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Separated Shoulder – explained

04 Apr 2017

What is a separated shoulder?

Although commonly mistaken in conversation, a separated shoulder is not the same as a dislocated shoulder – dislocation refers to when the head of the humerus (upper arm bone) separates from the shoulder joint. It is a common injury. Separated shoulder is a little more complex and more to do with the ligaments than the shoulder joint itself.

A separated shoulder refers to an injury to the Acromioclavicular joint (AC joint) which makes up a part of the shoulder complex.  The joint is formed between the clavicle and the highest point of the scapula (acromion) and it creates stability through the shoulder joint with overhead and cross body movements with the arm. The ligaments present through the joint provide the AC joint with increased stability.


Injury to the AC joint can result from direct blunt force trauma to the shoulder.  
Some common causes involve:

  • A fall onto your shoulder
  • Contact sports which involve tackling or taking hits to the shoulder
  • Motor vehicle accidents  


Types of AC injuries:

There are 6 different types which depends on the extent of the injury and the number of ligaments involved.  They can be differentiated by a physical assessment and the use of an x-ray

It’s vital to get a correct diagnosis, which is available to you at Physico City Physiotherapy, as we work closely with the doctors of Hyde Park Medical centre, all medical services are available.

Type I, II, III are managed conservatively and recovery can range anywhere between 2-12 weeks.

Type IV, V, and VI are more serious of an injury and would require surgical intervention.

Shoulder Injury Physio Sydney CBD

Signs & Symptoms:

  • Pain at the top of the shoulder
  • Bruising and/or swelling
  • A deformity or a visible bump on the top of the shoulder
  • Limited shoulder range, usually with overhead and across body movements.



There is no quick fix for an injury such as a separated shoulder, you must follow the guidance of your health practitioner to assure it heals correctly. It is recommended that Type I, II, and III AC injuries to be managed conservatively as most people are able to return to near-full function in the presence of a deformity.  

Conservative treatments may involve:arm sling for shoulder injury sydney cbd


Surgical Procedures

Surgical interventions to repair the AC joint are typically recommended for more severe injuries or for those who are not responding to conservative therapy.  In this case, it is vital to follow your surgeon’s post-operative orders and seek a qualified physiotherapist with your rehabilitation. Rehabilitation will generally consist of rest, followed by gentle strength building exercise, it’s important to only go as far with your exercise therapy as prescribed when recovering from a separated shoulder injury

Should you feel you have injured your shoulder, do not delay, the position of the tissues as they heal is very important to you making a full recovery. Contact our helpful team of extensively qualified Physiotherapists at our Sydney CBD location today on 9267 3775


28 Mar 2017

sydney cbd physioWhat is causing your headache?

There are countless potential causes to a headache. It may be to do with lifestyle; water (not enough), diet (too much sugar, salt, caffeine), sleep habits (not enough, bad bed), stress levels (tension headaches, high blood pressure), incorrect glasses, headgear or lighting in your work space, a change on medication or supplement…

Or, in can be more to do with a physical illness; migraines, sinus congestion, ear or tooth infection, hormonal imbalance, cluster headaches, coughing headaches etc…in cases of sudden or severe headaches, stroke, tumors, concussion, meningitis and intracranial hematomas all need to be ruled out.

If you are getting chronic (repeating) headaches it is important to see your doctor to rule out any of the illnesses above.

A Headache can be related to an imbalance, injury or illness in another part of the body, this can throw you off balance, affecting how your head receives blood, lymph and neural flow.

Tension Headache?

Tension Headache is the most common headache in Australia.

If you’ve had a read of the symptoms presenting in the illnesses by following the links above, and/or, seen your doctor and you are satisfied you do not have a serious condition, it is likely your headache is coming from Posture and / or Stress – known as Tension Headache.

The head sits atop of the posture. Its position of balance is affected by the rest of the body. You’ve heard that the ears need to stay aligned for our sense of balance to work? This is true. The head or we should say, neck, will automatically adjust its position to hold the head and ear canals and eyes straight.

