation of these muscles when completing the above chin-tuck exercises, however you may when adding the head-lift and turns.
• If you are having trouble completing these exercises, contact your Physiotherapist.

Also known as the Jefferson Curl, this resisted spinal flexion exercise is designed to increase the loading capacity of the spine. This exercise should be completed under the guidance of a Physiotherapist following an assessment to determine it’s suitability.

Instructions:

• Come into standing on a step with the feet hip width apart
• Soften through the back of the knees
• Using a weight prescribed, slowly begin to roll down through the spine as if you were peeling yourself off a velcro wall
• Allow the hips to move backwards as the spine rounds
• The weight will pass down towards the floor
• Slowly begin to roll back up through the spine to ‘re-stick’ onto the wall
• Repeat as per Physiotherapist guidelines

Instructions

• Sit on a chair or on the edge of a bed with your feet flat on the ground.
• Put your hands next you on the chair/bed to help you balance.
• Keeping your knee bent, lift up your leg and then lower it down.
• Repeat this on the other side, as though you are marching on the spot.
• Repeat this as many times or for as long as your Physiotherapist has prescribed.

Precautions

• Make sure your feet are firmly planted on the ground.
• This exercise should not be painful, stop if you do feel pain.
• If you are experiencing any issues, contact your Physiotherapist

Instructions

• Sit in a chair with your feet flat on the ground.
• Point your hands towards the ground.
• Slowly bend forwards, taking your hands closer to the ground.
• Make sure to begin bending at your neck, and slowly roll down each segment of your back.
• Continue until you reach a deep, yet comfortable point, do not push into pain.
• Slowly return to sitting up straight.
• Repeat this 5-10 times, or as prescribed by your Physiotherapist.

Precautions

• Make sure your feet are planted firmly on the ground.
• This exercise should not be painful.
• If you are experiencing pain, try not bending quite as deep. If pain continues, stop this exercise.
• If you are unsure about this exercise, contact your Physiotherapist.

Instructions:

• Lie on the floor or a wide bench
• The floor will stop your elbows going past your body which limits the load on your shoulder
• Start with the narrow grip version and progress to the wide grip if you feel comfortable

Narrow Grip:

Wide Grip

Instructions:

• Start with the Isometric version of each exercise
• Isometric = press and hold
• Move through the progressions within comfort
• When you can complete 3 sets of 10 bridges with the band loop please speak to your physiotherapist about further progression

1. Hip Abduction/External Rotation – Isometric

• Pull out against the band and hold

2. Hip Abduction/External Rotation – Concentric/Eccentric

• Pull out against the band then return to the starting position. Repeat.

3. Hip Abduction – Isometric

• Pull out against the band and hold

4. Hip Abduction – Concentric/Eccentric

• Pull out against the band then return to the starting position. Repeat.

5. Hip Abduction/External Rotation + Bridge

• Pull out against the band. Keep pressure on the band.
• While pulling out against the band, push through your feet to lift your bum eg. bridge
• Lower down while keeping tension on the band.
• Repeat.

Instructions

• Start with 1. and move through the progressions once your current version is painfree and no longer feeling challenging
• Once you can complete 3 sets of 10 single leg bridges with arms across chest speak to your physio about the next level of progression

1. Bridge: Feet level with arms by sides

2. Bridge: Feet level with arms across chest

3. Bridge: Feet staggered with arms by sides

4. Bridge: Feet staggered with arms across chest

5. Bridge: Single leg with arms by sides

6. Bridge: Single leg with arms across chest

Phase 1:

• Increase tension by laterally flexing your neck away from the affected side
• Decrease tension by elevating the shoulder girdle

Phase 2:

• Decrease tension by laterally flexing your neck towards the affected side
• Increase tension by depressing the shoulder girdle

Phase 1:

• Increase tension by laterally flexing the neck away from the affected side
• Increase tension by depressing the shoulder girdle

Phase 2:

• Decrease tension by laterally flexing the neck towards the affected side
• Decrease tension by depressing the shoulder girdle

Instructions

Phase 1:

• To increase tension laterally flex the neck away from the affected side
• To increase tension extend the elbow, wrist and fingers

Phase 2:

• To decrease tension laterally flex the neck towards the affected side
• To decrease tension bend the elbow, wrist and fingers

Online Physiotherapy & Telehealth Physio Services Australia-Wide

Peak Physio has been providing Telehealth Services to our clients on a local and international scale for years. Our expert practitioners utilise video call technology that facilitates real time diagnosis, education and treatment no matter the injury or concern.

This technology has allowed us to maintain a high level of patient care without limiting factors such as transport, location or mobility status.

What does Telehealth Physio involve?

To complete a Telehealth Consultation you will need access to internet and either a computer or mobile device that has a microphone and camera.

Our administration team will provide a link to a call at your appointment time where you have a clear visual of your Physiotherapist. It is best to complete this in a space where there is minimal background noise and you have space around you.

