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National Pain Week is convened by Chronic Pain Australia:

"We are dedicated to reducing the social and other barriers to living with chronic pain. We are a group of people who are tired of the way things are for people in pain."

"The Chronic Pain Australia vision is that no Australian living with persistent pain should suffer alone or without access to resources and information which help them effectively manage their pain in a manner promoting dignity and self respect, regardless of age, gender, culture, belief, socio-economic or compensation status."

For treatment options and planning for your future contact us and make a booking to see one of our staff. Phone 4323 2421.


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The anterior cruciate ligament (ACL) plays a pivotal role in preventing your shin bone (tibia) from moving forwards with respect to your thigh bone (femur). Tears of the ACL are commonly seen in pivoting sports such as football, and can take as long as 6-12 months for a complete return to competitive sport. More significantly, a third of players are unable to return to pre-injury levels of competition two years after ACL reconstruction surgery. It is for this reason that it's worthwhile taking measures to prevent an ACL injury.


Most (60-80%) of ACL injuries occur in non-contact situations, namely during a cutting manoeuvre and during one leg landing. Therefore it's sensible to be aware of unfavourable lower leg positions where the knee collapses inward with respect to the hip and foot. This position is commonly referred to by researchers as the 'point of no return' or the 'injury prone position'. Players should instead adopt the 'position of safety' where the knee is flexed but is kept straight with respect to the hip and foot. Both of these positions are outlined in figures 2 and 3 below.

point-of-no-return diag

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Many children complain of heel pain that is worsened with physical activity. Such a complaint can actually be a condition called Sever’s disease. This condition is an irritation of the Achilles tendon (at the bottom of the calf muscle) as it attaches onto the heel bone (calcaneus). Severs disease is sometimes called calcaneal apophysitis. This condition usually occurs during rapid growth, often in the early stages of puberty. It is slightly more common in boys than girls and it generally occurs in children aged 7-14 years. Children with this condition will complain of pain in the heel of one or both feet and are usually tender to touch and may be swollen. They may also walk and run with a limp. Sever’s disease is common in sports that involve running and jumping, such as football.

Risk factors for Sever’s disease include tight calf muscles, weakness in the lower limb muscles, pronated (flat) feet, poor footwear and high levels of sport or other physical activity.

Children with Sever’s disease should be assessed by a physiotherapist to ascertain the contributing factors to this condition. Treatment may include the prescription of orthotics to create a better foot/ankle position, calf stretching, lower limb strengthening and modification of activity. Some children may require a heel raise in their shoes to reduce the load on their heel. Icing can also be helpful in the acute stage of this condition to decrease pain and swelling. Occasionally, medication will be required to settle the inflammation and decrease pain.

Sever’s disease is a self-limiting condition that will settle once the irritation resolves. In most cases the patient will have no pain and be able to return to sport anywhere between two weeks to two months. Patients should continue with a home exercise program including stretching and strengthening to prevent this condition occurring again.

anatomy of the heel

Brukner, P., & Khan, K. (2007). Clinical Sports Medicine (3rd Ed.). Sydney: McGraw-Hill.
Micheli, L., & Ireland, M. (1987). Prevention and management of calcaneal apophysitis in children: an overuse syndrome. Journal of pediatric orthopedics, 7(1), 34-38.
Tagged in: Children Physio
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Exercise can develop muscle and bone strength, increase joint flexibility, prevent or treat injuries, reduce the risk of disease such as Osteoporosis and Diabetes, improve health, manage body mass, control your mood, help you sleep better and give you more energy. A lack of activity can be detrimental to your health.

When we talk about activity, we refer to 2 types; activities of daily living (ADLs), and specific exercise. Activities of daily living are the activities we do each day as a consequence of our lives; such as self care, work, housecleaning, washing the car, etc. These can vary from low intensity to very strenuous, and as they use calories, they are an important part of your daily activity levels. We also need to perform specific exercise each day though. This is time specifically for you to work out, and these are separate to ADLs. This can involve a range of activities and should include an aerobic, strength and flexibility component.

 The current evidence for levels of activity levels for an adult population to promote or maintain healthy living are:

Aerobic activity: Moderate-intensity cardiovascular activity for a minimum of 30 mins, five days each week; or vigorous-intensity activity for a minimum of 20 mins, three days each week. This refers to walking, jogging, running, cycling, swimming, kayaking, bushwalking etc.
Muscle strengthening activity: Strength training should be performed a minimum of two non-consecutive days each week. This should include 8-10 different exercises incorporating the major muscle groups, and 10-15 reps should be performed on each exercise. The level of effort should be moderate to high. Strength training can involve machines, free weights and resistance bands.
Flexibility activity: Flexibility training should be performed once a week to maintain muscle length and three-five times a week to increase muscle flexibility. A general stretching routine should include all large muscle groups. Specific flexibility training should follow all aerobic and strength training, targeting the muscles that were used. Stretches should be held for 15-30 seconds and repeated 3-5 times.
Intensity can be measured on a 10 point scale – where lying down/sitting is 0 and maximal effort is 10. Moderate activity refers to 5-6/10. This would produce an increase in breathing and heart rate. Vigorous activity is a 7-8/10 and would produce a dramatic increase in breathing and heart rate.

These recommendations are minimum levels of activity required for health benefits and separate to your ADLs.

If you are interested in getting started in an exercise program to suit your specific needs or goals , please contact Hills St Advanced Rehabilitation & Exercise Centre on (02) 4323 2421 and speak to our tertiary qualified Exercise Physiologist, Natalie Gale,  about how to get started. We offer a range of programs and will design an exercise program that is individualised. Don’t forget, the recommendations are for minimum levels of physical activity, so if you aren’t doing enough you might just need that extra support to get you started on your path to a healthier life.

The next newsletter will deal with the specific exercise programs we offer. Please stay tuned for more information about Hills St Advanced Rehabilitation & Exercise Centre.

Tagged in: Exercise
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Improve your move

Improve your move video, from the Australian Physiotherapy Association:

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