How Physiotherapy Can Help with Shoulder Impingement

Tennis elbow is one of those injuries that sounds like it only happens on the court, but in truth, you don’t need to play tennis to get it. At Active Balance we see people with tennis elbow caused by everything from computer work to gardening, DIY, or repetitive lifting at work. So, what exactly is it, and how can physio help? What is tennis elbow? Tennis elbow (the medical term is lateral epicondylitis) is a condition where the tendons around the outside of the elbow become irritated or overloaded. This usually happens from repetitive movements, gripping, or heavy lifting. Common symptoms include: Pain on the outside of the elbow Discomfort when gripping, lifting, or twisting (like turning a door handle or opening a jar) Stiffness or weakness in the forearm How physio at Active Balance can help: Our physios use a combination of hands-on treatment, education, and exercise therapy to get you back to doing what you love without pain holding you back. Here’s how we approach tennis elbow: Accurate assessment: We take the time to properly assess your elbow, arm, and even your shoulder and neck, since these areas can all contribute to your symptoms. Hands-on treatment: To help ease pain and improve movement, we use a variety of techniques depending on what suits your body best. This may include: Manual therapy and gentle joint mobilisation Myofascial release to reduce tightness in surrounding muscles Dry needling to target muscle tension and trigger points Electro dry needling for pain relief and tissue healing support These treatments can provide short-term relief while we work on the long-term solution through exercise and strength building. Rehab plan: The most important part of recovery is a graded strengthening program for the forearm and surrounding muscles. We’ll guide you through specific exercises to gradually load the tendon in a safe way so it heals stronger. Load management advice: We’ll look at the daily activities that may be aggravating your elbow and show you ways to modify them. Simple changes to the way you lift, grip, or position your arm can make a big difference. Extra support when needed: In some cases, we may use strapping and/or bracing to help speed up recovery, ease symptoms and manage stubborn pain. How long does recovery take? Every case is different, but with the right treatment and consistent rehab, many people notice significant improvement in 2-6 weeks. The key is not just reducing pain, but also rebuilding strength so the problem doesn’t keep coming back. Takeaway Tennis elbow can be frustrating and painful, but the good news is, with the right approach, it’s very treatable. Our physios are here to help you recover, rebuild strength, and get back to the activities you enjoy. If elbow pain is slowing you down, book an appointment with our team today and let’s get you moving comfortably again.

Headaches are something almost everyone experiences at some point, but for some people, they’re far more than just an occasional annoyance. Persistent or recurring headaches can interfere with work, sleep, exercise, and even your social life. While pain relieving medication can help in the short term, many people are surprised to learn that physiotherapy can play an important role in both treating and preventing headaches. In this post, we’ll look at common types of headaches, how physiotherapy helps, and what the research says works best. Common Types of Headaches We See in the Clinic Not all headaches are the same, and treatment will vary depending on what’s causing your symptoms. Some of the most common types we see include: Tension-type headaches – Often described as a tight band across the head, linked to muscle tension, stress, or poor posture. Cervicogenic headaches – Headaches that actually start in the neck or upper spine, often radiating to the temples, forehead, or behind the eyes. Migraine – More complex, often severe, and sometimes accompanied by nausea, light sensitivity, or visual changes. While physiotherapy can’t “cure” migraines, it can help reduce frequency and severity in some cases. How Physiotherapy Can Help with Headaches: When you see one of our physios, you can expect a thorough assessment to determine whether your headache is likely to respond to physio treatment. We’ll discuss your symptoms, daily habits, posture, and lifestyle to understand what may be triggering or worsening your pain. Hands-On Treatment Research shows that manual therapy, when targeted appropriately, can be very effective for tension-type and cervicogenic headaches. This may include: Joint mobilisation or manipulation of the cervical spine (neck) to help reduce stiffness. Soft tissue techniques such as trigger point release, myofascial