Virtual Physio Consultation

Our Physiotherapists are highly skilled professionals who are qualified in the assessment, diagnosis, treatment and management of musculoskeletal injuries. Your Physiotherapist will initially conduct a subjective assessment. This is where you will discuss your primary concerns, pain patterns, medical and social history. During this assessment your Physiotherapist will guide you to work towards a diagnosis.

The objective assessment is where via video, you will complete a series of movements, actions or self-conducted strength assessments. Your Physiotherapist may ask you to perform a series of movements during this time to gain an understanding of your capacity.

Following this, your Physiotherapist will develop a comprehensive treatment program based on your assessment. This program will be designed to promote healing, restore normal range of motion and function, relieve pain, strengthen the area, and reduce risk of re-injury. 

Management techniques will include education around your diagnosis, healing and recovery, advice around hot/cold modalities and pharmacological intervention. The primary focus is on the prescription of mobility or strengthening exercises which may be used during the consultation and prescribed for independent completion. Manual therapy techniques will not be completed during a Telehealth consultation however self management strategies may be provided if appropriate.

Who is Online Physio useful for?

Telehealth consultations may be appropriate for the following population groups:

• Elderly
• Those without transport or mobility restrictions
• Individuals living in rural or remote areas
• Travellers
• Acute injuries
• NDIS clients
• Chronic and persistent pain
• Post-operative rehabilitation
• Pre-operative rehabilitation
• Neurodivergent

Having a resource such as Telehealth available, removes typical barriers for individuals requiring Physiotherapy intervention.

Who Can Access Our Telehealth Services?

We provide Telehealth Physiotherapy consultations to patients across Sydney, Melbourne, Brisbane, Perth, Adelaide, and all regional areas of Australia. We can even offer online physio consults internationally! 🌏

How to Book?

If you or someone you know would benefit from Telehealth, you can schedule an appointment by calling our friendly team or simply booking online (you can select any location for Telehealth!).

Our Physiotherapists are qualified and trained in the assessment, diagnosis, treatment and management of a variety of neurological conditions. These conditions include, but are not limited to, multiple sclerosis, functional neurological disorders, stroke, Parkinson’s disease, Guillain-Barre syndrome, cervical and lumbar radiculopathy, and peripheral neuropathies.

How does Physiotherapy treat Neurological Conditions?

Exercise

Neurological physiotherapy uses a variety of techniques to promote functional movement by training your brain and spinal cord (central nervous system), as well as the nerves throughout your body (peripheral nervous system) to communicate effectively with your muscles to help your body move. Our physiotherapists use specific exercises that stimulate these nervous systems to strengthen these neurological pathways and promote neuroplasticity (your brains ability to adapt and reorganise itself to help promote function).

Mobility Assessments & Mobility Aid Prescription

Our ability to safely move and get from A to B is essential. In the case of many neurological conditions, our ability to move and walk may be effected and can increase the risk of injury. For example, falling due to reduced lower limb strength or sensation.

Our physiotherapists are able to determine an appropriate mobility aid to meet your needs by assessing your ability to get in/out of bed, on/off a chair, walking on flat ground and up/down stairs. Depending on when and where you find it difficult to move, our physiotherapists can then advise you as to what strategies you may find helpful to mobilise, as well as prescribe necessary mobility aids to ensure you do this safely.

The mobility aids can include various kinds of crutches, walking sticks and four wheeled walkers to meet the needs of our clients.

Splinting & Orthoses

In addition to mobility aids, some neurological conditions require a splint to ensure our limbs are well supported and are not at risk of causing further injuries such as tripping over a paralysed foot, or contractures (when muscles tighten in a shortened position).

We have a variety of splints that we can prescribe to our patients depending on their needs. These include, but are not limited to:
– Ankle foot orthosis (AFO/foot drop splint)
– Resting night splint for both hands and feet
– Shoulder slings
– Various hand splints

Manual Therapy

Techniques involving manual therapy have strong evidence to suggest they are effective in reducing chronic pain associated with some neurological conditions, in addition to improving joint and muscle flexibility.

We use a variety of hands on techniques, including massage, trigger point dry needling, joint mobilization and stretching, in conjunction with exercise therapy to help reduce pain and improve function.

Instructions:

• Lying on your back
• Tuck your chin in and reach up to the roof, lifting your shoulders off the ground
• Keep your chin tucked in throughout the movement

Instructions:

• For all 3 variations of this exercise, imagine you have a glass of water balancing on the base of your spine and you want to avoid “spilling any water”
• Aim for slow, controlled movement as you lift the arm in front of you.
• Avoid moving through the pelvis or the lumbar spine.

