North Lakes Physiotherapy Services

• An injury that is most often seen in sports people
• Often seen when an athlete is landing from a jump, changing direction, or twisting
• Diffuse swelling around the affected knee is typically seen quickly
• Instability and giving way sensations can be felt, clients may also describe a lack of confidence in the knee
• Can be seen with other injuries such as MCL strains, meniscal tears or muscle injuries surrounding the knee

What we will discuss:

• Your mechanism of injury
• Symptoms you felt or saw within the first 24 hours
• Whether you have any looseness, instability or giving way at the knee
• Your goals for rehabilitation
• What sport you play, including for how many years, what position you play and which club you play for
• Symptoms such as pain, instability, giving way, clicking, catching, or locking
• If you have noticed any pattern to your pain such as worse at night or worse in the morning
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

What we will assess:

• Range of movement at the knee, hip, and ankle
• Ligament tests
• Meniscal tests
• Functional testing
• Nerve tests
• Assessment of muscle tone and flexibility
• Assessment of joint stiffness
• Specific special tests that may be clinically relevant

Other Referrals

• GP
• Orthopaedic specialist
• Podiatrist
• Nutritionist
• Psychologist
• Strength and conditioning coach

Scans/Investigations

• MRI scans are the most recommended and can potentially be acquired bulk billed from your GP. It can detect ligament injuries, meniscal injuries, muscle injuries as well as any cartilage concerns within the knee joint.
• Ultrasound scans may be utilised for MCL or LCL strains but are not recommended for assessment of ACL injuries.
• X-ray may be utilised to rule out any fractures if you present to the hospital but is unlikely to be utilised by a GP investigating for an ACL injury.
• CT scans would only be recommended in very select circumstances, as such they are not commonly used when investigating ACL injuries.

What we can offer

At PRP Physio we can provide rehabilitation via non-surgical management pathways or surgical options. Currently there is not enough research to determine if one pathway is more effective than the other. We place a strong emphasis on ensuring you are educated regarding both pathways to ensure you can make an informed choice. Below we have listed how the two pathways differs from each other, we are able to discuss these options further in your appointment.

It is important to remember that neither of these options is wrong, it is up to you to determine, at your current stage of life and goals of your rehabilitation, which one is the best choice for you once you have received all of the information possible.

• Initial stages
  • Hands on treatment including massage and joint mobilisation of the knee, calf, ankle, or hip
  • Taping techniques or brace fitting to support the knee
  • Gait/Walking advice and education – prescription of crutches if needed
  • Mobility and stretching exercises with some strengthening involvement
• Mid stages
  • Reducing reliance on hands on treatment
  • Increasing exposure to exercise within appointments
  • Increasing strength demands in home programs
  • Introduction of dynamic and plyometric exercises
  • Building towards return to training
• Late stages
  • Majority of the focus will be on exercise, strengthening, and stretching
  • Small focus on hands on techniques to release any specific muscles or joints
  • Increased sports specific demands during exercises and increases in training
  • Build towards returning to gameplay and increasing intensity

Long term recommendations

PRP Physio can recommend a range of services for you to look after your knee health in the long term. We can provide:

• Field based speed and agility classes
• Sports performance programs
• Mobility and flexibility classes
• Online training program prescription
• Strength and conditioning programs
• One on one exercise with gym equipment or field-based training

We recommend that all our clients take a proactive approach following their rehabilitation with us and are proud to offer these services to our clients.

If you are interested in reading more about ACL injuries, be sure to check out our blog series on this injury.

What is it

• One of the most common sporting injuries, particularly in AFL, soccer, and rugby
• Has a high incidence of recurrent injuries even though so many resources such as research have been allocated to reduce the burden
• Varying types of strains and mechanisms such as high-speed sprinting or stretching mechanisms requiring specific treatment pathways
• Eccentric (muscle lengthening under load) exercise has been found to have significantly positive effects on reducing the risk profile of hamstring injuries
• Following an injury, we recommend you continue performing injury prevention exercises specific to the hamstrings to maintain a low risk profile for future injuries

What we will discuss:

• How your hamstring strain occurred
• Your current exercise routine
• Previous history of hamstring injuries
• Your goals for rehabilitation
• What sport you play – useful information also includes what position, how long you have played for
• Symptoms including pain and how it behaves throughout the day and week
• Aggravating movements and positions
• Any neural pain or changes to sensations such as pins and needles, numbness, or tingling
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

What we will assess

• Range of movement at the affected joints and muscles
• Isolated muscle contractions
• Nerve tests
• Functional movement assessment
• Assessment of muscle tone and flexibility
• Assessment of joint stiffness
• Specific special tests that may be clinically relevant

Other Referrals

• GP
• Strength and conditioning coach

Scans/Investigations

• MRI is the most clinically useful form of imaging however it is not always recommended unless your rehabilitation does not progress as expected. Research has been able to determine that early MRI does not offer significant value over clinical assessment in most presentations.
• Ultrasound may be utilised to assess a hamstring muscle strain as it can accurately assess the location and severity of the muscle injury.