release, or massage to ease tension in neck and shoulder muscles. Dry needling or myofascial cupping to target tight, irritable muscles that may be contributing to pain. These treatments all aim to relieve pressure and restore normal movement, often providing significant short-term relief. Rehabilitation and Posture Advice Hands-on care is only part of the solution. We will also look to provide exercises to strengthen the neck, shoulders, and upper back, which helps to improve posture and reduce strain. Even small daily changes like adjusting your workstation, breaking up screen time, or improving your sleep position can make a big difference over time. Education and Support Living with ongoing headaches can be frustrating and emotionally draining. We take the time to listen, explain what’s happening in your body, and help you feel confident in managing your symptoms. Many people find relief simply by understanding their triggers and having a plan to manage flare-ups. What the Evidence Says: The research into physiotherapy for headaches is encouraging: Cervicogenic headaches: Multiple studies support the use of manual therapy and specific exercise for reducing both intensity and frequency. The Journal of Orthopaedic & Sports Physical Therapy reports that cervical mobilisation combined with strengthening exercises is particularly effective. Tension-type headaches: Evidence suggests that physiotherapy, especially manual therapy and relaxation strategies, helps reduce symptoms. Combining this with lifestyle changes (ergonomics, stress management) gives the best outcomes. Migraines: While physio doesn’t replace medical management, there’s evidence that manual therapy and posture correction can reduce attack frequency and improve quality of life when used alongside other treatments. Key Takeaways Physiotherapy can be very effective for tension-type and cervicogenic headaches, and can support people living with migraines. Treatment often includes manual therapy, dry needling, trigger point therapy, myofascial cupping, and targeted exercises. Evidence shows that combining hands-on care with exercise and education provides the best outcomes. Our physios will work with you not only to relieve symptoms, but to understand your triggers, build resilience, and get you back to living without constant headache worries. If you’ve been struggling with recurring headaches, don’t just put up with them or rely solely on medication. Book an appointment with one of our physiotherapists — together, we’ll create a treatment plan that helps you move, feel, and live better.

Sever’s Disease, otherwise know as calcaneal apophysitis, is a common cause of heel pain in growing children, mostly between 8–14 years old. It occurs when the growth plate at the back of the heel becomes inflamed, often due to increased activity in sports like soccer, basketball, or running. Understanding Sever’s Disease Symptoms of Sever’s include: Heel pain that worsens with activity Tenderness at the back of the heel Limping or altered gait Swelling in some cases It’s important to note that Sever’s Disease is related to growth and activity, and is generally not permanent damage, so is usually fully reversible with appropriate management. How Our Physios Can Help: Our physiotherapists can provide a thorough assessment to identify contributing factors such as foot biomechanics, muscle tightness, and training loads. Treatments can include: Stretching & Strengthening: Calf stretches and foot strengthening to reduce stress on the heel bone Manual Therapy: Gentle soft tissue release to ease tight muscles in the calves and hamstrings can provide significant relief Education: Guidance for parents and children on activity modification and footwear when symptoms are flared up Supportive Taping or Orthotics: When necessary, to offload the heel. Referral on to podiatry may be required for custom orthotics or more complex or stubborn cases. Gradual Return-to-Sport Programs: Helping to ensure safe progression without flare-ups Evidence-Based Care Research supports conservative management with activity modification, stretching, and strengthening as first-line interventions for Sever’s. Physiotherapy has been shown to reduce pain, improve function, and allow children to continue participating in sport safely. Clinic Approach We understand how frustrating it can be to have to reduce or alter training loads in young athletes. We combine clinical expertise with empathy, working with both children and parents to help manage expectations, support recovery, and provide reassurance that recovery is achievable. Takeaway With early physiotherapy intervention, Sever’s Disease resolves in most cases, allowing children to remain active while preventing long-term issues.