Instructions:

• Maintain good core control throughout movement
• If you feel your lower back ‘arching’ you are probably moving too far or too quickly

Instructions:

• Maintain good core control throughout
• If you feel your lower back ‘arching’ excessively you may not be ready for this exercise

Instructions:

• Aim to keep shoulders, hips and ankles in alignment eg. don’t let hips sag towards the ground or don’t stick your bum up in the air

Instructions:

• Push through your feet to lift your bum up in the air
• When lowering down, try to roll your spine down one segment/vertebrae at a time
• This is a great way to re-introduce flexion/bending in a safe and comfortable position

Instructions:

• Lying on your back with your neck relaxed
• Push through your cheekbone to assist your neck to rotate/turn
• Only push as far as you feel comfortable – don’t force it

1. Knee to chest – other knee bent

• Start with both knees bent and your feet on the floor
• Gently pull your knee towards your chest
• Hold this position or gently move in and out

2. Knee to chest – other knee straight

• Start with both knees straight
• Gently pull your knee towards your chest
• Hold this position or gently move in and out

Instructions:

• Hop up and down
• Try to feel ‘bouncy’
• To make this exercise more challenging, try to limit your contact time with the ground

Instructions:

• Jump up/down continuously
• Try to feel ‘bouncy’
• To make this exercise harder, try to limit your contact time with the ground

Instructions:

• Bounce or ‘pulse’ through your knee
• Single leg version increases the load through your knee

Instructions:

• Bounce or ‘pulse’ up and down through your knee
• This exercise is used to prepare your knee for more dynamic loading like jumping and running

Instructions:

• Bounce or ‘pulse’ through your ankle
• Single leg version increases the load

Instructions

• Bounce or ‘pulse’ up and down through ankle
• This adds a slightly more dynamic load through the ankle, calf and achilles tendon
• This exercise is used to prepare your body for jumping, hopping and running

Instructions:

• Fill a bottle of water 3 quarters full with water
• Use the water in the bottle to create an oscillating resistance as you move between external rotation and internal rotation
• Usually completed for at least 30 seconds per set as this is an endurance/control exercise
• Usually you will start with your elbow by your side and move into higher/more challenging ranges as directed by your physiotherapist

Wall Walk Instructions:

• Place a band around your hands
• Place your forearms flush against the wall
• Pull out against the band keeping your forearms parallel
• Walk your arms up/down the wall

Bilateral Flexion Level 1 Instructions:

• Place your looped band around both wrists
• Keeping elbows by side, press wrists away from each other
• Keep the tension on the band and your elbows in the same angle
• From this position, bring your hands up towards the roof, keeping tension on the band
• Return to the starting position
• Repeat as per physiotherapist guidelines

Level 2 instructions:

• Place your looped band around both wrists
• Keeping your elbows by your side and press your wrists away from each other
• Keep the tension on the band as you slowly bring your hands forwards and away from your body up to shoulder height.
• Return to the starting position
• Repeat as per physiotherapist guidelines

Extension in standing:

• Stand with your hands in the small of your back
• Arch backwards within comfort
• Increase movement within comfort if you find this movement relieving

Wall Arches

• Resting your forearms against the wall
• Let your hips sink forward to create an arch in your lower back
• Increase movement within comfort if you find this movement relieving

Instructions:

• Rest your shoulder against the wall with your arm straight for comfort
• Gently push your hips towards the wall to create a ‘side glide’ through your lumbar spine
• Your physiotherapist will specify which side should be against the wall depending on your pain location and postural presentation

Wall Angels

• Stand with your back against the wall
• Slide your arms up and down the wall to ‘open up’ your upper back
• Can also be completed lying on your back = Floor Angel

Thoracic extension against wall

• Stand with your back against the wall
• Link your fingers together and take your arms up above your head
• Reach to the sky with your arms while trying to flatten your lower back against the wall
• You should feel a stretch/movement through your upper back

Instructions:

• Come into an upright sitting position
• Position a swiss ball or foam roller as demonstrated below, in front of the target limb
• The ankle should be directly underneath the working knee at 90 degrees
• Begin to press out as if you were attempting to straighten the leg
• The ball/roller should stop the leg from moving beyond 90 degrees
• Sustain the contraction as prescribed by your Physiotherapist

Instructions

Once you can complete one variation of this exercise comfortably and pain free, work your way through these progressions as instructed by your physiotherapist

Chair Squat: Double leg shallow

• keeping your feet level with each other, squat down to touch your bum on the chair
• a higher chair means a shallower squat which places lower load on your knees

Chair Squat: Double leg shallow with staggered stance

• to increase the challenge, you can stagger your feet
• whichever foot is closer to you will do more work
• this is a great way to increase the load on an injured lower limb without going deeper into the squat

Chair Squat: Double leg deeper

• to increase the challenge you may want to move to a lower chair which will mean a deeper squat
• going lower into the squat increases the load on your knee

Chair Squat: Deeper with staggered stance

• if you want to increase the load further, you may go deeper into the squat in addition to staggering your feet
• remember, whichever foot is closer will do more work

Chair Squat: Single leg down, double leg up

• now we are moving towards some single leg variations
• this option is great if you are not yet able to complete a full single leg chair squat

Chair Squat: Single leg

• the final chair squat progression is doing it on one leg
• this requires a great deal of strength and control
• aim to keep your knee still and don’t let it wobble or ‘fall in’ towards your midline

