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When Life Gives You Lemons… Make Lemon Yoghurt Syrup Cake!

We promise you’ll fall in love with this winter treat from our Life Ready Physio Scarborough team!

 

What you’ll need for the lemon yoghurt cake

250g butter

3 tsp lemon rind finely grated

3/4 cup caster sugar

3 eggs

1 1/4 cups grek style yoghurt

1/4 cup lemon juice

1 1/2 cups self raising flour

1/2 cup plain flour


What you’ll need for the lemon syrup

1/4 cup lemon juice

2/3 cup caster sugar

 

What you’ll need to do

1. Preheat oven to 180C and grease a fluted ring pan

2. Beat butter, lemon rind and sugar with electric beaters until light and fluffy

3. Add eggs, one at a time, beating thoroughly before adding the next

4. Add half the yoghurt and half the lemon juice. Stir to combine

5. Sift half the flour over the butter mixture. Stir to combine

6. Repeat with remaining lemon juice, yoghurt and flour

7. Spread the mixture in to prepared pan. Bake at 180 degrees for 50mins. Cool in tin for 10 mins

While your cake is heating up in the oven, make the lemon syrup by stirring the lemon and sugar and 1/4 cup water over low heat until the sugar dissolves. Increase the heat to medium and bring mixture to the boil. Reduce the heat again and allow mixture to simmer for 3-5 minutes (or until it thickens). Serve warm syrup over the warm cake with a generous dollop of greek yoghurt. Enjoy!

 

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Muscle Injury: Cramp, Strain or Contusion?

By Gabby Charlton
Physiotherapist at Life Ready Physio Yokine


Muscles have a large blood supply and consequently bleed quite heavily when they are injured. Below are some guidelines on how to distinguish between three common muscle injuries – and the most up to date advice for early recovery and injury prevention.

 

  1. MUSCLE STRAIN

A muscle strain is a tear in the fibres of the muscle belly and is most commonly caused by overstretching a muscle. Muscle strains are graded depending on what percentage of muscle fibres are torn. Partial tears recover well with a specialised rehabilitation program from your physio, however a full thickness tear or a muscle rupture may require surgical repair. Muscle strains most commonly occur in large muscle groups (e.g. quadriceps, hamstrings and calves), however can occur in any skeletal muscle.

A athlete with a muscle strain will feel a sudden sharp pain in the muscle belly and an immediate loss of strength. Pain on stretch and/or pain on resisted muscle contraction are common symptoms of a strain. A good indication of the severity of the strain is the athletes’ post-injury function (can they walk/run or do they need assistance?)

 

What to do

  • RICE (Rest, Ice, Compress, Elevate) for 48 hours following injury

  • The athlete will cause further damage to the muscle if they continue playing

  • Leave ice on for 10 minutes, off for 20 minutes

  • Tubigrip or a compression bandage is the most efficient way to compress a muscle

  • When elevating, ensure the injured muscle is above the level of the heart so gravity can assist blood flow

  • A good warm-up prevents muscle strains during sport as it improves flexibility and contractility of the muscle fibres

  • See your physio as soon as possible after a muscle strain. Best rehabilitation results are achieved with early intervention. Strengthening and gentle walk/jogs can be started as early as 2-3 days post injury

 

What not to do

The following all increase the local inflammatory response, increasing pain and delaying recovery;

  • Take anti-inflammatories

  • Massage or place heat on the muscle within the first 48 hours

  • Drink alcohol within 48 hours of injury

 

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  1. CORK/CORKIE (CONTUSION)

A contusion (aka corkie) is a common injury in contact sports such as AFL and rugby. It occurs when a large external force (e.g. an opposition player) comes into contact with muscle or other soft tissue, causing bleeding and swelling of the area. Contusions can be extremely painful and often limit a player’s speed and power as excessive bleeding inhibits the muscle’s ability to contract.

The athlete will be very tender over the injury site and may have discolouration or bruising. Corkies can occur in any soft tissue, depending on where the player was contacted.