What is Whiplash? Whiplash is an injury to the neck caused by a sudden back-and-forth motion of the neck, most commonly occurring during car accidents or sports collisions. Symptoms can range from neck stiffness and headaches to shoulder pain and dizziness. Understanding Whiplash Whiplash affects multiple tissues of the neck, including muscles, ligaments, and joints. Common signs & symptoms include: Neck pain and stiffness Headaches originating from the base of the skull Reduced range of motion Shoulder, upper back, or arm pain Occasional dizziness or visual disturbances The emotional impact of whiplash is also often overlooked. Anxiety, frustration, and sleep disturbances can prolong recovery if not addressed alongside physical treatment. How Our Physios Can Help Physiotherapy for whiplash aims to combine symptom relief with active rehabilitation. Treatment strategies include: Manual Therapy: Gentle joint mobilisations and soft tissue release to help improve mobility and reduce stiffness Dry Needling & Trigger Point Therapy: Targeting overactive muscles to help ease tension Myofascial Cupping & Release: Promoting blood flow & allowing delivery of oxygen & nutrients to tight & tender muscles Electrotherapy: electro dry needling can be used to down regulate the nervous system and reduce pain Rehabilitation & targeted strengthening: Tailored exercises to help improve posture, strengthen supporting muscles, and restore range of motion Evidence-Based Care Cochrane reviews support early, active management of whiplash over immobilisation like neck braces. Exercise therapy improves pain and function, and combining hands-on care with active rehab optimises recovery. Takeaway Early physiotherapy intervention for whiplash can help reduce pain, restore mobility, and prevent chronic complications, helping you return to normal life safely. Got any questions or want to find out more? Feel free to get in touch with out friendly team 😊

Neck pain and muscle tension rate among the most common reasons people visit a physiotherapist. Whether it’s caused by prolonged sitting, poor posture, stress, or injury, neck discomfort can significantly impact your daily life, affecting work, sleep, and even your mood. Understanding Neck Pain Neck pain can come from from muscles, joints, nerves, or discs in the cervical spine. Common causes include: Prolonged sitting, computer or phone use Muscle strain from overuse or sudden movements Stress-related muscle tension (ever feel like you shoulders are sitting up by your ears?) Degenerative changes in the cervical spine such as in the disc or joints Symptoms often include stiffness, aching, reduced range of motion, headaches, and sometimes tingling or numbness in the arms. How Our Physios Can Help: When you visit our clinic, your physiotherapists will perform a thorough assessment aiming to identify the root cause of your pain. We focus not just on relieving symptoms but also on improving long-term function. Treatments may include a combination of the following: Manual Therapy: Gentle joint mobilisations and soft tissue release to help improve mobility and reduce stiffness Dry Needling & Trigger Point Therapy: Targeting overactive muscles to help ease tension Myofascial Cupping & Release: Promoting blood flow & allowing delivery of oxygen & nutrients to tight & tender muscles Electrotherapy: electro dry needling can be used to down regulate the nervous system and reduce pain Rehabilitation & targeted strengthening: Tailored exercises to help improve posture, strengthen supporting muscles, and restore range of motion Education & Lifestyle Advice: May include ergonomic guidance and strategies to prevent recurrence Evidence-Based Care Research consistently supports a combination of manual therapy and exercise for neck pain. A 2016 Cochrane Review found that multimodal physiotherapy approaches—combining hands-on therapy, exercise, and patient education—provide the best outcomes in reducing pain and improving function. Clinic Approach Our clinic philosophy prioritises holistic care. We combine thorough assessment, hands-on treatment, education, as well as emotional support. Neck pain can be frustrating and anxiety-inducing, we partner with you on your recovery journey, offering guidance, encouragement, and tailored treatment to help you regain comfort and confidence in movement. Takeaway Neck pain doesn’t have to control your life. With early and personalised physiotherapy, you can experience relief from pain, improved mobility, and strategies to prevent future episodes, allowing you to return to your daily activities with confidence. Have questions, feel free to get in touch with our friendly team 😊