What we can offer

• Initial stages
  • Hands on treatment including massage and joint mobilisation to improve efficiency of movement
  • Taping techniques to reduce load to the hamstring in the short term
  • Mobility and stretching exercises with some strengthening involvement
• Mid stages
  • Reducing reliance on hands on treatment
  • Increasing exposure to exercise within appointments
  • Increasing strength demands in home programs
  • Return to running program with on field assessments and prescription
• Late stages
  • Majority of the focus will be on exercise, strengthening, and stretching
  • Small focus on hands on techniques to release any specific muscles or joints

Long term recommendations

PRP Physio can recommend a range of services for you to look after your hamstring health in the long term. We can provide:

• Sports performance programs
• Speed and agility programs
• Mobility and flexibility programs
• Online training program prescription
• Strength and conditioning programs
• One on one exercise with gym equipment

We recommend that all our clients take a proactive approach following their rehabilitation with us and are proud to offer these services to our clients.

• One of the more common sporting injuries, particularly in AFL, soccer, netball, and rugby.
• Ankle ligament injuries tend to be the most common followed by the knee.
• Ruling out other significant injuries such as fractures in ankle sprains is a key differential diagnosis.
• Even though return to sport may occur quickly, preventative exercises and strategies such as taping, or bracing are recommended in the research.
• Higher grade knee ligament injuries may require a period in a brace to assist in the ligament healing process

Common Presentations

• Rolled ankle – Inversion (rolled inwards) or eversion (rolled outwards)
• MCL sprains
• LCL sprains
• Midfoot ligament sprains

What we will discuss:

• Your history of symptoms including potential mechanism, what the pain feels like and any other history of lower back pain. 
• Your current exercise routine – including what you do each day and how long for (either in minutes/hours or distance).
• Your goals for rehabilitation such as returning to work, sport or exercise, or hobbies.
• What sport you play, including for how many years, what position you play and which club you play for
• Symptoms including pain and how it behaves throughout the day and week
• If you have noticed any pattern to your pain such as worse at night or worse in the morning
• Any neural pain or changes to sensations such as pins and needles, numbness, or tingling
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

What we will assess:

• Range of movement at the affected joint
• Ligament tests
• Meniscus tests if a knee injury
• Nerve tests
• Assessment of muscle tone and flexibility
• Assessment of joint stiffness
• Specific special tests that may be clinically relevant

Other Referrals

• GP
• Podiatrist
• Strength and conditioning coach

Scans/Investigations

• X-ray is the most common form of imaging for ankle sprains, it is often utilised to rule out fractures of any of the bones surrounding the ankle. Your GP or physiotherapist will assess the ankle in correspondence with the Ottawa Rules to determine if you potentially have a fracture. These tests are sensitive for fractures but not specific, this means that even if you have multiple positive tests, we cannot be certain you have a fracture, hence why we refer for a scan.
• Ultrasound may be utilised in certain ankle sprain cases to assess for ligament and tendon integrity. Clinical assessment is highly accurate in determining which tissues are involved and can guide us towards a grading for the injury, a scan simply gives us more information. It is also able to detect any muscle or tendon changes around the ankle; it can commonly be seen that there is slight swelling/irritation of the tendons which can appear on ultrasound.
• MRI is the most referred investigation for suspected knee ligament sprains. Your GP may wish to rule out an ACL injury or any meniscal involvement. It will be able to visualise all the ligaments within the knee joint as well as other structures to provide you with a comprehensive view of the anatomy of the knee and any structures which may be involved.

What we can offer

• Initial stages
  • Hands on treatment including massage and joint mobilisation of the affected area
  • Taping techniques
  • Gait/Walking advice and education – crutch prescription if required
  • Mobility and stretching exercises with some strengthening involvement
• Mid stages
  • Reducing reliance on hands on treatment
  • Increasing exposure to exercise within appointments
  • Increasing strength demands in home programs
• Late stages
  • Majority of the focus will be on exercise, strengthening, and stretching
  • Small focus on hands on techniques to release any specific muscles or joints

Long term recommendations

PRP Physio can recommend a range of services for you to look after your ligament health in the long term. We can provide:

• Sports performance programs
• Speed and agility programs
• Mobility and flexibility programs
• Online training program prescription
• Strength and conditioning programs
• One on one exercise with gym equipment

We recommend that all our clients take a proactive approach following their rehabilitation with us and are proud to offer these services to our clients.