The spine is made up of a series of vertebrae stacked on top of one another with a cushion, known as the disc in between – the spine in the neck makes up the cervical spine. The spine is flexible, being able to move in all directions to support movement. The spine attaches to the skull under the occipital ridge. Often, somewhere along the spine, cervical spine or occipital ridge, the vertebra may sit out of place. This can be in a forward or side position.

When the head tilts forward to far during the day, when using a computer for example, the neck and back muscles and spine have to hold the head upright, this causes tension (tightening) to occur in the soft tissues, as well as a curve in the spine.

headaches physiotherapist sydney cbd

The head becomes a heavier load for the spine to carry, the further forward it sits


If the pelvis or mid back sits out of line, through leg crossing for example, this can in turn cause the rest of the back to sway out of line and, in turn, the head to tilt. The cervical spine will often tilt away from the curve to balance the head. Often, if this is the case, a lumpy, knotted presence is felt in the neck underneath the skull.

When we are under stress, our body assumes the position of fight or flight. This often means that the muscles of the shoulder and neck engage to a lightly heightened position. As well as this, blood flow to the brain is increased, this blood flow will sometimes struggle to reach the brain in times of stress and a feeling of pressure can grow in and around the head. Repeated stress can cause the tightening of the connective tissues that make up the head and neck.

The build up of tension and knots in the cervical spine and cranial muscle area can cause headaches by restricting blood flow, impinging nerves, creating an imbalance and muscular tension – which can spread across the muscles of the cranium creating a vice like pain in the head.


Treatment of a Tension Headache

  1. Try moving more and stretching throughout your day to a) loosen up tight areas and b) stop new restrictions appearing through sedentary action
  2. A Heat pack wrapped around the neck in the evening can be a useful tool for increasing blood flow to the affected area
  3. Gentle flowing exercise like Yoga or Pilates
  4. Check your desk set up so you can keep your back and neck straight
  5. Amend your posture so you are not crossing legs or leaning forward
  6. Remedial Massage to reduce tension from the scalp and shoulders and stress from your whole body
  7. Self massage – try squeezing and lifting the cranial muscles to ‘lift them away from the skull’
  8. Time to relax and reflect on the day so that stress does not build up
  9. Physiotherapy to access the position of the joints in your spine and skull
  10. Dry needling to reduce muscles knots and bring a sense of balance


There are a lot more tips to treat your headache

If you are unsure on what best to do, speak to our friendly team today

Our team of Sydney Physiotherapists can help you today without disrupting your working day

Lateral/Inversion Ankle Sprain

21 Mar 2017


What is a Sprained Ankle?

Ankle sprains are quite a common injury amongst all athletes.  The ligaments surrounding the ankle play a vital role in providing structural stability and create balance through the joint also known as proprioceptive feedback.  

An ankle sprain refers damage to one or more ligaments which surround the ankle joint.  There are different types of ankle sprains that correspond to the specific ligaments that are affected.

How does an Ankle Sprain occur?

Ankle Sprain Physio Sydney CBD

Ouch! Ankle Sprains are common

It can occur when you land on your foot in an awkward position or when your foot twists unexpectedly, causing a sudden or overstretching to the ligaments beyond its structural limits.  
Common causes can include:
– running or walking on uneven/unstable surfaces
– sudden stopping or quick changes in direction
– falling or landing onto another person’s foot

Recurrence rates of injury are quite high if an ankle sprain injury has not been properly addressed and rehabilitated back to a functional level. Many people we see for Physiotherapy have had an ankle injury untreated in the past, it is important to get any injury looked at by a Physiotherapist to assure you heal as best you can.

Which ligaments are affected?