If you’re a runner dealing with pain at the front of your hip, you may have assumed it’s a strained or overused hip flexor. After all, that’s the go-to explanation, right? Not so fast. While the hip flexors are often blamed, true hip flexor tendinopathy or strain is less common than you might think - especially if your pain shows up during specific parts of your run. Let’s take a quick look at the biomechanics of running. During the stance phase - when your foot is in contact with the ground - the hip flexors are not highly active. Instead, they’re most engaged during the early swing phase, when your leg is moving forward and off the ground. So if your pain is triggered during foot strike or while loading the leg, it’s unlikely your hip flexors are the root cause. However, we also need to look at the type of running you are doing. If you are a sprinter, this may be the case. But, in the general population and recreational athletes, we see endurance runners. Where the activity of the hip flexors is significantly reduced compared to sprinters. This raises the question: What else could be causing that anterior hip pain? One common culprit in endurance runners is bone stress injury, such as a femoral neck stress reaction or stress fracture. These injuries can irritate or inflame nearby tissues, including the hip flexor tendon, which might explain why you feel pain in that area - even if the tendon isn’t the source of the issue. In other words, your hip flexor might be hurting, but that doesn’t mean it’s injured. Other possible causes of anterior hip pain include: • Labral pathology • Femoroacetabular impingement (FAI) • Iliopsoas bursitis • Referred pain from the lower back or pelvis If your pain worsens with impact, persists after runs, or doesn’t improve within a day or two, it’s worth seeking evaluation. A Physiotherapist can assess movement patterns, strength imbalances, and structural contributors that may be driving your symptoms to help determine the best treatment forward. In short: Don’t be too quick to blame the hip flexors. Anterior hip pain in runners is often more complex and deserves a deeper look to ensure proper treatment. Struggling with hip and don't know where to start? Book an assessment with one of our physios today!

If you’ve ever started a new training program or increased your running distance, you might have felt a dull ache or sharp pain along the front of your shin. This is commonly referred to as shin splints. But, did you know that shin splints aren’t actually one single condition? The term shin splints is more of an umbrella phrase used to describe pain in the shin area from a variety of causes. Let’s break it down. Why Do Shin Splints Occur? Shin splints usually develop from overuse or overload of the muscles, tendons, and bones in the lower leg. Contributing factors can include: • Sudden increase in training load (more running, higher intensity, or harder surfaces) • Poor footwear that doesn’t provide adequate support • Biomechanical issues, such as flat feet, high arches, or weak hip/core muscles • Repetitive impact activities like running, jumping, or dancing • Training surfaces like hard concrete, uneven ground, or too much treadmill running can increase stress • Insufficient recovery between sessions In simple terms, shin splints happen when your body isn’t keeping up with the demands being placed on it. Front vs Inside Shin Pain Not all shin splints feel the same — where your pain is located can give clues about the underlying cause: Pain on the Inside of the Shin (Medial Shin) • Most often Medial Tibial Stress Syndrome (MTSS) • Feels like a dull ache or soreness along the inner edge of the shin bone • Caused by irritation where muscles attach to the tibia • Common in runners and people who suddenly increase training load Pain on the Front of the Shin (Anterior Shin) This can come from a few different causes: • Tibialis anterior overload/tendinopathy, e.i. pain along the outer front of the shin, worse when lifting the foot (e.g., during running or uphill walking). • Stress reaction or stress fracture → sharp, pinpoint pain on the front of the shin bone that worsens with impact and may linger at rest. • Chronic Exertional Compartment Syndrome (CECS) → cramping, tightness, or pressure at the front of the shin during exercise, easing with rest. Sometimes accompanied by numbness or weakness in the foot. In short: inside shin pain = usually muscle overload (MTSS), front shin pain = can be muscle, bone, or compartment-related. The Different Types of Shin Splints “Shin splints” isn’t a diagnosis on its own. It’s a general