 

What to do

  • RICE (Rest, Ice, Compress, Elevate) for 48 hours following injury

  • The athlete will cause further damage to the muscle if they continue playing

  • Leave ice on for 10 minutes, off for 20 minutes

  • Tubigrip or a compression bandage is the most efficient way to compress a muscle

  • When elevating, ensure the injured muscle is above the level of the heart so gravity can assist blood flow

  • Light exercise 12-24 hours after injury (e.g. walk, swim, bike ride)

  • See your physio if the pain from a corkie lasts longer than 3-4 days. Manual therapy and a guided exercise program will speed up recovery

 

What not to do

The following all increase the local inflammatory response, increasing pain and delaying recovery;

  • Take anti-inflammatories

  • Massage or place heat on the muscle within the first 48 hours

  • Drink alcohol within 48 hours of injury

 

pexels-photo-221210

 

 

  1. MUSCLE CRAMP

A cramp is an involuntary, painful episode of sudden muscle contraction that can last from seconds to minutes depending on the severity. Constant firing of motor neurons cause a continuous muscle contraction, which can be visible. The exact cause of cramps has not been scientifically proven, however it is believed dehydration results in an imbalance of minerals in the body, triggering a change in motor neuron activity. Muscle cramps usually occur after an extensive period of activity, when the muscle is the most fatigued and the athlete is at most risk of dehydration.

Once a cramp has subsided, the muscle should return to full pain free strength and the athlete can continue to exercise. The most common muscles to cramp are hamstrings and calves, however any skeletal muscle can be affected.

 

What to do

  • Stretch the cramping muscle to stop the contraction

  • Ice the muscle AFTER ceasing exercise

  • Prevent cramping by hydration properly prior, during and post exercise

  • Replenishing electrolytes (lost in sweat) help the body retain water and prevent dehydration. Electrolytes are found in sports drinks like Gatorade

  • See your physio if the pain from a cramp lasts longer than 48 hours to rule out a muscle strain

 

What not to do

  • Consume drinks with diuretics, which will result in further dehydration. This includes coffee, tea, soft drink and alcohol

 

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Ouch! My ankle really hurts

By Greg Hearn
Physiotherapist at Life Ready Physio Baldivis


What is an ankle sprain?

Ankle sprains are one of the most common musculoskeletal injuries, accounting for 15-20% of all sporting injuries. The vast majority of ankle sprains involve the ligaments on the outside of the ankle (lateral ligament complex). This consists of the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament.

Together, these ligaments connect bones together on the outside of the foot, prevent excessive movement occurring, and provide stability to the ankle.

 

How do ankle sprains occur?

Ankle sprains most commonly occur when the foot is internally rotated while the toes are on the ground, and the heel up.

Injury typically occurs to the anterior talofibular ligament first, followed to a varying degree by injury to the calcaneofibular ligament.

The posterior talofibular ligament is usually spared from injury unless the ankle is dislocated.

 

How is an ankle sprain graded?

Ankle ligament sprains are usually graded on the basis of severity. Grade one is mild stretching of the ligaments without rupture or joint instability.

Grade two is partial rupture of the ligament with moderate pain and swelling. There may be functional limitations and slight to moderate instability that generally affects the ability to bear weight through the ankle.

Grade three is a complete ligament rupture with marked pain, swelling, and bruising. In grade three injuries there is a marked impairment of function with instability.

 

What treatment is involved in ankle sprains?

Initially treatment involves applying the rest, ice, compression, and elevation principle to control the acute inflammatory process and prevent further damage.

Taping and bracing may be used in the short term to provide stability to the ankle and assist in return to normal activities.

Treatment may then be progressed to functional rehabilitation which is aimed at restoring and improving strength, proprioception, and protective balance reactions at the ankle to prevent recurrent sprains occurring.

In severe cases, surgical intervention may be recommended. This primarily involves repairing the ruptured ligaments with internal sutures. However, there is currently very little evidence to suggest that surgical intervention is any more effective than functional rehabilitation.