Due to the anatomical structures of the ankle joint, the majority of ankle sprains occur on the lateral (outside) aspect of the ankle (Lateral/Inversion Ankle Sprain).  As a result, the most common ligament that is damaged is the Anterior talofibular ligament (ATFL).  Depending on the severity and mechanism of injury, other lateral ligaments of the ankle such as the Calcaneo-fibular ligament (CFL) and Posterior-talofibular ligament (PTFL) may be damaged as well.

ankle inury sydney physio

Less commonly injured are the Deltoid ligaments which is on the medial aspect of the ankle (Eversion sprain) as well as the Syndesmosis (High ankle sprain)

The degree of which the ligament is torn can be categorized into different grades:sprained ankle physio sydney cbd
Grade I: Mild – microscopic tearing of the ligament
Grade II: Moderate – partial tearing of the ligament
Grade III: Severe – complete rupture of the ligament


Symptoms of a Sprained Ankle:

The symptoms of a sprained ankle will vary depending on the severity of the injury.  
In general, you may experience:
– Pain
– Swelling and/or discolouration
– Tenderness on Palpation
– Instability of the ankle


Management principles:

During the early stages of your injury, it is recommended to follow the RICE method to control pain and allow for optimal healing.

Relative Rest

As your symptoms begin to settle down, your next aim is to restore any loss of range of motion in the ankle and to gradually strengthen the musculature around it.  This can be achieved by simple active ankle movements and some gentle stretching exercises, all within a pain-free range, advised by your Sydney Physiotherapist.  The addition of isometric strengthening exercises can be used to start the strengthening process. The use of therabands or elastic tubing are often used to help progress with your exercises.

Balance, or proprioceptive, training is also a vital part in your rehabilitation.  People often tend to forget the importance of re-teaching the muscles how to provide dynamic stability.  Better control of the ankle can be promoted by utilizing a variety of unstable surfaces or single-leg exercises in your routine.  

The last step is to progress and tailor your exercises to the specific demands of your sport before you return to play.  The aim at this stage of rehab is to safely and effectively return to sport without re-injury. For example: start with jogging along the sidelines and progress with short and quick accelerations/decelerations.  Also, incorporate lateral movements by introducing small changes in direction while running or performing cross-over type drills.  The addition of dribbling a ball between cones also adds another layer of complexity.  The ideas are endless when it comes to sport-specific training.

It is important to seek a health professional if you continue to have concerns regarding your injury.  A qualified physiotherapist would be able to help aid in a diagnosis and provide rehabilitation guidelines for you to follow to ensure effective recovery.


Kick Start your Health in the New Year

20 Dec 2016

At Physico City Physio in Sydney CBD we have you covered for all your health needs in the new year.

Kick start your healthy New Year and make 2017 the year you focus on your health. Your benefits will be plenty!


Regular Exercise is key for a healthy body and mind! Make sure you are hitting the mark with expert advice from our Exercise Physiologist. Exercise Physiology can help you to be at your healthiest, treat health problems brought about from injury or imbalance and encourage you to reach your fitness goals!

Wanting to get fit? Key for avoiding injury is taking it slowly, one step at a time, not running before you can confidently walk. Try lower weights, more reps, focusing on building a strong posture with Pilates.

Our Sydney Physiotherapists are also trained Pilates Instructors, offering morning, lunch time and after work Pilates Classes in Sydney CBD for your convenience. Make 2017 the year you take control of your back pain with this expertly run controlled exercise classes.

Should you be unfortunate to sustain and injury in your bid to be at optimum fitness, our Sports Injury Physiotherapists are on stand by to help you. Our team have so much experience in the field, you can be sure you will be back to your best in no time. We have a range of Physio Aides as well as exercise handouts so you can get the best support in and out of the clinic.


Body and Mind

Old injury getting in the way of your goals? Or perhaps it’s stress, aches or swelling effecting your happiness? A Remedial Massage is designed to remedy your problems in a Holistic Manner, which means looking at all aspects of your body , lifestyle and health history to design a treatment and care plan unique for your needs to help with even the oldest of pain and discomfort in a relaxing environment, a blissful way to start your year!

If stress levels are effecting your quality of life, or perhaps there are anxieties or troubled times in 2016 that you would rather shed for the new year, our team of expert Psychologists are here for you and they can help.

Sydney NutritionistNutrition

Our Accredited Nutritionist and practising Sydney Dietitian is here to help kick-start your healthy new year with a taste bud sizzling menu of healthy meal ideas, nutritional ingredients and all manner of healthy food stuff for prevention or treatment of food related health conditions.

You are what you eat, make sure in 2017 you are as fresh as a fruit bowl with our selection of therapies.