term that can include several different conditions: Medial Tibial Stress Syndrome (MTSS) The most common type of shin splints. Pain is felt along the inside edge of the shinbone (tibia) and is usually caused by irritation of the muscles and tissues that attach there. Stress Reactions and Stress Fractures If overload continues, the shin bone itself can develop tiny cracks called stress fractures. Pain is usually sharp, more localised, and worsens with impact. Chronic Exertional Compartment Syndrome (CECS) A less common condition where muscle swelling during exercise is restricted by tight surrounding tissue, causing cramping, pain, or tightness that eases with rest Other Causes: Tendinopathies (e.g. tibialis anterior tendinopathy) Nerve irritation Vascular issues (rare) Because there are so many possible causes, a professional assessment is needed. Treatment and Management of Shin Splints The right treatment depends on the cause, but general approaches include: Short-Term Relief • Relative rest: Swap running/jumping for cycling, swimming, or other low-impact options. • Manual therapies: treatments like massage, dry needling, cupping, and joint mobilisation can help ease tight muscles, improve blood flow, and reduce pain. • Footwear check: Supportive, activity-appropriate shoes are key. • Surface change: e.g. move from running on concrete to grass to reduce impact. Rehabilitation and Prevention • Strength training: Focus on calves, shins, hips, and trunk for better load tolerance. • Mobility work: Work to improve ankle mobility & flexibility of the muscles around the ankles. • Load management: Gradually increase running distance and intensity (no more than ~10% per week). • Surface check: Where possible, run on softer, varied surfaces like grass or trails rather than always on hard concrete. • Training variety: Mix impact and non-impact workouts to reduce repetitive stress. When to Worry About Stress Fractures While many cases of shin splints settle with rest and rehab, stress fractures require more caution. You should seek assessment if you notice: • Sharp, pinpoint pain in one spot on the shin • Pain that worsens the more you exercise • Pain that lingers at rest or at night • Swelling or tenderness over the bone Stress fractures usually need a longer period of rest, medical imaging, and a carefully guided return to sport. Final Thoughts Shin splints are very common, especially in runners and athletes, but they’re not always straightforward. Because shin pain can stem from issues like MTSS, stress fractures, or compartment syndrome, getting a clear diagnosis is key. The good news is, with the right combination of rest, manual therapies, strength training, load management, and recovery strategies, most people make a full return to activity. If you’ve been struggling with shin pain, or you’re worried about the possibility of a stress fracture, book an assessment with your physiotherapist. The sooner we can get to the root of the problem, the quicker you can get back to pain-free movement.

Hey everyone, This time of year, in the middle of winter sports and running events, we often see a surge of knee-related issues walking (and sometimes hobbling) into the clinic. One of the most common conditions we treat is patellofemoral pain syndrome (PFPS) or “Runner’s Knee”. So, let’s take a moment to dive into what it is, why it happens, and how we can help you manage it. What Is Patellofemoral Pain Syndrome? PFPS is a broad term used to describe pain at the front of the knee, typically felt under or around the kneecap. It is particularly common in active individuals, especially those who frequently run, jump, or squat. Due to its prevalence among runners, it is often referred to as runner’s knee. Activities involving repeated knee movement, as well as prolonged immobility, can aggravate the discomfort. Those with PFPS may experience sensations such as clicking, grinding, or rubbing around the kneecap, and the pain can sometimes be triggered by applying pressure to the area. If any of this sounds familiar, keep reading! What Causes PFPS? PFPS can be caused by trauma to the front of the knee, but there’s usually not a single cause. Instead, PFPS tends to result from a combination of factors, such as: • Muscular imbalances (e.g. weakness or tightness) • Restricted joint mobility • Repetitive or excessive loading through the knee • Anatomical factors We also look beyond the knee as issues at the hip and ankle can significantly contribute to PFPS symptoms. For example, reduced ankle dorsiflexion can shift forces abnormally through the knee, increasing stress on the body and altering movement