Precautions

• If you experience an increase in symptoms during or after this exercise please contact your physiotherapist for advice

Instructions

• Complete a chin tuck by retracting your head and tucking in your chin
• A prompt which may be helpful is “imagine giving yourself a double chin”
• Then slowly begin to tilt your head back
• Move slowly and within comfortable limits
• Return to starting position
• Repeat as per Physiotherapist guidelines

Precautions

If you experience an increase in neck or arm symptoms please cease this exercise and contact your physiotherapist for advice

Instructions:

• Come into lying on your back with a pillow underneath the knees
• Fasten a belt / strap without any tension above the knees when the feet are together
• Keeping your pelvis and lower back in a neutral position, press the legs out against the belt
• This should activate the muscles through the outer hip
• Sustain for 5-8s or as prescribed by your Physiotherapist
• Repeat as per Physiotherapist guidelines

Variation 2: hip and knee flexion

• Come into lying on your back with the knees bent to 90 degrees
• Secure a belt above the knees and ensure it is secure
• Press the knees out into the belt
• Sustain for 5-8s or as prescribed by your Physiotherapist
• Repeat as prescribed

We often blame our upper traps for being too tight. This might result in neck pain and possible cervicogenic headaches. The trapezius is divided into three parts; the upper part having descending fibres, the middle part across your shoulder blades, and the lower part starting at the lower thoracic junction going up to the shoulder blades. When your upper traps are tight, the lower fibres may not be working optimally. By learning to engage the lower portion helps relax the upper fibres around the top of your shoulders and neck.

Instructions

• Comfortably lie down on your belly
• Drop your shoulders down onto the bed/floor
• Start by relaxing the muscles at the top of your shoulders (upper trapezius)
• Slowly engage the muscle from your lower shoulder blade and pull it towards the spine
• Hold for 5 seconds
• Slowly lower back to the ground
• Repeat as per your physiotherapist guidelines

Precautions

• Make sure your neck is neutral and you feel comfortable

Nerve sliders or neural ‘flossing’ provide an effective strategy to alleviate neural tension within the muscle interface that is passes through. The anatomy of neural tissue varies greatly from that of a muscle therefore improving mobility is achieved differently to traditional stretching methods.

Instructions

• Sit comfortably on a chair sideways from a higher surface such as a table our counter
• Place your elbow comfortably over a pillow 90 degrees from the side body
• Maintaining a bent elbow turn the palm up to the roof
• Extend the wrist as if you’re holding a plate flat on the palm
• Slowly extend the hand to the point of resistance either felt at the upper arm, elbow, or forearm
• Tilt your head towards the extended arm
• Return starting by bending the wrist, elbow until the fingers point towards the head
• Allow your head tilt to the opposite shoulder
• Return the head to neutral as you recommence extending the arm
• Repeat this ‘flossing’ motion as per Physiotherapists instructions

Precautions

• Make sure your shoulder does not lift while doing the movement
• You should sense a gentle stretch
• Stop if this flossing movement is increasing nerve irritation

Instructions:

• Come into standing close to the wall holding onto the pole or door frame with the target limb
• Keeping the chest square to the wall, begin straightening the elbow
• Once completely extended, use the opposing arm to grab onto the pole or door frame to return to the start position
• Repeat as per Physiotherapist guidelines

Instructions:

• Anchor the theraband at wrist height and come into standing
• Hold the band with the target limb and position the thumb forward
• Maintaining a straight elbow, pull the band to line the wrist up with the hip
• Slowly control the return of the band to the start position
• Repeat as per Physiotherapists guidelines

Instructions:

• This exercise can be completed in a seated or standing position
• Hold onto weights prescribed by your physiotherapist
• Hold the dumbbells with the ends up and bring up towards shoulders
• Then press up towards the roof
• Return to the starting position and repeat as per physiotherapist guidelines

Instructions:

• For this exercise use weight as prescribed by your physiotherapist
• Come to a position on the bench, lying down flat with head rested on the bench and feet on the ground
• From here, push weights up towards the roof to straighten elbows
• Return to starting position and repeat as per physiotherapist instruction

Instructions:

• Hold a weight as prescribed by your physiotherapist
• Place the other hand on a bench with a split stance to create the bent over position
• From here, keep your arm straight by your side
• Bring the weight up towards the roof until it is inline with your shoulder
• Return to starting position and repeat as per physiotherapist guideline

Instructions:

• Come to a 4-point kneeling position with hands stacked underneath shoulders and knees under shoulders
• Place the looped band ends of the band around both ankles
• From this position, hover one foot just above the ground
• Bring the foot out away from the body to internally rotate the hip
• Return to the starting position and repeat as per physiotherapist instruction

Instructions: elbow flexion, neutral wrist

• Come into sitting or standing with the elbow bent to 90 degrees
• With the palm facing downward, resist the upward movement of the hand
• This can be completed using your own hand, a flat firm surface such as a table or a dumbbell (see videos below)
• Hold for a period of time determined by your Physiotherapist, this will usually be in seconds
• Repeat as per Physiotherapist guidelines