• These are more commonly seen in people aged 30+
• The shoulder and the elbow are the most common locations
• At the shoulder, pain may be diffuse and globally around the shoulder, whereas at the elbow it is often more locally defined
• Some stiffness may be felt in the mornings which warms up with activity
• Often it will coincide with an increase in activity – playing tennis or squash after a break, typing a long report at work or increase in study time, building a deck on the weekend, painting a room.
• There are varying stages of presentations, of which require different treatment and management pathways.
• Differential diagnosis of anatomical structures is needed to determine the best treatment techniques and pathways particularly at the elbow, determining a tendinopathy from a nerve-based pain driver is key.

Common presentations

• Tennis elbow (lateral epicondylalgia)
• Golfer’s elbow (medial epicondylalgia)
• Dequervain’s tenosynovitis
• Rotator cuff tendinopathy

What we will discuss:

• Your history of symptoms including potential mechanism, what the pain feels like and any other history of lower back pain. 
• Your current exercise routine – including what you do each day and how long for (either in minutes/hours or distance).
• Your goals for rehabilitation such as returning to work, sport or exercise, or hobbies.
• What sport you play, including for how many years, what position you play and which club you play for
• Symptoms including pain and how it behaves throughout the day and week
• If you have noticed any pattern to your pain such as worse at night or worse in the morning
• Any neural pain or changes to sensations such as pins and needles, numbness, or tingling
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

What we will assess:

• Range of movement at the spine and affected joints
• Nerve tests
• Isolated muscle contractions
• Muscle strength testing
• Assessment of muscle tone and flexibility
• Assessment of joint stiffness
• Specific special tests that may be clinically relevant

Other Referrals

• GP
• Occupational therapist
• Nutritionist
• Orthopaedic surgeon

Scans/Investigations

• Ultrasound is often the most utilised investigation for tendinopathies followed by MRI. The benefit of ultrasound is the dynamic nature of it, being able to assess the tendon and the way it is moving against other structures is beneficial. MRI can assist in tendon structure and may be used to rule out other pain sources.
• In certain cases blood tests may be beneficial to determine if there may be a systemic driver of your symptoms rather than a mechanical source, in these cases referral to your GP and medical advice is recommended while you continue your exercise rehabilitation.
• For very particular cases of elbow pain referral to a neurologist for investigations surrounding the nerve and how it is functioning may be necessary

What we can offer

• Initial stages
  • Hands on treatment including massage and joint mobilisation of the affected region
  • Taping techniques to temporarily reduce load to the region
  • Mobility and stretching exercises, as well as targeted strength training
• Mid stages
  • Reducing reliance on hands on treatment
  • Increasing exposure to exercise within appointments
  • Increasing strength demands in home programs
• Late stages
  • Majority of the focus will be on exercise, strengthening, and stretching
  • Small focus on hands on techniques to release any specific muscles or joints

Long term recommendations

PRP Physio can recommend a range of services for you to look after your tendon health in the long term. We can provide:

• Sports performance programs
• Mobility and flexibility classes
• Online training program prescription
• Strength and conditioning programs
• One on one exercise with gym equipment

We recommend that all our clients take a proactive approach following their rehabilitation with us and are proud to offer these services to our clients.

• Can be seen in a wide range of demographics and populations
• Often it will be described as pain on the tendon, along the tendon or at/near the tendon insertion point
• Typically, it will be painful and stiff for up to 30mins in the morning
• The stiffness and pain may return if you have been sedentary for a period
• Often it will coincide with an increase in activity – boot camps, 12 week challenges, long hikes for example
• There are varying stages of presentations, of which require different treatment and management pathways
• Differential diagnosis of anatomical structures is needed to determine the best treatment techniques and pathways

Common Presentations

• Hamstring tendinopathy
• Quadriceps tendinopathy
• Patella tendinopathy
• Achilles tendinopathy
• Achilles tenosynovitis

What we will discuss:

• Your history of symptoms including potential mechanism, what the pain feels like and any other history of lower back pain. 
• Your current exercise routine – including what you do each day and how long for (either in minutes/hours or distance).
• Your goals for rehabilitation such as returning to work, sport or exercise, or hobbies.
• What sport you play, including for how many years, what position you play and which club you play for
• Symptoms including pain and how it behaves throughout the day and week
• If you have noticed any pattern to your pain such as worse at night or worse in the morning
• Any neural pain or changes to sensations such as pins and needles, numbness, or tingling
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