 

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  1. Peterson et al (2013): Treatment of acute ankle ligament injuries: a systematic review. Arch Orthop Trauma Surg. 133: 1129-1141
  2. Brukner P & Khan K (2012): Clinical Sports Medicine (4th ed). McGraw Hill Co., Sydney
  3. Kerkhoffs et al (2010): Surgical versus conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults. Cochrane Database of Systematic Reviews. 2: 1 -79
  4. Chaudhry et al (2015): Cochrane in CORR: Surgical versus conservative treatment for acute injuries of the lateral ligament complex of the ankle in adults (Review). Clinical Orthopaedics and Related Research. 473: 17-22
  5. Pihlajamaki et al (2010). Surgical versus functional treatment for acute ruptures of the lateral ligament complex of the ankle in young men: A randomized controlled trial. The Journal of Bone and Joint Surgery. 92: 2367-2374
  6. The Australasian College of Podiatric Surgeons. The Economic Impact of Podiatric Surgery: Melbourne (Australia): Access Economics; 2008.
  7. Kerkhoffs et al (2012): Diagnosis, treatment and prevention of ankle sprains: an evidence based guideline. British Journal of Sports Medicine. 46: 854-860
  8. Prado et al (2014): A comparative, prospective, and randomized study of two conservative treatment protocols for first episode lateral ankle ligament injuries. American Orthopaedic Foot and Ankle Society. 35(3): 201-206
  9. Mckeon et al (2008): Systematic review of postural control and lateral ankle instability, part 2: Is balance training clinically effective. Journal of Athletic Training. 43(3): 305-315
  10. Hupperets et al (2009): Effect of unsupervised home based proprioceptive training on recurrences of ankle sprain: randomized controlled trial. British Medical Journal. 9(339): 276-278
  11. Holme et al (1999): The effect of supervised rehabilitation on strength, postural sway, position sense and re-injury risk after acute ankle ligament sprain. Scandinavian Journal of Medicine & Science in Sports. 9(2): 104-9

Let’s go vertigo

By Jeremy Ong
Physiotherapist at Life Ready Mobile 


We’ve all experienced situations of vertigo (when the room spins around us) or dizziness when we change head positions or stand up too quickly. In most people they subside quickly and we don’t think about them again, however if they are repetitive and causing problems, it’s possible you may have Benign Paroxysmal Positional Vertigo (BPPV), a common disorder of the inner ear.


What is BPPV?

BPPV is caused by tiny crystals, called otoconia, that have incorrectly collected within a sensitive part of the inner ear. To get technical, otoconia are calcium carbonate crystals that are normally located inside the utricle of the inner ear. Vertigo/dizziness occurs when these crystals are displaced from the utricle into the semicircular canals of the inner ear, resulting in miscommunication along the vestibular system (our balance and orientation system). When you change the position of your head, the otoconia move with the semicircular canals and this causes the vertigo/dizziness. As the otoconia stop and settle into their new position, the symptoms normally subside.


What causes it?

BPPV is quite common and can be caused in the following:

  • Head or ear injury

  • Degeneration of the inner ear structures (as part of the normal aging process)

  • Ear surgery or infection, such as otitis media

  • Vestibular neuritis (viral infection of the inner ear)

  • Meniere’s disease

  • Some types of minor strokes


What are the symptoms?

Most commonly BPPV presents as vertigo, with a feeling of dizziness or lightheadedness following an episode, with more severe cases also leading to imbalance and nausea. These symptoms are usually brought on by a change in the position of the head from activities such as getting out of bed, rolling over in bed or tilting the head back to look up.

Symptoms are usually intermittent, so it may be present for weeks, stop and come back some time later.


What is the treatment?

The good news it that BPPV isn’t permanent and symptoms may actually go away within six months of onset by themselves. During this period, medication to prevent motion sickness or nausea is sometimes prescribed.

There are also manoeuvres able to be performed by a physiotherapist in the clinic that are specifically intended to move the otoconia out of the semicircular canals. Treatment will be selected by your clinician according to what symptoms you may present with. These treatments normally alleviate symptoms in the majority of patients immediately, however a second treatment may be necessary.

If symptoms don’t subside and manoeuvres don’t help, surgery maybe recommended. As with all surgery there is risk, however it has been found effective for individuals who have not responded to other treatments and when symptoms are sever and long-standing.

 

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The problem hamstring

By Jamie Athanassiou
Physiotherapist at Life Ready Physio Scarborough


Hamstring strains can be more difficult to manage than other muscle strains as they have a high recurrence rate and a number of different contributing factors. Don’t let this worry you though, as there are effective rehabilitation strategies that minimise the risk of re-injury and facilitate a safe return to sport.


How do hamstring strains occur?

It’s a common misconception that hamstring strains occur due to the muscle being overstretched, however most hamstring strains occur during maximal sprinting at the end of the swing phase (when the swinging leg begins to slow down before the foot touches the ground).