Instructions: elbow flexion, wrist extension

• Complete as per the above instructions with the wrist in extension
• Sustain as per Physiotherapists instructions

Instructions: elbow extension

• Come into sitting holding a dumbbell palm down
• Keep the wrist in neutral
• Extend the elbow and hold for the period of time determined by your Physiotherapist

Instructions:

• Come into lying either on the floor or using a bench as shown
• Using a weight prescribed, bend the elbow to move the weight towards the head
• Extend the elbow by taking the wrist straight up towards the ceiling
• The movement is only occurring at the elbow joint
• Try and keep the shoulder steady throughout the movement
• This exercise can be completed either double arm or single arm, your Physiotherapist will discuss the appropriate option for you
• Complete as per Physiotherapist guidelines

An Enhanced Primary Care (EPC) plan is a service whereby your GP can refer you for up to 5 physiotherapy sessions per calendar year. The sessions are partially funded by Medicare.

Medicare EPC Physiotherapy

If your GP has provided you with an EPC referral:

• You can still book an appointment as normal (including online).
• Please bring your referral paperwork to your appointment.
• Please be aware that we do not bulk bill. Sessions are charged at our normal rates and you will receive a partial rebate from Medicare. 
• Rebates can be processed for you at the time of assessment. Please bring your medicare card and a debit card for on-the-spot rebates. You can also claim the rebate at a later time by contacting medicare.
• We will liaise with your treating GP and provide updates regarding your progress.

Instructions

• Stand with a theraband tied around your wrists
• Add tension to the band by moving your wrists away so they are inline with your elbows
• Pretend that you are holding onto a box and place the box on the designated shelf as prescribed by your physiotherapist while simultaneously stepping forward (it does not matter what leg you step with)
• Repeat as prescribed by your physiotherapist

Middle Shelf Instructions:

Top Shelf Instructions:

Precautions

• If this exacerbates your pain, please stop the exercise and notify your physiotherapist

Instructions

• Stand in a lunge position with a theraband tied around your front knee with the resistance pulling across your body
• Bend both knees, lowering your back knee to the ground with resisting the pull of the theraband
  • Your front knee should track inline with your second and third toe
• Slowly return to a standing position

Precautions

• Support yourself using a bench/chair/etc if you find it difficult to balance
• Avoid your front knee deviating across your body
• Avoid your front knee bending further ahead from your toes
• If this exacerbates your pain, stop the exercise and notify your physiotherapist

Instructions

• Stand in front of a bench and place your hands on top of it to help lightly support your weight
• Keeping your hands on the bench, walk slowly backwards within a comfortable range and return
• Your centre of mass should remain over your feet
• You should feel a gentle stretch near the base of your spine
• Complete this exercise as prescribed by your physiotherapist

Precautions

• If this exacerbates your pain, stop this exercise immediately and speak to your physiotherapist

Trigger point release instructions:

• Clench your back teeth to feel for the muscle belly
• Using your knuckle find the muscle, relax the jaw
• Move the knuckle around on the muscle to locate an area of tension
• Gently apply pressure to the muscle
• Sustain for 10s whilst deep breathing into the belly
• The muscle should soften off/release
• You may need to sustain the pressure for > 30 seconds

Self-massage

• Using the knuckle of the first and second digit follow the line of the jaw towards the ear
• Continue using this action to cross the muscles above the jaw towards the ear

Instructions:

• Come into a comfortable upright position
• Take your ear towards the shoulder opposite to the target side
• Rotate your nose and chin towards the roof
• Sustain as per Physiotherapists guidelines and repeat on the other side

Precautions:

If you experience any pins and needles, burning or tingling please stop immediately.

Instructions:

• Stand close to a kitchen bench or a pole/support
• Lift one leg out to the side while keeping the other supported on the ground
• Make sure you don’t externally rotate the leg out (pointing toe outwards)

Our Budgewoi practice (formerly ‘Budgewoi Physiotherapy’) has been assisting the local community for more than 40 years.

Address: 1/56 Tenth Ave, Budgewoi NSW 2262
Phone: (02) 4390 0299

Precautions:

• If the tape makes your skin, red itchy or hot please remove the tape

What is Temporomandibular Dysfunction?

The Temporomandibular Joint (TMJ) is located where the jaw bone, known as the mandible, meets the temporal bone of the skull. It is involved in breathing, chewing, making facial expressions, yawning and talking and is therefore the most used joint in your body. Signs of TMJ dysfunction can include pain and tenderness, jaw clicking and popping or even grinding, inability to fully close the mouth or alternatively, limited mouth opening. There is also an intra-articular disc within the joint capsule which can be a source of pain due to either inflammation or degeneration. Other symptoms linked to TMJ dysfunction can include pain on chewing, headaches, waking up with jaw soreness, tinnitus or ringing ears. During a dental check-up, the dentist may point out excess wearing of the teeth from clenching or grinding.