What we will assess

• Range of movement at the affected joints
• Nerve tests
• Functional movement assessment
• Assessment of muscle tone and flexibility
• Assessment of joint stiffness
• Specific special tests that may be clinically relevant

Other Referrals

• GP
• Podiatrist
• Nutritionist
• Strength and conditioning coach

Scans/Investigations

• Ultrasound is often the most utilised investigation for tendinopathies followed by MRI. The benefit of ultrasound is the dynamic nature of it, being able to assess the tendon and the way it is moving against other structures is beneficial. MRI can assist in tendon structure and may be used to rule out other pain sources.
• X-ray may be utilised for Achilles tendon issues to determine if any bony structures may be affecting the tendon.
• In certain cases blood tests may be beneficial to determine if there may be a systemic driver of your symptoms rather than a mechanical source, in these cases referral to your GP and medical advice is recommended while you continue your exercise rehabilitation.

What we can offer

• Initial stages
  • Hands on treatment including massage and joint mobilisation to improve efficiency of movement
  • Taping techniques to improve movement patterns and enhance effects of exercise programs
  • Mobility and stretching exercises, as well as targeted strength training
• Mid stages
  • Reducing reliance on hands on treatment
  • Increasing exposure to exercise within appointments
  • Increasing strength demands in home programs
• Late stages
  • Majority of the focus will be on exercise, strengthening, and stretching
  • Small focus on hands on techniques to release any specific muscles or joints

Long term recommendations

PRP Physio can recommend a range of services for you to look after your tendon health in the long term. We can provide:

• Field based speed and agility classes
• Sports performance programs
• Mobility and flexibility classes
• Online training program prescription
• Strength and conditioning programs
• One on one exercise with gym equipment or field-based training

We recommend that all our clients take a proactive approach following their rehabilitation with us and are proud to offer these services to our clients.

• Common in a range of groups ranging from desk workers, active sporting populations and older clients
• Headaches are a common associated symptom with neck pain
• Referred pain to the arm or upper back can be an associated symptom
• Neck pain following a motor vehicle accident can sometimes occur within the next 24-48 hours

Common presentations

• Whiplash
• Headaches
• Postural related pain
• Referred pain to shoulder blade region
• Referred pain to the arm

What we will discuss:

• Your history of symptoms including potential mechanism, what the pain feels like and any other history of lower back pain. 
• Your current exercise routine – including what you do each day and how long for (either in minutes/hours or distance).
• Your goals for rehabilitation such as returning to work, sport or exercise, or hobbies.
• What sport you play, including for how many years, what position you play and which club you play for
• Symptoms including pain and how it behaves throughout the day and week
• If you have noticed any pattern to your pain such as worse at night or worse in the morning
• Any neural pain or changes to sensations such as pins and needles, numbness, or tingling
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

What we will assess

• Range of movement at the spine and shoulder joints
• Nerve tests
• Assessment of muscle tone and flexibility
• Assessment of joint stiffness
• Specific special tests that may be clinically relevant

Other Referrals

• GP
• Neurologist
• Orthopaedic surgeon
• Occupational therapist
• Nutritionist

Scans/Investigations

• MRI’s are the most referred investigation for neck pain in adults. It is often utilised to assess soft tissue structures such as discs to rule out any nerve impingement. It is important you discuss the results of your scan with your GP and physiotherapist to ensure the interpretation is accurate.
• X-ray’s may be used in certain cases to rule out any fractures within the neck joints.

What we can offer

• Initial stages
  • Hands on treatment including massage and joint mobilisation of the neck, upper back, or shoulder
  • Taping techniques to reduce load to the neck muscles and joints
  • Mobility and stretching exercises with some strengthening involvement
• Mid stages
  • Reducing reliance on hands on treatment
  • Increasing exposure to exercise within appointments
  • Increasing strength demands in home programs
• Late stages
  • Majority of the focus will be on exercise, strengthening, and stretching
  • Small focus on hands on techniques to release any specific muscles or joints

Long term recommendations

PRP Physio can recommend a range of services for you to look after your neck health in the long term. We can provide:

• Mobility and flexibility classes
• Online training program prescription
• Strength and conditioning programs
• One on one exercise with gym equipment

We recommend that all our clients take a proactive approach following their rehabilitation with us and are proud to offer these services to our clients.