 

Returning to sport safely and minimising the risk of re-injury

  1. Hamstring strengthening

After a hamstring strain it is very important to rebuild strength in the injured muscle. Eccentric exercise has been shown to be the best way to rebuild hamstring strength in a way that helps prevent re-injury. This can be done using the Nordic curl exercise as shown in the images below. There should always be at least one day of rest between performing these exercises and they should be continued even after you’ve returned to sport.

 

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  1. Core stability

Improving stability of the pelvis and lumbar spine is also a very important part of the rehabilitation process and involves strengthening muscles such as gluteus medius and transversus abdominus. This includes exercises such as the single leg bridge catch and single leg squats.

 

  1. Progressive running program

Gradually building your speed, stride length and distance is important in returning from injury. A progressive running program is the best way to safely return to running and should start as early as day two post injury, if possible. Initially, running should involve slow-medium paced jogging from 500m to 2km, then progress to interval running over 100m when able. Once athletes have the ability to accelerate and decelerate fairly well they can sport specific tasks such as jumping, direction changes and kicking.

 

  1. Don’t go back too soon

Time taken to return to sport depends on the severity of injury and level of rehabilitation. Athletes with a mild strain can take 2-3 weeks, moderate strains can take 4-8 weeks and a complete rupture may require surgery, in which case rehabilitation can take three months.

To ensure athletes don’t return to sport too soon it can be useful to use a checklist of required tasks that must be completed before returning to sport such as the following:

  • Completion of a progressive running program

  • Full range of motion

  • Near full strength (at least 90% compared to other side)

  • Pain free maximal contraction

  • Successfully completing a full week of training at full intensity

 

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Heeling the pain

By Inge Kriek
Physiotherapist at Life Ready Physio Rockingham


Plantar fasciopathy, which you may also know as plantar fasciitis, is an overuse condition of the plantar fascia at its attachment to the calcaneus (heel bone) in the ankle. Your plantar fascia stops the over flattening of the arch in your foot and when there is extra stress or load placed through the fascia, plantar fasciopathy may follow.

 

Image via: http://www.rehabexercise.org

Signs and symptoms

  • Sharp intense pain underneath the heel and arch of the foot

  • Pain with the first few steps after waking up (referred to as “first-step pain”)

  • Pain after standing up, getting out of the car or resuming walking after rest

  • Pain decreases with activity – only to return post-activity with an ache

  • Mild swelling in the heel


Causes

There are two common groups of people who are most likely to develop plantar fasciopathy.

  1. Runners who increase their training load too much too quickly, putting the fascia under increased load

  2. People with an increased BMI (>30), especially those who spend a lot of time on their feet during the day as the extra load increases the stress on the plantar fascia

However, being a runner and having a greater BMI are not only the causes for developing plantar fasciopathy. Other risk factors that may predispose a person to plantar fasciopathy include:

  • Foot position – changes in the arch of the foot (either flat feet or high arch) can change the way the plantar fascia absorbs load

  • Training volume – an increase in load or training volume often seen in runners, ballet dancers and aerobics

  • Standing work – a job that has a person standing on their feet all day

  • Flexibility and strength – muscle fatigue can cause excess stress on the plantar fascia


Management 

Treatment for plantar fasciopathy is always dependent on an individual’s presentation and lifestyle factors. Common physiotherapy treatments include:

  • Techniques to reduce muscle tightness – dry needling or soft tissue massage

  • Strengthening program

  • Foot mobilisation

  • Plantar fascia and calf stretches

  • Fascial release

  • Taping of the foot (low-dye)

  • Education on activity modification

  • Provision of foot orthoses or heel pads


The good news

Plantar fasciopathy has a good success rate with physiotherapy treatment, with over 90% of people improving over a 2-3 month period.

Contact your local Life Ready physiotherapist if you believe you may be experiencing plantar fasciopathy!

 

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Image via: http://www.rehabexercise.org

First world (neck) problems

By Tim Ho
Physiotherapist at Life Ready Physio Yokine


 

It has been over a decade since the first iPhone was released in January 2007 and our reliance on mobile devices and technology has only increased over that time. The terms “text neck” and “tech neck” both refer to neck pain and associated conditions that relate to the poor postures we adopt when using our mobile phones, laptops, computers, tablets and gaming devices.