patterns; hence ultimately resulting in PFPS. How We Assess It at Active Balance Physio & Wellness At our clinic, we take a holistic approach to evaluating and treating PFPS. Our assessments go beyond just the knee—we look at strength, flexibility, joint mobility, and overall movement patterns throughout the entire lower limb. We combine standard physiotherapy assessment techniques with advanced technology when appropriate, such as VALD Force Decks and Dynamometers. Keep an eye out for upcoming posts where we’ll dive deeper into how the Vald Force Decks work! This thorough evaluation helps us accurately identify conditions like patellofemoral pain syndrome (PFPS) and tailor an effective treatment plan. How We Treat Patellofemoral Pain Treatment is always tailored to the individual, but typically includes: 1. Load Management We help you reduce aggravating movements temporarily while staying active in a way that supports recovery. Taping techniques, such as McConnell taping , can also help offload the patellofemoral joint (joint underneath the kneecap) and ease symptoms. 2. Strengthening & Mobility Work You’ll learn self-management techniques, including: • Foam rolling • Targeted mobility exercises • Personalised strengthening program designed to improve muscular balance and enhance joint control 3. Manual Therapy This may include massage, dry needling, and/or joint mobilisations to ease pain and improve your movement quality; setting the stage for effective exercise and return to activity. Experiencing These Symptoms? If you think that you’re experiencing PSFS, you don’t have to keep pushing through the pain. Book an appointment with us at Active Balance Physio & Wellness. We’re here to help you move better, feel better, and get back to doing what you love. Feel free to contact us via our website, email, or phone number, 0450877731.

Is it normal to be sore after Myotherapy Treatment During and immediately after treatment During the initial 15-30 minutes of myotherapy treatment, pain inhibition and movement facilitation will occur. In the later stages of treatment (greater than or equal to 15-30 minutes), analgesia with inhibition of autonomic and motor functions will occur. The result will be sympathoinhibition and muscular relaxation. Vasodilatation in the injured muscle tissue will also occur, promoting the normal healing processes. The resulting response after treatment are varying degrees of fatigue, disorientation, lethargy and relaxation. Often patients will state that they feel "high" post treatment. There is also a cutaneous reddening of the skin and a sudomotor reaction which creates an increase in perspiration over the entire body. 12 Hours Post Treatment The immediate post-myotherapy responses subside after a few hours. Roughly 12 - 72 post treatment, the patient will feel muscular aching which feels similar to delayed onset muscle soreness. The intensity of the muscle soreness varies depending upon the chronicity of the condition. The more chronic the pathology, the more intense the muscle soreness and the longer it lasts. Clinically it is not unusual for patients to report a return of the original injury acute symptoms, i.e., return of arm or leg pain or paresthesia that has been absent. Management With continued treatment, the post-myotherapy local soreness lessens with a concomitant drop in pain complaint and an increase in pain-free function. With treatment once every 10-14 days (needed to allow the body to go through the acute healing processes), the superficial muscle hardening decreases, allowing treatment of the deeper muscle hardening which clinically appears to be the chief cause of pain. On many occasions, a patient's symptoms including paresthesia and referred pain is reproduced when the pathological muscle hardening is located. A stretching program is initiated to facilitate a continued increase in circulation and to promote lengthening of shortened muscles and related soft tissues. It is important to note that the techniques should stretch as much of the anatomical muscular chain as possible. Stretching individual muscles does not appear to be as effective. Once the muscles are able to shorten and lengthen without stimulating the nociceptors, the patient will have less pain when functioning or performing therapeutic exercises. At this point, a comprehensive reconditioning program can be initiated to deal with the usual physical deconditioning that affects the chronic pain patient. Continued myotherapy visits of increasing intervals between treatments as the muscle hardening decreases is recommended to completely treat the individual and restore function.