• One of the most common musculoskeletal presentations to GP’s and Physiotherapists in Australia
• Can often occur without a distinct injury mechanism, clients will often tell stories of small activities such as picking a pen up off the floor as the instigating factor for their symptoms
• Strengthening has been shown to have a positive effect in reducing recurrent back pain
• An accurate assessment and diagnosis is necessary to fast-track your treatment 

Common presentations

• Muscle related low back pain – often perceived as tightness or muscle spasm
• Joint related low back pain – often perceived as stiffness
• Disc related lower back pain
• Sciatica
• Spondylolysthesis
• Postural related pain
• Referred pain to the lower limb

What we will discuss:

• Your history of symptoms including potential mechanism, what the pain feels like and any other history of lower back pain. 
• Your current exercise routine – including what you do each day and how long for (either in minutes/hours or distance).
• Your goals for rehabilitation such as returning to work, sport or exercise, or hobbies.
• What sport you play, including for how many years, what position you play and which club you play for
• Symptoms including pain and how it behaves throughout the day and week
• If you have noticed any pattern to your pain such as worse at night or worse in the morning
• Any neural pain or changes to sensations such as pins and needles, numbness, or tingling
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

What we will assess:

• Range of movement at the spine and hip joints
• Nerve tests
• Assessment of muscle tone and flexibility
• Assessment of joint stiffness
• Specific special tests that may be clinically relevant

Other Referrals

• GP
• Neurologist
• Orthopaedic surgeon
• Occupational therapist
• Nutritionist

Scans/Investigations

• MRI’s are the most referred investigation for low back pain in adults. It is often utilised to assess soft tissue structures such as discs to rule out any nerve impingement. It is important you discuss the results of your scan with your GP and physiotherapist to ensure the interpretation is accurate.
• X-ray’s may be used in certain cases to rule out fractures in older adults or in young athletes.
• CT scans can be utilised to assess for bone stress injuries in young adults, however, some GP’s can be conservative due to the radiation exposure.

What we can offer

• Initial stages
  • Hands on treatment including massage and joint mobilisation of the spine and hip joints
  • Taping techniques to support the lower back
  • Mobility and stretching exercises with some strengthening involvement
• Mid stages
  • Reducing reliance on hands on treatment
  • Increasing exposure to exercise within appointments
  • Increasing strength demands in home programs
• Late stages
  • Majority of the focus will be on exercise, strengthening, and stretching
  • Small focus on hands on techniques to release any specific muscles or joints

Long term recommendations

PRP Physio can recommend a range of services for you to look after your back health in the long term. We can provide:

• Mobility and flexibility classes
• Online training program prescription
• Strength and conditioning programs
• One on one exercise with gym equipment

We recommend that all our clients take a proactive approach following their rehabilitation with us and are proud to offer these services to our clients.

• One of the most common presentations to GP’s and Physiotherapists in Australia
• Array of different causes of pain stemming from the shoulder joint itself, the neck, upper back, rib joints or muscles or other tissues within or around the shoulder
• Significant limitations of function can occur, particularly if it is the dominant arm that is affected
• Certain presentations such as frozen shoulder (adhesive capsulitis) have conflicting research regarding optimal management strategies
• Injuries such as shoulder dislocations or subluxations should be treated very differently to other presentations such as an acutely overloaded shoulder – for example built a deck on the weekend and woke with a sore shoulder on Monday morning.

Common Presentations

• Bursitis
• Frozen Shoulder/Adhesive Capsulitis
• Rotator cuff tendinopathy
• Rotator cuff tears

What we will discuss:

• Your history of symptoms including potential mechanism, what the pain feels like and any other history of lower back pain. 
• Your current exercise routine – including what you do each day and how long for (either in minutes/hours or distance).
• Your goals for rehabilitation such as returning to work, sport or exercise, or hobbies.
• What sport you play, including for how many years, what position you play and which club you play for
• Symptoms including pain and how it behaves throughout the day and week
• If you have noticed any pattern to your pain such as worse at night or worse in the morning
• Any neural pain or changes to sensations such as pins and needles, numbness, or tingling
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

We will also discuss:

• Your current exercise routine
• Injury history
• Your goals for rehabilitation
• What sport you play – useful information also includes what position, how long you have played for
• Symptoms including pain and how it behaves throughout the day and week
• Aggravating movements and positions
• Any neural pain or changes to sensations such as pins and needles, numbness, or tingling
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

What we will assess:

• Range of movement at the spine and shoulder joints
• Nerve tests
• Functional movement assessment
• Isolated muscle contractions
• Muscle strength testing
• Assessment of muscle tone and flexibility
• Assessment of joint stiffness
• Specific special tests that may be clinically relevant