In good or ideal posture, your head is aligned over your shoulders which allows for even distribution of the weight of your head axially by the spine, resulting in less effort of your postural muscles to maintain this position.

In contrast, the typical posture we tend to assume whilst using our technological devices is that of a forward head posture or a flexed neck posture usually with rounded shoulders. This flexed posture can increase the mechanical load on the neck 3-5 times that of balanced upright posture, which results in the muscles around your neck having to work much harder to keep your head in that position.

 

 

Tips for preventing “text or tech” neck 

  1. Correct or make modifications to your posture by using a tablet holder, holding your phone upright, or prop your laptop up so that the screen is at eye level. This will reduce the amount of flexion at your neck which in turn reduces the mechanical demand on your neck

  2. Take frequent breaks or limit the time spent on these devices. If you are sitting for long periods, get up off and go for a short walk or consider a standing work station. It is recommended to have short frequent breaks of 5-10 minutes every 50-60 minutes that you are desk-bound

  3. Stay active or engage in regular physical activity like Pilates, yoga and tai chi which condition your muscles so that they are better equipped to tolerate load and don’t fatigue as quickly. Exercise is also great for maintaining joint mobility

 

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Text-neck

If you are suffering from “tech or text neck” our Life Ready physiotherapists are well equipped to provide the right advice, treatment and tailor specific exercises to help you manage and prevent technology and posture related pains. Contact us for an appointment today!

 

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 Images via 98five.com and thephysiocompany.com

Rectus Abdominus Diastasis. What is it all about?

By Kate Fosdike
Women’s Health Physiotherapist at Life Ready Physio Yokine


What is a RAD?

You may have heard of Rectus Abdominus Diastasis (RAD, diastasis rectii or abdominal separation) and might be wondering, ‘what does this actually mean?!’

RAD is a common condition affecting many women during and after pregnancy. It refers to a separation between the two halves of the outer-most layer of the abdominal muscles. To fully understand RAD, you first have to understand a little bit about the anatomy of the abdominal wall.

The abdominal wall is made of up of four different muscles which sit in layers. The deepest layer runs horizontally across the abdomen, below the belly button and is called the Transverse Abdominus (TA). Next come the Internal and External Obliques which run diagonally across the abdomen in different directions. Finally, the Rectus Abdominus (RA) runs vertically between the ribs and the hips.

The RA is made up of two identical halves (left and right) which are joined in the middle by a connective tissue sheath called the linea alba. During pregnancy, your body produces a hormone called relaxin, which, as the name suggests, helps relax the connective tissues, allowing them to stretch. Relaxin effects all the connective tissues throughout the body, including the linea alba. This hormone is amazing as it allows your body to grow and birth your baby!

As your baby grows, the linea alba can stretch, making room for your baby and causing the two halves of the rectus abdominus to move further apart. This effect can be more pronounced in women who have a very tight or a very loose RA muscle, and in women who are small framed.

 

Image via moveforwardpt.com

Image via moveforwardpt.com

So, why is this significant?

Although RAD during pregnancy is not abnormal, it is important to know whether you have one, so that you can take positive steps to manage it appropriately. If you routinely perform activities which place too much load on the muscles and connective tissues, RAD may persist after you have your baby and have consequences for your abdominal muscle function in the future.

After you give birth, the linea alba should return to its usual width and the rectus muscles should move back together towards your midline. If significant RAD persists postnatally, you will likely notice both functional and cosmetic issues.

Cosmetically, RAD gives the appearance of a ‘bulgy belly’ or ‘mummy tummy’ – your lower abdomen will protrude. In terms of function, significant RAD often results in lower back pain or pelvic girdle pain due to a reduction in the support function of the abdominal muscles. Studies also suggest a link between significant RAD and pelvic floor muscle dysfunction. These women may suffer from urinary leakage or prolapse.

Women’s health physiotherapists routinely screen for RAD both during and after pregnancy and can advise you on the management and rehabilitation of RAD.

If you are concerned about RAD during or after your pregnancy, make an appointment to see our women’s health team at Life Ready today! We have post-graduate trained women’s health physiotherapists treating at our Baldivis, Midland, Mobile and Yokine clinics.