The Rise of the Standing Desk

17 Oct 2016

Working as a Remedial Massage Therapist in Sydney CBD, I have noticed an increasing number of my clients are telling me they have recently opted for a standing desk at work.
Many city workers find that long hours and high pressure leads to chronic back pain, and therefore choose to vary their position more during the day to try and resolve the problems caused by being too still and, typically, hunched over a computer.

Have you got a stiff back? Book a Remedial Massage in Sydney CBD today.

And they are indeed correct that a standing desk will bring more variation to your posture and can be a great factor in reducing postural pain, particularly in the shoulders and neck; but it does depend on where the pain is coming from, so I thought I would share with you my thoughts on the rise of the standing desk.

Postural implications

Everyone knows that sitting for long periods causes ‘bad posture’ – if this is you, please read our recent article on postural pain. Not everybody appreciates why though and that it’s not necessarily the seating that is the issue, it’s the length of time you spend in a position that causes postural pain. Naturally, we would be on the move way more than we are, our bodies are designed to move.
So the implications of a standing desk are that you will increase the length of time standing, and therefore, increase the pressure on certain parts of your body that are, commonly, not as strong as the areas you use most.
By opting for standing daily, you are increasing the pressure on the lumbar (low back) region, which can lead to more frequent lower back pain and stiffness. This generally is because we have weaker abdominal than lumbar muscles, so, when stood, instead of our backs being supported by a strong and straight structure, we tend to arch the back and throw the centre of gravity of balance, meaning our lower backs support our entire upper body weight and movement.
To attempt to counteract the increased feelings of pressure in the lumbar region, a natural human antic is to swing our weight into one leg, or the other, or one to the other (are you standing right now? See if you are doing it!), some people tend to cross one leg over the over, or over extend one knee whilst the other goes slack. All these positions will reduce lumbar stress and the potential of Lordosis (an inwardly curved lower back) but they do, in turn, cause an uneven pattern of tension to spread through the body, starting in the legs and pelvis and effecting everything right up to the neck and the position of the skull.
I know what you’re thinking; “oh no, so I’ll just keep getting problems, is there no release from the pattern?” – Well, there is. With a few simple steps, you can transform your back pain for good.

Stand up for a Straight posture!

1. The first thing to remember is, good habits take a little time to form, so work on building them with subtle reminders on your computer, a post it note etc etc.
2. Look at your feet, they should be both pointing forward, about hip width apart
3. Bend your knees, they should go over your feet, not to the side of them, work first of all to get your feet and knees in a good position, then, as you rise, focus on your pelvic floor muscles, by tucking your tail bone under to increase the length of your spine and engage your essential core muscles
4. See your pubic bone tuck forward and raise slightly as you draw your tail bone under (see image – go from a to b!) and stand up straight. Follow this line from the pubis up through the naval and to the sternum, lifting and elongated your spine as you do
5. Check your pubis and sternum line up (see skeleton image) and are one above the other. Lifting and positioning your sternum correctly takes pressure off those tight shoulders you have been battling with since you had a sit sown desk, as it puts your head back on top of your spine!remedial-massage-therapist-sydney-cbd
6. Finally, imagine a string coming from the centre of your skull, lifting your head tall and proud and lengthening through the spine.
7. Now you are straight, how does that feel? Tightness in the pelvic area? A few small pelvic thrusts – actioned by drawing on the core and clenching the glutes, will loosen it up

Once you have reached your ‘happy’ posture, adjust your desk to fit with it. Assure you check frequently that you are engaged in the core, just give it a little pull if you aren’t, you’ll get a nice tight tummy as a bonus and a strong back to support your standing days.
Do check that your standing desk (or any desk) provides are support for when you are using the computer, so tuck in tight to the desk and have an arm rest, otherwise, when arms ‘float’ you are liable to get elbow problems and RSI (repetitive strain injury) from keyboard and mouse work.

Don’t forget to take regular breaks, stretch once or twice a day at least and get regular massage at our Sydney CBD Remedial Massage & Physio clinic, where we will give you tailored advice on how best to work on your posture to reduce work related pain

Book online now >

Or call (02)9267 3775