Other Referrals

• GP
• Orthopaedic surgeon
• Neurologist
• Strength and conditioning coach

Scans/Investigations

• X-ray may be utilised in certain cases where there is a mechanism of injury such as a fall onto the tip of the shoulder in a rugby game to rule out any fractures of the clavicle or surrounding bone structures. It can also assess for any changes at the AC joint locally, some higher-grade AC joint injuries may experience what is called a “step deformity”. This occurs when the joint becomes slightly misaligned and can have a distinctive appearance on scan and to the naked eye.
• Ultrasound is most utilised in cases with no mechanism of injury, often clinicians are looking for bursal inflammation, tendon changes of the rotator cuff or the biceps tendon, among others. These scans can provide a vast amount of information, but it is important that the findings are clinically correlated to your symptoms. A significant number of people without shoulder pain may have the same findings on an ultrasound of their shoulder.
• MRI is often utilised in cases where there has been a mechanism of injury, such as a dislocation or if the shoulder pain is not responding in a typical manner and investigations so far have provided minimal information. MRI’s, as with ultrasounds can provide a lot of information about the internal structures of the shoulder, as such, always discuss these findings with your GP, specialist, and physiotherapist. 

What we can offer

• Initial stages
  • Hands on treatment including massage and joint mobilisation to the shoulder and upper back regions
  • Taping techniques to support the shoulder
  • Mobility and stretching exercises, as well as targeted strength training
• Mid stages
  • Reducing reliance on hands on treatment
  • Increasing exposure to exercise within appointments
  • Increasing strength demands in home programs
• Late stages
  • Majority of the focus will be on exercise, strengthening, and stretching
  • Small focus on hands on techniques to release any specific muscles or joints

Long term recommendations

PRP Physio can recommend a range of services for you to look after your shoulder health in the long term. We can provide:

• Sports performance programs
• Mobility and flexibility programs
• Online training program prescription
• Strength and conditioning programs
• One on one exercise with gym equipment

We recommend that all our clients take a proactive approach following their rehabilitation with us and are proud to offer these services to our clients.

What is it

• Shoulder dislocations or subluxations occasionally occur and the ongoing effects if not treated correctly can lead to recurrent injuries
• AC joint injuries require targeted treatment and progressive exercise
• Recurrent dislocations or laxity (looseness) can be common after an initial dislocation incident
• In some sports, such as swimming, a certain degree of laxity can provide a performance benefit, it is important though, that you have the strength to control the increase in movement at the joint

Common Presentations

• Shoulder dislocations
• AC joint injuries
• Burners or Stingers
• Rotator cuff injuries – tendon or muscle injuries
• Biceps tendon injuries
• Pectoral muscle injuries

What we will discuss:

• Your history of symptoms including potential mechanism, what the pain feels like and any other history of lower back pain. 
• Your current exercise routine – including what you do each day and how long for (either in minutes/hours or distance).
• Your goals for rehabilitation such as returning to work, sport or exercise, or hobbies.
• What sport you play, including for how many years, what position you play and which club you play for
• Symptoms including pain and how it behaves throughout the day and week
• If you have noticed any pattern to your pain such as worse at night or worse in the morning
• Any neural pain or changes to sensations such as pins and needles, numbness, or tingling
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

What we will assess:

• Range of movement at the spine and shoulder joints
• Nerve tests
• Functional movement assessment
• Isolated muscle contractions
• Muscle strength testing
• Assessment of muscle tone and flexibility
• Assessment of joint stiffness
• Specific special tests that may be clinically relevant

Other Referrals

• GP
• Orthopaedic surgeon
• Neurologist
• Strength and conditioning coach

Scans/Investigations

• X-ray may be utilised in certain cases where there is a mechanism of injury such as a fall onto the tip of the shoulder in a rugby game to rule out any fractures of the clavicle or surrounding bone structures. It can also assess for any changes at the AC joint locally, some higher-grade AC joint injuries may experience what is called a “step deformity”. This occurs when the joint becomes slightly misaligned and can have a distinctive appearance on scan and to the naked eye.
• MRI is often utilised in cases where there has been a mechanism of injury, such as a dislocation or if the shoulder pain is not responding in a typical manner and investigations so far have provided minimal information. MRI’s, as with ultrasounds can provide a lot of information about the internal structures of the shoulder, as such, always discuss these findings with your GP, specialist, and physiotherapist. 
• Ultrasounds may be utilised later after the initial diagnosis has been made if symptoms do not respond in their normal manner. It is often utilised to rule out other potential pain sources such as bursitis or if there is any tendon or muscle involvement in the injury.