Instructions:

These 6 exercises are completed 6 times per day. Please discuss with your Physiotherapist if they are appropriate for you.

1. Breathing control: sitting with good posture, position the tongue at the roof of the mouth with the mouth closed and breath through the nose. x 6 breaths
2. Jaw depression: place the tongue at the roof of the mouth and open the jaw x 6
3. Stabilisation exercises: maintain the position of the tongue on the roof of the mouth
   • Place the hand under the chin and attempt to depress the jaw as above, provide resistance to restrict this movement. Hold for 2-3 seconds and repeat x6
   • Place the hand either side of the jaw to restrict jaw deviation left and right. Complete on one side x 6 with a hold for 2-3 seconds.
4. Upper cervical lengthening: interlace the hands behind the back of the upper neck near the hairline. Using the edge of the hands, gently glide up and over as the chin draws towards the chest. This should elicit a stretching sensation. Repeat x 6.
5. Chin tuck: sitting with good posture, draw the chin down/back as if you are taking the base of the skull backwards. Your head should maintain an upright position without the chin drawing down the chest. Think a horizontal movement back. Hold for 2-3 seconds and repeat x 6.
6. Scapula setting: sitting with good posture, squeeze the shoulder blades together and hold for a few seconds. Repeat x 6.

Video demonstration:

Beach Chair Instructions:

• Lye down on your back with a pillow under the head
• Bring your hands around the back of the neck and let the elbows flare out towards your side
• Gently press down into the pillow with the elbows until you feel a stretch

Standing instructions:

• Come to a standing position facing the edge of a door frame
• From here, place the affected palm against the side of the door, keeping elbow and arm tucked into the side of your body
• Gently turn away from the affected limb until you start to feel a stretch through the shoulder
• Repeat as per physiotherapist instruction

Precautions:

• Stop this exercise if it exacerbates your pain
• If you have trouble completing this exercise talk to your physiotherapist

Instructions:

• Place your self beside a table with arm on top of the table
• Make sure the surface is easy to slide along, you can wear sleeves or use a tea towel
• Slide the arm out sideways as you lean into the movement
• Repeat as per physiotherapist guidelines

Precautions:

• Stop this exercise if it exacerbates your pain
• If you have trouble completing this exercise talk to your physiotherapist

Instructions:

• Place your self beside a table with arm on top of the table
• Make sure the surface is easy to slide along, you can wear sleeves or use a tea towel
• Slide the arm forwards as you lean into the movement
• Repeat as per physiotherapist guidelines

Precautions:

• Stop this exercise if it exacerbates your pain
• If you have trouble completing this exercise talk to your physiotherapist

Instructions

• Lying on your back interlace use a towel to help keep your leg in a comfortable position.
• Start by letting your ankle turn inwards till you feel a stretch up the side of the leg.
• Then bring the ankle back to neutral and bring the neck and shoulders off the bed and repeat
• Complete as per Physiotherapist guidelines

Precautions

• Perform this exercise strictly as guided by your physiotherapist – do not be tempted to perform more repetitions as this may irritate the tissue
• If your symptoms become aggravated, stop immediately and notify your physiotherapist

Instructions

• Stand into a band that is securely placed around an object that is not going to move when you lean away
• Walk backwards creating a tension in the band
• Standing with your feet hip distance apart
• Have both feet facing forward
• Think about leading the movement from your sit bones  
• Gently bend your knees and then swing your sit bones behind you and let the band counter balance you
• Let your trunk lean forward while trying to keep your spine aligned
• Keep the back of your neck nice and long
• Go to the depth that feels comfortable for you but not below 90 degrees – you should feel tightness at the back of the thigh
• Hold and repeat as per physiotherapist guidelines

Precautions

• If you are aware that you are unsteady or feeling weak in your legs, please use your hands on a stable surface throughout
• You may want to position yourself with a surface in front of you to help with balance that you can place your hands on if needed
• You may find having a chair behind you works better to try to squat to this height for feedback
• Ensure to complete the exercise slowly and controlled
• Stop if you feel pain or are unsure of the technique
• If you are unsure, please speak to your physiotherapist

Instructions

• Allow the knee to bend to the point of resistance while lunging forward and slowly transfer weight backwards to return to the start position.
• Repeat as per Physiotherapists guidelines.

Precautions

• Lean into knee flexion as tolerated, only bend into a slight stretch/discomfort.
• If you’re experiencing pain or are unsure of the movement please speak to your physiotherapist.