 

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Why running doesn’t have to be a pain in the butt

By Ellen Jackson
Physiotherapist at Life Ready Physio Warwick


While running related injuries are very common, they can be prevented! Whether your goal this is year is to run a marathon, complete a fun run or simply run a lap of your local park, here are six steps you can take to keep any aches and pains at bay.

 

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1. Gradually increase the load

One of the most common causes of running related injuries comes from increasing the load too quickly. If you’re planning on going from not running at all, to running 5km plus every day, chances are, something will start to hurt sooner or later.

It is incredibly important to slowly expose the body to exercise and build intensity, frequency and duration over time. This allows the body to adapt and build strength to prevent muscles and tendons becoming overworked and sore.

Set yourself a training schedule where you gradually increase the total kilometres each week over a 6-12 week period. Mix it up with short, long and interval style runs, with some rest days in between.

 

2. Keep your muscles strong!

It is very important to complement your running training with a solid strength and conditioning program. Keeping your glutes, quads, hamstrings and calf muscles strong is crucial in ensuring optimal biomechanics with your running style and preventing muscles from becoming overworked and sore.

Clinical Pilates is a great way to strengthen and stretch these muscle groups and can be modified by your physiotherapist to target specific areas of weakness.

 

3. Take the time to warm up AND cool down properly

I can tell you now, bending down to put your running shoes on does not count as an adequate warm up! It is vital to warm up our muscles and tendons prior to exercise to ensure they are functioning optimally to minimise the risk of muscular strains. 5-10 minutes of dynamic stretching prior to exercise is best.

After your run, the cool down period is equally important as it allows time for the muscles to relax, provides time for lactic re-absorption and reduces the risk of muscle soreness post exercise. Try a 5 minute walk, followed by static stretching. Ask your physiotherapist for more information if you’re unsure.

 

4. The foam roller is your friend

Often stretching isn’t enough to manage the increase in muscle tightness that comes from running. Foam rolling is a great way to release your tight muscles and fascia to manage muscular aches, pain and delayed onset muscle soreness (DOMS). Try at least 30 seconds through your gluten, quads, hamstrings and calves after every run and also whenever your muscles are feeling tight.

 

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5. Wear appropriate footwear

Every foot is different, and it so important to have footwear that is comfortable and supportive. Having shoes that fit properly is crucial to ensuring optimal foot biomechanics and preventing injury. Get your feet properly fitted when buying your new runners and check with your physiotherapist or podiatrist if you are unsure of the best shoe for you.

 

6. Don’t push through the pain

Above all, ensure any aches and pains are checked early to prevent them from turning into a full-blown injury. If a specific pain persists for than two days, best advice is to have it reviewed by your physiotherapist. A physiotherapist can properly assess the areas of concern and give you advice on how to best continue with your training. Manual therapy techniques such as massage, dry needling and taping can be used to unload sore muscles, tendons and joints so that you can get back to running pain free.

 

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Headaches. Why are they such a pain in the neck?

By Tully Hogan-West
Physiotherapist at Life Ready Physio Midland

 

For some people, headaches are a fact of life. They can occur regularly and often differ in severity – from a light throbbing or tension in the head which is easily ignored, all the way to an intense pain that demands attention.

There are three main types of headaches – migraines, tension headaches and cervicogenic headaches (coming from the neck). Neck headaches are by far the most common presentation and luckily, they are the easiest to treat.

 

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Why do they occur?

These types of headaches can occur due to stressful periods of our lives, long stints at work, poor posture or dehydration. Situations when the muscles on the back of our neck become too tight i.e. – sitting too long in front of the computer with a poor posture and dealing with stress. The tension present in the neck results in a referral of pain into the head, often behind the eye, the base of the skull, or the top of our head.


How can physiotherapy help?

If you suffer from either a regular headache that seems to get worse over the week, or if it even strikes frequently during the month, then as physiotherapists, we can help you to determine the root cause of your pain. Once we have pinpointed the source of your pain, the next step is assisting in implementing the necessary changes in your day or week to reduce the frequency and intensity of your headaches. A range of exercises and postural adaptions can make a huge difference and enable you can take control of your pain and stop it from affecting your life.

In addition to changing your posture and lifestyle/work factors, receiving targeted treatment to the muscles and joints in the top of your neck is hugely beneficial in reducing the headache symptoms.

 

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