What we can offer

• Initial stages
  • Hands on treatment including massage and joint mobilisation to optimise movement at the shoulder and upper back regions
  • Taping techniques to support the shoulder
  • Mobility and stretching exercises, as well as targeted strength training
• Mid stages
  • Reducing reliance on hands on treatment
  • Increasing exposure to exercise within appointments
  • Increasing strength demands in home programs
• Late stages
  • Majority of the focus will be on exercise, strengthening, and stretching
  • Small focus on hands on techniques to release any specific muscles or joints

Long term recommendations

PRP Physio can recommend a range of services for you to look after your shoulder health in the long term. We can provide:

• Sports performance programs
• Mobility and flexibility programs
• Online training program prescription
• Strength and conditioning programs
• One on one exercise with gym equipment

We recommend that all our clients take a proactive approach following their rehabilitation with us and are proud to offer these services to our clients.

What is it

• Growing pains associated with adolescence can be common, particularly in active teenagers
• The most common areas for pain are the knee and the ankle where the patella and achilles tendon attach
• More serious injuries can be seen in adolescence and is important that an early and accurate diagnosis is made
• The rapid changes seen in teenagers due to growth spurts can often result in a lack of movement control, often we will see teenagers landing from a jump and their knees bend inwards. This is a sign that they need to develop further strength and movement control to adequately perform this movement in an efficient pattern.

Common Presentations

• Osgood-Schlatters Disease
• Sever’s Disease
• Sinding-Larsen-Johansenn Syndrome
• Growth plate fractures
• Osteochondritis dissecans
• Scoliosis
• Spondylolysthesis
• Pars defect

What we will discuss:

• Any recent growth spurts
• Your current exercise routine as well as any changes in duration or intensity
• Previous history of injuries
• Your goals for rehabilitation
• What sport you play – useful information also includes what position, how long you have played for
• Symptoms including pain and how it behaves throughout the day and week
• Aggravating movements and positions
• Any neural pain or changes to sensations such as pins and needles, numbness, or tingling
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

What we will assess

• Range of movement at the affected joints and muscles
• Isolated muscle contractions
• Nerve tests
• Functional movement assessment
• Assessment of muscle tone and flexibility
• Assessment of joint stiffness
• Specific special tests that may be clinically relevant

Other Referrals

• GP
• Podiatrist
• Nutritionist
• Orthopaedic surgeon
• Strength and conditioning coach

Scans/Investigations

• A range of varying imaging techniques can be used to assess injuries in adolescents with a large dependence upon the area and type of presentation they present with. Instead of listing how imaging techniques are used we will provide the most common investigations for body sections:
  • Shoulder – MRI most common
  • Spine – MRI most common, X-ray may be utilised as a screening exam prior to MRI and CT scan may be used if more information is required, some GP’s are reluctant due to the radiation exposure in teenagers.
  • Hip – MRI and x-ray most common, will largely depend upon the presentation as to which is used
  • Knee – MRI most common
  • Ankle – x-ray and ultrasound most common and MRI used occasionally

What we can offer

• Initial stages
  • Hands on treatment including massage and joint mobilisation to improve efficiency of movement
  • Taping techniques to reduce load to the affected region
  • Mobility and stretching exercises with some strengthening involvement
• Mid stages
  • Reducing reliance on hands on treatment
  • Increasing exposure to exercise within appointments
  • Increasing strength demands in home programs
  • Return to running program with on field assessments and prescription
• Late stages
  • Majority of the focus will be on exercise, strengthening, and stretching
  • Small focus on hands on techniques to release any specific muscles or joints

Long term recommendations

PRP Physio can recommend a range of services for you to look after your health in the long term. We can provide:

• Mobility and flexibility programs
• Sports performance programs
• Online training program prescription
• Strength and conditioning programs
• One on one exercise with gym equipment

We recommend that all our clients take a proactive approach following their rehabilitation with us and are proud to offer these services to our clients.

• Often described by clients as a sharp shooting or a burning pain
• May have “electric shock” or hot and cold sensations
• Sensation changes such as pins and needles, sensation loss or a dead arm/leg feeling may be accompanied by the pain itself
• Referral patterns are common, often there may be a pattern of symptoms fitting to a specific level of the spine either at the neck or lower back
• Heightened senses to a painful stimulus, or a painful stimulus to something that isn’t normally painful can be seen, this is a sign of nerve sensitivity

Common Presentations

• Sciatica
• Carpal tunnel syndrome
• Nerve entrapment
• Radiculopathy – referral pain from neck, mid back or lower back

What we will discuss:

• Your history of symptoms including potential mechanism, what the pain feels like and any other history of lower back pain.
• Your current exercise routine – including what you do each day and how long for (either in minutes/hours or distance).
•  Your goals for rehabilitation such as returning to work, sport or exercise, or hobbies.
• What sport you play, including for how many years, what position you play and which club you play for
• Symptoms including pain and how it behaves throughout the day and week
• If you have noticed any pattern to your pain such as worse at night or worse in the morning
• Any neural pain or changes to sensations such as pins and needles, numbness, or tingling
• Any concerns or questions you might have such as treatment options, scans/investigations, or any other queries

What we will assess:

• Range of movement at the spine and affected joints
• Functional movement assessment
• Nerve tests
• Assessment of muscle tone and flexibility
• Assessment of joint stiffness
• Specific special tests that may be clinically relevant

Other Referrals

GP
Orthopaedic surgeon
Neurologist
Strength and conditioning coach

Scans/Investigations

• MRI is commonly utilised to image for spinal pain and nerve pain, it can allow us to assess the nerves as they travel from the spinal segment to assess if there is any involvement. If assessing for a peripheral nerve involvement, some enlargement of the nerve may be seen on MRI which could indicate an inflammatory process, likely driven by a compression of the nerve.
• X-ray may be utilised in certain cases but is less likely, often it may be used to assess the joint space at the spinal levels. This is more likely to be utilised in older individuals than in younger populations.
• Ultrasounds is commonly utilised to assess for peripheral nerve involvement. It allows for specific assessment of the nerve and due to its dynamic nature, it can assess how the nerve is moving and any potential entrapment of the nerve. Often, a positive report will indicate an enlargement of the nerve, indicating an inflammatory and potential compression of the nerve.
• Nerve conduction tests may be utilised to determine if it is more of a peripheral or central (spinal region) driver. It can accurately determine the site and location of a nerve compression. These will often be undertaken following a referral to a neurologist.

What we can offer

Initial stages
o Hands on treatment including massage and joint mobilisation of the affected
muscles or joints
o Taping techniques to reduce nerve pain
o Mobility and stretching exercises with some strengthening involvement

Mid stages
o Reducing reliance on hands on treatment
o Increasing exposure to exercise within appointments
o Increasing strength demands in home programs

Late stages
o Majority of the focus will be on exercise, strengthening, and stretching
o Small focus on hands on techniques to release any specific muscles or joints

Long term recommendations

PRP Physio can recommend a range of services for you to look after your nerve health in the long term.

We can provide:

• Mobility and flexibility programs
• Online training program prescription
•  Strength and conditioning programs
• One on one exercise with gym equipment

We recommend that all our clients take a proactive approach following their rehabilitation with us and are proud to offer these services to our clients.

Dry needling is a commonly utilised technique in physiotherapy to assist in reducing muscle tone. Prior consent and signing a waiver is required before completing this treatment however the risks remain incredibly low. We utilise single use needles and have undertaken specific training in dry needling.

Soft tissue massage, deep tissue massage, and trigger point release therapy are commonly utilised techniques by our North Lakes physiotherapists. We utilise these techniques with our clients when indicated. Often it can result in quick reductions in muscle tone, improved movement, and pain relief.

All of the hands on treatment can be done resulting in short term pain relief and improvements and function. But countless bodies of research has shown that long term improvements in function is seen with a physio prescribed exercise program. Developing the adequate strength, mobility, flexibility, power, and control is needed to complete a thorough physiotherapy rehabilitation.

Blood Flow Restriction training is a specific form of exercise where occlusion of venous (blood flowing in) flow at either 50% (upper limb) or 80% (lower limb) occurs. This creates a hypoxic environment for the muscles where the effects of low level exercise is amplified.

Biomechanics incorporates a detailed analysis of sport specific movements in order to minimise the risk of injury, improve sports performance, and identify potential abnormalities or areas of weakness. Our North Lakes physiotherapists are highly skilled in assessing specific movement patterns relating to your sport. It’s important to remember that not all movements are equal though. You may be able to expertly perform a single leg squat, but this may not translate to landing on one leg due to the increased forces. Our ability to assess your movement patterns outdoors on a field is an ability next to no other clinic has.

Physiotherapy in a clinic can be great, physio at home can be even better, but for an athlete wanting to return from a sports injury, there’s no better place to be than out on the field or on the court. We can meet you at any location you desire. For an athlete nearing a return to sport after a sports injury, being confident in your ability to perform sport specific movements is integral.

Coupling nicely with massage, joint mobilisations can help to relieve forms of joint stiffness, referred pain such as sciatica, or improve joint pain such as osteoarthritis. Our physiotherapists are experienced in these hands on treatments with the aim of fast pain relief, improvement in range of motion, and reducing sensations of stiffness.