Instructions:

• For this exercise, place a Bosu ball or similiar on the floor
• Come to a position lying face down with the Bosu directly under your hips and stomach
• From here, place your hands together in front and rest your head on top
• Lift through your upper back and neck so your head, hands and elbows come off the floor
• Return to the starting position and repeat as per physiotherapist guidelines

Instructions:

Supine:

• Come to a position lying on your back
• Place your ankles on either a Swiss or Bosu ball, keeping your knees at a 70-90 degree angle
• From this position alternate lifting each ankle up and down into the ball
• This should be performed quickly and for the duration prescribed by your physiotherapist

Prone:

• For this variation, you will need a partner to assist the position of the Swiss ball
• Lie on your tummy and have the Swiss ball placed over your tail bone and gluteals
• From here, bend both knees so that your ankles are pressing against the ball and your knees at roughly a 90 degree angle
• From this position alternate lifting each ankle up and down into the ball
• This should be performed quickly and for the duration prescribed by your physiotherapist

Instructions

• Lean yourself up against a wall with straight legs
• Bring your weight onto your heels and lift the toes up performing ankle dorsiflexion

Precautions

• If you are unsure of the exercise or are experiencing pain whilst performing the movement, please speak to your physiotherapist

Instructions:

• Come to a standing position with a band around your trunk
• From this position you are going to jump to to your side trying to stick the landing with your knee bent
• Complete the same movement to the opposite side and return to the starting position
• Repeat as per physiotherapist instruction.

Instructions:

• Hold onto a weight prescribed by your physiotherapist
• From here walk up and down the prescribed distance, carrying the weight in one arm by your side
• Repeat as per physiotherapist guidelines

Instructions:

• Come to a full plank position, with hands under shoulders and legs out straight on your toes
• From this position, bring one arm at a time to lean onto your elbow and forearm.
• Return to the starting position and repeat as per physiotherapist guideline.
• Ensure you maintain a plank position throughout the entirety of the movement

Instructions:

• Come to a standing position holding a ball in your affected limb
• Bring your arm up into an abducted position so your elbow is in line with your shoulder
• Keep the ball close to the wall and throw the ball against the wall
• Catch the ball, keeping the arm in the same position
• Repeat as per physiotherapist guidelines

Instructions:

• In a standing position, hold onto a handled band or cable machine
• Bring your shoulder into a abducted position with your elbow in line with your shoulder
• From here, externally rotate the shoulder so your hand is directly above the elbow joint
• Then press the hand up towards the roof to the end range position
• Return to the starting position by reversing the movements
• Repeat as per physiotherapist instruction

Instructions:

• Place your TheraBand around your wrists.
• Come into a full plank position
• From this position, step your hands and feet out one side at a time so you end up in the same position.
• Repeat as per physiotherapist guidelines

Instructions:

• Come to a 4-point kneeling position, with hands under shoulders and knees under hips
• Hold the a tennis ball in one hand, and take your weight through the other arm
• From here, bounce the ball
• While the ball is in the air, place your other hand back onto the floor and catch the ball in the opposite hand
• Repeat as per physiotherapist guidelines

Instructions:

• To perform this exercise, you will need a bench/chair/table to complete it
• Place both hands on the bench with fingers pointing towards your body
• Bring your feet out in front of your heaps to a stable position
• Keep your hands in the same position and bend through your elbows, your hips should dip down towards to floor
• From the end range position, push through your hands to straighten your elbows and return to the starting position
• Repeat as per physiotherapist instruction

Instructions:

• This exercise can be completed in sitting, standing or lying on your back
• Bring the unaffected side underneath the wrist of the affected limb
• Press the affected limb into the unaffected limb, keeping the elbow at the same angle
• Hold and repeat as per physiotherapist instruction

Instructions:

• Come to a position lying on your back with your feet towards a chair/bench/table
• From here bring your legs on top of the chair so that your knees and hips are at a 90 degree angle
• In this position, focus on deep breathing in through the nose and out through the mouth
• Hold and repeat as per physiotherapist guidelines

Instructions:

• In either standing or sitting, position yourself next to a wall with the affected side
• From here, bring your ear down towards your shoulder until your head rests against the wall
• Press the side of your head into the wall and hold for 5 seconds
• Return to the starting position and repeat as per physiotherapist guidelines

These two videos demonstrate the same style of contraction in supine and prone lying positions. Your Physiotherapist will determine which is appropriate for you. There are varying ranges also demonstrated, you and your Physiotherapist will determine which range to work into dependent on pain levels and rehabilitation goals.

Instructions: Supine

• Come into lying on your back with the target limb bent. Initially these exercises commence at 90 degrees as demonstrated at the start of the video.
• Dig the heel down and back towards your sit bone. You should feel your hamstring active during this contraction.
• Sustain the contraction for 5s or as designated by your therapist.

Instructions: Prone

• Lying on your stomach, bend the target knee to 90 degrees and apply resistance or a ‘block’ with the opposing limb.
• Sustain for 5s or as designated by your therapist.
• Continue to reduce the amount of knee bend as determined appropriate with your Physiotherapist.

Instructions:

• Position yourself in front of the band
• Using both arms slowly pull the band towards both cheeks with elbows slightly upward
• Think about squeezing your shoulder blades together while relaxing your neck and the top of your shoulders

Precautions:

• If you are unsure of the movement please speak to your physiotherapist

Instructions:

• Keep the arms by the side holding 2 dumbells
• Lean slightly forward from the hips
• Extend the elbows out straight while keeping the middle of the elbows by the side of the body and repeat

Precautions:

• If you are unsure of the exercise or are experiencing pain whilst performing the movement, please speak to your physiotherapist

The Pogo Jump varies from skipping or jumping as the movement is completed on ‘stiff’ legs. The goal is to generate the movement with the ankle exclusively. The following videos demonstrate a bilateral and unilateral variation, your Physiotherapist will prescribe one that is appropriate for you.

Bilateral Instructions:

• With straight knees, bring the weight forward onto the toes as you push your heels off the ground
• Land on stiff legs and propel immediately again through the ankle
• Repeat as per Physiotherapist guidelines

Unilateral instructions:

• Using a step, place the unaffected limb onto the step
• Stand at the top with the target limb off the step
• As you bend through the knee of the leg on the step, lower the target limb to the floor on a stiff leg
• Keep the target knee straight and propel yourself into a jump with the ankle only
• Repeat as per Physiotherapist guidelines

Isometrics involve the target limb being put under load without moving through range. This is a great way to introduce load to tendons and muscles without provoking painful symptoms. The following three videos demonstrate a single leg isometric heel raise through bottom-mid and end-range. Your Physiotherapist will prescribe which exercise is appropriate for you and for what duration.

Instructions:

• Stand with the heels coming off the edge of the step/ledge
• With straight knees maintain the heels in a bottom-mid-end range position
• Once in position, take the unaffected limb off the step and maintain contact with the forefoot of the target limb
• Keep the heel in a neutral position without inward/outward rotation
• Maintain for the duration as per Physiotherapist guidelines
• Ensure there is something stable to maintain balance

Seated variation:

• Sitting on your bottom extend the legs out against a wall or step
• With the target limb, press the forefoot into the step without letting the ankle joint move
• Keep the knee pressing into the ground to maintain a straight leg
• Relax the pressure from the forefoot and repeat as per Physiotherapist guidelines
• Ensure you’re sitting upright on the sit bones and not collapsing through the chest

Instructions:

• Place a band around something thats sterdy
• Wrap the band around the big toe
• Bring/extend the toe upwards towards you while controlling the movement on the way down

Precautions:

• If you’re unsure of the movement please consult your physiotherapist

Instructions:

• Take a band and place it under and around the big toe
• Let the band bring you up into extension then push down against the band with the big toe

Variation 1: Standing

Variation 2: Long lie

Precautions:

• If you are unsure of the exercise, please consult your physiotherapist

Instructions:

• Lie on your tummy
• Bend both knees up and hook one leg around the other at the ankle at the back
• Slower lower the leg to the bed while pushing against the other foot as you lower down

Precautions:

• If you are unsure of the exercise or experiencing discomfort, speak to your physiotherapist

Stretch 1: Banana stretch

Instructions:

• Find a wall/doorway that can be gripped with the hands
• Stand close to the doorway and grab with both hands
• Draw the side of the body thats furthest away for the wall outwards until you feel a stretch up the side of the body

Precautions:

• The sensation should be a strong stretch, not pain.
• If you experience pain, stop the exercise or reduce the movement.
• If you are unsure of the stretch or experiencing discomfort, speak to your physiotherapist

Stretch 2: Variation of Banana

Instructions:

• Find a wall/doorway
• Stand half a metre to a metre away from the wall and either cross one foot behind or have your feet together
• Draw the side of the body thats furthest away for the wall outwards until you feel a stretch and reach the hand towards the wall making a banana shape

Precautions:

• The sensation should be a strong stretch, not pain.
• If you experience pain, stop the exercise or reduce the movement.
• If you are unsure of the stretch or experiencing discomfort, speak to your physiotherapist

Stretch 3: Kneeling stretch

Instructions:

• Find yourself near a chair or bench
• Kneel down and place the arm above the head and reach over towards the surface your leaning on

Precautions:

• The sensation should be a strong stretch, not pain.
• If you experience pain, stop the exercise or reduce the movement.
• If you are unsure of the stretch or experiencing discomfort, speak to your physiotherapist

Stretch 4: Childs pose with Lateral Flexion

Instructions:

• Lye in childs pose
• walk hands out to the corner of the room and repeat

Precautions:

• The sensation should be a strong stretch, not pain.
• If you experience pain, stop the exercise or reduce the movement.
• If you are unsure of the stretch or experiencing discomfort, speak to your physiotherapist

Stretch 5: sidelying stretch

Instructions:

• Start by sitting on the edge of the bed
• Lay down onto the unaffected side while keeping your legs over the edge of the bed
• You can raise your top arm over your head to increase the stretch in your side body if required
• Maintain this position for 1-2 minutes

Precautions:

• The sensation should be a strong stretch, not pain.
• If you experience pain, stop the exercise or reduce the movement.
• If you are unsure of the stretch or experiencing discomfort, speak to your physiotherapist